1. Home Health Agencies Melia Belonus, Director Bureau of Community Program Licensure & Certification Cindy Boyne, Director Division of Home Health

2. Number of Home Health Agencies 2007 379 2008401 2009410 2010434 4/30/11 447  384 are Medicare certified

3. Top 5 Home Health Deficiencies Plan of Care (G0159) Conformance with Physician Orders (G0165) Acceptance of Patients, POC, Med Sup (G0158)

4. Top 5 Home Health Deficiencies Plan of Care (G0160) Compliance with Fed, State, Local Laws (G0118)

5. New HHA Survey Protocols Focus – Data driven survey Changes scope of standard survey  Evaluates 9 of 15 Conditions Patient –focused, outcome –oriented  Limited paper review  Review of outcome data prior to survey HHA Survey Investigation Worksheets

6. New HHA Survey Protocols Efficient:  Increased use of HHA interview, data  Paper review limited to PE or Extended  Guidelines for citation of deficiencies Effective:  Targeted patient care standards  Enhanced consistency in deficiency citations

7. Survey Protocols Standard survey – Level 1 standards  Most relate to patient care processes Partial Extended survey – Level 2 standards  Guidelines for further investigation  Condition level guidance  Related conditions for further investigation Extended survey – condition cited, all examined

8. Standard Survey Protocols Level 1 standards Focus on delivery of quality patient care Address 9 of 15 Conditions Increased use of interviews Minimal need to review non-clinical paper Compliance with all Level 1 – survey ends

9. Standard Survey Expands Expected outcomes not met for 1 or more Level 1 standards Surveyor recognizes other issues Survey becomes Partial Extended survey Level 2 standards are evaluated Surveyor discretion -Review additional standards under same condition or related conditions

10. 484.10Patient Rights Level 1 G107, G109 Consider citing the condition when: The HHA is out of compliance with G107 and G109 and one additional tag within that condition. (G100-G116) or associated conditions Level 2 G101, G108, G111, G114 Associated CoPs 484.12 484.14 484.18 Standard Survey Partial Extended Survey

11. Condition Level Deficiencies Guidelines for citing conditions Guidelines, not requirements May be cited for serious findings unrelated to Level 1 or 2 standards Immediate jeopardy - always condition Extended survey – all conditions reviewed

12. Number of Hospice Agencies 2006147 2007163 2008171 2009 179 2010185  25 In-patient facilities

13. Top 5 Hospice Deficiencies New COP’s Plan of Care (L543) Update of Comprehensive Assessment (L533) Time Frame for Assessment Completion (L523) Content of Comprehensive Assessment (L524) Content of Plan of Care (L547)

14. Hotline

15. Home Health Complaints – 4/1/10 – 3/31/11 Total # HHA – 447 # HHA w complaints – 46 % HHA w Complaints – 10% Total # Complaints - 54 Substantiated - 19 Unsubstantiated - 35 %Substantiated - 35%

16. Hospice Complaints 4/1/10 – 3/31/11 Total # Hospices – 185 # Hospices w Complaints – 23 %of Hospices w complaints – 12% Total # Complaints - 24  Substantiated – 6  Unsubstantiated – 18 % Substantiated – 25%

17. Helpful Tips Event Reporting System (ERS)  Chapter 51 reporting requirements  Unique login online submission of events Message Board  www.health.state.pa.us/facility  Log in NOT required  Announcements, updates, alerts  ERS User’s manual available

18. OASIS Top Online Resources  OASIS Implementation Manual - www.cms.hhs.gov/OASIS/05_UserManual.asp  CMS Q&As - https://www.qtso.com/hhadownload.html  OASIS Certificate & Competency Board - www.oasiscertificate.org

19. OASIS Pa OASIS Education Coordinator  Duane Sapar (dsapar@state.pa.us) or  Michael Hodge (mhodge@state.pa.us) They can be contact at (717) 783-1379

20. Contact Department of Home Health  http://www.health.state.pa.us Division of Home Health 132 Kline Plaza, Suite A Harrisburg, Pa 17104 717-783-1379