The Home Health Guide to Medicare Service Delivery, 2017 Edition
J'non Griffin, RN, MHA, WCC, HCS-D, COS-C, HCS-H
Updated to reflect the 2017 home health PPS final rule, new Conditions of Participation (CoP), and OASIS-C2, The Home Health Guide to Medicare Service Delivery, 2017 Edition, offers a one-stop solution for home health professionals that are looking for answers to their Medicare compliance questions. This book also enables agencies to ensure services are delivered according to current Medicare regulations and helps staff understand how to produce patient care documentation that supports compliance and proper payment claims.
This manual provides:
- Quick access to concise, up-to-date CMS regulations, including new CoPs and interpretive analyses
- A go-to resource for anyone in the home health agency, useful for orientation, training, and reference when stumped by a regulatory or operational question
- An overview of the home health PPS final rule, featuring complete interpretation and compliance guidelines on all PPS regulations
- “Nuts and bolts” education—this book takes the most complicated aspects of Medicare healthcare services and explains them in an easy-to-understand way
Updated regulations include:
- The 2017 home health PPS final rule
- Payment rebasing
- Home health quality changes
- Coding changes
- Changes in methodology used to calculate outlier payments (episodes of care with unusual variations in the type or amount of medically necessary care)
- Changes in payment for negative pressure wound therapy performed using a disposable device for patients under a home health plan of care
- Additions and modifications to the home health value-based purchasing model
Table of Contents
- The Basics of Medicare Service Delivery: Presents the fundamentals of Medicare coverage criteria and the new Conditions of Participation. This includes a section dedicated to survey preparation.
- The Prospective Payment System (PPS): Gives an overview of critical concepts, including the Home Health Resource Group, consolidated billing requirements, and clinical issues with an impact on billing for the current payment system.
- All About the OASIS: Discusses the fundamentals of the OASIS-C2 and assessments.
- Compliance and Care Delivery: Highlights issues related to visits, physician orders, start of care, recertification, and discharge.
- Documentation Essentials: Looks at documentation fundamentals, the clinical record, diagnoses, and the plan of care. This includes a section related to the 485 and elements of content.
About the Author
J'non Griffin, RN, MHA, WCC, HCS-D, COS-C, HCS-H, is a 30-year veteran of homecare. She received her master’s degree in healthcare administration in 2005. She has experience as a field nurse, director, and executive with home health and hospice agencies both large and small. Griffin has served as director of staff development and appeals for home health and hospice agencies. She has taken part in mock surveys for agencies, and prepared agencies for accreditation. She has also been involved in accreditation surveys, acquisitions, and the resolution of many regulatory crises with state survey agencies and intermediaries.
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Published: March 30, 2017
Page Count: 360