Issuu

ASAP

A Weekly Publication Of HCA Home Care Association of New York State

Legislative Issues  Public Policy

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News

Volume 20, No. 38 October 30, 2015

Governor Cuomo Again Vetoes Essential Personnel Bill Despite close work with the Governor’s office and others to address any outstanding issues, as well as vigorous outreach from HCA, our government-affairs representatives, the bill sponsors in the Legislature, and messages from many home care provider members, Governor Cuomo has again vetoed legislation to grant “essential-personnel” status to home care and hospice staff in emergency response and preparedness (A5125-B/S.3482-B). The bill had been unanimously passed by the Senate and Assembly, and its Assembly sponsor, Michael Cusick, was especially active in engaging with the Governor’s office to garner the Administration’s support See VETO p. 3

Federal Budget Deal Emerges – Along With New House Speaker Amid leadership changes in the U.S. House of Representatives, Congress and the President have reached a federal budget deal. The deal, which has already won House and Senate approval, allows for an increase in the U.S. debt-limit, averting a default on payments. See BUDGET p. 2

Inside ASAP Governor Cuomo Again Vetoes Essential Personnel Bill.....................1 CMS Issues Final 2016 HHPPS...............................................................1 Federal Budget Deal Emerges – Along With New House Speaker.......1 HCA Meet-Ups Coming to Providers in Patchogue, NYC, Tarrytown......4 HCA, Hospitals, Medical Society Team Up on F2F Rule Solutions.......6 Quality Symposium: A Great Way to Celebrate Home Care Month.....7 Member Hiring Announcement.............................................................7 HCA Presents Quality Tool to DOH......................................................8 2016 State Wage Parity Levels to Be Announced..................................9 HCA Meets with DOH on Vital Reimbursement Issues........................9 Governor Signs Bills Affecting Providers, Employers.........................10 DSRIP Update......................................................................................10 Home Care Salary & Benefits Report Released..................................10 MLTC Forum Strengthens Discussion of Payment, Policy Needs........11 Progress Notes: The ICD-10 Transition So Far....................................12 Influenza Resources Disseminated.....................................................12 Weekly Influenza Surveillance Report.................................................13 CMS Issues Proposed Rule on Discharge Planning................................13 Minor Changes Eyed for Home Health Change-of-Care Notice.......14 CMS to Host Home Health Open Door Forum: November 4............15 Workers’ Compensation Assessment Rate Announced for 2016.......16 Nonprofit Capital Investment Program RFA Released......................16 Provider Training Available on NYMMIS..............................................17 Rule Issued on Access to Covered Services for Medicaid...................18 Publications.................................................................................18

CMS Issues Final 2016 Home Health HHPPS The U.S. Centers for Medicare and Medicaid Services (CMS) yesterday issued its final rule for the 2016 home health prospective payment system (HHPPS). CMS projects a $260 million reduction in overall Medicare payments to home health agencies in 2016. See HHHPPS p. 4

Helping New Yorkers Feel Right At Home

ASAP – a publication of the Home Care Association of New York State BUDGET from p. 1 Impending debt-limit deadlines have been a perennial source of crisis negotiations plaguing the federal government over the past few years, prodding a series of last-minute spending and budget actions – like the one reached this week – to raise the borrowing limit and forestall a government shut-down. Under the measure, spending would increase by $80 billion, offset by reductions and other changes, including an extension of the 2 percent cuts to Medicare provider payments, temporarily allocating payroll tax revenue from the trust fund for retired workers to the Disability Insurance Trust Fund, and amendments to the eligibility requirements of the Social Security Disability Insurance Program. The deal also reduces a planned major increase in Medicare Part B premiums for new enrollees and those who pay a higher “income-based” premium, and it repeals a provision of the Affordable Care Act (which was, as of yet, not implemented) to require certain employers to automatically enroll employees into a company-offered health

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insurance plan if the company has 200 or more employees. The agreement does not contain any direct threats to home care, such as Medicare home health copayments or other cost-sharing impacts on beneficiaries, which have been proposed in the past, drawing staunch opposition from HCA and federal partners. However, the persistence of 2 percent cuts to Medicare have been an ongoing concern and a target of HCA advocacy, as we continue to press for Medicare payments that meet the needs of serving patients. This week’s deal came just after U.S. House Speaker John Boehner announced that he was stepping down, prompting votes this week for his replacement. On Thursday, the House voted in favor of Rep. Paul Ryan to replace Boehner. Rep. Ryan was Mitt Romney’s running-mate in the last Presidential election and a longtime chair of the House Ways and Means Committee, which made him a top negotiator over budget issues. Meanwhile, the U.S. Centers for Medicare and Medicaid Services late this week has finalized its 2016 payment program for home care under the Home Health Prospective Payment System Rule (HHPPS). Please see the related p. 1 story about the impact of this rule in 2016. HCA will keep the membership posted of further updates from Washington as they emerge, especially in the budget arena.

ASAP is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in ASAP are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. President: Editor:

Joanne Cunningham, jcunningham@hcanys.org Roger L. Noyes, Director of Communications, rnoyes@hcanys.org Al Cardillo, Executive Vice President, Policy & Programs, acardillo@hcanys.org Patrick Conole, Vice President, Finance & Management, pconole@hcanys.org Andrew Koski, Vice President, Program Policy and Services, akoski@hcanys.org Alexandra Blais, Director of Public Policy, ablais@hcanys.org Laura Constable, Senior Director, Membership & Operations, lconstable@hcanys.org Celisia Street, Director of Education, cstreet@hcanys.org Mercedes Teague, Finance Manager, mteague@hcanys.org Jenny Kerbein, Director of Governance and Special Projects, jkerbein@hcanys.org Billi Hoen, Manager, Meeting and Events, bhoen@hcanys.org Teresa Brown, Administrative Assistant, tbrown@hcanys.org 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

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VETO from p. 1 throughout the legislative process. Assemblyman Cusick and Senator Andrew Lanza, the Senate sponsor, both represent Staten Island, a community hardest hit by devastating storms like Superstorm Sandy. The veto message came at the eleventh hour, as the deadline for Executive action was approaching late Monday night, amid wide support for the bill’s signature, and final outreach from HCA and our contract government-affairs representatives at Wilson Elser who communicated directly to high-ranking Executivelevel staff, urging the Governor’s signature of the bill. Governor Cuomo’s veto comes as a stunning move, especially given the demonstrated need for this legislation recognized within segments of the Governor’s own Administration, and in the context of emergency preparedness and response measures otherwise being a hallmark of the Governor’s public policy work in the aftermath of major emergency disasters like Superstorms Sandy, Irene and Lee, as well as last November’s blizzard in Western New York. All of these events had compromised the efforts of home care and hospice staff to reach vulnerable patients in need of care, relief, and services because this staff was not adequately recognized for the work they are required to do under the umbrella of their emergency management plans. The Governor’s veto asserts that there would be unfunded costs to municipalities, including costs stemming from “consultation with potentially hundreds of home health and hospice organizations”; although, we stress, the state already requires “consultation” between government organizations and health care providers through mechanisms like the Health Commerce System, eFinds, the Health Electronic Response Data System (HERDS), through regional and sub-regional Health Emergency Preparedness Coalitions, and County Emergency Operations Centers (EOCs), or County Offices of Emergency Management, all of which are already staffed and equipped for handling duties related to communication with providers over emergency response. This multi-tiered architecture for “consultation” with providers during emergencies has long been a tenet of emergency preparedness from the local municipality level on up to the Governor’s own Administration. The Governor’s veto message also cites “liability regarding the safety of medical personnel granted access to restricted emergency areas as well as those in need of care,” without recognizing the greater liability for access to patient care in the absence of some mechanism to allow a response from providers to meet the needs of their patients. HCA and our government-affairs representatives are continuing to follow-up with high-ranking Cuomo Administration officials to delve into the rationale and basis of information upon which this bill has been vetoed and to determine next steps for recognition of home care in state-mandated emergency preparedness and response activities so that the mistakes of prior disasters are not repeated in the future. In absence of this legislation, it is imperative that state officials work now in the meantime with HCA to formulate an appropriate and efficient route for ensuring home care and hospice access to vulnerable patients in need, an issue which was cited again and again in after-action reports by the government’s own emergency management officials following major storms and natural disasters over the past three years. Please stay tuned for further updates.

ASAP – a publication of the Home Care Association of New York State HHPPS from p. 1 This decrease reflects the effects of: a 1.9 percent market-basket update ($345 million increase); a 0.97 percent reduction for “nominal” case-mix growth (also known as “case-mix creep”) occurring in 2012 through 2014 ($165 million decrease); and a 3.45 percent decrease in payments due to the third year (out of four) of rebasing adjustments ($440 million decrease). The final rule includes some modest improvements on the payment side, compared to the proposed rule, in that it lowers the multi-year case-mix creep adjustment to 2.88 percent, compared to a proposed 3.41 percent; it also phases in that reduction over three years rather than two. This phase-in begins with reductions of 0.97 percent in 2016, 2017 and 2018, instead of the proposed 1.72 percent reduction in 2016 and 2017. However, the final rule adds yet another year of rebasing reductions, at 3.45 percent (applicable to the 2010 rates), which is the regimen implemented in 2014 and 2015 as part of the four-year rebasing process. In dollar terms, this 3.45 percent rebasing cut amounts to a base episode rate reduction of $80.95 – again consistent with the last two years of rebasing, and at the upper limit permitted by law (under the Affordable Care Act). CMS’s episodic base rate would be offset on the upside by a market basket update (2.3 percent), which is itself subject to a downward productivity adjustment of 0.4 percent, resulting in a net market basket update of 1.9 percent.

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HCA Regional Meet-Ups Coming to Patchogue, NYC and Tarrytown Next Week HCA’s next round of regional meetings is coming up next week, following our first round in upstate New York. The Meet-Ups, as they are called, will bring you together with our executive team to discuss regional experiences, needs, concerns and recommendations. These events are free-of-charge, coming to Patchogue and New York City on November 5 and Westchester on November 6. The Meet-Ups will focus on how the regional DSRIP networks and other payment models are working for you. We’ll use your feedback to help leverage home care’s role in the DSRIP programs of today, as well as the Value-Based Payment projects of tomorrow. We’ll also open the floor for other payment or service issues affecting your region. Agencies in the Long Island, New York City and Westchester regions can RSVP to attend one of these Meet-Ups by completing the form at https:// www.surveymonkey.com/r/HCAmeetups. Specific locations are below: •

Patchogue: Brookhaven Memorial Hospital Medical Ctr., 103 West Main St. (entrance & free parking on Lake St.), Patchogue, NY 11772.

•

NYC: Hunter College Brookdale Campus, Room W237 (2nd Floor), 425 East 25th Street, Between 1st and FDR, New York, NY 10010.

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Tarrytown: VNA of Hudson Valley, McCann Conference Room, 3rd Floor, 540 White Plains Rd., Tarrytown, NY 10591.

Therefore, CMS’s final base episodic rate is $2,965.12 for 2016, versus $2,869.27 in 2014 and $2,961.38 in 2015. Please keep in mind, however, that a trend-line comparison of the base episodic rate between 2014 and 2016 can be deceiving. This is due to the fact that CMS has also reduced all of the case-mix weights by an aggregate 2.37 percent. And to achieve budget neutrality, as required by statute, CMS then had to offset the casemix reductions through an upward adjustment in the Continued on next page 4

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Continued from p. 4 base episodic rate by the same amount (an uptick of 2.37 percent). This means that the base episode rate cumulatively seems to trend higher between 2014 and 2016, but only because it includes the budget neutrality offset to make up the difference for reductions separately made to the case-mix weights. The final rule provides additional details on the full transition to a new wage index and very specific details about the new rates, including calculations for outlier payments, Low Utilization Payment Update percentages, and more. Home Health Value Based Purchasing Pilot Update The rule also finalizes a new home health value-based purchasing pilot program in nine states. New York State is not one of the nine states selected for this pilot. Beginning January 1, CMS will implement the pilot model among all Medicare-certified agencies in Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee who will compete on value in the model, where payment is tied to quality performance. Agencies in these nine states will have their payments adjusted by a maximum (upward or downward) adjustment of: 3 percent in 2018; 5 percent in 2019; 6 percent in 2020; 7 percent in 2021; and 8 percent in 2022. Compared to the proposed rule, the maximum payment reduction in the first year of the value-based purchasing program was reduced from 5 percent to 3 percent. CMS will continue to use 2015 as the baseline year for performance, with 2016 as the first year of performance measurement. HHQRP Update CMS is finalizing, as proposed, one standardized cross-setting measure for 2016 under the “skin integrity and changes to skin integrity” domain. Measures for the other domains will be addressed through future rulemaking. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 requires home health and other providers to submit standardized patient assessment data, as well as standardized data on quality measures and resource use and other measures for purposes of interoperability and to improve quality, payment, and discharge planning, among other purposes. The rule also includes the establishment of a minimum threshold for submission of Outcome and Assessment Information Set (OASIS) assessments for purposes of quality reporting compliance. A CMS fact sheet with more information is at https://www.cms.gov/Newsroom/MediaReleaseDatabase/ Fact-sheets/2015-Fact-sheets-items/2015-10-29-3.html. Next Steps Given that this very detailed final rule was just released yesterday, it will require HCA review and analysis as well as conversations with partner organizations to assess the full impact and next steps for advocacy. HCA will provide you with a more detailed summary of the final rule once our review is complete, including greater detail on the payment calculations, and any regulatory changes that will help you budget for 2016. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org. 5

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HCA, Hospitals, Medical Society Team Up on F2F Rule Solutions HCA convened a meeting this week of hospital and physician partners to discuss and set into motion a collaborative approach to streamlining and fulfilling face-to-face documentation and eligibility requirements for Medicare-covered home care services. The meeting included HCA, members of an HCA Face-to-Face Workgroup, the Healthcare Association of New York State (HANYS), the Iroquois Healthcare Alliance (or IHA, which is the upstate regional hospital association), and the Medical Society of the State of New York (MSSNY). HCA and HCA Face-to-Face Workgroup members presented a draft document intended to serve as an “addendum” to a physician’s record to help fulfill Medicare face-to-face and home care eligibility certification. The draft addendum follows months of discussion and refinement by the workgroup, including vetting with the U.S. Centers for Medicare and Medicaid Services (CMS) fiscal intermediary and administrative contractor National Government Services (NGS). Those efforts have been previously covered in ASAP and in other communications. At this week’s “partners” meeting, HCA, workgroup members and association colleagues delved into the challenges of face-to-face compliance, including the further complications arising from the subjectivity of audit reviews. HCA described how the structure, content and use of the draft addendum could help mitigate these challenges. Workgroup members who have already engaged with affiliated hospitals on use of the draft described the positive feedback they have received, and also cited systemic challenges. A main challenge is the integration of face-to-face and patient eligibility data elements into hospital, physician and home care provider electronic health records, particularly in the context of other federal and state program changes. Other challenges include how to ensure that the documentation elsewhere in the physician’s record thoroughly supports and comports with the information completed on the addendum and in CMS’s regulatory requirements; and seeking CMS’s support in the use of the form, particularly in its audit/compliance process. One across-the-board gain would be a concise, uniform document that all could adopt and use. Our respective associations agreed to continue working together toward a mutual goal of improving the faceto-face process within our available means (e.g., meeting CMS approval and support). HANYS, IHA and MSSNY will further review the HCA draft and reconvene with us in a couple of weeks to offer more feedback and discuss ideas for next steps. Meanwhile, HCA will also continue to work at the federal level to seek substantial reform in the CMS faceto-face requirements. Among these efforts is HCA’s Congressional proposal to allow certification of face-toface (and the medical criteria for Medicare coverage) via the physician’s signature on the “485”/plan of care, with the date of the face-to-face encounter. For further information, please contact Al Cardillo at acardillo@hcanys.org or Patrick Conole at pconole@hcanys.org.

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Nov. 17-18 Quality Symposium: A Great Way to Celebrate National Home Care Month with Staff Education HCA’s last big conference of 2015, our Quality Symposium, falls in November, which is also National Home Care Month. What better way to celebrate National Home Care Month than to focus on the quality of care provided to your patients, and to inspire your staff in this direction? This Symposium, on November 17 and 18, is a great opportunity to end the year by giving your staff the benefit of learning from top experts in the quality-of-care field, a benefit that also accrues to your agency, as staff return from the Symposium inspired and ready to meet the challenges and imperatives of home care quality in 2016. This imperative is indeed changing, especially in the shifting marketplace of contract relationships, valuebased payments and a new urgency for you to communicate your quality proposition to MLTC plans and other partners. In fact, our Quality Symposium offers a full day of access to experts in the field about quality in the arena of contract relationships between CHHAs, LTHHCPs, LHCSAs and managed care plans we well as other partnerships. We’ll also provide: insights about specific clinical tools and protocols; model home care quality management programs; CMS Star Ratings; the link between home care quality and compliance; and a demo of HCA’s first-of-its-kind home care Quality Risk Tool (see related p. 8 story), which will help you take a systematic approach to meeting the rubric of best-practices and regulatory requirements for quality assurance. This conference provides something for everyone, whether you are CHHA, LTHHCP or LHCSA. As you prepare your end-of-year education commitments for staff, please consider this last big HCA conference of the year. See the brochure at the back of ASAP for a detailed agenda and register online at: https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1011709.

HIRING Patient Relations Manager Americare, New York’s leader in home health care, seeks a high energy, dynamic, selfstarter for an exciting career opportunity in its patient relations department. The Patient Relations Manager’s primary responsibility will be to develop relationships and educate MDs about home care and the benefits to their patients. The ideal candidate will have 2-3 years home care or pharmaceutical experience. An excellent compensation and benefits package is offered, including: 401K with company match, medical, dental and direct deposit. E-mail résumé to hrrecruiter@americareny.com. www.americareny.com. EOE

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HCA Presents Quality Measurement, Risk & Compliance Tool to DOH HCA presented our Quality Measurement, Risk and Compliance Tool (HQMT) to state Department of Health (DOH) officials in a meeting this week, seeking to vet our product and garner the Department’s feedback, input, potential collaboration and support. HCA Board and Quality Committee member Laurie Neander, President and CEO of Basset Healthcare Network At Home Care, and HCA Executive Vice President Al Cardillo, presented HQMT in a joint meeting with the DOH Office of Health Care Quality and the Division of Home and Community Based Services. In the meeting, HCA discussed: the origins and evolution of HQMT, spurred by the HCA Quality Committee and HCA Board of Directors; the comprehensive quality and compliance metrics incorporated into the tool; its proactive purposes and extensive capabilities; agency-specific and association goals for use of HQMT in the domain of quality best-practices and compliance; planned steps for implementation; and opportunities for state support. In September, HCA issued a Request for Proposals (RFP) for potential software and benchmarking organizations to enter into agreement with HCA to automate and offer data services to HCA agencies through HQMT. Organizations are now responding to the RFP and HCA expects to begin reviewing the proposals soon. HCA also briefed the Department on several other quality initiatives that we have in motion, seeking DOH collaboration and support for home care innovations aimed at improving overall public/patient health and quality of care. HQMT demo at Quality Symposium on Nov. 17-18 HCA will be featuring a full updated presentation and status report on HQMT, along with a number of our other quality initiatives, at HCA’s upcoming Quality Symposium on November 17-18 in Troy, near Albany. (See related p. 7 article and program brochure at the back of this week’s ASAP.) The Symposium will also feature key presentations from DOH quality leaders, and experts/innovators from throughout the field. For further information, please contact Al Cardillo at acardillo@hcanys.org.

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2016 State Wage Parity Levels to Be Announced HCA expects the state Department of Health (DOH) to post the state Home Care Worker Parity levels for 2016 early next week. The levels for New York City, covering the period March 1, 2016 to February 28, 2017, are expected to be the same as for this year, while the levels for Long Island and Westchester for this period are expected to increase. The new levels will be posted at http://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm (same site for this year’s levels) and HCA will announce the amounts once they are released. As described in previous ASAP articles and alerts (also, see the separate story below on an HCA reimbursement meeting with DOH), HCA has made it a top priority to advocate that the state provide immediate compensation to home care agencies and managed care plans for their cost increases due to changes in overtime calculation and travel expenses. HCA has also asked the state to provide additional funding to home care providers operating under Medicaid fee-for-service and managed care to address state and local living wage laws and increases in workers’ compensation and other labor costs. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

HCA Meets with DOH on Vital Reimbursement Issues This week, HCA met with state Department of Health (DOH) Bureau of Long Term Care Reimbursement staff to discuss a variety of payment issues affecting home care agencies and MLTC plans. HCA asked to be briefed on the status of the 2014 and 2015 rate packages still awaiting approval from the U.S. Centers for Medicare and Medicaid Services (CMS) for MLTCs and Programs of All-Inclusive Care for the Elderly (PACE). HCA emphasized the adverse effects upon both plans and providers from these significant lags in adjusted premiums. HCA urged expeditious approval of the premium increases and enhancements necessary for both the plans and their providers to be adequately reimbursed. DOH described its intentions to seek approval in the next week or so from the U.S. Centers for Medicare and Medicaid Services (CMS) for its $35 million share for the Quality Incentive Vital Access Provider Pool (QIVAPP) program. DOH acknowledged HCA’s concerns that the process of awarding and distributing QIVAPP funds has been problematic (especially DOH’s payment reconciliation that will require some of the initially paid providers to return portions of their round-one QIVAPP funding) and invited HCA to offer suggestions for an improved approach. DOH confirmed that another $70 million will be available for the 2015-16 state fiscal year. DOH confirmed that it is trying to obtain estimates on the new costs incurred by plans and providers for overtime (through its plan survey) and is drafting a Dear Administrator Letter to outline how DOH will provide financial relief for these new expenses. HCA asked the state’s thoughts on establishing a “stop-loss pool” to pay for new overtime costs instead of trying to calculate a premium adjustment which would have to account for so many variable factors and costs, possibly underfunding premiums and provider reimbursement. HCA suggested that such a pool could ensure adequate reimbursement of plans and providers while simultaneously allowing for actual overtime experience and cost data to be collected, and to eventually use this 9

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more accurate data for premium/rate adjustment. Moreover, this might assist in the initial overtime reimbursement period as the CMS premium rate approval process takes months to complete. DOH invited HCA to submit this concept in proposal form. HCA also requested that DOH examine areas of MLTC premiums that warrant adjustment for other new costs not reflected in the current premium base. For example, HCA stressed recent years’ exorbitant increases in workers’ compensation costs, and expected increases in state worker Wage Parity levels for Long Island and Westchester, which are new costs not otherwise being factored into actuarial determinations of MLTC premium need. HCA appreciates DOH’s engagement with us on these issues, concerns and recommendations. For more information, contact HCA Policy staff.

Governor Signs Bills Affecting Providers, Employers This week, Governor Cuomo announced that he signed the following bills: •

•

Wage Deduction Extender (S.5623 Young/A.7594 Titus). This extends for an additional three years (until November 2018) categories of permissible wage deductions that an employer may take from their employees with their written consent. CARE Act (S.676-B Hannon/A. 1323-B Rosenthal). The Caregiver, Advise, Record and Enable (CARE) Act specifies requirements for caregiver identification, training and support in the hospital discharge planning process. This legislation allows a patient to designate, upon entry to a hospital, a caregiver in the patient’s medical record; requires the hospital to notify and offer to meet with the designated caregiver to discuss the patient’s plan of care prior to discharge or transfer to another facility; and requires the hospital to adequately train the designated caregiver in certain after-care tasks upon the patient’s discharge.

DSRIP Update On Monday, November 9 and Tuesday, November 10, the Delivery System Reform Incentive Payment (DSRIP) Project Approval and Oversight Panel (PAOP) will hold a meeting of the upstate-based DSRIP Performing Provider Systems (PPSs) in Albany. It will allow the nonNew York City PPSs to give brief presentations and answer any questions from the panel. The meeting is open to the public, but there will be no public comment period at these meetings. No pre-registration is required. Monday, November 9, will be a full-day meeting, structured as an update session for the panel members, and an opportunity for the panel members to check in with each of the PPSs. Tuesday, November 10, will be a half-day meeting. The meetings will be webcast at: http://www.health.ny.gov/ events/webcasts/

Home Care Salary & Benefits Report Released The 2015-2016 Homecare Salary & Benefits Report, published by Hospital & Healthcare Compensation Service, is now available for purchase. The 258-page report contains 64 jobs, reporting on salaries, bonuses, and hourly and per-visit rates. Data are reported by state, county, nine geographic regions, nationally, and according to agency type and revenue size. Also included are 18 fringe benefits, planned percent increases, turnover rates, and personnel policies. To order, visit the Hospital & Healthcare Compensation Service website at www.hhcsinc.com or call (201) 405-0075.

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MLTC Forum Strengthens Discussion of Payment, Policy Needs Another set of Forums coming up for LTHHCPs, LHCSAs and HCC Members: Register Today! HCA and MLTC members are meeting in New York City today for our MLTC Forum. The meeting is one of several program-specific HCA Forums being held over the next few months. Other upcoming sessions include HCA’s LTHHCP Forum on November 13; HCC Member Forum on November 16; and Downstate LHCSA Forum on November 23. Topping the agenda at today’s MLTC Forum are payment and premium issues affecting the plans and their contracting home care providers alike. This includes a planned discussion of 2014 and 2015 MLTC base premiums and adjustments, to draw input from the plans about the adequacy of current rates, given many of the increased costs imposed upon the system. The Forum is a great opportunity to engage with HCA’s MLTC plan members on specific concerns from the angle of HCA’s expertise in the community-based service realm, though these sessions also explore other MLTC concerns across the spectrum of its benefit structure. Home care comprises a significant portion of the MLTC portfolio, and home care-specific issues like the Wage Parity Law, new overtime requirements under the Fair Labor Standards Act, workers’ compensation issues and other labor and wage issues have put strains on the payment system. HCA is engaging with members on all of these issues. HCA is also briefing the group on discussions over standardized coding and billing practices in MLTC. Those discussions stem from HCA-advocated legislation, which passed in the state budget, seeking uniformity and efficiency across the system. Uniform coding options are being explored by a workgroup of plans, providers and the state Department of Health for the purpose of easing the administrative complexity of provider and plan billing. The Forum is also raising issues related to the processing of Quality Incentive Vital Access Provider Pool monies for meeting wage parity, as well as progress on other policy matters that affect the coordination and status of MLTC services, such as the state’s proposal for an MLTC-plus model, value-based payments, the Delivery System Reform Incentive Program and other issues. Drilling down into specific changes and proposals on the horizon, HCA is also discussing new developments such as the soon-expected flexibility in requirements for home care physician order timelines, state audit and compliance issues, quality innovations in home care, the prospect of advanced home health aide legislation reemerging in 2016, and other areas for legislative, policy, education and collaborative work on behalf of HCA’s MLTC members. We thank Empire Blue Cross Blue Shield for hosting the location of this Forum, and the HCA MLTC members for taking part in an active exchange of ideas and updates. Register for next slate of Forums If you are an LTHHCP, LHCSA or Home Care Council of HCA member, please be sure to register for the next set of Forums that relates to your provider type. Registration for the LTHHCP and LHCSA Forums are at http://hca-nys.org/wp-content/uploads/2015/09/HCA-Combined-Forum-Registration-Form-2015.pdf. Registration for the HCC Forum is at http://hca-nys.org/wp-content/uploads/2015/10/ HCCForumRegistrationForm111615.pdf. For more information, please contact a member of HCA’s Policy staff. 11

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Progress Notes: The ICD-10 Transition So Far The U.S. Centers for Medicare and Medicaid Services (CMS) this week provided a progress update on billing performance under the transition to ICD-10, which went into effect on October 1. CMS says it is monitoring claims processing post-October 1, but won’t have a more complete progress update until November, given the lag of some claims being submitted and processed due to the 30-day billing allowance and the legal requirement that Medicare must wait two weeks to remit payment, delaying the processing of claims in certain cases. Nevertheless, for the period October 1 to 27, CMS reported that a total of 4.6 million claims were submitted per day, with 2 percent rejected due to invalid or incomplete information. Claims rejected due to invalid ICD-10 codes or invalid ICD-9 codes (i.e., for services prior to October 1) were: 0.09 percent and 0.11 percent, respectively. Total claims denied during this period amounted to 10 percent of total claims processed. For general ICD-10 information, visit CMS’s “Road to 10” website (http://www.roadto10.org/) and www.cms.gov/icd10. CMS says your first line for help with Medicare claims questions should be the Medicare Administrative Contractor, which, in New York’s case, is National Government Services (NGS) at https://www.ngsmedicare.com. Other help options are the ICD-10 Coordination Center at icd10@cms.hhs.gov or the ICD-10 Ombudsman, Dr. Bill Rogers, at ICD10_ombudsman@cms.hhs.gov. For more information, please contact the HCA Policy staff.

Influenza Resources Disseminated The state Department of Health (DOH) has disseminated a variety of resources to help providers with the flu season, including resources targeted to National Influenza Vaccination Week (December 6 to December 12). These include: •

U.S. Centers for Disease Control and Prevention (CDC) resources at www.cdc.gov/flu/NIVW/ resources.htm and www.cdc.gov/flu/index.htm.

•

The CDC publication “No More Excuses – You Need a Flu Vaccine” fact sheet at http://www.cdc.gov/ flu/pdf/freeresources/general/no-excuses-flu-vaccine.pdf.

•

DOH’s Seasonal Influenza website at www.health.ny.gov/diseases/communicable/influenza/seasonal.

•

DOH Provider Training and Education information at http://www.health.ny.gov/prevention/ immunization/providers/training_and_education.htm. Continued on next page

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 38 October 30, 2015 

 Continued from p. 12 •

DOH’s flu mask requirement at http://www.health.ny.gov/diseases/communicable/influenza/ seasonal/providers/prevention_of_influenza_transmission/.

As reported in last week’s ASAP, DOH has not yet declared influenza to be prevalent and thus the flu mask requirement is not in effect now. However, DOH has announced that the Healthcare Personnel Influenza Vaccination Report will open on November 2 and must be submitted by May 1, 2016. This year’s report covers personnel employed by or affiliated with a facility or agency from October 1, 2015 through March 31, 2016.

Weekly Influenza Surveillance Report This week, DOH posted the first 2015-16 Weekly Influenza Surveillance Report, which covers the week ending October 17. Report highlights include: •

Influenza activity level was categorized as geographically sporadic. Sporadic activity has been reported for two consecutive weeks.

•

There were 30 laboratory-confirmed influenza reports, an 11 percent increase over last week.

•

Of the 995 specimens submitted to NYS WHO/NREVSS laboratories, 3 (0.3 percent) were positive for influenza.

•

Of the 13 specimens submitted to Wadsworth Center, none were positive for influenza.

•

The number of patients hospitalized with laboratory-confirmed influenza was 10, a 17 percent decrease over last week.

•

There have been no influenza-associated pediatric deaths reported this season.

All Weekly Influenza Surveillance Reports are posted on the Health Commerce System at https://commerce.health.state.ny.us/public/hcs_login.html.

CMS Issues Proposed Rule on Discharge Planning On Thursday, October 29, the U.S. Centers for Medicare and Medicaid Services (CMS) released a proposed rule regarding discharge planning that would impact hospitals and home health agencies, among others. According to CMS, its goal is to improve quality and outcomes while reducing avoidable complications and hospital readmissions by further engaging the patient in care transition planning. The proposed rule would also apply the elements of the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act) of 2014 that relate to discharge planning. The IMPACT Act requires hospitals (including inpatient rehabilitation facilities and long term care hospitals), critical access hospitals, and home health agencies to develop discharge plans in partnership with patients in

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 38 October 30, 2015 

order to reflect the individual patient’s needs, preferences, and goals. The proposal suggests that “patients and their caregivers frequently are not meaningfully involved in the discharge planning process and are unable to name their diagnoses; list their medications, their purpose, or the major side effects; cannot explain their followup plan of care; or articulate their treatment preferences and goals of care.” The proposed rule sets a specific timeframe for discharge plan development, and would give hospitals 24 hours from time of admission or registration to begin to identify the discharge needs for every inpatient, as well as certain categories of outpatients. Further, these providers would have to supply discharge instructions to those patients being discharged, have a medication reconciliation process that seeks to improve patient safety with enhanced medication management, develop a follow-up process after discharges, and more. All of this would need to be coordinated and evaluated by a registered nurse, social worker, or other qualified individual. As noted above, the proposed rule highlights the significance of the patient’s engagement throughout discharge planning and aims to better prepare patients and families for the period post-discharge. HCA will continue to review the proposed rule, particularly its impact on home care providers and patients, and provide more information in the weeks to come.

Minor Changes Eyed for Home Health Change-of-Care Notice The U.S. Centers for Medicare and Medicaid Services (CMS) has announced its intent to make non-substantive changes to the Home Health Change of Care Notice (HHCCN). The notice, along with a revised HHCCN, Form Instructions and Supporting Statement, is at https:// www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/ CMS-10280.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending. According to the notice, CMS will make non-substantive changes “which add language informing beneficiaries of their rights under Section 504 of the Rehabilitation Act of 1973 by alerting the beneficiary to CMS’s nondiscrimination practices and the availability of alternate forms of this notice if needed.” The actual new language, inserted at the bottom of the HHCCN, is as follows: CMS does not discriminate in its programs and activities. To request this publication in an alternative format, please call: 1-800-MEDICARE or email: AltFormatRequest@cms.hhs.gov.

The HHCCN is used to notify beneficiaries of plan-of-care changes under fee-for-service or original Medicare. Home health agencies must provide the HHCCN whenever they plan to reduce or terminate a beneficiary’s home health services due to a physician ordered change in the plan of care, a lack of orders to continue the care, or limitation of the HHA in providing the specific service (i.e. staffing shortages or safety concerns in a beneficiary’s home). The current HHCCN and accompanying instructions are at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/HHCCN.html. Continued on next page

Volume 20, No. 38 October 30, 2015

ASAP – a publication of the Home Care Association of New York State



 Continued from p. 14 The HHCCN differs from the Advance Beneficiary Notice of Noncoverage (ABN). This form is given to individuals prior to providing an item or service that is usually paid for by Medicare but may not be paid for in this particular case because: • • • •

It is not considered medically reasonable and necessary; The care is custodial; The individual is not confined to the home; or The individual does not need intermittent skilled nursing care.

Information on the ABN is at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ ABN.html.

CMS to Host Home Health Open Door Forum: November 4 The U.S. Centers for Medicare and Medicaid Services (CMS) will host the next Home Health and Hospice Open Door Forum on Wednesday, November 4, 2015 from 2-3 p.m. Agenda items include: •

The 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements.

•

Prevention of ICD-10 Formatting Issues in ASIS.

•

October and January Star Ratings and Individual Measure Preview Reports.

•

Hospice Quality Reporting Program Updates: New Reports and Training Modules.

•

IMPACT Website.

The dial-in and passcode is: •

Dial-In: 1-800-837-1935

•

Passcode: 8112871

CMS recommends that participants call in 10 to 15 minutes before the scheduled 2 p.m. start time. HCA members can submit question to CMS prior to the call at Homehealth_Hospice_DME_ODF-L@cms.hhs.gov. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 38 October 30, 2015 

Workers’ Compensation Assessment Rate Announced for 2016 The Workers’ Compensation Board has announced the assessment rate for all employers, effective January 1, 2016, to be 12.9 percent of the standard premium or premium equivalent. The new rate shall be effective for policies renewing on or after January 1, 2016 and represents a decrease from the 2015 rate of 13.2 percent. Any questions can be directed to the Workers’ Compensation Board at WCBFinanceOffice@wcb.ny.gov.

Nonprofit Infrastructure Capital Investment Program RFA Released This week, the state released a Request for Applications (RFA) for the Nonprofit Infrastructure Capital Investment Program (NICIP). The program – included in the 2015-16 final state budget – was created, according to the RFA, to support the work of the state’s nonprofit partners, including home care agencies. The RFA is at http://hca-nys.org/wp-content/uploads/2015/10/NonprofitInfrastructureCapitalInvestment.pdf. The program will make targeted investments throughout the state in capital projects that will improve or maintain the quality, efficiency, accessibility, and reach of nonprofit human services organizations that provide direct services to New Yorkers through state contracts, state-authorized payments, and/or state payment rates. The NICIP grant will fund capital projects in the following areas: •

Technology upgrades that improve electronic records, data analysis, or confidentiality;

•

Renovations or expansions of space used for direct program services;

•

Modifications to make spaces more sustainable and energy efficient resulting in overall cost and energy savings; and

•

Accessibility renovations.

A total of $50 million is available; of that amount, $30 million will be reserved for projects that involve construction (renovations or expansions of program space, accessibility renovations, or energy efficiency modifications); and $10 million will be reserved for projects related to technology. The remaining $10 million of the available funding will be placed into a “base pool” to fund projects from either category. NCIP will be administered by the Dormitory Authority of the State of New York (DASNY). The amount of funding available to applicants depends on the applicant’s annual revenue, as reported on the IRS form 990, and the type of project they are proposing. Grants will range from a minimum of $50,000 to a maximum of $1 million for larger nonprofit human services organizations.

Continued on next page

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Volume 20, No. 38 October 30, 2015 

Continued from p. 16 Eligibility requirements are further spelled out in the RFA at http://hca-nys.org/wp-content/uploads/2015/10/NonprofitInfrastructureCapitalInvestment.pdf. The due date, using the Grants Gateway, is by 4 p.m. on December 23, 2015. All questions must be e-mailed to the RFA Coordinator by 4 p.m. on November 10, 2015. Answers to all questions of a substantive nature will be posted to the DASNY website (www.dasny.org) by December 2, 2015. There will not be a Bidder’s Conference for this RFA.

Provider Training Available on NYMMIS The state Department of Health (DOH) and Xerox Healthcare, LLC, announced that training opportunities are now available for the new New York State Medicaid Management Information System (NYMMIS). The interim website, www.interimnymmis.com, is a source for the most current information on NYMMIS. The current schedule of training sessions is available under the Training and Events Calendar link on the website. Current training sessions include: •

Introduction to NYMMIS – a course for first-time users with a focus on understanding the basic system elements and how they work

•

NYMMIS Features and Functionality – a course to learn the basic features and functionality of NYMMIS.

•

Introduction to Provider Enrollment (for new provider enrollments only) – learn how to use the NYMMIS to complete an electronic enrollment.

•

Enterprise Login and Navigation – external users will be shown how to login and navigate the MMIS.

To sign up for training on the new system, send registration requests to USA.all.nymmis.training.inquiries@xerox.com with the following information: attendee name, organization, e-mail address, phone number, requested date, time, and location. Classroom sizes are limited and will be confirmed on a first-come, first-served basis. In addition, to stay up-to-date on future announcements as well as additional training sessions and topics, you can sign up for the ListServ on the above interim site. In April of this year, DOH announced that Xerox State Healthcare, LLC was awarded a five-year contract to implement and administer a new MMIS

ASAP – a publication of the Home Care Association of New York State

Volume 20, No. 38 October 30, 2015 

Rule Issued on Ensuring Access to Covered Services for Medicaid Beneficiaries This week, the U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period to “strengthen access to essential health care services for Medicaid.” The rule can be viewed at https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27697.pdf. It will be available at this link until it is published in the Federal Register on November 2. According to CMS, the goals of the final rule include: 1) measuring and linking beneficiaries’ needs and utilization of services with availability of care and providers; 2) increasing beneficiaries’ involvement through multiple feedback mechanisms; and 3) increasing stakeholder, provider, and beneficiary engagement when considering proposed changes to Medicaid fee-for-service payment rates that could potentially impact beneficiaries’ ability to obtain care. The final rule requires states to develop an access review plan that sets out the data elements and other information to be used to ensure beneficiary access to mandatory and optional services. States must also establish new procedures to review the effects on beneficiary access of proposed rate reductions and payment restructuring, and they must implement ongoing access monitoring reviews of key services, and additional services as warranted. The final rule also strengthens CMS’s ability to review and ensure Medicaid payment rates are consistent with efficiency, economy and quality of care. The final rule becomes effective on January 4, 2016, at which time states must meet the requirements established through the provisions of the rule. During the 60-day period, CMS will accept comments from the public on the access review requirements. In conjunction, CMS has released a request for information (RFI) to solicit comments on additional approaches for better compliance with Medicaid access requirements. This includes comments on the potential development of standardized core set measures of access, access measures for long-term care and home and community based services, national access-to-care thresholds, and resolution processes that beneficiaries could use. CMS will accept responses to the request for information through January 4, 2016. More information on the RFI is at https://s3.amazonaws.com/public-inspection.federalregister.gov/201527696.pdf.

Publications •

“Leveling the Playing Field: Improving Technology Access and Design for People with Intellectual Disabilities,” by the President’s Committee for People with Intellectual Disabilities http://www.acl.gov/programs/aidd/Programs/PCPID/docs/PCPID-2015-Report-to-President.pdf

•· “Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2013,” by Truven Health Analytics http://www.nasuad.org/sites/nasuad/files/LTSS%20Expenditure%20Report%202013.pdf For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org. 18

The Quality Imperative: Raising the Bar in Home Health Care

November 17 & 18, 2015 Hilton Garden Inn 235 Hoosick Street Troy, NY 12180

www.eventville.com/hcanys

November 17 & 18, 2015 Hilton Garden Inn 235 Hoosick Street Troy, NY 12180

The Quality Imperative: Raising the Bar in Home Health Care Quality outcomes have always driven your work in home care. But today’s environment is making quality deliverables a more commanding imperative, and a linchpin for the success of your agency. CAHPS surveys, Home Health Compare, HQRP, OASIS … in many respects, these are the first legacy of quality improvement leverage points. They remain important concerns. But today, home care is faced with new and even bigger machinery for inducing quality enhancement that demand an equally vigorous response from CHHAs, LTHHCPs, and LHCSAs alike. All home care providers must focus their energies, resources and intellectual capital to understand and retool their organizations for the new quality imperative. HCA’s Quality Symposium presents an opportunity to learn the broad strokes and inner workings of New York State’s quality home care imperative. You’ll hear about concrete tools, resources and information that will arm agencies to effectively compete in this environment. You’ll also learn about interventions for specific clinical areas that align with the demands of MLTC, DSRIP, Value Based Payments and other new care models.

Tuesday, November 17 – Day 1

AGENDA Thanks to our Exhibitors:

8:30am

Registration Opens with Light Breakfast

9:00am

HCA Welcome

9:00 – 10:00am

State Update on Quality & Payment Innovation Patrick Roohan, Director, Office of Quality and Patient Safety, NYS Department of Health Hear from one of New York State’s most influential and thoughtful policymakers about the plans and vision of the State in designing state policy to encourage and promote quality health care. Mr. Roohan will discuss the State’s vision for quality innovation and improvement through policy changes that will affect how all health care providers (including home care) participate in the Medicaid marketplace.

10:00 – 10:45am

HCA Quality Risk Tool Laurie Neander, Chief Executive Officer, Bassett Healthcare Network: At Home Care Al Cardillo, Executive Vice President, HCA HCA, working with key home care leaders across New York State, has formulated and developed a quality of care risk tool that is currently in the RFP stages of development. This session will offer a look at this unique HCA quality risk tool that will be available to members in 2016. It will arm agencies with a thorough, methodical tool to measure risk areas in clinical, financial and operational quality oversight.

10:45 – 11:00am

Break

November 17 & 18, 2015 Hilton Garden Inn 235 Hoosick Street Troy, NY 12180

The Quality Imperative: Raising the Bar in Home Health Care Tuesday, November 17 – Day 1 - continued 11:00am – Noon

Wound Care: There’s an App for that Nathan Ie, CEO, Co-Founder, Parable Lorraine Poliey RN, WCC, DAPWCA, Wound Care Program Manager, Montefiore Home Care This session will offer insights on a new App designed to help providers reduce the cost of and challenges associated with wound care. Parable (f/k/a Healogram) enables providers to more effectively and efficiently measure, monitor, and manage wound patients. Parable co-founder Nathan Ie and wound care program manager Lorraine Poliey, RN of Montefiore Home Care will outline details on Parable’s functionality and share practical insights on ease of implementation, impact on care delivery and potential for enhanced patient outcomes.

Noon – 12:45pm

Lunch

12:45 – 1:45pm

Quality Innovation in Managed Care and Home Care Tracy Langlais, Vice President, Medical Affairs Operations, CDPHP As New York’s health care system evolves, health plans including MCOs feel enormous pressure to meet the highest quality outcomes and benchmarks. Aligning home care’s emphasis and priorities on quality innovations and outcomes with the benchmarks that are of utmost importance to managed care plans can lower cost and improve care for patients. Learn from one of the state’s most innovative managed care plans about its priorities for quality innovation and alignment with home care partners.

1:45 – 2:45pm

The Quality Compliance Connection Matthew Babcock, Assistant Medicaid Inspector General for Compliance, Office of the Medicaid Inspector General The aim of healthcare reform is to move from a fragmented healthcare delivery system to a lower cost and more efficient integrated model with better patient outcomes. Hear from one of the OMIG’s most knowledgeable health system compliance experts about how home care providers can structure their quality programs to meet the needs of an integrated system, while assuring compliance in an evolving system.

2:45 – 3:00pm

Break

3:00 – 4:30pm

CMS Star Rating System and NYS Home Care Quality Indicators

Hotel Information Hilton Garden Inn 235 Hoosick Street Troy, NY 12180 HCA has reserved a limited block of rooms at the rate of $129 per night. To make a reservation for the evening of Monday, November 16 or Tuesday, November 17, please call (877) 782-9444 before November 2, and ask for the HCA Quality Symposium group rate.

Sara Butterfield, RN, BSN, CPHQ, CCM, Director, Upstate Health Care Quality Improvement, IPRO Learn from one of New York State’s most knowledgeable quality innovation experts about the impact the Star Rating System has had on New York’s home care provider community, and steps that can be taken by agencies to improve Day 2 Agenda their scores. continued on next page… 4:30 pm

Wrap Up and Adjourn Day 1

November 17 & 18, 2015 Hilton Garden Inn 235 Hoosick Street Troy, NY 12180

The Quality Imperative: Raising the Bar in Home Health Care

REGISTRATION FORM Wednesday, November 18 – Day 2 8:00am

Registration and Light Breakfast

Registration Deadline is November 2.

Name: _____________________________________________ Title:_______________________________________________ Agency:____________________________________________

8:30-10:00am

Quality Care Values in Contracted Home Health Care Services Marki Flannery, Executive Vice President and Chief of Provider Operations, Visiting Nurse Service of New York Maureen Forster, Empire Blue Cross Blue Shield Health Plus This session will offer insights, tools, and innovative program models for enhancing the quality of your home health care services in areas valued by health plans and contracting agencies. Learn from health plan and contracting agency representatives about their current quality initiatives and the quality related indicators/ measures they are seeking in an optimal contracted Licensed Home Care Service Agency to inform your strategic planning toward sustainability and growth in an increasingly competitive service delivery environment. Attendees will have an opportunity for questions and answers with panelists.

Address:____________________________________________ City/State/Zip:_______________________________________ Phone:_____________________________ Ext._____________ Email: ______________________________________________ (Required)

www.eventville.com/hcanys

FEE SCHEDULE Full Symposium (Nov 17 & 18) HCA Member Rate Per Person

$259 □

HCA Member Group Rate (3 or more)

$239 □

Non-Member Rate

$339 □

November 17 Only

10am – 10:15am

Break

10:15am – 11am Quality Care Innovations in LHCSA Delivery James P. Rolla, Vice President, People Care, Inc. Michelle Mazzacco, Vice President/Director, Eddy Visiting Nurse Association/St. Peter’s Health Partners

An executive panel from agencies providing licensed home care services will outline their quality care innovation efforts and provide guidance, tools and tips for planning and implementing quality initiatives. Attendees will have an opportunity for question and answers with panelists.

11:00am – Noon Common Areas of Quality Risk

(and Remedy) Identified in Surveillance Rebecca Fuller Gray, Director, Division of Home and Community Based Services, NYS Department of Health (Invited)

This session will provide invaluable insights from the state surveillance of home care agencies and proactive opportunity for quality promotion/risk mitigation from the State’s Director for home care services. In this presentation, Ms. Fuller-Gray will examine areas of quality risk and/or deficiency identified in DOH surveys and present recommendations for remedy, and most importantly, prevention/mitigation of these risk areas and overall quality promotion.

Noon

Wrap Up and Adjourn

Thanks to our Exhibitors:

HCA Member Rate

$199 □

Non-Member Rate

$279 □

November 18 Only HCA Member Rate

$ 89 □

Non-Member Rate

$159 □ TOTAL: $___________

PAYMENT Please check method of payment: (Checks must be received by date of program).

____MC ____VISA ____ AM EXP

____ Check*

*Make checks payable to : HCA Education and Research and mail to: 388 Broadway, 4th Floor, Albany, NY 12207 Credit Card #: _________________________________ Exp. Date:______________ Security Code: _________ ______________________________________________ Name and/or Company Name on Card

______________________________________________ Billing Address of card (including City, State and Zip Code)

______________________________________________ Authorized Signature

Cancellations received in writing via email to info@hcanys.org by November 2, are refundable less a 25% administrative fee. No refunds after this date or for no shows. Substitutions are permitted.

Please fax to: (518) 426-8788