Volume 8, Number 43 May  29, 2019




Dear Healthcare at Home Colleague,

Our lead news story this week concerns an investigative finding by the HHS Office of Inspector General that extrapolated a $55,000 overpayment into a $7.5 million repayment demand. You will want to read how the accused Illinois HHA is fighting back in court. Many agencies hit with unreasonable overpayment demands have chosen the Chapter 11 route and closed their doors. Click below on "OIG Uses Homebound Status and Skilled Care Need to Target Providers" to read the official OIG statement.

We accompany this story with one of our occasional editorial comments, believing the details needed some elaboration and interpretation. We interviewed an attorney and a former CMS employee to try to understand how reviewers' extrapolation power started to spiral out of control. In the process, we think we found the source of the problem. You'll be surprised to discover who it is. But a solution may be on the horizon. Apparently, CMS has decided it is as much of a victim of the situation as the accused HHAs are. When an agency shuts down instead of paying, CMS is left with nothing.

This is important because it could happen to any home health agency, in fact, to any Medicare provider. In our opinion piece, we think the experts we interviewed gave us a solid understanding of not only how this happens but why extrapolation became a death sentence. Click on "What Does the OIG vs EHS Story Mean?" As always, let us know what you think by writing to editor@homecaretechreport.com.

In our continuing examination of strategies to prepare for the major Medicare reimbursement changes coming in January, we invited a guest author to discuss the advantages of outsourcing coding and billing functions. Though Kristin Donar is Director of Revenue Cycle Management for HEALTHCAREfirst, she has sent us a vendor-neutral argument in favor of letting professionals take over certain tasks in order to improve accuracy and timeliness and, consequently, increase episode payment levels.

News for non-medical providers:
While the news is heavily oriented toward Medicare skilled providers this week, private duty providers will be interested in our Vendor Watch column, especially you who are searching for value to add to your services. GrandCare is a technology company that places large-screen communication systems into homes to allow designated family members and professional caregivers to remotely monitor and communicate with clients in their residences. The Wisconsin company announced the appointment of a new CEO this week, longtime friend of and occasional contributor to this publication, Laura Mitchell, who started in marketing and rose up through the ranks to take the reins.

It was good to see so many regular readers in New York, Colorado, and Pennsylvania this month. I get to stay home for a while but am looking forward to meeting more of you at the NAHC Financial Managers conference in July, the LincolnHealth Senior Living 360 gathering in August, and the HCAOA Annual Meeting in September.

Senior staff reporter Darcey Trescone and I wish you a great week and a great summer. Keep making a difference!

 

Editor signature
Tim Rowan



OIG Uses Homebound Status and Skilled Care Need to Target Providers
A Chicago-area HHA received a $7.5 million overpayment bill from the OIG. This is the OIG statement on one example case among many.

What Does the EHS vs. OIG Story Mean?
This could happen to any HHA. Understand the financial and political motivations on all sides before it happens to you.

Outsourcing Coding and Billing: Key to PDGM Success?
As PDGM will demand a higher level of accuracy and timeliness, it may make sense to outsource coding and billing to experts.

CMS News: Hospice Compare and PACE Improvements
— National Training Program Monthly Update Webinar
— May 2019 Hospice Compare refresh of quality data is now available; now includes additional information on hospice characteristics to complement existing quality and patient experience metrics.
— Final rule removes redundancy, reduces administrative burden on PACE providers.

Vendor Watch
— GrandCare Systems appoints Laura Mitchell as new CEO, expands executive team

 
When you click on these ads,
you make sure HCTR continues to come to you for free.

























During the 4th Quarter of 2019, web sites of the above advertisers were visited by home care and hospice executives and staff 3664 times.

To inquire about placing your message here, contact:

Kristin@rowanresources.com

Last Week's Most-Read Stories:
PDGM Vendor Perspectives and Preparations
Casamba and Thornberry discuss their PDGM perspectives and preparations.
 
Music as Medicine to Improve Patient Outcomes
Singfit is using music as medicine to address the needs of dementia and COPD patient's in home care.

As of this date, approximately 33,781,000 Baby Boomers have become Medicare eligible.



Notable Upcoming Conferences Free Webinars

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

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.

 


 

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.

 


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

Homecare 100 *January 19-22
JW Marriott Miami Turnberry Resort
Miami, FL

https://www.homecare100.com/

FREE WEBINAR: Most Common Questions About PDGM Webinar

Sponsored by: Healthcare Synergy

Date: February 6

Time: 1:00 EST / 10:00 PST

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

Information and Registration

Objectives:

  1. Understand the transition between the 1st and 2nd 30 day claim periods
  2. Discuss the requirements for the order and timing of the 1st claim final claim and 2nd claim's RAP.
  3. Verbal requirements for orders leading up to the 2nd 30 day claim period.
  4. Understand visits within the 60 day episode and how they affect the 30 day claims.
  5. Understand LUPAs and the thresholds between the 30 day claims.

Speaker: 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.


Training: Sales Coach Certification

Presented by Healthcare Strategica, LLC

Featuring: Michael Ferris
Location: Westin Lake Las Vegas Resort, Henderson, NV
Date: February 18-21

Information and registration

Your sales management team is critical to the results from the sales teams they manage, day to day, month to month and quarter to quarter. The goal must be to drive more admissions with less expenditure on sales and marketing. The best way to do that is to is to increase the number of admissions generated by EVERY member of the sales team.  That will drive down your acquisition cost of each new admission – this metric, cost of sales per admission, is the one that will drive most top and bottom line success!

Sales Managers have four basic functions – manage, train, coach and mentor. For most, the greatest challenge is to have enough time to spend in the field coaching ALL of their sales professionals.  We know, though our research and experience, that the NUMBER ONE way to increase the results of home health and hospice sales professionals is to have regular, effective sales coaching.  Coaching WILL drive the most results consistently.

Sales Coach is the newest, fastest growing position in home care. A Sales Coach can spend the entire week in the field or in the training room, wherever you need them. This frees up your time and allows you to be able to manage a larger team, spend more time where it counts, have consistent on-boarding practices and a happier sales team that is hitting and exceeding all expectations.

Our new Sales Coach Certification Course is the answer to having a Sales Coach up and operational in a hurry. Sales Coach Certification Course participants will get actual time working with and coaching Bootcamp attendees. And, because this is a very nice, secluded, non-gaming location, there is not the same level of distraction you find at a casino on the strip.

Who should attend?

•            Sales Coaches
•            Sales Managers who want to improve their coaching, training and onboarding
•            Senior Leadership who want to understand how to maximize their sales structure for success

Location:

Westin Lake Las Vegas Resort located in Henderson, NV – about a 30 minute drive from the Las Vegas airport.  Uber or Lyft is your best option but if you drive, parking is free!  Once you are there, you have everything you need and a shuttle to take you to restaurants or stores in the area.  The special room rate is available for a few days before and after the event, so if you want to hit the golf course or just relax, please come early or stay late.  This is a non-gaming property that has restaurants, bars, pools, putting green, sport court, gym, hiking and biking trails.


Webinar: "Unleashing the Power of the Next Generation of Healthcare Professionals"

Sponsored by: HIMSS

Date: February 21
Time: 10:00 am CST

Information and Registration

Learn:
• How to align the expectations of young healthcare professionals closer to the reality of their roles

• How they perceive technology and the role it plays in delivering value-based care

• What kind of working environment will keep these young healthcare professionals motivated


Free Webinar Series: Presented by Simione Consultants

New Considerations for the Home Health Cost Report
Date: February 24
Time: 3:00-4:00 PM EST

Presenter: Tom Boyd, MBA, CFE, CHFP, Vice President of Reimbursable Services, Simione Healthcare Consultants
Register

 

Creating Value in Home Health and Hospice
Date: February 27
Time: 2:00-3:00 PM EST

Presenter: David Berman, CPA, CGMA, CVA, Principal, Mergers & Acquisitions, Simione Healthcare Consultants
Register


The Hospice Cost Report: Ensure Timely, Accurate Results
Date: March 3
Time: 3:00-4:00 PM EST
Presenter: Tom Boyd, MBA, CFE, CHFP, Vice President of Reimbursable Services, Simione Healthcare Consultants
Register

 

What's in Your Sales & Marketing Playbook?
(Co-Sponsored by PlayMaker Health)
Date: March 19
Time: 3:00-4:00 PM EDT
Presenter:
Melynda Lee, MBA, Director, Growth Solutions, Simione Healthcare Consultants

Register

 

The 5 Top Reasons Why Post-Acute Deals Fail & What To Do About Them
Date: March 24
Time: 2:00-3:00 PM EDT
Presenter: Laura Gramenelles, RN, BSN, HCS-D, COS-C, Director, Mergers & Acquisitions, Simione Healthcare Consultants
Register


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


Conference: Leading Age Leadership Conference

Hosted by: VNAA, Elevating Home, and Leading Age

Date: April 5-6
Location:
OMNI Shoreham Hotel, Washington DC

Information and Registration

With the Leadership Summit, LeadingAge has designed an event for forward-thinking leaders to connect, engage in dialogue, and deepen their knowledge about the future—how we can shape it, and the paths to get there together.

 


Seminars - NAHC and HHFMA PDGM Roadshow 

Sponsored by: The National Association for Home Care & Hospice (NAHC), Home Care and Hospice Financial Managers Association (HHFMA), and NAHC Forum of State Associations, have joined together to co-host 12 intensive, one-day seminars across the country to prepare home health operators for PDGM.  

The Patient-Driven Groupings Model (PDGM) is here and home health agencies are already dealing with the most important change to home health payment in the 21st century. What is working? What is causing problems? Agencies need the latest information and advice on how to make sure their businesses prosper in the PDGM era.

Dates and Locations:
  • March 30:    Boston area, MA
  • March 30:    Seattle, WA
  • March 31:    Kansas City, MO
  • March 31:    Charlotte, NC
  • April 1:         Ontario, CA
  • April 7:         Orlando, FL                              
  • April 7:    Houston, TX
  • April 7:    Columbus, OH
  • April 7:    Salt Lake City, UT
  • April 8:    New Orleans, LA
  • April 8:    Minneapolis, MN
  • April 14:  Philadelphia area, PA
Additional Information and Registration To Be Announced Soon!


*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

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.


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



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

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