[3051] Administrator’s Guide to Developing Your Director of Nursing
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary:Guidance to ensure the Administration and clinical team works
together.
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 Lopez, BSN, RN
Program Description: Regardless of an Administrator’s credentials, they are held
responsible for both the operational and clinical aspects of home care services. Home care is one of the toughest industries for compliance
given the never ending maze of rules and regulations. This is true both in the Administrative side and Clinical side. With that comes the
very delicate question, how does an Administrator help develop and guide the Director of Nursing to ensure clinical issues don’t balloon to
enforcement level violations that could affect the overall operation of the agency? Ensuring the Administration and clinical team works
together is critical to successful operations. In this presentation you will hear from your colleague and TAHC&H President who can share helpful
tips to implementing this team approach in your agency.
Presentation Date: 08.10.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and indicate an intent to
change or enhance their practice by implementing best practices that allow the administrator to effectively train the Director of Nursing to oversee the clinical operations of the agency.
About the Presenter:
Jennifer Lopez, BSN, RN is the State Health Services Director
for ResCare. She has worked in healthcare for over 25 years in many different settings including acute care, physician office, home health care
and residential services. She received her LVN from Cooke County College in 1987, Associates Degree in Nursing from North Central Texas College
in 1991 and her Bachelor’s Degree in Nursing from The University of Texas, Austin in 2003. She is also a Certified Developmental Disabilities Nurse (CDDN).
Her current responsibilities include providing education, training and clinical support for the ICF, HCS and CLASS programs in Texas.
She also serves as President of the Texas Association of Home Care and Hospice. Jennifer has a vast range of expertise in the areas of operations,
due diligence, QA, clinical, state and federal regulations, compliance and investigations. Jennifer has a passion to ensure each person cared for
receives the highest quality care possible.
[3051] Administrator’s Guide to Developing Your Director of Nursing
$37.50
[3050] How to Save Face with Face-to-Face
Education-Training Credits:
1.25 Hr(s) HCSSA Administrator/Alternate
Summary:The latest and greatest advice on doing Face to Face right!
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][6]risk assessment and management
§558.260[a][8]skills for working with clients, families, and other professional service providers
Faculty: Jennifer Warfield
Program Description: The face-to-face encounter documentation
has been a challenge for the home health industry, especially since the Medicare contractors have reported that preliminary
results for the Probe and Educate Review were not favorable. We still have much to learn when it comes to achieving better
results. If you have already received your five ADRs, use this presentation to learn how to make improvements going forward.
Additionally, of course, for those who have either not received any ADRs or those who have received denials, this is your
opportunity to learn effective strategies for making corrections. It’s important to note that accurate F2F documentation is
an essential part of pre-claim reviews. Join PPS Plus’s Education Director, Jennifer Warfield, as she explains and defines
required documentation, how to receive cooperation from providers, and how to respond to the ADRs for F2F documentation.
Presentation Date: 08.10.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and indicate an intent to
change or enhance their practice by implementing nursing documentation practices that will meet the intent of the Face-to-Face requirements.
About the Presenter:
Jennifer Warfield With over 30 years of healthcare experience,
Jennifer Warfield serves as the education director for PPS Plus, provider of OASIS analysis software, based in Biloxi, MS. She is the author of
two coding guidebooks, certified as a home care coding and OASIS specialist, ICD-10 trainer and frequently travels across the country to educate
home health professionals on important industry topics, like Face to Face documentation, pre-claim review, value-based purchasing, OASIS accuracy and ICD-10 coding.
[3050] How to Save Face with Face-to-Face
$37.50
[3049] Achieve Rewards from Your Performance Data
Education-Training Credits:
1.5 Hr(s) HCSSA Administrator/Alternate
Summary: TX MCOs present potential VBP/VPC approaches.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][8]skills for working with clients, families, and other professional service providers
Faculty: Angie Parks, United Healthcare; Robert Wells and Ceseley Rollins, Superior Health Plan; Kelley Longhofer, Community First
Program Description: Texas Medicaid payors are beginning to look at new payment models called “Value-Based Payments (VBP)
and/or Value Based Contracting (VBC).” The idea behind the new models is for payors to work with providers to ensure delivery of high quality and cost-effective care to their members.
TAHC&H brings you three (3) Medicaid Managed Care Organizations (MCOs) to present a panel discussion about steps a provider might want to take for structuring a VBP/VBC with a payor.
Providers will also learn how these (3) Texas MCOs are currently rolling-out VBP/VBC. They will spend time discussing the process they implement with providers and elements
needed to create VBP/VBC. Implementing a program in collaboration with your MCO could earn your organization rewards for quality services and care. Understanding how your data is
involved as well as other reporting requirements is critical to your success, so don’t miss this opportunity to be ahead of the curve rather than behind it!
Presentation Date: 08.09.2017
Learning Outcomes(s): Participants will actively engage in the learning activity and implement agency data
evaluation projects that will enhance their ability to participate in Value-Based Purchasing programs.
About the Presenter:
Angie Parks serves as the Senior Director for Quality Management & Performance
for UnitedHealthcare Community Plan of Texas. She has been with the plan since 2013. She oversees the local quality programs for UHC’s Medicaid, MMP and DSNP plans.
Ms. Parks is a registered nurse who holds a Bachelor of Science in Nursing from the University of Texas Health Science Center, and a Bachelor of Science in Adult & Corporate
Fitness/Wellness from Abilene Christian University.
About the Presenter:
Ceseley Rollins has been working with the STAR+PLUS program since 1998. She began working
in Houston, Texas shortly after the initial implementation for the STAR+PLUS program and has been working for the program ever since. Ceseley has played a significant role
with each STAR+PLUS expansion/implementation due to her role as Provider Relations Manager, Director of Operations, through her current role as Vice President, Medicaid
Operations for Complex Care Programs which includes STAR+PLUS, STAR Kids and STAR Health.
About the Presenter:
Robert Wells is the manager of Superior Healthplan’s Transformation Projects group. He
designs and manages value based incentive projects and works closely with HHSC to implement state directed alternative payment models. For several years, Robert has been
on the forefront of finding new ways for managed care organizations and Superior to interact with their provider networks. Robert has a background in provider relations
and business operations and lives in Austin with his wife, three children and six chickens.
About the Presenter:
Kelley Longhofer has 25 Years in Health Care Operations for Commercial, Medicare and Medicaid,
20 Years in Managed Medicaid Program Management and Operations as well as Provider Network Management, and 18 Years with STAR+PLUS and now STAR Kids in Program Management and
Operations. Kelley has worked in national health plan organization as well as local Texas provider sponsored health plans. Kelley is currently working with Community First Health
Plans in San Antonio after a long tenure with Amerigroup.
[3049] Achieve Rewards from Your Performance Data
$45.00
[3048] Violence in Home Care: Protecting Your Workforce
Education-Training Credits:
1.5 Hr(s) HCSSA Administrator/Alternate
Summary: The risk of violence from clients, family and community against your workforce.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][6]risk assessment and management
§558.260[a][8]skills for working with clients, families, and other professional service providers
Faculty: Robert Liles, JD and Anthony Cutrona, JD
Program Description: Home healthcare workers often face an unsafe and unpredictable
environment as they visit a client’s neighborhood and home. Since more violent incidents occur in health care settings than any other profession,
your administrative staff are also vulnerable. The presenters discuss the extent of the problem and what measures your home health agency or
hospice can take to help protect your workforce from violence.
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 reporting programs that will encourage healthcare staff to more readily report incidents of violence.
About the Presenter:
Robert Liles, JD has a background that is somewhat unique. In addition
to a law degree, he holds a Master’s in Health Care Administration. Robert has worked on the provider side, as a federal prosecutor and now represents
home health and hospice agencies around the country in connection with Medicare and Medicaid audits and investigations. While working as a federal prosecutor,
he was asked to serve as the first National Health Care Fraud Coordinator for the DOJ’s, Executive Office for U.S. Attorneys. In this capacity, he advised
prosecutors around the country regarding health care fraud statutes, schemes, investigative tools, privacy concerns, and compliance issues. Robert is a
nationally-recognized speaker and educator on health law regulatory issues. He has taught and lectured at regional and national conferences, seminars and
webcasts to federal and state prosecutors, auditors, industry representatives, providers and suppliers on a variety of regulatory issues.
About the Presenter:
Anthony Cutrona, JD began practicing home health law as general counsel
for a Houston home health agency in 1996 and opened his solo health law practice in 1997. In 2000, the Texas Association for Home Care named him its Associate
Member of the Year. Last year, after 20 years of representing home health care providers throughout Texas, Anthony joined Liles Parker as a Partner and opened
its San Antonio office. He continues to represent home health agencies in license and survey matters, administrative appeals, implementation of compliance programs,
employment issues, and defends nurses in Board of Nursing matters.
[3048] Violence in Home Care: Protecting Your Workforce
$45.00
[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
$45.00
[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
$30.00
[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
$45.00
[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)
$30.00
[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
$30.00
[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!
$45.00
[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
$30.00
[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
$30.00
[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
$45.00
[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
$37.50
[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
$30.00
[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
$30.00
[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
$45.00
[2603] SHOW ME THE MONEY!! Bonafide Ways to Improve Cash Flow and Cash Maintenance
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
Summary: A cash receipt plan to help keep cash in the bank.
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: Home care and hospice revenues are becoming more and more
difficult to obtain and nearly impossible to keep in today’s atmosphere of non-traditional Medicare with the scrutiny of government
contractors in post payment reviews. This Program explores several key components of a cash receipts plan that will help the agency improve
its conversion of receivables to real “cash in bank.” Surrounding the agency with a robust and timely billing and collections process, while
incorporating key compliance steps, will assist the agency in maintaining its cash in post payment audits. This program also offers processes that
can be implemented to reduce the risk of denials, overpayments or suspension of payments.
Measuring revenue cycle performance over time will prove the worth of developing a comprehensive revenue management program
into home health or hospice operations. Presentation Date: 8.21.2014
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify three typical threats to revenue cycle performance.
Recall two measures to improve the timely conversion of receivables to cash.
Identify three steps to incorporate clinical triggers into the revenue management plan.
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 she has successfully merged clinical and financial strategies into
successful operational plans for numerous providers nationwide. She serves as a Medicare coverage expert for health care facilities who are undergoing audits by
federal contractors through all levels of appeals. Jan has also authored several publications including Home Health Agency—Policies and Procedures, “Care Guides
for Home Health Practice under PPS”. She heads a team of more than 25 consultants at MJS & Associates, LLC.
[2603] SHOW ME THE MONEY!! Bonafide Ways to Improve Cash Flow and Cash Maintenance
$45.00
[2513] Achieving HIPAA Compliance
Education-Training Credits:
1.00 Hr(s) HCSSA Administrator/Alternate
Summary: HIPAA compliance is a hot topic again...and will remain that way. Find out why.
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][6]risk assessment and management
Faculty: Acevedo, Luis
Program Description: Achieving compliance with current HIPAA’s Privacy and Security
Rules continues to prove an overwhelming task for home health
and hospice administrators. Policy development, employee training
requirements, technical oversight and notice requirements
may seem too onerous or burdensome to your daily operation.
Never fear! It is not the end of the world! You can learn to be
compliant and minimize your agency’s risk and potential liability
and protect your patients privacy rights. Presentation Date: 11.19.2013
Program Objectives: Upon completion of this program, the viewer will be able to:
Describe an example of an administrative safeguard under the Privacy Rule
List one example of when a healthcare provider can release protected health information without authorization
Identify one situation in which a healthcare provider can be subject to a penalty for a HIPAA violation
Identify one entity to which the Security Rule would apply
Identify one duty of the HIPAA Privacy Officer
About the Presenter:
Luis Acevedo, JD, 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
access, regulation, compliance, Stark Law, anti-kickback and e-health. As a former in-house counsel for Atlantis Health Care Group, Inc.
he offers impressive experience in corporate, real estate and business counseling. Mr. Acevedo has used his extensive background to help
health care clients resolve internal conflicts, sales and transactions, and conflicts with government agencies.
[2513] Achieving HIPAA Compliance
$30.00
[2470] How To Get Something Out of Your Financial Statements (other than a headache)
Summary: Dexter explores financial statements and shows you how to get more from them than just kindling.
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: Braff, Dexter
Program Description: Every month...ok, maybe, maybe not...you
get financial statements. They look impressive – lots of columns, numbers, and ledger accounts, perhaps even a profit.
Unfortunately, as billing systems capture more and more data, financial statements
have gotten so dense and unwieldy that the information you need – and the insight you can get – is beyond the reach of
practically anyone without CPA in their title. Dexter explores financial statements and shows you how to get more from them than just kindling.
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify the key components of a financial statement
Evaluate the most important areas of the financial statement to focus on
Discuss how financial statements can misrepresent the “true” performance
About the Presenter:
Dexter Braff has more than 20 years experience
in health care mergers and acquisitions. Prior to forming The braff group, he was an associate and senior appraiser with Telesis
Mergers & Acquisitions. He also served as regional Director of Finance for Foster Medical Corporation. Dexter has written numerous
feature articles on mergers and acquisitions and finance and has authored the chapter on Home Health Care Valuation in the Handbook
of Business Valuation published by John Wiley & Sons. Additionally, Dexter is a frequent speaker at major industry conferences and
state association meetings. Dexter holds an MBA from the University of Pittsburgh and received the Vincent W. Lanfear Award for
academic achievement, a Masters of Science from the University of Oregon, and a Bachelor of Arts from Cornell University.
Education-Training Credits:
1.50 Hr(s) HCSSA Administrator/Alternate
[2470] How To Get Something Out of Your Financial Statements (other than a headache)
$45.00