Volume 4, Number 44 December  16, 2015



Dear Healthcare at Home Colleague,

We make a sincere attempt to balance our news and feature articles between Private Duty and Medicare/Medicaid home healthcare agencies, in order to meet everyone's needs. This week, we focus on a situation that is causing great concern to owners and administrators of certified agencies. Medicare Administrative Contractors have stepped up their efforts to find reasons to deny claims. At the same time Zone Program Integrity Contractors are issuing more ADRs and recouping more payments.

This week, we devote this entire issue to an exploration of the justifications these contractors use for denying and recouping payments, and how agencies make themselves more vulnerable to auditor probes. Essentially, it boils down to documentation that does not demonstrate medical necessity for services performed. This can include both physician and nurse written documents, and it can include homebound status affecting the entire episode as well as treatments and teachings provided at every visit.

We interviewed a number of software company executives to learn about their positions on the issue, not only about how software can help clinicians produce audit-proof documentation but whether such help is the responsibility of home health software vendors at all. You will learn that the entire Medicare improper payment rate is around 12% but that the home health rate is nearly 60%. 

And you will learn that there is not a strong consensus among software company executives about whether home care EMR software can and should help solve this problem. More than ever, we would appreciate your feedback about the three articles in this week's issue. Write to us at editor@homecaretechreport.com.

And don't forget there is still time to register to join me in Orlando at the end of January for the Executive Strategic Summit conducted by the Home Care Sales and Marketing Society. Register here and be sure to use the code HCTECH to get your 15% discount off the registration fee.

Christmas is this Friday and I want to take a moment to wish all my readers the happiest of holiday seasons. Our office will be officially closed now through January 4, but we will respond to emails once a day and return urgent phone calls. Have a terrific holiday week! Keep making a difference!

Editor signature
Tim Rowan



Payment Denial Prevention: What Is Software's Responsibility?
When Medicare contractors deny or recoup payments, where do you direct both blame and solutions, toward your clinicians or toward your software vendor?

CMS Language Most Often Used to Deny Claims
What does CMS have to say? Be familiar with the language MACs and ZPICs use as leverage to deny payments.

Software Features That Empower Clinical Best Practice
The general consensus among software company executives is that their software itself can help clinicians do their job better. We got several of them to tell us specifically what features they believe software should have to play this role.

 
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During the 1st Quarter of 2018, web sites of the above advertisers were visited by home care and hospice executives and staff 2597 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

Last Week's Most-Read Stories:
OCR Audits Coming, Check Your HIPAA Readiness
You have been warned.
 
Sutter Health Acquires Competitor
One of California's largest healthcare at home organizations gets larger.

As of this date, approximately 19,921,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

Home Care Sales & Marketing Society Executive Strategic Summit * Home Care Sales and Marketing Society
January 28-29
Holiday Inn Orlando Downtown Disney
Lake Buena Vista
More information

Leading Change Together
Illinois HomeCare & Hospice Council Annual Meeting and Exposition
March 9-10
Lombard
Information and Registration


ITS' A Whole New Ballgame: 2017 Annual ConferenceMichigan Home Care & Hospice Association

May 3-5
Grand Traverse Resort
Acme, MI
Information and Registration


ICD-10 Coding Conference
Texas Association for Home Care & Hospice

Featuring Lisa Selman-Holman
September 13-14
Westin Galleria
Houston

Receive up to 11 clock or contact hours.

http://tahch.org/tahchorg/education/icd10


Public Policy Leadership Conference
Visiting Nurse Associations of America

Wednesday, September 14 at 8:00 AM through Thursday, September 15 at 3:00 PM
Washington Court Hotel
Washington, DC

More information and registration

 


By the Numbers: ICD-10 Coding Conference
Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston


Information and registration



By the Numbers: ICD-10 Coding Conference

Texas Association for Home Care & Hospice
September 13-14
Westin Galleria Hotel
Houston

Information and registration


HURRICANE Home Care Marketing Boot Camp 2.0 *
October 5-7
Embassy Suites Philadelphia Airport
http://homecaremarketing.net/hurricanebootcamp/

Home Care Sales and Marketing Society *
6th Annual Conference

Learn tactics and techniques for gaining more patients and clients. This year, two breakout tracks: "Field Sales Tactics" and "Internal Operational Excellence: Intake, Admissions and Inquiry."

October 6-7
Bally's Hotel and Casino
Las Vegas
Click here for more information


Annual Meeting *
National Association for Home Care and Hospice

October 23-25
Gaylord Palms Resort and Convention Center
Orlando

Information and Registration


Pre-Claim Revue Implementation
Palmetto GBA and CGS Tours Texas in Partnership with TAHC&H

Multiple Locations:
October 11 – McAllen
October 13 – San Antonio
November 16 – Houston
November 17 – Dallas
Details for each conference


The Journey Forward
South Carolina Home Care & Hospice Association Annual Conference
December 5-6
Hyatt Place + Hyatt House | Historic District
Charleston
www.schchaconferences.com

The 6th Annual Medicare Compliance Cruise *

Presented by Pearson & Bernard, PSC

January 15-22
Departs from Ft. Lauderdale
Information and registration


2017 Northeast Home Health Leadership Summit

Sponsoring Associations:

  • Connecticut Association for Healthcare at Home
  • Home Care and Hospice Alliance of Maine
  • Home Care Alliance of Massachusetts
  • Home Care Association of New Hampshire
  • Home Care and Hospice Association of New Jersey
  • Home Care Association of New York State
  • New York State Association of Health Care Providers
  • Rhode Island Partnership for Home Care
  • VNAs of Vermont

January 17-19, 2017
Colonnade Hotel
Boston

Information and Registration


OASIS-C2: The Next Steps

Texas Association for Home Care & Hospice
Presented by Lisa Selman-Holman
January 19, 2017
Westin Riverwalk Hotel

San Antonio 
Details and registration


Homecare 100 *February 4-7
Ritz-Carlton
Amelia Island, FL
Registration is full. To be added to the waiting list, contact Miriam Adams at madams@lincolnhc.com

National Leadership Conference *
Sponsored by:
Visiting Nurse Associations of America

Alliance for Home Health Quality and Innovation

April 19-21

Hilton San Diego Bayfront
https://www.homebasedcareevents.com/

Omaha System International ConferenceA Key to Practice, Documentation and Information Management
April 20-22, 2017
Eagan, MN
Bi-annual conference offers opportunities to gain knowledge about using electronic health records across diverse settings, exchanging health information, and enabling data sharing among practice, education, and research. For additional information about the conference, the call for poster abstracts and award nominations, and to register, visit www.omahasystem.org/conferences.html.
Email abstracts to lchoromanski@gillettechildrens.com

ATA Annual Meeting

American Telemedicine Association
April 23-25
Orange County Convention Center
Orlando

http://www.ata2017.org


Pediatric Home Care Conference

Texas Association for Home Care & Hospice
May 9
Omni Austin Hotel Southpark

Details and registration


New England Home Care & Hospice Conference & Trade ShowMay 16-18
Radisson Hotel
Manchester, NH
Brochure and Registration

Annual Conference *Home Care Association of Colorado
May 17-19
Keystone Resort & Conference Center
Keystone, CO
http://www.homecareofcolorado.org


Home Health Emergency Preparedness CoP Requirements:
Getting Your Agency Ready

Featuring Mary St. Pierre, RN, BSN, MGA
Free, sponsored by HEALTHCAREfirstSeptember 13

1:00 pm Central Time
Omni Austin Hotel Southpark

Details and registration

http://www.healthcarefirst.com/webinars/

  • Overview of the emergency preparedness requirement
  • What surveyors will be looking for
  • Steps home health agencies should take to prepare

Our Home Care Landscape: Big Challenges, Bigger Opportunities *
Annual Meeting of the Home Care Association of America
October 8-11
Austin, TX
Information and registration

AHHC 2017 Leadership ConferenceAssociation for Home & Hospice Care of North Carolina
October 9-10
Holiday Inn Resort
Wrightsville Beach

Click here to register

*HCTR will see you there.
MHHA Annual Conference

Michigan Home Care & Hospice Association
April 25-26
Amway Grand Plaza
Grand Rapids
Information and Registration


New England Home Care and Hospice 2018 Conference
Presented by Home Care Associations of:
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont


April 25-27
Cliff House Maine Hotel
Cape Neddick

Information and Registration


2018 Annual Conference

AHHC of North Carolina

May 7-9
Sheraton Imperial Hotel & Convention Center

Register


2018 National Leadership Conference

Home Care Association of America

September 22-25
Marriott Wardman Park Hotel
Washington DC

Information for Providers and Exhibitors


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

2017 Regulatory Updates, Including Home Health Conditions of Participation

Free Webinar Hosted by DeVero Software and Relias Learning
Featured Speakers: Michael Tidd, Healthcare Synergy; Robert Love, DeVero
Tuesday, March 21
2:00 pm EDT / 11:00 am PDT

Register Here


Juggling the New CoPs and Other Applicable Laws

Sponsored by Kinnser Software
Featuring Robert W. Markette, Jr., Esq., CHC, of Hall, Render, Killian, Heath & Lyman, P.C.
Thursday, January 25
1:00 - 2:00 pm EDT

Attend to Learn:

  • Why "legal representative" is a concept you should already be familiar with
  • What compliance with the nondiscrimination provision of the Affordable Care Act may mean for the new CoPs
  • Why you must be more aware of harassment issues and prepared to take action
  • How harassment issues affect your discharge policies

Free: Register here



How to be the TOP DOG Sales Rep
Sponsored by PlaymakerCRM
Featuring Cheryl Peltekis, RN
December 14
2:00 EST
Register here


Grow Your Census with Online Marketing Tools

Sponsored by Shoshana Technologies

October 20
http://rosemarksystem.com



Improving CAHPS Response Rates: 2 Free Webinars

Sponsored by HEALTHCAREfirst
Featuring:
Liz Silva, Director of Home Health & Hospice, HEALTHCAREfirst

Hospice CAHPS: Wednesday, May 2
2:00 pm EDT
Free Registration

Home Health HHCAHPS: Thursday, May 10
2:00 pm EDT
Free Registration

With greater visibility into quality through public reporting on Hospice Compare and Home Health Compare, hospice and home health providers have an even greater incentive for performance improvement. During each 45-minute webinar, we will discuss methods and activities that have been instrumental in improving CAHPS survey response rates, a key element of implementing a data-driven approach and improving your scores. To be discussed:

  • Hospice CAHPS Regulations
  • Response Rate Calculation
  • Available Benchmarks
  • Effective Strategies to Improve Response Rates

 



Navigating the Final Rule for Medicare PPS for CY 2017
Sponsored by PPS Plus
Tuesday, November 15, 1:00 - 2:30 pm CST
Featuring Dave Macke, CHFP, FHFMA
Director of Reimbursement Services, VonLehman & Company
FREE

Register here


Are You Marketing to the Wrong Person?
A Different Way to Get Home Health Referrals

Presented by Healthcare Synergy
Featuring: Melinda Rodriguez, PT, DPT, MSCS, LSVT
Date: Wednesday, March 7
Time: 10:00 a.m. PST; 1:00 p.m. EST

In this Webinar, you will:
  • Learn another way to market inpatient facilities other than discharge planners, case managers or social workers.
  • Discuss the role of Home Health in the challenging healthcare environment – Short Term Home health.
  • Describe the Continuum of Care Concept in the post acute care network
  • Identify strategies to reduce risk of acute care readmission.
  • Discuss options for discharge disposition for potential skilled nursing facility candidates to decrease SNF discharge rate for inpatient rehab units.

Register



Why your claims are being denied:  Performing a self-assessment of your ZPIC, Pre-Claims, and VBP liabilities

Featuring Michael McGowan, CEO, OperaCare
Tuesday, January 17
2:00 p.m. EST
Cost:  $79
Register


2017 What You Need to Know about Electronic Visit Verification

EVV offers many benefits to agencies and care providers, and choosing the right solution can lead to improved operating efficiency, caregiver communication, quality of care, and client satisfaction.

Wednesday, March 15
11:00 am MST - 12:15 pm MST

Register Here



How to Attract and Retain Health System Relationships

Presented by Netsmart
Ongoing
Free
Watch now

 


Under Pressure — OASIS Service Utilization Review

Presented by Michael McGowan of OperaCare
Thursday, April 6
12:00 p.m. EDT
Cost: $49
Registration



What You Need To Know About Electronic Visit Verification
Presented by Darby Anderson, CDO, Addus HomeCare Corporation
Sponsored by CellTrak
Wednesday, April 12
1:00 p.m. EDT
Cost:  Complimentary
Registration link
 


Understanding the Effect Functional Scoring Has on Your Agency
Presented by Chad Whitefield, PTA, Managing Partner of Advance Rehabilitation Management Group
Thursday, April 13
2:00 p.m. EST
Cost:  $99
Registration link 


Increase Referrals, not Overhead- Streamlining the Intake Experience

A streamlined, efficient intake process creates a better patient experience and improves referral relationships. During this webinar, industry experts will share their quick tips and best practices for improving your intake process and managing your organization's revenue cycle.

Sponsored by Forcura
Featuring: Craig Mandeville, Founder & CEO of Forcura Jessica Stover, Senior Manager of Blacktree Healthcare Consulting
Tuesday, Oct 3
2:00 pm EDT

Registration


QAPI Overview

Presented by Diane Link, BlackTree Healthcare Consulting
Tuesday, May 23rd
2:00 p.m. EST
Cost:  $99
Registration


Good Ways to Break Bad News: Social Worker Edition

Presented by Curaport
Featuring:
Heather Calhoun, RN, BSN, COS-C, HSC-D

Date: Tuesday, May 1 
Time: 2:00 p.m. EDT

Fee: $79
Information & Registration

*This education session is pending approval from the National Association of Social Workers for one (1) contact hour of Continuing Education for Social Workers.

 

 

 



Clinical Impact of OASIS-D

Presented by HEALTHCAREfirst

Featuring:

Deanna Loftus, HEALTHCAREfirst Director of Regulatory Compliance
Mary St. Pierre, RN, BSN, MGA, Regulatory Consultant

Tuesday, May 1
2:00 pm EDT

Free Registration

In March 2018, CMS released the draft of the latest version of the OASIS data set, OASIS-D. Modifications are being made to OASIS in order to comply with the IMPACT Act, to reduce data collection burden, and to improve formatting throughout the document. CMS is seeking approval from the Office of Management and Budget for a January 1, 2019 implementation date. Topics:

  • Addition of six new standardized items
  • The removal of 28 OASIS questions that will no longer be assessed.
  • Modification to M1311 to support a new standardized pressure ulcer measure.
  • Addition of responses to M1028, M1311, M2102 and removal of responses to M2310.
  • Review of additional changes to OASIS

 



The Penalty Box Compliance Series
Part 7: Audit-Proof Your Visit Notes

Presented by Curaport

Featuring: Kristi Bajer, RN, MSN

Wednesday, April 18
1:00 p.m. EDT
$39

Information and registration

Description: An auditor shows up on your doorstep and fear sets into your agency.  You have worked hard to be compliant, but you still have several days of anxiety until the auditor pronounces you have passed and are deficiency free!   Everyone celebrates.  The next day you receive 20 audits from CMS. Don't let this happen to you and your agency!  Learn from the compliance experts at OperaCare how to ensure compliance with the new CoP's. This education session in part 7 of the Penalty Box Compliance Series.

*This education session is approved for one (1) contact hour of Continuing Education.

 

 

 





What Does Behavioral Health Have to do With Home Health Outcomes?

Presented by: Netsmart/DeVero
Featuring: Katherine J. Vanderhorst ,RN-BC,BSN and Dr. Amy Craven

Thursday, February 22
2:00 p.m. Eastern
Learn why integrating behavioral health with chronic care management can improve star ratings.

Many home health patients have co-existing Chronic Behavioral Health problems that are not dealt with. If not addressed, problems like anxiety and depression leave patients unable to self-manage diabetes, congestive heart failure, CHF, COPD and other serious medical conditions. This presentation will show why recognizing and managing behavioral health diagnoses and can have a positive outcome on your agency’s STAR ratings. Presented by Katherine J. Vanderhorst ,RN-BC,BSN and Dr. Amy Craven.

Registration



The Penalty Box Compliance Series Part 6: Audit-Proof Your Visit Notes

Presented by Curaport
Featuring Kristi Bajer, RN, MSN

Wednesday, March 21
1:00 p.m. EDT
$39

Information and registration

*This education session is approved for one (1) contact hour of Continuing Education for Nursing


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

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Home Care Technology Report is published by Rowan Consulting Associations, Inc., Colorado Springs, CO. All rights reserved. Request reprint permission by writing to editor@homecaretechreport.com.

HCTR is free to subscribers and supported by its generous advertisers. To inquire about presenting your message to our 5,000 subscribers, write to Kristin in our ad sales department, Kristin@RowanResources.com.