Educational Session Descriptions

MONDAY, April 7, 2008
Concurrent Educational Sessions (100 series)
10:45 am to 12:15 pm

101. The Home Health Quality Improvement (HHQI) Campaign – What it Means for the Future of Home Care Practice

More than one-half of the nation’s 8,800 Medicare-certified home health agencies have volunteered to participate in the Home Health Quality Improvement (HHQI) Campaign launched in January 2007 by the Centers for Medicare & Medicaid Services. A 12-month project aimed at reducing avoidable hospitalizations, the campaign will have issued 12 best practices packages by April 2008 and provided reports so participating agencies can assess their progress. This session will provide an evaluation of the campaign’s efforts and results, as well as insight into what the project findings might have for the future of home care practice.

Objectives:

1. Describe the HHQI Campaign;
2. Discuss the results of the campaign’s efforts;
3. Discuss the potential effect the campaign will have on the future of home care practice; and
4. Describe the role Quality Improvement Organizations (QIOs) will play in home care quality in the future.

Faculty: Misty Kevech, MS, RN, COSC, Training and Communications Liaison, Quality Insights of Pennsylvania, Pittsburgh, PA

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

102. The Future of Private Plans under the Medicare Program

The Medicare program has had a private plan option for decades, but enrollment levels have waxed and waned depending on actions taken by Congress relative to reimbursement and regulatory requirements. Dubbed “Medicare Advantage” (MA) under the Medicare Modernization, Improvement, and Prescription Drug Act of 2003, private plans saw dramatic enrollment increases in 2006. As oversight during 2006 and 2007 revealed concerns about excess payments to plans, key players in Congress began to press for program reforms. This session will chart historic changes in the MA program and provide insight into recent regulatory and legislative activities expected to have an impact on the program’s future popularity and the effect on the delivery of home health services.

Objectives:

1. Outline major changes to the MA program;
2. Describe recent regulatory and legislative changes to the MA program; and
3. Discuss the potential impact these changes may have on plan participation, enrollment and delivery of home health services to plan enrollees.

Faculty: Vicki Gottlich, JD, LLM, Senior Policy Attorney, Center for Medicare Advocacy, Inc., Washington, DC; Marsha Gold, SC.D., Senior Fellow, Mathematica Policy Research, Washington, DC.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/RE).

103. Answers from the Experts: CMS Panel on the Medicare Hospice Benefit

This popular annual program is a tradition for the NAHC policy conference as it provides attendees the opportunity to hear from and ask questions of a panel of top Centers for Medicare & Medicaid Services hospice experts. CMS will address important issues of the day, leaving time for providers to focus attention on other topics of concern. Among the items discussed will be: results of the CMS quality assurance/performance improvement project, new hospice conditions of participation (CoPs), survey and certification issues, hospice medical review and other regulatory areas of interest.

Objectives:

1. Discuss CMS hospice quality project;
2. Discuss status of proposed hospice conditions of participation; and
3. Identify top survey deficiencies.

Faculty: Terri Deutch, Technical Advisor, Division of Community Post Acute Care; Sandra Bastinelli, MS, RN, Director, Division of Medical Review, Program Integrity Group, Office of Financial Management ; Kim Roche, MA, BSN, RNC, CCS-P, Nurse Consultant, Division of Continuing Care Providers, all of Centers for Medicare & Medicaid Services, Baltimore, MD

Course Level: Intermediate

MONDAY, April 7, 2008
Concurrent Educational Sessions (200 series)
2:15 to 3:45 pm

201. CMS Panel on Home Health Regulatory & Policy Issues

Representatives from the Centers for Medicare & Medicaid Services will discuss regulatory and policy initiatives for 2008 and beyond. In addition to the latest on vital topics like payment and survey and certification issues, panelists will discuss CMS quality initiatives and other efforts.

Objectives:

1. Describe major regulatory and policy changes CMS is planning to make in the home health program;
2. Discuss the rationale behind the changes; and
3. Identify how these changes will impact your agency and how operations must be modified in order to comply with changes.

Faculty: Patricia Sevast, Nurse Consultant, Survey and Certification Group, Center for Medicaid and State Operations; Lori Anderson, Acting Director, Division of Home Health, Hospice and HCPCS, Chronic Care Policy Group, Center for Medicaid Management; Sandra Bastinelli, MS, RN, Director, Division of Medical Review, Program Integrity Group, Office of Financial Management; all from Center for Medicare & Medicaid Services, Baltimore, MD

Course Level: Intermediate

202. Advocacy from A to Z – How to Lobby Your Member of Congress

This program will familiarize participants with the methods and techniques of lobbying to empower them to communicate successfully with their members of Congress regarding home care and hospice priorities. Participants will learn how to conduct a lobbying visit, avoid common errors and do effective follow up. Both presenters have extensive experience working on Capitol Hill and knowledge of current home care and hospice legislative issues.

Objectives:

1. Discuss how to successfully conduct a lobbying visit;
2. Demonstrate what to do during the three most common types of legislative interviews and how to avoid the two most common mistakes;
3. Outline follow-up activities; and
4. Describe the most effective means for communicating with members of Congress.

Faculty: Jeffrey Kincheloe, JD, Director of Government Affairs/Senate, and Yvonne Santa Anna, RN, MSG, Director of Government Affairs/U.S. House, both of the National Association for Home Care & Hospice, Washington, D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

203. Hospice Financial Benchmarks

NAHC has developed a comprehensive, state-of-the-art set of financial benchmarks for hospice services based on the most recently available Medicare cost reports. These benchmarks provide valuable insight into the elements of operations that make a successful hospice. This program reviews the hospice financial data from a practical perspective – including insights into what the numbers mean in real life terms and what you can do with them.

Objectives:

1. Identify hospice financial benchmarks as developed through Medicare cost reports;
2. Discuss various interpretations of the benchmarks; and
3. Describe potential best practices in hospice operations that emerge from the benchmarks.

Faculty: Robert Simione, Principal, Simione Consultants, LLC, Hamden, Conn.; and Amanda Thomas, Director of Research, National Association for Home Care and Hospice, Washington, D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/FIN).

MONDAY, April 7, 2008
Concurrent Educational Sessions (300 series)
4 to 5:30 pm

301. Home Health Demonstration Projects – What is Pilot is Prologue

The Centers for Medicare & Medicaid Services frequently conducts demonstration projects to determine the advisability of making wholesale changes to the Medicare program. Current projects include the post-acute care assessment project, a criminal background check pilot program, and the home health pay for performance and adult day care demonstrations. This session will review the purposes of pending demonstrations, findings to date and likely next steps.
Objectives:

1. List three demonstration projects related to home health being conducted by CMS;
2. Identify preliminary findings in the demonstration projects; and
3. Explain the possibility and timing of pilot program expansions.

Faculty: Sydney Trieger, Director, Division of Health Promotion and Disease Prevention, Office of Research, Development, and Information, Centers for Medicare & Medicaid Services, Baltimore, MD; Mary St.Pierre, Vice President for Regulatory Affairs, National Association for Home Care & Hospice, Washington, DC.; Shannon Flood, Health Economist, Division of Research on Traditional Medicare, Research and Evaluation Group, Office of Research, Development and Information (ORDI), Centers for Medicare & Medicaid Services, Baltimore, MD

Course Level: Intermediate

302. The Evolving Face of the Home Health PPS: An Analysis of the Latest Changes and their Impact on Agencies

In January 2008 Medicare-certified home health agencies will have only begun the difficult task of adapting to the first round of major programmatic changes since inception of the prospective payment system (PPS) in October 2000. This session will provide an in-depth look at some of the first data available on the impact of the PPS changes on agencies, and valuable insights into how agencies are adapting.

Objectives:

1. Identify organizational and operational impacts of PPS reform;
2. Explain changes in clinical services triggered by the revised PPS; and
3. Recognize emerging factors in the revised PPS that affect revenue and costs.

Faculty: Amanda Twiss, President/CEO, Outcome Systems, Inc., Seattle, WA; Dexter Braff, MBA, MS, President, The Braff Group, Pittsburgh, PA; Betty Gordon, Principal, Operational Consulting Division, Simione Consultants, Westborough, MA

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

303. Measuring Quality of Care in Hospice and Palliative Care Programs

At the request of the Centers for Medicare & Medicaid Services, The Carolinas Center for Medical Excellence developed a package of instruments, measures and procedures to assist hospices and palliative care programs assess and monitor quality of care. Dr. Schenck, the Project Director, will describe the results of key informant interviews and measures testing conducted in the development of the quality measures. The recommended quality measures will be described. The National Association for Home Care & Hospice’s QAPI Collaborative Project tested and developed quality of care measures to help hospices and provide standardization to allow for comparisons within a hospice and/or with other hospices. Succinct patient satisfaction and family satisfaction survey tools were also tested and refined. Presenters will share the data collection and reporting tools and the survey instruments developed and tested. Suggestions on how the measures can be used by hospices and palliative care programs to monitor quality will be discussed.

Objectives:

1. Describe recommended quality of care measures for targeted domains of care;
2. Identify domains of care for which there are gaps in our ability to measure quality;
3. Describe how these quality measures can be used by hospice and palliative care programs; and
4. Discuss the NAHC data collection instruments and new Patient and Family Satisfaction Survey tools.

Faculty: Dena Schulman-Green, PhD, Research Scientist, Yale School of Nursing, New Haven, CT; Anna Schenck, PhD, MSPH, Director of Hospice, The Carolina Center for Medical Excellence, Cary, NC

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

Legal Symposium Workshops

WEDNESDAY, April 9, 2008
Concurrent Educational Sessions (400 series)
8:30 to 10 am

401. Issues in Wage & Hour Law Compliance

One of the most basic areas to master as a manager is still one of the most complex and challenging – as well as one of the most litigious. This session will provide attendees a global view of issues in wage and hour law along with guidance on steps that can be taken to limit or avoid legal challenges altogether. Topics includ are: per visit pay, overtime for companionship services, travel time considerations, documentation of working hours and others.

Objectives:

1. Identify current compliance standards under the Fair Labor Standards Act regarding minimum wage and overtime obligations;
2. Recognize issues and concerns in tracking and documenting “hours worked” by home care and hospice personnel; and
3. Identify the importance of compliance with both federal and state wage and hour laws.

Invited Faculty: John C. Gilliland, II, Esquire, Gillaland Markette & Milligan LLP, Indianapolis, Ind.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/RE).

402. Legal Issues in Patient Freedom of Choice

The competition for patient referrals is as fierce as ever with the growth in numbers of home health agencies and hospices. Complaints of patient steering, directed hospital discharges and blocking of patients choice of provider are heard everyday. What really are the rights and responsibilities of patients, referral sources and home health agencies/hospices? This program offers both the standards that must be met to achieve compliance with patient choice and the steps to take when your competitor is missing the mark.

Objectives:

1. Identify federal obligations of hospitals in discharge planning in relation to patient referrals;
2. Explain options available to referral sources regarding the patient’s exercise of their freedom of choice; and
3. Identify available remedial action including complaints to state survey units and Federal False Claims Act litigation.

Faculty: William A. Dombi, Esquire, VP for Law and Director, Center for Health Care Law, and Denise Bonn, Esquire, Deputy Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/RE).

WEDNESDAY, April 9, 2008
Concurrent Educational Sessions (500 series)
10:15 to 11:45 am

501. Unionization in Home Care and Hospice

Several national unions have had a growing presence in home care and hospice in recent years. Bargaining units exist representing nurses, therapists and home care aides. This unionization has brought benefits in some situations and burdens in others. This program focuses on the rights and responsibilities of health care companies facing the development of a union. What are the best steps to take to avoid a legal misstep?

Objectives:

1. Explain federal law standards for responding to an effort to establish a union shop;
2. Identify the steps to avoid when attempting to respond to a unionization effort; and
3. Recognize successful strategies in working with a union when one is established in your company.

Faculty: John C. Gilliland, II, Esquire, Gilliland, Markette & Milligan LLP, Indianapolis, IN.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

502. Managing Medicare Home Health & Hospice Medical Review and Appeals

In recent months, Medicare has stepped up medical review of home health and hospice claims. CMS is signaling that it will continue this heightened attention because of fraud and abuse concerns as well as the growth in expenditures. How should you respond to a medical review focus on your company? Do you have any rights? How does the new appeals process work to protect your rights? Answers to these questions and others are provided in this timely program.

Objectives:

1. Recognize crucial steps to take in responding to a claims review focus on your company;
2. Identify provider rights with alleged Medicare overpayments; and
3. Explain the Medicare appeals process.

Faculty: Mary St. Pierre, RN, VP for Regulatory Affairs, and William A. Dombi, Esquire, VP for Law and Director, Center for Health Care Law, both of National Association for Home Care & Hospice, Washington D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/RE).

WEDNESDAY, April 9, 2008
Concurrent Educational Sessions (600 series)
1:45 to 3:15 pm

601. The Ps and Qs of Paid Medical Directors

It has become standard operating procedure for a home health agency to have a paid medical director. Medical directors are a choice for home health agencies and a requirement for hospices. However, both settings present certain compliance responsibilities when the medical director is paid. This workshop provides an in-depth explanation and review of the requirements that are applicable under the federal anti-kickback laws and the Stark II provisions regulating financial relationships with physicians.

Objectives:

1. Describe limitations on paid employment or contracting with a physician as a Medical Director;
2. Explain the standards for application of “safe harbors” and exceptions with a paid Medical Director; and
3. Identify contract and performance documentation recommendations.

Faculty: Denise Bonn, Esquire, Deputy Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/SKA).

602. Legal Issues in Home Health & Hospice Survey and Certification

The life span of a Medicare home health agency or hospice is dependent on continued compliance with the conditions of participation. Survey deficiencies can set in motion a termination process or require the provider to undertake significant changes to return to compliance. This program addresses the standards for conducting surveys, the most common deficiencies cited, the provider’s right to protest, and the termination appeal process.

Objectives:

1. Identify most common deficiencies cited by surveyors;
2. Explain provider rights in the Medicare survey process; and
3. Describe provider appeals rights and alternative remedies.

Faculty: Mary St. Pierre, RN, VP for Regulatory Affairs, and William A. Dombi, Esquire, VP for Law and Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington D.C.

Course Level: Intermediate; 1.5 Nursing CEs; 1.0 Accounting CPE (NASBA/RE).