game show featuring questions about basic home health.

1. Certification
10
20
30
40
50
Survey
10
20
30
40
50
OASIS Basics
10
20
30
40
50
Covered
Services
10
20
30
40
50
Baby, you can
be a star.
10
20
30
40
50

2. Care Planning

3. Question
What must be present in order for an MD’s
signature to be considered valid by Medicare?

4. Answer
Both the signature and date.

5. Question
What are the four elements of an order?

6. Answer
WHO will perform the skill
WHAT the skill is
FREQUENCY of the skill/visit
DURATION of the order

7. Question
PRN orders are invalid without this.

8. Answer
Description of the circumstances necessitating a
PRN visit. Ex: 2 SNV PRN pain. NOT: 2 SNV PRN

9. Question
What must be present in the plan of care for
recertification episodes?

10. Answer
MD estimate of how much longer services are
expected to continue.

11. Question
What are the three elements of a home health goal?

12. Answer
WHO will achieve the goal?
WHAT will be achieved?
WHEN it will be achieved.

13. Survey preparedness

14. Question
How often must a home health aide supervisory visit
be performed?

15. Answer
At intervals of NO greater than 14 days.

16. Question
Coordination of care is a frequent home health
deficiency. Name 3 ways to improve Care
Coordination.

17. Answer1. Document conferences with therapists
2. Attend Case conference
3. Hold case conference every week or two
4. Call or Fax MD for significant changes even when you know they won’t do
anything.
5. Document communication with your coders
6. Write reasonable parameters
7. Ensure parameters are written for INRs, BGL, etc.
8. Get over the idea that Physicians are too important to be bothered

18. Question
How much experience must a nurse have before
assuming the role of the Director of Nursing?

19. Answer
One year

20. Question
Why would a home health agency be required to
use an outside organization or individual to train
home health aides?

21. Answer
Conditional level deficiency (even after corrected)
Payment suspension
Sanctions

22. Question
Your agency has opted out of completing the 486.
What would a surveyor expect to see?

23. Answer
An alternative 60 day summary.

24. OASIS

25. Question
You find your patient in distress upon arrival at her
house for a routine visit. She is pale, diaphoretic
and you are unable to palpate a radial pulse. 911 is
activated and you stay with the patient until they
arrive. Later you learn that she died en route to the
hospital. What OASIS assessment do you complete?

26. Answer
Death at home.

27. Question
A physician calls in a referral for a patient to be
admitted the following day after they are released
from the hospital. The hospital discharge is delayed
due to complications and the patient is discharged
three days later. How do you respond to M0102 –
Date of Physician-ordered Start of Care?

28. Answer
The date should be revised to reflect the date the
patient was released from the hospital after
conferencing with the MD.

29. QuestionYou are dispatched to admit a patient following Stent placement which
0ccurred the prior morning. Hospital documentation reveals your pt
required IV sedation because the procedure lasted almost two hours.
He also developed a hematoma, causing pain requiring narcotic pain
relief. Post discharge instructions include no bending or lifting and to
begin Coumadin.
He is sitting on the sofa ‘no worse for the wear’ when you arrive. He is
able to ambulate and transfer independently. How do you answer the
OASIS question about ambulation?

30. AnswerAble to walk only with the supervision or assistance
of another person at all times.
The patient’s ability may change as the patient’s condition improves
or declines, as medical restrictions are imposed or lifted, or as the
environment is modified. The clinician must consider what the patient
is able to do on the day of the assessment. Day of assessment is the
24 hour period ending with the visit. Because of heart cath,
hematoma and anticoagulation he was not safe to do anything for the
majority of that time period.

31. QuestionPt was admitted February 28 and was recertified
April 28 for an additional episode. How do you
answer M1041?

32. Answer
Yes

33. QuestionUpon admission, you find that the patient’s daughter has
not filled all the prescriptions, including the pain meds
because she doesn’t want her mother to get ‘hooked’ like
she did. How do you respond to M2000?

34. Answer
2 – Problems found during review.

35. Covered Services

36. QuestionYour patient was admitted following an MD visit
where his blood pressure was 190/110. The pt was
started on meds and the MD ordered home health
services to monitor his response. How long would
services be covered if all goes well for the patient?
Ex: Blood pressure returns to normal with drugs
and the patient has minimal side effects that do not
warrant treatment.

37. Answer
Three weeks

38. Question Mr. Smith has a long history of diabetes and was
recently put on insulin despite compliance with his
treatment plan. The skilled nurse visits him twice a
week and fills his med box and insulin syringes.
Although the patient has demonstrated competency
with self-injection, the nurse is teaching his wife
how to draw up and inject insulin in case of an
emergency where he is unable. Is the nurse
providing reasonable and necessary services?
Explain.

39. Answer
Yes. Teaching and training caregivers is a skilled
service. Pre-filling syringes and med boxes are not.

40. Question
Your medical director asks you to admit one of his
patients who needs blood drawn every month to
monitor therapy with a new psychiatric med. What
do you tell the MD?

41. Answer
Sorry, Charlie. The need for lab draws does not
qualify a patient to receive home health services.

42. Question
What does Medicare consider to be intermittent
skilled care?

43. Answer
medically predictable recurring need for skilled nursing services (does
not cover one time visits)
provided or needed on fewer than 7 days each week, or less than 8
hours each day for periods of 21 days. Daily visits can be extended in
certain circumstances.
(No one time or daily visits past 21 days without endpoint statement.

44. Question
When is Ostomy Care (nursing care) covered?

45. Answer
In the immediate post operative period or if there is
a complication.

46. Home Health Star Ratings

47. Question
What does CAHPS measure?

48. Answer
Patient/caregiver perception of care

49. Question
What two datasets determine the number of stars
an agency is awarded?

50. Answer
OASIS and HHCAHPS

51. Question
How can agencies get an advanced look at their
Quality of Patient Care Star Ratings?

52. Answer
The Provider Preview Reports that show a HHA’s
Quality of Patient Care Star Rating are
available through CASPER.

53. Question
When you preview your quality of care data, you
discover that you only have one star. This is vastly
different from what you believe your data reflects.
What do you do?

54. Answerthe HHA may request a review of their rating.
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-
AssessmentInstruments/HomeHealthQualityInits/HHQIHom
eHealthStarRatings.html.

55. Question
Who collects HHCAHPS data?

56. Answer
A Medicare approved vendor.