New Products
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
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
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
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
Abuse, Neglect & Exploitation: New Rules from TX Senate Bill 1880
[2826] Abuse, Neglect & Exploitation: New Rules from TX Senate Bill 1880
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:How new rules & investigation process identified in the
recently passed Senate Bill 1880 that dictates an agency's policies and responses to suspected ANE
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.259[d][7]abuse, neglect, and exploitation
§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:Brooks, Troy
Program Description: Texas has some of the most stringent
regulations related to the identification and investigation of suspected ANE in home
health and hospice. This program discusses the new rules & investigation process
identified in the recently passed Senate Bill 1880 that dictates an agency's
policies and responses to suspected ANE. Also examined are common mistakes that
agencies make with regard to ANE complaints and practical steps to avoid them. From
the intake of the complaint to the closing of the investigation, this program
addresses the processes needed to maintain compliance with Texas regulations. Presentation Date: 11.17.2015
Program Objectives: Upon completion of this program, the viewer will be able to:
Identify the rule that addresses self-reported incidents of abuse, neglect,
and exploitation for Home and Community Support Services Agencies.
Identify two laws that provide definitions for ANE as it is used in §
97.249.
Describe an allegation of abuse.
Describe Texas Senate Bill 1880.
About the Presenter:
Troy Brooks is a former Assistant General
Counsel for the Texas Department of Human Services, and has worked extensively with the Home and Community Support Services
Agencies Program. Troy now represents home health agencies across Texas in Medicare and Medicaid disputes with government
agencies and their contractors. He also represents home health agencies in negotiating and responding to government fraud
investigations. Troy runs his own law firm, Brooks Acevedo Attorney at Law, here in Houston, Texas.
[2826] Abuse, Neglect & Exploitation: New Rules from TX Senate Bill 1880
- Speaker
- Brooks, Troy
- Model
- 2826
$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
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
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
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
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
Abuse, Neglect & Exploitation: New Investigative Procedures & Reporting
[2970] Abuse, Neglect & Exploitation: New Investigative Procedures & Reporting
Education-Training Credits:
1.0 Hr(s) HCSSA Administrator/Alternate
Summary:This program addresses the processes needed to maintain compliance with Texas ANE regulations.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.259[d][7]abuse, neglect, and exploitation
§558.260[a][6]risk assessment and management
Faculty:Brooks, Troy
Program Description:
Texas has some of the most stringent regulations related to the identifcation
and investigation of suspected ANE in home health and hospice. This program presents the new rules & investigation
process identifed in Senate Bill 1880 that was passed last legislative sessions. SB 1880 provides for the Texas
Department of Family and Protective Services to be the state agency with primary
jurisdiction over ANE investigations. Examined is how these investigations have changed since the
implementation of SB 1880 and what has not changed. By examining common mistakes that agencies make with
regard to ANE complaints you will learn practical steps to avoid them. From the intake of the complaint to the
closing of the investigation, this program addresses the processes needed to maintain compliance with Texas regulations. Presentation Date: 11.14.2016
Learning Outcomes(s): Participants will actively engage in the discussion and incorporate best practices
for identifying and reporting abuse, neglect, and exploitation into their practice.
About the Presenter:
Troy Brooks is a former Assistant General Counsel for the
Texas Department of Human Services, and has worked extensively with the Home and Community Support Services Agencies Program. Troy now
represents home health and hospice agencies across Texas in Medicare and Medicaid disputes with government agencies and their contractors.
He also represents home health agencies in negotiating and responding to government fraud investigations. Troy runs his own law firm,
Brooks Acevedo Attorney at Law in Houston, Texas.
[2970] Abuse, Neglect & Exploitation: New Investigative Procedures & Reporting
- Speaker
- Brooks, Troy
- Model
- 2970
$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
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
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
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
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
Violence in Home Care: Protecting Your Workforce
[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
- Speaker
- Liles, R & Cutrona, A
- Model
- 3048
$45.00
Achieve Rewards from Your Performance Data
[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
- Speaker
- Parks,Wells,Rollins & Longhofer
- Model
- 3049
$45.00
How to Save Face with Face-to-Face
[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
- Speaker
- Warfield, Jennifer
- Model
- 3050
$37.50
Administrator’s Guide to Developing Your Director of Nursing
[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
- Speaker
- Lopez, Jennifer
- Model
- 3051
$37.50
