July 2015
True Colors Shining Through
“Be a yardstick of quality. Some people aren’t used to an environment where excellence is expected.” - Steve Jobs “Quality is never an accident. It is always the result of intelligent effort.” - John Ruskin Question: What can you hold without touching it?
This past week, CMS
released its 2015 Agency Ratings report for homecare agencies. Agencies were rated based upon quality measures and patient improvement results gathered from OASIS assessments. Only 239 agencies received a five star rating. I don’t mind shamelessly bragging that the first two agencies that implemented our point of care software are on that list. While reviewing their home health compare results, it became clear that those two agencies completely annihilate their competitors in every major quality indicator. Not just one or two - they crushed the competition in basically every single category. It got me wondering, “Why do some companies consistently produce quality products and
services while most of their competitors do not?” I won’t bore you with my explorations into answering this question. I will simply give you the answer. Quality companies are quality companies because they consistently COMMUNICATE about quality and their ACTIONS reinforce quality. They talk about it so much, it becomes ingrained in the psyche of the company and its employees. It is a phenomenon that is easy to spot when you start looking for it. You can see it at Chick-fil-A when the cashier smiles and asks if she can deliver your food to your table. You typically won’t see it at McDonald’s, where the cashier will roll her eyes at you if you ask for extra ketchup. Look around and listen to the
- By Jonathon Kovar
manager at each location. At the first place, you will hear someone who is consistently setting an example of quality customer service. At the latter, you will typically hear a manager who exemplifies speed and cost-cutting. Without a doubt, those managers are reflections of the communications they receive from their superiors. In the end, the company culture always shines through, from top to bottom. I have been thinking about this phenomenon a lot lately. Over the past six years, I have seen our software company grow substantially and receive a fair amount of praise for its innovation and new features. Our first few years in business, I heard our employees tell customers about new updates with excitement and enthusiasm. Looking back, I can see why. It was because I constantly talked to Continued on page 2 Jonathon Kovar is CEO of HealthTrust Software, an author, speaker, and healthcare attorney.
HEALTHTRUST ICD-10 SUMMARY On July 23rd we hosted a webinar to show clients how HealthTrust will handle the ICD-9 to ICD-10 transition. Among the topics covered were: 1. A new column on the Referral and Patient screen, on the DX tab allows for the input of ten ICD-10 codes for the patient. These codes will function just like the current ICD-9 diagnosis. Starting for DOS on or after October 1st, these codes will be placed on all non-PPS claims as the diagnosis codes for billing. 2. A new column on the Referral and Patient screen, on the
Referral->Services tab allows for discipline-specific diagnosis codes to be added per service category. These will also function like the current ICD-9 codes. Starting for DOS on or after October 1st, these codes will be placed on all non-PPS claims as the primary diagnosis code for billing (if the payer setting for allowing this is turned on). 3. Several new ICD-10 M-elements will be added to the OASIS assessments to allow for entry of ICD-10 codes where appropriate. Agencies will need to start using these fields on August 3rd for all episodes
that end on or after October 1. Although these codes will not affect the HHRG calculation, they will be used when billing the final claim when the episode ends on or after October 1st. 4. A wizard is being created in the software that can be used to help crosswalk ICD-9 codes to ICD-10 codes to help with the transition and training of field staff. A webinar will be held in late August showing this feature. The July 23rd webinar recording will be available in the software soon. Be looking for an alert with the details.
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our employees about our new features with excitement and enthusiasm. For the past two years, the focus at HealthTrust has been on quality control and stability. Unfortunately, I haven’t seen the same excitement in our employees in that timespan. Recently, I started asking why. Turns out, the blame can once again be placed squarely on my shoulders. In the early days, we had daily and weekly meetings to discuss, explain, and celebrate new features and enhancements to the software. I was excited. I was involved. The two-year process to improve quality though has largely been handled through our managers. The message our managers received was “quality is important, but not important enough for the CEO to be involved in the daily and weekly meetings.” Unfortunately, people do what they see, not what they hear. I could preach about quality all day, but unless my example showed that quality was of supreme importance, then quality wasn’t important at all. Over the past few weeks, we’ve been making changes to bring our actions more in line with our words. It was easy to talk about quality. It
was difficult to act quality. It was easy to set a goal. It was difficult to perform the work, day in and day out, to accomplish that goal. If our leaders aren’t “yardsticks of quality”, then the followers will assume excellence isn’t expected. A culture of quality only exists where leaders actively pursue quality. So that brings me back to our riddle: What can you hold without touching it? The answer is “a conversation.” You can’t hold culture in your hands. You can’t hold quality. You can, however, hold a conversation and with it, you can touch the lives of your employees and customers. Start a conversation with your staff about quality. Then, set an example of quality. The only way you are going to join those other 5-star agencies is by actively setting an example of quality. It starts at the top. It starts with you. What will your customers see when they look at your agency? For better or worse, they see you. Your true colors will shine through in your company. Let them HEAR and SEE quality.
HEALTHTRUST SOFTWARE RELEASE Pediatric Therapy Point of Care
After several long discussions with multiple therapy providers, HealthTrust Software has decided to implement a few changes to the Therapy Point of Care system. These changes will help us to usher in some of the other longstanding feature requests that users have submitted. We would love to hear your feedback about these changes so please email us at Support@HealthTrustSoftware.com as we will use your opinions and suggestions for future updates. To update to the latest version of Offline Point of Care please perform the following steps: 1. Login to Point of Care 2. Sync
3. Close Point of Care 4. Login to Point of Care 5. Click Sync a. This step can take up to 45 minutes depending upon your internet connection b. Users will be able to view a list of updates as they are downloaded 6. Once this process is finished, the device will be updated PLEASE GO TO: https://secure.healthtrustsoftware.com/healthtrustsoftware/application/documents/therapyPointOfCareUpdates.pdf FOR THE COMPLETE GUIDE
Contact Your Members of Congress to Co-Sponsor the Home Health Care Planning Improvement Act of 2015 The National Association for Home Care & Hospice (NAHC) is continuing to visit members of the Senate to build support for the Home Health Care Planning Improvement Act of 2015 (S. 578/H.R. 1342. Thus far, 34 members of the U.S. Senate and 126 members of the U.S. House of Representatives have indicated their support. NAHC and other organizations supporting the bill continue
to pursue the goal of 40 co-sponsors for the Senate bill and as many as possible for the House bill. NAHC is working with key champions in Congress to receive a Congressional Budget Office score of the legislation and technical assistance from the Centers for Medicare & Medicaid Services so that the bill can move forward in the Committee process. More Congressional cosponsors would increase the
likelihood of the bill being included in a future Committee markup. Recent meetings have been held with the offices of Senators Pat Toomey (R-PA), John Hoeven (R-ND), Rand Paul (R-KY), John McCain (R-AZ) Tim Scott (R-SC), Deb Fischer (R-NE), and Tom Cotton (R-AR). To see if your Senators have cosponsored the bill go to http://www.nahc.org/assets/1/7/S_578_Cosponsors.pdf
**Summary of the Home Health Care Planning Improvement Act of 2015** Nurse practitioners and physician assistants are currently authorized to work in states either independently or in coordination with physicians to treat, diagnose, and prescribe medicine. However, they are unable to order home health care services. The fact that non-physician health professionals are unable to certify home health services is increasingly a problem because more and more people
are receiving home-based care from non-physician health professionals. As a result, patients face the burden of first visiting an unknown physician in order to receive home health care. NAHC strongly supports this legislation, which will reduce expensive hospitalizations and nursing home stays. “Outside experts assessed the impact of the bill earlier last year and projected a Medicare savings
of $7.1 million in 2015 and up to a ten-year savings of $252.6 million,” stated a letter in support of the legislation from leading senior and disability advocacy groups including NAHC. “This analysis also notes the potential to reduce beneficiary admissions to and lengths of stay in institutional settings under the policy change.”
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It's in the software....
POINT OF CARE VALIDATION ARE YOU USING IT EVERY DAY?
5 Reasons You SHOULD be Using CV Every Day:
1. Care Validation turns your Referrals into Patients when the admission visit is “passed� 2. CV allows you to review all documentation as soon as the clinician turns their documentation in 3. CV ensures all clinicians are documenting appropriately and turning documentation in on time 4. Use CV daily so your agency does not get a back log of visit documentation and consequently, will not have claims to bill on time 5. Use CV daily so your patients receive the appropriate care in a timely manor
PASSING A VISIT:
When passing a visit in Care Validation users will review the information in the field documentation and set the Validation Status to Pass. This will pass the visit and the visit will be in "Confirmed status."
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FAILING A VISIT:
If corrections need to be made, they can be made in the Field Validation window, or you can fail the visit back to the clinician to make their own corrections. If you select FAIL for the Validation Status, input comments in the space provided. Once the visit is failed, the next time the clinician syncs (if using the offline version), it will be sent back to their device for review. If the clinician is using the online version of HealthTrust Software, they will simply need to log in and go to the Point of Care section under the Schedule tab.
MAKING CHANGES TO A VISIT AFTER IT HAS BEEN PASSED:
Once the user has passed the visit, it will not appear from the Care Validation window and will be stored in the database. The user can make a change to the visit by typing a note in the Printout Addendum tab in the charge tab.
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Jeremy Drake New Product Development and Testing Coordinator (and proof reader and copy editor and unofficial Friday lunch invocation deliverer) Let another praise you, and not your own mouth; A stranger, and not your own lips Proverbs 27:2 This is a verse that came to mind when I was asked to write my own feature for this month’s newsletter. Usually it’s a third party saying glowing things about the employee with a few quotes thrown in here and there for good measure but that’s a little more difficult to do when you have to write it yourself. In general, you don’t want to write 3 paragraphs about why you’re one of the most valued employees and how much everyone loves you, because
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then you sound like one of those people who thinks that if he hadn’t been born, people would wonder why. At the same time, though, you don’t want to just write a boring outline of how long you’ve been working here and what exactly you do at the company with no flair. After all, someone once said, “I try to be humble, but what if nobody notices?” So with Proverbs 27:2 in mind, I thought instead of just talking about
myself, I would also throw in a few quotes from some other employees that were aimed in my direction. While I was gone on vacation not too long ago, I brought my work computer so I could check in and make sure I wasn’t needed for anything. I chimed in on our instant messaging systems a few times to see how things were going and received the following unsolicited comments: “I like you Jeremy”
“I miss you Jeremy” “Jeremy’s dead. To me.” “It’s just separation anxiety. I’ll get over it.” “I bet he is sitting on a chair on the beach, sipping a drink with an orange slice on the rim, skyping us sorry suckers sitting in this dark room with (name redacted)”
This is not necessarily the motto I live my life by, but I usually don’t succeed on the first try, so in that sense, I guess you could say I have accomplished quite a bit… or not. I’m not quite so sure of the practical applications of this kind of thing, but suffice it to say that I tend to approach things face first, which more often than I’d like to admit, leads to me falling on my face. I think a
proach, my mom once said of the difference between my older brother (by 3 years) and me was that as small children, if we wanted to attempt to walk down some steps, he would gingerly place a foot on the next step until sure that it would support his weight before attempting to go down the next step whereas I would pretty much dive down the steps face first, consequences be hanged. So, a degree in agriculture business, a short career in the landscaping industry, a more successful tenure at a software company, a hasty move back to East Texas along with an attempt at software support, and a soberingly brief tenure as a high school teacher have all led me to where I sit today at HealthTrust Software in Nacogdoches, Texas. All within the past 6 years. This, by the way, includes buying 3 vehicles (not all at once), moving to 3 different houses, and having 2 kids (with 1 on the way). I have a very understanding and supportive wife.
“Wait… almost drowned?!” So according to my fellow employees, my absence brings about a few different kinds of emotions; admiration, longing, resentment, and concern (for the record, I wasn’t on a beach but I did almost drown). It’s nice to be wanted. Hopefully my presence brings about those kinds of emotions as well. At least most of them. When I think about how I got here and what has kept me here the past almost 2 years, the following quote comes to mind: “If at first you succeed, you probably
more apt description would be as follows: For affliction does not come from the dust,nor does trouble sprout up from the ground, but man is born to trouble, as the sparks fly upward. Job 5:6-7 Any time I’ve fallen on my face, it definitely has been self-inflicted. haven’t accomplished much.”
I landed face first here at HealthTrust, and it hasn’t always been smooth, but it has been rewarding. If there’s one thing I’ve learned up to this point, it’s that, “The heart of man plans his way, but the Lord establishes his steps.” Oh, and at a year-and-a-half, my son Ryder has already shown that he inherited his daddy’s face-first approach to things. Joy.
As an example of this face-first ap-
Top left: Jeremy and son Ryder. Left: Megan, daughter Averly, son Ryder and Jeremy on a recent family vacation in Hot Springs, Arkansas. Above Center: Daughter Avery and Jeremy. 7
Reminder: All Providers Must Re-enroll in Texas Medicaid to Comply with Federal Regulations Texas Medicaid must comply with federal regulations requiring all providers to reenroll in the Medicaid program every three to five years. This means any Medicaid provider enrolled before January 1, 2013, must be fully re-enrolled by March 24, 2016. To be considered fully re-enrolled, providers must submit a completed re-enrollment application and receive notification from TMHP that their application has been approved. Application processing times will vary based on accuracy and complexity of the application. To allow sufficient time for application processing and to avoid a lapse in enrollment status, providers are encouraged to begin this process immediately. Medicaid providers who are not fully re-enrolled by March 24, 2016, may experience: • Interruption in reimbursement for Medicaid services provided in fee-for-service and managed care, • Denial of claims for Medicaid services indicating that the provider is not actively enrolled, and • Difficulties with or removal from managed care organization (MCO) or dental maintenance organization (DMO) networks. Providers must be enrolled in Texas Medicaid before they can be contracted and credentialed by an MCO or DMO. Providers must be re-enrolled to maintain credentialing with their plans. In addition, Medicaid providers who are not re-enrolled prior to the March 24, 2016, deadline will have to complete a new enrollment application to return to the program. Providers can find more information about the federal re-enrollment requirement on this website at www.tmhp.com/Pages/Topics/ACA.aspx. For help with enrollment, providers can contact the TMHP Contact Center (1-800-9259126, option 2) or the TMHP CSHCN Services Program Contact Center (1-800-5682413). Providers can also email TMHP at PE-Email@tmhp.com to request assistance with enrollment questions.
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