Home Health & Hospice Week

The prospective payment system refinements this year haven't hurt publicly traded home care chains too much.

Gentiva Health Services Inc. reported net income of $12.0 million on revenues of $346.2 million for the quarter ended July 1. That's up from a $9.0 million profit on $307.3 million in revenues for the same period in 2007.

The Melville, NY-based national chain also announced a hospice acquisition in South Carolina, a Certificate of Need state. Gentiva bought Hospice of Charleston and plans to serve the three counties covered by its CON, "rounding out its home health coverage in the state," the company says in a release.

Meanwhile, regional chain LHC Group Inc. reported net income of $6.3 million on revenues of $90.1 million for the quarter ended June 30. That's compared to a $5.0 million profit on $70.6 million in revenues for the same time in 2007.

This earnings report showed "the first quarter in which the company experienced the full impact of the Medicare reimbursement changes," CEO Keith Myers notes in a release. "We ... see these results as confirmation of the ability of our management team to successfully adapt to changes in the reimbursement environment."

The Lafayette, LA-based company also whittled its days sales outstanding (DSO) from 75 to 60 days in that time period, it touts.

And LHC has acquired the assets of Mor-ristown-Hamblen Home Health and Hospice located in Morristown, TN, from Morristown-Hamblen Healthcare System. The company will combine the acquisition with its joint venture with the University of Tennessee Medical Center home care program and operate them under the Morristown-Hamblen name, LHC says in a release.

The agencies' combined net annual revenue is $2.8 million, LHC adds.

• Gas prices may have ticked down a bit, but home care workers and companies are still groaning under the weight of the fuel burden.

The national average price of gasoline is down about 18 cents per gallon from two weeks ago, to $3.88, says the federal Energy Information Administration. But that's still about $1.04 more per gallon than one year ago, the EIA says.

Grayson Home Health in Sherman, TX is offering company vehicles and gas cards on top of mileage reimbursement, reports TV station KXII. The company is also reducing in-person visits by using telehealth, it told the station.

The CBS Evening News highlighted the problem in a July 30 segment. North Country Home Services in upstate New York says aides are refusing cases in rural areas and asking for paychecks early, CBS reported.

• In addition to payment rates for 2009, the Centers for Medicare & Medicaid Services also issued the hospice cap amount for the year ending Oct. 31, 2008.

The cap amount is $22,386.15, CMS says in Aug. 1 Transmittal No. 1570 (CR 6155). The transmittal is online at http://www.cms.hhs.gov/transmittals/downloads/R1570CP.pdf.

• If you're looking to diversify your payor mix, you might look to companies and organizations that want to provide backup care for their employees.

For example: The University of Virginia recently initiated a backup care benefit for its employees, it notes in a release. Employees can pay a $30 copay per day for private duty home care for their relatives, allowing them to return to work.

A third party called Work Options Group manages the backup care arranging, which also includes child care and adult care at centers, UVA notes in a release. The Group contracts with four home care providers for in-home care coverage.

• Extremely hot weather takes a toll on seniors, with sometimes fatal results. For a tip sheet that will help your patients understand how to deal with hot weather and its risks, go online to http://www.niapublications.org/agepages/hyperther.asp. A Spanish version is available online at www.niapublications.org/agepages/hyperther-sp.asp.

• Make sure your hospice election notice is up to snuff or risk losing your reimbursement.

"The [hospice] Notice of Election as well as Transfers and Revocations are not retroactive and cannot be back dated," regional home health intermediary Palmetto GBA says on its Web site. "Upon request from the Palmetto GBA medical review department for medical records ... the Notice of Election must be submitted along with other documentation."

If you don't have a valid NOE for the patient, Medicare won't pay you for her. A valid notice must include the hospice's identification; the patient's (or representative's) acknowledgement of full understanding of hospice care; the patient's (or rep's) acknowledgement that certain Medicare services are waived by the election; the effective date of the election; and the patient's (or rep's) signature.

Hospices should have an "in-house procedure that ensures that the process of election, transfer and revocation is fully explained to and understood by the beneficiary, representative and transferring hospice provider should a transfer become necessary," Palmetto instructs.

• If you're slacking off on your cost report duties because no reimbursement is directly tied to the document, CMS is not happy with you. "In reviewing the [Medicare Cost Report] data submitted by providers, it appears that many are failing to completely fill out their MCR with valid data likely due to the misconception that the data submitted on the MCR do not impact their payments," CMS says in Aug. 1 Transmittal No. 362 (CR 6132).

"MCR data play a central role in the development of the input price indexes (market baskets) used to update PPS payments," CMS says in the transmittal. "Similarly, they are essential in evaluating Medicare payment adequacy."

CMS instructs its contractors to tell providers why their cost report data is important. "It is crucial that Medicare providers fill out these reports with complete and valid data," the transmittal says.

It's not just CMS who cares about the data. The Medicare Payment Advisory Commission al-so relies on it to make its influential policy recommendations, CMS notes.

The transmittal is online at www.cms.hhs.gov/transmittals/downloads/R362OTN.pdf.

• Don't plan any major claims submission work on Sat. Aug. 30 if Palmetto is your intermediary. The Fiscal Intermediary Shared System (FISS) will be out of commission that day due to implementation of the newest FISS release, the regional home health intermediary says on its Web site.

• The integration of VistaCare Inc. into Odyssey HealthCare Inc.'s operations is taking a toll on the for-profit hospice company's bottom line.

Dallas-based Odyssey reports net income of $1.7 million on revenues of $160.7 million for the quarter ended June 30. That's compared to a $4.2 million profit on revenues of $99.6 million in the same period of 2007.

VistaCare's integration is affecting net income, Odyssey CEO Robert Lefton says in a release. Caps in former VistaCare locations are also a challenge.

Another problem is an increase of bad debt due to additional development requests from intermediaries, Odyssey reveals.

• A Miami durable medical equipment supplier has been taken into custody on charges that she defrauded the Florida Medicaid program of $447,000, says the Florida Attorney General.

The Medicaid Fraud Control Unit began investigating Maria Escarpio, owner of Yema Home Health Care, after receiving information from the state's Agency for Health Care Admini-stration's Program Integrity Unit about suspicious billings, AG Bill McCollum says in a release.

In 2003 and 2004, Escarpio billed the Medicaid Program more than $440,000 for wound care supplies and more than $6,800 for oxygen equipment that were never furnished, investigators charge. Escarpio faces criminal charges and a civil lawsuit, the AG notes.

• Although summer weather is still here, it's time to start thinking about flu season.

August is National Immunization Aware-ness Month, CMS notes. "As a health care professional, you play an important role in helping your Medicare patients and others understand the importance of disease prevention through immunizations," CMS says in a message to providers. "Your recommendation is one the most important factors in increasing immunization rates among people with Medicare."

More information about National Awareness Immunization Month is online at www.cdc.gov/vaccines/events/niam/default.htm#add.