QAPI Program Utilization_Manual

2. OASIS Item M0855: To which Inpatient Facility has the patient been admitted? Item #1 » Making the Most of Home Health Compare One very effective method of using Home Health Compare outcomes is to: 1. Go to website. 2. Select all the agencies in your service area. 3. Study and compare findings. 4. Compare your agency to major competitors. 5. Make graphs that highlight the positives. 6. Use graphs to explain how you are addressing the negatives. 7. Be able to explain why percentages are what they are. 8. Be able to specify what the agency is doing that has affected percentages. 9. Note the outcome percentage differences over time. 10. Make graphs that reflect percentages over time. 11. Use graphs as appropriate to market your services to the public and referral source relationship. 12. Plan to periodically provide graphs with discussion. Access Home Health Care Compare at website: http://www.medicare.gov/ H HCompare/Home.asp » Home Health Episode Management Episode management generally describes a method used by home health providers to periodically review a 60-day episode of care. It may include OASIS accuracy, proper ICD-9 coding, projected therapy utilization and follow-up, supply use, projected reimbursement, and the HHRG relative to visits and the plan of care. The following questions are especially helpful in guiding home health episode management. Note: For a complimentary Episode Management Tool, email your request to: info@outcome- architecs.com OASIS Accuracy • Was the assessment submitted within regulatory/agency approved timeframe? • Is the assessment complete? • Are there incongruent OASIS responses? • Do we know the agency’s % of OASIS data entry error? ICD-9 Coding • Are the codes appropriate to the chief reason for the episode of care? • Are codes supported by medical record documentation? • Is the correct coding sequence used? • Is coding to the highest degree of specificity? • Is there correct use of additional codes, and code first” notes? • Are correct codes used for case mix diagnoses? • Are V-codes used correctly? Care Coordination • Is there a clearly defined process? • Is the process working? • How does the process support agency episode management? • Are discipline coordinating care with each other? 101