5 Changes Your Agency Must Make Now For Success in PDGM
1. Embrace Collaboration- Check your agency’s policy on collaboration and update it to reflect the expansion of the one clinician rule if necessary.
- Start using non-licensed staff to gather and enter information like assistive device use, medications, and primary DX codes. These can be taken straight from the H&P, saving hours of “paper work” for your high paid clinicians
- Use scribing to decrease charting time and the cost of OASIS collection
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Downloads/Expansion-of-the-Home-Health-One-Clinician-Convention-August-2017.pdf
- Stop underscoring the M questions and GG edits, while relying on narratives CMS does not read
- Use automated tools for QA to get the highest appropriate level of OASIS accuracy
- Perform QA while the Clinician is in the home—delay, results in a less accurate OASIS
3. Use data to manage patient care –including THERAPY
- Service utilization should be based on OASIS scores and clinical groupings as managed by your QA staff
- Therapy utilization must be controlled by the agency with the input of the therapist
- The length of stay should be projected at the SOC, using OASIS data, not subjective opinions
4. Make care planning a Quality Assurance task
- Become very familiar with the Home Health Quality Improvement website
- Build a care plan library based on common primary ICD-10 diagnoses
- Always start with the primary DX evidenced-based care plan
- Make needed changes to be “patient specific”
www.homehealthquality.org
5. Look at you Census differently
- Having a high unduplicated census is the key to profitability
- Meeting outcomes with a 30-50 day LOS when possible will dramatically increase STAR scores
