Education Session Information

March 7-9, 2018 | Washington, DC

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The National Leadership Conference provides partners with many opportunities to interact with leaders in home-based care. Our attendees represent senior and emerging leaders from home-based care provider organizations around the country.

This continuing nursing education activity was submitted for approval to the Maryland Nurses Association, an accredited approver by the American Nurses’ Credentialing Center’s Commission on Accreditation. (* Denotes sessions submitted for approval of contact hours.)

Jump to: Preconference | General Session 1 | General Session 2Concurrent Session 1 | Concurrent Session 2Concurrent Session 3 | Concurrent Session 4 | Concurrent Session 5 | General Session 3

Click here to view a full conference schedule.

Preconference: Wednesday, March 7, 12:00 – 3:45 p.m.

Interactive Direct Advocacy Engagement Preconference*
This preconference session will focus on the legislative priorities for home health and hospice while enhancing your direct advocacy skills. Participants will be able to tailor legislative asks to their agency while developing talking points, elevator speeches and other engagement tools. This session will be highly interactive. Additional fee required.

General Session 1: Wednesday, March 7, 4:00 – 5:30 p.m.

The Vital Role of Home-Based Care in Innovating America's Health Delivery System
Hear from leading elected officials about the vital role that home-based care plays in the innovation of America's health delivery system. As CMS pushes the move from volume to value-based care with high-quality outcomes, learn about health care-based political priorities for the remainder of the 115th Congress.
Dr. Steven Strongwater, MD, President and CEO, Atrius Health, will discuss the Atrius Health and VNA Care partnership successes. Following his presentation, he will be joined by a panel of research leaders from Excel Health Group, ElevatingHOME, and KNG Health Consulting to discuss national home health financial data and original research. Participants will have the opportunity to ask questions following the presentation.

Concurrent Session 1: Thursday, March 8, 10:45 – 11:45 a.m.
Accrediting agencies are looking at the conditions of participation, however, CMS uses the Medicare benefit policy manual which contains the conditions of payment; your agency needs to understand both. Back end QAPI slows down both identification and resolution of issues and pushes the timeline for improvement in STARS, VBP to a year or more. Agencies are often blind sided with ADR, RAC, and ZPIC audits despite high marks on surveys because they are auditing from accrediting guidelines, not CMS triggers CMS is using algorithms to look at EVERY OASIS you submit. Top triggers are over utilization and indications that medical necessity and homebound status are questionable. New COP's are only meeting the requirements accrediting agencies are already using.

Learning Outcomes/Objective
1. Understand why a good survey does not protect against audits (or help you pass them)
2. Learn the difference between CMS and accrediting agencies audit triggers
3. Stop confusing your billing audit with a QAPI program
4. Understand how to get the data you need

- Kristi Bajer, BSN, RN, Vice President, Clinical Operations, OperaCare
- Michael McGowan, President, OperaCare
Historically, the incentives for home care and EMS have been misaligned with home care desiring to maintain high quality care in the home and EMS agencies desiring to transport patients to an emergency department. Klarus Home Care's experience in partnering with their local EMS agency have enhanced care coordination, reduced preventable ED visits and increased referrals. Come learn about Klarus' innovative partnership and how you can implement similar partnerships in your market.
Learning Outcomes/Objectives
1. Understand the historical misalignment of incentives between home care and EMS
2. Learn the goals of the Klarus partnership with EMS
3. Learn the key components and best practices of a home care and EMS partnership
4. Understand the how the outcomes from the partnership have achieved the simultaneous goals of enhancing care coordination, reducing preventable ED visits and increasing home care referrals

- J. Daniel Bruce, Administrator, Klarus Home Care
- Matt Zavadsky, Chief Strategic Integration Officer, MedStar Mobile Healthcare
Staff play a vital role in the success of home health. Being able to attract and retain top-notch employees is very agency's dream. But how do you get there? In this engaging presentation, Anne-Lise Gere SPHR, Principal at Gere Consulting LLC, and Caleb Roseme, President of Assured Quality Homecare share their experience to achieve the "Holy Grail" of home health employment. By focusing on critical systems and consistent actions, providers can stand apart from their competition and build the foundations of a thriving business. Using real-life examples, Anne-Lise (HR consultant) and Caleb (agency owner) provide practical tips and techniques on how to become (and remain) an Employer of Choice:
- Recruitment: Establish a solid recruitment strategy with the "3-legged stool" approach.
- Retention: Keep caregivers longer and utilization your existing workforce.
- On-boarding goes beyond the Orientation session. A mentoring program is crucial to create a productive (millennial) workforce.
- Career progression for caregivers.
- Compensation & Benefits: Be competitive but don't break the bank
- Recognition: Understand what forms of recognition your caregivers value

The presentation comes with a workbook (pdf format) to develop a practical action plan to implement back at work.

Learning Outcomes/Objectives
1. Understand how good HR strategies contribute to better business results.
2. Develop a plan for more effective staff recruitment
3. Outline action steps for better staff retention

- Anne Lise Gere, SPHR, Principal Consultant, Gere Consulting Associates LLC
- Caleb Roseme, President, Assured Quality Homecare
Share elements of Lean Daily Management outcomes and progress Hartford Healthcare at Home has made in integrating lean into daily operations. Multiple forms of waste eliminated (rework, waiting, defects, over processing, transportation, etc.) which resulted in standard work development that has been scaled across CT to over 600 clinicians, elimination of duplication of work that impact 7 roles and 12 key processes. Estimated cost savings >$300k over one-year period.

Learning Outcomes/Objectives
1. Implement standard communication process
2. Implement driver and key performance indicator trending and pareto tracking
3. Implement an improvement center that drives improvement toward key drivers
4. Lean tools that will help understand problems, introduce root cause analysis approach and countermeasure develop to support eliminate of root cause

- Andrea Griffith, Lean Sensei, Hartford Healthcare

 Concurrent Session 2: Thursday, March 8, 1:30 – 2:30 p.m.​
Now more than ever the health care landscape is focused on lowering the cost of care across the continuum and to do so is dependent on the data that providers are using to make decisions. Home Health and Hospice services are cost effective care options that provides high quality care at a lower cost.
Through claims data Home Health & Hospice organizations can validate their market position and gain insights into their contribution to patient Medicare spending. These data elements will define opportunities to collaborate with other providers in advancing higher quality care while leading the industry in lowering the overall cost in Medicare spending. This session will focus on the changing healthcare landscape and the power data has in making operation decisions.

Learning Outcomes/Objectives 
1. Define the changing Healthcare landscape
2. Identify trends in home health and hospice Medicare spending across the continuum of care
3. Outline strategies for data use in identifying market opportunities and driving lower Medicare spending

- Raymond Belles, Managing Consultant, BKD, LLP CPAs & Advisors.
- Wanda Coley, MBA, Chief Operating Officer, Well Care Home Health
This presentation will describe our agency's partnership with our primary care clinics to improve outcomes for both settings. Our first strategy within this partnership includes making a home care RN and a palliative care team member part of the primary care clinic's interdisciplinary team. In our first clinic, this decreased those physician's hospitalization scores from 10.3% to 3.8% from October 2016 to September 2017.

Additionally, our home care outcomes for patients with a primary care provider within that clinic included improvement in case mix (from 0.8 to 0.94) and decrease in LUPA rate (from 24.32% to 8.57%) by involving more disciplines as a result of that interdisciplinary team meeting and identifying the needs of the patient outside of the narrow focus of the hospital discharge note as well as utilizing the primary care provider relationship to establish a home care episode for patients who may otherwise have declined home care services. Home care outcomes for patients with a primary care provider within this first clinic also experienced a decrease in 30-day hospitalization (7.14% to 2.5%) and all acute care hospitalization rates (39.96% to 23.73%). During the first quarter the home care RN was included in the IDT meetings at the pilot clinic, the hospice referrals from the four physicians there increased from 4 from the first quarter to 10 the second quarter she was involved. Additional strategies included in this partnership include a shared senior leadership team and setting shared key performance indicators to further improve the communication and collaboration between these two settings. This included a strategy to improve PPV rates for home care with demonstrated success with improvement in home care rates from 88.54% to 91.22%.

Learning Outcomes/Objectives
1. Identify opportunities for partnership with primary care clinics to improve physician and home care outcomes.
2. Identify strategies to develop a cross-continuum interdisciplinary team between physician practices and home care agencies.
3. Identify key performance indicators that overlap between physician clinics and home care agencies.
4. Identify strategies to improve outcomes that overlap between physician clinics and home care agencies.

- Jenn Ofelt, RN, BSN, MSN, MHCA, Executive Director, UnityPoint at Home
- Mag VanOosten, Chief Clinical Officer, UnityPoint at Home
Description to come

Learning Outcomes/Objectives

- Dr. Kendall Ford, PT, MSEd, PhD, ACHE, COS-C, CPHQ, Director of Quality, Education and Rehab Services, Memorial Hermann Healthcare System
- Tina Hilmas, RN, BSN, MS, CPPS, Assistant Director, Center for Patient Safety
Description to come

Learning Outcomes/Objectives

- Everett Devaney, FACHE, President and CEO, VNANE
- Holly Chaffee, RN, BSN, MSN, President and CEO, Porchlight VNA/Home Care

Concurrent Session 3: Thursday, March 8, 3:00 – 4:00 p.m.​
In home health and hospice, communication between clinical and financial teams is imperative to an agency's success. In this presentation, we will highlight effective communications strategies that will provide agency leadership with the tools needed to overcome common barriers that can ultimately disrupt overall operations.
By implementing certain communications strategies, agencies will be able to increase agency efficiency and ultimately improve the quality of care their patients receive.
Learning Outcomes/Objectives
1. Identify the barriers commonly encountered between clinical and financial teams
2. Explain how overall operations can be affected by a lack of communication between teams
3. Identify the areas of opportunities for improvement within their organization
4. Identify the areas of opportunities for improvement within their organization, and implement changes within their organization to help to position their agency for success

- Ann Painter, MSN, RN, Senior Vice President, Christiana Care Home Health & Community Services
- Nick Seabrook, Managing Director, BlackTree Healthcare Consulting
The Center for Medicare and Medicaid Services (CMS) gathers a great deal of information about hospices from claims, cost reports, the Hospice Item Set and surveys. CMS uses this data to analyze programs and quality of performance. This session will discuss how hospice leadership can also use CMS data to improve service delivery, increase quality scores and optimize their revenue cycle.

Learning Outcomes/Objectives
1. Use claims data to analyze the quality of care provided based on visits by discipline, length of visit, location of visit and frequency of visit.
2. Explain key components of care they expect from patient care teams and how those components are reflected in past practice by the teams.
3. Compare their cost report results to existing internal financial statements and make decisions about possible changes in care models.

- Teresa Craig, CPA, Director, Client Strategy, Netsmart
This Caregiver Recruiting and Retention Crisis is causing major headaches for home care leaders. Clients and patients are upset with the lack of dependability and continuity. Caregivers are frustrated, and turnover is huge. Schedulers are burning out from the stress. Supervisors and managers are fed-up. Sales people are tentative because they can't sell services your agency can't deliver. And you are losing money because of unfilled shifts, missed visits, and lost patients and clients. All of this produces increased hassles, stress, and frustration for owners, CEOs, and leaders. In this interactive presentation, Stephen Tweed will describe the magnitude of this crisis. He'll explore how it is negatively affecting you, your team members, and your agency. He will explain the latest research that is being conducted by Leading Home Care to define the problem, develop a solution, and present a system to conquer the crisis. Stephen will lead you through The Seven Step Caregiver Solution System, and describe in detail how to make this work. He'll give you specific examples of how leading companies are renewing, revitalizing, and rejuvenating their talent attraction processes.
Learning Outcomes/Objectives
1. Describe the magnitude of the Crisis facing home health and hospice leaders
2. Discuss the most effective solution
3. Explore a Seven Step System for caregiver recruiting and retention 

- Stephen Tweed, CSP, CEO, Leading Home Care ... a Tweed Jeffries company
There is clear evidence regarding the connection between employee engagement and the patient experience. The VNA Health Group utilizes analysis of data collected from patient relations software, outbound calls, CAHP scores and Gallup employee engagement surveys, as a way to measure the patient and staff experience. This presentation will provide the framework that drives the efforts being made to monitor and track results that are reported via dashboards to staff, leadership, and Board Committees, ensuring total transparency with measurement and outcomes. Our approach allows for opportunities to drive improvement throughout the organization, as well as provide positive reinforcement and recognition in areas of best practices. Recognizing staff empowers them and improves morale which leads to enhanced patient experience.he Center for Medicare and Medicaid Services (CMS) gathers a great deal of information about hospices from claims, cost reports, the Hospice Item Set and surveys. CMS uses this data to analyze programs and quality of performance. This session will discuss how hospice leadership can also use CMS data to improve service delivery, increase quality scores and optimize their revenue cycle.

Learning Outcomes/Objectives
1. Prioritize necessary steps to create a patient experience improvement program from the ground up.
2. Understand various ways to go beyond the HHCAHPS to capture, measure and report patient experience feedback.
3. Utilize patient relations software and outbound calls to validate and improve HHCAHP scores and categorize areas of best practice and caring opportunities.
4. Engaging staff to understand opportunities and methodologies to address improvement initiatives.

- Marie Perillo, MSN, Chief Patient Experience Officer and VP of Service Excellence, VNA Health Group
- Dr. Robert Rosati, Vice President of Data and Quality, VNA Health Group
- Lisa Dillon Zwerdling, RN, MSN-BC, Director of Patient Relations & Special Projects, VNA Health Group
- Joan Forrer, Director of Performance Improvement, VNA Health Group

Concurrent Session 4: Thursday, March 8, 4:15 – 5:15 p.m.
MedPAC and CMS have long believed that Home Health Providers are overpaid, and this belief has been the basis of many recent or proposed reforms including HHGM. This progressive presentation identifies areas of the HHPPS Model where costs don’t align with the current Med Pac homecare goals. In addition, HH protocols are identified to resolve these issues while preparing for HHGM and other reforms. Case Studies are employed to demonstrate how Providers are employing Utilization Review to gain care control while increasing clinical scores (5 Star) and fiscal margins (>25%).

Learning Outcomes/Objectives
1. Identify why Med Pac believes HH is overpaid
2. Identify areas where savings are available in daily HH operations
3. Propose Utilization Review processes to address value-based programming for cost control
4. Demonstrate Case-Studies where HH Providers employ UR management for elevated clinical and fiscal outcomes

- Kimberly McCormick, RN, BSN, Executive Clinical Director, HHSM
- Arnie Cisneros, PT, President/CEO, HHSM
Firstly - Distinguish between complaints and grievances and highlight new CMS home health standard on Investigation of Complaints. Secondly - Present the complaints of a robust but simple Complaints Management Program with model for the development. Thirdly - Taxonomy for categorizing/classifying complaints as a simple first step towards collection and aggregation of data. Finally - How agencies can "drill-down" and interpret HHCAHPS results using the taxonomy and initiate performance improvement activities as indicated.

Learning Outcomes/Objectives
1. Gain insight into the new CMS home health standard and other AO requirements.
2. Utilize a simple frame-work for Complaints Management within the agency.
3. Confidently receive and appropriately log, investigate, analyze and resolve patient complaints.
4. Effectively utilize HHCAHPS data to boost star rating scores

- Jacqueline Lindsay, RN, BSN, MPH, JD, Director, Accreditation, Community Health Accreditation Partner


Track: Workforce
Description to come
Learning Outcomes/Objectives

- To come
Attendees will take home "real life" examples of how they can transform their agency into a 5-Star Agency with innovative examples of transparent leadership, organizational changes and productivity models. These practices include use of data analysis and the importance of well-trained/certified staff along with invested leaders. CHI Health at Home currently has five of their seven agencies listed on "Home Care Elite" with one listed as one in the top 100 and two in the top 500.

Learning Outcomes/Objectives
1. The learner will be able to describe how transparent leaders employ owners and not renters.
2. The learner will be able to describe what organizational changes may be necessary to attain 5-Star Rating.
3. The learner will be able to describe what business practices are necessary to improve to a positive bottom line.
4. The learner will be able to describe what practices improve employee satisfaction.

- Sue Heitkamp, RN, BSN, President, CHI Health at Home
- Joelle Goldade, RN, BSN, HCS-D, COS-S, Director of Clinical Operations, CHI Health at Home

Concurrent Session 5: Friday, March 9, 9:15 – 10:15 a.m.​


Track: Financial
Description to come.

Learning Outcomes/Objectives
1. To come

- Keith Boroch, Associate Vice President - Post-Acute Consulting, McBee Associates
Define a delivery system continuum of services developed to provide community based palliative care. Review pilot outcomes measured during participation in the Medicare Care Choices Model to include predicted cost-savings and impact upon hospice program performance. Review evolution of Home Based Primary Care Service program developed in partnership with system health plan. Data review includes projected cost saving and improved quality of life for patients.

Learning Outcomes/Objectives
1. Review lessons learned from MCCM phase 1 provider 
2. Understand program sustainability potential of community palliative offering (while we live in a fee for service world)
3. Understand strategy for developing unique programming in partnership with a health plan

- Dr. Iris Boettcher, MD, Division Chief, Long Term Care & Geriatrics, Spectrum Health Medical Group
- Dr. Simin Beg, MD, Division Chief, Spectrum Health Medical Group
- Karen Pakkala, BS, MBA, FACHE, Chief Operating Officer, Spectrum Health Continuing Care


Track: Workforce
Description to come.
Learning Outcomes/Objectives
1. TBD

Hospice deaths in less than 7 days of admission had increased to 54%. Home care admits to Hospice decreased to less than 20%. Goal was to decrease the number of patients dying in less than 7 days to 35% and increase admits from home care to 35%. The project achieved 27% on deaths and 48% on admissions.

Learning Outcomes/Objectives
1. Describe key tactics needed in partnering daily to identify earlier hospice referrals.
2. Identify proactive triggers to identifying hospice patients earlier in home care.
3. Identify standard work for implementing hospice and home care joint visits
4. Describe the importance of patient, family and staff satisfaction in earlier referrals to hospice.

- Micki Schaefer, BSW, MSW, Director, Hospice & Palliative Care, HealthEast
- Nicole Klimas, Clinical Services Supervisor, HealthEast Home Care

General Session 3: Friday, March 9, 10:45 a.m. – 12:00 p.m.

IMPACT Act Data Element Review and Town Hall
CMS will conduct a robust process of public outreach and consensus vetting for their standardized patient assessment data element work to meet the requirements of the IMPACT Act of 2014, Section 2(a). These data elements may be used to inform a variety of metrics, including case-mix adjustment, medical complexity, interoperable exchange, clinical decision support, and measure development. Leadership from CMS will discuss the status of their data element work, including testing and potential outcomes. The session will include an open forum for CMS to respond to attendee questions concerns.