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NAHC Report: Issue# 2475, 7/25/2014
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CMS Announces OASIS-C1/ICD9 Webinar
California Groups Sue State Over Duals Demonstration
For Your Information: Voting Open through September 30 for Top Home Care & Hospice Nurse
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CMS Announces OASIS-C1/ICD9 Webinar

The Centers for Medicare & Medicaid Services (CMS) Survey and Certification Group is sponsoring a webinar entitled “OASIS-C1/ICD9” on September 3, 2014, 2:00-3:30 pm EST. The OASIS-C1/ICD9 will go into effect January 1, 2015.

A new version of the OASIS data items set (i.e. OASIS-C1) had been scheduled for implementation on October1, 2014. However, five data items contained in OASIS-C1 require the use ICD-10 codes. In light of the fact that ICD-10 has been delayed until at least October 1, 2015, CMS has determined that it is necessary to make interim changes to the OASIS-C1 data items set and also the process for the reporting of OASIS-C1 data.

The following is a summary of the changes that CMS will be making in the Home Health Quality Reporting Program:

A. OASIS-C1 Implementation

1. A modified version of OASIS-C1 will be created, in which the 5 items that use ICD-10 codes (i.e. - M1011, M1017, M1021, M1023, M1025) will be replaced with the corresponding ICD-9 based items from OASIS-C (i.e. – M1010, M1016, M1020, M1022, M1024).

This modified version of OASIS-C1 that will be referred to as “OASIS-C1/ICD-9 Version.”

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California Groups Sue State Over Duals Demonstration

On July 2, in Westside Center for Independent Living v. DHCS, the Los Angeles County Medical Association joined three independent living centers, two dual-eligible beneficiaries, and an ophthalmologist in filing a lawsuit (the Petition) against California, calling on the Sacramento Superior Court to halt the state’s dual eligible demonstration, the Coordinated Care Initiative (CCI). California responded by filing an answer (the State’s Response) to the lawsuit on the same day. The National Council on Medicaid Home Care – a NAHC affiliate- discusses the key elements of the lawsuit and California’s response below.

Notices and Other Documentation

Insufficient notice. The Petition alleged that insufficient notice was given. The relevant California statute states that prior to contacting with health plans, DHCS must [a]t least 90 days prior to enrollment, inform dual-eligible beneficiaries through a notice written at not more than a sixth-grade reading level that includes, at a minimum”: (1) “how the Medi-Cal system of care will change,” (2) “when the changes will occur,” and (3) “who they can contact for assistance with choosing a managed care health plan or with problems they encounter. [Petition, page 14]

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Voting Open through September 30 for Top Home Care & Hospice Nurse

The National Association for Home Care & Hospice (NAHC) and its affiliate Home Healthcare Nurses Association (HHNA) recently announced the top 10 finalists for Home Care & Hospice Nurse of the Year. Now NAHC and HHNA invite their members, affiliated state associations, and the general public to visit NAHC’s website and vote for this year’s winner. The 2014 Home Care & Hospice Nurse of the Year will be announced at the NAHC Annual Meeting & Exposition on October 19 - 22, 2014 at the Phoenix Convention Center in Phoenix, Arizona.

When the meeting convenes, the top nurse and nine final contenders will come before NAHC members and get the recognition they deserve. “It is most appropriate that we make the effort to identify and celebrate the best among us, the nurses who distinguish themselves by the size of their hearts, by their professionalism, and by their work ethic,” said Andrea L. Devoti, RN, chairman of the NAHC board of directors. “Our focus is to highlight the impact that nurses make day in and day out in homes across the country, despite the challenges they face,” she explained. “And it’s time for the public to honor nurses and thank them for all they contribute,” added Elaine D. Stephens, RN, NAHC executive Vice President and current chairman of HHNA. “This is our chance to remind everyone how hard it is for nurses to do their vital work while facing senseless cuts in reimbursement.”

An expert committee chose 50 state winners, and narrowed them down to 10 top contenders, based on an essay about each nurse and thoughtful evaluation of their credentials. These 50 state nurses are featured in CARING online and will be invited to the NAHC Annual Meeting. Their registration fees will be waived, and they will be honored at a reception. The top 10 contenders will receive a $70 gift certificate from Hopkins Medical Products, now marking 70 years in business. The one who is chosen Home Care & Hospice Nurse of the Year will have their travel and hotel expenses paid, and receive a new Apple iPad along with a $140 gift certificate from Hopkins Medical Products. The winner will also serve as a symbol of what nurses can do, and we need you to help pick this special nurse. To view the top 10 honorees, click here. Cast your vote for one of these 10 nurses who inspire us by their commitment to patients and love for their work.

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