Significant and positive changes have been made to the process and outcome measures reported on Home Health Compare.  As an outcomes and benchmarking company, we realized several years ago that it was imperative to make a big investment in our reporting infrastructure, one that would allow us to accommodate frequent changes from CMS and stay in synch with real-time reporting without much advance notice. We're pleased to announce that the SHP Real-time Home Health Compare report will be right in synch with the CMS changes. We'll all be watching closely to see what impact these changes have on scores.

Following is a recap of CMS' changes. Make sure your staff is well-briefed on these new calculations.

Process Measures

Timely Initiation of Care: The specifications for this measure have been changed 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 inpatient 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 healthcare referral and a referral was made subsequent to the inpatient discharge.

Multifactor Fall Risk Assessment Conducted For Patients 65 And Older: This measure was changed to exclude patients who are chairfast or bedfast, and to include all patients who are age 18 and older. The descriptive name of the measure has been updated to Multifactor Fall Risk Assessment Conducted for All Patients Who Can Ambulate.

Depression Assessment Conducted, Depression Interventions in Plan of Care and Depression Interventions Implemented during All Episodes of Care: Exclusions based on level of consciousness for these three measures have 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.

Outcomes

Exclusions based on level of consciousness were changed to rely on the values of M1700 (Cognitive Functioning) in addition to M1710 (When Confused) and M1720 (When Anxious). The change applies to all improvement measures except for dyspnea, surgical wound status, and UTI. Improvements for these three measures are still computed for non-responsive patients.

HHCAHPS

No changes at this time.