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Home Care Campbell

By 1st November, 2017 Comments Off

Available in varying time frames

  • Hourly
  • Live-Ins
  • 24-Hour Care
  • Overnight Care

A full-range of services are available and flexible with individual needs.
Caring Companionship
Homemaker & Sitter Services
Meal Planning & Preparation
Light Housekeeping
Medication Reminders
Shopping & Running Errands
Transportation to Appointments

Schedule A Free Consultation Now.

Home Care Cupertino

By 1st November, 2017 Comments Off

Available in varying time frames

  • Hourly
  • Live-Ins
  • 24-Hour Care
  • Overnight Care

A full-range of services are available and flexible with individual needs.
Caring Companionship
Homemaker & Sitter Services
Meal Planning & Preparation
Light Housekeeping
Medication Reminders
Shopping & Running Errands
Transportation to Appointments

Schedule A Free Consultation Now.

Home Care Walnut Creek

By 1st November, 2017 Comments Off

Available in varying time frames

  • Hourly
  • Live-Ins
  • 24-Hour Care
  • Overnight Care

A full-range of services are available and flexible with individual needs.
Caring Companionship
Homemaker & Sitter Services
Meal Planning & Preparation
Light Housekeeping
Medication Reminders
Shopping & Running Errands
Transportation to Appointments

Schedule A Free Consultation Now.

CMS Issues Final Rule to Modernize Home Health Conditions of Participation

By 11th January, 2017 Care Home No Comments

By Amy Baxter | January 9, 2017

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule outlining the Medicare and Medicaid Conditions of Participation (CoP) for home health agencies. Prior to the new finalized rule published Monday, the CoPs had not been updated in roughly two decades, when many of the requirements were first created.

The new rule was long-expected after a draft proposal was introduced in late 2014. The rule needed to be finalized within a three-year window and will be published on the Federal Register on January 13, 2017.

The conditions govern how home health agencies can qualify to participate in Medicare and Medicaid. The new CoPs are estimated to cost $293.3 million to implement in the first year and $290.1 million in subsequent years. The CoPs will be effective July 13, 2017, CMS stated in the rule.

“Our priority is to ensure that Medicare and Medicaid beneficiaries who receive health services at home get the highest level of patient-centered care from home health agencies,” Kate Goodrich, CMS chief medical officer and director of the Center for Clinical Standards and Quality for CMS, said in a press release. “Today’s announcement is the first update in many years to Medicare and Medicaid home health agency rules and reflects current best practices for in-home care, based on recommendations from stakeholder and medical evidence.”

Currently, there are more than 5 million Medicare and Medicaid beneficiaries receiving home health care from nearly 12,600 home health care angelicas participating in Medicare and Medicaid nationwide. Many industry groups, including the Visiting Nurse Associations of America (VNAA) and the National Association for Home Care & Hospice (NAHC), were generally supportive of the initiatives introduced in the draft proposal back in 2014.

“We do agree with many of the main principles the CoP, the conditions, were trying to get at, which was patient-centered care,” Joy Cameron, vice president of public policy at the Visiting Nurse Association of America (VNAA), said during a policy update call with members Monday. “It will be interesting to see the difference between the draft and now, because a significant amount of time has passed.”

At the same time, the groups were actively engaged during the comment period and hoped to make several changes and clarifications to the proposals.

Content of the Final Rule

Specifically, the finalized rule includes several updates to the CoPs. As summarized by CMS in its announcement of the rule, they include:

—A requirement for an integrated communication system that ensures patient needs are met, care is coordinated and that there is active communication between a home health agency and the patient’s physicians.

—A requriement for data-driven, agency-wide quality assessment and performance improvement (QAPI) program that evaluates and improves agency care for patients at all times.

—An expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services, such as coordinating referrals and assuring plans of care meet patients’ needs.

Other CoPs that are included in the final rule related to ensuring documented communication, care coordination and a comprehensive patient assessment that ensures all aspects of patient wellbeing. The rule also requires clearly stated comprehensive patient rights and the steps to assure those rights.

During the proposal period, industry groups voiced their concerns over some of the new CoPs, including allowing enough time for a new QAPI program and an ample implementation period to comply with all new requirements. Groups also voiced concern over how new communication requirements are documented and what actions home health agencies must take.

A Long Time Coming

As stated, the rule is the first update in decades of the fundamental requirements for home health agencies to participate in Medicare and Medicaid. However, the waiting was not for lack of trying. A proposed rule was published by CMS in early 1997 that would have revised the entire set of HHA CoPs.

Unfortunately, thanks to the sheer amount of comments and “rapidly changing nature of the HHA industry at that time,” the rule was never finalized in its entirety, according to CMS. Instead, just the OASIS rule was finalized in 1999.

Prior to publishing the proposed CoP changes in 2014, CMS took into account comments from the 1997 period, the agency stated.

Written by Amy Baxter

Study: Registered Nurses Vital to Home Care Technology Success

By 8th July, 2016 Care Home No Comments

By Alana Stramowski | January 8, 2017

Technology is transforming the home care industry, but it hasn’t been easy to prove exactly how certain technology like telehealth and remote monitoring will help patient outcomes. However, there are now solid, research-backed tactics home care agencies can implement to increase positive health outcomes.

To see positive impacts of technology, home care companies need to focus on supporting and training their registered nurses as well as realizing that technology should not replace all human contact, according to a report released Wednesday from the University of California San Francisco.

The report, supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), studied the use of electronic remote monitoring technologies and telehealth services of organizations for patients receiving long-term in-home care as well as those with chronic conditions such as obstructive pulmonary disease and kidney disease.

Focus on nurses

When it comes to ensuring positive outcomes from new technologies, training all workers who are caring for patients is important, but the primary health professionals involved in remote monitoring programs are nurses, Aubri Kottek, MPH, author of the report and research analyst at the Phil R. Lee Institute for Health Policy Studies at the Healthforce Center at the University of California San Francisco, told Home Health Care News.

“Predominantly nurses are the ones using the data from the telehealth or remote technology so this speaks to some of the training requirements that we need to make sure new graduates are equipped with,” she said.

Though health professionals like licensed practical nurses, medical assistants and community health workers could review the data first to check for red flags, nurses or mid-level providers are most often doing follow-up care, the report points out.

This also means agencies should focus more intensive training on nurses.

“The RNs’ scope of practice allows them the independence to utilize assessment skills while simultaneously following well-defined policies and procedures to communicate and act upon data,” the report says.

Tech can’t fix everything

Even though technology is where the health system wants to go, due to increasing the bottom line, it still cannot replace the human connection made between a nurse and patient, Kottek said.

“The findings are clear in the literature that people don’t want telehealth to replace human contact, they want to augment it,” a principal investigator who studied the aging process and health technology, said in the report. “We need to be cognizant that we don’t replace contact or home visits. When you walk in a home you’ll see a fall hazard you won’t see in a video conference.”

If home care providers can find a healthy balance of remote technology and human connection it will not only help the patients thrive, but improve the overall success of the provider, Kottek explained.

“I heard from several people during my research for the report say they’ve seen improvements in readmissions rates or have see how they can save money using telehealth or remote monitoring,” she said. “There’s the potential to do that if the program is developed mindfully and if you take into account the workflow and how efficient the program could be.”

See the full report from UCSF.

Written by Alana Stramowski

Addressing OIG’s Characteristics of Home Health Fraud — Without Toppling the Whole System

By 8th July, 2016 Care Home No Comments

By Guest Contributor | January 6, 2017

The numbers don’t lie.

After more than 10 years serving in the New York Office of the Medicaid Inspector General, including as the Acting Inspector General, I can attest firsthand to the unfortunate instances of fraud, waste and abuse that occur with too much regularity in home health care and home care.

Between 2011 and 2015 alone, investigations from the national Office of the Inspector General (OIG) resulted in more than 350 criminal and civil actions and $975 million in receivables. In fact, the OIG estimates more than $10 billion in improper payments in the 2015 fiscal year.

In spite of the numbers that point to the need for improvements, home health and home care play a vital role in the broader healthcare ecosystem, and increasingly, states are relying on managed care organizations (MCOs) to deliver efficient and effective Medicaid programs. For MCOs and state Medicaid programs alike, the balance between preventing fraud and continuing to provide quality care is a delicate one.

As valuable as the OIG observations about common characteristics of fraud are, they are correlations that are typically not precise enough to employ at the time of service and billing and are best used for post-payment targeting.

So how do we reduce fraud before billing occurs without impeding the necessary services and billing payment cycles and impacting the whole system?

At the simplest level, fraud can be limited with three steps:

Step 1 – Electronically gather and standardize critical data: A physician’s referral, the initial assessment, the resulting plan of care (POC), care authorizations, schedules and the details of each visit, including the duties performed, should all be gathered and standardized. Leveraging a robust technology platform, one that goes beyond traditional Electronic Visit Verification (EVV) will allow home care and home health care providers to effectively monitor and manage a standardized list of duties to ensure they are authorized and consistent with the POC.

Step 2 – Apply real-time edits to the standardized data to ensure that the visit is fully authorized and consistent with the necessary care. Any exceptions should be actively addressed and resolved. By leveraging a technology platform or EVV solution, home care stakeholders can make real-time edits to ensure that a visit is scheduled at the time of clock in, that the duties are consistent with the POC and make proactive recommendations if any key details are inconsistent with the POC.

Step 3 – Monitor and improve. Making the data available not only to the provider, but to the payer level (managed care plans) and, ultimately, the state Medicaid program level is essential to provider oversight and the ability to make comparisons. By enabling monitoring at each level of the ecosystem, the ability to isolate issues and drive improvement is enhanced dramatically.

Going beyond the data – ensuring collaboration

While following the described steps and making standardized data available are effective, obstacles remain.

The siloed nature of the home and home health care system results in many opportunities for fraud, waste and abuse, but it also opens up the door to miscommunication. Integrating platforms between payers and their network providers and extending communication and collaboration opportunities to daily operational activities can streamline the entire home care and home healthcare process.

As Acting Medicaid Inspector General, it was clear to me that the systems least fraught with fraud were those that shared information freely between Medicaid payer and provider. When two parties collaborate effectively, there is more opportunity to recognize issues, spot instances of fraud and proactively prevent them.

It’s clear that the home care system is continuing to evolve to the point where all stakeholders are actively communicating and collaborating. This leads to better member outcomes, less hospital readmissions and, ultimately, a more effective health care system.

While fraud, waste and abuse in home care and home health care will never be eliminated, standardizing, automating, monitoring and, ultimately, collaborating are the best steps to effectively address the problem while avoiding steps that could impact the whole system.

Tom Meyer is the chief program integrity officer at HHAeXchange. Meyer served as New York State’s Acting Medicaid Inspector General, offers more than 30 years of experience in information technology, and more than 10 years in the New York State Office of the Medicaid Inspector General.

Editor’s Picks: Pre-Claim Affirmation Rate Tops 90% in Illinois

By 8th July, 2016 Care Home No Comments

By Amy Baxter | January 6, 2017

New year, new us! While we stayed busy sticking to our New Year’s resolutions—for now, anyway—we were sure to keep our readers up to date on the latest home health care and home care news. Readers wanted to know where seniors are looking to retire and why, as well as some of the top home health Medicare schemes as observed by one assistant U.S. attorney.

There was some good news for Illinois home health care providers taking part in the Pre-Claim Review Demonstration (PCRD). The affirmation rate for pre-claim requests, including partial and fully affirmed pre-claim requests, ticked up to 90.8% in the 22nd week of the program, which ended Dec. 31, 2016, according to the Centers for Medicare & Medicaid Services (CMS). The affirmation rate has seen a dramatic increase since the start of the program, which began in Illinois in August 2016. PCRD is expected to begin in Florida beginning April 1, 2017.

Here in the newsroom, the story of a Virginia Beach doctor who captures intimate moments between caregivers and patients in photographs caught our eye.

We’re also keeping our eye on the incoming Trump administration, as Republicans noted they aim to get a bill to repeal Obamacare to President Trump’s desk ASAP.

Most Read

These Are The Top 10 State For Retirement—The majority of older Americans wish to age in place, but aside from living near family and friends, they are also looking at other factors to choose where they want to live as they age. The best states for retirement were found based on life expectancy, tax friendliness ranking, violent crime per 100,000, the cost of living index and health care costs, according to a recent study from MoneySavingPro.com.

U.S. Attorney: Common Home Health Schemes ’Turn System Upside Down’—Home health care agency owners would be the first to say the industry is seeing an onslaught of new regulations. However, there may be good reason for it—the industry is rife with improper and fraudulent payments, according to the Centers for Medicare & Medicaid Services (CMS).

BrightStar CEO: Major Tech, Workforce Investments Sharpen Competitive Edge—For Chicago-based home care provider BrightStar Care, 2016 was a milestone year after it opened its 300th franchise location. Home Health Care News caught up with CEO Shelly Sun to hear about the company’s plans for growth in 2017, technology investments and top challenges and concerns across the industry.

Around the Web

Doctors Who Always Noticed Caregivers Photographs Them in Retirement—Dr. Michael Geller of Virginia Beach always noticed caregivers waiting with patients he was examining, sensing their behind-the-scenes work, The Virginian-Pilot writes. After observing caregivers and their intimate moments with patients, he picked up a camera to capture them.

Transforming Health Care Delivery through the CMS Innovation Center: Better Care, Healthier People and Smarter Spending—The CMS Innovation Center prepared its third annual report to Congress, summarizing the progress and outcomes of its numerous initiatives over the last year.

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