Learning Objectives:

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• Obtain and complete the Medicare Provider Enrollment Form - 855A
• Determine the appropriate background and experience for key agency hires
• Make informed decisions regarding the purchase of policies and procedures, information systems, documentation tools and other agency necessities
• Possess a working knowledge of the Medicare Conditions of Participation
• Know how to avoid fraud and abuse issues
• Accounting requirements for a Medicare HHA
• Financial reports filed with Medicare
• Awareness of regulatory business requirements
• Know the value of best business practices
• Keen awareness of the governmental agencies that may and will affect you
• Anyone who is starting a Medicare-Certified HHA

 

 

Agenda

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Part I: Introduction and General Overview
This session will introduce you to the home health business. It will review the necessary steps that must be taken to begin the process of agency start-up. Help you understand requirements for facility, financial, time, and personnel. Understand how to create effective billing, budget and other financial systems/processes. Define administrative and clinical needs, action plan and develop timeline, understand compliance and get the answers to the: Who, Why, What, Where, How and When regarding agency start up.

Part II: Medicare Requirements
This session will identify the requirements established by the Centers for Medicare and Medicaid Services as it relates to receiving Medicare payments.

Part III: Personnel/P&Ps/Processes & Systems
This session will review personnel considerations including Administrator and DPCS positions and contract requirements, policies and procedures, information system and documentation process.

Part IV: Marketing/Community Liaisons
This session will identify the essential components to effectively marketing your services. It will help you identify the right hires and liaison between agency and referral sources. Identify various ways to get your name out there and how to work collaboratively with Intake personnel.

Part V: Basic Accounting Requirements
This session will help you understand the basics of accounting. It will review operating budget, chart of accounts, balance sheets and income statements.

Part VI: Processes
This session will review orientation/supervision of staff, documentation, staff training and development and performance improvement.

Part VII: Medicare conditions of Participation (CoP's)
This session will review the Federal Register and revised Medicare CoPs and interpretive guidelines. It will review patient rights, and help you to understand how the CMS alphabet soup affects your agency; HHABN, OASIS, PoC, CLIA.

Part VIII: Business Resources
This session will identify important resources necessary to be successful in the business. Reviews Accounting Software, Medicare Billing Software, Payroll Services, Unions, Benchmarking & Productivity and Education.

Part IX: Skilled Nursing
This session will identify all skilled care identified under the Medicare CoPs. From Therapy, to skilled nursing duties of an LVN and RN, to certified Home Health Aides, these duties are required under the PoC.

Part X: Outcome-Based Quality Improvement
This session will help you understand OBQI/OBQM; its purpose, reports, process, outcomes and value.

Part XI: Governmental Agencies and Contractors
This session will identify the various government agency players in the home health field. Know who they are, what they do and how their roles affect your agency's existence.

Part XII: Fraud and Abuse History
This session will identify how to avoid fraud and abuse. Examples of fraud and abuse cases are shared to help you understand the terms "Whistleblower", MACs, RACs and OIG.

 

 

Faculty

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Mary Lou Connolly, RN, MS Consultant McCoy & Connolly Consulting, Inc. Former Administrator, UCSD Home Care	Nancy McCoy, RN, MS Consultant McCoy & Connolly Consulting, Inc. Former Dir. Of Clinical Services, UCSD Home Care	Thomas Boyd, BA, MBA Principal Boyd and Nicholas, Inc

 

Mary Lou Connolly & Nancy McCoy were administrators and directors of clinical services respectively at the University of California San Diego Home Care for ten years. They have nearly forty years of combined experience in home health in private proprietary, non-profit, single owner and hospital based agencies. Since July of 2002 Nancy & Mary Lou have consulted with numerous home health agencies to perform mock surveys, assist in developing & implementing Plans of Correction, providing staff education and training, assisting in home health agency start-ups and performing medical record audits. In addition, they have assisted agencies in review of ADR's and the appeals process and conduct organizational assessments to increase agency efficiency. Nancy & Mary Lou conduct annual CAHSAH seminars on the survey process and agency start-up as well as speaking at the annual CAHSAH conference on a variety of home care topics.

Thomas E. Boyd has over thirty years of Medicare reimbursement experience including almost twelve years with one of Medicare intermediaries for home health agencies. He is the chairperson of the NAHC/HHFMA task force committee on the HHA cost report. He has been a consultant to Medicare certified home health agencies and hospices since 1989 and has been a principal of Boyd and Nicholas, Inc. since 1993. Tom has a BA in Management/Accounting from Sonoma State University and a MBA in Business Administration from St. Mary's College. He is a member of the HHFMA Advisory Board of Directors, the Association of Certified Fraud Examiners, and the U.S. Chess Federation. Mr. Boyd has spoken on home health financial and compliance issues before NAHC, NHPCO and more than a dozen state and regional home health care associations.