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MCN Healthcare: StayAlert! - Immediate Regulatory Updates Icon

StayAlert! Headlines

Jul 28 2014
OASIS-C1 Implementation Update

The Centers for Medicare and Medicaid Services (CMS) informing Home Health Agency provides of an update for the OASIS-C1 implementation.  As StayAlert reviewed in May 7, 2014 the implementation date for OASIS-C, originally scheduled for October 1, 2014 has been postponed. 

The Protecting Access to Medicare Act of 2014 (PAMA) was enacted in April 2014.  PAMA delayed adoption of ICD-10 until at least October 1, 2015.  CMS has determined that the ICD-10 delay will have an impact on the Home Health Quality Reporting Program and more specifically on the implementation of OASIS-C1 because the 5 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."

2. The current version of the OASIS data set (OASIS-C) will remain in effect until 11:59:59 p.m. on 12/31/2014;

3. The OASIS-C1 / ICD-9 Version will go into effect at 12:00 a.m. on 01/01/2015 and shall remain in effect until ICD-10 is implemented or until otherwise determined by CMS. 

B. Conversion to Assessment Submission and Processing (ASAP) System

1. OASIS submissions to the State system will discontinue starting at 6:00 p.m. ET on 12/26/2014. The HHA State submission system will no longer be used for OASIS submissions. New, modification, or inactivation records in the current flat file format must be submitted prior to 6:00 p.m. ET on 12/26/2014.

2. Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the Assessment Submission and Processing system. With the implementation of the OASIS ASAP system, Home Health Agencies will no longer submit OASIS assessment data to CMS via their State databases.

C. Payment Grouper Updates

1. An updated home health payment grouper will be provided to accommodate assessments submitted 10/01/2014 and later using OASIS-C and ICD-9-CM codes;

2. An updated home health payment grouper will be provided to accommodate assessments submitted 01/01/2015 and later using OASIS-C1 and ICD-9-CM codes;

3. At this time, a new home health payment grouper update is not planned until 10/01/2015.

Additionally, on September 3, 2014, CMS's Survey and Certification Group is sponsoring a webinar on "OASIS-C1/ICD-9". The topics of this 1 ½ hour webinar will include:

  • The new OASIS-C1/ICD-9 data set and its implementation, scheduled for January 1, 2015;
  • Types of changes made to the data set;
  • OASIS-C1/ICD-9 Guidance Manual changes; and
  • OASIS Q&As update.

Please see the attached memorandum form CMS for additional information and for webinar call-in instructions.

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Jul 25 2014
Class I Recall - GE Healthcare, LLC - Single-Width Airway Modules (E-MiniC) and Accessories and Extension Modules (N-FC, N-FCREC)

A recall has been issued for the GE Healthcare, LLC, Single-Width Airway Modules (E-MiniC) and Accessories and Extension Modules (N-FC, N-FCREC).  The affected CO2 detectors may fail or provide incorrect CO2 values for mechanically and spontaneous ventilated patients.

  • Manufacturing Dates: February 10, 2012 through October 2, 2012
  • Distribution Dates: February 2012 to April 2014
  • Affected Product Details:
    • Single-Width Airway Modules (E-miniC) -Serial Numbers 6818561 through 6898777.
    • The Extension Modules N-FC and N-FCREC - Serial Numbers 6799191 through 6905206.
    • The serial number can be found on the device plate attached to the module.

 There have no reports of injuries or deaths assocated with the malfunctioned devices to date.

On June 11, 2014, the firm sent an Urgent Medical Devise Correction Letter (see below under Resources) to their customers. The letter identified the affected products, problem and provided safety instructions.  Customers should read the letter and follow the instructions provided. 

For questions about this Recall, customers may contact GE Healthcare Technical Support at 1-800-558-7044, Monday - Friday, 8:00 am  - 5:00 pm, Central Time or the local service representative.

Class I recalls are the most serious type of recall and involve situations in which there is a reasonable probability that use of these products will cause serious adverse health consequences or death.

Health care professionals and consumers may report adverse reactions or quality problems they experienced using these products to MedWatch:  The FDA Safety Informatin and Adverse Event Reporting Program either online, by regular mail or by FAX.

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Jul 23 2014
Updated Guidance from SHEA on Central-Line Associated Blood Stream Infections

The Society for Healthcare Epidemiology of America has issued updated guidance for preventing central line-associated blood stream infections in hospitals.  Published in the July Issue of Infection Control and Hospital Epidemiology, the guidance updates the 2008 "Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals."

The purpose of the guidance document is to provide hospitals with practical recommendations for implementing and prioritizing central line-associated bloodstream infection (CLABSI) prevention efforts.  The recommendations in the guidance focus on central venous catheters (CVCs) and therefore the recommendations may not be effective for preventing bloodstream infections related to other intravascular devices. The guidance reviews both basic recommendations that should be adopted by all acute care hospitals and also specific practices that can be considered when CLABSIs are not controlled by the basic recommendations. 

Today's StayAlert! Notice reviews the basic recommendations. Please review the article for the Special Approaches for preventing CLABSI recommendations.  Basic recommendations include:

Before Insertion:

  • Have an evidence-based list of indications for CVC's readily available
  • Require education for healthcare personnel involved in the insertion, care and maintenance of CVCs.  Education should include CLABSI prevention strategies.
  • Ensure that any healthcare professional who inserts a CVC undergoes a credentialing process (as established by the individual healthcare organization) to ensure their competency before independently inserting a CVC.
  • Bathe all ICU patients over two (2) months of age with a  chlorhexidine preparation on a daily basis

During Insertion:

  • Processes should be in place to ensure infection prevention strategies are adhered to at the time of CVC insertion, i.e., a checklist
  • Hand hygiene must be performed prior to catheter insertion
  • When possible do not use the femoral vein for CVC access in obese adult patients
  • When possible utilize an all-inclusive catheter kit/cart
  • Utilize ultrasound guidance for the insertion of internal jugular catheters
  • Use maximum sterile barrier precautions during CVC insertion
  • Use an alcoholic chlorhexidine antiseptic for skin preparation

After Insertion:

  • Ensure appropriate staffing and limit use of float nurses in ICUs
  • Disinfect catheter hubs, needleless connectors, and injection ports before accessing the CVC
  • Remove all non- essential catheters as soon as possible
  • For non-tunneled CVCs in adults and children, change transparent dressings and perform site care with a chlorhexidine-based antiseptic every 5-7 days or immediately if the dressing is soiled, loose, or damp; change gauze dressings every 2 days or earlier if the dressing is soiled, loose, or damp
  • Replace administration sets not used for blood, blood products, or lipids at intervals not longer than 96 hours
  • Use antimicrobial ointments for hemodialysis catheter-insertion sites
  • Perform surveillance for CLABSI in ICU and non-ICU settings

The Guidance also addresses approaches that should not be considered routine for the prevention of CLABS i.e., systemic antimicrobial prophylaxis and routine catheter replacement are not recommended

Joint Commission National Patient Safety Goal (NPSG.07.04.01) requires hospitals to implement strategies to reduce central line associated blood stream infections.  Guidance such as this update from SHEA is a valuable tool for hospitals as they seek to prevent and decrease CLABSI and meet JTC requirements.

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MCN Healthcare: Policy Library - Customizable Policy Documents Icon

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MCN's NEW Ambulatory Surgical Center/Outpatient Surgery Department Policy and Procedure Manual is cross referenced to TJC standards, AAAHC standards and CMS regulations. Policies and procedures meet AORN and CDC recommendations and guidelines. This comprehensive reference guide has over 290 policies and procedures that are ready to customize to your organization. See also the Administrative Manual for Ambulatory Care Facilities and the Ambulatory Services EOC Manual.

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