New Products
Trends in Fraud, Waste, and Abuse
[3047] Trends in Fraud, Waste, and Abuse
Education-Training Credits:
1.5 Hr(s) HCSSA Administrator/Alternate
Summary:Former Federal Prosecuters explain how your data helps determine fraud.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][6]risk assessment and management
§558.260[a][7]financial management
Faculty: Mindy Sauter, JD and Mike Elliott, JD
Program Description: In order to curtail the continued presence of fraud, waste, and abuse within
government programs, specifically home health and hospice, the OIG has implemented the use of data analytics to highlight providers who are outliers
in terms of billing trends. It is essential that providers become aware of how their data analytics will be observed by an outside party.
Along those same lines, emphasis is now being placed on provider-administered compliance programs. Successfully administered compliance
programs will be key if a provider’s data analytics ever come into question. Use this presentation to gain insight from the original Federal
prosecutors in the Dr. Roy case who successfully led the indictment for one of the largest fraud cases in home health.
Presentation Date: 08.09.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and
indicate an intent to change or enhance their practice by implementing compliance training and education within the agency’s operations.
About the Presenters:
Mindy Sauter, JD and Mike Elliott, JD are both former Assistant United States Attorneys
who investigated and prosecuted health care fraud throughout the United States.
Mindy is a graduate of Oklahoma State University and SMU law school. Before she was a federal prosecutor,
Mindy was an Assistant District Attorney in Dallas where she tried hundreds of cases and supervised felony prosecutions.
Mike is a graduate of the United States Naval Academy and the University of Miami School of Law.
Prior to working in both the Southern and Northern Districts of Texas with the Department of Justice, Mike was in private practice in New York City.
Their firm, Elliott Sauter, focuses on representing health care organizations and professionals in regulatory, compliance and criminal matters.
Elliott Sauter is based out of Dallas, TX.
[3047] Trends in Fraud, Waste, and Abuse
- Speaker
- Sauter, Mindy & Elliot
- Model
- 3047
$45.00
Increase Your Svc Value:Tips for Successful Participation in Medicare Value-Based Purchasing
[3046] Increase Your Service Value: Tips for Successful Participation in Medicaid VBP
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary:Texas Medicaid Value-Based Payments
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][5]quality improvement
§558.260[a][7]financial management
Faculty: Matt Ferrara, Director, Office of Quality Oversight, Andy Vasquez, Deputy Associate
Commissioner of Quality & Program Improvement., Jami Snyder, Associate Commissioner, Medicaid/CHIP Services, Texas Health & Human Services
Program Description: With over half of all Medicaid beneficiaries receiving services through
managed care organizations (MCOs), states have a unique opportunity to use MCO contracts and relationships to accelerate wide-scale adoption of value-based
payments (VBP). Texas is jumping on board with this concept and your agency needs the tools to succeed in this new world. It is key for providers to
position themselves successfully to contract with MCOs by understanding the data needed to develop mutually agreeable quality based contracts.
During this presentation you will hear directly from HHSC about how they are requiring MCOs to develop alternate payment structures between them
and their health care providers to encourage innovation, quality and efficiency. Hear directly from Jami Snyder, Associate Commissioner, Medicaid CHIP, who
also implemented VBP in Arizona about the approaches Texas is taking to implement VBP through MCO contracts. Don’t be left behind!
Presentation Date: 08.09.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and indicate an intent to
change or enhance their practice by evaluating MCO pay for quality programs in relation to their agency’s services.
About the Presenter:
Jami Snyder is the Associate Commissioner for the Medicaid and CHIP Services Department
at the Health and Human Services Commission, and serves as the state's Medicaid director. Jami most recently served as Chief Deputy Director for Medicaid and CHIP for HHSC.
Prior to that, she served as the Chief Operating Officer for The University of Arizona Health Plans (UAHP), a division of Banner Health. She has over 18 years of experience
in both the public and private sectors, including extensive regulatory experience stemming from her tenure with the Arizona Health Care Cost Containment System (AHCCCS) and
the Arizona Department of Health Services, where she was charged with overseeing the state's Medicaid-contracted health plans, including compliance with established federal
and state managed care regulations and performance in a variety of areas such as network sufficiency, payment modernization, customer service and the provision of self-directed
care. Snyder graduated from Gustavus Adolphus College with a Bachelor of Arts in Political Science and has a Master of Arts in Political Science from Arizona State University.
About the Presenter:
Matt Ferrara is the Director of the Office of Quality Oversight within the Quality and
Program Improvement Section at the Texas Health and Human Service Commission (HHSC). This office manages and coordinates quality initiatives within the Texas Medicaid
and CHIP programs, as well as across the various Texas Health and Human Service agencies. He has held this position for over 5 years. Prior to his employment at HHSC, Matt
worked in the mental health and substance use disorder fields for 13 years for the Texas Commission on Alcohol and Drug Abuse, TDMHMR, and Texas Department of State Health
Services. Before state employment, Matt served for 8 years in direct service and executive capacities for a private provider of community based long term service and
supports in Central Texas and El Paso. He is a graduate of Texas State University San Marcos with a major in Social Work.
About the Presenter:
Andy Vasquez has over 20 years of Texas Medicaid experience. During those years he has led
teams through several evolutionary changes in Medicaid pharmacy benefits management. He spent the last 10 years serving as director of the Medicaid Vendor Drug Program and
now serves as a Medicaid & CHIP Services Deputy Associate Commissioner. He leads five offices that recently joined to form the Quality & Program Improvement Section;
working to improve the quality of healthcare for low-income Texans, especially people enrolled in Medicaid and CHIP. Andy is a graduate of the University of Texas at
Austin with a Bachelor of Arts in Computer Sciences.
[3046] Increase Your Service Value: Tips for Successful Participation in Medicaid VBP
- Speaker
- Ferrara,M & Vasquez,A & Snyder,J
- Model
- 3046
$37.50
So You Think Your Compliance Program is Effective?
[3045] So You Think Your Compliance
Program is Effective?
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary:Can you show an "effective" compliance program?
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][6]risk assessment and management
Faculty: Jennifer Papapanagiotou, JD and Richard Pecore, JD
Program Description: Effectiveness is the new standard for compliance programs.
It is no longer good enough simply to have a compliance program; now you must show that it is an "effective" compliance program.
This presentation will review how to assess your compliance program for effectiveness, utilizing the government's newly published guidance documents.
It will also give attendees tips for inexpensive ways to improve the effectiveness of their compliance programs. Participants will:
Understand what makes a compliance program effective.
Be able to apply standard criteria to their compliance programs, in order to assess whether their program would be considered effective.
Understand inexpensive and easy to utilize means for making their compliance programs more effective.
Presentation Date: 08.09.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and indicate an
intent to change or enhance their practice by utilizing public resources to develop an effective work plan to protect against fraud and abuse and related sanctions.
About the Presenter:
Jennifer Papapanagiotou, JD has a legal practice that focuses on compliance, regulatory and transactional
matters for a wide array of health care providers, including home health and hospice agencies. She has extensive experience in analyzing proposed and existing business arrangements for
compliance with federal and state fraud and abuse laws, and drafting a wide variety of legal agreements. Ms. Papapanagiotou is knowledgeable in all aspects of state licensing for home
health and hospice providers, and in Medicare and Medicaid enrollment, including initial enrollment, changes of ownership and appeals of revocation actions. Finally, she assists clients
with compliance plans, forming new businesses, and addressing Medicare and Medicaid program coverage and reimbursement issues.
About the Presenter:
Richard B. Pecore, JD is a licensed Texas attorney with over 20 years of experience. Mr. Pecore is a
graduate of the University of Texas and South Texas College of Law Houston. Mr. Pecore joined Liles Parker as an associate attorney in January 2012 and became a partner with the firm in
February 2016. Mr. Pecore has worked on a variety of health care related matters, and the past 6 years focusing on Medicare and Medicaid administrative provider appeals and creating
provider regulatory compliance plans. Since joining Liles Parker, Mr. Pecore has focused on “big box” Medicare and Medicaid overpayments. He has successfully defended overpayment cases
ranging in value from $15,000 to $6 million dollars. Mr. Pecore is a Certified Medical Compliance Officer with PMI, is a member of the American Health Lawyers Association. Mr. Pecore
lives in Kingwood, Texas.
[3045] So You Think Your Compliance Program is Effective?
- Speaker
- Papapanagiotou, J & Pecore, R
- Model
- 3045
$37.50
Contracting with MCOs: Benefit vs. Pitfalls
[2974] Contracting with MCOs: Benefit vs, Pitfalls
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:The pros and cons of working with MCOs in and out of network.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty:Spears, Jan
Program Description:
This program presents the pros and cons of working with MCOs in and out of network. As
traditional payor sources implement payment reductions, new payment models or move exclusively
to Managed Care, home health agencies are once again looking at the best way to work within the
Managed Care arena. Some MCOs can pick and choose their provider networks based upon
geographical area, STARs reporting, and pricing models. Medicaid MCOs typically offer below
market value contracts. Although the MCO must follow the home health rules, the payer can
establish additional requirements such as prior authorization, timeframes for physician signatures,
etc. that can be more stringent than the traditional counterpart. The avenues for appeals are
cumbersome and often leave the provider “holding the bag.”
Learn how to package your agency for
quality, cost and satisfaction in advance of seeking contracts with the MCOs in your area. Delivering
care in accordance with MCO requirements requires process modifcation for order development,
authorization management and billing. In addition, the presenter touches on best practice processes to improve
coverage and reduce days outstanding on your claims. Presentation Date: 11.15.2016
Learning Outcomes(s): Participants will actively engage in the activity and
indicate an intent to change or enhance their practice by delivering care in accordance
with Managed Care Organization (MCO) requirements while incorporating best documentation practices in order
to ensure coverage and reduce days outstanding on agency claims.
About the Presenter:
Jan Spears is Co-owner and Chief Executive Officer of MJS & Associates.
She has more than 30 years’ experience in the health care field. Ms. Spears has owned and operated a multimillion dollar home health care company as
well as consulted for over 300 homecare providers in 25 states. As a full time consultant for the past 15 years, Ms. Spears has successfully merged
clinical and financial strategies into successful operational plans for numerous providers nationwide. Jan serves as a Medicare coverage expert for
health care facilities who are undergoing audits by federal contractors through all levels of appeals. She has authored several publications and heads
a team of more than 25 consultants at MJS & Associates.
[2974] Contracting with MCOs: Benefit vs, Pitfalls
- Speaker
- Spears, Jan
- Model
- 2974
$30.00
HIPAA Compliance - Minimizing Your Risk
[2973] HIPAA Compliance - Minimizing Your Risk
Education-Training Credits:
1.5 Hr(s) HCSSA Administrator/Alternate
Summary:Learn to be HIPAA compliant and
minimize your agency’s risk and potential liability.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][2]development and interpretation of agency policies
§558.260[a][3]basic principles of management in a licensed health-related setting
Faculty:Acevedo, Luis
Program Description:
Achieving compliance with HIPAA’s Privacy and Security Rules continues to prove an overwhelming
task for home health and hospice administrators. The recent initiation of compliance audits has
most providers on the edge and running for the hills! Are you ready for an audit? Is policy
development, employee training and technical oversight enough? Learn to be compliant and
minimize your agency’s risk and potential liability. Presentation Date: 11.15.2016
Learning Outcomes(s): Participants will actively engage in the learning activity and indicate
an intent to change their practice by adhering to the HIPAA Privacy Rule, Security Rule, and Breach
Notification Audit Program in an effort to protect patient privacy.
About the Presenter:
Luis Acevedo, Esq. with Brooks Acevedo Attorneys at Law,
has substantial experience in executive management of large healthcare corporations, as well as extensive knowledge of Health Law including
licensing, access, regulation, compliance, Stark Law, anti-kickback and e-health. He offers impressive experience in
healthcare transactions, corporate and business counseling. Mr. Acevedo has used his extensive background to help health care
clients with sales and transactions, to resolve internal conflicts, as well as conflicts with government agencies.
[2973] HIPAA Compliance - Minimizing Your Risk
- Speaker
- Acevedo, Luis
- Model
- 2973
$45.00
The World Has Changed: Word-of-Mouth Went Viral!
[2960] The World Has Changed: Word-of-Mouth Went Viral (and Nobody Told the Home Care Industry)
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary: Ways to use social media in successful marketing
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][10]marketing
Faculty:McManus, Roger
Program Description:
Dentists, Auto Shops and Pizza Parlors have all used the power of satisfied current customers to
draw new ones. Whether through Facebook Fans, Google Reviews or Yelp Yappers, the influence of
consumers on buying behavior has changed marketing in this country forever. Amazingly, online consumer
feedback about Home Care is almost non-existent. And, there are a range of easy and almost
cost-free ways to make it happen! This huge oversight is a massive opportunity for those in the
Home Care business who act quickly. In this program you will learn economical, fool-proof ways to exploit this
enormous gap resulting in more clients -- and the ability to attract more quality staff to serve them. Your view
of marketing Home Care services will be turned completely upside down. Presentation Date: 08.11.2016
Learning Outcome: Upon completion of this program, the viewer will be able to:
Discuss economical ways to use social media in successful marketing to clients and to attract higher quality staff.
About the Presenters:
Roger McManus earned his undergraduate and graduate MBA degrees from Wake Forest University.
Throughout his career, he has focused on the sources of information that allow owners of small businesses, like home care agencies, to gain faster growth and greater freedom.
He capsulized those objectives in his 2011 book, Entrepreneurial Insanity, which he is currently restructuring in partnership with Tim Rowan to specifically address the issues
facing owners of home care agencies in a book titled, Entrepreneurial Insanity in the Home Care Industry to be published Fall 2016.
[2960] The World Has Changed: Word-of-Mouth Went Viral (and Nobody Told the Home Care Industry)
- Speaker
- McManus, Roger
- Model
- 2960
$30.00
Best Business Practices for Private Pay Agencies
[2958] Best Business Practices for Private Pay Agencies
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary: Business success tips for private pay agencies
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][5]quality improvement
§558.260[a][7]financial management
§558.260[a][10]marketing
Faculty:Cargle, Ken; Rine, Jennifer; Franco, Carolyn
Program Description:
Private Pay agencies take pride in focusing on client relationships, avoiding the “cookie cutter”
mentality of home health services. What makes the successful agency tick, and… earn a
profit? A seasoned panel of experts from the world of private pay presents
how they have fine-tuned their business strategies in critical areas including staffing, operations and marketing. Presentation Date: 08.11.2016
Learning Outcome: Upon completion of this program, the viewer will be able to:
Examine business success tips for private pay agencies including strategies for proper staffing, efficient operations and effective marketing.
About the Presenters:
Ken Cargle is the Administrator/Owner of Goodcare Health Services in Amarillo, Texas.
Ken has been active in home care for over 20 years and has owned a Medicare Certified agency (1994-2000) and has owned a Private Duty agency since 2000.
He received his Bachelor of Arts and Masters of Divinity from Texas Christian University. Professional activities include serving on the American Cancer
Society Board, Alzheimer’s Association Board, and the South Randall County Hospital Board. Ken is also the current president of the Texas Association for Home Care & Hospice.
Jennifer Rine has been a Registered Nurse since 1989 with wide-ranging clinical experience from medical-surgical oncology, labor and delivery, pediatrics, long term care and rehabilitation, and home infusion nursing. She returned to school and completed her BSN in 2008. As the Director of Nursing and Administrator for BrightStar Care her vision is to develop a reputation for passionate patient-centered care and excellence in the home setting by ensuring patients and their families experience the best possible care from a team that is well-trained and supported.
Carolyn Franco, BBA is the Administrator for Home Health Resources Agency- the private duty sister company to Home Health Resources, a licensed and certified home health agency. (HHR) Carolyn has been an organizational leader in the home health and community setting since 1996 when she began her health care career working for HHR, which was opened by her mother. She has 20 years experience in managing home care operations; having previously served as Chief Financial Officer and Director of Human Resources. Carolyn is deeply committed to using her extensive knowledge and experience to address challenges and barriers associated with recruitment, retention, supervision, and training of our most valuable asset, our caregivers, and to bringing Personal Assistance Services to the forefront of the senior care continuum.
[2958] Best Business Practices for Private Pay Agencies
- Speaker
- Cargele,K / Rine,J / Franco,C
- Model
- 2958
$30.00
Countdown to STAR Kids
[2954] Count Down to STAR Kids!
Education-Training Credits:
1.5 Hr(s) HCSSA Administrator/Alternate
Summary: All about the STAR Kids managed care model
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
§558.260[a][8]skills for working with clients, families, and other professional service providers
Faculty:Dees, Brian
Program Description: November 1, 2016 is the start date of STAR Kids. This program includes a
presentation from Brian Dees and other HHSC staff as to what’s left to prepare as the STAR Kids implementation date approaches.
Many questions from providers in attendance are addressed. The presenters also share what providers need to know as families
choose their plans and their services transition to managed care. Presentation Date: 08.10.2016
Learning Outcome: Upon completion of this program, the viewer will be able to:
Discuss the history, implementation plans, and clinical program requirements for the new STAR Kids managed care model.
About the Presenter:
Brian Dees has been a policy advisor in the Medicaid and CHIP
Division of the Health and Human Services Commission since 2011. He has worked closely on implementation of STAR Kids, a new Medicaid managed
care program for children and young adults with disabilities that aims to improve care coordination. He has also worked on projects ranging
from improving Medicaid program policies, to legislative analysis, to designing assessment tools for home and community-based services.
Brian holds a bachelor's degree from Austin College in Sherman, Texas, and a master's degree from the
University of Edinburgh in Edinburgh, Scotland. He lives in Austin, Texas, with his wife, Kellie, and two dogs, Dmitri and Seven.
[2954] Count Down to STAR Kids!
- Speaker
- Dees, Brian
- Model
- 2954
$45.00
New Dept of Labor Rules: Overtime Criteria & Other Risks for HHAs
[2950] New DOL Rule: Overtime Criteria and Other Risks for HHAs
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:Recent employment law changes & problems common to home health and hospice
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty:Haff, Alicia
Program Description: There are Big Changes from the Department of Labor (DOL) in the overtime criteria! Employers may now have
to pay overtime for employees whom did not meet those criteria last year. Don’t risk being a target
for a DOL investigation – get the facts! This program addresses many employment law problems
common to home health & hospice providers including...
overtime
on-call
travel time
hourly vs. contract workers
PRN
live-ins
work separations
Fair Labor Standards Act
Presentation Date: 08.10.2016
Learning Outcome: Upon completion of this program, the viewer will be able to:
Apply the recent changes in overtime laws and recognize employment law problems common to home health and hospice.
About the Presenter:
Alicia Haff, JD, Partner, ETC Companies, has practiced law in
Texas since 1997, after graduating from The University of Texas School of Law in Austin in 1996. Healthcare issues and specifically, the
Affordable Care Act, passed in 2010, have become Alicia’s passion. To that end, she obtained her Certified Health Care Specialist
designation and is certified as a Patient Protection and Affordable Care Act Professional. As part of her consulting practice,
Alicia is retained on a regular basis by clients to advise on the intricacies of the Affordable Care Act and clients’
need to come into compliance with the law and regulations.
[2950] New DOL Rule: Overtime Criteria and Other Risks for HHAs
- Speaker
- Haff, Alicia
- Model
- 2950
$30.00
How to Improve Outcomes While Dealing with Reimbursement Cuts
[2949] How to Improve Outcomes While Dealing with Reimbursement Cuts
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:CMS rebasing, Value-Based Purchasing, and episode management strategies to reduce risk
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty:Salmons, Laurie
Program Description:
With the third year of PPS cost rebasing around the corner, it remains very important for agencies to monitor
costs while improving clinical outcomes. Agencies MUST make their operations more efficient to preserve
margins. Meanwhile, on the clinical front, reporting measures call for agencies to focus heavily on reducing
ACH rates. Effective episode management that uses best practice processes and triggers will be the key to
success in both these areas. Presentation Date: 08.10.2016
Learning Outcome: Upon completion of this program, the viewer will be able to:
Describe CMS rebasing, Value-Based Purchasing, and episode management strategies to reduce risk.
About the Presenter:
Laurie Salmons, RN, BSN, Clinical Consulting Manager, McBee Associates, has been a
registered nurse for over 30 years with 20 of those years being spent in the home care industry. Her specialty is working with home care providers to
improve the care delivery services of the elderly while in their homes through episode and disease management strategies.
She has lectured on home care issues for the National Association of Home Care and Hospice and
at regional and state conferences as well. Laurie co-authored a manual on Best Practices for the Home Care Patient.
[2949] How to Improve Outcomes While Dealing with Reimbursement Cuts
- Speaker
- Salmons, Laurie
- Model
- 2949
$30.00
Infection Control Components for Home Care & Hospice
[2822] Infection Control Components for Home Care & Hospice
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:Infection control compliance strategies.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.259[d][8]infection control
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][6]risk assessment and management
Faculty:Kelley, Freda
Program Description: This program presents the role of the hospice and home care
administrator in the adoption and enforcement of infection control practices. With focus on
compliance in our world today, setting the standard for basic infection control practices is crucial.
Key infection prevention strategies are presented to assist in the management of re-hospitalization rates,
patient satisfaction and quality patient care. The presenter also demonstrates how providers, practitioners,
patients and lawmakers are all currently involved in this issue. Learn what you as an administrator should
be asking of your agency with regard to this topic. Presentation Date: 11.16.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify issues in standard infection control practices from our history and events in the world today that impact both patients and providers.
List key implications for infection control practice in the home healthcare setting.
State how providers, practitioners, patients and lawmakers are all currently involved in infection control issues.
Identify the regulatory administrator responsibilities in infection control practice in the home care and hospice agency.
About the Presenter:
Freda Kelley has been a Registered Nurse since 1975 and
has personal experience with the changes of infection prevention and control practice over the years. Her focused area of practice in
home care began in 1985. It was her initial experience as a PRN field nurse in a small, hospital-based home healthcare agency in rural
West Texas that set her professional future. Freda has served as a Branch Agency Director, Administrator, Supervising Nurse and now
as Vice-President of Clinical Services of a home care organization in Ft. Worth.
[2822] Infection Control Components for Home Care & Hospice
- Speaker
- Kelley, Freda
- Model
- 2822
$30.00
A Corporate Integrity Agreement May be Good Medicine
[2821] A Corporate Integrity Agreement May be Good Medicine
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary:Ensure your risk and
compliance programs meet the Federal Sentencing Guidelines (FSG).
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][6]risk assessment and management
Faculty: Bommelje, Karen
Program Description:
In today's healthcare environment there is an ever-increasing amount of scrutiny and government oversight
of home health and hospice providers. It may not be a question of "if" you are ever under investigation,
but "when" your agency is under the microscope. It is becoming increasingly necessary to ensure your risk and
compliance programs meet the Federal Sentencing Guidelines (FSG).
This program looks at specific Corporate Integrity Agreements (CIAs) and
how closely mirrored they are to the FSG. A robust, effective and ethical compliance program that is more than
a binder on the shelf will be a key to keeping the "medicine" away! Presentation Date: 11.17.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify the Seven Elements of a compliance program
Explain how to evaluate the effectiveness of your current compliance plan
Describe how an effective compliance plan will assist in reducing risk
About the Presenter:
Karen Bommelje is a seasoned professional with more than 25 years of
nursing, management, and consulting experience in the health care industry, including: home care, pediatrics, hospice, long-term care, home care pharmacy/infusion, and
medical equipment/respiratory. Prior experience includes Corporate and Regional positions with multi-site Home Health and Hospice providers.
Karen’s focus since 1991 has been in Regulatory, Quality, Accreditation and Compliance areas.
Karen has been with Simione Healthcare consultants for the past five years where she is a Senior Manager on the Compliance Team responsible for
management of regulatory and compliance projects for attorneys and clients.
[2821] A Corporate Integrity Agreement May be Good Medicine
- Speaker
- Bommelje, Karen
- Model
- 2821
$45.00
The Most Interesting Employment Issues in the World for HH & Hospice
[2819] The Most Interesting Employment Issues in the World...for Home Health and Hospice
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary:Key employment issues impacting the home health care and hospice industry.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
Faculty: Stern, Daniel
Program Description:
Two years ago it felt like a new employment rule was put into effect each week but now it seems like a daily occurrence.
Most of the activity is being generated by state and federal agencies making it extremely difficult to remain up to date
on employment law issues. This program presents the hot buttons of liability including which employees are exempt under
the Fair Labor Standards Act and how to pay them (the new regulations will make it much more expensive).
The federal government has also issued new guidance regarding independent contractors.
Compensable time quandaries such as travel, on-call, waiting time and bonuses (discretionary and/or non-discretionary) are discussed.
If you use the companionship exemption, you need to know the Department of Labor seems to have succeeded in basically eliminating
it for home health care agencies. The need to provide leaves of absence seems to have expanded to the point that employees may not ever have to come to work.
Finally, we are still having fun reading what the National Labor Relations Board says employees may post on Facebook about employers...and not be disciplined! Presentation Date: 11.17.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify key employment issues impacting the home health care and hospice industry
Discuss ways to effectively respond to the new issues impacting the home health care and hospice industry.
Identify expected changes in regulatory agency enforcement activity
Describe effective tools for preventing employment related claims
About the Presenter:
Daniel Stern advises employers on labor and employment matters including
affirmative action plans; wage and hour issues; and discrimination and harassment claims. By recommending and developing effective employment policies
and procedures, he helps clients reduce the risk of employment-related lawsuits.
Dan works with employer clients to bring their existing workplace policies into compliance with best practices in
the human resources field, and he provides day-to-day counseling which enables clients to make wise decisions in human resource matters. Understanding the
frequent and complex employment issues continually faced by today’s employers, Dan has designed his practice so that he is readily and quickly available to his clients.
He is a frequent speaker and author on employment matters and labor-related legislative changes, with a particular focus on wage and hour issues.
He is Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization.
[2819] The Most Interesting Employment Issues in the World...for Home Health and Hospice
- Speaker
- Stern, Daniel
- Model
- 2819
$45.00
What Financial Reports Really Mean to the Health Care Manager
[2741] What Financial Reports Really Mean to the Health Care Manager
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary: Financial reports for non-financial folks...
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty: Spears, Jan
Program Description: Whether you are planning for growth and
need capital investment or a business loan, or planning for a sale and need a quick evaluation of
your agency’s worth, or if you simply need a measurement of your month-to-month progress, financial
reports are the first critical pieces to which you must look. If these reports are prepared internally or
from outsourced to an accounting firm, understanding the significance of the information is the responsibility
of the owner, administrator and, yes, the clinical management team. This program explains key concepts that your financials might reveal about the agency and covers topics such as....
standard reporting formats and recommended frequencies
cash vs accrual options
fixed vs variable costs
debt to equity ratios
break-even points
and a brief review of case-mix weights as these affect your revenue performance
You will learn some standard formulas that you can apply to trend your financial performance
from point to point in your reporting year in key areas such as management of accounts receivables through Days Outstanding calculations. This program is
presented in a friendly environment for the non-accounting managers! Presentation Date: 08.13.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify two reasons why clinical managers need to understand financial reports
Recall the difference between cash versus accrual methods in financial reporting
Identify three of the four standard financial reports formats that are products of financial data
Calculate Days Sales Outstanding as a component of evaluating accounts receivable stability
Identify four components that affect case mix rates for the Medicare home health patient
Calculate debt to equity ratio as a component of agency’s liquidity
About the Presenter:
Jan Spears is Co-owner and Chief Executive Officer of
MJS & Associates, LLC. She has more than 30 years’ experience in the health care field. Ms. Spears has owned and operated a multimillion
dollar home health care company as well as consulted for over 300 homecare providers in 25 states. As a full time consultant for the past 15 years,
Ms. Spears has successfully merged clinical and financial strategies into successful operational plans for numerous providers nationwide. Jan serves
as a Medicare coverage expert for health care facilities who are undergoing audits by federal contractors through all levels of appeals. She has
authored several publications and heads a team of more than 25 consultants at MJS & Associates, LLC.
[2741] What Financial Reports Really Mean to the Health Care Manager
- Speaker
- Spears, Jan
- Model
- 2741
$37.50
Destination Documentation: Surviving Medicare Denials & Audits
[2739] Destination Documentation: Surviving Medicare Denials & Audits
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary: Focus on Documentation...
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][2]development and interpretation of agency policies
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty: Warfield, Jennifer
Program Description: Agencies are constantly at risk of audits, denials,
sanctions and or penalties for missing or inadequate documentation. This program will help you learn to avoid pitfalls of poor
documentation, recognize areas which are likely to trigger an audit and detect items that frequently contradict care deemed to be
reasonable and necessary. Additionally, you will learn ways to safeguard your agency by properly responding to ADR’s and audits. Presentation Date: 08.13.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Describe documentation areas likely to trigger an audit
List OASIS items that frequently contradict care that is reasonable and necessary
Identify ways to safeguard your agency from audits and denials
About the Presenter:
Jennifer Warfield As a well-known homecare coding and OASIS specialist with
extensive nursing experience, Jennifer Warfield is an informational ally for hundreds of home health agencies across the country. Certified as an official
ICD-9 and ICD-10 trainer, Jennifer provides education on important industry topics, including coding, OASIS and documentation. Her passion for being an
educational resource keeps her traveling across the country to agencies and associations, conducting educational workshops and speaking at numerous home
care conferences. Her expert knowledge plays an integral role in the development of OASIS Analysis Plus, PPS Plus Software’s OASIS analysis software.
Jennifer received a bachelor’s degree in nursing from the University of South Alabama in Mobile, a home care coding
specialist – diagnosis certification from the Board of Medical Specialty Coding in Gaithersburg, Maryland and earned her Certificate for OASIS Specialist-Clinical
from the OASIS Certificate & Competency Board in New Iberia, Louisiana. She is author of two ICD-9 coding guidebooks, Tips, Tricks & Tidbits for Home Health
Professionals, and is currently serving as the education director at PPS Plus Software in Biloxi, Mississippi.
[2739] Destination Documentation: Surviving Medicare Denials & Audits
- Speaker
- Warfield, Jennifer
- Model
- 2739
$45.00
Therapy Documentation: Required Rehab Content, Goal Writing, Visit Note Production
[2735] Therapy Documentation: Required Rehab Content, Goal Writing, & Visit Note Production
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary: Rewiring your rehab concession to assure a skilled, audit-proof therapy program.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty: Cisneros, Arnie
Program Description: Home Health rehab reforms have
modified many therapy requirements including elimination of the 10-visit threshold, objective testing, and
ongoing re-assessment re]inement to name a few. Auditors have focused on the rehab elements of patient claims
as they produce denials for unskilled or unnecessary care delivery. The Affordable Care Act (ACA) bundling model
will focus on the rehab content in homecare programs as they seek greater efficiency under decreased utilization
to achieve cost reduction goals.
Therapy ST/LT goal production, skilled per visit documentation, patient compliance,
caregiver involvement, and discharge planning and management are all addressed by a PPS-compliant, objective test-based
therapy evaluation. Clinical case examples will outline the good and bad in current therapy documentation, with strategies
to manage successful therapy programs. Start today on rewiring your rehab concession to assure a skilled, audit-proof therapy program. Presentation Date: 08.12.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify current rehabilitation elements in the Medicare PPS (Prospective Payment System) Home Health model.
Describe Goal Writing for Home Health rehabilitation services.
Describe Visit Note Production for Home Health rehabilitation.
About the Presenter:
Arnie Cisneros, PT, President of Home Health Strategic Management, is one of the most progressive speakers in Home Health today.
His legacy as a rehab provider across the care continuum allows for insight into contemporary healthcare delivery. He is renowned for his adaptation of traditional care philosophies to address current and
future healthcare initiatives. Arnie’s refinement of clinical delivery mechanisms, integration of new protocols at the staff level, and adaptation of traditional care philosophies has helped providers
of all sizes to achieve Medicare compliance. He has also become the leading clinical authority on the audit scrutiny that has come to the homecare industry, and is serving as a Post-Acute consultant for
CMS Pioneer ACO grant recipients.
Arnie is a contributor to CARING magazine and Decision Health publications, and presents nationally on homecare topics and care models proposed by CMS and
Med Pac for the future of the Home Health industry.
[2735] Therapy Documentation: Required Rehab Content, Goal Writing, & Visit Note Production
- Speaker
- Cisneros, Arnie
- Model
- 2735
$37.50
Achieving Efficiencies in Back Office Staffing & Structure
[2662] Achieving Efficiencies in Back Office Staffing & Structure
Education-Training Credits:
1.00 Hr(s) HCSSA Administrator/Alternate
Summary: How to measure & control back office costs.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][7]financial management
Faculty: Gaboury, Melinda
Program Description: Having and efficient back office that is accountable to key performance
metrics is a key component to financial wellbeing. As
an administrator, you are responsible for “implementing an
accounting and budgeting system that promotes the health and
safety of the agency’s clients” (TAC §558.243).
This program presents
the cost indicators that must be understood in making operational
decisions, items needed to develop billing performance
measures that hold the billing department accountable and detail
items to review in order to evaluate your back office structure.
Supervising nurses may also benefit from a working knowledge
of back-office processes to improve collaboration between billing
and clinical aspects of patient care. Presentation Date: 11.18.2014
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify the cost indicators that must be understood in making operational decisions regarding back office staff
Develop billing department performance measures
Detail items to review to evaluate back office structure
About the Presenter:
Melinda Gaboury, COS-C, is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc.
(HPS). Melinda and Mark Cannon founded the company in April 2001 to provide financial, reimbursement, clinical
and cost reporting services to the home health industry. She has over 20 years’ experience in Medicare Home
Health Reimbursement and has remained on the cutting edge of Medicare PPS since the regulation’s inception.
She has helped her clients bridge the gap between clinical and financial issues and has been a seminar and
webcast presenter for 20+ State Home Care Associations. She is also the author of “Home Health Pocket Guide
to OASIS-C.”
[2662] Achieving Efficiencies in Back Office Staffing & Structure
- Speaker
- Gaboury, Melinda
- Model
- 2662
$30.00
Patient-Centered Medical Home (PCMH) Collaborative Care
[2598] The Quest for the Perfect Triad for Patient-Centered Medical Home (PCMH): Collaborative Care between Primary Care, Home Health and Hospital Teams
Education-Training Credits:
1.00 Hr(s) HCSSA Administrator/Alternate
Summary: Learn how PCMH strategies improved care coordination,
care delivery, and patient outcomes.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][5]quality improvement
§558.260[a][7]financial management
§558.260[a][8]skills for working with clients, families, and other professional service providers
Faculty: Khan, Nusrat (Ness)
Program Description: The current void of collaborative care between
the primary care physician’s practice, inpatient care, and home health is
costly for the U.S. healthcare system and can result in poor outcomes. Home health and primary care in a patient-centered
medical home (PCMH) has a role in addressing this need through a new approach with better care-
team collaboration.
PCMH is a patient-centric model of healthcare delivery based on ongoing, personal relationships
between patients, physicians, and healthcare teams, which includes the patient as a team member. In this program a primary care physician
describes how a Texas physician practice transformed into a medical home, adopted PCMH
strategies and partnered with hospitalists and preferred home health partners to improve care coordination,
care delivery, and patient outcomes. Learn why...and how home care is part of the PCMH team.
Presentation Date: 8.20.2014
Program Objectives: Upon completion of this program, the viewer will be able to:
Define the patient-centered medical home model of care delivery.
Discuss the importance of care coordination as it relates to improved care at a reduced
cost.
Describe the implications for future collaboration between home care providers and
physician practices.
About the Presenter:
Nusrat (Ness) Khan, MD, MBA, FAAP, is
the Medical Director of MedPeds Medical Clinic, PA in Weatherford, TX. He
completed his early education, college, and medical school in North Carolina and completed specialty training
and board certification at the Cleveland Clinic Foundation in Cleveland, Ohio. He is double board certified
in Internal Medicine and Pediatrics. His love of teaching manifested early in his career; he has received
teaching awards at Cleveland Clinic Foundation, and at University of North Texas Health Sciences Center.
Dr. Khan remains a strong believer patient centered medical care model. For the last 2 years he has being
working on creating and implementing models for patient centered care plans that allow seamless information
and care transfer at transitions of care between outpatient clinics, Home Health Care, and inpatient care.
[2598] The Quest for the Perfect Triad for Patient-Centered Medical Home (PCMH): Collaborative Care between Primary Care, Home Health and Hospital Teams
- Speaker
- Kahn, Nusrat
- Model
- 2598
$30.00
Affordable Care Act [ACA] & Employer Mandate: The Numbers Count!
[2607] Affordable Care Act (ACA) and Employer Mandate- The Numbers Count!
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary: Find out what numbers in the ACA can impact your agency.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][2]development and interpretation of agency policies
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty: Haff, Alicia
Program Description: The US Treasury Department published final regulations
implementing Employer Shared Responsibility Under the Affordable Care Act (ACA) for 2015. The final rules provide, for 2015, that an
employer responsibility provision will generally apply to larger firms with 100 or more full-time employees starting in 2015 and
employers with 50 or more full-time employees starting in 2016.
This program addresses the transition provisions, and clarifies whether employees of certain
types or in certain occupations are considered full-time, including volunteers. It provides information about the employer
responsibility provisions in 2015 such as who must offer coverage to at least 70 percent of full-time employees as
one of the conditions for avoiding an assessable payment, rather than 95 percent which will begin in 2016. Alicia also discusses
the full-time employee status determination and an optional look-back measurement method to make it easier to determine
whether employees with varying hours and seasonal employees are full-time, help clarify the method and the
alternative monthly method of determining full-time status, and review the final rules which provide safe harbors that
make it easy for employers to determine whether the coverage they offer is affordable to employees and next steps for simplifying
employer information reporting. Presentation Date: 8.21.2014
Program Objectives: Upon completion of this program, the viewer will be able to:
Recognize that knowledge is power when understanding the employer mandate.
Identify which employer size “sandbox” applies to your organization.
Identify which employees must be offered coverage in 2015 to avoid costly penalties.
Design a recordkeeping system to track employer mandate requirements.
About the Presenter:
Alicia J. Haff, JD, has practiced
law in Texas since 1997, having obtained her Bachelor of Arts in History from Trinity University in 1992 and her
Juris Doctorate from the University Of Texas School Of Law in Austin. From 1997 until 2010, Alicia spent her time
litigating employment disputes, commercial matters and personal injury claims. Healthcare issues and specifically,
the Affordable Care Act, passed in 2010, have become Alicia’s passion. To that end, she obtained her Texas General
Lines License in 2007 and thereafter, obtained her Certified Health Care Specialist designation and is certified as
a Patient Protection and Affordable Care Act Professional. As part of her consulting practice, Alicia is retained on
a regular basis by clients to advise on the intricacies of the Affordable Care Act and clients’ need to come into
compliance with the law and surrounding regulations.
[2607] Affordable Care Act (ACA) and Employer Mandate- The Numbers Count!
- Speaker
- Haff, Alicia
- Model
- 2607
$45.00
Bridging Business & Clinical: Achieving Operational Excellence
[2606] Bridging Business and Clinical: Achieving Operational Excellence
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary: Three TAHC&H presidents share their expertise.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][2]development and interpretation of agency policies
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Faculty: Lee, Lucy & Cargle, Ken & Madison, Dana
Program Description: It’s a simple fact – if business operations can’t
“stay in the black”- you won’t be providing patient care very long. Aligning
staff skills and patients’ needs with operational goals can be a challenge. Where do you begin with strategic planning, annual
goal setting and efficiencies? How do you assess administrative overhead? Business managers must consider a multitude
of factors to achieve operational goals and inspire process improvement. What about fixed costs vs. variable costs;
productivity expectations of clinical staff; controlling overtime costs; benchmarks for cost centers? Don’t be overwhelmed!
Learn from the best…in this program a panel of seasoned veterans of successful home care agencies share their expertise
on how to run “the business.” Learn their secrets including enhancing communications with staff to promote the goal of
shared responsibility for operational success. Presentation Date: 8.21.2014
Program Objectives: Upon completion of this program, the viewer will be able to:
Discuss the relationship between clinical practice and financial realities.
Describe the importance of goal setting to achieve business objectives.
Identify at least two strategies to motivate agency staff to achieve clinical operational
objectives.
About the Presenters:
Lucy Lee, RN, MS, CHCE, Founder and President of a rural
Texas home health agency, Lucy has been involved in the home health industry for over 28 years. She has first-hand knowledge of the
practical aspects of home health agency management, having worked in all levels of home health care from contract field nurse
through director of patient care to administrator, and is now responsible for strategic planning and alliances. Lucy has served
on the board of TAHC&H representing certified agencies, and has served as secretary, and as president of the association. She has a
Master’s degree in Healthcare Administration and is a Certified Home/Hospice Care Executive.
About the Presenters:
Ken Cargle is the Administrator/Owner of Goodcare
Health Services in Amarillo, Texas. Ken has been active in home care for 19 years and has owned both a Medicare Certified agency and
a Private Duty agency. He received his Bachelor of Arts and Masters of Divinity from Texas Christian University and is an active leader
of the Texas Association for Home Care & Hospice; where he has served as President, the Owner auspice, the Licensed Home Health auspice,
and the Licensed and Certified auspice. He has served and chaired on various TAHC&H committees, subcommittees, councils and task forces,
and actively participates on the TAHC&H Owner’s Forum Networking Group.
About the Presenters:
Dana Madison, RN, BSN, MBA is the Administrator/Owner of
Calvert Home Health Care, Ltd in Lubbock. Dana’s health care experience includes working as an RN for 30 years, a hospital administrator for
2 years, a Practice Manager in a physician’s office for 8 years and a home health administrator and owner for 19 years. Dana received her BSN
from Texas Women’s University in Dallas, and an MBA in Health Care Administration from the University of Dallas. Dana served as the President
of the Texas Association for Home Care & Hospice from 2010 – 2012.
[2606] Bridging Business and Clinical: Achieving Operational Excellence
- Speaker
- Cargle, K / Lee, L / Madison, D
- Model
- 2606
$45.00
