Volume 8, Number 40 January  16, 2019



Dear Healthcare at Home Colleague,

Isn't it fascinating to watch different judges come to different conclusions when faced with nearly the same case? In a recent issue, we reprinted (with permission) a report from home care attorney Elizabeth Hogue about a court case that declared CMS may hang on to your money during the appeals process, even if that process takes three to five years. This week, Ms. Hogue is back with another case from a different district that concluded exactly the opposite. This more reasonable judge said it is crazy to recoup and hold payments until the ALJ court decides an appeal when the ALJ system is backlogged for years. With attorney Hogue's assistance, we will continue to report on the developments in this case for you. Pay attention to her warning at the end of the article. The only problem is that I'm not sure we publish often enough to keep up with all the various court decisions.

In other news:
Clinicians with both skilled and non-skilled providers should be captivated by the new research we were alerted to by Wellpepper, a mobile technology company with a physical therapy telehealth app. Both Boston and Harvard Universities wanted to know whether an app could encourage people with Parkinson's Disease and others prone to falls to maintain their exercise routine. The studies are ongoing but preliminary results are promising. When you read it, think in terms of ways to adapt to Home Health PDGM, Medicare Advantage in Private Duty, and the need to maintain 5-star patient outcomes with fewer in-person visits.

We continue to parse our software implementation satisfaction survey results with two articles this week. In "Is There Really No ROI?" staff writer Darcey Trescone brings her years of implementation experience to bear to survey responses to questions about ROI expectations vs. reality. She supplements that analysis with insights into innovations that software developers bring to their products. Take a look and consider your stance on Darcey's definition of evolutionary innovation and revolutionary innovation. Which type helps EMR software customers, which harms?

As you read this, I am delivering a presentation at the 8th annual Compliance Cruise on new technologies that help home health agencies with regulatory compliance. This annual conference is an in-depth educational experience organized by home care attorneys Lucian Bernard and Liz Pearson. I'll come back with a full report on what we learn.

Have a great week. Keep making a difference!


Editor signature
Tim Rowan



Preventing Recoupment - Appeal, Appeal, Appeal!
The U.S. District Court for the Southern District of Texas ruled that CMS could not recoup monies until after Administrative Law Judge hearings have been held.

Is There Really No ROI?
EMR ROI requires measurement, monitoring and agency effort to be achieved.

Innovation: Why it is Important to Understand
Will your vendor's planned product roadmap innovation support your agencies needs?

Two Universities Find Mobile Digital Interventions Inspire People With Parkinson's Disease
Boston University Center for Neurorehabilitation and Harvard University release findings from studies on the effectiveness of in-home, mobile-device directed physical therapy exercises.

Vendor Watch
— AxisCare releases offline version of "Caregiver GPS" mobile app

 
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During the 3rd Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 2767 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

Last Week's Most-Read Stories:
BREAKING NEWS: CMS Creates New Cause for Payment Denials
Plan of Care is now not only a Condition of Participation but also a Condition of Payment. Failure to include will result in payment denial.
 
So How Are We Doing? Agencies Report on EMR Satisfaction
Are home health, home care, and hospice agencies satisfied with the EMR systems in our industry? We asked them.

As of this date, approximately 32,318,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

National Healthcare CNO/CMO/Informatics Summit

Presented by Marcus Evans Events

Date: March 18-19, 2019
Location: The Langham Huntington, Pasadena, Los Angeles, CA

The Healthcare Summits are the premium forums bringing senior level medical executives and solution providers together. The one-on-one business meetings provide access to senior medical executives within the largest healthcare organizations across the United States. A thorough selection process ensures a qualified audience, which grants unparalleled business and networking opportunities in a luxurious and stimulating environment.
Information and registration

 


2019 Omaha System International Conference: A Key to Practice, Documentation, and Information Management

Date: April 3-5, 2019
Location: Eagan, Minnesota
Fees: Pre-Conference (1 day): $165
Conference (2 days): $335
Pre-conference and Conference (all 3 days): $500

Registration and Information
The Omaha System International Conference is held every two years as a venue for those in practice, education, research, and software development to exchange experiences. There is something for everyone involved with the Omaha System, from beginners to experts to everyone in between. Joyce Sensmeier, HIMSS is the keynote speaker, and The University of Texas at Austin School of Nursing is the school host. The 2019 PDF flier includes location and registration information, speaker/planner list, agenda, exhibitors, and more.

National Healthcare CXO Summit

Presented by Marcus Evans Events


Date: May 19-21
Location: Eau Palm Beach Resort

Keynote Presenters: Susan Blumenthal, past US Assistant Surgeon General; Nicholas Webb, Healthcare Futurist

Registration Information

The National Healthcare CXO Summit is the premium forum bringing senior level healthcare executives and solution providers together. As an invitation-only event, taking place behind closed doors, the Summit offers an intimate environment for a focused discussion of key new drivers shaping the healthcare industry.


WEBINAR: 5 Crucial Ways to Prepare for PDGM

Sponsored by: HealthCare Synergy

Featuring: Michael Tidd, LVN, COS-C, COS-D
Dates: November 13
Time:
10:00 am PST / 1:00 am EST

Information and Registration

Agencies are rapidly trying to prepare for the PDGM payment model. We will show you the most crucial ways an agency can prepare for the internal changes needed for PDGM. While most agencies are focusing on how to instruct clinicians on the change, PDGM has the most impact on office functions. Attend and gain insight on the things the agency needs to be doing now to prepare for January 1, 2020.

Objectives:
1. Learn agency level changes that can be implemented to be successful in 2020
2. Understand how to approach budgeting and finances under PDGM
3. What do your clinicians really need to know to ensure the agencies continued success

Michael Tidd has over 19 years of experience in the Home Care Industry and is a frequent speaker at HealthCare Synergy Workshops and Webinars. He is a Software Developer, LVN and Certified in ICD-9/10 Coding and OASIS (COS-C, HCS-D). As the Clinical Manager for HealthCare Synergy, he directs the Outsourced Management Services, assists in directing the development of the Healthcare Assistant Web Edition, oversees the Clinical Documentation Auditing provided to clients and directs the Clinical Form Development for the Healthcare Assistant Web Edition. Michael continues to educate agencies in the ongoing regulations that CMS produces, the proper application of the Medicare Conditions of Participation and completing timely, accurate and defendable clinical documentation to survive in the current Medicare Reimbursement Model.


Webinar: Post-Acute Care Quality Reporting Programs

Presented by: CMS

Date: Thursday, November 14

Time: 2:00 - 3:00 pm EST

Fee: Free

Description: The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar for Medicare-certified hospice providers to provide an overview on Hospital Quality Reporting Program (HQRP) requirements.

During this webinar, CMS subject matter experts will provide information on the following topics:

  • Hospice Item Set (HIS) reporting requirements;
  • HQRP compliance cycle;
  • How to achieve hospice compliance;
  • CAHPs survey requirements; and
  • How to switch CAHPS survey research vendors.

CMS will answer questions at the end of the webinar as time permits.

Register

Free Webinar: Your path to 99 - An Actionable Webinar on Achieving 99% Claims Reimbursement

Presented by: Complia Health

Date: November 13, 2019

Time: 1:30 PM EST

Reserve Your Webinar Seat

Billing is complex. Improving your billing and claims filing process doesn't have to be.

Getting on the path to a 99% claims acceptance rate can be simple, but the key is in understanding, and then overcoming, the common pitfalls that create problems for home health care agencies in the first place.

Join industry expert Scott Brashears to learn how to better identify potential problems in your agency processes and get the insights into solving for more accurate and timely filings that will put your agency on the path to 99.



Conference: Two Sales Training Boot Camps: Home Health and Hospice & Palliative Care

Presented by Healthcare Strategica, LLC

Featuring: Michael Ferris
Location: Westin Lake Las Vegas Resort

Bootcamp 1: PDGM Home Health Sales
Date: November 12-13

Bootcamp 2: Hospice & Palliative Care Sales
Date: November 14-15


Register with code "HCTR" for $100 off.

Michael Ferris brings 20+ years of experience to your sales team!

Home Health Sales Training Bootcamp

The Home Health Sales Training Bootcamp has an extensive training related to Success Under PDGM.  We will cover what the Sales Professionals need to know about PDGM and more importantly what the referral partners need to know!  How to have those conversations to drive more referrals and avoid the pitfalls experienced by hospices when "failure to thrive" was no longer an acceptable primary diagnosis to qualify for hospice services.

Hospice Sales Training Bootcamp

The Hospice and Palliative Care Sales Training Bootcamp is new and improved with the best of class sales training for hospice with the addition of How to Conduct Family / Patient Meetings for Maximum Success and How to Sell Palliative Care.  Send your Hospice Sales Representatives to us and we will send them back to you ready to drive significant incremental growth in quality admissions.

Each Sales Professional Will Receive:

  • Class Workbook
  • Laminated Field Cards
  • Copy of Definitive Guide to Home Health Sales: Achieve Superstar Success - PDGM Success Edition ($79 value)
  • One on one coaching
  • 90-day sales campaign planning tool
  • Lunch each day

Conference: Successful Hospice Transformation

Hosted Dixon Healthcare Solutions, Inc.

Date: December 5-6
Location
: Bally's, Las Vegas
Time: 7:00 am - 4:00 pm
Speakers: Richard K. Dixon, Cheryl Peltekis, RN, Meaghan McCormick, Esq., Donna Floyd, RN, BSN, Annette Lee, RN, MS, HCS-D, COS-C; Cory Mertz, managing partner for a leading healthcare M&A firm.

Information and Registration

Approved for up to 10 hours of Continuing Nursing Education by Corexcel, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation.

 


Conference: Successful Home Health Transformation

Hosted Dixon Healthcare Solutions, Inc.

Date: December 5-6
Location
: Bally's, Las Vegas
Time: 7:00 am - 4:00 pm
Speakers: Richard K. Dixon, Cheryl Peltekis, RN, Meaghan McCormick, Esq., Donna Floyd, RN, BSN, J'non Griffin, RN, MHA, HCS-D, BCCH-C, COS-C, WCC; Annette Lee, RN, MS, HCS-D, COS-C; Cory Mertz, managing partner for a leading healthcare M&A firm.

Information and Registration

Approved for up to 10 hours of Continuing Nursing Education by Corexcel, an accredited provider by the American Nurses Credentialing Center's Commission on Accreditation.

 


Seminars: PDGM Success Seminars hosted by Axxess *
Sponsored by: BKD, Aegis Therapies, HealthCare ConsultLink, Home Health Care News, Gateway Home Health Coding and Consulting, Worldview, Connected Home Living, Laengrich Healthcare Partners and Swift Medical

Dates and Locations (open to all Home Care providers):
  • Dallas, TX Tuesday, September 24
  • Houston, TX Thursday, September 26
  • Boston, MA Tuesday, November 5
  • Fort Lauderdale, FL Thursday, November 14
  • Chicago, IL Tuesday, October 22
  • Columbus, OH Thursday, November 12
  • Las Vegas, NV Friday, October 4
  • McAllen, TX Tuesday, December 3
  • San Antonio, TX Thursday, December 5
Information and Registration (early bird discount code: Axxess2020)
The one-day seminars will focus on the following learning objectives:
  • The PDGM impact numbers that matter most, along with operational strategies to ensure proper reimbursement                   
  • Specific actions to take for each PDGM risk factor, including coding, non-groupable diagnoses, LUPA avoidance and management, chronic care management, and therapy management
  • How to drive growth for your organization through institutional referral strategies and the use of specialty programs, including wound care and complex nursing
Including specifics such as:
  • How to get the most important OASIS information you need in five minutes
  • Implementing maintenance therapy programs and telemonitoring
  • Setting up visit schedules that prevent avoidable LUPAs 
  • How each component of PDGM builds the case weight 
  • Restructuring intake processes to obtain necessary billing information

WEBINAR: Manage Intake Orders with WellSky + Forcura

Date: December 5
Time: 1:00 pm - 2:00 pm EST

Information and registration

Jonathan Fluhart, Intrepid USA VP of Technology & Process Excellence and Windy Adams, Forcura Director of Strategic Partnerships, will share how the WellSky and Forcura workflow solution is enabling Intrepid USA to:

  • Go 100% paperless by digitizing all faxes and eliminating manual document scanning
  • Streamline intake documentation by driving referrals, authorizations and labs to one centralized location
  • Instantly reconcile signed orders and notifications that documents are ready for approval and billing

 

WEBINAR: PDGM Preparation: Operational Strategies

Sponsored by Kornetti & Krafft Health Care Solutions & MedBridge

Date: December 5
Time: 1:00 pm EST

Information and Registration

Knowing that resources are tight as PDGM approaches, Kornetti & Krafft is offering a free overview of OASIS D1 to ensure that changes to this critical data collection instrument do not get lost in the shuffle.

What is Included:

  • Highlight key differences between OASIS D and D1
  • Make an informed decision about the use of "=" as a response
  • As an outsourced OASIS/Coding company, the most commonly seen OASIS errors and proven strategies for success will be included.

 


Seminar: "COM-CARE-CON" First Annual Technology Deep Dive

Sponsored by: Ohio Council for Home Care & Hospice

Date:
December 12
Time: 9:00 am - 5:00 pm
Location: Crown Plaza North, Columbus

Information and Registration
Com-Care-Con is a one-day conference that will highlight new technologies in the Home Care and Hospice Industries with speakers, exhibitors, and demonstrations of new technologies.

Speakers:

Tim Rowan - Keynote
Healthcare Advisory Network discussing Telehealth
Medline discussing AI in Wound Care
Complia discussing Alternative EVV

FREE WEBINAR: Quarterly Home Health Topics Discussion: The Truth about PDGM Reimbursement

Sponsored by: Healthcare Synergy

Date: December 18

Presented by: Michael Tidd, LVN, COS-C, COS-D

Information and Registration


Conference: The 17th Annual World Health Care Congress

17 Years of Empowering and Connecting Leaders in Health Care Transformation

Date: March 29-April 1, 2020
Location
: Washington, DC

Information and Registration

It’s never too soon to begin planning your experience at the 2020 World Health Care Congress. View the agenda snapshot and gain access to 100+ sessions across 15+ learning tracks:

  • Payer Transformation
  • Member Engagement and Retention
  • Provider Transformation
  • Care Delivery Integration
  • Medicaid & Health Policy
  • Behavioral Health - NEW IN 2020!
  • SDoH Business Strategy
  • SDoH Tech
  • Pop Health Analytics
  • AI & ML Applications - NEW IN 2020!
  • Innovation & Investments
  • Front Line Leadership
  • Women Leaders in Health Care
  • Self-Insurance Strategy
  • Worksite Clinics
  • Direct Contracting
  • Workplace Mental Health
  • Benefits Adviser Leadership
  • Medical Travel


*The Rowan Report will see you there.

Your state or national association meeting not listed? Send the details to Conferences@RowanResources.com using this format:

Conference Title
Sponsoring Association
Date(s)
Hotel or Conference Center, City, State
URL

Navigating the Hospice Cost Report

Sponsored by: ElevatingHOME

Date: February 19, 2019
Time: 12:00pm EST
Fee: FREE

Register Now

CMS has stated that 66% of the cost reports previously filed should not have been accepted and will now be subject to more strenuous requirements. The cost reports will be used by CMS to recalibrate and adjust the hospice daily payment rates.

Join Elevating Home for this webinar as Tom Boyd, Vice President of Reimbursable Services with Simione Healthcare Consultants discusses what is new and help participants identify and understand the requirements for the completion of the Medicare Hospice cost report.



 

The Hospice Cost Report: A Requirement & A Management Tool

Presented by: Tom Boyd, MBA, CFE, CHFP, Vice President of Reimbursable Services, Simione Healthcare Consultants

Date: February 14
Time: 2:00 - 3:00 EST
Fee: FREE

Register now

Join Simione Healthcare Consultants for an overview of hospice cost reporting and ways to make sense of all the required information to support timely, accurate and affordable filing. A Simione cost report is backed by our longstanding experience with reimbursement and government reporting. Discover the difference and get the bigger picture on your hospice finances!



Interoperability for Service Providers through CMS’s EMDI Initiative

Presented by: ElevatingHOME and VNAA

Featuring: Pallavi Talekar, Project Manager, Scope Infotech, Inc.; Ray Wilkerson, Sr. Business Analyst, Scope Infotech, Inc.; Nandini Ganguly, Business Analyst, Scope Infotech, Inc.; Kishan Patel Business Analyst, Scope Infotech, Inc.; Briana Barnes, Project Coordinator, Scope Infotech, Inc.

Date: Tuesday, July 30
Time:
12:00 pm EDT
Fee:
Free to ElevatingHome, VNAA, and Alliance for Home Health Quality Improvement members

Registration

Representatives from the EMDI Initiative team will discuss interoperability using health IT standards, including Fast Healthcare Interoperability Resources (FHIR). Participants will learn about pilot opportunities with CMS to enhance provider workflow using three critical use cases. Participants will:
  • Gain knowledge of interoperability concepts and use of latest standards, including FHIR;
  • Gather information on three critical use cases in the post-acute care setting to reduce provider burden and enhance their interoperability footprint; and
  • Identify next steps for participation in an upcoming pilot opportunity with CMS.


Learning Series Webinar: Million Hearts®2022 & Related Medicare-Covered Preventive Services 
CMS National Training Program

Date: February 14, 2019
Time: 1:00 - 2:30 EST
Fee: FREE

Register now

This webinar provides an overview of:

  • National Initiative—Million Hearts® 2022
  • Heart Disease and Stroke in the U.S.
  • Medicare-Covered Preventive Services Related to Heart Health

 



Security Risk Assessment Tool Overview and User Feedback Session

Presented by: CMS

Date: Wednesday July 17

Time: 1:00 pm EDT

Fee: Free

ONC and the HHS Office for Civil Rights are holding a training session and overview of the Security Risk Assessment (SRA) Tool. The tool is designed to assist small to medium providers in conducting an internal security risk assessment. This assessment will aid providers with their security risk analysis as required by the HIPAA Security Rule and the CMS EHR Incentive program. Following the webinar, participants will have the opportunity to ask questions and provide feedback.
 
Register


PDGM’s Behavioral Adjustments - What You Need to Know Now

Sponsored by eSolutions

Featuring: Karri Wright, Sr. Director, Product Management at Homecare Homebase

Date: Thursday, August 29
Time: 2:00 pm CDT
Fee: Free

REGISTER NOW

The webinar covers:

  • CMS assumptions and intended adjustments and their impact on:
    • Upcoding
    • Comorbidities
    • LUPA Avoidance
  • Considerations for HHAs
  • Evaluating your HHA data now to assess tomorrow based on today’s reality


A QUALITY JOB: Clinical Management & Care Coordination Under PDGM

Hosted by VNAA
Sponsored by MatrixCare/Brightree
Presented by Simione Healthcare Consultants

Featuring: Laura Wilson, RN, BSN, Sr. Manager, Simione Healthcare Consultants
Date: Wednesday, September 11
Time: 12:00 pm EDT

Free Registration

PDGM is so much more than a billing change! Home health agencies preparing for payment reform need to look closely at clinical operations to make accommodations that will uphold quality, including care alternatives that add value to the equation. In this webinar, we’ll share insights based on the findings of gap analyses to help your organization make a successful transition under the new requirements. Recommended Attendees: Clinical Managers, Intake Staff, Coders / QA, Finance & Billing personnel Hosted by VNAA, sponsored by MatrixCare/Brightree, presented by Simione Healthcare Consultants



Hospice compliance 2019: confronting a surprising new survey focus
Sponsored by: Wellsky
Featuring: Robert Markette, esq.
Date: March 14
Time: Noon CDT
Fee: None
Hospice providers today are confronting a new and unexpected survey focus. Hospice surveyors are increasingly focused on issues relating to hospice administration. This administrative focus includes topics such as your hospice’s corporate structure, the relationship between your hospice’s parent office and its multiple locations, and the role and job title of your administrator. Hospice providers who have been successfully operating for years are suddenly finding themselves hit with condition level citations. How will your hospice team adapt to the major survey focus of 2019? Join renowned hospice attorney Robert W. Markette of Hall, Render, Killian, Heath & Lyman, P.C. for an exclusive webinar that will prepare you and your team for the major survey focus of 2019.

Information and registration

Attend and learn:
Why a poorly drafted organizational chart can be a significant problem for your hospice
What hospice surveyors are looking for in the relationship between your hospice’s parent office and its multiple locations
Why calling your administrator something other than “administrator” could be a survey issue


Webinar hosts, send your announcements to: Conferences@RowanResources.com

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