This blog post is a summary of our industry topic webinar, 'The Facility Assessment: Meeting the Challenge.' Continue reading for additional resources and a link to the video. Facility assessments are critical in the healthcare industry, especially in light of recent regulatory changes. These assessments play a significant role in ensuring that healthcare facilities meet the needs of their residents while adhering to industry standards.

The 2024 AHCA/NCAL National Quality Award Program recipients have been announced and we are extremely pleased to congratulate the 203 SHP clients who received the award this year.

When a resident is preparing to leave a skilled nursing facility, healthcare professionals use something called the Discharge Function Score to gauge how well they’ll manage on their own. This score is crucial because it helps determine the level of support or care the resident might need after they leave. But how exactly is this score calculated? Let’s break it down in simple terms.

The annual SHPBest™ award program was created to recognize home health and hospice providers that consistently provide outstanding performance in patient and caregiver satisfaction. SHP would like to congratulate the 2023 SHP Best-of-the-Best winners, who have been acknowledged for achieving the highest overall HHCAHPS patient satisfaction or CAHPS Hospice caregiver satisfaction scores of all eligible SHP clients during the 2023 calendar year.

With the new Discharge Function Score measure now included in SHP reports, many have asked “What do we do at the agency level?” One of the most impactful things you can do is to educate your staff about the new measure. In order to understand why DFS is important, let them know it’s a part of Home Health Value Based Purchasing (HHVBP). A simplified way of educating your staff about HHVBP is to explain that reimbursement is tied to the quality of care we provide to our patients. DFS accounts for a significant amount weighing in at 20%.

On July 1st, 2023 CMS began requiring home health agencies to document their utilization of telehealth services on their Medicare Fee-For-Service (FFS) claims. As finalized in the CY 2023 Home Health Payment System Rate Update, agencies are responsible to identify one of three services they provide using new Healthcare Common Procedure Coding System (HCPCS) codes. These codes are added as a separate visit line on the claim based on the date each service is provided. CMS notes in the rule that these services are for reporting only, since CMS does not reimburse for these services. The HCPCS codes are:

Now that CY 2023 is closed and we await the CMS CY 2025 proposed rule for home health, it is an opportune time to revisit the data trends in the Patient Driven Groupings Model (PDGM) by leveraging SHP national benchmarks. Delving into these insights, one can discern intriguing patterns that have emerged over the years. To no one’s surprise, Home Health Agency (HHA) Medicare visits per 30-day period have continued to decrease over the first four years of PDGM.

Since the advent of Payroll Based Journal (PBJ) reporting by CMS in 2016, facilities have struggled with preparing and submitting accurate PBJ data. Penalties applied for a failure to submit complete and accurate data can result in defaulting to a one-star rating and negatively impacting overall 5-star ratings.

In the first week of January 2024, CMS quietly announced the release of the latest draft of OASIS version E1. The subdued announcement can be attributed to the limited updates planned for the tool, set to take effect on January 1, 2025. CMS has mentioned that the accompanying OASIS-E1 manual will be made available at a later date.

The recently published Medicare and Medicaid CY 2024 Home Health Prospective Payment System Rate Final Rule, documented in the Federal Register on November 13th, solidifies significant shifts in the Home Health Value-Based Purchasing Program (HH VBP) and Home Health Quality Reporting Program (HH QRP). Despite input from industry stakeholders, the Centers for Medicare & Medicaid Services (CMS) held firm on their proposed changes.