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General Session • Tuesday @ 9:00am

Update from Washington, D.C.

Bill Dombi, President

National Association for Home Care & Hospice

Sponsored by:

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NAHC's Update from Washington, D.C.

General Session

Tuesday, 6/22

9:00am-10:30am

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Bill Dombi, President, National Association for Home Care & Hospice (NAHC)

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As President of the National Association for Home Care & Hospice (NAHC), William Dombi has shown exemplary leadership throughout the COVID-19 pandemic. His unique vantage point of the recent federal policy changes impacting home health and hospice agencies across the nation include myriad legislative and regulatory developments that have dramatically overhauled home- and community-based care, with more changes in sight. During this information-packed session, Bill will examine federal policy and program changes in response to COVID-19 and lessons-learned from the pandemic. This session brings up-to-the minute details on the legislative, regulatory and legal matters that directly impact home care.  Don’t miss this opportunity to benefit from the insight of one of the industry’s leading voices and get your questions answered. 

Sponsored by:

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Care Management: Driving Quality for Serious Illness While Bridging Payor and Provider

Breakout Session C1

Tuesday, 6/22

11:00am-12:30pm

For: Hospice, Home Health, Palliative

Christine Lau, RN, LCSW, APHSW-C, VP of Operations and Care Management

Teleios Collaborative Network

Rebecca Collins, MS, RN, CCM, CHPN, NE-BC, CENP, Director of Care Management, Pure HealthCare

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As serious illness care moves toward value-based reimbursement models, care management will be more important than ever to ensure high quality care.  In this session we will discuss the specifics of care management focused on serious illness: how it works with various serious illness provider models (such as home care, home based primary care and palliative care) and key elements that should be provided regardless of the payor source.  You will learn care management basics: role descriptions, staffing ratios, essential elements of assessment, standardized assessment, tools, and how to address social determinants of health - even with limited staffing.  Finally, we will cover the basic requirements needed for billing Medicare care management codes for patients not enrolled in a value-based payor group: including chronic care management, complex chronic care management, principle care management, and transitional care management codes.

 

Updates for Home Care from NC DHSR

Breakout Session C2

Tuesday, 6/22

11:00am-12:30pm

For: Home Care

Kathie Smith, BSN, RN, VP of Home Care and State Relations, AHHC of NC

In this session, AHHC’s Kathie Smith will relay updates from the North Carolina Department of Health and Human Services (DHSR) related to a number of issues affecting home care providers including DHSR licensure survey data trends and COVID-19 pandemic waivers.

 

PDGM Revenue Cycle Management Changes

Breakout Session C3

Tuesday, 6/22

11:00am-12:30pm

For: Home Health

Melinda Gaboury, Co-Founder and CEO, Healthcare Provider Solutions

The most significant change in Homecare Reimbursement in 20 years went into effect January 2020. The Patient Driven Groupings Model - PDGM is complicated, confusing and overwhelming.  CMS has provided some data on the revenue impacts and new PDGM components, but there is more to be considered. Revenue Cycle, from beginning to end, will require changes to adapt.  Preparing now is essential in being prepared for the PDGM onslaught. 

 

Legal and Regulatory Changes That Providers Need to Know

Breakout Session C4/IDD3

Tuesday, 6/22

11:00am-12:30pm

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Matthew W. Wolfe, JD, MPP, Partner, Parker Poe

E. Bahati Mutisya, JD, Associate, Parker Poe

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This interactive and wide-ranging panel presentation will involve Parker Poe attorneys that represent and counsel home health, hospice, palliative care, and home care providers in a variety of manners.  The content will be based on recent changes and updates on legal and regulatory matters for providers and will include the following:  employment issues, payor disputes, licensure, contracting, mergers and acquisitions, program integrity, and other topics.

 

Hospice Eligibility Documentation

Breakout Session D1

Tuesday, 6/22

1:30pm-3:00pm

For: Hospice

Melinda Gaboury, Co-Founder and CEO, Healthcare Provider Solutions

Accurate hospice eligibility documentation is critical to fulfilling the CoPs and payment requirements. The lack of supporting documentation for a terminal prognosis is the number one reason for denial. Reviewers often look for a significant decline in patient condition. Although this is not a requirement of hospice care, terminal prognosis is. This session will help clinicians document the slightest changes in baseline measures. More importantly, you’ll learn how to capture in documentation the occurring changes that support terminal prognosis – even without a decline in baseline measures. Go beyond the LCDs and common tools for documenting eligibility by drilling down to the details and characteristics that differentiate terminal and chronic patients with the same diagnosis.

 

Labor Trends: The Latest in Recruitment and Retention

Breakout Session D2

Tuesday, 6/22

1:30pm-3:00pm

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Maggie Keen, Vice President of Strategic Initiatives, myCNAjobs

The labor market continues to quickly evolve, delivering new challenges and opportunities to senior care companies. Join myCNAjobs, the largest caregiver network in the nation connecting over 3.9 million people to jobs last year, for the latest look at what’s trending in caregiver and nurse aide recruitment, what’s most important in job search and staying onboard at a company, and how the front-line labor pool is thinking about work. We’ll explore new thinking and strategies to recruit and retain care workers to build a sustainable workforce to help improve the continuity of care.

 

Optimizing and Managing Wound Care Patient Outcomes Under PDGM

Breakout Session D3

Tuesday, 6/22

1:30pm-3:00pm

For: Home Health

Chris Attaya, VP of Product Strategy, SHP Data

Sue Payne, MBA, RN, CHCE, Home Care Strategies Advisor, Corridor

Wound care patients are the most expensive to care for in home health.  Under the PDGM case-mix re-calibration, agencies have a better chance to be successful if they manage costs in caring for the patient.  Understanding the clinical picture of wound patients in comparison to patients in other PDGM clinical groups is important. Managing visit utilization, identifying wound supplies to assist with wound healing while managing cost, and employing technology will help to improve outcomes and profitability for wound patients.  Join the presenters as they provide a deep dive and case examples into optimizing and managing Wound care patients under PDGM.

 

Empathy Training Through Symptom Simulation Burden

Breakout Session D4

Tuesday, 6/22

1:30pm-2:30pm*

*Please note this session is 60 minutes

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Polly Addison, M. Ed., BSN, RN, Informatics Educator, Transitions LifeCare

Providing quality care to all patients requires the ability to feel and demonstrate empathic behaviors.  To acquire a heightened level of empathy, the learner needs to internalize a process of experiencing first-hand real-life symptom burdens common at end of life. Making this happen during new employee orientation is a challenge but with powerful outcomes. Objectives:  Increase empathy levels for new staff and throughout the agency; knowledge of teaching methods that result in retention of information.

 

Update on North Carolina's Tailored Plans

Breakout Session D5/IDD4

Tuesday, 6/22

1:30pm-3:00pm

For: I/DD

Victor Armstrong, Director of the NC Division of Mental Health, Developmental Disabilities, Substance Abuse Services, NC DHHS

Mya Lewis, I/DD & TBI Section Chief, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, NC DHHS

As we begin the process of transitioning from our LME/MCO system to Tailored Plans, we invite you to join Victor Armstrong, Director of the NC Division of Mental Health, Developmental Disabilities, Substance Abuse Services and Mya Lewis I/DD and TBI Section Chief for the Division of Mental Health, Developmental Disabilities and Substance Abuse Services for a discussion on where our I/DD system in going and how you can be ready for this next change.

 

Medical Review in the Hospice Medicare Certified World

Breakout Session E1

Tuesday, 6/22

3:30pm-5:00pm

For: Hospice

Melinda Gaboury, Co-Founder and CEO, Healthcare Provider Solutions

This session will take agencies through the winding road of Medicare scrutiny. While billing the Medicare benefit and getting paid relatively easy, there is always a risk of things being reviewed at some point. What can you do to avoid denials? Participants will be able to define the levels of Medical Review that are currently active:  including, UPIC, SMRC, MAC ADR, and RAC.  The session will review how to respond to any level of medical review that may occur. This session will also discuss PEPPER reports and other data analysis that agencies will need to review to ensure that their risk from medical review is limited. This session will review some North Carolina specific PEPPER data so you can tell where you stand compared to others in the state.  Don’t be caught in the position of believing that everything is just okay or that the Public Health Emergency is a shield from medical review. Attendees will take away information that will assist in assuring that your hospice truly is accurately documenting. Learning Objectives:

  • Outline the Multiple Post Payment Review Contractors  

  • List the current edits being used in targeting hospices across the nation 

  • Detail the requirements for successfully submitting medical records for review 

  • Discuss the top 5 denial reasons under medical review

  • Outline the targets that are calculated on the PEPPER Reports 

  • Detail the targets and other data from the PEPPER reports specific to North Carolina

 

Managed Care Updates from the NC DHHS Division of Health Benefits

Breakout Session E2

Tuesday, 6/22

3:30pm-5:00pm

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Dave Richard, Deputy Secretary for Medicaid, Division of Health Benefits, NC DHHS

Jay Ludlam, Assistant Secretary for Medicaid, Division of Health Benefits, NC DHHS

We are almost there! The launch of our state’s managed care system is just around the corner! We know you have lots of questions and we want to help providers prepare for the start of Standard Plans in NC. We also know you have questions about what comes next for services that are not included in Standard Plans. We invite you to join Deputy Secretary for Medicaid Dave Richard and Jay Ludlam Assistant Secretary for Medicaid as they present updates on the start of Standard Plans in North Carolina as well as answering any questions you may have on what comes next.

 

RCD Non-Affirmations and Denials: Appeals and Options

Breakout Session E3

Tuesday, 6/22

3:30pm-5:00pm

For: Home Health

Joe Osentoski, RN-BC, Senior Consultant, Gateway Home Health Coding & Consulting

This presentation provides an overview of the RCD choices, agency options for a non-affirmed or denied claim, and preventive measures that minimize chances of an unfavorable RCD claim submission.  This uses common denial reasons (applicable to the ADR choices) and non-affirmation reasons (for pre-claim reviews) and addresses how to prevent these for a smoother RCD experience. The process for filing appeals is also covered.  Some areas covered include physician face-to-face (F2F) issues, certification deficiencies, and the most common medical necessity denials, including therapy documentation.  A thorough walk-through of F2F encounter requirements and how the F2F content links with PDGM payment and possible denials or non-affirmations is covered.  How these are applied to appeals for denied claims is presented.

 

Engaging Non-English Speaking Patients: How to Promote Health Equity Among the LEP Population

Breakout Session E4/IDD5

Tuesday, 6/22

3:30pm-5:00pm

For: Home Care, Home Health, Hospice, Palliative Care, I/DD

Michael Pepe, Director of Solutions Engineering, Synzi

Gerard Barsoum, Director of National Accounts, AMN Language Services

There are currently more than 25 million LEP individuals in the U.S. At least 350 languages are spoken in U.S. homes.  How is your organization able to provide a vulnerable patient population with additional, meaningful access points to healthcare – and help them strengthen adherence – if your team members are not communicating with these patients in their primary or preferred language? This session will explain why promoting health equity amongst the LEP (Limited English Proficient) Patient Population is critical to your impact and outcomes.  The presentation is designed to provide you with information and insights that will help your organization:   

  • Ensure Meaningful Access for patients with LEP  

  • Help patients overcoming language-based inequity in Home Health

  • Use telehealth to better engage LEP patients 

  • Communicate with the most vulnerable patients during the pandemic