Home Health & Hospice Week

A new leader soon will take the reins and lead policy-making decisions at the Centers for Medicare & Medicaid Services. President George Bush revealed that he will place Mark McClellan at Medicare's helm to fill the vacancy left after Tom Scully's departure in December. McClellan has served as commissioner of the Food and Drug Administration since 2002. The native Texan has also been Bush's top advisor on health policy as a member of the White House Council of Economic Advisers. Previously at Stanford University, he wore several hats including associate professor, director of the program on health outcomes research, and attending physician for internal medicine at Stanford Health Services. Dr. McClellan holds a BA from the University of Texas, a master's degree from Harvard University, a medical degree from Harvard-MIT Division of Health Sciences and Technology, and a Ph.D. from MIT. Hospices will see the benefit of the Medicare reform law passed in December sooner than they may have thought. Effective Dec. 8, 2003, hospices can contract for core services "in extraordinary, exigent, or other non-routine circumstances," CMS says in a Feb. 12 letter to surveyors (S&C-04-21). The hospice will maintain responsibility for any contracted services, however, CMS stresses. Examples of qualifying circumstances include staffing shortages due to illness and unanticipated high patient loads, says the letter. It's also OK for hospices to contract for highly specialized, infrequently used RN services, the letter adds. But continuous care doesn't qualify as such, CMS warns. Even though the hospice conditions of participation (COPs) haven't been modified yet, surveyors shouldn't cite hospices for these contracting activities allowed by the new law, according to the letter at www.cms.hhs.gov/medicaid/survey-cert/sc0421.pdf. Baltimore-based Johns Hopkins has reached an settlement for undisclosed terms with the parents of a two-year-old home care patient who died as a result of incorrect total parenteral nutrition solution (see Eli's HCW, Vol. XIII, No. 3). And Johns Hopkins is naming a playroom after Brianna Cohen, who died Dec. 4 after potassium levels in the TPN she received from the infusion pharmacy at Johns Hopkins Home Care were four to five times higher than called for, reports the Associated Press. An investigation by Maryland's Office of Health Care Quality found numerous procedural breakdowns at Hopkins Home Care, including inadequate supervision, poor record keeping and failure to adhere to state regulations, AP says. Investigators found 14 medication errors and six delivery "incidents" in 2003 at Hopkins Home Care and concluded "that the follow up actions and plans were inappropriate/ineffective," AP reports. Hopkins says it has put into place "substantive measures" to ensure patient safety. A few long-time fraud hawks want to know why there's no funding increase for the HHS Office of Inspector General in [...]