The snow seems to be tapering off here. I heard on the radio this morning that DC is supposed to get another foot of snow on top of the 18 inches they’re under already. Fortunately there are some ways to keep from succumbing completely to cabin fever when you’re snowed in.
NGS has extended the Registration and On-Demand Playback of the Medicare University 2009 Virtual Convention until March 31st. In NGS’s own words: For the low cost of $150, you have access to over 60 unique on-demand courses, not offered through Medicare University, at a time that is convenient for you until March 31, 2010. Plus, you can earn as many as 57 continuing education units!
Access the Medicare University here: http://www.ngsmedicareconvention.com/
MHCA also offers webinars that you can access from the comfort of your couch and jammies. The next one will take place this Thursday, Feb. 11th. New TB Rules are Nearly One Year Old – Is Your Business on Track? https://m360.mnhomecare.org/event.aspx?eventID=14035&instance=0
Hopefully the snow will be cleared by next Thursday (the 25th) but in case it isn’t, you can also sign up for the MHCA Medicare Roundup Webinar (info here:https://m360.mnhomecare.org/event.aspx?eventID=14239&instance=0).
It is a snowy day here in the hinterlands, and we’re supposed to get another six to eight inches by noon tomorrow. What that means is we won’t see grass again until May. But there’s an upside to it–Februrary is National Heart Month, which is all about spreading awareness about heart disease and reminding people that, to avoid heart disease, they should eat right and excercise. Well, nothing gets your heart rate up like trudging through and/or shoveling heaps and heaps of snow. Of course, dancing helps a lot too:
Lastly, this one is for all the fashionistas out there. I mean, who doesn’t love Tim Gunn?
I can scarcely believe it, but this is my 80th post! 20 more and I’ll reach 100, and that, dear readers, is a real milestone. By my calculations, I should reach that milestone in about 4 weeks.
Anyway, the question I answered earlier this week–about how new home care agencies can go about getting those first clients–got me thinking. What are some ways to advertise for free? One of the best ways is Craigslist.
Craigslist has been given a bad rap recently; every time it appears in the news, it’s in conjunction with something sleazy or gruesome. But keep in mind that those instances are but a few amid millions. In other words, don’t let the media hype scare you away from something that can potentially bring in clients, and that doesn’t cost you any money.
Getting Started
For the purposes of this post, I’m going to assume you know nothing about Craiglist–feel free to skip ahead. When you first log in to Craigslist, you’ll see a list of cities. The first thing to do is select yours. Now you’ll want to create an account. (Don’t worry, it’s free.) Click on “my account”, which will take you to a login page. You’ll see a link that says, “Don’t have an account? Sign up.” Click that, follow the steps, and you’ll be all set with your account.
Where to Post
You’ll need to post your ad in either Household Services or Small Biz Ads. I’ve seen postings for home care in both. (You’ll want to stay away from therapeutic. That’s full of masssage therapists–some who are legit and some who are questionable, hypnotists and psychic palm readers. Plus, Craiglist charges you to post there now.)
Post in either Household Services or Small Biz Ads. Avoid therapeutic.
The most important thing to remember is be specific. If your ad isn’t clear about what it is you’re offering, you won’t get many inquiries. List the services you provide. Use bullet points. Define terms–remember, your potential clients might not be familiar with terms we use every day. So, if you say you offer palliative care, you’d want to say something like “We offer palliative care (pain and stress reduction)”. Include a link to your website, and a phone number where users can reach you. Be upfront about payments. If you don’t take MA or EW, say so. Conversely, if you accept payments on a sliding scale, let people know! Lastly, a catchy title for your ad can generate more views and increase the calls you’ll get.
Home health agencies and hospices may not technically be under Recovery Audit Contractor (RAC) reviews just yet, but at least one RAC is investigating areas that affect home care & hospice.
Health Data Insights (HDI), the RAC contractor for Region D, posted 66 new approved issues for review in January. Most of them apply to hospitals, but HDI is also approved to review durable medical equipment topics, two of which affect home health and hospice. The RAC will look for DME claims improperly paid for beneficiaries in a hospice stay. This could cause suppliers to come knocking on hospice doors for payment for claims dating as far back as Oct. 1, 2007.
CMS approved “Medical Supplies and Home Health Consolidated Billing” as another RAC issue on Jan. 6. The RAC will look for DME and supply claims paid by Medicare that should have been covered by an HHA under bundling back to Oct. 1, 2007, which could cause suppliers to go back and ask agencies for those payments.
While this has not yet been an activity for Minnesota RAC, now that one RAC has identified home health and hospice issue, the others won’t be too far behind. Expect to start seeing letters form the RAC (in region D at least for now). When you receive a request for information, respond promptly. RAC demonstration noted a significant percentage of claims recouped simply because the provider failed to provide documentation in a timely manner.
Don’t donate money to Medicare because you did not respond in time!
This week’s OASIS-C tip is brought to you by Spaghetti O’s, Shell Oil and the letter X.
Assessments
1. Understand the time period under consideration for each item. Report what is true on the day of assessment (including the preceding 24 hours) unless a different time period has been indicated in the item.
2. When the client’s ability status varies on the day of assessment, report the client’s usual status or what is true >50% of the time unless the question specifies differently.
3. ADL/IADL Items:
- Report the client’s ability, not actual performance or willingness to perform a task. While presence/absence of a caregiver may impact performance, it does not impact client’s ability to perform a task
- The level of ability refers to the client’s ability to safely complete the specified activities
- If a client’s ability varies between different tasks included in a multi-task item, report what is true in a majority of the included tasks, giving more weight to tasks that are more frequently performed; majority rules!
Documenting the client’s current status
1. Responses to items documenting the client’s current status should be based on independent observation of the client’s condition and ability at the time of assessment without referring back to prior assessments unless collection of items includes review of the care episode (e.g. “look back” items in OASIS-C).
2. Combine observation, interview and other relevant strategies to complete OASIS items as needed. However, when assessing physiologic or functional health statue, direct observation (WATCH the client perform the activity) is the preferred strategy.
3. Consider medical restrictions when determining ability.
Common Sense Tips
1. Stay current with evolving CMS OASIS guidance updates; ignorance is not a defense! (We’ll post updates here, of course.)
2. Only one clinician takes responsibility for accurately completing a comprehensive assessment although collaboration is allowed and appropriate for specific items; “one-clinician rule”. (e.g. The PT can’t evaluate the ADLs and the RN the other items).
3. When an OASIS item specifies “one calendar day” this means until the end of the next calendar day.
Yesterday I received an interesting question from a commenter:
I would welcome tips, suggestions, regarding how to aquire home health care clients as well as PCA eligible recipients. How did those in established agencies go about getting those first clients?
How do you get those first clients? Go where the clients are. Market directly to potential clients whenever possible. For example, if you want to market to elderly clients who may benefit from home care services, go to senior centers and offer to do a free educational program for the seniors. Talk about community resources within the area (make sure you do a little research so you know what they are), including home care services. Cover information in general about home health care services, without doing a hard sell on YOUR agency. Then leave your agency contact information. Also make sure your county public health and social services departments know that you are out there and looking for clients. You will need to contract with them but that won’t happen if they don’t know you exist. Some providers have had great success through radio advertising but be sure you market to the customer base you want. There are many things you can do to reach potential clients. Good luck. The clients are out there – they just need to know YOU are out there.
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I may have mentioned this in a previous post but it is worth repeating: the Home Health Prospective Payment System Personal Computer Pricer (geez…try saying THAT ten times fast!) is available via the CMS website: http://www.cms.hhs.gov/PCPricer/05_HH.asp
CMS asks that if you use the HH PPS PC pricer, to please download the 2010 version.
Lastly, it’s Friday, another week comes to an end. I only hope I can say the same for the cold. Have a good weekend and stay warm!
It’s a brisk one today, kids! Don’t you just love it when the wind cuts through your layers of clothes and the snow squeaks like styrofoam? I tell you, it really makes my day…and wearing an itchy wool hat really is the cherry that rounds off my January sundae. Anyway, speaking of January, here’s the summary of the January Open Door Forum.
- OASIS-C resources: CMS reminds providers that there are several resources available for staff education, including:
- OASIS-C Guidance Manual (September 2009) — http://www.cms.hhs.gov/HomeHealthQualityInits/downloads/HHQIOASIS-CManual200912.zip
- OASIS-C National Provider Calls. The transcripts of all three calls are available at — http://www.cms.hhs.gov/HomeHealthQualityInits/02_CMSSponsoredCalls.asp#TopOfPage
- OASIS submission and CASPER system: Beginning in late February, CMS will roll out changes in security. CMS is moving from an agency-shared login ID to personal login IDs. Any person responsible for submitting data or accessing reports will need his/her own login ID. CMS will work with small groups of states, completing the rollout in July. Each state’s OASIS Welcome page will post details. For more information, click on — https://www.qtso.com/download/Conversion_Personal_Login_IDs.pdf.
- Home health capitalization requirements: CMS is trying to ensure that regional home health intermediaries (RHHI) apply the capitalization requirements consistently. The intermediary will verify that a new agency meets the requirements at the time of application and prior to receiving billing privileges. Find more information on the capitalization requirements in Transmittal 312 at — http://www.cms.hhs.gov/transmittals/downloads/R312PI.pdf.
- Agency Sale: Sale of an agency within 36 months of the effective date of Medicare enrollment: Medicare contractors cannot provide information about a change in ownership. The seller must maintain records and the buyer must perform due diligence.
- Home Health Advance Beneficiary Notice (HHABN): CMS says that the notice was approved; however, it will be another couple of months before it’s ready.
- PSF SAS Data Files Last week, CMS posted the January 2010 quarterly Provider-specific Files (PSF) Statistical Analysis Software (SAS) data files. These files contain information about the facts specific to home health providers that affect computations for the Prospective Payment System (PPS). Download them at —http://www.cms.hhs.gov/ProspMedicareFeeSvcPmtGen/Downloads/hha_sas_psf1001.zip
- CMS Updated Pricer: CMS has updated the Home Health PPS Pricer for calendar year 2010. The Pricer makes:
Download the Pricer zip file at — http://www.cms.hhs.gov/PCPricer/Downloads/ZZWeb_HHA1031001.zip. Check out the Pricer Web site at — http://www.cms.hhs.gov/PCPricer/05_HH.asp.
Well, we’ve come to my favorite part of the week, and I hope it’s your’s too: it’s time for the OASIS-C Tip of the Week! This week’s tip focuses M2100: Types and Sources of Assistance.
When answering Types and Sources of Assistance (M2100), consider the following:
- Note that there are several tasks within the various categories. If a patient needs assistance with any of those tasks consider the task that represents the most need and the availability and ability of the caregiver(s) to meet that need.
- If more than one response in a row applies, (e.g., the caregiver(s) provides the assistance but also needs training or assistance), select the response that represents the greatest need.
- Medication administration refers to any type of medication (prescribed or OTC) and any route of administration including oral, inhalant, injectable, topical, or administration via g-tube/j-tube, etc.
- This item identifies availability and ability of the caregiver(s) to provide categories of assistance needed by the patient. It does NOT include home health agency staff.
