If it was good enough for Socrates, it’s good enough for me. Socrates, a champion of independent thinking, believed one of the best ways to learn was through dialogue with others. I continue to learn so much from listening to the members of the four home care advisory groups. The individuals who represent these four groups—home health (including personal care), home medical equipment (including clinical respiratory services and rehabilitation technology), hospice and pharmacy—have willingly shared their constructive feedback on a number of topics such as improving the value of accreditation, new products, standards and survey process changes and environmental influences.
Since the groups’ inception in early 2000, The Joint Commission has come to rely on these opportunities for our customers to offer their advice and insight. I look forward to our next idea exchange and am thankful to the 36 people who are currently participating as advisory group members. One thing I’ve learned over the years—don’t ask for input unless you’re going to use it. Well, we did and we did.
We’re always looking for new members with a fresh perspective on how to improve the accreditation process for the home care field. Contact me if you’re interested in participating. I’d love to hear from you! You can reach me at (630) 792-5742, or dzak@jointcommission.org.
Debra Zak, Ph.D., R.N.
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As quick as a click, accredited home care organizations can educate themselves on the 2009 National Patient Safety Goals and related requirements. The Joint Commission website includes the 2009 National Patient Safety Goal chapter, a chapter outline, a renumbering grid, and a history tracking report that shows a side-by-side comparison of the 2009 and 2008 Goals. The NPSG chapter outlines which elements of performance are applicable to each home care service segment.
For 2009, the language of some of the requirements has been expanded to further clarify applicability. For example, for the 2008 requirement 3E, now NPSG.03.05.01, Reduce the likelihood of [patient] harm associated with the use of anticoagulation therapy, language was added to specify when this requirement applies. In addition, the requirements for medication reconciliation across the continuum of care were revised and clarified, based in part on feedback from the 2007 Medication Reconciliation Summit.
There are also new requirements that focus on preventing central line-associated bloodstream infections. These additions build on an existing Goal to reduce the risk of health care-associated infections. The new infection-related requirements have a one-year phase-in period that includes defined milestones, with full implementation expected by January 1, 2010.
For more information on the 2009 NPSGs, click here.
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Eligibility statements for the home medical equipment and clinical respiratory services segments of the Home Care Accreditation Program were recently revised in response to concerns about confusing language. The key eligibility changes for HMEs are:
- Language that discussed the intention to bill to Medicare Part B as the significant descriptor of HME-eligible services was removed.
- Eligibility was expanded to all sites of care for those HME providers billing Medicare Part B DMEPOS.
- Whether services are provided in the patient’s place of residence now determines eligibility for organizations not billing Medicare Part B DMEPOS.
- New language allows organizations that provide 100 percent of their services on behalf of another organization to be eligible for accreditation when they might be forced to cease operation if accreditation is not awarded.
- A note explains eligible services for organizations surveyed under the pharmaceutical services standards.
With respect to CRS, eligible services must be provided in the home by a licensed health care practitioner and in conjunction with medical equipment provided by that same organization. An added note also offers examples of eligible CSR services.
The complete eligibility statements for both service segments appear in the July issue of The Joint Commission Perspectives. Or, visit The Joint Commission website and click on #1 under “3 Easy Steps.”
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The Centers for Medicare & Medicaid Services recently published revised Conditions of Participation that take effect December 2 for hospices. The Joint Commission is required to conform to the revised Conditions of Participation because of its deemed status relationship with CMS. Currently, Joint Commission staff members are in the process of making those revisions, and a crosswalk is expected to be available on The Joint Commission website in October. Hospices that elect to use Joint Commission accreditation for deeming purposes on or after December 2 will be held to CMS’ revised Conditions of Participation.
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Standard PI.3.20, which requires an annual proactive risk assessment, is being eliminated for all accredited home care organizations, effective January 1, 2009. This standard, commonly referred to as the Failure Mode and Effects Analysis, required home care organization to select a high-risk process to analyze each year. While a FMEA is no longer required, the Leadership chapter of the 2009 manual (Standard LD.04.04.05, EP 6) includes a section in the Safety Management Program that touches on the proactive risk assessment and its value in evaluating an organization’s safety program. For more information, read the Performance Improvement History Tracking Report 2008-2009 under Standard PI.3.20.
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Home care customers will see welcomed improvements in The Joint Commission’s accreditation manuals this fall. For the first time ever, a complimentary, single-user license electronic manual, or E-dition, will be available for all accredited home care organizations. This web-based product will allow organizations to pull up service-specific standards and elements of performance. For example, using the filter feature on the E-dition, an organization that only provides personal care services will see only the standards and elements of performance that apply to those services. The single-user E-dition will be posted in November, and home care organizations can purchase additional user licenses and site licenses at that time.
The redesign of the print manual was heavily influenced by customer input. Key features include:
- Color-coded tabs that distinguish standards and requirements from accreditation policies and procedures
- Links from certain EPs to associated requirements in other chapters
- Standards and EPs related to a focused area of improvement placed in elevant chapters
- Chapters arranged alphabetically
- Icons that alert readers to certain requirements, such as when documentation is required to demonstrate compliance
Accredited home care organizations will receive a complimentary copy of the 2009 print manual in a portable binder format in September. A spiral-bound standards book and the larger size manual also will be available for purchase.
Both versions of the manual include five new chapters: Emergency Management; Equipment; Life Safety; Record of Care, Treatment and Services; and Waived Testing. All standards were renumbered to allow for electronic sorting and the addition of any new requirements that may occur in the future. In addition, for home health and hospice organizations that elect the deemed status option with The Joint Commission, elements of performance have been rewritten to include the actual text of the Medicare Conditions of Participation.
For more information, read the transcript from the July 24 telephone conference call on 2009 standards changes for home care.
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The Joint Commission is developing a new Health Care Services Certification product that will capture specialty services that “fall between the cracks” of the current certification and accreditation programs. These services include any program organized around a care delivery system that treats patients regardless of diagnosis, such as palliative care, cardiac services and subacute care, among others. Take a brief survey .
Home Care: Executive Briefings
November 11, Phoenix, Ariz.
Home Care Accreditation Essentials
November 12-13, Phoenix, Ariz.
To register, call JCR Customer Service at (877) 223-6866, or visit www.jcrinc.com.
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The Joint Commission’s home care team will exhibit at the following conferences:
- National Association for Home Care and Hospice, October 12-14, Fort Lauderdale, Fla., booth 805
- Medtrade, October 28-30, Atlanta, Ga., booth 3937
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Debra Zak, Ph.D., R.N., executive director
(630) 792-5742 or dzak@jointcommission.org
Bob Floro, director
(630) 792-5741 or rfloro@jointcommission.org
Margherita Labson, R.N., associate director
(630) 792-5284 or mlabson@jointcommission.org
Richard Cornwell, account executive
(630) 792-5294 or rcornwell@jointcommission.org
Account representative
(630) 792-3007
Standards Interpretation Group
(630) 792-5900
JCR Customer Service
(877) 223-6866
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