Minnesota’s Home Care laws and 245D laws are in the process of changing this year.  This has lead to some confusion and panic in the home care world.  We are trying to get a handle on Minnesota’s numbers when it comes to waivered service providers.

Does your agency provide waivered services through DHS?   Let us know!



Tuesday, April 15, 2014 – Wednesday, April 16, 2014
ICD-10 Beginner Course – Eagan, MN
8:00AM – 4:00PM (Both Days)


Be certain you and your coders have the tools needed to achieve accurate ICD-10 coding in 2014. This workshop is designed to ensure successful coding by providing the proper steps for accurate coding. We will provide guidance on the “language of coding” and how to think like a coder and provide home health clinicians and coders with current ICD-10 coding standards essential for accurate outcomes and payments.


Thursday, April 17, 2014 – Friday, April 18, 2014
ICD-10 Beginner Course – St. Cloud, MN
8:00AM – 4:00PM (Both Days)


Be certain you and your coders have the tools needed to achieve accurate ICD-10 coding in 2014. This workshop is designed to ensure successful coding by providing the proper steps for accurate coding. We will provide guidance on the “language of coding” and how to think like a coder and provide home health clinicians and coders with current ICD-10 coding standards essential for accurate outcomes and payments.


Decision Health offers all MHCA Members 10% off of Decision Health Coding Manuals and products – - Get your discount code by calling the MHCA office at: 651-635-0607


The Medicare Home Health Drug Regimen Review Class – FEB. 17


Member Rates:
Early Bird Rates Until February 3rd: $90 1st Reg. / $75 each additional
Standard Rates After February 3rd: $125 1st Reg. / $100 each additional

Non-Member Rates
Early Bird Rates Until February 3rd: $120
Standard Rates After February 3rd: $150

Helping your home care patients successfully manage medications is key to promoting optimal outcomes and preventing adverse events. Accurate completion of the mandatory Drug Regimen Review is the first step in the process. This interactive course give participants the need-to-know information to successfully manage a medication review with their home care patients. Through lecture, discussion and hands-on activities, course participants will be introduced to a three-phase model for completing the drug review activities including documentation, patient assessment, and drug regimen interpretation.

Special consideration for the competence level of the individual clinician and agency policy will be discussed. Competency assessment methods will documnet areas of proficiency, and identify areas requiring further support and training for each participant. Completion of related OASIS-C items and their relationship to Process Measures will be highlighted.

*Note: While designed to support the educational needs of home care therapists, this program is equally appropiate for nurses interested in understanding the drug review regulatory requirements and seeking objective practices and strategies for compliance.

Educational Goals:

  • Describe the purpose of the drug regimen review in home care
  • Identify regulations associated with medication review
  • Differentiate between side effects, interactions, ineffective drug therapy, non-compliance, and duplicate drug therapy
  • Recognize characteristics of high alert or high risk medications
  • Cite components of the OASIS medication process measure items
  • Describe a three-phase drug regimen review
  • Successfully complete drug regimen review competency activities

Attendees also will receive a comprehensive handout; including original, practical tools to facilitate effective performance of the drug regimen review, including:

  • Drug Review worksheets
  • Sample Medication Profile tools
  • Patient Assessment Algorithms for assessing Significant Side Effects,
  • Non-Compliance, and Ineffective Drug Therapy
  • Policy & Procedures for therapist involvement in drug review activities
  • Competency Assessment Tools for drug review activities

Hospice/Palliative Care List Serve

9 out of 10 adults would prefer to be cared for at home rather than in a hospital or

 nursing home if diagnosed with a terminal illness.

96%of hospice care is provided in the patient’s home or place they call home.

Here, at MHCA, we recognize the importance of Hospice and Palliative Care.  Networking with other Hospice and Palliative Care agencies is important and we recognize that.  Due to this need we have started a list serve for agencies to share questions and bounce ideas off of each other.  This is just our starting point and hope to continue to good work for all of our agency members.

If you are a member of Minnesota HomeCare Association and would like to become a member of the list serve, please email me at kschlottman@mnhomecare.org

Where do you begin when trying to get billing/appeal help with Blue Cross Blue Shield?

Blue Cross Blue Shield is a large insurance company for both commercial and government health insurance in the state of Minnesota.  If you have questions about a bill (as a provider) or trying to get an appeal completed, where do you call??

MHCA had a wonderful quarterly meeting with BCBS yesterday and this question was discussed.  If you ever have a question or concern as a provider, always start with the customer service number for BCBS.  They will direct you to the proper person to talk to.  Have you ever been told that they they do not have a expedited process for appeals or claims?  They do!  Make it known that it needs to be expedited for whatever reason and they will do the best they can do to help you help your client.  

MHCA is in the process of putting together a tool kit for our members regarding BCBS.  Stay tuned to the near future!!

Have a great holiday season!!

Maintenance Therapy for Home Health

Maintenance therapy has been around since the 1960′s, but how many agencies actually bill for maintenance therapy?  Are you truly providing maintenance therapy or is it restorative therapy?  Our rehab team here at MHCA had a great discussion regarding this today.  What are your thoughts regarding the following scenarios?  Would you consider this maintenance therapy or restorative and why?

Scenario #1 – A patient has been seen by OT for progression of right upper extremity ROM and function which had declined secondary to late effect of CVA.  Within the restorative episode, the patient was fitted with a small hand splint and provided with a home program that will require ongoing caregiver assistance.  Caregiver training was incorporated into the episode.  This patient is anticipating a change in caregivers in one month following completion of restorative therapy.  The OT would like to order 2-3 maintenance visits to be provided when the new caregiver is available.

Scenario #2 – You evaluate a client with Parkinson’s that you have seen for 3 episodes prior to this episode over the last 2 years following falls or a decline in status.  Client has a history of multiple hospitalizations every 4-5 moths over the last 2 years due to falls and change of status. When questioning client and family, it is relayed that the client performs well initially after receiving services and then falls or declines to the point of needing to be rehopitalized.  After evaluating client, you determine that the client is at prior level of function and after modifying the home program, is independent with caregivers in previous programs that you had set up on your last episode.  Your plan is to visit the client 1x/month over the next 3-4 months to reassess and modify the program as indicated.

Scenario #3 – You have an MS client who seems to cycle through the services at your agency.  The client has limited caregiver support thus follow through has been zero to none.  Would she qualify for maintenance therapy?

I look forward to the great discussion!!

Home Care – An ever changing world…

The world of home care is changing at a rapid pace affecting the nurses and doctors and everyone else involved in the health care field. How can we possibly stay on top of all of them? This is where information and education come in. The more we know as medical professionals, the better we can do our jobs, right?

The goal of this blog is to do just that by keeping you abreast of all of the changes taking place at Minnesota Home Care on a monthly basis. We welcome your comments, questions, concerns and any feedback you might have.


Plan Of Treatment For Therapy


1) Is it acceptable for therapy to use a range of frequencies on their Plan Of Treatment, ie: 1-3 times a week for three weeks, or 2 times a week for 2-4 weeks, or 1-3 times a week for 2-5 weeks.

2) When a Physical Therapist performs a supervisory 6th visit of a Physical Therapy Assistant must it be on exactly the 6th visit or could it occur on the 5th PTA visit?



1) Per the Medicare Benefit Policy Manual – Chapter 7, here is the regulation on using ranges

“Orders for care may indicate a specific range in the frequency of visits to ensure that the most appropriate level of services is provided during the 60-day episode to home health patients. When a range of visits is ordered, the upper limit of the range is considered the specific frequency.” 

So, if you 2-3x/week for 2 weeks – it would mean you intend to provide 3x/week for 2 weeks. If your agency consistent is using ranges for order and not providing the upper limit of the range, it may be a red flag for survey when auditing your compliance with the ordered frequency and duration.

2) It may occur anytime on or before the 6th.  Your supervisory visit just should not be beyond the 6th visit.


If you are interested in getting free access to our Nurse Consultants, free web-based training through Rochester Community and Technical College, the ability to network and get free education at our Region or Team Meetings and more, visit our website to find out more information about joining!