Blueprint for OASIS Accuracy Returns This November

Staying on top of OASIS coding is never easy, and PDGM will bring additional challenges in 2020. Join us November 4-5, 2019 in Devens for an intensive, two-day, workshop & exam from OASIS Answers. Though open to all, Alliance members can attend at a significant discount.

Staying on top of OASIS coding is never easy but – with the new PDGM standards arriving in a few months – 2020 is going to be a real challenge.

That’s why we’re pleased to offer Blueprint for OASIS Accuracy, a two-day, data-collection workshop in Devens, Massachusetts on November 4-5, 2019.

Register for OASIS

This workshop — designed by OASIS Answers — provides a comprehensive look at the OASIS items including the OASIS-D1 revisions and OASIS-related PDGM information effective January 1, 2020. The course awards 13 CEUs. Attendees can also take an optional exam at the same location the following day (registration and payment for the exam is entirely separate from the workshop).

Though the program is available to all, members may attend for just $429.00 per registrant, a discount of $150 off the non-member rate. If you’ve been thinking about having the Alliance join, this will give you immediate return on your investment.

Return to www.thinkhomecare.org.

Full 2019 HR Management Conference Agenda Announced!

HCA will host an HR Management Half-Day Conference on Tuesday, October 29 at the College of the Holy Cross in Worcester, MA. This conference is an excellent resource for HR Managers, CEOs, COOs, and Clinical Directors.

HCA will host an HR Management Half-Day Conference on Tuesday, October 29 at the College of the Holy Cross in Worcester, MA. This conference is an excellent resource for HR Managers, CEOs, COOs, and Clinical Directors. Topics will include the following:

  • Attracting a Talented Workforce, Sheri Heller, PHR, SHRM-CP, Senior HR Advisor MassPay HR & Services
    Attracting and keeping talented employees in today’s job market is more difficult than ever. Learn about best practices to ensure successful talent acquisition efforts that will lead to a high-performing workforce. This session will include topics on talent sourcing vs. recruiting; finding the right talent pool; building your employer brand; the candidate experience; and creating the perfect job ad.
  • Discrimination Law Issues for the Home Care Industry, Layla Taylor, Esq. Partner, Sullivan Hayes & Quinn
    Employment discrimination laws have been established to prevent discrimination based on race, sex, sexual orientation, religion, national origin, physical disability, and age. Learn from Taylor the important key points relating to patient choice and anti-discrimination case law for your employees. Topics such as employee religious and disabiliaty accommodations to vaccinations will be covered.
  • The Step-by-Step HR Department Checklist, Julie Brinkman, COO, Hireology
    Whether you have a staff of 5 or 500, clear HR policies and consistent processes are essential to success on the people side of your business. This presentation will review a comprehensive HR checklist developed by Hireology and BambooHR designed to help home care agencies establish a new HR function or improve the HR systems and initiatives that are already in place in your agency. This checklist includes key elements such as an overview of important HR policies and processes, recruitment best practices to attract quality candidates, and tips for developing and maintaining a successful HR team.
  • Home Care Alliance Workforce Initiatives, HCA of MA Staff
    The HCA Board has identified Workforce Development as a critical priority issue under its current Strategic Plan. A Board working group had identified a number of initiatives for the Alliance and Foundation to expand our member support on workforce issues, addressing staff development at all levels: executive, management, supervisory, and all levels of direct care. This session will review results to date on some of the projects already in progress, preview future objectives, and solicit member input on new initiatives to help ensure a skilled and motivated workforce for the future.

Registration is only $50/Person for HCA of MA Members!

Download the Brochure/ Registration Flyer Here

2019 Private Care Management Conference Agenda Announced

2019 Private Care Management Conference Agenda Announced!

Labor Management Relations, Robert Brooks, Labor & Employment Partner, Verrill Dana
Learn strategies to develop an effective plan of action when dealing with the current labor laws. This session will review recent and ongoing developments relating to handling your employees; such as, hiring, firing, discipline, and payment of wages. Additionally, hear more on the new Massachusetts Home Care Worker Registry Act and how it impacts your organization.


Recruiting, Onboarding & Educating the Caregiver Workforce of the Future,Helen Adeosun, EdM, Co-Founder & CEO of CareAcademy
Educating caregivers is the number one health intervention for today’s home care agency. Learn staffing best practices to help find new caregivers and educate existing caregivers to meet the growing needs of clients in their care. Attendees will learn several actionable steps that agency owners and management can take today to ensure that their caregivers have the knowledge they need that a structured training program can offer, and the positive impact for retention, home care ROI and business.  


Preventing Verbal Abuse of Workers: The Safe Home Care Project,Margaret M. Quinn, ScD, CIH, Professor and Director, Safe Home Care Project, Zuckerberg College of Health Sciences, UMass Lowell
Previous studies have found that violent behaviors, including verbal abuse as well as physical assault, by patients towards health care workers is common and leads to injuries, illness, burnout and job turnover.  The Safe Home Care Project team conducted a survey of nearly 1,000 Massachusetts home care aides and found that about 1 in 4 experienced verbal abuse from clients within the past year. The study identified home care conditions under which verbal abuse was most likely to occur and recommendations for prevention that can improve safety for both aides and their clients.  


Key Metrics to Motivate Staff, Improve Retention and Promote Growth, Kunu Kaushal, Senior Solutions Home Care
Learn from the Senior Solutions Home Care founder and CEO Kunu Kaushal who grew his Tennessee-based home care business from zero to $18+ million in nine years, with 800+ clients and 10 locations. The first session will share actual usable metrics, and formulas to help operate your agency at peak performance. Areas covered will include financials, operations, staffing, and recruitment. Move beyond revenue metrics to incentivize staff and provide more clarity around roles related to scheduling, recruitment and human resources. This simple, budget-driven model uses national metrics and KPIs that consider salaries and profitability for setting goals, defining responsibilities and motivating your staff.  


Building Your Leadership TeamKunu Kaushal, Senior Solutions Home Care
In the second session you will learn his culture “secrets”, what makes a company’s culture great, how employee engagement can impact that culture. Kunu will share how he managed to build an attractive work culture, recognize when it’s time to let someone go, how to manage accountability, and more. Additionally, Learn how a great leadership team is built, including how to identify when it’s time to add to the team, ways to divide roles in order to maximize the team’s efficiency and key skill sets to identify when hiring.

Download the Brochure Here

Registration:
$99 – Members
$199 – Non-Members

Advocate and Engage on PDGM

There are many ways that home health agencies will need to prepare their agencies for the radical changes coming from PDGM in January 2020. The Alliance is here to help.

Last month, the Centers for Medicare & Medicaid Services (CMS) issued its proposed rule for 2019 home health payment rates and policy changes, which includes significant provisions that will impact your organization, staff, and the patients you serve.

Between now and when the Patient Driven Grouping Model (PDGM) goes into effect on January 1, 2020, there are multiple ways that home health agencies will need to prepare their agencies for the radical change. (See Coding and Billing webinars coming in September, at the bottom of this page) At the same time, home care must take action to mitigate the impact of what PDGM will look like and how it will impact organizational viability.

Home care’s collective advocacy efforts have undeniably made a difference in the past, including putting a stop (at least in Massachusetts) to the Pre-Claim Review Demonstration and scrapping the Home Health Groupings Model thanks to more than 1,200 comments submitted to CMS last year. The more that CMS and lawmakers hear from home health professionals, the better our chances are at reducing the severe cuts that accompany PDGM in its proposed form.

As currently proposed, the 2020 rule will:

  • Reduce the Medicare base rate by 8.01% next year, which amounts to a $1.298 billion reduction in home health payments in 2020 alone. CMS proposes the reduction to account for anticipated changes in provider behavior that are unrelated to changes in patients served or services delivered that increase payments. This newly proposed “behavioral adjustment” reduction is up from the 6.42% reduction that CMS initially proposed, and the reduction would start before any actual behavioral changes occur.
  • Phasing out RAPS over 2020 with total elimination of RAPs in 2021. Next year, CMS proposed reducing RAPs from 60/50% to 20% for existing home health agencies (HHAs), while new agencies would get no RAP. CMS claims that RAPs create fraud risks.
  • Starting in 2021, a Notice of Admission (NOA) must be submitted Notice of Admission must be submitted within five days of the start of care. For every day late, CMS plans to reduce base-rate reimbursements for the unit of care.

The Solution: Pass S.433/H.R.2573

This month, Congress is in recess and back in the states, which presents a pivotal opportunity for home health industry professionals to engage with lawmakers about a key legislative priority – the Home Health Payment Innovation Act (S.433/H.R.2573).

This legislation prohibits CMS’s ability to adjust payment based on “behavioral assumptions” as opposed to observed evidence of behavioral changes, thus rescinding the proposed 8.01% adjustment.
Additionally, this important legislation would:

  1. Achieve full budget neutrality over the period of 2020-2029.
  2. Require behavioral adjustments based on real, actual changes in provider behavior in response to the new payment model.
  3. Permit a phase-in of rate adjustments (up or down) when an annual adjustment would be greater than 2 percent. However, the phase-in would operate to ensure full budget neutrality by 2029.

Email your Members of Congress

It’s not too late to get members of Congress informed and engaged on this important legislation. You can send an email directly from HCA’s member advocacy center.

At this point, Congressman Jim McGovern is the only member of the MA delegation signed on as a cosponsor. We must do better.

Fact Sheet: Senate 433 & HR 2573

Advocate in Person

Join home health industry advocates next month in Washington, D.C. for The Council of State Home Care Associations’ Third Annual Public Policy Summit and Advocacy Day!  On September 9, participate in a full-day summit featuring speakers including Hillary Loeffler, Director of the CMS’ Division of Home Health & Hospice.  On September 10, we be on Capitol Hill meeting with members of Congress to convey the critical need to pass S.433/H.R.2357.

Program details can be found here and registration information can be found at The Council’s website.

Submit Comments to CMS by September 9

Click here to submit comments to CMS in response to the 2020 proposed rule by 5:00 PM ET on Monday, September 9, 2019.

HCA and other industry organizations will provide more thorough comments on other problematic areas of the proposed rule. As previously stated, there is strength in numbers, so the more business-focused comments from providers – both large and small – are critical to giving CMS a full and clear picture of how devastating PDGM will be should it be implemented as proposed. Watch Update for draft comments.

Return to www.thinkhomecare.org.

Patient Legal Advocates

Information for clients/patients needing legal assistance around lost benefits or insurance.

The movement of many insured into “managed” environments has resulted in some questions to the HCA of MA regarding clients’ rights should home care services be terminated or suspended. Every Managed Care Organization (MCO) or Accountable Care Organization (ACO) – be they serving Medicare or Medicaid clients – has an obligation to have some form of patient (although not necessarily agency) internal appeal process. Agencies who are working with these organization should be versed in what these processes are.

For clients for whom the changes are threatening their well being, or seemingly discriminatory, or based on a pattern of inappropriate clinical decision making, there are legal services entities in this state who may be able to help. This list includes their names and contact information. Please note: these legal services entities will generally only take up a case if a client or, in some cases, a family member of a client calls. Keep this information on hand and share with any client who may need assistance.

Return to www.thinkhomecare.org.

HCA of MA Has Got You Covered for PDGM Education

HCA of MA is providing 4 unique opportunities at free or discounted rates to learn comprehensive elements of the new Medicare Patient-Driven Groupings Model (PDGM) being introduced this January.

HCA of MA is providing 4 unique opportunities at free or discounted rates to learn comprehensive elements of the new Medicare Patient-Driven Groupings Model (PDGM) being introduced this January.

PDGM: 4-Part Preparedness Series: August 6, 7, 13, & 14
Online Webinar Series

Is your agency prepared for the all the changes that will come with PDGM? This 4-part webinar series with Melinda Gaboury will give you the essentials your agency will need to prepare for PDGM. This series will cover coding changes, OASIS integrity, financial structure changes,LUPA’s, changes revenue cycles, and more!
• August 6th – PDGM Structure and Financial Changes
• August 7th – PDGM Coding & OASIS Integrity
• August 13th – PDGM Operational Decision Necessities
• August 14th – PDGM Revenue Cycle Changes
Instructor: Melinda Gabourey, Healthcare Provider Solutions

REGISTRATION
HCA Members: $379/Line for Full Series
HCA Potential Members: $599/Line for Full Series

All webinars are recorded

2020 Home Health Final Rule: September 11
Online Webinar

The 2020 Home Health Proposed Rule will be a seismic change in home health care. Learn from experts in the industry to help
understand the propsed rule and its impacts. Topics will include a review of Medicare’s new payment rates for home health, changes in use of PT assistants, and informed feedback to provide to CMS by the comments deadline of September 9, 2019, and more!

REGISTRATION
HCA Members: FREE
HCA Potential Members: $99/Line

PDGM Bootcamp: September 24, 9:00-4:00
Methuen, MA

Home Health Care Clinical Managers/Supervisors of Clinical Services, Quality Management staff and Clinical Educators will play a key role in the successful implementation of the new Medicare Patient Driven Groupings payment Model (PDGM). In this interactive session, attendees will learn the four key elements of the PDGM scoring system: admission source and timing, clinical groupings, functional levels and comorbidities. Managers will leave with specific techniques for obtaining accurate information to support coding, scoring and billing. All, while using the least resources to produce the best outcomes. Areas covered include: optimizing complex care, episode utilization and case management, interdisciplinary teamwork, care coordination and collaboration. The session will also describe key PDGM measures and monitoring techniques to optimize efficiency, achieve success and prevent pitfalls.

REGISTRATION
HCA Members: $159/Person
HCA Potential Members: $399/Person

PDGM Education by the National Association for Home Care
Online Webinar Series/ Videos

In a partnership with the National Association for Home Care, we are pleased to extend a special NAHC discount on several PDGM educational offerings all members of HCA of MA!

PDGM Video
If you’re familiar with PDGM but aren’t sure what the first steps are, this 5 ½ hour introductory course is for you. Leading industry experts will equip you with what you need to know to about the most significant change to impact home health in decades.

Webinar Series
If you want a deeper understanding of PDGM and how certain components will affect your business, this seven-part series is what you’ve been looking for. These webinars will focus on all parts of your agency, including risk factors, documentation review, clinical management and more. If you can’t attend the live webinar, don’t worry each of them will be recorded and available on- demand. You and your staff will have unlimited access.

Learn more on all education and register at:
www.thinkhomecare.org/Education

Members Flock to HCA’s Quality Improvement Meeting

Lots of member interest in HCA’s July QI meeting to discuss medical record audits and upcoming proposed rule changes.

With the sundry of regulation changes in the home health industry over the past few months, the July 24th Quality Improvement (QI) meeting had over 45 members participating in-person and by phone. The numerous medical record audits plaguing the industry dominated the meeting’s discussion.

Multiple agencies have received letters from C2C Innovation Solutions informing them that some claims under appeal have been selected for potential reopening as part of the Medicare Appeals Demonstration. The C2C auditors are conducting the analysis of claims previously adjudicated unfavorably by the Qualified Independent Contractor (QIC), that are currently pending at the Office of Medicare Hearings and Appeals (OMHA) and may be resolved favorably by the QIC.

Other audits that agencies are experiencing are new Targeted Probe and Educate (TPE) audits. These medical record requests are for 5-7 visits and lengths of stay greater than 90 days. No agency is in the third round of the Face-to Face TPE.

One agency reported at the meeting that they are facing three audits simultaneously; a hospice General Inpatient care (GIP) Targeted Probe from NGS, a home health PERM request for Face-to-Face (awaiting ALJ) and eight GIP Post Payment Review by Noridian.

During the meeting there was a lot of member engagement related the 2020 Proposed Rule; the proposal to require OASIS for all payors and the 8% behavioral adjustment. Agencies also discussed strategies for management with PDGM and the process for completing OASIS B-1 for January 1st episodes. PDGM will be a standing QI agenda item.

The HCA is planning to host a PDGM Networking Meeting to help our members with the transition to this new payment model. We are hoping to begin the meetings in September and have a guest speakers and consultants to assist with planning for this historic payment change. Stay tune for further details.

Don’t forget to check out our PDGM Bootcamp on September 24th!