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The Ohio Department of Aging

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May 2011

Pilot computer system streamlines admissions to nursing homes from hospitals
Long-term care consumers will be better served, while state and local resources are maximized

The Ohio Department of Aging is working with the Central Ohio Area Agency on Aging, Riverside and Dublin Methodist Hospitals, approximately 50 nursing homes in the Central Ohio area and state agencies to develop HENS a new, web-based application that will streamline the way hospitals, nursing facilities and PAAs communicate. The Hospital Exemption Notification System, or HENS, allows for the paperless transmittal of information required to adequately track individuals who are discharged from a hospital into a nursing home.

HENS computer system

By law, any individual who is to be admitted to a Medicaid-certified nursing facility must undergo a pre-admission screening and resident review (PASRR). The PASRR screening helps to prevent an individual with special needs, such as mental health issues, from being placed long-term in a nursing home setting if they cannot be adequately cared for there. Prior to December 2009, a hospital only had to send documentation to a nursing facility certifying that it had met the requirements of the PASRR hospital exemption provision. This was generally documented on the hospital's usual discharge paperwork and sent directly to the nursing facility. Often, however, these discharges were not reported to the PASSPORT Administrative Agency (PAA) unless the consumers sought Medicaid payment for the nursing home stay. As a result, the state was unable to effectively track and identify these individuals as required by federal law, nor could we provide adequate education and information to help them make informed choices about their care options.

Currently, the state requires hospitals to complete the hospital exemption form, signed by a physician and send it to the nursing facility, with a copy to the PAA. Hospitals typically fax the form to both places at once. Staff at the PAA review the form to determine whether follow-up contact may be appropriate to explore care options, and then must manually enter the information into the state's computer system, a labor-intensive process.

HENS allows hospitals to complete the hospital exemption form on-line and send it electronically to the nursing home and the PAA. The system meets federal electronic certification requirements, eliminating the need for a physician's signature. The information then is easily uploaded into the state's computer system. Answers to three key questions in HENS will automatically refer the form to either the Ohio Department of Mental Health or the Department of Developmental Disabilities to determine if follow-up contact with the individual is needed or desired.

HENS is part of the state's ongoing efforts to identify and eliminate inefficiencies and unnecessary costs in the state's Medicaid program. Department of Aging staff developed HENS to free administrative staff time and resources that can be better used for other functions. Participants in the HENS pilot have reported that they like its simplicity and ease of use, and agree that it streamlines the process for sharing notification information among multiple partners. Further testing and refinement is needed before it can be implemented statewide, but HENS shows promise as one tool to help transform Ohio's long-term care system into one that helps Ohioans access the care they need in the settings they prefer, and at the best price for them and state taxpayers.

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Aging Eye Summit: Focus on Age-Related Macular Degeneration - June 16, 2011
Register for the free Aging Eye Summit: Focus on Age-Related Macular Degeneration (), Thursday, June 16 at The Ohio State University Havener Eye Institute, Columbus, OH. Participants will discuss the early detection, prevention and treatment of age-related macular degeneration (AMD), how to raise awareness among key stakeholders and decision-makers, how to develop collaborations to meet the increased demands for services and how to foster vision research in Ohio.


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