Home Health & Hospice Week

Demonstration projects aim to keep patients out of institutions.

Seventeen states soon will put more money into keeping seniors in their homes.

The Centers for Medicare & Medicaid Services is giving $23 million in grants to the states "for demonstration programs that will help build Medicaid long-term care programs to keep people in the community and out of institutions," according to a CMS release.

CMS will issue up to $1.75 billion in such grants between 2007 and 2011, it says. The funding, which was legislated in the Deficit Reduction Act of 2005, will "help states shift Medicaid's traditional emphasis on institutional care to a system offering greater choices for individuals and a full range of home- and community-based services," the release says.

The demonstrations are a Money Follows the Person initiative. "There is more evidence than ever that people who need long-term care prefer to remain in their own homes and communities whenever possible," CMS Acting Administrator Leslie Norwalk says. "States will also get more for their money by giving the elderly and people with disabilities more control over how and where they get the Medicaid services they need."

The states propose to use the grants to transition more than 20,000 individuals from institutions into community settings. The states are Wisconsin, New York, Washington, Connecticut, Michigan, Oklahoma, Arkansas, Maryland, Nebraska, New Hampshire, California, Indiana, Texas, South Carolina, Missouri, Iowa and Ohio. CMS may award more 2007 grants later this year. The change is part of the Bush Administra-tion's New Freedom Initiative.

• If you're having to pay your physical therapists more, you're not the only one. The median hourly pay rate for home care PTs increased 3 percent in 2006 to $32.54, according to Oakland, NJ-based Hospital & Healthcare Compensation Service. That's up from $31.52 in 2005, according to HCS' 2006-2007 HOMECARE Salary & Benefits Report.

And it may be getting harder to keep therapists at current pay rates. Turnover increased from 14.9 percent in 2005 to 18.5 percent in 2006, according to the compensation survey based on data from more than 1,300 home health agencies.

Home care is middle of the road for therapist pay. Hospital PTs earned $30.81 per hour in 2006, while nursing home therapists earned $33.00 per hour, HCS says. For information on ordering the report, go to www.hhcsinc.com.

• Durable medical equipment suppliers now have a new site of their own. CMS has announced it will list program transmittals specific to durable medical equipment, prosthetics, orthotics and supplies on a distinct Web page.

The list begins with program transmittals released in December 2006. As CMS releases DME program transmittals, it will add them to the DMEPOS Transmittals list, the agency says.

To access the site, go to www.cms.hhs.gov/DMEPOSFeeSched/DMEPOSTrans/list.asp.

• States now can offer a Medicaid home care benefit without going through the waiver process, CMS says in a release. The change was mandated in the Deficit Reduction Act of 2005.

• You may have to pay your workers more if a minimum wage bill passes into federal law. The House of Representatives has passed a bill calling for a minimum wage hike from the current $5.15 to $7.25 over two years. That could cause some home care providers--particularly those in low-wage areas or offering private duty care--to raise aide salaries, notes The Wichita Eagle.

Hidden trap: The wage increase will also cause employers to bump up pay differentials for workers who get promoted or gain seniority, the newspaper notes.
Observers expect the Senate to pass the bill as well, although perhaps with tax benefit modifications to win President Bush's signature.

• The American Association for Respiratory Care and other stakeholders have their eye on Washington as CMS puts the finishing touches on a national coverage policy for outpatient pulmonary rehabilitation.

"The AARC has ... vigorously advocated that the Medicare program issue a national coverage policy for pulmonary rehab," says AARC's Cheryl West in a statement. The current "patchwork system" of local coverage policies is inconsistent and has left some patients without access to the service at all, she reports.

The new coverage policy stands to enhance access to pulmonary rehab for patients with chronic obstructive pulmonary disease (COPD) and other chronic lung diseases, says AARC.

• CMS has about 300 more home health agencies signed on for its quality improvement national campaign. Home health giant Gentiva Health Services Inc. is enrolling all of its offices in the program that offers tools to improve outcomes (see Eli's HCW, Vol. XVI, No. 2).

Gentiva's overall rate of patients requiring unplanned hospitalizations is already well below the national average, the company notes in a release--22 percent versus the national average of 28 percent.

Each month beginning in March, the QI campaign will focus on a different home care best practice, Gentiva notes. Those include disease management, falls prevention, medication management and other programs that can help to reduce avoidable hospital stays.

 • A Baltimore-based senior care management team has purchased its fourth Virginia home health agency. Calvert Health Partners bought Assured Home Health Care from Henix Partners for undisclosed terms, Calvert says in a release.

Assured has locations in Staunton and Charlottesville. CHP will fold Assured's operations into its Advantage Care agency operations. CHP is offering Assured workers employment with Advantage. Calvert purchased three agencies including Advantage last fall (see Eli's HCW, Vol. XV, No. 41).

"We look forward to continuing our growth and further development of our services as we spread across Virginia and other adjoining mid-Atlantic states," Calvert CEO David Nelson says in a release. "Calvert Health will continue to actively pursue additional acquisitions of diverse senior care service companies and will meld them into a fully integrated health services organization," Nelson continues. "This is just the beginning."

• The feds' battle against fraudulent DME suppliers has landed a 67-year-old Massachusetts man in prison. James Taylor was fined $6,000 and ordered to pay $636,088 in restitution, an amount that will supplement the $279,560 he already paid to settle a civil suit, prosecutors said following the Jan. 10 sentencing (United States v. Taylor, D. Mass., No. 06-cr-10223-PBS).

Taylor's two-and-a-half year prison term will be followed by two years of supervised release. Pros-ecutors say Taylor defrauded Medicare and an insurance company of nearly $1 million by submitting false claims about the services provided by DME firms he owned.