Essential Training At Your Finger Tips

<!--td {border: 1px solid #ccc;}br {mso-data-placement:same-cell;}--> "Despite the COVID-19 public health emergency and the full resumption of the Medicare Review Choice Demonstration (RCD), medical review activities have been fully resumed. The triggering of a medical review poses an additional challenge to agency operations. Aside from the RCD, multiple Medicare, Medicare Advantage, and commercial insurance reviewers examine medical records for accuracy, including those that are newly billed and reopened claims. It is common for home health agencies to focus on survey compliance rather than reviewing their medical records from a compliance and payment perspective. Medical reviews, audits, or probes can pose great difficulties if you are selected to undergo one of these processes. Compliant clinical records are the key to success, whether it is through the RCD, the Unified Program Integrity Contractor (UPIC), the Recovery Audit Contractor (RAC), the Supplemental Medical Review Contractor (SMRC), or Comprehensive Error Rate Testing (CERT). The required rules and regulations should be incorporated into the content at the time of creation, not later. The presentation begins by outlining key coverage requirements from Medicare regulations and what they actually require. It then provides examples of how to reflect these in the home health record to address known denial reasons. These include both nursing and therapy medical necessity requirements. In linking what is actually needed with known denial reasons, it shows how proper documentation can prevent negative outcomes. This also applies to the RCD when the full record is not reviewed in pre-claim review or when it is reviewed under an Additional Documentation Request (ADR) option. This session provides a solid foundation for educating your staff to prevent future denials and audits. Your current staff can learn how to chart correctly, while new staff can learn from the actual regulations to start off right. The topics covered in this session can also be applied to Medicare Advantage medical reviews that are not subject to the RCD." Read more

With the onset of the Patient-Driven Groupings Model (PDGM) during the pandemic era, many home health providers have failed to address the operational changes required to manage rehab under the new value-based model. As a result of the PDGM removing rehab visits from the payment calculation, many agencies have struggled with changes required to manage rehab content and outcomes. Recent work with multiple home health providers since the onset of the PDGM has revealed the connection between PDGM-compliant rehab programs, 5-Star Ratings, and optimal reimbursement. During this four-part webinar series, attendees will learn how Medicare positioned rehab management at the center of the PDGM despite removing per/visit therapy payments. Discover how to utilize the FIL (Functional Impairment Level) successfully to deliver value-based rehab programs based on the content modifications required for PDGM outcome success. In that manner, providers can develop the OASIS accuracy necessary for optimal reimbursement, while simultaneously establishing the care pathways required for 5-Star Ratings, single-digit readmissions, and optimal fiscal margins. This exciting series breaks down the Medicare approach to the PDGM’s development to assure an understanding of rehab changes and how to achieve compliance with your therapy staff and programs. Beginning with a 10,000-foot view of the hidden value opportunities in the PDGM’s rehab regulations, home health administrators, managers and supervisors will gain insight into how to rewire therapy for new levels of success. In subsequent presentations, the development of PDGM-compliant rehab plans of care (POCs) and visit content can assure a value-based therapy episode. Finally, required rehab content necessary for skill, and denials occurring under the PDGM will round out where we are today in terms of qualified therapy expectations. The series concludes with a summary of the PDGM’s rehab POC development and in-episode delivery from admission to discharge, with a nod to future IMPACT Act reforms that will modify rehab even more. Don’t miss the exciting and informative series to optimize your rehab programs for PDGM success.   Speaker/Course Author - Arnie Cisneros, PT  Read more

With the onset of the Patient-Driven Groupings Model (PDGM) during the pandemic era, many home health providers have failed to address the operational changes required to manage rehab under the new value-based model. As a result of the PDGM removing rehab visits from the payment calculation, many agencies have struggled with changes required to manage rehab content and outcomes. Recent work with multiple home health providers since the onset of the PDGM has revealed the connection between PDGM-compliant rehab programs, 5-Star Ratings, and optimal reimbursement. During this four-part webinar series, attendees will learn how Medicare positioned rehab management at the center of the PDGM despite removing per/visit therapy payments. Discover how to utilize the FIL (Functional Impairment Level) successfully to deliver value-based rehab programs based on the content modifications required for PDGM outcome success. In that manner, providers can develop the OASIS accuracy necessary for optimal reimbursement, while simultaneously establishing the care pathways required for 5-Star Ratings, single-digit readmissions, and optimal fiscal margins. This exciting series breaks down the Medicare approach to the PDGM’s development to assure an understanding of rehab changes and how to achieve compliance with your therapy staff and programs. Beginning with a 10,000-foot view of the hidden value opportunities in the PDGM’s rehab regulations, home health administrators, managers and supervisors will gain insight into how to rewire therapy for new levels of success. In subsequent presentations, the development of PDGM-compliant rehab plans of care (POCs) and visit content can assure a value-based therapy episode. Finally, required rehab content necessary for skill, and denials occurring under the PDGM will round out where we are today in terms of qualified therapy expectations. The series concludes with a summary of the PDGM’s rehab POC development and in-episode delivery from admission to discharge, with a nod to future IMPACT Act reforms that will modify rehab even more. Don’t miss the exciting and informative series to optimize your rehab programs for PDGM success.   Speaker/Course Author - Arnie Cisneros, PT  Read more

<!--td {border: 1px solid #ccc;}br {mso-data-placement:same-cell;}--> Medicare-certified home health agencies are required to take part in the Home Health Quality Reporting Program (HH QRP) by collecting and reporting both the Outcomes and Assessment Information Set (OASIS) patient quality of care results, as well as the Home Health Care Consumer Assessment of Healthcare Providers (HHCAHPS) patient survey results. With the implementation of OASIS-E on January 1, 2023, the Transfer of Health Information to the Patient Post-Acute Care (PAC) measure will be collected. The session will discuss this new quality measure and provide an overview of current measures. It will include information on when and how measures will be collected and reported, as well as which measures are slated for retirement. Attend this session to learn the latest HH QRP information and best practice strategies that will help you position your agency for success. Read more

<!--td {border: 1px solid #ccc;}br {mso-data-placement:same-cell;}--> This session will provide an overview of what the Quality Assurance and Performance Improvement (QAPI) program entails, as well as the purpose and importance of having a quality improvement program for both Medicare and Private Duty providers. Becky Tolson, RN, Clinical Compliance Educator at the Accreditation Commission for Health Care (ACHC), will discuss the five standards of effective quality management, how to implement a Performance Improvement Project (PIP), and how to evaluate the success of a program. In addition, this session will examine what ongoing considerations your program should include and what the top deficiencies are in accreditation surveys. Read more

<!--td {border: 1px solid #ccc;}br {mso-data-placement:same-cell;}--> "COVID-19 has emphasized the importance of mental health services. According to a June 2021 report, 40% of people had mental health or substance abuse problems. Patients/clients receiving home care experienced unprecedented levels of anxiety and depression due to the increased isolation caused by COVID-19. Still more troubling, the suicide rate in many states now exceeds the COVID-19 mortality rate. Over the past two years, COVID-19 quarantines and closures have strained access to mental health services despite the demonstrated need for them. In this session, we'll discuss why your organization should provide behavioral health services, and how adding this service can assist patients/clients with managing mental health conditions, which can negatively affect their medical comorbidities." Read more