Blogs - Tagged: Home Health

Graceful Transitions in Leadership

Posted: 04.18.14 | Category: Leadership Insights

By: Jeannee Parker Martin, Vice Chairwoman & Principal

To paraphrase Ellen Goodman, Pulitzer prize winning columnist and author, there is a trick to the graceful exit – it begins with a vision to recognize when a job, a life stage, a relationship is over and to let it go. It means leaving what’s over without denying its validity or its past importance in our lives. It involves a sense of the future, a belief that every exit line is an entry. And, when we transition, we can take ourselves along. Quite gracefully.

As I move from my role as CEO to Vice Chairman & Principal, it is imperative to focus on a smooth transition, a graceful exit to allow the new CEO to lead. As our newly appointed CEO, Des Varady, said at TCG’s 25th anniversary party last week, “heart” is at the core of what TCG
does – caring about patients, staff and colleagues; teaching and sharing what we know to assure high quality outcomes and performance; and guts to take risks, to do the right things right, and to adapt as the industry changes. And the heart of a graceful transition is having the guts to step aside, to encourage and coach, to guide and counsel, and to let go of operational decision-making.

Des joined TCG just over a year ago, and has since led key operational initiatives. His experience and background will help take TCG to the next stage. He is committed to TCG’s strategic vision and will work with the executive team and board to continue to grow and transform the company – as partners with our staff, our clients, and our strategic partners. I look forward to working with him, as a board member, to continue our growth trajectory and partnering with our clients to achieve success. Learn more in our recent press release.

During times of transition, we must lead with confidence and transition gracefully – respecting the past and present, and preparing the company for the future. Ours was not an overnight transition, but one that has occurred gradually and has allowed us to transition smoothly. Allow yourself time, if possible, when placing new executives in key leadership roles. It helps ground your staff, clients and strategic partners.

In his new book, Catalyst, Stephen Smith reminds us that “The world has a deep inventory of people who are better, faster, smarter or more experienced than us.” And, as CEOs, we must transition gracefully to allow them to soar.

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The Importance of a Consistent Monitoring Process

Posted: 04.15.14 | Category: TCG Solutions

The sixth element of an effective compliance program is ongoing auditing and monitoring activities. While auditing typically involves the concurrent or retrospective review of identified risk areas, monitoring is about the day-to-day activities and processes we use to make sure we are compliant. The OIG devotes much more ink to auditing in their Compliance Guidance, but it is the initial monitoring activities that produce good audit results.

Monitor transitive verb – to watch, observe, listen to, or check (something) for a special purpose over a period of time (Merriam-Webster Digital Dictionary)

A few examples of monitoring activities:

  • Verifying employees, contractors and physicians against the OIG Exclusion List (physicians are frequently overlooked)
  • Confirming appropriate signatures, dates and documentation prior to billing for services
  • Verifying that patient visits are scheduled appropriately and according to the plan of care
  • Ensuring appropriate staffing levels to meet the needs of the patient population

Of course, these activities can later be audited but let’s look at the monitoring process. Notice the term process.

Process noun – a series of actions that produce something or that lead to a particular result (Merriam-Webster Digital Dictionary)

As compliance professionals, we are looking for a particular result from our monitoring activities. To make sure our results are consistent, we need to ensure our processes are consistent. In other words, processes should be written, especially those that relate to monitoring activities. Belief that a process was in place is not a good defense, and “informal” or “unwritten” processes create unnecessary risk.

For additional Resources, check out these websites:

Prepare. Reinforce. Go Further.

TCG Compliance Solutions is ready to assist you in implementing and enhancing effective controls and best practices for seamless compliance.

Contact us for the necessary expertise, resources and tools to improve and maintain compliance.

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Don’t Let Your Guard Down!

Posted: 03.27.14 | Category: TCG Solutions

Whether you’re boxing or fencing or providing home health or hospice care, it’s never wise to let your guard down. The recently announced ‘pause’ in RAC audits has received a lot of press, but scrutiny for home care providers by MACs and ZPICs are unaffected by the ‘pause,’ and their audits will continue unabated for home health and hospice providers. A new RAC with a dedicated focus on home health, hospice and HME is in the works and will be up and running before too long.

CMS Change Request 4825, effective March 6, 2014, ups the ante even further. This change authorizes contractors who determine that one claim does not meet Medicare payment criteria to also deny any related claim without requesting additional documentation. The National Association for Home Care and Hospice (NAHC) cautions that this policy change could have significant implications for home health and hospice providers since they often submit multiple claims for a single incident of illness – for example, submitting claims for several episodes for home health services or several months for hospice care.

Effective documentation and monitoring has never been so critical. Ensure your staff understands how to document right the first time, and make sure you have processes in place to prevent problems before they become pervasive. Click here for more information.

TCG can help you avoid a cycle of denials and appeals. We can provide clinical documentation experts to help you conduct one-time or recurring third-party reviews and/or test your processes.

  • Clinical and Billing Record Reviews
  • OASIS, diagnosis coding and HHRG integrity for Medicare home health PPS
  • Hospice LCD and Eligibility
  • Pre-billing Reviews
  • Documentation Training
  • Process Design and Training

Check out TCG’s self-help resources:

About the Author

William C. Musick, BS, MBA, CHC

Mr. Musick is a Senior Associate and Project Manager with The Corridor Group and has over 20 years of experience in health care operations management, financial and systems analysis and project management. He is a licensed consultant with the Standards for Excellence Institute and is also certified by the Compliance Certification Board in Healthcare Compliance (CHC). Bill is an expert in feasibility analysis for the development of hospice and end-of-life care services, facility planning and development, strategic planning and financial risk/benefit analysis. He also works with chief executives and boards of directors to achieve new levels of effectiveness in the governance of public benefit organizations. Bill has a special interest in supporting home health and hospice providers develop and sustain a culture of compliance.

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