The latest Home Health Compare results, released July 18, 2013, reflect a data collection period of April 2012 to March 2013. The Unplanned Hospital Care / Emergency Room Use and the Home Health CAHPS Survey (HHCAHPS) results were also updated and reflect a data collection period of January through December 2012. The national average for unplanned hospitalization remains unchanged at 17 percent. However, the national average for emergency room use worsened to 12 percent from 11 percent last quarter.
The table below is some key process measure standings from the July update:
|Process Measure Standing||Outcome|
|Multifactor falls risk assessment||Increased by two percentage points to 96%|
|Pressure ulcer prevention; pressure ulcer prevention included in plan of care; depression assessment; pneumococcal polysaccharide vaccine; improvement in management of oral medications; and influenza immunization||Increased by one percentage point|
|Timely initiation of care||Decreased one percentage point to 91%.|
CMS has updated calculation methods for several of measures. The changes impact how agencies measure timely initiation of care, multifactor fall risk assessment, depression assessment, and the majority of improvement outcome measures.
- The timely initiation of care measure has been altered to conform to the Medicare Conditions of Participation for prompt initiation of care upon resumption of care after discharge from an inpatient facility. The patient must be seen within two days of discharge, even if the physician specifies a later resumption of care date. This requirement does not apply if the patient was discharged from the inpatient facility without a home health care referral and a referral was made subsequent to the inpatient discharge.
- The multifactor fall risk assessment measure, traditionally conducted for patients 65 and over have been altered to exclude patients who are chairfast or bedfast, but will include all patients who are age 18 and over. The descriptive name of the measure has been changed to Multifactor Fall Risk Assessment Conducted for All Patients Who Can Ambulate.
- For the measures, depression assessment conducted, depression interventions in plan of care, and depression interventions implemented during all episodes of care, the exclusion based on level of consciousness has been changed to rely on OASIS item M1700 cognitive functioning in addition to items M1710 When Confused and M1720 When Anxious. A patient is excluded from the denominator for these measures if the response to any of the items M1700, M1710, or M1720 indicates that the patient’s level of consciousness is insufficient to enable a valid assessment of depression.
All improvement outcomes except dyspnea and surgical wound status have been updated, which now exclude non-responsive patients.