PDGM will bring complexity to the admission process with new requirements for early vs. late and community vs. institutional admissions. Add to that the changes required by the new CoPs, and the need to rethink intake process becomes clear. Learn how to identify potential compliance issues in your current intake processes so you can avoid issues later. - Tool: Intake tool

 

How you get what you pay for can lead to non-compliance and diverging goals between provider and employees under PDGM. Paying on a per visit basis is about to become a thing of the past. It’s time to re-evaluate employee costs. Learn how to structure the cost, how to calculate the value of therapy, and what you can learn from modeling and clinical practice guidelines so you can successfully make the shift from volume to value.

 

From clinician care plans that support the selection of diagnoses that fit into PDGM grouping to documentation and CoP adherence, find out what staff needs to know to make sure they are ready for PDGM in their daily work. - Tool: Revenue cycle flow sheet

 

The new CoPs, Value Based Purchasing and PDGM will bring new compliance issues as they influence and affect the revenue cycle. Regulators are already tracking agency performance using claims data, so understanding your agency’s own trends in 2019 is vitally important to your future in 2020. Learn how to maximize case-mix under PDGM – and reimbursement – without gaming the system. - Tool: Process review checklists. Key VBP metrics to watch

 

PDGM is a game-changer for Therapy in home health. Get an overview of the latest research and learn how to properly utilize therapy under PDGM. Understand the value of therapy so you can facilitate the shift from a volume- to a value-based system of care for the Medicare Part A Home Health beneficiary, with the intent of better aligning payment for services to patient characteristics. - Tool: Clinical (therapist) dashboard

In proposing PDGM, CMS outlined behaviors they expect home health agencies to perform in response to the new payment model. Learn how to avoid being accused of gaming of the system. Take a deep dive into each of the assumptions and learn transparency, supportive documentation, and effective processes can keep your agency in the clear. - Tool: Care planning and care coordination worksheet

 

 

 

From changes in regulation to PDGM, get all the latest compliance developments. Plus, learn the most common reasons for claims denials and gain an understanding of where those issues are outlined in the regulations.

An effective compliance plan has just seven elements, but putting each aspect to work in your agency poses a variety of challenges. Learn how to build a culture of compliance that will support your plan. Get expert advice for each step of the way from teaching and communicating through peer review to getting staff buy-in and ownership. You’ll learn how to designate a compliance office and committee (Element 1), and the requirements for conducting regular and effective staff training and education (Element 3). - Tools: Compliance officer job description, Compliance Committee Confidentiality Agreement, Compliance Education Plan and Record, Agency Evaluation of Clinical Orientation Objectives, Education of Staff Policy

When non-compliance rears its ugly head, it’s not just an agency issue. As an individual practitioner, noncompliance could impact your license. When you attest that you’ve met payor requirements for reimbursement are you making certain you’re not putting your professional future at risk? - Tool: Entry level skill set for physical therapy, Therapist job description

 

Learn about the top 10 home health survey issues and find out what you can do to guard against trouble in this panel discussion.

 

Written policies, practices and standards of conduct that meet the OIG’s standards will help your agency guard against charges of fraud or violations of home health regulatory guidelines (Element 2). Learn how to develop and implement policies, procedures and standards of conduct that are compliant and enforceable. Understand common home care risk areas and claims-processing areas flagged by the OIG and learn the key policies and procedures you should have in place. - Tool: Standards of conduct, Standards of Conduct Employee Attestation

Every year providers are faced with a myriad of changes and this year is no different. Whether it’s the DOLs notice of proposed rulemaking, new survey interpretations or the annual PPS rule, change is a constant. This session will review key regulatory changes and enforcement trends of importance to home health and hospice providers. This will include the DOLs' recent proposed changes to the salary basis of payment, EEOC enforcement trends, changes at the NLRB, HIPAA enforcement trends, new OIG guidance and workplan issues, and more. Providers will learn from this discussion key areas of compliance focus to consider in planning their 2020 compliance efforts.

Before you purchase an EMR, you need to do your due diligence. Expecting an EMR to be everything you need right out of the box could present some hurdles. Make sure you know the questions to ask and considerations to keep in mind to make the most of this investment and boost compliance in your organization.

An effective compliance plan must include a process to receive complaints, procedures to protect the anonymity of complainants and protection against retaliation for whistleblowers (Element 4). Learn how to develop a system to respond to allegations of improper or illegal activities, including creating disciplinary guidelines and enforcing disciplinary action against violators (Element 5). - Tools: Sample hotline reports form, Hiring Practices, Pre-employment Checklist, Progressive Discipline Policy

 

Home health and hospice agencies have an important role to play in preventing opioid abuse. At least one accrediting body has announced new standards around patient and family education when opioids are prescribed including safe use, storage and disposal of opioids. Requirements such as these are likely to expand throughout the industry. Gain a firm grasp on compliant and practical ways your agency can play a part in preventing opioid abuse. Learn the latest statics and discover solutions for controls, disposal and what to do when pills are missing. - Tool: Medication Disposal Checklist for Homes and Hospice Patients

An unbiased, outside, multi-disciplinary compliance audit can be the key to long-term results in your agency. Learn how you can use audits to monitor compliance and reduce problems (Element 6). Then, discover how to implement and measure the effectiveness of outside audits. Finally, learn how to develop compliant policies for corrective action (Element 7). - Tool: Internal compliance checklists for outside audits.

 

 

The regulatory requirements that we face today force us to look at compliancy and security much differently than we have in the past. It’s now essential to build a cultural mindset that involves all staff members. Review key areas of concern, risk identification and management, and learn proper ways to respond to events. Discover effective policies and procedures, and discuss how training and ongoing education are key to further develop the proper mindset and protect the data entrusted to us by those to whom we provide care.

The revised CoPs have brought their share of challenges. This session will give you a solid grounding in the key issues that have changed including documentation and home visit requirements. Get strategies to address top survey deficiencies on an ongoing basis with a focus on patient chart audits, employee record audits, field supervisory visits, and quality and infection control program requirements. - Tool: Visit Observation Checklist COP Chart Audit Checklist COP Policy Checklist

Investing in your compliance program can save your agency money. Understand the financial impact of survey deficiencies and false claims and use this data to demonstrate the ROI of your compliance program. Learn about the costs of non-compliance for common risk areas in home care and how your compliance program can help your agency steer clear. Plus, learn how to share your compliance program successes to gain support from the governing body.

 

As the home health industry navigates the ever-changing terrain of regulation and reform, the challenges are great. To continue to thrive, you need highly effective strategies for employee compliance buy-in and retention. Learn how to leverage the talents of your team to succeed in the face of change. Get strategies that work and learn how to bounce back when things don’t go as planned. - Tool: Hospital readmission prevention toolkit.

Fraud and misconduct continue to be challenging issues for home health leaders, staff, and board members. Reports and charges of fraud, abuse or misconduct can subject your agency to legal and regulatory critique as well as significantly damage the reputation of the agency. Managing the risk is complex. Home Health leadership needs to assure there are specific ways to identify, mitigate, and respond to these risks. Learn how to build a sense of compliance into what people do every day in the field from orientation on.

 

Put everything you’ve learned about compliance to work in this interactive session. Break into groups with your fellow attendees to work through a compliance scenario

Join the AHCC board for this conference wrap-up. Learn key take-aways and get answers to your compliance questions.