Legislative Update: November 26, 2019

VNAA Launches Two Best Practice Modules on Blueprint for Excellence! VNAA work groups have just completed two new modules of the Blueprint for Excellence,Home Healthcare Worker Safety’ and ‘Registered Nurse Orientation Pathway.’ The Blueprint for Excellence is a widely recognized online tool created by leaders in home health and hospice to guide adoption of clinical and operational best practices. VNAA’s best practice recommendations on Home Healthcare Worker Safety are paired with online tools and resources to support agencies with improvement. VNAA’s recommendations include proactively using data on workers’ risk; implementing policy and procedure for reporting and preventing risk to workers and patients; developing protocols for reducing risks in the home environment; regular training for staff including using scenarios or role playing on de-escalating risky situations; and identifying community resources to support patients. The VNAA Registered Nurse Orientation Pathway bolsters recruitment and retention in the RN workforce. The module offers best practice recommendations and a 4-part orientation tool. The customizable tool includes checklists to guide orientation experiences for new nurses, skills needed for independent care delivery in the home, home care standards of care, and collaborative nurse coaching documentation. VNAA is hosting free webinars December 3 (worker safety) and December 19 (RN orientation). Visit the Blueprint for Excellence here and sign up for webinars here.
Federal Office of the Inspector General Issues Another Hospice Report.  A new HHS OIG report was released November 18, 2019 entitled "Registered Nurses Did Not Always Visit Medicare Beneficiaries’ Homes at Least Once Every 14 Days to Assess the Quality of Care and Services Provided by Hospice Aides." The OIG found that registered nurses (RN) did not always make or document hospice visits in accordance with Federal requirements. The OIG concluded that as a result, there was no assurance that beneficiaries admitted to those hospices received the appropriate care. The OIG recommended that CMS promote hospices' compliance with the condition-of-participation standard on RN visits, which could include working with State survey agencies and accreditation organizations to increase emphasis on oversight of this requirement, educating hospices about the requirements associated with this standard, and making this standard a quality measure.  The OIG report comes on the heels of an October report by the Government Accountability Office (GAO), “ Medicare Hospice Care: Opportunities Exist to Strengthen CMS Oversight of Hospice Providers” which found higher rates of discharge alive and lack of visits in the last days of life among for-profit hospices. LeadingAge staff will continue to engage with CMS on behalf of VNAA/ElevatingHome. Contact Mollie Gurian for more information.

Opportunity to Join VNAA Clinical Committee: In keeping with VNAA’s tradition of promoting collaborative improvement in home health and hospice practice, VNAA is convening a Clinical Committee; senior clinical leaders of VNAA/ElevatingHome member organizations are invited to join. The Committee is a forum for home health and hospice member to engage in dialogue, problem solve, and share effective strategies. It is co-chaired by Kathy Peirce President, Executive Director, and Chief Nursing Officer of VNA of Care New England and Lynda Tanner, President and CEO, Visiting Nurse & Hospice. The Committee will set clinical goals for VNAA, provide insights on members’ educational needs, clinical policy and quality issues, and oversee special projects. The Committee will meet monthly by video-enabled conference call for a facilitated discussion.  For information or to volunteer, contact Liza Greenberg, RN, MPH, Senior Clinical Consultant

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