September 30, 2019 Edition of The Situation Report

COST REPORTS

MSSNY MEETING

OVERTIME EXEMPTION CHANGES

HUDSON VALLEY DRILL

HCA, colleagues discuss concerns over new cost report planned next year for all home care providers (non-hospital CHHAs and LHCSAs) and FIs.

HCA continues to work collaboratively with the state’s Medical Society on issues of mutual concern, interest.

A new federal rule ups the salary thresholds to be met for certain employees when an employer exercises overtime pay exemptions. NYS thresholds already apply at higher levels, with some technical differences.

Keep your eye ready for a newly announced drill timetable in late February or early March testing surge capabilities for home care, other providers in the lower Hudson Valley.

PAGE 4

PAGE 5

PAGE 7

PAGE 11

Your Source for HOME CARE News, Policy and Advocacy

Vol. 4, Issue 34| September 30, 2019

UPCOMING PROGRAMS

CMS Allows Pseudo-Patient Training, Embraces Other HCA Proposals

HCA Member Call on DSRIP Waiver Oct. 3, 2019 1-2 p.m.

(See p. 1 story)

A newly posted final federal rule on regulatory relief includes or responds to several key recommendations made by HCA and colleagues in our recent comments to the U.S. Centers for Medicare and Medicaid Services (CMS).

Compliance Experts Lead October 17 HCA Symposium Oct. 17 (Albany)

The changes, which go into effect on November 29, 2019, are outlined in a memo sent to members last week by HCA Vice President Andrew Koski. It is at https://hca-nys.org/wpcontent/uploads/2019/09/092719MemoonRegRelief.pdf.

PDGM Bootcamp for Clinical Managers and Quality Staff Oct. 23 (Fairport)

Notably, CMS has embraced a recommendation urged repeatedly by HCA and the National Association for Home Care and Hospice (NAHC) allowing for the use of pseudo-patients (not only actual patients) when conducting home health aide competency evaluations.

See EMBRACES p. 4

Save The Date: 2020 Northeast Home Health Leadership Summit Jan. 28-30 (Boston)

Join Oct. 3 HCA Call on New DSRIP Extender Plan

Overcome Compliance Perils, PDGM Complexity in October

On October 3, from 1 to 2 p.m., HCA invites you to join a members-only call where we’ll discuss the state’s new road map, or “concept paper,” to extend the Delivery System Reform Incentive Payment (DSRIP) program waiver for four more years.

See CALL p. 2

October brings two major HCA education programs that your staff need, helping protect your organization from perilous compliance risks and succeed with complex new clinical standards under the PatientDriven Groupings Model (PDGM).

See OCTOBER p. 3

Find all the details and registration for our upcoming programs and events at https:// hca-nys.org/ events-education/ upcoming-events.

INSIDE CMS Allows Pseudo-Patient HHA Training.......................................................1 Join Oct. 3 HCA Call on New DSRIP Extender Plan.............................................1 Overcome Compliance Perils, PDGM Complexity in October...........................1 Member News..............................................................................................2 HCA Member Hiring Announcement..............................................................3 HCA Presses Concerns on New Home Care Cost Report...................................4 HCA, MSSNY Discuss Collaboration on PDGM, DSRIP Waiver, Sepsis.................5 Gov’s “Business Acumen” Group Eyes Support for CBO, SDH.............................6

NGS Advisory Meeting Yields Key Hospice Updates.........................................6 ‘White Collar’ Exemption Final Rule Announced...............................................7 Capitol Report Covers Sepsis, Home Care & Autism, NORCs, 24-Hr Care.............8 PHHPC Committee Acts on Home Care Applications..........................................9 New PDGM Resources from NGS and Webinars Coming Soon.............................9 CASPER and Star Rating Preview Reports Available..........................................10 HHCAHPS Preview Reports with Star Ratings Available....................................11 Coalition Surge Test to be held in Lower Hudson Valley.....................................11 Health Resources..........................................................................................12

The Situation Report: the Home Care Association of New York State CALL from p. 1 Like the current DSRIP waiver, this renewal attempts to further shape, on a sweeping scale, the delivery system for all state health care services, including home care, hospice and MLTC. All HCA members should plan to participate in this week’s call and read the state’s concept paper closely at https:// www.health.ny.gov/health_care/medicaid/redesign/dsrip/2019/ amendment_req.htm.

Please register in advance for the call at https:// www.surveymonkey.com/r/DSRIP2Call and we will send dial-in instructions using the e-mail address in your registration.

As reported in last week’s newsletter, the $8 billion waiver renewal echoes some themes that HCA and six collaborating associations outlined in a recent letter to state officials. However, the details for involvement of home and community care are not entirely apparent in the Department’s plan. Those forthcoming details would fall within the context of the current DSRIP structure, much of which has been rolled out very differently from the originally stated intentions for community-based care.

Our call on October 3 will: summarize the waiver proposal; highlight some opportunity domains where HCA members can work to possibly leverage a role in the next stage of DSRIP; provide some additional context information from our recent conversations with Department of Health officials on the waiver and the role of home and community services therein; and gain feedback from the membership for next steps based on your own experiences with the current DSRIP structure and your recommendations for navigating phase II of the program.

Member News: Tim Leddy Appointed to Aging Svcs. Board HCA Board Member Timothy P. Leddy, President & CEO of the Westchester Visiting Nurse Services Group, Inc. – parent organization of VNS Westchester and Westchester Care at Home – was recently appointed to the Board of The Westchester Public/Private Partnership for Aging Services (WPPP). The WPPP is a dynamic partnership of government, business and voluntary service agencies who work together to enhance the quality of life for the fast-growing senior population in Westchester County.

Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

2

Volume 4, No. 34 September 30, 2019 

The Situation Report is a weekly publication of the Home Care Association of New York State (HCA).

Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Al Cardillo President and CEO acardillo@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Rebecca Fuller Gray Executive V ice President for Clinical and Program Affairs rgray@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org Alyssa Lovelace Director for Policy and Advocacy alovelace@hcanys.org Lauren Ford Director of Program Research, Development and Policy lford@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 & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

OCTOBER from p. 1 Compliance Symposium on October 17 As reported in last week’s edition of The Situation Report, the state Office of the Medicaid Inspector General (OMIG) recently made work plan updates delineating specific audit focus areas. These include wage parity law adherence, cost reporting accuracy, consistency among enrollment records and plans of care and claims for medical necessity, fee-for-service and waiver program integrity, and much more. All of these pertinent OMIG target areas for home care, hospice and MLTC (along with additional major compliance topics) will be addressed by one of eight top legal and compliance experts at our October 17 Corporate Compliance Symposium.

See our brochure and register online at the following links: https://hca-nys.org/wp-content/uploads/2019/ 09/HCA-Corporate-Compliance-Registration-Form-2019-FINAL.pdf and https://events.eply.com/ 2019CorporateComplianceSymposium3089619.

PDGM Clinical and Quality Action Planning on October 23 PDGM is often viewed in reimbursement and finance terms, which makes sense because PDGM is a payment model. Yet the driving forces for these historic Medicare payment changes are clinical in nature: new admission source categories, new clinical groupings, new coding standards, and so much more. After rave reviews from her July session downstate, HCA has Barbara Katz, RN back for an encore PDGM Bootcamp, this time in the Rochester region, where she will give your clinical and quality management teams the tools for developing an action plan and operating procedures for PDGM readiness. Register at https://hca-nys.org/wp-content/uploads/2019/09/HCA-PDGM-Bootcamp-with-Barb-Katz-Registration-Form10-23-19-2.pdf.

HIRING: Clinical Assessment Managers (RNs) VNSNY is hiring Clinical Assessment (UAS) Managers to join our team. Use your clinical skills to assess member needs and identify solutions that promote high quality health care services. Option to work in any of the following counties: Monroe, Dutchess, Onondaga, Ulster, Orange, Oneida, Putnam, Delaware, Otsego, Sullivan, Rockland, Madison, Herkimer.

We offer: flexible schedules, comprehensive training and ongoing support, competitive pay rates, great benefits (for full time) and telework opportunities. Qualifications:    

Current license to practice as an RN in NYS (BSN preferred) Minimum six months of utilization review or care management experience at a Managed Care Organization or discharge planning experience required Demonstrated success with conflict management skills Knowledge of Medicaid or Medicare regulations required

Apply full time: https://jobs.vnsny.org/job/brooklyn/rn-uas-assessment-upstate-new-york-counties/1238/13316863 Apply per Diem: https://jobs.vnsny.org/job/brooklyn/rn-uas-assessments-per-diem-upstate-new-york-counties/1238/12539568 VNSNY is the nation’s largest not-for-profit home- and community-based health care organization. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.

3

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

EMBRACES from p. 1 As we noted in our most recent comments: “This restriction not only presents concerns for the agency’s ability to perform competency evaluations for all skills” but “in particular, for those related to timely assessment of bathing and shampooing skills. We urge in the strongest terms that this important policy permitting the pseudo-patient be maintained.”

Other changes in the new rule relate to: aide competency evaluations in the event of a deficiency; verbal notification of patients’ rights (versus written notifications); hospice interdisciplinary group requirements related to the use of a pharmacology expert; and certain emergency preparedness training, exercises and program review requirements.

In addition to rule changes, CMS also suspends previously proposed actions that were not yet in effect but were intended for the future. These concern the provision of information (to patients and families) regarding the use, storage and disposal of controlled substances, as well as proposed requirements for providing requested clinical records to a patient within certain timeframes.

This rule was in response to a proposed rule in September 2018 and a request for information from stakeholders on regulatory relief. While HCA’s comments in this process, as elsewhere, targeted longstanding payment policies like the face-to-face requirement and homebound status, CMS said that such comments not related to the Conditions of Participation are outside the scope of this rule. These remain major areas of HCA advocacy for relief.

HCA will provide additional information on all these changes as more guidance is issued.

HCA Presses Concerns on New Home Care Cost Report Timetable, Elements Last week, HCA met with the state Department of Health (DOH) and its contractor, KPMG, as part of a workgroup to further discuss the state’s proposed new cost report for all home care providers. The meeting included other associations, as well as some providers and fiscal intermediaries (FIs) from the field.

As previously reported, this new cost report is being developed for Licensed Home Care Services Agencies (LHCSAs), non-hospital-based Certified Home Health Agencies (CHHAs) and FIs. DOH intends to release it sometime in spring 2020 (based on 2019 data) along with education programs to assist in its completion.

The purpose of last week’s meeting was to discuss the experiences of providers selected to pilot the new cost report using 2018 data.

HCA has already sent DOH some issues raised by our members and reinforced at the meeting. These included the need for more time beyond what DOH has planned, so that agencies can work with their vendors and staff on systems changes that are necessary to collect the required data. We also noted the hardship of requiring agencies to use their 2019 data, which is an incomplete data set.

Other concerns include: how LHCSAs and/or FIs should complete the report if they have only one Medicaid provider number but operate numerous offices serving multiple counties; whether CHHAs in more than one county would continue to aggregate their data; the effect of a new upcoming FI procurement process on FI

4

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

completion of the report; the unfeasible October 25 deadline for providers who are testing the new report; and more.

We recommended that DOH roll out the cost report in 2021 based on 2020 data to ensure adequate time to prepare for this major change and to ensure data reliability.

Other issues raised by workgroup members included: how reliable the 2019 data would be since much cannot be converted to the proposed new schedules; the role of KPMG as an auditor; the need to include system vendors on the state’s workgroup; the necessity for salary and related information on the ten highest paid administrative staff; questions about information requested on various schedules; why the new cost report does not include unreimbursed services (as on the current cost report); and whether a CHHA and/or LHCSA is responsible for including data on aide services provided by LHCSAs to CHHA patients.

DOH agreed to try to address all of these issues and will be holding weekly meetings in October on the new cost report with workgroup members.

For more information, including a review of the proposed cost report, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662; or Patrick Conole at pconole@hcanys.org or (518) 810-0661.

HCA, MSSNY Discuss Collaboration on PDGM, DSRIP Waiver, Sepsis HCA President Al Cardillo and Vice President Patrick Conole presented Thursday to the Medical Society of the State of New York’s (MSSNY) Long Term Care Committee on several key, mutual concerns.

Our agenda included the following issues: the Patient Driven Groupings Model (PDGM); the state’s plans to renew its federal 1115 waiver and Delivery System Reform Incentive Payment (DSRIP) program; and an update on sepsis prevention and care.

The PDGM discussion raised significant concerns about: the impact on agencies and services; home care financial stability; added physician documentation and administrative requirements; reimbursement for therapeutic services; the unfairness of the “behavioral adjustment” cut under PDGM; and more.

The groups also discussed core mutual concerns on DSRIP, in terms of funding, the authority and opportunities for collaboration, and the need for multilateral participation in the waiver/DSRIP initiatives, versus the current institution-focused orientation of DSRIP, where community providers are regarded substantially as “downstream” entities.

Meetings are currently being scheduled with the Legislature and Governor’s office for HCA, MSSNY and fellow associations to pursue concerns and recommendations.

MSSNY is a partner on HCA’s steering committee in the implementation of our home care sepsis screening and intervention initiative Stop Sepsis at Home. HCA provided the committee with an update on the initiative and legislation pending action from the Governor to support home care’s work. Next steps include a pediatric version of the tool, collaborative care models for sepsis survivors and data analysis, we noted. Several committee physicians asked for local presentations of the tool and our work.

5

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

Governor’s “Business Acumen” Advisory Group Eyes Support for CBO, SDH The Governor’s advisory group for promoting business acumen in community based organizations (CBO) met on Thursday. In these discussions, CBOs include local Area Agencies on Aging, home care agencies and entities providing community support services addressing social determinants of health (SDH).

The group’s directors and consultants sought to address priority questions on CBO needs, barriers and value opportunities, with specific focus on: SDH; CBO collaboration with hospitals, physicians, managed care and other partners; and recommendations for CBO/SDH services support.

HCA offered recommendations for addressing CBO barriers and better supporting the health system’s overall capacities for assessing, securing, arranging and providing for SDH-related services.

HCA recommended that the state actively support creative CBO collaboration for coordinated, value-based community services and pathways. These coordinated services and pathways could further be partnered with hospital, physician and/or managed care value-based arrangements. The state’s current value-based payment program focuses on and designates “innovators” at the Performing Provider System (PPS) level under DSRIP – that is, by the lead DSRIP entities – and we suggested an applicable form of “innovator status” for CBOs. Throughout the discussion, HCA connected these and our other recommendations to areas of the state’s 1115 waiver and DSRIP renewal considerations as expressed in a joint association letter that HCA and six colleague associations sent to state officials. The letter is available at https://hca-nys.org/wp-content/uploads/2019/08/ Joint-Letter-1115-Waiver.pdf.

NGS Advisory Meeting Yields Key Hospice Updates HCA Vice President for Finance and Management Patrick Conole participated last week in a hospice advisory meeting with the state’s Medicare Administrative Contractor (MAC), National Government Services (NGS), which yielded important technical updates for the hospice membership.

The purpose of the meeting (for provider representatives in Jurisdiction 6) was to discuss important MAC issues, information or developments, and for HCA and colleagues to pose questions or concerns on behalf of our hospice membership.

HCA has prepared a detailed memo with updates from the meeting. It can be read here: https://hca-nys.org/wp-content/uploads/2019/09/092019NGSHospiceMtgSummary.pdf.

Updates include: audit and reimbursement issues; top reason codes for claim denials and tips from the Medicare regulations to avoid denials; Comprehensive Error Rate Testing (CERT) results; the status of the Targeted Probe-and-Educate initiative; NGS education; new online functionalities; and other important items.

As noted in last week’s edition of The Situation Report, HCA is a member of the Hospice Advisory Council of the National Association for Home Care and Hospice (NAHC). The Council has been actively engaging to develop a strong, proactive policy response to a recent federal audit report of hospice survey findings across the country. We are also working to address core issues related to hospice reimbursement, new policy and

6

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

procedural rules, and regulatory flexibility needs. This venue is further supported by HCA’s ongoing collaborative work with the Hospice and Palliative Care Association of New York State (HPCANYS).

‘White Collar’ Exemption Final Rule Announced This week, the U.S. Department of Labor (DOL) finalized a rule, effective January 1, 2020, which changes the salary thresholds for exemption of overtime pay (known as the “white-collar” exemptions).

Specifically, the rule updates the earnings threshold amounts that exempt executive, administrative, or professional employees from the Fair Labor Standards Act (FLSA) minimum wage and overtime requirements.

It also allows employers to count a portion of certain bonuses/commissions towards meeting the salary level.

More information is at https://www.dol.gov/whd/overtime2019/. The rule is at https://www.govinfo.gov/ content/pkg/FR-2019-09-27/pdf/2019-20353.pdf.

The new rule: 

Raises the enforcement threshold of the “standard salary level” from $455 to $684 per week (or $35,568 per year for a full-year worker).



Raises the enforcement threshold for the total annual compensation level of “highly compensated employees (HCE)” from the currently-enforced level of $100,000 to $107,432 per year.



Allows employers to use nondiscretionary bonuses and incentive payments (including commissions) that are paid at least annually to satisfy up to 10 percent of the standard salary level, in recognition of evolving pay practices.

In terms of federal law, this change intends for expanded applicability of required overtime pay; yet New York State regulations already exceed these new federal thresholds. This means that employees deemed eligible for overtime under the new federal thresholds must already be paid overtime by state standards, as outlined below.

Dependent on size and location, the New York White-Collar Exemption salary thresholds range from $43,264 ($832 per week) to $58,500 ($1,125 per week). These thresholds are as follows (per week):    

NYC-Large Employers (11 or more): $1,125 NYC-Small Employers (10 or fewer): $1,012.50 Long Island & Westchester: $900 Remainder of New York State: $832

These state thresholds generally take precedence over those in the final federal regulation because they are higher than the federal level amount.

There is, however, one distinction in the federal versus state regulations. New York’s regulations do not include a minimum salary requirement for “professional” exempt employees and, thus, New York State employers need to follow the federal guidelines for such workers.

Continued on next page

7

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

Continued from previous page Exemptions are not based solely on pay and hours; they are also based on whether the employee is labelled as “professional,” “executive,” or “administrative.”

For more information regarding New York State thresholds, please refer to the links listed here: 

https://www.labor.ny.gov/legal/counsel/pdf/administrative-employee-overtime-exemptionfrequently-asked-questions.pdf



https://www.labor.ny.gov/legal/counsel/pdf/executive-employee-overtime-exemption-frequentlyasked-questions.pdf



https://www.labor.ny.gov/legal/counsel/pdf/professional-employee-overtime-exemption-frequentlyasked-questions.pdf

Capitol Report Features Sepsis Survivor, Home Care & Autism, a NORC-Home Care Partnership, 24-Hour Care and More Last Wednesday, HCA sent out the September edition of our Capitol Report e-newsletter to the Legislature.

(An archive of all ten editions to date is at https://hca-nys.org/hca-capitol-report.)

Our top story, on Sepsis Survivor Jillian Thibault, quickly reached the top-three ranking of pages that were viewed on HCA’s website last week. The article capped HCA’s recognition of Sepsis Awareness Month in September.

Jillian has experienced multiple bouts of sepsis in recent years due to infections at the site of a central venous line needed for nutrition. A home care nurse from the Visiting Nurse Association of Albany has been working with Jillian to assist with IV treatment monitoring, checking vital signs and providing a set of eyes and ears for sepsis risk guided by HCA’s Stop Sepsis at Home screening protocols.

“Meghan has been a pivotal point in my care,” says Jillian of her nurse, and she “has taught me more than is probably necessary.”

HCA also reports on the work of Diloram Kamilova, an RN at Americare Certified Special Services who specializes in pediatric home care services. As we note, many people don’t realize that home care serves pediatric populations. This omission is shown in data revealing that only 2 percent of Medicaid spending for children with medical complexity is invested in home care nationally. Not only does Diloram help many of Americare’s 250 pediatric patients but she has specifically led the charge in helping kids with autism spectrum disorder (ASD) get the right care at home, making an incredible difference training her peers on patient-centered care for children with ASD. On the legislative front, our report also presents HCA’s position on a bill seeking to eliminate 24-hour/livein care through a hard cap on hours. HCA has been writing about this issue extensively throughout the past

8

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

month in the wake of a press conference and media reports in which legislators have pushed momentum on this bill (S.6640/A.8064).

We also feature the work of Parker Jewish Institute for Healthcare and Rehabilitation in serving individuals living in Naturally Occurring Retirement Communities (NORCs) as well as a Rochester-area ABC news affiliate report sharing the story of home care nurse Carla Wahls, RN, whose personal battles with sepsis coincided with her work on HCA’s Stop Sepsis at Home campaign.

HCA is proud to highlight the work of our members. If you have a program or news item you’d like us to share with the Legislature, please tell us about it for consideration. Contact HCA’s Communications Director Roger Noyes at rnoyes@hcanys.org.

PHHPC Committee Acts on Home Care Applications The Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review acted on a number of home care applications at its September 26 meeting.

The agenda and supporting documents are at https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2019-09-26/index.htm.

It approved the following applications: 

A change of ownership by a Certified Home Health Agency (CHHA).



An existing Licensed Home Care Services Agency (LHCSA) with a site in Rockland County and a site in the Bronx seeking to acquire a LHCSA in Albany that serves 11 counties.



A for-profit LHCSA requesting approval to convert to a not-for-profit corporation.



An entity seeking to obtain licensure as a LHCSA that will serve five counties under an exception to the existing LHCSA moratorium. The applicant will serve patients with implanted intrathecal pain pumps who suffer from severe, chronic pain and spasticity.

These applications will go to the full PHHPC for review at its October 10 meeting.

New PDGM Resources from NGS and Webinars Coming Soon National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), reports that it is planning to offer webinars soon on the Patient Driven Groupings Model (PDGM) to help providers get ready to bill properly.

In the meantime, NGS encourages providers to review PDGM information from the U.S. Centers for Medicare and Medicaid Services (CMS) at the following links as part of your readiness work: 

9

MLN Matters Article MM11081: Home Health Patient-Driven Groupings Model (PDGM) Split Implementation (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM11081.pdf) Continued on next page

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

Continued from previous page 

MLN Matters Article MM11395: Home Health Patient-Driven Groupings Model Revised and Additional Manual Instructions (https://www.cms.gov/Outreach-and-Education/MedicareLearning-Network-MLN/MLNMattersArticles/Downloads/MM11395.pdf)



MLN Matters Article MM11272 Home Health Patient-Driven Groupings Model Additional Manual Instructions (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM11272.pdf)



Overview of the Patient-Driven Groupings Model: CMS PDGM Presentation (https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2019-02-12-PDGMPresentation.pdf)



Home Health Patient-Driven Groupings Model: Operational Issues presentation (https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2019-08-21-HHPDGM-Presentation.pdf)



Home Health Agency (HHA) Center on the CMS website (https://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center.html)

HCA will notify the membership when NGS announces dates for the billing webinars.

See p. 1 article on HCA’s PDGM Bootcamp for clinicians and quality managers.

CASPER and Star Rating Preview Reports Available for the January 2020 Refresh Providers can now download the latest Provider Preview Reports and the Quality of Patient Care (QoPC) Star Rating Preview Reports from CASPER. These reports preview data that will be displayed in the Home Health Compare website beginning around January 23, 2020.

The Provider Preview Reports remain in the CASPER folder and are available to providers for 60 days only. The QoPC Star Ratings Provider Preview Reports remain in the CASPER folders and are available to providers for 90 days only.

Providers are encouraged to save a copy of their preview reports for later reference. HCA members can learn more about the home health quality reporting program data submission deadlines at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ HomeHealthQualityInits/Home-Health-Quality-Reporting-Data-Submission-Deadlines.html as well as about the Home Health Star Ratings at https://www.cms.gov/Medicare/Quality-Initiatives-PatientAssessment-Instruments/HomeHealthQualityInits/HHQIHomeHealthStarRatings.html.

10

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

HHCAHPS Preview Reports with Star Ratings Available Preview Reports reflecting results from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey from April 2018 through March 2019 (second quarter of 2018 to the first quarter of 2019) are now available at https://homehealthcahps.org under the “For HHAs” tab.

You must be logged into the website to view your report. These same data will be updated on Home Health Compare on www.medicare.gov in October 2019.

The Preview Reports present the publicly reported results with star ratings for those agencies with a sufficient number of completed interviews to receive star ratings. Agencies must have data for 40 or more patient surveys in the reporting period in order to have star ratings.

For more information about the Preview Reports, please refer to this document on the HHCAHPS website, accessible once you are logged in: https://homehealthcahps.org/ LinkClick.aspx?fileticket=rEmqINcxYK8%3d&tabid=277 For more information about HHCAHPS star ratings, including Frequently Asked Questions, go to: https://homehealthcahps.org/GeneralInformation/StarRatingsInformation.aspx If you have any questions about the HHCAHPS star ratings or your HHCAHPS Preview Report, please contact the HHCAHPS Survey Coordination Team via e-mail at hhcahps@rti.org or call toll-free at (866) 354-0985.

Coalition Surge Test to be held in Lower Hudson Valley The Lower Hudson Valley Health Emergency Preparedness Coalition (HEPC) will be conducting its third Coalition Surge Test (CST) exercise in late February/early March 2020.

This Exercise is for agencies in Westchester, Dutchess, Orange, Putnam, Rockland, Ulster and Sullivan counties.

It is a Table Top Exercise (TTX) with an Interoperable Communication (IOC) Functional Exercise (FE) added to it. The exercise will be at least three hours long to provide adequate time for participants to complete all objectives.

CST tests a coalition’s ability to work in a coordinated way to find appropriate destinations for patients using a simulated evacuation of at least 20 percent of a coalition’s staffed acute-care bed capacity.

All participants will be provided with a two-week window, but not an exact date for the exercise.

An Integrated Health Alerting Network System (IHANS) notification through the Health Commerce System (HCS) will be sent out one hour prior to the start of the exercise. Agencies which have been preidentified to play an evacuating location will receive an IHANS message two hours in advance.

Continued on next page

11

The Situation Report: the Home Care Association of New York State

Volume 4, No. 34 September 30, 2019 

Continued from previous page This exercise will meet one of the exercise requirements (community based) mandated by the U.S. Centers for Medicare and Medicaid Services (CMS).

The exercise will be followed by a hot-wash at the 3rd Quarter Lower Hudson Valley sub-region HEPC meeting on March 11, 2020.

If you are interested in participating in the exercise, please register no later than October 11, 2019 by sending the following information to Gyongyi.McQueston@health.ny.gov: 

Agency/organization name



Name, title, e-mail and cell phone number (or another phone number where you can be reached during the exercise) of Point of Contact (POC).



Name(s) and contact information for person(s) who will evaluate the exercise at your agency.

HEPCs are regional coalitions of health care providers, local and state emergency managers and local public health preparedness officials who work together to develop and coordinate emergency preparedness activities.

If you have any questions, contact Gyongyi McQueston of the Office of Health Emergency Preparedness at (914) 654-4995; (518) 491-2982 (cell); or gyongyi.mcqueston@health.ny.gov.

Health Resources

12



“Are Medicare Advantage Plans Using New Supplemental Benefit Flexibility to Address Enrollees’ Health-Related Social Needs?” by the Urban Institute https://www.urban.org/sites/default/files/publication/101067/sdh_medicare_advantage_0.pdf



“New York State County Health Rankings in National Perspective,” by NYS Health Foundation https://nyshealthfoundation.org/wp-content/uploads/2019/09/new-york-state-county-healthrankings-national-perspective-sep-2019.pdf



“Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health,” by National Academies of Sciences, Engineering and Medicine https://tinyurl.com/y3w3gk9z