Behavioral Health Home Care

Behavioral Health Home Care integrates behavioral health interventions into home care services for patients whose mental illness, substance abuse, intellectual/developmental disabilities make it difficult, or otherwise prevent them from receiving care outside of their homes. Services are provided by a psychiatric nurse and other home care personnel, as ordered by a physician.

Watch the above video to learn more about ACHC’s Behavioral Health Home Care service.

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

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Pharmacy | Sleep  | Behavioral Health

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Advisor Tips: On-Site Survey

In this Advisor Tips video with Danny Hupp, one of ACHC’s DMEPOS and Pharmacy Accreditation Advisors, he discusses three tips to help you prepare for your survey.

  1. Complete your Preliminary Evidence Report (PER) Checklist
    • The PER Checklist will be submitted on Customer Central
  2. Organize your patient and personnel files
    • ACHC’s Surveyors will review a random selection of files for compliance
  3. Conduct a mock survey with your staff members
    • This will help your team get in the survey-ready mindset

Learn more by watching the video above.

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

Danny

CMS Moratoria Extension

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In response to recent high profile instances of fraud, waste, and abuse, the Centers for Medicare and Medicaid Services (CMS) released Survey and Certification letter 14-10-HHA on February 4, 2014, extending the moratoria on home health agency enrollment. These moratoria are phase two of the original release in July, 2013 that curtailed the enrollment of any new home health agency in Chicago, IL (Cook, DuPage, Kane, Lake, McHenry, and Will counties) and Miami, FL (Miami-Dade and Monroe counties). CMS reports that these areas were chosen due to high risk for fraud, high utilization, and a disproportionately large number of new providers.

In this new phase, CMS has extended the moratoria in the above areas, and has also added four additional targeted areas – Fort Lauderdale, FL (Broward county), Detroit, MI (Macomb, Monroe, Oakland, Washtenaw, and Wayne counties), Dallas, TX (Collin, Dallas, Denton, Ellis, Kaufman, Rockwell, and Tarrant counties) and Houston, TX (Brazoria, Chambers, Fort Bend, Galveston, Harris, Liberty, Montgomery, and Waller counties).

The moratoria will affect any home health agency located in the above areas that has applied for, or is in the process of obtaining a Medicare provider number, but has not been approved by the Medicare Administrative Contractor (MAC) as of January 30, 2014.  In order for a home health agency’s application to be considered complete, CMS requires that the following steps must be fully completed:

  1. The agency’s initial Medicare certification survey must have been completed
  2. The second MAC review has been completed
  3. CMS regional office sent the tie-in notice to the MAC
  4. The MAC performed a site visit
  5. The MAC switched the agency’s Provider Enrollment Chain Organization System (PECOS) record to approved

If all of these steps were not completed prior to the implementation date of the moratoria, the agency’s application will be denied. If an organization’s status is denied, they will be notified by the MAC. Once the moratorium is lifted, the agency will need to complete a new enrollment application if it continues to seek a Medicare provider number. In addition, the MAC will deny any application for a branch addition location in the above areas as well. Agencies affected will have the right to appeal by following information found in the denial letter issued by the MAC.

Unfortunately, home health surveys conducted by an accrediting organization in these targeted areas for initial deeming purposes will not be accepted by CMS and will not be accepted as a valid survey during the moratoria. ACHC can continue to process prospective home health agency’s application for accreditation only. For more information, contact your Accreditation Advisor at (855) 937-2242.

Download the survey and certification letters, and the FAQs issued by CMS ››

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

Maintaining Survey Readiness

ACHC Survey Readiness

As we embark into  2014, many of us set New Year’s Resolutions only to break our well-intentioned goals and ideals a few short weeks or months later as the daily hustle and bustle of life and work resumes. One New Year’s Resolution that should be established and kept is maintaining survey readiness. We know that we should always be “survey ready” but maintaining that on a daily basis becomes difficult as more pressing issues arise.

A few key points in maintaining survey readiness are:

  • Ensure you have the most current ACHC Standards for Accreditation and your policy and procedure manuals are consistent with ACHC Standards as well as any additional federal and/or local regulations.
  • Stay current with the monthly Did You Know publications sent by ACHC.
  • Audit medical and personnel records on a continuous basis to identify issues of non-compliance early and develop an internal Plan of Correction for any issues of non-compliance found.
  • Access ACHC’s Customer Central portal frequently for the latest information and resources to assist you in maintaining survey readiness.

ACHC has created tools to assist you with this endeavor. These tools coincide with key time frames; at 6, 12, and 24 months post-survey as well as 6 months prior to renewal.

For example, some annual requirements including program evaluation, staff education, and personnel evaluations are often overlooked or not completed on time. The tools ACHC has created provide you with checklists to help you to stay on track in between surveys. ACHC conducts surveys every three years, but as we know, random, unannounced surveys by any regulatory body could happen at any time and staying current is the key to a successful survey outcome.

Download the Continued Compliance documents by logging into your Customer Central Account and navigate to ‘After Accreditation’ -> ‘Continued Compliance’.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

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Lisa MeadowsAbout the Author: Lisa Meadows

As Clinical Compliance Educator for Home Health, Hospice and Private Duty, Lisa brings over 20 years of medical social work experience to the classroom, including acute care hospitalization and home and hospice health care.  Previously an ACHC Hospice Surveyor, Lisa currently travels across the U.S. as a Presenter and an Educator, speaking on accreditation and other relevant health care topics.

ACHC Whiteboard Sessions – Needs Assessment Survey


In this Whiteboard Session ACHC’s CEO, José Domingos, discusses the results from the 2013 Needs Assessment Survey. The data collected consisted of more than 2,000 respondents, including new and existing customers. ACHC identified three common trends among the responses:

1. Customers were satisfied with ACHC’s level of customer service

  • Average a 4.7 out of 5.0 for the last six months

2. Providers desired more educational resources. ACHC now offers:

3. Providers want a more streamlined accreditation process

  • Reduced required files submitted for the PER
  • Updated online customer portal: Customer Central

Learn more by watching the video above.

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

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Survey The Expert Podcast: Episode 11 “Behavioral Health Integration”

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[iOS Users]
[5:37]

In today’s Survey The Expert podcast, we’ll be joined by Britt Welch, ACHC’s Behavioral Health Manager. He has over twenty-five years of experience in the behavioral health field and offers his knowledge of clinical practice, community mental health services, and state government.

Episode Highlights:
Behavioral Health integration positively affects patient care

  • Helps to manage patient’s disability
  • Reduces costs
  • Leads to better outcomes

ACHC’s Behavioral Health standards were developed with the integration of care framework

  • 5 services are currently available for accreditation
  • 10 services launching in 2014

Learn more by visiting achc.org or by contacting Britt Welch at (855) 937-2242 ext. 235

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Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

ACHC Whiteboard Sessions – HME: Doing More With Less

In the video ACHC’s Clinical Educator, Greg Stowell, talks about three strategies to help improve your HME facility.

  • First, Review your Administration department. This includes your P&Ps and staffing needs.
  • Next, Greg suggests that there is always room for improvement in your Operations department.
  • Finally, watch your inventory levels. Having both too much, and not enough can be detrimental to your bottom line.

Learn more by watching the video.

About Greg Stowell:

Greg has over 30 years of industry experience where he has owned and managed local and regional HME and Rehabilitation organizations. He also brings previous experience as a certified Orthotist and holds his RESNA ATP certification. Additionally, he serves as the current chair of RESNA’s Delivery, Outcomes and Policy SIG.

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

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CMS Home Health Sanctions: Protect yourself with ACHC accreditation

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REDUCING YOUR RISK

With the implementation of the first phase of CMS sanctions for Home Health providers on July 1, 2013, agencies across the country are rightfully concerned about what resources are available to help them avoid steep penalties and ensure compliance with Medicare Conditions of Participation (CoPs). With fines totaling thousands of dollars per day on the horizon, a strong compliance program achieved through earning and maintaining ACHC accreditation is a key strategy. Since ACHC standards are written for providers, by providers, and incorporate the Medicare CoPs, agencies that choose to become accredited are taking an important step in reducing their risk.

In addition to the widely-recognized benefits of accreditation, the following are examples of how ACHC will help you avoid these sanctions:

  • All condition-level and standard-level violations cited during any on-site survey conducted by ACHC are not subject to the CMS sanctions.
  • For providers who have deemed status, CMS only conducts on-site surveys for complaint or validation purposes, significantly limiting the risk of an on-site visit during which sanctions could be imposed.
  • New Home Health agencies are frequently less familiar with CMS requirements. ACHC providers have access to a variety of resources, as well as a personal Accreditation Advisor and Surveyors with industry-specific experience aimed at helping you before, during and after the accreditation process.

Proper education of staff is also a key component to establishing and maintaining a strong compliance program, especially as it relates to the implementation of policy in direct patient care. During your on-site accreditation survey, your Surveyor will be evaluating staff providing patient care to ensure it is reflective of both professional standards of practice and agency policy. ACHC also provides audit tools to ensure compliance with essential standards related to personnel records, client charts and other required documentation and standards.

EXAMPLES OF NON-MONETARY SANCTIONS:  Effective July 1, 2013

  • Directed Plan of Correction: CMS may impose a directed plan of correction developed by CMS or a temporary manager. If compliance is still not achieved, CMS could impose one or more additional sanctions until compliance is achieved or the agency is terminated.
  • Directed In-Service Training:  CMS could require HHA staff to attend in-service training programs if CMS determines that education would lead to correction of deficiencies. Providers of educational programs must be approved by CMS or the State, and the cost associated with the in-service training would be the responsibility of the HHA.
  • Temporary Management: CMS could impose the temporary management sanction if CMS determines that management limitations contribute to a HHA’s inability to correct deficiencies. The HHA would be required to pay for the salary and additional costs incurred.

EXAMPLES OF UPCOMING SANCTIONS: Effective July 1, 2014

Civil Money Penalties – CMS may impose a civil money penalty against an HHA for either the number of days the HHA is not in compliance or for each instance the HHA is not in compliance. Penalties can range up to $10,000 per day.

  • Suspension of payment for all new admissions – CMS may suspend payment for all new Medicare admissions regardless of whether the Condition Level deficiencies pose immediate jeopardy.

ABOUT THE SANCTIONS

CMS-stated sanctions are applicable in the event of a condition-level deficiency, unless the standard-level deficiency is considered to impose significant harm to an individual or if an agency has a standard-level deficiency previously found to be a conditional-level deficiency. CMS will delay the application of civil money penalties, payment suspension and the Informal Dispute Resolution (IDR) process until July 1, 2014. For more information about the CMS sanctions, read the Federal Register, Vol. 77, No. 217 published November 8, 2012. Read more by downloading the CMS PDF › ›

Listen to the original Podcast from November 2012››

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Ready for accreditation? Contact ACHC at (855) 937-2242 to learn more.

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

Is Your DMEPOS Application Addendum Filled Out Correctly?

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One of the most critical aspects of the ACHC application process that DMEPOS providers must complete is the DMEPOS Accreditation Application Addendum.  The DMEPOS Accreditation Application Addendum is a checklist that the customer must complete to show the equipment and supplies that they are currently billing to Medicare Part B.  It is imperative that the DMEPOS Accreditation Application Addendum matches page 9 of the current 855S enrollment application for each Provider Transaction Access Number (PTAN) or Medicare Provider Number.

During the on-site survey, our Surveyors use the completed DMEPOS Accreditation Application Addendum to determine if that the specific location has appropriate inventory and is equipped to provide each product code to patients in a timely manner.   For organizations with multiple locations/PTANs, each location should have its own unique DMEPOS Accreditation Application Addendum even if the equipment and supplies provided is the same.

Before the ACHC survey is completed, the surveyor will sit down with a representative from the organization to review the DMEPOS Accreditation Application Addendum and ensure that the correct product codes have been selected.  The ACHC surveyor and representative will sign and date the form acknowledging the codes that will be reported to Medicare.  When the organization’s Accreditation Advisor issues the approval, they will include a copy of the signed DMEPOS Accreditation Application Addendum with the documentation.

ACHC strongly encourages all of our customers to carefully review their DMEPOS Accreditation Application Addendums when submitting their application and also while on-site with their ACHC Surveyor. Renewing ACHC customers should complete a new DMEPOS Accreditation Application Addendum for each three-year accreditation cycle.

To verify the product codes that you are currently accredited for, please log into your Customer Central account. If you have any other questions or need any assistance in completing a DMEPOS Accreditation Application Addendum, please contact your organization’s Accreditation Advisor at 855-YES-ACHC (937-2242).

Home Health | Hospice | DMEPOS | Private Duty
Pharmacy | Sleep  | Behavioral Health

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About the Author:

matthew_hughesMatt Hughes is the Director of Business Development & Customer Service. His primary functions are working with current corporate customers along with identifying new opportunities to help grow ACHC.  He works closely with state associations and other member organizations throughout the country.