Wednesday, September 30, 2020 | 10:15am-11:15am
E1: General Inpatient Level of Care: Get it Right
Joe Osentoski, BAS, RN-BC, Chief Reimbursement Recovery Consultant, Gateway Home Health Coding & Consulting
The HHS OIG Report (OEI-02-10-00491) concluded that “Hospices Inappropriately Billed Medicare Over $250 Million,” causing CMS to instruct its Supplemental Medical Review Contractor (SMRC) to initiate a nationwide postpayment review of claims for general hospice inpatient level of care (01-009 General Inpatient Hospice Notification
of Medical Review). Even hospices far under the allowed percentage of General Inpatient (GIP) level of care have been subject to these reviews. In addition, all hospices providing GIP are under additional scrutiny to support their GIP was reasonable and necessary. This session will walk attendees through the CMS requirements for GIP level of care, as well as provide documentation guidelines for when to change the level of care and for each of 15 common situations that precipitate GIP, such as agitation, pain management, respiratory distress, and wound care. Coordination needs with the care center staff are also covered. Specific charting tips are provided to ensure a complete record of GIP service is generated.
E2: Home Care and Hospice Advocacy: Perfecting the Advocacy Vision Through Storytelling
Lee Dobson, Area Director, Government Affairs, BAYADA Home Health Care
Wendy Chavez, MSN, RN, Director, The Advocacy Center, Thrive Skilled Pediatric Care
Lawmakers make decisions every day that impact home care from what is covered to the reimbursement rate and how we deliver care. Join us for an interactive session where you will learn the issues and how to approach a lawmaker to garner support for home care. You will be able to practice your pitch during a mock legislative meeting. By leveraging grassroots together, we will make a difference for our clients/patients and the staff who care for them at home.
E3: 270 Days Into PDGM
Rob Simione, CPA, Director; Julia Maroney, RN, MHSA, HCS-D, COS-C, Managing Director, Simione Healthcare Consultants
Turn the post-PDGM jitters into strong steps for success. Home health organizations can still make changes to ensure that clinical and financial operations make the grade. Many areas of operations - intake, clinical, coding, OASIS, and referral partners - have been impacted. What did we learn and how can we continue to make changes to ensure success operationally under PDGM? This session will assist you in evaluating where further adjustments to operations are needed.
For: Home Health
E4: Hospice Documentation
Melinda Gaboury, CEO/co-Founder, 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.
Wednesday, September 30, 2020 | 11:30am-12:30pm
F1: Clinical Manager Development
Andrew Reed, System Analyst/CPA, CEO & Chief Teaching Officer, Multi-View, Inc.
A World-Class Hospice or Homecare organization can only be built from the strength and quality of its Clinical Managers. This is because up to 70% of the 1) development, 2) morale and 3) retention of staff comes from the immediate Manager as all frontline clinicians take their behavior and performance cues from this critical position. Therefore, this level of management requires laser-beam FOCUS. Methods of organizations that operate at the 90th percentile and insights from work with over 1,000 Hospices will be shared in this session.
F2: Compliant Data Security
Ricky Smith, President, Innovative Business Technologies
Our new reality: risks are on the rise. With data breaches in the last nine years affecting over 2,500 healthcare data breaches and more than 500 records. Data breaches and resulting regulatory and legal action have escalated in healthcare with penalties reaching millions in 2019 so far. Learn about the common areas of vulnerability, the impact
of data loss, key elements for protecting your organization, and ways to reduce risk.
F3: An Agency’s Journey to Quality Cycle Management in the Era of PDGM
Laura Page-Greifinger, BSN, RN, MSA, Chairman of the Board/co-Founder, Quality In Real Time (QIRT)
The patient-driven groupings model (PDGM) is much more than a change to the prospective payment system. It represents a paradigm shift for agencies that will require continuous quality improvement throughout the patient journey. Quality Cycle Management (QCM) is a means by which management can hold staff accountable. QCM encompasses and connects all parts of the workflow process achieving the goal of patient-centered care and lower health-care costs. In this session we will walk attendees through the patient journey, identifying best practices and expected outcomes for each task and the metrics by which to measure results.
For: Home Health
F4: Inside the Black Box of the VA: A Guide to VA Resources
Toni Cutson, MD, Medical Director, Hospice and Palliative Medicine Services; Jamie Grant, MSW, LCSW, Hospice & Palliative Care Coordinator - Durham VA Medical Center
Join Dr. Toni Cutson and Jamie Grant, MSW, LCSW with the Durham VA Healthcare System for a comprehensive review and insight on how to access and navigate the VA system. This session will include a review of the VA health care system components, helpful tools and resources designed to improve knowledge and understanding of the VA healthcare system, veteran demographics, specific war time period diseases and conditions and helpful suggestions for how to develop relationships with local community partners who serve Veterans.