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November Advisor Newsletter

IMPORTANT REMINDER: November 16 is the deadline for submitting staffing data for the period of July 1 to September 30. Providers that miss this deadline are subject to suppression of your “Overall Staffing Rating” and “Registered Nurse Staffing Rating” for the December 2017 Nursing Home Compare update.

What’s Your “QAPI Plan”?

With LTC RoP Phase 2 requirements in effect as of Nov. 28, make your QAPI Plan a priority!

All nursing home facilities

Facilities must develop and submit a plan that describes their QAPI/QAA (Quality Assessment and Assurance) programming. A “QAPI Plan” must demonstrate efforts in assuring care and services are maintained at acceptable levels of performance and continually improved.

The “QAPI Plan” must be submitted within one year and must be presented to CMS upon request and/or during any federal/state survey.

A “QAPI Plan” is intended to assure the continued quality of care for nursing home residents. By requiring a consistent, standardized “QAPI Plan”, CMS will ensure care delivery and services meet acceptable standards and that – should problems arise – there is a process in place to identify/correct deficiencies. “QAPI Plans” should also reveal opportunities for improvement, making it a valuable tool for promoting progress and development within your community.

HealthPRO®/Heritage encourages our clients to develop a “QAPI Plan” in consideration of the following:

  • QAPI Committee’s scope of responsibilities and activities must be included
  • Processes related to identifying and correcting deficiencies must be detailed
  • Your “QAPI Plan” must be reflective of size, scope of practice, departments, patient types (as per the facility assessment)
  • Key components to be included relate to how your facility will:
    • Track and measure performance;
    • Establish goals and thresholds for performance measurement;
    • Identify and prioritize quality deficiencies;
    • Systematically analyze underlying causes of systemic quality deficiencies;
    • Develop and implement corrective action or performance improvement activities;
    • Monitor/evaluate the effectiveness of corrective action/performance improvement activities, and revise as needed.

HealthPRO®/Heritage can assist and answer questions related to Phase 2 requirements. We are here to help! Click here for a sample “QAPI Plan” to get you started.

Home Health Agencies Face Growing Compliance Scrutiny
The “New Frontier” of home health services begs the question: “What concerns regarding compliance applies for this growing sector of our industry?”

CMS is dedicated to ensuring that all aspects of rehabilitation care delivery are the highest quality. According to experts from the HealthPRO®/Heritage Compliance Division, it is critical to continually monitor newly enacted legislation, regulations, sub-regulatory guidance and offer guidance to assure services meet/ exceed expectations. Likewise, all compliance-related initiatives and programs should also serve to align compliance strategies with overall mission, vision and values.

Specifically, compliance programming for HHA should include initiatives such as:

  • Documentation integrity audits should be completed quarterly. Results should be used to support QAPI efforts and initiatives. Supplemental training should be provided to clinicians identified as needing extra support/education.
  • A “Denials Management Team” should be well-prepared on handling appeals processes and should also support denial prevention initiatives.
  • A library of resources for clinical programming (with CMS expertise re: requirements and regulations) including audit support for therapy OASIS items to support accuracy of OASIS assessments.
  • Efficient EMR solution (HealthPRO Heritage at Home uses Therapy Sync) that assists with tracking of regulatory requirements (e.g.: frequency/timely submission of documentation, reassessment requirements, documentation trends, etc.).
  • Comprehensive onboarding processes (e.g.: core competencies checklist for infection control, bag technique, documentation requirements, HIPAA, workplace safety, patient centered care, OASIS and homecare rules and regulations, etc.).
  • Online learning (e.g.: ”CEU 360” is available via Heritage Health at Home) to ensure ongoing education through diversified and relevant education offerings, based on latest evidence-based care standards.
To learn more about home health regulatory/compliance topics, reach out to HealthPRO® Heritage at Home to ask our experts about industry trends, common programming ideas as well as services to support compliance initiatives. Fortifying compliance standards is a growing priority for home health agencies. As this sector grows and takes on more challenges, a strong foundation built on compliance safeguards will be imperative!

Tags: skilled nursing facility, CMS, Long Term Care, Advisor Newsletter, Advisor, Home Health, QAPI Plan