[3745] Clinical Documentation Improvement (CDI) - Implementation for Home Health & Hospice
Describes the process for setting up a CDI in your agency to improve multiple aspects of your agency's operation.
Presentation Info:
- TAHC&H Event | Winter Conference | Recorded for On-Demand Access
- Presentation Date | February 9, 2023
Program Description: CDI is rapidly making its way into the home health and hospice industry! The onslaught of medical reviews resulting in denial of
payment, significant overpayments, and even suspension of payments has pointed out one clear fact - a Clinical Documentation Improvement Program is tantamount to survival. The name is new;
the process is not. Agencies have been doing many pieces of CDI for years but have failed to formalize it into a robust CDI Program. Improving documentation to support skilled need,
coding, outcomes, quality initiatives, reimbursement is ongoing and is distributed among many roles in the office. But the time to formalize the program is NOW!
This presentation describes the process for setting up a CDI in your agency with the purpose being to improve patient outcomes, prevent denials, maintain survey readiness, improve the
integrity of documentation and coding process to ensure accurate reimbursement, protect the agency from liability and claims errors, improve Agency Star Ratings,
Value Based Purchasing Outcomes, and CAHPS while maintaining peace of mind in the agency's overall operation. CDI can be a part of the QAPI program, but
CDI goes beyond the QAPI program involving metrics, financials and operations in addition to clinical functions tracked in QAPI.
HCSSA Topic(s) Addressed:
- §558.259[d][4]agency responsibilities
- §558.260[a][3]basic principles of management in a licensed health-related setting
- §558.260[a][5]quality improvement
- §558.260[a][7]financial management
Education-Training Credits:
- TX HCSSA Administrator/Alternate Continuing Education
- Continuing Education for Nurses
- 1.5 Contact Hr(s)
- This program awards CNE until 02.09.2025
Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.
Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses
Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151
Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation.
Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.”
Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use
their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence
of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the
education activity. The toll free number is 1(866) 262-9730.
TAHC&H Faculty/Presenter(s): M Jan Spears, CPCO, MJS & Associates, LLC
About the Presenter(s):
Jan Spears is Co-owner and Chief Executive Officer of MJS & Associates, LLC. She has more than 35 years’ experience in
health care administration and regulatory and reimbursement areas of practice. Ms. Spears has owned and operated a multimillion dollar home health care company as well as consulted for more
than 300 homecare providers in 25 states in the past 20 years. Ms. Spears has successfully merged clinical and financial strategies into successful operational plans for numerous
providers nationwide. She serves as a Medicare coverage expert for health care facilities who are undergoing audits by federal contractors through all levels of appeals. Since
2015, Spears has also provided testimony as a Medicare reimbursement and billing expert at criminal trials for physicians, home health and other provider types involved in
Medicare fraud litigation, including the largest physician fraud case in U.S. history. She has authored several publications including most recently the development of
process and forms for complying with upcoming pre-claim review initiatives. Always the advocate for home health and hospice and as a certified educator in the state,
Spears is a frequent guest speaker at stakeholder association meetings in Texas and surrounding states where she provides practical guidance to people in the
trenches of the health care.
[3745] Clinical Documentation Improvement (CDI) - Implementation for Home Health & Hospice
