Topical Webinar: Home Care Survey – Be Prepared! June 23, 2015 Please Mute your phone until question time. Please do not place phone on Hold. Bev Larson, RN, MPH, CPHQ Implementation Consultant/Trainer (608) Chris Atwood-Thorson, RN Rusk County, WI Home Care (715)

Advance Preparation- Keep On Your Toes!

Advance Preparation Estimate Survey Visit Date Review the State Ops Manual for Updates Review Conditions of Participation (1/1/2015) Review any state Home Health /Hospice Licensure and Certification Survey Guide

Advance Preparation Plan for private space Self Audits on a routine basis so no surprises – in the 6 months before they are due – Time sheets against charting… complete? – Admissions – Referrals – Discharges – Timeliness of OASIS, Physician orders signed – Audit for timeliness e-signatures if your policy – Keep updating but not printing

Advance Preparation Practice pulling reports – changing range of dates – changing filters – who’s job will it be? – Print schedules – keep them printed & ready if due Prepare for what the surveyor will ask for – keep it together, for instance in a 3 ring binder Prepare staff – Staff Meeting item – Name tags – Focus on the visit – hands on care – Universal Precautions

Today’s the Day… Hello Ms./Mr. Surveyor!

Set the Tone – Act calm… remember you’re prepared! – They don’t want to wait.. execute your plan – Private space ready? Coffee? Doughnuts!

Paper vs. Electronic – Ask if they want to use EHR to review themselves or have a staff member assigned to assist record review – If they will review, someone else sets up login/password for a read-only employee – “How do I setup a Home Care Surveyor to use Nightingale Notes” – Find under : Help>Knowledge Base>How do I?

Paper vs. Electronic – If paper, consider a “mini-chart” for them to take on visit – Client Admissions/Referral Data – Medications and Allergies – Signed 485 (Physician Plan of Care) – To Go Report from last visit (Nursing Plan of Care) – Therapy signed Plan of Care – Home Health Aide Assignments

Paper vs. Electronic If paper, to do record review, add the following: – OASIS & Omaha Systems Problem Report (integrated OASIS) – Demonstrate OASIS signature and visit signature until e-signature feature added – Visit Reports for range of dates asked for – Vitals History, if pertinent – Discharge Report, if any

Entrance Conference – to choose visits – All unduplicated patients all disciplines for past 12 months, regardless of pay source (Admissions Report by Pay Source in Nightingale Notes) – Discharges with the previous days, sorted in date order – Home Visit schedules for all disciplines for days of survey

Entrance Conference – Agency Review – Personnel – List of personnel with hire dates (Nightingale Notes Report if using custom tab) – Personnel files – In-Service Education files (? Custom tab) – Current Licensure Report ( ? Custom tab) – Sample of a Time Report for 2 weeks maybe

Entrance Conference – Agency Review – Agency Information – ID of the Services provided entirely and directly by agency employees – Policy and Procedures/OASIS Procedure/Records/E- signature, etc. – Last HH Agency Survey & Deficiency Report – Professional Advisory Meeting Minutes – Any State license of agency, if required – CLIA Lab License/certification – for agency

Entrance Conference – Agency Review – Record Information – Admission Packets – Record Review Committee Minutes/Results – Adverse Event Reviews – OBQI Reports / Outcomes/ Corrections

Get ready to make visits – If use Scheduler, plan how to view or print – As soon as clients chosen, print mini-chart if requested or review on screen – Keep it calm and flowing! You are prepared!

Exit Conference – Encourage staff to attend if possible – Anticipate what else might be requested or required – If deficiency, can you provide info now? – Take lots of notes & ask yourself how Nightingale Notes reporting/charting might be improved for next time.

Questions for Chris How did you do that? Why do you do that? How did that work?

REPORTS FOR SURVEY – MANAGEMENT-BOARD – Let’s go look at some examples of reports Bev Larson Champ Software

Reports – Multi-Purpose – Management Travel Report – for reimbursement and Medicare Cost Report Admissions, Visit/Time, Discharge- workload, financial Referral Reports – for outreach, relationship management CAHPS report – to do CAHPS survey – Board Meetings Visits by Pay Source Visits by Discipline Referrals by Source Visits by Service or Program Admissions this month by Pay Source

Reports – Multi-Purpose – Record Reviews – Client On Demand Medications and Allergies Visit Compilation – on screen Completed Interventions Discharge Report – Record Reviews – Activity On Demand Client Problem List Vitals History Visits by Discipline – custom for this client only – Record Review – on Report Main tab 485 Not signed Oasis not signed/batched KBS Change Graph – this client only Home Health Aide Supervision visits to check for frequency

Surveyor may want to vary diagnosis and age of client visits, as well as pay source

How do I get an Unduplicated County of Clients for Home Care? Admissions by Pay Source exported to Excel

After removed duplications, then can put in a formula to get Count Got the Unduplicated Count of “10” by entering in the cell “=CountA ( A2:A45) or click on last one and then top cell and Enter.

Discharge Report For the Surveyor

Discharge Report For the Board Use “Hide Details”

Referral Report for Board… Maybe Surveyor?

For the Surveyor - To Go Form for Client Visit

For the Surveyor - Employee License Information

For the Surveyor - Employee In-service Information

Questions for Bev How did you do that? Why do you do that? How did that work?

Here’s to your Success! Thanks, Chris Atwood-Thorson!