by Kristin Rowan | Dec 19, 2024 | Admin, Caring for the Caregiver, Clinical, Editorial
Medical and non-medical caregivers in home health, hospice, palliative, and home care are the life-blood of the industry, without whom Care at Home would not exist.
Agency owners are limited in their capacity to compensate caregivers, working with CMS reimbursement rates, PDGM, and VBPM. However, Agency owners also know that caregivers are selfless, caring, empathetic, and dedicated. They also spend hours upon hours on documentation, drive billions of miles per year (literally), and adapt to changing industry regulations regularly.
So, how do you, as an agency owner, executive, or manager, care for your caregivers in a meaningful way to express your appreciation for all that they do? How can you impact the high turnover rate? Pay raises are limited by CMS and insurance companies. Benefits are expensive for an already low-margin industry. Extended vacations limit the care you can provide your clients.
The Advantages of Employee Recognition
When your employees are engaged and feel appreciated, they are more loyal. Loyal employees are less likely to leave for another job, even if the pay rate is slightly higher. Employee recognition helps retain your best employees, increases their engagement, encourages best practices, and can be used as a recruitment tool when you need more staff.
A 2023 study highlights the importance of employee recognition. Employees who are likely to be recognized are more than twice as likely to go above and beyond their regular duties. Hearing a sincere “thank you” from the boss yields a 69% increase in extra effort. Personal recognition would encourage 37% of respondents to do better work more often.
Employee recognition programs don’t have to overhaul your organization, take a lot of time, or cost a lot of money. Start simple and see where it takes you.
Celebrate Major Achievements and Small Wins
It’s important to recognize major achievements like gaining a new licensure, getting a referral for a new client, a positive online review, or a great star rating. How long an employee is with the company is an easy milestone to celebrate. Accolades for 30, 60, & 90 days, one year, five years, 10 years go a long way.
Equally important is celebrating smaller victories like completing a training, submitting accurate documentation, picking up an open visit, and birthdays.
Giving your employees the opportunity to recognize and celebrate each other creates a culture of appreciation within your agency, even when your employees are rarely together. Picking up a shift, trading a day off, helping answer a question, or simply encouraging a new employee during training are things you might not see, but your employees will. Give them an outlet to celebrate each other.
Peer-to-peer recognition can be done with group text messages or an internal IM system like Slack or Microsoft Teams. For employees who are in the office, you can create a message board for notes, encouragement, and thanks. Create a monthly gift and let employees nominate someone for an act of kindness or helpfulness.
Once you’ve established a Culture of Caring, ask your employees what they want and need. If recognition isn’t meaningful, it may not have the desired effect.
A study out of the Leonard Davis Institute of Health Economics, 30% of registered nurses and 25% of licensed practical nurses left their positions in a home care agency in the course of one year. Part of the reason for the high turnover rate is schedule volatility. Another study concluded that high schedule variability in just 30 days increased the risk of turnover by 20%.
No change will eliminate client cancellations or immediate starts-of-care under the acceptance-to-service policy. But, that doesn’t mean you can’t minimize the volatility of a schedule.
Automating the scheduling process using existing technology now allows home care agencies to offer open appointments in a “gig economy” style. Caregivers are notified by AI of a visit that needs to be covered, giving them the option to change their schedule. That autonomy reduces the feeling of stress caregivers have over schedule changes.
Stand-alone software options for automated scheduling and reduced schedule changes include Axle Health and Caring on Demand for home health and CareSmartz360 for non-medical supportive care. AI powered scheduling inside EMRs and agency management software include AlayaCare, HomeCare Homebase, CareVoyant, Axxess, Careswitch, and AxisCare, among others.
Some sources suggest that home health workers spend up to three hours per shift at home finishing documentation. Visit times increase when employees are documenting on paper or on a device during the visit.
One of the latest innovations in care at home software is AI powered talk-to-text scribe tools. Mobile applications using artificial intelligence record visits and transcribe conversations. The documentation tool scans the transcript as well as all patient data from the EMR and creates the needed documentation. Once a visit is over, the AI tool can finish documentation sometimes within minutes, requiring just a quick review by the visiting caregiver before submitting for QA.
Talk-to-text scribe tools are both stand-alone voice capture and integrated documentation tools. Some of the best talk-to-text scribe tools we’ve found are Athelas Scribe, Ybot, Andy, and Nvoq. OASIS and documentation automation reduces the burden on caregivers even more, almost eliminating the additional time spent at home reviewing charts and documentation. Some of the best OASIS and documentation automated software we’ve reviewed are Andy, Enzo, and Brellium. The Rowan Report will have reviews of these products in 2025.
Communication and Connection
Care at home workers are a disparate group, rarely being in the same place at the same time, missing out on company culture, office parties, trading stories around the water cooler, and engaging with fellow employees, managers, and executives. Access to colleagues and management is an integral part of employee engagement and satisfaction.
Before you share the personal cell phone numbers of your entire agency, remember that all communication between employees, management, and clients should be secure and HIPAA compliant. Agencies have already seen the consequences both to their bottom line and with government agencies for failure to comply with secure messaging requirements.
Luckily, there are plenty of secure messaging platforms available for agencies to use. Employing messaging technology not only increases employee engagement, but also provides a level of security between caregivers and their patients and families. If you’ve now realized that you’ve been communicating on insecure platforms, check out Buzz, Qliqsoft, and Zingage.
Whether you start with a simple calendar to remind yourself which employees have been with you the longest, or invest in every AI tool available, the key here is to recognize that your caregivers are giving their all every day for their primary purpose of excellent patient-centered care.
No matter how you decide to do it, make 2025 the Year of the Caregiver and show your appreciation for all that they do for you. We couldn’t do what we do without them.
Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
by Kristin Rowan | Oct 31, 2024 | Partner News
QAPIplus Launches 3.0 Platform, Enhancing Quality and Compliance for Home Health and Hospice Providers
New user interface, more customizations, enhanced PIPs and EMR integrations make managing quality and compliance programs even easier for home health and hospice organizations.
GLENDALE, Calif., Oct. 14, 2024 — QAPIplus, the first and only comprehensive quality and compliance management solution for home health and hospice, is excited to announce the launch of QAPIplus 3.0.
This significant update introduces a modernized user interface, enhanced features for managing Performance Improvement (PI) projects, and deeper integrations with leading electronic medical record (EMR) systems. These enhancements are designed to streamline workflows, save even more time, and provide an improved user experience for agencies focused on delivering the highest standards of care.
“We listened carefully to feedback from our customers, and QAPIplus 3.0 reflects their needs and priorities. Our users asked for a more intuitive interface and better ways to manage their compliance and quality workflows. With these enhancements, we’re delivering the tools they need to succeed.”
Co-Founder and CEO, QAPIplus
“This update streamlines the entire quality and compliance workflow even more than before,” said Lara Koraian, Co-Founder and CTO of QAPIplus. “By automating repetitive tasks and improving user management, QAPIplus 3.0 saves agencies valuable time while ensuring that critical compliance needs are met efficiently.”
Top Benefits of QAPIplus 3.0 Include
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- Time Savings: Automated PIPs workflows including progress tracking, assigning specific users, and delegating tasks.
- Easier Navigation: A modern, streamlined design makes the platform more intuitive and easier to navigate.
- More Customization: Enhanced control over notifications allows for a more tailored experience for each user.
- Seamless Data Flow: Enhanced integrations with leading EMR platforms to automatically populate incident data in the QAPIplus platform.
With QAPIplus 3.0, home health and hospice agencies can continue to elevate their quality and compliance programs while reducing the administrative burden on staff.
As the only software solution created specifically for home health and hospice organizations that digitizes and automates your quality and compliance programs, QAPIplus empowers you to achieve your highest performance, minimize burden, and improve your bottom line.
QAPIplus is the only quality management software solution to earn CHAP Verification and ACHC Certification for home health and hospice organizations.
This press release originally appeared on PRNewswire and reprinted with permission from QAPIplus. For more information or to request permission to print, use the media contact above.
by Tim Rowan | Oct 25, 2024 | Admin, Advocacy, Regulatory
by Tim Rowan, Editor Emeritus
National Alliance for Care at Home
The merger of the National Association for Home Care and Hospice and the National Hospice and Palliative Care Organization, which was inked on July 1, became official this week in Tampa, Florida. The new National Alliance for Care at Home said farewell to retiring NAHC President Bill Dombi and gave a rousing welcome to incoming Alliance CEO, Steven Landers, MD. Both Bill’s farewell address and Dr. Landers’ introduction speech ended with the same theme. We do what we do for the good of our patients. Yes, there is money. Yes, there are politics. In the end, our legacy and our future are about people.
Integrity, Quality and Compliance
That future will begin with a commitment to patient care excellence. Dr. Landers closed his opening address with an announcement. From now on, every member, upon beginning or renewing their annual membership, will be asked to sign an attestation pledging their company and themselves personally to commit to Integrity, Quality, and Compliance. “Our members will be known to the world as the best in the industry,” he proclaimed. “They will assure patients, families, and payers that they participate in Medicare and Medicaid quality performance standards.”
In a press conference the next day, Dr. Landers elaborated that NAHC and NHPCO have always worked with public and private payers and law enforcement agencies to rid our industry of those who are not in it for noble reasons. Those cooperative efforts will continue, he told the reporters. The new attestation will further assure the world that members of The Alliance publicly join that mission. One is reminded of a code of conduct common to all our national military academies. “We will not lie, steal, or cheat, nor tolerate among us anyone who does.”
The Alliance is new, and Dr. Landers candidly admits he is gradually learning his new role as he goes along. But he is guided by a commitment to care in the home that has been with him since medical school. “I didn’t want to be just another cog in the system,” he told 2,000+ attendees. “The first time I went along on a home visit, I immediately realized that this is what I wanted to commit my career to.” Through his years at the VNA and Cleveland Clinic, he saw the power of in-home care, including its ability to extend live expectancy and reduce the total cost of care.
Bill Dombi will serve the new Alliance through the end of this year before fully entering retirement. Following his closing address on the last day of the conference, during which he summarized his 38 years with NAHC (years that began with a promise to his wife Lynn that they would only have to leave their home in Connecticut for the DC area for three to four years), I asked him what he planned to do that first day in January. He said that he accumulated a ton of frequent flyer miles during his career and that they would love to travel somewhere other than state and national association conference cities.
He also mentioned the ongoing legal actions he initiated to force CMS to develop more honest formulae for calculating Home Health reimbursement and added, “It is very difficult to change litigators in the middle of a lawsuit.” Draw your own conclusion but take it from one who knows how difficult it is to completely walk away from this mission and its people. We may not have heard the last of William A. Dombi.
Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com
Tim@RowanResources.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. homecaretechreport.com One copy may be printed for personal use: further reproduction by permission only. editor@homecaretechreport.com
by Elizabeth E. Hogue, Esq. | Jan 31, 2024 | Admin, Regulatory
by Elizabeth E Hogue, Esq.
Providers may have heard or read about the importance of Fraud and Abuse Compliance Plans in their organizations. Despite the wealth of available information about Compliance Plans, many providers continue to express uncertainty about their value. Here are some of the questions providers commonly ask about Compliance Plans:
Why should we have a Fraud and Abuse Compliance Plan?
First, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services has clearly stated that, consistent with the Affordable Care Act (ACA) as described below, all providers are now expected to have current Compliance Plans that are fully implemented.
As a practical matter, when providers establish and maintain Compliance Plans, it clearly discourages regulators from pursuing allegations of fraud and abuse violations.
Technically speaking, the Federal Sentencing Guidelines make it clear that establishment and implementation of Compliance Plans is considered to be a mitigating factor. That is, if accusations of criminal conduct are made, the consequences may be substantially less severe because of a properly implemented Compliance Plan.
In addition, providers with Compliance Plans are more likely to avoid fraud and abuse. This is because Plans routinely establish an obligation on the part of every employee to report possible instances of fraud and abuse, and Plans include training for all employees.
Compliance Plans may help to prevent qui tam or so-called “whistleblower” lawsuits by private individuals, rather than by government enforcers, who believe that they have identified instances of fraud and abuse. There are significant incentives to bring these legal actions since whistleblowers receive a share of monies recovered because of their efforts. Some whistleblowers have received millions of dollars. Compliance Plans make it clear that employees have an obligation to bring any potential fraud and abuse issues to the attention of their employers first. Compliance Plans provide a clear path to resolve fraud and abuse issues internally.
In addition, the federal Affordable Care Act (ACA) requires providers to have Compliance Plans. In short, it’s the law!
Finally, the Deficit Reduction Act (DRA) requires providers who receive more than $5 million in monies from state Medicaid Programs per year to implement policies and procedures, provide education to employees, and put information in their employee handbooks about fraud and abuse compliance. These requirements can be met through implementation of Fraud and Abuse Compliance Plans.
We don’t receive reimbursement from the Medicare or Medicaid Programs. Do we still need a Compliance Plan?
Statutes and regulations governing fraud and abuse also apply to providers who receive payments from any federal and state healthcare programs, including Medicaid, Medicaid waiver and other federal and state health care programs, such as TriCare and the VA. Many private insurers have followed the federal government’s lead in terms of fraud and abuse enforcement. Therefore, providers that don’t receive reimbursement from the Medicare Program must have compliance plans, too.
We hear that the OIG of the U.S. Department for Health and Human Services has provided guidance for various segments of the healthcare industry regarding Compliance Plans.
- Specifically, the OIG has already published guidance for clinical laboratories, hospitals, home health agencies, hospices, physicians’ practices, third-party billing companies, and home medical equipment companies. Should we just use the model guidance that is applicable to us?
The answer is, “No!” Guidance from the OIG is not a model Compliance Plan. Guidance from the OIG consists of general guidelines and does not constitute valid Compliance Plans. In addition, the OIG has made it clear that Plans must be customized for each organization.
We have read that, before implementing Compliance Plans, providers must conduct expensive internal audits that can take many months to complete. Is this true?
While beginning the compliance process with an extensive internal audit is certainly one way to proceed, it is not the only viable way to work toward compliance. It is equally valid to begin with Compliance Plans that are customized for the organization and include training for all employees about fraud and abuse, and Compliance Plans. Then all staff members can subsequently participate in internal compliance activities, including audits, with a process in place to handle any issues that arise as a result of the audits.
We have all sorts of policies and procedures in our organization. Why do we need something else called a Compliance Plan?
Compliance Plans are specific types of documents that routinely address fraud and abuse issues that providers do not usually cover in internal policies and procedures. In addition, providers may not gain benefits under the Federal Sentencing Guidelines described in paragraph one (1) above if there is no formal document called a Compliance Plan.
We just spent a lot of money to become accredited or reaccredited. Doesn’t certification mean that we are in compliance?
On the contrary, Compliance Plans appropriately address potential fraud and abuse issues. They also include mechanisms for helping to ensure compliance, such as processes for identification and correction of potential problems that are not addressed during the certification process. In other words, organizations may be accredited, but fail to meet applicable compliance standards for fraud and abuse.
Will the fact that our organization has a Compliance Plan make any difference regarding the outcome of fraud and abuse investigations and the imposition of Corporate Integrity Agreements (CIA’s)?
Yes, it may make a considerable difference, based on statements from the OIG. If providers have Compliance Plans in place during investigations that are current and fully implemented, the OIG may be less aggressive in pursuing potential violations. Enforcers are likely to ask for information about Compliance Plans and related policies and procedures. Enforcers are now also likely to ask providers to show them how much money they have spent on fraud and abuse compliance activities!
When the OIG discovers problems with fraud and abuse in organizations, providers are usually asked to develop and implement a Corporate Integrity Agreement (CIA). The OIG often requires CIA’s to include a process for stringent monitoring by the OIG on a continuous basis. These monitoring activities can be extremely burdensome to providers in terms of both time and money. Providers with valid Compliance Plans may not be asked to develop and implement CIA’s.
Now is the time for all providers to recognize and act upon the need to establish and maintain Compliance Plans. “Working on it” is no longer good enough.
©2024 Elizabeth E. Hogue, Esq. All rights reserved.
No portion of this material may be reproduced in any form without the advance written permission of the author.
