SPRING 2009 ® Surveyor® 501 (C)(3) Nonprofit Organization Volume 19, No. 1 CMS Deeming Authority for: An ISO 9001:2000 Certified Company DMEPOS and Home Health (Hospice Approval Coming Soon) Arcadia Resources, Kerr Drug, Inc. SIZEWise & Duane Chooses ACHC ACHC is pleased to announce that Reade Choose ACHC Kerr Drug, Inc. has chosen ACHC Arcadia Resources, Inc. Arcadia HealthCareSM for DMEPOS Accreditation. Since is a service mark of Arcadia Resources, Inc. the industry requires Medicare (NYSE Alternext: KAD), and is a leading accreditation by September 2009 provider of home health care / medical for all pharmacies, a search staffing; respiratory / home health equipment ensued for the best provider. and specialty pharmacy services under (Continued on Page 17) its proprietary DailyMed™ program. The Company, headquartered in Indianapolis, Indiana, has grown to 97 locations in 21 states and currently services over 50,000 homes annually through its 4,000 full and part-time associates. Arcadia HealthCare’s comprehensive solutions and business strategies support the Company’s overall vision of “Keeping People at Home and Healthier Longer.” “We are Continued on page 6 Home Infusion Benchmarks for 2008: A Year in Review Barbara Rosenblum, Founder and CEO Strategic Healthcare Programs (SHP) Data are most helpful when they’re current and actionable, but it’s hard to resist the temptation to look backward as a new year begins, and benchmarks are the best tool for that job. SHP presents a home infusion year-in-review with industry benchmarks from 212 providers that range from large, non-profit, and hospital-based, to small, for-profit, and rural-based. Pediatric patients comprised 19.82% of the SHP database; Adults between the ages of 18-65 comprised 58.24%; and those over 65 comprised 21.95%. Continued on page 4 INSIDE: The Medicare Cost Report: Improve Your Financials (Part 4 of Turning an Annual Pain into a Gain 5): by Richard Wetherell I Page 3 Tom Boyd, Boyd and Nicholas, Inc. Spotlight on Provider: Critical Homecare Solutions I Page 10 As with any compliance requirement, it can often be a “pain” to prepare your annual cost report; however, proper completion The “HME Educator” Announce- can provide you with significant benefits: regulatory compliance, ment: What is it? I Page 17 maintaining Medicare payments, access to management informa- tion, achievement of competitive advantage, avoiding Medicaid ACHC Announcement: Sleep Centers & Home Sleep Testing fraud and protecting your PPS rates to name a few. One or more Standards I Page 17 of these reasons should inspire you to do your best. Continued on page 2 Surveyor Spring 2009 1 The Medicare Cost Report: Turning an Annual Pain Into a Gain (Continued from Page 1 ) Would you like to know your direct reports. Does anyone note the govern- cost per nursing visit? Would you like ment being selective in their use of this Editor-in-Chief to know how many LUPA visits you do cost report data? Deric Rutledge as compared to your state average? Marketing Communications Manager In some states if you file a Medicaid Would you like to know your competi- [email protected] cost report that mirrors in whole or tor's direct cost per visit? Would you part the Medicare cost report, you Assistant/Copy Editors like to know how many episodes he/ may be subject to Medicare cost she performed and how many visits Leslie Knuth report regulations. In this scenario, an Vice President of Quality Assurance per full episode he/she completes incorrectly filed cost report can subject Kimberly Martin also? All this information and much you to a false claims action by the Account Manager more can be obtained from the Medi- state. care cost report. ACHC Board Officers We all know that not filing your cost Every Medicare-certified home health Dick Wetherell – Chair report or filing a cost report that will Vice President for Quality, Telflex Medical, Inc. agency (HHA) has to file an annual be rejected by the government can cost report. That said, many still be- Chris Clasen, BS, RRT, RCP – Vice Chair cause your Medicare payments to be Director of Respiratory Care, Blue Ridge lieve that the cost report is of no value Health Care Center completely stopped until an acceptable and has no effect on PPS rates. The re- report is filed. However, did you know Denise Fletcher, Esq. – Secretary sult is clear - The National Association Board Certified Health Law, Texas Board of that CMS has the authority to "raise of Home Health and Hospice (NAHC) Legal Specialization, Brown & Fortunato the bar" on what constitutes an accept- estimates that only 4,000 of 7,000 Rick Ferris – Treasurer able cost report? Because of the large cost reports from 2007 were useable Clinical Pharmacist, Nutrishare number of cost reports that were ac- for this very reason. Gibbie Harris, MSPH, FNP cepted but were worthless for data use, Assistant Treasurer the Center for Medicare and Medicaid Buncombe County Health Director, Buncombe Unfortunately, however, cost reports County Health Center are routinely used to set reimburse- Services (CMS) issued instructions to ment rates. In fact, the PPS rates as of the Medicare contractors to educate ACHC Board Members January 1, 2008 include adjustments providers on how and why to properly Conrad Banks that were determined from the 2003 prepare the cost report (CMS transmit- President, co-owner Responsive Solutions, Inc. cost reports. The adjustments for tal 362, 8/01/08). With this new devel- John Barrett billable medical supplies were largely opment, that which was acceptable in Senior Consultant, Quality Systems Engineering determined from the historical cost the past may suddenly no longer be so. Floyd Boyer, RRT, RCP reports as well. Executive Director, NC Respiratory Care Board The good news - the Home Care and Hospice Financial Managers Associa- Richard Bulich Furthermore, the reason we are not Managed Health Care Associates using a wage index determined from tion (HHFMA) has formed an MCR Task Force Committee to develop and Barbara Stover Gingerich, RN MS the HHA cost report is because the FACHE CHCE government does not trust the data. implement an action plan that: President, Advantage Consultants, Inc. Meanwhile, MedPAC is proposing ad- I. Educates the provider community Doug Martin, ditional PPS rate cuts based upon the on the value of filing accurate cost Vice President, Southern Pharmaceutical data obtained from aggregated cost Corporation & SPC Medical Inc. Continued on page 17 Gale Pollock, Maj Gen (Ret) CRNA, FACHE, FAAN Executive Director Center for Ocular Regeneration and Vision Restoration University of Pittsburgh Medical Center CORE Purpose: CORE Values: To help our customers succeed Laura Prioli • Integrity • Flexibility without Compromising Health Care/Medical Device Specialist, SGS • Innovation CORE Mission: Quality Barbara Rosenblum, To support healthcare organizations and • Enhancing Founder & CEO, Strategic Healthcare Programs • Concern for the providers in optimizing wellness through Outcomes standards that promote the effective, Entire Healthcare Tom Tucker • Excellence in Vice President Sales & Marketing, Attentus efficient delivery of quality services and Continuum all Things Medical Sales, Inc. products 2 Surveyor Spring 2009 Strategy Implementation Improve your Financials and Customer Satisfaction Through Strategy Implementation. (4th of a 5 part series) By Richard M. Wetherell trategy Implementation and utilization of the balanced Here is an example of an integration of balanced score card Sscore card will help you improve your profits and delight into target agreements: your customers. As we have discussed, the four key cat- egories are Financial, Customer, Processes & Learning and Target Agreement Growth (people). This process helps improve communica- Name tions with all your team members and ensures that you are Date focused on the right objectives as we have discussed in the first three articles. Goals derived from the strategy (Balanced Scorecard) Now that you have defined your strategy map and balanced score card you must cascade your objectives and goals throughout the organization. Let me caution you, the first year you implement this, it will be time consuming to work Goals within the framework of Example: with your team members so that the agreed upon goals will the operational day-to-day work • lower defective rate tie into your firm’s balanced score card objectives. • no customer complaints • restructuring of filing system Even though there is software available to help you cascade your balanced score card, it is my experience that it is best Goals for the career Example: to use a template in Excel or PowerPoint the first year. I have development • development of MS Excel know-how sample templates that you may have. Email me at Wether- • sucessful completion [email protected] and I will send you a copy of templates that of management course other firms have found helpful. During the second or third year of using the balanced score card you may find it useful Making strategy everyone’s everyday job takes work and to use a software package to help automate the process. good communication channels. Approaches that people have found successful are: one on one face to face com- Strategy Can't be Fully Described by One BSC – munications, town hall meetings, video conferences, voice A System of BSCs is Needed mail, letters, newsletters and overall open communications. Corporate F First Level BSC K P As you can see, it will take work to Pot communicate your strategy and balanced score card in order to achieve alignment within your organization. Second Level BSC F F F K P K P K P As you can see, it will take work to communicate your strat- egy and balanced score card in order to achieve alignment Pot Pot Pot within your organization. Firms have found that this process Following works for large and small firms of five people or more.