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Home Health & Hospice Week

Industry Notes:

Pennsylvania HHA Coughs Up Seven-Figure Settlement

Published on Thu Dec 02, 2004

Aide training costs agency big.

Making sure employees' certification is up to snuff could be one of the most important compliance measures your home health agency takes.
 
Case in point: To resolve charges that its home health aides were not sufficiently trained, Philadelphia-based Nursing Home Care Management Inc., doing business as Prestige Home Care Agency, agreed to a $1.5 million settlement with the Department of Health and Human Services, Patrick L. Meehan, U.S. Attorney for the eastern district of Pennsylvania, says in a release. Prestige also agreed to a five-year corporate integrity agreement.
 
Medicare requires home health aides to have successfully completed a minimum of 75 hours of classroom and supervised practical training. The instruction and training should address observation, reporting and documentation of patient status, basic infection-control procedures, knowledge of emergency procedures and reading and recording temperature, pulse and respiration, Meehan notes.
 
Prestige submitted claims for services rendered by aides who lacked any training or whose training was inadequate and incomplete, prosecutors said. "The provider knowingly sent unqualified and ineligible workers into patients' homes to provide vital healthcare services," Meehan charges.
 
"This is a serious violation of patient trust," Meehan says. "A homebound patient has no choice but to accept on faith that the individual helping care for them is qualified."
 
As part of the settlement, Prestige denied the government's allegations.

 

  • Acute or not acute? Home health coders in a quandary over whether to use revenue-enhancing acute stroke diagnosis codes versus late effect stroke codes have finally gotten some guidance from the Centers for Medicare & Medicaid Services. HIPAA requires providers to follow ICD-9 coding guidelines, which mandate late effect CVA coding in the post
    acute setting.
     
    But CMS continues to direct HHAs to use the acute stroke codes (now in the 434 series) to secure their rightful payment benefits, a CMS official told Josephine Sienkiewicz of the Home Care Association of New Jersey in a Nov. 15 written clarification. For more information on this and other coding issues, see the December issue of Eli's ICD-9 Coding Alert at     www.elihealthcare.com.

     

  • Your hospice could be overlooking an untapped market - the African-American population. In a recent survey commissioned by VITAS Innovative Hospice Care, "we found that the African-American community indicated they knew the least about hospice initially, and when informed about hospice by the surveyor, they were also least likely to want to use hospice services if given the opportunity," notes VITAS spokesperson Mark Cohen in a release. "Less than 10 percent of hospice services nationwide are provided to African-American patients. We need to do more to reach out to them."
     
    Other findings from the survey of 400 adults conducted by Bendixen & Associates: 83 percent of respondents would prefer to be cared for at home by family members and home health professionals, if faced with a terminal illness, and 98 percent of respondents whose family members had a hospice experience said it was a positive one.

     

  • Congress is giving the Visiting Nurse Associations of America $200,000 to establish a best practices clearinghouse for chronic care management. Lawmakers approved the funding in the omnibus appropriations bill that passed before Thanksgiving, VNAA says in a release. Sen. Edward Kennedy (D-MA) was instrumental in securing the funding, the association cheers.

     

  • Don't be surprised if your Joint Commission on Accreditation of Healthcare Organizations standards look different in the future. The Oakbrook Terrace, IL-based accrediting body "is conducting an intensive review of its home care standards to increase their relevance to the various home care organizations accredited by the Joint Commission," it says in a recent newsletter.

    JCAHO's Home Care Advisory Group currently is providing input regarding applicability, clarity, and relevance of the current home care standards, as well as recommendations for change, the accrediting body says.

     

  • An HHA owner faces charges of padding time sheets. Michelle Hunter, owner of Ohio-based skilled nursing and home care company Guardian Health Services, was charged Nov. 15 with exaggerating the service hours billed to Medicaid.
     
    In 2003, Guardian partnered with residential care facility Vantage Place. Under the agreement, Hunter billed Ohio Medicaid for skilled nursing services provided by Guardian nurses. Based on medical notes, nurses provided only one hour of care per visit.
     
    But according to U.S. Attorney Gregory White, on 1,918 Medicaid claims Guardian falsely stated the skilled nursing visits were two hours. This resulted in an overpayment of about $33,000. If convicted, Hunter could face up to five years in prison, a $250,000 fine and three years' supervised release.

     

  • The respiratory therapy services market is still looking good to investors. Tempe, AZ-based O2 Science has secured $10.2 million in financing from private equity investment firm Kline Hawkes & Co. in Los Angeles. O2 Science, which has 16 locations, plans to use the financing to pay down debt and expand through acquisitions and internal growth, it says in a release.
     
    "Each year, we consider more than 200 companies for investment but only actually select a handful," says Klaus Koch, Principal at Kline Hawkes. The financing was part of a recent management buyout - O2's executives bought out DVI Inc., a financier that filed bankruptcy last September (see Eli's HCW, Vol. XIII, No. 25, p. 199).

     

  • The IRS mileage rate will shoot up next year. The new rate effective Jan. 1 will be 40.5 cents a mile, up from the current 37.5 cents. "The 3-cent increase in the business mileage rate was the largest one-year rise ever," the IRS says. "The primary reasons were higher prices for vehicles and fuel."

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