OIG questions HHA fall reporting 

WASHINGTON – Over half of the falls among Medicare home health patients hospitalized for falls with major injury were not reported on patient assessments by home health agencies (HHAs) as required, according to a new Office of Inspector General report. Due to this high rate of non-reporting, Care Compare may not provide accurate information about the incidence of these falls, the OIG says. Reporting on OASIS assessments was worse among younger home health patients (compared to older patients) and patients who identified as Black, Hispanic, or Asian (compared to White), the OIG found. Reporting was also lower among for profit HHAs as compared to nonprofit and government-owned agencies. Notably, HHAs with the lowest Care Compare major injury fall rates reported falls less often than HHAs with higher Care Compare fall rates, indicating that Care Compare does not provide the public with accurate information about how often home health patients fell, it says. Finally, for many Medicare home health patients who fell and were hospitalized, there was no OASIS assessment at all associated with the hospitalization, which raises additional concerns about potential noncompliance with data submission requirements and its impact on the accuracy of information about falls with major injury on Care Compare, the OIG says. The OIG recommend that CMS (1) take steps to ensure the completeness and accuracy of the HHA reported OASIS data used to calculate the falls with major injury quality measure; (2) use data sources, in addition to OASIS assessments, to improve the accuracy of the quality measure related to falls with major injury; (3) ensure that HHAs submit required OASIS assessments when their patients are hospitalized; and (4) explore whether improvements to the quality measure related to falls can also be used to improve the accuracy of other home health measures. CMS concurred with all four recommendations.