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In light of the current statewide moratorium, certified home care providers are considering expanding their business, by offering private duty and Medicaid waiver services under their certified license. While this can open the door to a new line of potential referrals, this can prove to be problematic to certified providers, who must apply the Conditions of Participation (CoP) to all the patients they care for. This webinar will focus on when and how to appropriately apply the CoPs to private pay and Medicaid waiver patients. We will also delve into the creation of separate business lines or satellite offices and their impact on the application of the CoPs. If you are contemplating adding or are currently servicing private pay or Medicaid waiver patients, under your certified license, and find yourself unsure as to when and how the CoPs apply, then this is one webinar you don’t want to miss! Course Instructor - Nancy Allen Read More

The OASIS-C2 brought significant changes that affect clinicians' assessment strategies and require renewed focus to ensure compliant application of guidance. This presentation will include the three new items and their importance in risk adjustment of one of the new IMPACT outcomes, subtle modification in five items to facilitate cross-setting standardization with other post-acute care settings, the importance of adhering to a uniform "look-back" time period, and significant guidance in manual changes - especially in pressure ulcers. Read More

“I don’t know why I’m getting audited.” This is all too common a response a home health provider gives after the surveyor walks in the agency door. CMS believes that home health is a hotbed for fraud, waste and abuse. Home health agencies believe that they have done absolutely nothing wrong, and that they are being unfairly targeted by the government – ultimately to suspend payments and lead to insolvency. Here’s the truth: you are not being randomly targeted. CMS uses a distinct set of data points from the same OASIS data that you submit to determine if you are going to be audited. So as an agency, you believe that you are running your business in compliance with Medicare’s requirements, not based on data but based on what ‘feels right’. But at the same time, your data is being pushed through computers and identifying you as wasting the money being given to provide care. It is truly man versus the machine. Course Instructors - Kristi Bajer and Michael McGowan Read More

Music has been found to improve the quality of life for individuals with Alzheimer's Disease and other related dementias.  Cristina Rodriguez, President of Mind&Melody, Inc., will provide easy ways home care providers can incorporate sound therapy during client visits.   Read More

"Home health is in a constant state of flux. When we’re not dealing with the day to day of our clients and their needs, the industry is constantly bombarded with new regulations. CMS says this is to curb the rampant fraud in the industry. Home health, however, says that the federal government is out of touch, and has no idea of the importance home health serves our larger health care system. Navigating the compliance requirements of the payor while meeting the needs of patients and staff can only be done through system-ness and adherence to standardized patient care. As we navigate the waters of VBP, the Home Health Groupings Model (HHGM), and the additional Alternative Payment Models mandated by CMS, we need to evolve or retire our provider numbers. Ultimately, we need to look carefully at how we provide care, reduce costs, and increase outcomes. Changing our processes to be proactive rather than reactive we need to learn the lessons of those who have gone before us, to not only save our businesses, but grow them." - Kristi Bajer and Michael McGowan Read More

Accrediting agencies are looking at the Conditions of Participation (CoPs), however, the Centers for Medicare & Medicaid Services (CMS) uses the Medicare benefit policy manual which contains the conditions of payment; your agency needs to understand both. Backend Quality Assurance (QA) and Performance Improvement (PI) slows down both identification and resolution of issues and pushes the timeline for improvement in stars, Value-Based Purchasing (VBP) to a year or more. Agencies are often blind sided with Additional Documentation Reviews (ADR), Recovery Auditor Contractor (RAC), and Zone Program Integrtity Contractor (ZPIC) audits despite high marks on surveys because they are auditing from accrediting guidelines, not CMS triggers. CMS is using algorithms to look at every OASIS you submit. Top triggers are over utilization and indications that medical necessity and homebound status are questionable. New CoPs are only meeting the requirements accrediting agencies are already using. Course Instructor - Kristi Bajer and Michael McGowan Read More

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