Home care's coronavirus response

From patient screening to emergency plans, home health providers try to meet challenges and protect patients

Home health agencies across the nation are responding to the COVID-19 pandemic by screening patients for the coronavirus, adding information about it to routine patient education efforts, and in some cases, activating agency emergency plans for infectious disease. “The coronavirus poses some particular challenges to the home health field, as our patients are among the most vulnerable to the coronavirus,” said Home Health Solutions Owner J’non Griffin, an industry expert on implementation of emergency plans at home health agencies. Home Health Solutions is a nationwide consulting and outsourcing firm for home health, hospice and long-term care. J’non spent much of 2018 helping agencies around the country develop new emergency preparedness plans which Medicare required them to implement that year. Now she’s seeing many agencies activate those plans, which were specifically required to address the spread of infectious diseases such as the SARS-COv2 coronavirus. “Agencies were required to develop a plan for handling infectious diseases as part of an all-hazards risk assessment detailing how they would respond to all potential man-made and natural disasters,” J’non said. “Now we’re seeing many agencies having to implement those plans to protect their patients. This coronavirus is a particular threat to frail, sick and elderly homebound patients who have underlying medical conditions such as diabetes or respiratory and heart conditions.” This is not a drill Agencies in counties or states where officials have declared a state of emergency due to the coronavirus should go ahead and activate their infectious disease emergency plans now, J’non said. Plan activation will exempt agencies from Medicare’s requirement to engage each year in a community-wide emergency drill with a full evaluation after their plan is tested – but agencies will still need to fulfill the evaluation requirement. “Agencies will need document their response to the coronavirus outbreak and identify any areas where improvement is needed,” J’non said. Tabletop exercises Agencies in areas where state and local officials have not proclaimed a state of emergency related to the coronavirus may be eligible to conduct a tabletop exercise to meet Medicare’s emergency preparedness requirements this year. The World Heath Organization (WHO) is making available a training simulation based on the coronavirus .The package is available by clicking here, and includes a Power Point presentation, participant’s guide and a facilitator’s guide, and is customizable for various types of agencies and facilities. “Not every agency will be able to use the tabletop exercise, because it will depend on where they are in the timeframe Medicare sets up within the regulations for emergency plan testing and evaluation,” J’non cautioned. Agencies are only allowed to rely on a tabletop exercise when an annual community-wide drill cannot be held. Medicare allows agencies to replace that annual drill with an individual facility-based exercise as often as once every other year – and in the alternate year, the agency may choose whether it holds a drill, a tabletop exercise or a workshop that includes a group discussion led by a facilitator. HCAF briefing set for March 19 The Home Care Association of Florida (HCAF) will sponsor a 30-minute webinar briefing on the coronavirus on March 19, featuring helpful information specifically for home care providers. (Register here.) “We’ll cover what to do, and the next steps to prepare your staff and patients,” J’non said. She will present the briefing for HCAF. “There are so many considerations for agencies right now – from handling shortages of hand sanitizer to dealing with personnel shortages due to workers who do may not have child care available during school closings. Agencies are having to develop child care plans, come up with appropriate ways to screen their patients, make certain they are getting the right information out to their patients, review infection control procedures with staff and more,” J’non said. Add COVID-19 to risk assessment J’non also advises home health agencies to add COVID-19, the illness caused by the SARS-Cov2 coronavirus, as a specific line item on the all-hazards risks and vulnerabilities assessment which is required as part of agency emergency plans. The assessment must include a full description of all identified natural and man-made risks to the operation of the agency as well as plans for how the agency will continue to communicate with staff and care for patients under emergency circumstances. Threats which must be identified in the risk assessment include including fire, flood, weather events, hacking and other cybersecurity threats, mass shootings and more. In a February 2019 memorandum to state survey agency directors, the Centers for Medicare and Medicaid Services (CMS) specifically included infectious diseases as one of the threats home care providers are required to address. “These are important steps for home care providers to take right now not only to meet Medicare requirements but to make use of emergency planning efforts to better protect and care for our vulnerable homebound patients during this health care challenge,” J’non said.

No time for RAC audits and ADRs? We get it. Home care providers have their hands full right now with the first-year implementation of Medicare's new Patient-Driven Groupings Model (PDM), a coronavirus pandemic -- and, in some states, the Review Choice Demonstration as well. If you don't have time to deal with ADRs or RAC audits right now, contact us. We can help.