by Cheryl Peltekis, RN
For most of 2019, we have been hearing about all the fears that PDGM will bring our home health agencies. We have heard issues with cash flow, 1/3 of the companies going out of business, and rumors of agencies that won’t survive with Rap Payments decreased to 20%.
I really felt like we were in the Chicken Little Movie, with the chicken running around screaming, "The sky is falling!" Now, the first week is here and the sky is still in place.
First, we need to make sure that (with every referral) we get a list of all the possible diagnosis codes. This is going to help with getting the correct clinical group and capture the additional reimbursement for co-morbidities.
Next, we need to make sure that we have everything needed to support the face-to-face documentation. We don’t want anything to slow down the billing process or admission process. It is critical that every referral can become an admission and we do not want to have the face-to-face encounter making our intake offices have a delay in accepting patients.
You must look at the referral sources and decide on how to service the patients without losing your shirts. You must know that you have the right therapist who will treat the patient according to what they need to keep out of the hospital and recover safely at home. You want to make sure you have therapy assistants working with your therapist to keep the cost of servicing the patient down.
You may need to add home health aide services to support patients more on days that the therapist isn’t seeing the patient. There may be opportunity to land some of the accounts from competitors that are fearful of taking therapy cases as well. If you can figure out how to do it without losing money, you may quickly become a preferred agency from your referral sources.
We need to make sure that our staff is scoring the functional assessments correctly, that every nurse is reading OASIS answers from the bottom up when completing the assessment. Too many times the nurse reads the possible OASIS answers from the top down and they underscore the patient's functional status.
If your nurse still has questions about how to score functional assessment you can have one of your physical or occupational therapists collaborate with your nurse on possible answers. The OASIS Guidance Manual is the best resource out there. I am always shocked when I ask clients how they train their staff on OASIS and many clients never mention one of the best resources available to agencies. And it is free!
The OASIS Guidance manual shows each item's intent, and response-specific instructions. It also provides data sources and resources for answering the functional assessments. I always make sure each new nurse knows how to answer the functional assessment questions.
If you are a salesperson, you may be pressured more than ever to bring in new business. You may be pressured to bring in facility referrals because they reimburse the agency at a higher level. You will not be successful setting out to sell without a repeatable sales process that is proven to give you results.
Cheryl Peltekis, RN, is the owner of Immediate Home Care and Hospice in Bensalm, Pennsylvania and a principal with Home Care Sales, a consulting and education firm. With her business partner Melanie Stover, Cheryl offers a High-Performance Sales Academy for agency owners and sales professionals (homecaresales.com) and a live, online sales coaching series (homecaresales.com/high-performance-coaching).
©2020 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in the Home Care Sales blog at homecaresales.com/blog. Reprinted by permission.