Thursday, February 23, 2006

The Physician Perspective: What Doctors Really Want Before Sending You Patients

He did it again! My good friend, Dr. M. Tray Dunaway blew them away with the opening keynote presentation at the Home Health Line Power Referrals conference in Las Vegas today. Dr. Dunaway is a surgeon from Camden SC who now helps physicans improve their coding, and home health agencies that want to build relationships with physicians.

Tray has a powerful speaking style that includes original songs that he sings during and in closing his programs. He also is able to communicate in very creative ways how we can better understand the needs and wants of physicians.

He used the metaphor of the relationship with your spouse in understanding how to get closer to doctors. He talked about the first date, follow up dates, going steady, getting engaged, and marriage.

He suggested:
  • Strategically choose the physicians you will seek out
  • Be choosy. Don't go after everyone
  • Create two lists: Must Haves, and Relationship Breakers
  • Identify the top quality candidates
  • Learn to recognize the "diamonds in the rough"

Dr. Dunaway made many other powerful points:

  • "Facts tell - emotions Sell"
  • Clinical excellence is assumed. They buy based on how good you are at who you are and how you make them feel.
  • With regard to quality data on Home Health Compare: "If you don't provide your own value interpretation, someone else will do it for you."
  • Clinical Excellence + Customer Service Excellence = Success in a long line of referrals
  • Physician time is your biggest obstacle. Physician information overload is your second biggest obstacle
  • A Physician's behavior is determined by his or her "Emotional Intelligence."

He then focused on identifying and communicating with "Opinion Leaders" in the medical communityl. The most efffective mode of chaning physician behavior is academic detailing to physician leaders.

For more information, visit Dr. Dunaway's web site:

Also, visit our web site to order a copy of a brand new audio CD program on Building Relationships with Physicians, with Stephen Tweed, CSP and M. Tray Dunaway, MD, FACS, CSP.

Leverage Telehealth to Earn More Referrals

Liz Powell, COO of the VNA of Western Pennsylvania presented a very effective program on how their agency has used telehealth in increase referrals, improve patient outcomes, and grow the bottom line. This was a delightful program for me because VNA of W. PA. in Butler, PA was my second home health care client when I started working with home health agencies back in 1982. (The first was the VNA of Venango County in Oil City, PA)

Liz Presented a Step-by-Step case study of how they did it:
  • Set Goals
  • Select the right system ( VNA uses HomMed)
  • Implement a Home Health Model
  • Work out the logistics
  • Develop Marketing Strategies to Assure Success
  • Allocate Funds for Marketing
  • Define Target Markets
  • Create Marketing Materials
  • Select Target Markets

The results of their program:

  • Referrals to the agency increased by 22%
  • Home Health PPS visits per episode decreased from 19 t0 11
  • Nurses were able to carry larger case loads
  • Census increased with the same number of nursing staff
  • ER visits decreased 61.7% for CHF patients
  • Rehospitalizatin decreased by 65.9% for CHF patients
  • The agency made an amazing financial turnaround

For more information on this program, visit their web site:

Online Referral Machine: Harness the Hidden Power of Your Agency's Web Site

Brendan Killackey, President of Progressive Technology Partners is the guy to revitalized the web presence of the VNS of New York. Brendan presented some key points about how to optimize your web site to drive referrals:

  • Move beyond brochureware. Most visitors come online to be sold. They come 24/7. One of the most active times is Monday morning when they get to work after spending the weekend with an elderly parent.
  • Bring traffic to your site with SEO - Search Engine Optimization
  • Text is the fundamental element of bringing people to your site ... NOT grahics.
  • Text is page-specific, and SEO is about optimizing individual pages of your site.
  • Text is HTML based - not image based. Only text is indexable by search engines.
  • Use keyword search to find the terms that people are entering into Google and Yahoo!
  • A site map is a list of links to all pages on yoru web site. It helps search engines index all of your pages.

For examples, visit the VNSNY site:

Stay tuned to this BLOG as we introduce you to "Web-Centric Marketing and Recruiting" for home health agencies, coming soon from Leading Home Care.

Hospice Heats Up: Critical Sales Strategies to Promote This Unique Service

We're still at the Home Health Line Power Home Health Referrals conference in Las Vegas.

The final breakout session today was presented by Polly Rehnwall, from Salt Lake City. What a refreshing, somewhat irreverant presentation on some totally new ways to increase your Hospice Census.

Polly focused on growing your Census by generating referrals and converting referrals. Conversion is a big issue. Many hospices are able to get the referrals, but fail to convert them to admissions. The Best programs are able to convert 75% of their referrals to admissions. Although Polly says that many agencies sanitize their conversion numbers by not counting all of their inquiries.

Polly suggested focusing on three key targets: Long Term Care Facilities, Consumers, and Patients and families.

Some key points on marketing to LTC Facailities:
  • Have a "Real Nursing Home Program."
  • Make routine visits to Hospice patients in nursing homes during evenings and weekends. That's when families are there, and they're the ones who really benefit from your visits.
  • Set up preferred provide agreements with ALFs.
  • When making a visit to a facility as this question: "Is there anyone else I can help you with today?"

Some key points in marketing to consumers:

  • "Inquiries" = admissions until proven otherwise
  • Beware of sanitized conversion rates
  • To every caller say, "Tell me about it." Find out what they are experiencing.
  • Schedule a home visit regardless of the circumstances. You can't admit someone if you don't schedule a visit.

Some key points in marketing to families and patients

  • Avoid "eventness" when a family learns of the diagnosis. Don't get caught in the vortex
  • Take small steps
  • Give them direction
  • When you get a "yes" answer, shut up!

You look at these bullet points and ponder. What does this all mean? This was the most interesting, thought stimulating program on business development I've seen in a long time.

To learn more, contact her:

Polly Rehnwall, Inc.

Salt Lake City, UT

Daily Update from the Home Health Line Power Referrals Conference in Las Vegas

I'm writing to you today from Caesars Palace in Las Vegas where Home Health Line and Decision Health are sponsoring their bi-annual Power Home Health Referrals conference. I was the opening speaker yesterday at the Pre-conference Workshop on the topic, Building Your Marketing Referrals Dashboard. About 120 home health care CEOs, CMOs, CFOs, and CNOs along with some sales reps and clinical liasions came out a day early to pick up some advanced techniques on growing their home health agencies.

It was great fun kicking off the conference, describing the Marketing Dashboard, sharing our Top Ten Techniques for Highly Effective Home Care Marketers, and giving away some FREE prizes. For a summary of the key points of my program, click on the link to see the February 22, 2006 issue of Stephen Tweed's Leading Home Care report. (Give us a day or so to get it posted on the web site.)

One of the things we gave away is a copy of our brand new CD set, Building Relationships with Physicians, featuring my good friend and fellow speaker M. Tray Dunaway, MD, FACS, CSP. Dr. Dunaway was our guest expert on Building Relationships with Physicians during four different teleseminar series that we provided in 2003 and 2004. We have combined the four different CDs into one new set and it's now available on our web site at

Over the next two days, I'll be adding additional posts to this BLOG to give you some insights on the programs provided by the speakers at the Power Home Health Referrals conference. You can join us for the next conference in Orlando in May. Here's a link to the brochure:

Interactive & Innovative Training for Home Care Professionals

Michael Giudicissi ( MG to his friends) is Vice President of Busines Development for Heritate Home Care in Albuquerque, NM. A talented speaker and experienced home care sales manager, Michael gave the group some hands-on , down-to-earth tips on how to train sales professionals in home care.

Do You Know Who is Representing You? Most customers will judge your company by your representative. They make their initial judgement in 15 - 20 seconds, their long term judgement in the first 2 minutes, and it can take up to 20 "touches" to reverse an initial impression.

You cannot execute an effective sales training plan unless you know what training your staff needs. Spend time in the field with your sales force. Assist in making calls but don't do it for them. Evaluate each call after it's over and decide on training needs.

You NEED an IBS. Not Irritable Bowel Syndrome ... but an Initial Benefit Statement. This is a 15 - 20 second statement that sets the stage for the call and gets the sales rep 2 minutes to present your program. The IBS is concise, confident, informational and talks about why a referral sources is likely to be interested in what you are selling. It needs to be well prepared and flawlessly practiced.

Role Playing is a valuable training tool. In most cases, role playing is harder than the actual sales call. It involves drawing up realistic sales scenarios and giving your sales reps the opportunity to "play the roles" as they learn to think on their feet, respond to difficult questions, and handle rejection. Michael suggests having your sales reps practice by presenting to clinicians to get feedback on their presentaitons. He also recommends videotaping the sessions and providing instant self-review.

In closing, Michael shared "The Final Secret."

  • Show up
  • Be courteous and professional
  • Be ready to do business
  • 80% of your success in just being there
  • The other 20% is in the training
  • and Finally ... Ask For The Business!!!

You learn more about Heritage Home Healthcare & Hospice at

Star Liaison of the Year: Talent Search Winner Shares Success Secrets

We worked with Home Health Line and Decision Health to promote their Star Liaison competition to find the best home health agency business development reps. I was also invited to serve as one of the judges for the contest. Two candidates were selected as the Star Liaisons. One was invited to speak at this Pre-Conference workshop, and the other will be in Orlando in May for that conference.

The first Star Liaison is Penny Shadinger, RN, Program Liaison with Alacare Home Health & Hospice in Albertville, AL. Alacare is one of the largest home health and hospice agencies in Alabama, and is a leader in using technology to communicate with and monitor patients.

Penny did a wonderful job of describing her company, her service area, and how she goes about bringing in a substantial percentage of her company's total referrals. Penny discussed:

  • Giving Personalized Service with phone, fax, personal intake or online referrals
  • Being a True Team Player in working with clinical staff and other team members
  • Educating referral sources
  • Staying connected to referral sources
  • Using your car as your office, and how to prepare for each sales call

You can learn more about the programs and services of Alacare at

Legal Landmines: Top Home Health Agency Marketing Mistakes

The final speaker for the Power Referrals Pre-Conference Workshop was Lis Zink-Person, Esq. President of Pearson & Bernard in Covington, KY. Liz is a long time friend and well know attorney for home health agencies. Liz helps her clients avoid run-ins with the law in the areas of Mediare Fraud and Abuse, avoiding violations of Antikickback statues, and the Stark II law.

Liz shared with the group her "Top Ten Marketing Mistakes That Can Lead to Trouble."

1. No Marketing Policies - You need to have clearly written policies that guide your clinical and marketing staffs in what they can and cannot do in the way of business development in your company.

2. Buying Referrals from Anyone - Liz pointed out specific aspects of Antikickback law and Stark II that make it illegal to buy Medicare or Medicaid referrals.

3. Problem Relationships with Other Providers - Be cautious in developing business collaborations, joint ventures, or vendor relationships with Physicians, Hospitals, Assisted Living Facilities, and others who are in a position to refer patients.

4. Failure to Use Safe Harbor - 42 CFR ~ 1001.952 provides Safe Harbors to protect legitimate business relationships which would otherwise violate the law. These include arrangements for equipment rental, space rental, personal services, management services, discount buying groups, and employees. You need to protect these legitimate relationships with clear contracts, stated duties, and Fair Market Value rates.

5. Freebies to Facilities - You cannot provide FREE services to Assisted Living Facilities, Skilled Nursing Facilities, or Hospitals such as educational programs or discharge planning services. You also cannot rent space or a work station in an ALF or SNF at more than Fair Market Value rates.

6. Patient Inducements - It is a HIPAA restriction that prevents giving gifts to patients that may appear to be inducements to receive Medicare or Medicaid services. An OIG special advisory limits non-monetary gifts to $10 per gift and $50 value annually.

7. Untrained and Unsupervised Sales Force - Train your sales force and anyone who is involved in marketing on your established standards of conduct, and the rules and laws which govern inducements to make referrals.

8. Over-Incentivizing Marketers - It's OK to pay an incentive or bonus to Bona Fide W-2'd employees, but Liz cautions you not to let your sales reps get carried away with what they will do to get a referral in order to get that bonus. Pay for legitimate, legally compliant new business.

9. Skimping on Compliance - Non-compliant marketers are trouble. Audit referral sources and other employees to make sure your marketers are operating within the bounds of legal activity.

10. Believing the Government - OIG, FBI, and Government attorneys get promoted for successful fraud cases. Don't become a "notch on their belt."

For more information on the legas do's and don'ts of marketing home health care services, you can contact Liz at:

Liz Zink-Pearson
Pearson and Bernard
Covington, KY

Monday, February 20, 2006

Survey Shows Preference for Non-Medical Home Care

Ashland, MA (PRWEB) February 20, 2006 -- Non-medical home care tops the list of preferred options for those seeking elder care services, according to the latest data gathered by ElderCarelink, an elder care referral service which spots trends and identifies growing elder care management needs. For those seeking elder care services, 54% preferred in-home care to assisted living and senior communities for seniors primarily between the ages of 75 and 84.

The numbers are consistent with growing trends for elderly to be cared for in the home rather than in nursing homes and assisted living centers. Using non-medical care can support families in their care efforts and support seniors in continuing to live independently. Utilizing home health care and personal care providers can be more cost effective as well. Elder home care services often include meal preparation, personal care services such as grooming and dressing, household services and transportation, according to the ElderCarelink survey.

“The trend toward caring for our seniors in the home is evident as concerns about quality of life and reluctance to turn to dependent living situations such as nursing homes or assisted living grow,” said Robert F. Brooks, Chief Executive Officer of ElderCarelink.

Getting to 'Yes' With Older Clients in Non-Medical Home Care

Our friend, Colleague, and Co-author Mike Sullivan sent us this article on how to sell your services to older clients. You'll find this extremely valuable:

Getting to "YES" with Older Clients

By Michael P. Sullivan

Older clients make decisions largely on the basis of intuition and gut reaction. Here's how you can tailor your presentations about non-medical home care to gain their approval.

Whether we like to admit it or not, the aging process changes us.
As with the senses of vision and hearing, our ability to process information decreases with age. The ability to process information accurately, completely, and quickly peaks in the early 20s and then declines. At age 40, on average, 50% of the inborn level of fluid intelligence-our ability to quickly and accurately process information-has disappeared; by age 60, on average, about 75% is gone.

But the good news is that we compensate for the loss of fluid intelligence with a second form of smarts: crystallized intelligence. That is our life knowledge-what we know from experience. The ability to use that form of intelligence does not decrease with age. In fact, we know more with each passing year.

For providers of non-medical home care, this means we have to handle older clients somewhat differently than we do their younger children. Older clients will understand what you have to say, but you've got to present it in a way that suits their stage of life.

Why older clients resist

If you were to be asked what two plus two equals, you would immediately know the answer, virtually without conscious thought; that is crystallized intelligence. On the other hand, if you were asked what 231 multiplied by 963 equals, you would not immediately know the answer, and neither would most other people.

They would have to process the information consciously in order to arrive at an answer. That is fluid intelligence, and with age, starting for many people in their mid-40s, they would make errors in processing and might arrive at the wrong answer.

Give older clients the right information

You will never get a recommendation accepted with clients unless they (1) get enough information and (2) feel comfortable with the amount of time they have to process it. "Enough" will vary for each person, and it is defined in two ways: by quantity and the kind of information the client wants.

Think about the information requirement like this:

People need different amounts of information to feel comfortable making decisions. Information is like water: some people need a glass and others need a gallon.

We regularly work with clients who want to know every conceivable detail, while others simply want top-line information. It's your job to figure out how much each individual needs.
People need different kinds of information. Older clients generally don't want very many numbers because they require fluid intelligence to process. Older clients typically need other kinds of information.

Once you have determined their information style, aid older clients using their crystallized intelligence-their experience-as it applies to the investment issue under discussion. Discuss your recommendations in terms of their life experiences. Get to know clients so that you can tailor recommendations to their lives.

Give older clients more time

At age 17, an individual's ability to process new information accurately, completely, and quickly is about at the peak. At age 60, that capability is very, very low. Yet, 17 year-olds have many more accidents driving automobiles than do 60-year-olds. Why?

The answer, of course, is experience. For the 17-year-old, every potentially dangerous situation is new. He has to think about it and then react. For the 60-year-old, every potentially dangerous situation has been seen many times over. He doesn't have to think about it; he can just react based on his experience, which has been hard-wired into his central nervous system.
Similarly, an aging investor who uses his life experience will usually be able to make a good decision. But, that often requires the advisor to help him connect that experience with the subject at hand. Make time in your meetings to do that.

Older clients make intuitive decisions

The upshot is that you must remember when you're working with older clients that they will substantially base their decisions on experience, which manifests itself as intuition and gut reaction. It's basically a chemical reaction!

When the brain hears a proposition, its neurotransmitters automatically kick in. Chemicals, like dopamine, transmit nerve impulses. When the input is positive-whether it's more money or a delicious meal-dopamine circuits are activated to different degrees. The amount of "yes juice" an individual produces in response to any individual reward is a function of his or her past experience and biology.

7 Quick Tips

Life experience is an amazing teacher, and older clients have a lot of it. So when working with them to meet their financial goals, keep these tips in mind:
1. Don't rush seniors into a decision.
2. Check in often during the conversation to make sure they are with you.
3. Ask them how much they need to know.
4. Don't inundate them with extraneous information.
5. Don't focus on numbers if it's not their style.
6. Show respect for their life experience.
7. Tie your suggestions to their life goals.

Remember that in non-medical home care, you're selling peace of mind, quality of life, and independence. Tap into the intuitive decision making of your older potential clients.

Mike Sullivan is a well-known consultant/trainer specializing in selling to the affluent 50-plus market. He has worked closely with Leading Home Care as an expert on selling to Bank Trust Officers. He is co-author with Stephen Tweed of "Increase Your Income Selling to Bank Trust Officers and Other Trusted Advisors."

His consultancy, 50-Plus Communications Consulting, provides value-added materials focused on sales to Baby Boomers and older customers principally through sales managers of financial institutions. For more information, call Mike at (704) 554-7863, e-mail him at or go to his website

Saturday, February 18, 2006

What if you made 2006, the best year of your life? Here's an idea that can make a real difference for your Home Health Care Agency.

My friend and fellow professional speaker, Mark LeBlanc sent me this message. Mark will be President of the National Speakers Association in 2008. (I was President in 2003).

You can apply Mark's ideas to your home health care business and have the best year ever.


What if you made 2006, the best year of your life?

By Mark LeBlanc
Small Business Success

Every December, most business owners, professionals, and people in sales, begin the arduous task of examining goals over the past year, and setting new ones for the coming year. I believe there is something inherently wrong with the traditional goal-setting process.

Down with goals!

Really? Sort of. What if there was a different way to look at achieving what you want to accomplish in your life and work.

One of the greatest obstacles to reaching your goals is the calendar year. That’s right. We’ve been taught to set and examine our goals every twelve months. And twelve months is simply too long of a time period to do justice to the goal-setting process. Too many people, places, and projects begging for your attention throughout the year, will derail you time and time again. We can also count on our new year’s resolutions to crash and burn, since the lion’s
share of them do, right?

Yes, you should still set some realistic goals, and goals that challenge you to become a better person, in mind, body, and spirit, as well as, goals that can help you achieve a higher level
of success. Here are four ideas that will increase your odds of reaching all of them, and having a little more fun along the way.

1. Create a snapshot of your ideal month. What does 1/12th of your year need to look like in order for you to reach your targeted goals. If you don’t have a clear vision of your ideal
month, then you will wait too long into the year before you get started on your goals.

2. Establish a set of benchmarks that you can realistically do, on a regular basis, in order to reach your goals. A benchmark is a simple number that measures an activity or
a result. In order to create the momentum you require, these activities must be doable, and not hard to implement, or painful. Once your momentum ball is rolling, it’s hard to stop it.

3. Create a floating twelve month calendar. Why have one new year’s celebration a year, when you can have twelve? If you truly focus your efforts on your ideal month, then review
your numbers every thirty days, and celebrate your progress. Once you have the habit down, and your tracking system in place, you will never be back at the bottom of the mountain,
looking at a bigger goal.

4. Reset your counters to zero every thirty days. No matter what happens at the end of the current month, reset your counters to zero, and start implementing your benchmarked
activities all over again. No plus or minus carryover. If you can strengthen this mindset, you will create a system for self-renewal that will make you unstoppable.

Now is a good time to re-examine your life and work, and think about what you really want, and explore the real reasons you have not reached the level of success you desire. Then
throw those reasons away, and re-commit yourself to what you do want. It may be time for a new way of looking at success, and a new system for accomplishing your goals, and making
your dreams come true. Cheers to making 2006, the best year of your life!

Mark LeBlanc runs Small Business Success, based in La Jolla, CA, and speaks for groups of business owners and professionals who want to sell more products and services. He is the Author of the soon-to-be released book, Growing Your Business When YOU Are the Business! He can be reached at (800) 690-0810.

Collecting From Insurance Companies

Hello everyone,

We have a collections issue. Our problem payor is Farm Bureau Automobile Insurance in the State of Michigan. On 11-04-04 we began 24 hour care for a MVA victum. I recieved a letter of intent from the adjuster at Farm Bureau. Farm Bureau paid for November, December. and part of January services. They then decided not to pay. We discontinued services for many reasons on May 11th 2005. This is the third Farm Bureau case we have had collection issues on.

We have had an attorney working on it since Sept. 2005. Any suggtions or similiar experiences

HHH Nursing Manager

Thanks, Marcia … for sharing this example with the rest of us.

There are several things you can do to prevent this type of situation in the future:

1. Have a paragraph in your service agreement with the client stating that they are responsible for payment. You will work with their insurance company, but if the insurance company delays payment or refuses payment, that the client is liable.

2. Make in clear in your agreement that failure to pay is cause to discontinue services. This will avoid any charges of abandonment.

3. Bill frequently, follow up quickly on slow payers, and keep the client informed that the insurance company has not paid. Remind them that it’s their responsibility to pay the bill, and that service will be discontinued if payment is not received.

We have found that it’s better to anticipate these types of claims and take action to prevent them. After a large bill has been accumulated, it’s always much more difficult and expensive to collect.

Hope this helps. I’ll look forward to hearing from others who have had similar problems. Add your comments below about collection problems and how you have addressed them.



First to Care Home Care, Inc. Named National Best Practice Home Health Agency

NEW YORK, Jan. 10 /PRNewswire/ -- First to Care Home Care, Inc. was named as a National Best Practice Agency by Briggs Corporation, the National Association for Home Care and Fazzi Associates in the National Home Care Quality Improvement/Hospitalization Reduction Project.

According to the nationally reported CMS Home Health Compare, First to Care's low hospitalization rates resulted in a ranking among the top 10% of the most successful agencies in the country for acute care hospitalization.

First To Care Home Care, Inc. is a participating program of Metropolitan Jewish Health System (MJHS).

Good News for Home Health Agencies: Medicare Advantage enrollment flat

The percentage of Medicare beneficiaries who are enrolling in Medicare Advantage managed care plans has remained flat during the last six months of 2005. According to data from CMS made available by VNAA, 13% of Medicare beneficiaries across the country were enrolled in Medicare Advantage as of December 30; the same % as in July of 2005.

That's good news for home health agencies who are not positioned to compete for managed care contracts, and who have had the experience of losing money on their managed care business in the past. You'll recall that the home health industry spend millions of dollars and millions of staff hours in the mid 1990s getting ready to compete for managed care business that never really materialized. And those agencies that were successful getting the contracts ususually did not come out very well economically.

What do you see happening with Medicare Advantage plans in your marketplace? Add your comments below.

Friday, February 17, 2006

Home Health Line Announces Winners of Star Liaison Contest

Industry newsletter Home Health Line has been conducting a search for the best home health marketer nationwide, and has found two“Star Liaisons”: Penny Shadinger of Alacare Home Health & Hospice in Birmingham, Ala., and Dawn Basko of Life Care at Home in Highlands Ranch, Colo.

Both winners have innovative approaches, documented achievements and the ability to share lessons learned with other home health marketing professionals. Their nominations detailed their success in getting the attention of referral sources, building on those relationships and ultimately growing business for their agencies.

As one of the judges who participated in selecting the winners, I can tell you that this was a close competition. All of the candidates that I reviewed have terrific home health care sales experience.

Shadinger and Basko will share their sales secrets with hundreds of attendees at ...hhl's Power Home Health Referrals: Advanced Marketing Strategies 2006, an annual three-day educational conference for home health marketing professionals. The meeting features a lineup of 15 expert presenters, several of whom served as Star Liaison Award judges.
Shadinger will present her winning strategies on Feb. 22 at Caesars Palace in Las Vegas, Nev. Basko will appear at an encore presentation of the meeting on May 10 at the Orlando World Marriott in Florida. Both winners get paid transportation, lodging and admission to the conference.

I'll look forward to meeting the two winners in person, as I'll be speaking at both conferences. I'll have an opportunity to interview the winners and bring you some of their strategies and insights for increasing your referrals. Stay tuned to this BLOG for more details.

For details on the Feb. 22-24 and May 10-12 conferences, including session descriptions and registration information, see

Thursday, February 16, 2006

Senator Santorum's bill champions long term home health care

WASHINGTON -- Sen. Rick Santorum introduced legislation yesterday that would create new tax incentives for Americans to save for long term home healthcare.

The Pennsylvania Republican said the legislation was the product of his conversations over the past year with older Pennsylvanians struggling to pay for home health care as their medical problems become more complicated.

Mr. Santorum said the measure was also an attempt to reduce the dependency of America's seniors on Medicaid. The cost of the federal program -- originally intended to provide health care for the poor -- has exploded in recent years as increasing numbers of seniors have depended on the program to pay for care in their later years such as nursing home costs, after draining their own assets.

Mr. Santorum's legislation includes four major provisions, according to his aides.:

1. The legislation would allow employers to create new programs for their employees that allow them to set aside pre-tax dollars for long-term care insurance in the same way employees can currently set aside money for 401K plans.

2. It would relax the rules for Flexible Spending Accounts by allowing employees to use money in those accounts for adult day care, home health care or respite care for any family member including parents, siblings, children, spouses or in-laws.

3. It would also create "long term care accounts" intended for individuals who may have trouble getting long term care insurance because of pre-existing conditions such as HIV or disabilities or those who cannot afford the insurance for medical care in later years.

4. The final change would allow for the creation of programs that combine annuities and long term care insurance.

What do you think about Federal tax incentives to encourage Americans to save for long term home health care? Add your comments below:

Sick Spouse Bad For Your Health

A study published in the New England Journal of Medicine shows that the debilitating illness or injury of a husband or wife can hasten the death of their spouse.

"You can die of a broken heart not just when a partner dies, but when your partner falls ill," said chief researcher Dr. Nicholas Christakis at Harvard Medical School.

The study at Harvard and the University of Pennsylvania was published Thursday in The New England Journal of Medicine. The research, backed by the National Institutes of Health, analyzed Medicare records from a representative national sample of 518,240 elderly couples over nine years.

Men were 4.5 percent more likely than usual to die on any given day after their wives were hospitalized; women with sick husbands were almost 3 percent more likely to die.
If the sick spouse dies, the partner's risk of death - whether from accidents, suicide, infections or pre-existing conditions, such as diabetes - shoots up fivefold, rising by 21 percent for men and 17 percent for women, the researchers said.

For the full story:

Why is this imortant to us? It leads to a better understanding of the value of non-medical home care to the surviving spouse. This research suggests to me that we can help not only the sick or injured person but their spouse as well when we provide home care services.

What do you think? Does home care for a sick or injured person also have tangible, observable benefits to their caregiver spouse? How can we quantify that? How can we use that as benefit in communicating the advantages of our services?

Let us hear from you. Add your comments below.

Wednesday, February 15, 2006

Accent Care Selects CareKeeper Software

ATLANTA, Jan. 24 /PRNewswire/ -- CareKeeper Software, Inc. announced todaythat it has signed agreements with national home health care providerAccentCare, Inc. headquartered in Irvine, California. AccentCare's operationsspan thirty-two branches in four states including California, Arizona,Washington and New York.

AccentCare will deploy CareKeeper's 100% web-basedhome health care software - VividNet, throughout the company to manage theirPrivate Duty, Certified Home Health and Medical Staffing divisions.

What software are you using for your Private Duty Home Care business?
How satisfied are you with your software? Tell us by adding your comments below.

State Home Care Associations adding services for Private Duty Home Care

I was in Boston yesterday presenting a half-day seminar on “Building your Private Duty Dashboard.” Twenty eight owners and managers of Private Duty Home Care companies from across the state gathered to learn more about how to grow their businesses and measure their performance.

Before I got home, I received the following email.

Hello Stephen,
First I want to thank you for the great wealth of information that you shared at the seminar today in Westboro. I learned a lot about the industry which is "new to me". You are an interesting speaker and well versed.
Secondly, I want to give you my e-mail address so that you can send the free template that you spoke of.

Thanks again.
Kathy Kilhart RN, BSN
Director of Elder Services
Gardner VNA
34 Pearly Lane
Gardner, MA 01440

The Home Care Alliance of Massachusetts has formed a Private Duty group that meets quarterly to share ideas and information. This is the first of a two-part series. The second session will be on March 14, 2006 when Heather Rooney, President of H2 Marketing will present a seminar on marketing Private Duty Home Care.

We’re working closely with a number of state home care associations who want to provide programs and services for the companies in their states who offer Private Duty or non-medical home care.
If you would like to attend the second program in the series, visit the HCAM web site at

Home Health Agency in The Netherlands using RFID technology for point of care patient records

A home health care company in the Netherlands called ALLEVO is using Radio Frequency Identification tags to speed up patient record keeping. These are the same tags Wal-Mart uses to track packages in shipping.

Every client is provided with a contact free chip card when they become Allévo clients. At each visit, the nurse touches the chip card using a Nokia 3220 phone with RFID reader to register their visit, thus eliminating the time needed to fill in forms. In addition, the nurse has secure access to the most up-to-date information on the client allowing them to focus on delivering care.

What new applications of technology do see being used in home care? Add your comments below.

Monday, February 13, 2006

Tweed's Pub and Restaurant

I'm in Westborough, Mass. this evening getting ready to present a half-day seminar for the Home Care Alliance of Mass. tomorrow. We'll be talking about "Building Your Private Duty Dashboard."

I stopped at the front desk to ask about a place to eat, and I was directed to Tweed's Pub and Restaurant. It's a wonderful neighborhood place owned by the Dunahue family. Lori, the server suggested the Lobster and Steamers ... a wonderful fresh lobster and a bucket of steamed clams. What fun! Turns out the name doesn't have anything to do with the sir name Tweed, but refers to the fabric in the cap of the owner's father in the restaurant logo.

No family connection, but fun anyway.

Wish you could be here with us tomorrow to talk about Private Duty Home Care. Stay tuned for a future post with more information on the content.


Growth of Home Care Spending

U.S. health care spending increased 7.9% in 2004 to nearly $1.9 trillion, outpacing inflation and wage growth and amounting to a record 16% of the nation's gross domestic product, according to an annual CMS report published in the January/February issue of Health Affairs, the Miami Herald reports. The combined health care spending by consumers, businesses and government totaled $6,280 per person in 2004, compared with $5,670 in 2003 (Pugh, Miami Herald, 1/10). The rate of growth in health care spending was the lowest since 2000's spending increase of 6.3%.

Spending on home health services for the elderly and disabled, "while only a small portion of overall spending," increased more than any other category, up 13.3% in 2004, the Herald reports (Miami Herald, 1/10). The increase was 11.1% in 2003. Spending for home care totaled $43.2 billion in 2004. Medicare spending for home care increased by 19.3% in 2004.

Source: Miami Herald

American Association for Homecare Announces Leadership Change

ALEXANDRIA, VA, February 6, 2006 -------- The American Association for Homecare (AAHomecare) announced that the Board of Directors and Kay Cox have reached a joint decision that she will step down as President and CEO effective today. “We thank Kay for all her efforts in furthering the interests of our members and we wish her all the best in her new endeavors,” said Tom Ryan, AAHomecare Chairman and CEO of Homecare Concepts.

“AAHomecare continues to aggressively pursue policies that strengthen homecare in the United States. AAHomecare has a powerful and dedicated network in its members, including the Board of Directors, AAHomecare Councils, Committees, and state associations throughout the U.S,” said Ryan.

AAHomecare Chief Operating Officer Sue Mairena will continue to be responsible for the day-to-day activities of the Association, working closely with the Executive Committee of the Board.

What is your experience with AAHomecare? Click on the comment link and tell us what you think.


Compare your Rates to SNFs and Home Care Around the Country

Danielle Greely, Office Coordinator at Boyd and Nicholas in Rohnert Park, California sent me this comparison of nursing home rates, home health aide rates, and homemaker rates at various locations around the country. Thought you’d find this useful.

Average Daily/Hourly Rates in the 10 Highest and 10 Lowest-Cost Markets

Market Nursing Facility (Single Room) Home Health Care Aide Homemaker/Companion

Highest Cost
Alaska $531/day $22/hr. $20/hr.
Stamford, Conn. $348/day $21/hr. $17/hr.
San Francisco $330/day $21/hr. $20/hr.
New York $320/day $15/hr. $15/hr.
Hartford, Conn. $292/day $23/hr. $18/hr.
Worcester, Mass. $287/day $22/hr. $19/hr.
Boston $227/day $22/hr. $21/hr.
Washington, D.C. $271/day $17/hr. $16/hr.
Rochester, N.Y. $269/day $20/hr. $18/hr.
Honolulu, Hawaii $262/day $19/hr. $17/hr.

Lowest Cost
Shreveport, LA $115/day $12/hr. $12/hr.
New Orleans $118/day $14/hr. $14/hr.
Birmingham, Ala. $135/day $13/hr. $13/hr.
Little Rock, Ark. $137/day $14/hr. $14/hr.
Wichita, Kan. $139/day $16/hr. $15/hr.
Oklahoma City $141/day $16/hr. $16/hr.
Kansas City, Mo. $146/day $17/hr. $15/hr.
Tulsa, Okla. $146/day $18/hr. $16/hr.
St. Louis $148/day $17/hr. $17/hr.
Charleston, SC $153/day $17/hr. $15/hr.

**Source: “2005 MetLife Market Survey of Nursing Home & Home Care Costs”

The key so success in home care is to not get caught up in competing on price. You don’t want to be the “Wal-Mart of Home Care.” You want to be positioned as the Lexus or BMW of home care. Follow our posts and we’ll give you tips and techniques on how to do that.

Have a great day.


Stephen Tweed’s Home Care Blog

Welcome to our Web Log … more commonly known as a BLOG. Our purpose is to bring you current information, ideas, and expertise to help you grow your home care business. This BLOG is written for CEOs, Executives, and managers of certified home health care agencies, Private Duty non-medical home care companies, and suppliers to the home care industry.

We’ll be posting new items to our blog nearly every day, so you will want to check back frequently for the latest, up-to-date information. If you have ideas or information you would like to pass on to your colleagues in the industry, we invite you to send us an email with your information. We invite you to comment on any item in our BLOG. Disagreement and controversy are encouraged. We want this to be an informative, interactive, interesting place for your to find out what’s happening in home care across the country.

Thanks for reading, and we’ll be talking with you soon.

Best regards,

Stephen Tweed, CSP
Chairman & CEO
Leading Home Care
… a Tweed Jeffries company