Home Health Articles and Information


Nov 1, 2019 12:16:00 PM / by Kristi Bajer, BSN, RN, COS-C

5 Changes Your Agency Must Make Now For Success in PDGM

1. Embrace Collaboration   2. Increase OASIS accuracy
  • 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”

 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

Tags: PDGM, Home Health, Quality assurance, OASIS

Kristi Bajer, BSN, RN, COS-C

Written by Kristi Bajer, BSN, RN, COS-C

Kristi Bajer BSN, RN, COS-C, brings over 10 years of real world experience as a clinician, director, and administrator in home health. She is a firm believer in diagnosis driven evidence-based care in home health. Currently, she assists agencies with external chart audits and Medicare appeals, as well as providing training and coaching on OperaCare implementation and building QAPI programs using data to drive success and protect agencies from government audits.