About the Author

vii

Dedication

viii

Chapter 1

The Specialty that is Home Health

1

The History of Home Health

1

The Specialty of Home Health Care

2

The Current Homecare Landscape

4

Home Health Administrator Requirements

4

The Administrator’s Orientation Pathway

6

Chapter 2

Home Health Personnel Management

9

Management Personnel

9

Agency Nonmanagement Personnel

19

Nonclinical or Support Personnel

22

Personnel Policies

23

Employment Laws

23

Employee Health Requirements

24

Compensation Models

25

Agency Staffing and Compensation

26

Chapter 3

Management and Agency Structure

31

Business Structure

31

For-Profit and Nonprofit

32

Organization, Services, and Administration

32

Leadership and Groups

33

The Importance of Committees

37

The Organizational Structure

38

Strategic Planning and Management

39

Ethical Issues

42

Clinical Accountability

44

Chapter 4

The Professional Advisory Committee

47

Introduction

47

Group of Professional Personnel

47

Composition and Responsibilities of the Pac

48

The Annual Agency Evaluation.

48

Chapter 5

Quality Assessment and Performance Improvement

57

The Agency’s Quality Program

57

The Foundation of the QAPI

58

Home Health Compare

64

Clinical Record Review

65

The House that Quality Built

66

Chapter 6

Policies and Procedures

69

Introduction

69

Writing Policies and Procedures

69

The Effects of Various Laws

76

Chapter 7

The Regulatory Environment

77

Introduction

77

Understanding the CoP

77

Understanding and Applying the Interpretive Guidelines

79

Accreditation Standards

80

A Word About the Medicare Payment Advisory Commission

82

Third-Party Audits and Scrutiny

82

Chapter 8

The Survey

85

The Survey Process

85

Survey Preparation

89

Survey’s Over: Now What?

93

The Top Home Health Citations

95

Chapter 9

The Payment Environment

97

Introduction

97

Medicare

97

Understanding the Medicare Prospective Payment System and Consolidated Billing

100

Agency-Provided Supplies

104

Medicaid

104

Veterans Affairs

105

Commercial Insurance

105

Billing and Collections

106

Chapter 10

The Oasis Assessment

107

The Oasis Data Set

107

Oasis-C Training and Education

108

The Oasis-C’s Relationship to Quality and Financial Health

108

Chapter 11

Finance and Budgeting

109

The Accounting System

109

The Budget Process

113

Visit Rates, Supply Charges, and Tracking

114

Reporting to the Governing Body and the Professional Advisory Committee

115

Chapter 12

Lessons and Tips from the Trenches

117

What have You Gotten Yourself Into?

117

Lessons Learned: Nursing

117

Lessons Learned: Homecare

119

Tips from the Trenches

120

The Nursing Journal

122

Conclusion

123

Homecare Administrator’s Field Guide References

125

Appendix

127