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Quality Management Role For The Betterment of Your Agency Picture

Quality Management Role For The Betterment of Your Agency

The Quality Manager can be a catalytic agent between departments in your organization. A Quality Manager in a strategic position in an organization can help improve revenues in multiple ways. Identifying processes assigned to staff ....

Up-date to ICD-10!

Changes to ICD-10 for 2018-2019 from the CDC!

Understanding Medicare Secondary Payer (MSP)

Understanding the role that Medicare Secondary Payer plays to patient care and your agency is critical.

Encouraging Physicians to Properly Complete Face to Face Encounters

Physicians may find themselves being denied payment by CMS for Case Management overseen fees and office visits due to poor documentation in their patient\\\'s medical record.


CMS Auditors

There are multiple points in the CMS reimbursement loop for home care agencies to receive denials from RACs Audits. One of those is failing respond to Palmetto GBA auto request for copies of medical records for review because the organization does n

CMS Star Report Picture

CMS Star Report

Do you know where to go to get your Medicare Star Report?

CMS Recovery Audits Contractors (RACs)

How many home health agencies failed to respond to Palmetto GBA auto request for copies of the medical record for review in Florida for an specific code probe?

Effective Communication Processes

Leadership tools must include alternative effective processes of communication in order to achieve cohesiveness in an organization and prevent negative events from occurring.

The Benefits of Accreditation for a Home Health Care Organization

HHCNToday have been there for many home health agencies before, during and after the accreditation and state surveys.

Agency #1 - Cited for incomplete infusion orders and lack of communication among team members. HHCNT assisted the organization to trace the formal processes used by the organization to admit and provide care for a patient on infusion services. Areas identified for improvement were:

1. Educating Community Liaisons on require information and medical orders for patients who require infusion services.
2. Providing education to Team Leaders on nursing standards in clinical practice, state regulations on specific requirements when writing orders and how to apply this requirements when writing infusion orders, communicating and documenting coordination of care with other health care providers in the community and the organization’s Administration policies and procedures.
3. Developed a standard Infusion Therapy Verbal Order form and a flow chart to assist clinicians to be consistent when writing infusion. Orders.
4. Results: Citation lifted.

Agency #2 – Agency placed on 100% Audit by CMS due to overutilization of therapies.
One hundred charts audited by CMS, lost revenue only 2%.

Agency #3 – Agency audited for Face to Face, homebound status, reasonable and necessary services. Won 89% of appeals, how?
Staff education done monthly on documentation, OASIS-C 1 and clinical practice. The organization has never been cited for any deficiency on state survey.

We always educate our home care agencies to conduct best business practice by following the rules, regulations and stay up-to-date on new rulings effecting the agency!

Medicare Accreditation /Non-Medicare Home Care Organizations that provide skills services requires accreditation by an accrediting body such as:

Medicare Accreditation/Non-Medicare Organization that provide nursing skills services requires accreditation by an accreditation bodies as ACHC. Accreditation helps to improves business activities, patient care outcomes and also helps determine if your organization complies with applicable local, state, federal rules and regulations.

There are several standard for accreditation that imposes a higher standard for an organization that’s ACHC Accredited for example in the State of Florida agency licensure (AHCA) does not requires tuberculin skin testing (PPD) or x-ray screening on all  direct care personnel upon hire and annually thereafter. While according to ACHC agencies need to follow Center of Disease Control (CDC) guidelines which recommends that all direct care personnel need to have a PPD upon hire and annually.