Friday, October 16, 2009

Parent's May Misguide Senior's Long Term Care

When seniors are searching for home care, they often seek the advice of their children first, particularly their daughters. Many seniors assume that their children have a better grip on the current economic situation and understand the health care system. The American Association for Long-Term Care Insurance found some unsettling results in a recent study.

Although the study was about long term care planning for women, if daughters of seniors misunderstand their own long term care plans, they also have the potential to misguide the care plans of their parents.

Almost 20 percent of women participants in a national survey believed that they already had long-term care coverage, while only about 5 percent of U.S. adults over the age of 45 actually had it. The survey suggests that many women may assume that their health coverage includes long-term care, when in reality it doesn’t.

Investigating long term care plans for both the senior and their child will help both understand the ins and outs of the system.

Thursday, October 15, 2009

Blackberry Report: The National State of the Home Care Industry Study

The National Association for Home Care & Hospice (NAHC) has announced the completion of The BlackBerry® Report: The National State of the Home Care Industry Study. The study, conducted to provide insights into essential advances and reforms in the delivery of home
health care services, is intended to help providers of these crucial services
prepare for pending overall health care reform.

The study, the largest of its kind, is designed to drive best practices that
can be shared for the benefit of the whole industry. The study demonstrates
the collaboration within the home care industry to prepare for proposed
reimbursement cuts, and to retool to use technology and data to improve
quality and patient care.

The first analysis of the BlackBerry Report (available at revealed key insights
that underscore the home care industry's commitment to the utilization of
technology to enhance quality and improve efficiencies and productivity
through the adoption of Electronic Medical Record Systems, Point of Service
(POS) Systems, hand held devices and telehealth.

Our friend and colleague, Dr. Bob Fazzi, presented the results of the survey at the NAHC annual conference in Los Angeles earlier this week. Some highlights from the study are:

  • Just over 65% of all agencies now have Electronic Medical Record
  • Eighty-three percent of these agencies report that the use of
    these systems has led to improvement in quality of care coordination.
  • Nearly 40% of all agencies now use some form of POS system in the
  • Handhelds account for 6.3% of hardware presently being used
  • Just over 36% of those agencies seeking to purchase new hardware report that they are
    interested in handhelds.
  • Twenty three percent of agencies report using telehealth systems.

Wednesday, October 14, 2009

Shield Healthcare Announces Story Contest to Honor Caregivers

VALENCIA, Calif., Oct. 14 -- Shield Healthcare, a leading
provider of medical supplies for care at home, is pleased to announce its 9th
annual story contest on "What Makes Caregiving Rewarding?" designed to
recognize and hear the voice of caregivers and home healthcare professionals,
featuring celebrity contest judge, Sandra Mitchell of KCAL 9/CBS 2 News.
Shield Healthcare understands that caregiving is a demanding job. A
significant number of our customers are family caregivers at home, tending to
a loved one with a chronic medical condition. They unselfishly take on the
challenge and responsibility of meeting the daily health and emotional needs
of the person in their care. This story contest is a positive way to recognize
and reward this important role. The contest runs through November 30, 2009 in
celebration of National Family Caregiver's Month.

Last year's winners included 3 mothers of special needs children, a nurse, and
a social worker. Winner Susan Agrawal wrote, "Among all the blessings that my
daughter has bestowed upon me, seeing her grow through inchstones has granted
me the best gift of all: the ability to see wonder and joy in the most
unexpected places."

The top three story winners will receive $1000 in American Express Gift
Cheques and a 1-year subscription to Today's Caregiver Magazine. The two
runner-ups will also be awarded the magazine subscription and $250 in American
Express Gift Cheques. All contest entries must be one-page, typed or
hand-written and postmarked by November 30, 2009. Entries should be mailed to
Shield Healthcare, Attn: Caring Solutions, 27911 Franklin Parkway, Valencia,
CA 91355 or emailed to Full contest details are
available on Shield's website at

Recovery Audit Contractors

RACs have been established to reduce improper payments by Medicare, to detect and collect overpayments, and to identify underpayments. They are to implement actions to prevent future improper payments.

There is no phase in strategy, and all Medicare provider types are available for RAC review once they have reached out to the providers. However, Mary's thought is that they will focus on recovering big dollars from hospitals, Rehab, and major surgeries, since that's where the biggest opportunities lie. The RACs are paid based on a percentage of the dollars they recover.

There are 4 RACs in place, and each covers one fourth of the country. The RACs jurisdictions match the MAC jurisdictions for DME. Mary suggested that everyone attemd the RAC presentation provided by CMS - Program 814. You need to know where previous improper payment have been found and if you are submitting claims with improper payments. Mary St. Pierre, Vice President for Regulatory Affairs at NAHC suggests that you prepare to respond to RAC Medical Record Requests, and stay calm and stay informed.

Medicare Administrative Contractors

Congress amended section 1816 of the Social Security Act to replace Medicare fiscal intermediaries and carrier contracting authorities with new Medicare Administrative Contractors (MACs). It requires all providers and suppliers to be generally assigned to a MAC based on geographic location. Large chain providers - EXCEPT Home Health & Hospice - are permitted to consolidate their billing activites under the MAC with jurisdiction over the chain's home office.

Home Health Care Regulatory Update

At the annual conference of the National Association for Home Care & Hospice, Mary St. Pierre, Vice President for Regulatory Affairs presented her update on new regulations affecting home health care. As always, Mary was wonderful in helping us understanding the regulations that will be affecting us. Here's a brief list of the regulatory issues the Mary covered, and a link to her handout materials for this presentation. A short report on each element will follow in future blog postings.

Regulatory Update Items*

* Medicare Administrative Contractors
* Recovery Audit Contractors
* Survey & Certification Future Considerations
* Post-Acute Care Demonstration
* Home Health Quality
* CHAMP - Collaboratin for Homecare Advances in Management Practice
* Red Flag Rule
* Medicare Home Health PPS Rule
* Case Mix Creep
* Outlier Policy Change
* Proposed Coverage Standards
* Provider Enrollment
* Physician Certification and Recertification
* Oasis Compliance and OASIS-C
* CAHPS - Consumer Assessment of Health Providers and Systems
* Delta OASIS-C Best Practices Project

There's clearly a lot of valuable information here, and you'll want to learn as much as you can about each of these items. Stay tuned for more details.

We appreciate your comments. If you were in Mary's session, what was most important for you?

Saturday, October 10, 2009

Injury And Hazards In Home Health Care Nursing Are A Growing Concern

Patients continue to enter home healthcare ''sicker and quicker," often with complex health problems that may require extensive nursing care. This increases the risk of needlestick injuries in home healthcare nurses. While very few studies have focused on the risks of home healthcare, it is the fastest growing healthcare sector in the U.S. In a recent study, led by researchers at Columbia University Mailman School of Public Health, the rate of needlestick-type injuries was 7.6 per 100 nurses.

At this rate, the scientists estimate that there are nearly 10,000 such injuries each year in home care nurses.

The findings were published in the September 2009 issue of American Journal of Infection Control.