Sharon Litwin answers agency questions about clinical documentation improvement

Following a recent DecisionHealth webinar about creating a concurrent review process and improving clinical documentation ahead of the Patient-Driven Groupings Model (PDGM), agencies asked questions of Sharon Litwin, founder and senior managing partner at 5 Star Consultants in Camdenton, Mo. Click here to see!

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Sharon Litwin answers agency questions about clinical documentation improvement

Understanding the Importance of CASPER

The acronym, CASPER, stands for Certification And Survey Provider Enhanced Reports. It is the computer system that compiles the OASIS data of every certified home health agency (HHA), and provides benchmarking information for your HHA’s current metrics against a prior period and national data. The data that is shown on the reports come from the OASIS assessment and is collected from two time-points:

  • Start of Care (SOC) to Discharge (D/C) and
  • Resumption of Care (ROC) to Discharge

Outcome Reports

Several outcome reports are accessible via your state’s Quality Improvement Evaluation System (QIES) website, which is the same one utilized for OASIS submissions.  When reviewing these reports, the bar graph portion is the most meaningful.  It will show your percentages for the current and prior periods as well as for the current national.  It is key to pay attention to asterisks, which designate the statistically significant meaningful data.

The following reports are available:

  • Agency Patient Related Characteristics

This report provides great information on your agency, such as patient demographics, payment sources, number of therapy days, length of patient stay, diagnoses and the results of many M items.  Your risk adjustment is affected by many of the items displayed in this report.It provides very useful information regarding differences between your agency and other HHAs.

  • Risk Adjusted Outcome Report

There are two types of Risk Adjusted Outcome Reports – OASIS based and claims based.  The outcomes from OASIS based are categorized as improvement items, stabilization items and other items.  Outcomes are compared on a bar graph report, providing information on the percentage of patients who improved and/or stabilized in various M items.The Risk Adjusted Outcome Report can provide your HHA a competitive advantage because you can improve in known poor performance areas and demonstrate how your HHA excels over other agencies in your area.

  • Potentially Avoidable Events(PAE) Reports

There are two types of PAE reports -Potentially Avoidable Event Risk Adjusted Report and Potentially Avoidable Event Patient Listing Report.  These reports are an excellent source of information for your QAPI program.  PAEs refer to significant changes in a patient’s clinical condition as demonstrated by emergent care or a patient’s health or general decline.

  • Process Measures Report

This report covers process measures, which are defined as the standards for home health best practices.The report includes your agency’s performance for every measure.  Proper clinical care planning and understanding of OASISM questions relating to the process measure are critical for good performance in the different measures.

How to Effectively Use CASPER Reports

To receive the most out of every CASPER report, someone should be assigned the task of looking into the system monthly for updated versions.  Once the reports are pulled, an analysis of the data should be conducted, focusing on the statistically significant areas.  Once you identify outliers for your HHA, an action plan should be developed for those items and incorporated into your agency’s QAPI program for on-going monitoring.It is essential that the results from these reports and QAPI are shared with all staff, including contracted staff to improve outcomes within the agency.

It is important to keep in mind that all of the information within the CASPER reports originates from what the clinician enters into the OASIS Assessment.  Home Health Compare is a website that publicly displays many of the outcomes from the CASPER reports, which can be found at: The type of information that is displayed on this website and made available to the public offers great marketability for those HHAs with better patient outcomes.This site also enables the public to choose the right quality home health agency that best fits their needs.

We can Help Your Staff with CASPER

CASPER is a key source of information that can help or hurt a home health agency’s reputation.  Our expert teamat 5 Star Consultants offers multiple years of experience working with CASPER and have performed CASPER analysis for agencies throughout the country.  We can help ensure your staf fis knowledgeable about its many reports and the key ways to achieve quality outcomes that are a step above your competition.  To learn more, please contact us at [email protected] or 866-428-4040.

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Southern Web SupportUnderstanding the Importance of CASPER