Home health agencies failed to report over half of falls with major injury and hospitalization among their Medicare patients

Home health agencies failed to report over half of falls with major injury and hospitalization among their Medicare patients

Collection:
Health Policy and Services Research
Series Title(s):
Issue brief (United States. Department of Health and Human Services. Office of Inspector General)
Contributor(s):
United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
Publication:
Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, September 2023
Language(s):
English
Format:
Text
Subject(s):
Accidental Falls
Accidental Injuries
Government Regulation
Home Care Agencies
Hospitalization
Mandatory Reporting
Medicare
Outcome Assessment, Health Care
Public Reporting of Healthcare Data
United States
Genre(s):
Technical Report
Abstract:
Why OIG Did This Review. Starting in 2019, home health agencies (HHAs) were required to report that their patients experienced falls with major injury in patient Outcome Assessment Information Set (OASIS) assessments. The Centers for Medicare & Medicaid Services (CMS) uses this HHA-reported information to calculate major injury fall rates at the agency level. Beginning in 2022, CMS included these fall rates as one of the Care Compare website’s quality measures, which provide consumers with information about HHA performance. OIG and others have found problems with using provider-reported information to assess quality in the past. We conducted this study to determine the extent of falls reporting by HHAs and implications for the accuracy of the falls information on Care Compare. How OIG Did This Review. We identified falls with major injury in Medicare hospital claims for home health patients. Whenever their patients are hospitalized, HHAs must submit an OASIS assessment. We checked whether the falls were reported in those OASIS assessments as required. We calculated non-reporting rates for these falls. We also examined whether reporting rates differed by patient or HHA characteristics, including whether HHAs had low fall rates on Care Compare.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)
Extent:
1 online resource (1 PDF file (31 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918716087806676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918716087806676