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Blog entries are © Kathy Quan ALL RIGHTS RESERVED.


Seeking Give Aways for Nurses Week 2018

I am seeking Give Aways for Nurses Week 2018 contest that will run on

See details here:

OASIS Podcasts and eBook

NEWS:I have begun to create podcasts with info about the OASIS for those of you who need to know a bit before you interview and transition to skilled home health care. Find them here: or see OASIS PODCASTS

(You’ll have to turn up your volume. I will try to improve my speaking with the next episodes.)

Also watch for my new eBook about OASIS Tips — publishing in Dec. 2017. 

CMS FInalizes New CoPs for Home Health Care

CMS has been working since 1997 to finalize a new set of CoPs for the Home Health Care industry. On January 9,2017,  the 347 page Final Rule was published in the Federal Register.  

The new rule improves the quaity of care and patient rights. Four new Standards include:

  • Patient Rights
  • Care planning, Coordination of Care and Quality of Care
  • QAPI 
  • Infection Control and Prevention

Discounted Price for Basic Dcumentation Skills Course

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The price for Documentation basics for INDIVIDUAL use  license Skilled Home Health Care has been discounted 50% to $99.

(The multiple use license for agencies and groups is $499). 

Sign up today to improve your documentation skills. 

Note: this course does NOT cover OASIS documentation.

5/25/17 UPDATE: This price has been permanently discounted to $99 for Individuals. For agencies who wish to use the course, or share the contents with their staff, the price is $499 and includes a post test to offer CE credits, and will include access to all future updates. 

Prior Authorization Demonstration Plan

June 2016: CMS has unveiled it’s concept for prior authorization of home health care and confusion ensues. It will be a demonstration porcess first and the first state to start it by Aug. 1 is Illinois.  Texas, Florida, Michigan and Massachesets willl follow shortly after that. 

Agencies in these states will "be required to submit documentation for review before processing claims for services. The requirement comes as a result of a 59% improper payment rate among home health claims in 2015, according to CMS.” 

CMS says there will be no additional paperwork required, just that it needs to be submitted earlier in the process to avoid the current “pay and chase process” wherby agencies bill and are paid, and then CMS has to chase down repayment when services are deemed improper. 

Read more…

Documentation Class Online

I have finally published my Power Point based online course on The Basics of Documentation in Skilled Home Health Care. It is available from Hre’s the direct link:

No cues yet, but if your agency purchases the annual subscription version for $499/year, they can use the class in their staff education curriculum and perhaps offer cues under their number. Individual course is $197. 

Exploring the Home Health Experience is now on Amazon and Kindle

Exploring the Home H Cover for Kindle

Exploriing the Home Health Care Experience is now available through Amazon and Amazon Kindle

New to Home Health Book Published!


As promised, my latest book about transitioning to home health care has published before Nov. 1. It’s available here: and will soon be available in Kindle verion on 

I will also be making available a Power Point Presentation that home health agencies can use for recruiting and orientation purposes to accompany the book. This should be available by late 2015 or early 2016. You can email me for details. 

Home Health Documentation Conference

On August 19, 2015 form 2:00-3:15 EDT, Kathy Quan, founder of will be presenting an audio conference for on home health documentation. The conference will focus on improving patient care and avoiding reimbursement denials through better documentation. Early Bird registration is open now and through August 5 you can save 20%. 

Course Highlights:

This comprehensive program covers: 

  • Why effective documentation practices matter to care and cost
  • Examples of what effective documentation looks like
  • A review of policies governing reimbursement of home health services and practical steps to help achieve payment for these services
  • Important standards and principles of home care documentation
  • Pros and cons of electronic documentation
  • Examples of appropriate documentation relative to the coverage criteria under CMS
  • A review of HH PPS final rule (79 FR 66032) documentation requirements

You’ll also learn best practice strategies and tips to: 

  • Minimize legal risks,
  • Develop foolproof auditing and documentation systems, and
  • Motivate nurses and clinicians to document completely and accurately.

National Public Health Week

BrightStar Care has launched a campaign to educate the public about private duty and intermittent home health care during National Public Health Week. This would also be a great time to push for the passage of The National Nurse for Public Health Act of 2015. Read more about this act (HR 379) and click on the link to call or email your Rep. today. 

Home Health Aide Infographic

Peer Recognition of Blog was recently honored by Nursing Assistants Guides as one of their Leading Online Resources for Home Health and Assisted lIving. (Many Thanks!!!) Scroll down the page, we’re listed at #14 in Home Health Care among some pretty incredible sources. Remember CNAs and CHHAs are a huge part of home health care and it’s great to see they have such a great website to support the work they do. 

CMS Defines Homebound MUSTS

Defining homebound status is something CMS has left as vague for many years. Recently the Office of the Inspector General (OIG) requested that CMS be more specific about what is required for a patient to be considered “homebound.”

CMS has finally responded using the term "confined to the home":

In order for a patient to be considered confined to the home, BOTH of the following criteria must be met:

1. The individual has a condition due to an illness or injury that restricts his or her ability to leave their place of residence except with the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person; or if leaving home is medically contraindicated.

2. The condition of the patient should be such that there exists a normal inability to leave home and, consequently, leaving the home would require a considerable and taxing effort.

This ruling becomes effective November 19,2013.



Utah Under CMS Probe

Home Health agencies state wide in Utah are under a probe from their CMS intermediary (a Celerian Group Company) based on data revealing recent higher utilization of therapy visits and a higher reimbursement rate than any other state served by CGS. 

According to CGS, the topic code for this review will be 5012W. The probe from CGS will select claims with 10 or more therapy visits.  The selected claims will then be reviewed for:

  • valid FTF encounter documentation
  • skilled need/ medical necessity
  • compliance with all CMS coverage guidelines
  • correct billing and coding

Are You In Danger of Denials?

An agency in Nj is facing a demand for $3million in payback for deficient documentation of PT services. They are currently fighting the ruling Are you certain your documentation practices won't be questioned? Read more…

Surprise: CMS is requiring HIPPS codes for Medicare Advantage patients beginning July 1 Read more… (you have to be registered to access)

In older news….

CMS issued updated Q&A regarding Therapy services (March 2013)

CMS issued updated Q&A regarding Face-to-Face encounters (March 2013) -- WATCH for more updates on this Hot Topic

Free Webinar about 2013 PPS Rule

Attention Home Health and Hospice agencies: Healthcare First is offering a FREE Webinar (“2013 PPS Proposed Rule: What it Says and What it Could Mean for Your Agency,) on Aug. 9 at 10:30 AM Central Time. 

2013 PPS rates posted in Federal Register

On July 13, the 2013 PPS rates, hospice quality reporting requirements, and survey and enforcement requirements were posted in the Federal Register.   

OIG Report on 2009 OASIS DATA Released

The OIG released their report entitled Limited Oversight of Home Health Agency OASIS Data. It contains some interesting facts including:

  • 6% of 2009 claims are missing-- representing $1 Billion in Medicare payments. Is this an indication of fraud? 
  • 15% of OASIS data sets were submitted late.
  • CMS failed to meet key responsibilities

The OIG has thoughts and recommendations for penalties to be imposed. 

Download and read the entire report here.

VNAA Supports Obama's Efforts to Reduce Waste & Costs- But Opposes Co-Pay for Home Health

In a statement released last week (2/13/12), the VNAA announced its support of President Barak Obama's efforts to cut waste and abuse in the Medicare and Medicaid systems. In his proposed 2013 FY budget, President Obama proposes efforts "to boost integrity and reduce improper payments."

The VNAA does however, oppose the proposal in the 2013 FY budget to impose a $100 co-pay for Medicare home health and hospice services. According to Andy Carter, VNAA President and CEO, "we urge Congress and the Administration to avoid across-the-board cuts or patient co-payments. And instead use targeted strategies to reduce payments, as the President's budget states [made to the wrong person, in the wrong amount, or for the wrong reason.]"

For more information read more….

Scrubs Work Well in Home Care

There has always been a debate in home health care about uniforms vs. wearing street clothes for safety measures as well as ease of care. Enforcing a professional look or dress code has been one of the of the biggest arguments against street clothes. Remember, you represent your company when you go out to see your patients. You also represent yourself as a professional. Look in the mirror and be honest--- would you trust this person to be your nurse? 

Another problem is that some of the homes you visit are less than ideal. How many times have you experienced the need to go straight home and shower for an hour, scouring every inch of your body before you can stop itching or imagining things crawling all over you?!! We've all been there-- or will have been there before your home care career is over. You want to burn your clothes and even scrub out your mouth and nose. Who knows what you have contaminated your car with. 

Scrubs offer a great option. They are professional and yet commonplace enough not to draw undue attention to you in the community as you get to your patient's homes. They can be laundered in strong detergents and hot water, and unlike your nice personal attire, not be ruined. 

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