MHA Today | December 27, 2017

MHA Today: News for Healthcare Leaders

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December 27, 2017

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

In This Issue
IV Therapy Administration Final Rule Available
CMS Clarifies Nursing Facility-Initiated Discharges
DHSS Updates Home Health And Hospice Aide Exam
Advanced Copy Of Revised Rural Health Clinic Guidance Available
Trajectories: ED Utilization Right Care. Right Place. Right Time.
CMS Releases OQR Specifications Manual Version 11.0a
CMS Updates EHR Known Issues Document
HRSA Offers Webinar To Assist Grant Applicants

Regulatory News
the latest actions of agencies monitoring health care


IV Therapy Administration Final Rule Available

Staff Contact: Sarah Willson

The final rule for requirements related to IV therapy administration certification has been published in the Missouri Register. The State Board of Nursing suggested revisions to 20 CSR 2200-6.060, which were posted for public comment in the Missouri Register on Sept. 15. The revisions received no public comment and were adopted as proposed. The regulatory changes are slated to take effect Feb. 2, 2018.

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CMS Clarifies Nursing Facility-Initiated Discharges

Staff Contact: Sarah Willson

The Centers for Medicare & Medicaid Services issued a survey and certification memo attempting to clarify nursing facility-initiated discharges. These discharges often prove difficult, not only for the patient and family, but also for the hospital to which patients are sent upon such discharge. Missouri hospitals frequently have nursing facility patients arrive at their emergency department only to learn the patient will not be accepted back by the facility because the patient has been “discharged.” Hospitals must know how to recognize and advocate for patients who may have been wrongly discharged. The ombudsman program is a crucial advocacy group for these patients and should be involved each time this occurs.

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DHSS Updates Home Health And Hospice Aide Exam

Staff Contact: Sarah Willson

The Missouri Department of Health and Senior Services Bureau of Home Care and Rehabilitative Standards sent an announcement last week to home care and hospice administrators alerting them of the availability of new aide competency exams located on its website. Implementation of CMS’ new home care standards will begin Saturday, Jan. 13, 2018. The exam will help agencies be in compliance with the new standards.

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Advanced Copy Of Revised Rural Health Clinic Guidance Available

Staff Contact: Jim Mikes

The State Operations Manual Appendix G Revised Rural Health Clinic Guidance has been released by the Centers for Medicare & Medicaid Services. This comprehensive revision is included in a survey and certification memo. Updates to Appendix G include the following features.

  • addition of a survey process component
  • reorganized guidance to include Automated Survey Processing Environment tag numbers correlating to regulatory text
  • renumbered tags
  • updated and clarified guidance reviewed for clarity and precision
  • timing of ASPEN changes

These changes are effective immediately.

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Quality and Population Health


Trajectories: ED Utilization Right Care. Right Place. Right Time.

Staff Contact: Alison Williams

The December 2017 issue of Trajectories focuses on emergency department utilization. EDs have evolved to become a major primary source of medical care in the U.S., essentially serving as the ultimate safety net for vulnerable populations.

An ED presence is critical to rural communities. Quick triage, assessment and early intervention, as well as appropriate transfer to higher levels of care, are an asset to those living long distances from more urban settings. The advent of the tele-ED is just one of several options available for rural EDs. Use of telemedicine technologies such as live-stream video, linked medical tools, and use of standardized care algorithms and protocols create a streamlined, cost-effective option, while keeping patients close to home. The digital market, through use of smart phones and devices, has exponential ability to expand, creating additional opportunities to perform an ED visit from the home setting.

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CMS Releases OQR Specifications Manual Version 11.0a

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released Hospital Outpatient Quality Reporting Program specifications manual version 11.0a effective for encounters Jan. 1, 2018, through Dec. 31, 2018. Major changes in the release include the following.

  • inclusion of version 11.0 release notes for reference
  • inclusion of two new outcome measures
    • OP-35: Admissions and emergency department visits for patients receiving outpatient chemotherapy
    • OP-36: Hospital visits after hospital outpatient surgery
  • removal of two measures submitted via a web-based tool beginning with encounter date Jan. 1, 2018
    • OP-25: Safe surgery checklist use
    • OP-26: Hospital outpatient volume on selected outpatient surgical procedures
  • removal of four chart-abstracted measures beginning with encounter date April 1, 2018
    • OP-1: Median time to fibrinolysis
    • OP-4: Aspirin at arrival
    • OP-20: Door to diagnostic evaluation by a qualified medical professional
    • OP-21: Median time to pain management for long bone fracture

A complete list of changes may be found in the release notes for versions 11.0 and 11.0a.

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CMS Updates EHR Known Issues Document

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services updated the known issues document associated with the Electronic Health Record Program with resolutions and newly identified issues.

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Noteworthy


HRSA Offers Webinar To Assist Grant Applicants

Staff Contact: Jim Mikes

The Health Resources and Services Administration is offering a technical assistance webinar to help applicants understand, prepare and submit an application for the Rural Health Network Development Planning Program. This grant will provide up to $100,000 to consortiums of at least three organizations to assist in the planning and development of an integrated health care network at the local level. The webinar will be offered at 1 p.m. Wednesday, Jan. 24, 2018.

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Consider This ...

Every year, adults have an average of two to three colds, and children have even more. More than 200 viruses can cause the common cold, and infections can spread from person to person through the air and close personal contact.

Source: Centers for Disease Control and Prevention