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Bulletin November 26th, 2019

These are your Weekly Ohio Council for Home Care and Hospice Headlines for November 26th, 2019.
If you would like the full links and stories to the following headlines, log in to the member portal!
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  • PALLIATIVE CARE and HOSPICE: Predictive Analytics Can Help Hospices Reach Patients Sooner, Hospice News, November 18, 2019


  • HOSPICE: GAO Report Recommends CMS Receive More Authority to Enforce Safety Requirements on Hospice, NAHC Report, November 22, 2019


  • HOME HEALTH: HHAs: Avoid Payment Delays, Register for iQIES by December 23 Act now!

OCHCH Members: Thank you very much for participating in OCHCH’s November 22nd RCD WEEKLY CALL!
OCHCH recently launched an awareness campaign to provide your agency with the assistance, information, resources, and training you need to tackle the challenges of RCD and PDGM. This campaign is called OPERATION: tackle.

As part of OPERATION: tackle we are hosting weekly conference calls on RCD that started on October 25th and will continue for the foreseeable future. These conference calls will provide an opportunity for us to share the latest developments of RCD, for you to share your challenges, and for our members to share best practices in a real time environment. On the November 22nd call you heard Charles Canaan, Palmetto GBA’s Provider Education Consultant discussed how PDGM is going to work with RCD, and answered numerous questions!

Click here to learn what PCR documents will be needed when PDGM is implemented on January 1, 2020

HOME HEALTH RCD Question: Encrypted Files



PDGM Questions & Answers from Palmetto GBA regarding when to discharge a patient and when to resume care when the patient goes into the hospital after 1/1/2020; and additional information on timing of institutional and hospitalizations and SNF admissions during an episode…

The OCHCH campaign to support your agency’s PDGM needs will be up and running the beginning of December. We will be scheduling weekly PDGM calls, and the helpdesk (Kathy and I) have been and will continue to answer PDGM questions. By the way, the PDGM Toolkit will be updated to include more links for you!!!
OCHCH will have a number of recordings available on our website of previous PDGM education webinars for your purchase or access. Moving forward OCHCH is committed to bringing you continued education on the implementation of PDGM and its impacts on our industry.


Help Desk Question of the Week

Helpdesk Question of the Week –

PALLIATIVE CARE: Nurse Practitioner prescribing in the home

Question: Can a Nurse Practitioner prescribe narcotics to a Palliative Care patient while doing a home visit in the patient’s home residence?

Answer: From the Ohio Board of Nursing-

Section 4723.481, ORC and Rule 4723.9, OAC govern APRN prescribing and can be accessed through the links below. And I have pasted Section 4723.481 below, for your convenience.
I.  To meet the requirements of 4723.481(C)(1), the CNP may prescribe a schedule II controlled substance to a patient if all of the following are the case:

(a) The patient has a terminal condition, as defined in section 2133.01 of the Revised Code.  [*Definition from 2133.01 (AA), ORC, is also pasted below for your convenience.]
(b) A physician initially prescribed the substance for the patient.
(c) The prescription is for an amount that does not exceed the amount necessary for the patient’s use in a single, seventy-two-hour period.

*Section 2133.01, ORC,  Modified uniform rights of terminally ill act definitions, defines “Terminal condition” to mean an irreversible, incurable, and untreatable condition caused by disease, illness, or injury from which, to a reasonable degree of medical certainty as determined in accordance with reasonable medical standards by a declarant’s or other patient’s attending physician and one other physician who has examined the declarant or other patient, both of the following apply:   (1) There can be no recovery.   (2) Death is likely to occur within a relatively short time if life-sustaining treatment is not administered.
II. To meet the requirements of 4723.481(C)(2), the CNP may prescribe a schedule II controlled substance to a patient from any of the specific locations listed in (C)(2)(a) through (n).  You will see that a patient’s home is not one of the locations listed there. The only exception to that would be if the patient is in a hospice program and receiving hospice care in their home – see 4723.481(C)(2)(f).
While “from a hospice care program as defined in section 3712.01 of the Revised Code” is one of the allowed locations, that does not include palliative programs.


APRN Decision Model

APRN Prescribing Process

Issusing a Valid Prescription

Alexandra Weingarth | Director of Policy and Advocacy

Ohio Council for Home Care & Hospice

Our Take

The Director of Aging, Ursel McElroy testified before the Ohio House of Representatives Aging and Long Term Care Committee last Thursday November 21st. She stated that:

  • Ohio is the sixth-largest 65-plus population in the nation.
  • There are approximately 2.8 million Ohioans over the age of 60.
  • Ohio’s 60-plus population is growing at a rate 28 times faster than the rest of the population

In our industry, we knew that this would be a hot topic within the executive branch and the legislature. The baby boomers are starting to age, and some would say the “silver tsunami” is approaching. Data supports that older adults prefer to age in their homes. Interestingly enough, The Director mentioned in her testimony that, “according to the US bureau of Labor Statistics, direct care workers (HH aides and personal care aides are the third and fourth fastest growing occupation in the county, yet the bureau notes that the low pay and high emotional stress demands cause workers to leave these occupations.”

We know that these occupations are on the rise, thus why we continuously work to urge government to reduce red tape regulations and consider making investments within the home health and hospice industries.

Additionally, the Director testified that the Ohio Department of Aging will be focusing on three priorities: Population Health, Economic Stability and Elder Justice. They will be looking at various ways of how to combat fraud waste and abuse, especially against older Ohioans.

For more information, please see the press release from the Ohio Department of Aging here.

Regulatory and Policy Digest Headlines

(Log in to The Member Portal to read full stories)

  • HOME HEALTH and HOSPICE: CMS Releases List of Potential Future Quality Measures, NAHC Report, November 21


  • HOSPICE: Hospice Quality Reporting Program Forum Webinar — December 4, MLN Connects, November 21, 2019


  • HOSPICE: CMS to Allow Hospices to Accept Medication Orders from Physician AssistantsHospice News, November 20, 2019


  • HOSPICE: Hospice Notice of Election (NOE) Timely Filing and Exceptional Circumstances GuidelinesPalmetto GBA, November 6, 2019


  • HOME HEALTH: Local Coverage Determination (LCD) and Medical Coverage Database (MCD) Article Updates: Home Health and Hospice


  • HOME HEALTH and HOSPICE: December 2019 JM Home Health and Hospice Medicare Advisory Palmetto GBA


  • HOME HEALTH and HOSPICE: Claim Status Category and Claim Status Codes Update, Palmetto GBA


  • HOME HEALTH and HOSPICE: Links:  Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE, Palmetto GBA


  • HOME HEALTH and HOSPICE: New Medicare Card: HICN Claims Reject January 1, 2020, Palmetto GBA


  • HOSPICE and HOME HEALTH: Hospice and Home Health Claims Processing Issues Log, Palmetto GBA
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News Clips and Links

  • PALLIATIVE CARE and HOSPICE: Hospices, Palliative Providers Innovate to Better Serve Rural PatientsHospice News, November 25, 2019
  • HOSPICE: The Top 10 Largest Hospice Providers of 2019Hospice News, November 20, 2019
  • HOSPICE: Misconceptions About Hospice Care Persist Among U.S. PublicHospice News, November 18, 2019
  • HOSPICE: New Penn Research Center Focused on Palliative Care for Dementia PatientsHospice News, November 25, 2019