Home Health Care Payment and Reimbursement

 

Centers for Medicare and Medicaid Services (CMS) statistics show that more than three million elderly and disabled beneficiaries with Medicare receive care from over 9,000 Medicare-certified home health agencies throughout the United States every year. They receive services such as skilled nursing, therapy, medical social services, and home health aide services. This course provides a basic understanding of how home health care agencies are reimbursed for these services. The course also reviews the Outcome and Assessment Information Set (OASIS) general assessment guidelines. This course corresponds to the Federal regulation G330.

$20.00

Hours: 0.50
REL-SRC-0-HHCPR

Certificates

Certificates provided by accrediting body (3 Match)

Florida Board of Nursing - Certified Nursing Assistants

0.5 HOURS


This is not an accredited course for professional license renewal. Florida CNAs may use this inservice toward meeting their annual inservice requirement.This activity is approved for 0.50 contact hours.

Non-Licensed Direct Care (DSP, HHA, CNA, DCW, PCA, IHA, NA)

0.5 HOURS


Washington State Department of Social and Health Services (ALL Direct Care Workers)

0.5 HOURS


Relias Learning, LLC is approved as a Curriculum Developer by the Washington State Department of Social and Health Services. This activity is approved for 0.50 contact hours for all WA State Direct Care Workers. Training Provider Code: WA0624. CE Approval Code: MG1619293

Course Details

Course Code: REL-SRC-0-HHCPR
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2022
Learning Objectives:
Give at least two examples of services that can be provided by a home health care agency
List the six main features of the home health care payment system
Describe the basic OASIS document guidelines
List four aspects of the OASIS document that impact reimbursement

Outline:
Section 1: What is Home Health Care?
A. About This Course
B. Learning Objectives
Section 2: The Six Main Features of the Home Health Care Payment System
A. Payment for the 60-Day Episode
B. Case-Mix Adjustment
C. Outlier Payments
D. Episode Timing
E. Let’s Review
Section 3: How is Payment Determined?
A. How is a Medicare home health patient assigned to a specific HHRG?
B. Let’s Review
Section 4: Oasis Basics
A. Let’s Review
Section 5: Conclusion
A. Course Summary
B. Course Contributors
C. References
D. Exam

Expert Reviewer: Barbara Knott, RN, MPA, ACHCE
Ms. Knott has 36 years of experience in healthcare, with the last 34 years spent in the home care field. She has been responsible for agency regulatory and accreditation compliance as well as quality assurance programs for home health and hospice. In her current position, she has oversight of the financial, operational, and quality performance of multiple home healthcare providers. Ms. Knott has received certification as an Advanced Certified Home Care Executive. Disclosure: Barbara Knott, RN, MPA, ACHCE has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Instructor: Debi Damas, RN
Debi Damas is a registered nurse in the state of Ohio. As Group Product Manager for Acute Care courses at Relias Learning, Ms. Damas works with accreditations experts to ensure that Relias courses accurately reflect regulations and standards of practice, set the direction of new content, and ensure that existing courses are maintained on an ongoing basis. She has worked in the acute setting in the Coronary Care Unit, Med-Surg and Post-Partum/Newborn Nursery. She also has extensive experience in the post-acute care space for over 18 years, holding positions as Nursing Assistant, Charge Nurse, MDS Nurse, Restorative Nurse, Director of Nursing, Regional Nurse, and Corporate Nurse. She has extensive experience working with the regulations in healthcare settings. She has a certificate in legal nurse consulting. Disclosure: Debi Damas, RN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Donna H. Miller, RN, CPHQ
Ms. Miller has 34 years of nursing experience, with 17 years in the home healthcare setting. Her home health responsibilities include managing overall agency operations, quality improvement, regulatory compliance, and infection control. She is a certified professional in healthcare quality and passionate about providing quality care and services across the health care continuum. Disclosure: Donna H. Miller, RN, CPHQ has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Lou Ann W. Robinson, RN, BSN
Ms. Robinson is an experienced educator, process analyst, and quality director, with over 25 years of clinical nursing practice and management experience in home health. Ms. Robinson is recognized for her expertise in process and performance improvement and quality assurance, as well as for her knowledge of regulatory compliance and results-oriented business practices. She believes passionately in community-based disease management, resident self-management, and quality resident care. Disclosure: Lou Ann W. Robinson, RN, BSN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: entry level General Staff; in the following settings: Home Health.
G Tags:
G330
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support by calling (800) 381-2321 or emailing [email protected]