Volume 5, Number 42 September  21, 2016



Dear Healthcare at Home Colleague,

I spent this week digging into the CMS decision to postpone its Pre-Claim Review pilot in Texas, Florida, Michigan, and Massachusetts. It comes down to their admission that it is not working in Illinois but the jury is out regarding why it is not working. CMS says Illinois providers are at fault and need more education. Illinois providers, and their state association, are convinced that it is Palmetto GBA reviewers who do not understand their own rules. There is also much confusion as to why the experiment, if CMS believes it has failed, was not stopped in Illinois rather than merely being postponed for future pilot states. 

I interviewed several Illinois HHA owners and an official with the Illinois Homecare and Hospice Council this week and I sat in on the IHHC conference call with NAHC's Bill Dombi. Last June, I also participated in the CMS Open Door Forum in which staffers outlined the Center's expectations for the experiment, expectations that largely failed to materialize. 

To the best of my ability, I have analyzed the Illinois experiences as reported by HHAs in Chicago and downstate. The three articles in this week's issue are the result of that analysis. I hope you find them useful. Most of all, I hope these articles are not read solely in Illinois. Even though early results have proven that Pre-Claim Review, in its current form, fails in its mission to separate fraudulent providers from honest ones, CMS continues to give every indication that they intend to go forward with the 5-year pilot and eventually expand it nationwide. Every Medicare provider reading this page needs to be prepared, not just my readers in the pilot states. 

I have done my best to help you prepare but there are of course many other sources. You need them all. Consider just one thing you will learn in my articles. Illinois is experiencing an 80% pre-claim "non-affirmation" rate. What will it mean to beneficiaries if that happens in 50 states? If there is a bottom line, it is this: every Medicare agency in the five pilot states and beyond needs to get on the phone with their Representatives and Senators and teach each one's staffer assigned to healthcare issues the truth about how badly this experiment is going. They are getting a different message from CMS, as you will see in my lead article.

Just before pressing 'send' on this week's issue, I saw that CMS has canceled its Open Door Forum that had been set for October 5. Their reason is that is conflicts with a National Provider Call on Emergency Preparedness Requirements. We will keep watch for any announcement of another ODF dedicated to the Pre-Claim Review experiment.

We will get back to our normal variety of topics next week but for now this is the story that impacts most of you so we have dedicated the entire issue to it.

Have as great of a week as you can. Keep making a difference!

Editor signature
Tim Rowan



CMS Postpones Pre-Claim
To many, CMS's decision to postpone implementation of the Pre-Claim Review experiment in Texas, Florida, Michigan, and Massachusetts does not come as a surprise. Poorly trained reviewers make so many mistakes, it may be wise to turn the program off in Illinois as well, where it has already begun but is not working.

Illinois Home Health Providers Frustrated, Angry, But Not Powerless
Almost everything that can go wrong has gone wrong in the first state burdened with poorly planned Pre-Claim Review experiment.

Home Health Providers Bear Some Responsibility Too
In marriage and in Medicare, there are always two valid sides to every argument. Just because most of the blame for the Illinois fiasco can be attributed to PGBA does not mean that HHAs are blameless. Those who intend to be in business next year must set the bar higher for employees who create, review, and submit clinical documentation.

Texas Association Urges Members to Continue PCR Training
In spite of the announced PCR delay, the Texas Association for Home Care and Hospice is warning its members to remain vigilant and continue preparing, saying, "PCR is still coming."

 
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Notable Upcoming Conferences Free Webinars

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


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

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

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

Click here to register

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

HCSSA Administrator Program
Texas Association for Home Care & Hospice
November 13-15
Westin Galleria
Houston
tahch.org

*HCTR will see you there.

4th Annual Home Care Winter Warm-Up
Home Care Association of Florida

January 16-17
Boca Raton Marriott
Keynotes by Stephen Tweed, Bill Dombi, 12 others

Information and Registration


CONNECTED HEALTH: Remote Patient Monitoring and Telehealth Summit

6th Annual Care Coordination and Technology Congress

January 24-26
Renaissance Atlanta Waverly Hotel & Convention Center
Agenda:
Designing successful bundles without collaboration between inpatient and post-acute (PAC) providers inhibits the cost-savings opportunities that make bundled payment a valuable model for hospitals and health systems. Designing care management incentives and solutions for complex patients requires integration across hospitals, home care, and the extended continuum of provider organizations.
Register for in-person or online participation


2018 National Leadership Conference
ElevatingHOME Annual Meeting
March 7-9
Grand Hyatt
Washington DC
Information and registration

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


A New Approach for Home Health Face-to-Face:
Updated Info, Updated Insights

Sponsored by Kinnser Software
Featuring Arlene Maxim, RN
Thursday, April 20
1:00 pm EDT

Learn:

  • What CMS requires for "adequate documentation" under Face-to-Face
  • How to handle inadequate progress notes provided by the physician/in-patient facility
  • Exactly what to include on your checklist of items for the physician's packet

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



Clinician Recruitment, Retention & Satisfaction: Does Technology Help or Hinder?

Sponsored by Brightree and Elevating Home
Featuring: Karri Harpole, RN, BSN, Brightree; Tarrah Lowry-Schreiner, President & CEO, Sangre de Cristo Hospice & Palliative Care; Wendy Cofran, CIO, Century Health Systems, Inc.; Melissa Polly, MBA, Brightree Product Marketing (moderator)

Wednesday, July 26
1:00 pm EDT

Learn:

  • Best practices related to the use of technology and the best way to engage clinicians in a model that provides the most value the organization, including recruitment, retention and satisfaction; 
  • From colleagues, how to get the most value from the use of technology from clinical documentation and nurse satisfaction to operational efficiencies; and,
  • How changes in the post-acute environment, from regulatory drivers to value-based care, drive effective utilization of technology.

Register



    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


    Workforce Webinar Series: Stacking the Odds in Your Favor
    Best Practice Selection Strategies


    Presented by ElevatingHOME

    All programs in the series have been archived for those unable to attend live:

     

    • Part 1, "Why Staff Leave and How to Keep Them," sponsored by Exact Recruiting, a Simione Talent Solution. Click here to view this session.
    • Part 2, "From Turnover to Engagement for the Healthcare Executive," sponsored by Relias. Click here to view this session.
    • Part 3, "The ROI of Using Pre-Hire Assessments," sponsored by Relias. Click here to view this session.
    • Part 4, "Stacking the Odds in Your Favor: Best Practice Selection Strategies," sponsored by Home Health Selection Solutions. Recorded 11/28, recording available soon.

    Upcoming topics in the Workforce Webinar Series:

    Part 5: "Recruiting and Compensation Strategies that Work," sponsored by Exact Recruiting, a Simione Talent Solution
    December 5 | 1:00 p.m. ET

    Register here

     

    Part 6: "Employee Engagement: Your Key to Exceeding Home Health and Hospice Outcomes," sponsored by Fazzi Associates
    December 12 | 1:00 p.m. ET

    Register here

     

    Part 7: TBD
    December 19 | 1:00 p.m. ET
    Details coming soon.


    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


    International Guidelines for Home Health Nursing

    Presented by: International Home Care Nurses Organization (IHCNO)

    Wednesday, October 25
    11
    :00 a.m. - 1:00 p.m. EDT
    Registration

    www.ihcno.org/Registration

    Contact person: Marilyn Harris marilyn@ihcno.org



    Patient Engagement & Health Literacy

    Presented by Curaport

    Featuring Stephanie Koehn, RMA, CPC CPPM, CPCO
    Thursday, December 7
    2:00 p.m. EST
    Cost: $39
    Click here to register



    QAPI Series, Part 4: Revenue Cycle Management

    Presented by Curaport

    Featuring Diane Link and Nick Seabrook of BlackTree Healthcare Consulting
    Tuesday, December 12
    2:00 p.m.EST
    Click here to register



    Strategic Use of Technology in Home Health and Hospice Organizations

    Presented by: Elevating Home and Brightree

    Thursday, October 12
    1:00 p.m. EDT

    Speakers include:

    • Melissa Polly, Brightree (Moderator)
    • Paul Pisano, CEO, Interim Healthcare - Hartford
    • Tarrah Lowry-Schreiner, CEO, Sangre de Cristo Hospice & Palliative Care
    • Todd Montigney, Managing Director and Founding Member, BlackTree Healthcare Consulting
    • Nick Knowlton, CommonWell Alliance and Brightree

    Registration



    The Penalty Box Compliance Series: Part 3, Care Planning for HHGM & VBP Success

    Presented by Curaport
    Featuring Kristi Bajer, RN, MSN, VP OperaCare
    Wednesday, December 6
    1:00 p.m. EST
    $39

    Click here to register



    Navigate your Way to Referral Success in 2018

    Presented by Home Care Sales

    Featuring Melanie Stover and Cheryl Peltekis
    Friday, December 15
    12:00 p
    .m. EST
    Registration and Information



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