Legal, Regulatory & Risk Management Educational Sessions

Legal, Regulatory & Risk Management, Hospice

Hiring Practices: Safely Navigating the Immigration Laws

Workforce shortages in health care have lead to increased use of foreign staff. Nurses from the Philippines, Ireland, and other far off locations have been a significant resource to the home care community. Personal care service providers may be tempted to hire low cost caregivers. This program provides the essential knowledge to safely navigate the complex rules when hiring immigrants.

Objectives:

• Identify federal laws applicable to hiring immigrant workers.
• Explain standards to follow when hiring a foreign worker with a proper visa.
• Discuss the consequences of hiring an illegal immigrant .

Faculty: TBD ;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Legal, Regulatory & Risk Management, Hospice

Staying Alive: Avoiding Risks of Fraud & Abuse

Home Care and Hospice present unique opportunities to improve the lives of the elderly and disabled. They also are opportunities for unethical and illegal conduct designed to secure great wealth. In between are the complex myriad of rules and regulations requiring constant attention to achieve compliance. This program focuses on today's risk areas for fraud and abuse in Medicare, Medicaid, and other government funded programs with real life experiences and helpful recommendations on how to stay alive through an open-eyed approach to compliance.

Objectives:

• Identify federal and state laws addressing fraudulent or abusive conduct in health care.
• Recognize current home care and hospice activities that are subject to oversight and prosecution.
• Explain actions that aid in the prevention of unintentional non-compliant conduct.

Faculty: William A. Dombi, Esq., Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington, DC; Denise Bonn, JD, Deputy Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington, DC;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Hospice, Legal, Regulatory & Risk Management

Strategic Electronic Methods to Meet Hospice Conditions of Participation

The Proposed Conditions of Participation (CoPs) for hospices were announced by the Centers for Medicare & Medicaid Services in 2005. The Hospice CoPs ensure that hospice patients receive high quality of care during the dying process. The goal of this presentation is to help the hospice community understand what the new CoPs include and how an electronic medical record can help agencies meet the CoPs.

Objectives:

• Describe an overview of the proposed CoPs and how it will affect agencies.
• Discuss how an electronic system can help hospices meet the CoP's.
• Identify methods for implementing an electronic system in the hospice setting.

Faculty: Sarah D'Orvilliers, Senior Solutions Designer, Cerner BeyondNow, Overland Park, KS; Catherine J. Boyne, President, Hospice of Baltimore, Baltimore, MD;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending);

Private Pay, Legal, Regulatory & Risk Management

Risk Management for Private Pay Home Care Agencies

The home care industry has had a honeymoon period with regard to legal liability. The party now seems to be coming to an end. Agencies are under increasing fire from patients and their families. Key areas of risk include theft by agency employees, non-compliant patients, and caregivers, abuse of patients by caregivers, liability for abandonment when agencies must discontinue services to patients, and admitting and continuing services to patients who are not appropriate for home care. The purpose of this presentation is to identify potential areas of risk for private pay agencies and to provide practical strategies for managing these risks.

Objectives:

• Identify three key areas of potential risk for home care providers.
• Describe four requirements of proof of negligence; three (3) requirements of proof of abandonment.
• Describe three practical strategies for managing risks of liability in home care.

Faculty: Elizabeth E. Hogue, Esq., Burtonsville, MD;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending);

Financial, Legal, Regulatory & Risk Management, Hospice

Fraud Detection, Deterrence, and Prevention: Are You Really Doing Enough?

Post-Sarbanes/Oxley, most financial executives are keenly aware of the risks of fraud. But are they doing enough to actually prevent it? Learn how to mitigate the likelihood of fraud in your organization to prevent loss of shareholder value, reduce reputation risks, and personal liability.

Objectives:

• Discuss fraud control strategies that mirror the COSO framework and create a culture of fraud awareness.
• Identify fraud risk assessments that encompass activities at the entity and process levels.
• Describe methods for mitigating fraud risk, including tools and processes for monitoring and responding to potential occurrences of fraud, and effective use of internal audit.

Faculty: Jeffrey G Blumengold, FHFMA, CPA, Partner and Leader, Health Care Forensic & Dispute Services, Deloitte Financial Advisory Services, LLP, New York, NY; Bruce J. Gavioli, Jr., Partner, Deloitte Financial Advisory Services LLP, New York, NY; Stephen G. Curry, Jr., Partner, Deloitte & Touche LLP, New York, NY;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Hospice, Legal, Regulatory & Risk Management

Enhance Hospice Care While Preparing for the New COPs

With the new Hospice Conditions of Participation (COPs), America's hospices now confront a need for better information about all phases of their operations, including costs, service utilization, clinical aspects of care and outcomes. Evaluating the outcomes of the domains of self-determination, comfort, safety, and effective grieving is simplified using systematic methods of information collection and retrieval. Participants will gain insight into information required by the new COPs, how to collect the information and how to use it to enhance patient care.

Objectives:

• Discuss the continuous, integrated health care process that a patient/family experiences across all aspects of hospice care.
• Incorporate outcome-oriented quality assessment and performance improvement.
• Facilitate flexibility in how the hospice meets performance expectations.

Faculty: Teresa Craig, CPA, CEO, Suncoast Solutions, Largo, FL; Betty Oldanie, RN, Vice President of Planning, The Hospice of the Florida Suncoast, Clearwater, FL;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Legal, Regulatory & Risk Management, Management & Human Resources, Hospice

Employment Law Update 2006: Understanding Unions, Employment Discrimination, and Federal Wage and Hour Laws

Health care is viewed as one of the most fertile areas for unionization. It also is an area that requires ongoing attention to the various federal laws that impact on hiring, firing, and compensation. This program explores the forces that drive unionization and the laws that regulate collective bargaining-the rights and responsibilities of employees and management. In addition, the workshop will cover developments in federal employment law under the Fair Labor Standards Act, the Age Discrimination in Employment Act, the Family Medical Leave Act, the Americans with Disabilities Act, and Title VII of the Civil Rights Act. Essential information for all employers is offered.

Objectives:

• Identify recent developments in employment discrimination law.
• Recognize home care-specific concerns in employee compensation under the Fair Labor Standards Act.
• Identify basic rights and responsibilities of management and labor with respect to unionization under the National Labor Relations Act.

Faculty: Joseph Maddaloni, Esq., MPA, Partner, Porzio, Bromberg & Newman, PC, Morristown, NJ; John Buck, Executive Director, Visiting Homemaker Service of Hudson County, Jersey City, NJ;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Quality & Outcomes, Legal, Regulatory & Risk Management

Bad Ideas for OASIS Accuracy

This session will highlight a number of strategies and practices that some agencies have implemented in efforts to improve OASIS data accuracy. In some cases, these practices to "improve accuracy" are in fact inefficient and counterproductive, and in some cases down-right noncompliant. Attendees will be introduced to a model to analyze OASIS data collection practices for effectiveness and compliance. A review of current problematic industry practices will be exposed and resolved.

Objectives:

• Identify examples of operational strategies and practices that may unintentionally have unfavorable effects on OASIS data accuracy.
• Identify opportunities and strategies to improve OASIS accuracy and compliance.
• Describe a process for critically evaluating data accuracy efforts for effectiveness and compliance.

Faculty: Linda Krulish, PT, MHS, COS-C, President, OASIS Answers, Inc., Redmond, WA; Patricia Sevast, BSN, RN, Nurse Consultant, Centers for Medicare & Medicaid Services, Baltimore, MD;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending);

Emergency & Pandemic Preparedness, Legal, Regulatory & Risk Management, Hospice

Maintaining the Lifeline: An Employer's Legal Guide to Worker Protections and Exposure

Risks of exposure to biological agents and other harmful substances must be guarded against at all times; the threat could increase substantially when caregivers are part of disaster recovery or pandemic treatment efforts. This workshop will provide clear guidance on a home care and hospice organization's obligations and options for maintaining optimum health and safety for these important workers.

Objectives:

• Define an employer's obligations relative to worker protections in the home and other care settings.
• Outline potential employer educational efforts to limit harmful exposure of workers.
• Identify various items of equipment that must/should/could be made available to increase worker protections against harmful agents.

Faculty: William A. Dombi, Esq., Director, Center for Health Care Law, National Association for Home Care & Hospice, Washington, DC;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Legal, Regulatory & Risk Management, Clinical & Disease Management, Hospice

Blueprint for Successful Compliance Planning: Legal and Clinical Aspects

Successful compliance planning must include an analysis of the applicable state and federal laws relating to today's health care industry. This presentation will address fraud and abuse, anti-kickback, and Stark laws. In addition, developing a compliance plan that invokes the protections awarded under the attorney-client privilege will be discussed. Finally, strategies will be analyzed on how to minimize risk once a problem is detected.

Objectives:

• Describe three components of an effective compliance plan relative to home care practice.
• Discuss three federal statutes that govern fraud and abuse in the health care industry.
• State three methods of monitoring and auditing to ensure effective compliance with fraud and abuse regulations.

Faculty: Katherine Karker-Jennings, Esq., Attorney at Law, Katherine Karker-Jennings, PA, Clarksville, MD; Glenda Burke, RN BS, Chief Financial Officer, Alternatives, A Consulting and Education Service, Panama City, FL;

Course Level: Advanced; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Legal, Regulatory & Risk Management, Clinical & Disease Management, Hospice

Meeting the Cultural and Linguistic Needs of a Diverse Patient Population

According to the Institute of Medicine (Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, 2002), cultural and linguistic minority populations do not achieve the same health outcomes as the majority population. This is a major ethical concern, that raises legal, regulatory, risk management, and business issues for all health care organizations, including home health care agencies. This presentation will describe the relationship of CLAS Standards and LEP requirements to quality care and good outcomes, will present strategies that participants can use to meet these standards and requirements at their agencies, and will discuss the relationship of CLAS Standards and LEP requirements to JCAHO standards.

Objectives:

• Describe the relationship of the CLAS Standards and LEP requirements to quality care and good outcomes.
• Incorporate strategies for meeting CLAS Standards and LEP requirements at his/her agency.
• Discuss the relationship of CLAS Standards and LEP requirements to JCAHO standards.

Faculty: Mary Narayan, MSSN, RN, CS, CTN , Education Consultant , Visiting Nurse Service Network , Vienna , VA;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending);

Hospice, Legal, Regulatory & Risk Management

The New Medicare Appeals Process & Strategies for Success

The presentation will address the significant highlights of the new Medicare regulations impacting the appeals process for Medicare hospice providers. The presentation will also address successful past appeal strategies and how these and other approaches can be utilized under the new appeals process.

Objectives:

• Describe the new Medicare appeals process.
• Identify successful appeal strategies for third party payer audits to be used under the new process.
• Discusscompliance strategies to avoid third party payer audits.

Faculty: Andrew Wachler, Esq., Principal, Wachler & Associates, P.C., Royal Oak, MI; Marilyn Brady, RN, Director of Clinical Support Services, Hospice of Michigan, Detroit, MI;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Hospice, Legal, Regulatory & Risk Management

Medicare Hospice Benefit Conditions of Participation: Whats New?

The Hospice Conditions of Participation (CoPs) have not been rewritten since the beginning of the Medicare Hospice Benefit in 1983. The proposed CoP were printed in the Federal Register at the end of May with comments accepted by the end of July 2005. The final CoPs are not likely to be released until the fall of 2007 and must publish by May 27, 2008. It is important for all hospices to prepare their operations to meet what are likely to be the new regulatory requirements. To help hospices understand the proposed changes, the National Association for Home Care & Hospice (NAHC) has asked the Centers for Medicare & Medicaid Services (CMS) staffers responsible for rewriting the CoPs to do a presentation and discuss as much as possible the trends and findings in compiling the comments that were received, as well as the current status of the final conditions as they move through the regulatory process. This session will review the proposed changes and compare them with the current regulations.

Objectives:

• Identify differences between the old and new CoPs.
• Discuss the impact of the new CoPs on hospice operations.
• Identify status of new CoPs.

Faculty: Mary Rossi-Coajou, MS, RN, Health Program Evaluations Officer, Office of Clinical Standards and Quality, CMS, Baltimore, MD; Danielle Shearer, Health Insurance Specialist, Office of Clinical Standards and Quality, CMS, Baltimore, MD;

Course Level: Intermediate; 1.8 nursing CEs (MNA Approval Pending); 1.0 CPEs (NASBA/SKA);

Legal, Regulatory & Risk Management

United Government Services (UGS): Meet Your Medicare Regional Home Health Intermediary

United Government Services will host an informative session to provide an update on the latest Medicare information for home health and hospice providers. This is a wonderful opportunity for providers to present their questions and concerns directly to the intermediary.

Objectives:

Faculty: RHHI Staff ;

Course Level: Not Applicable;

Legal, Regulatory & Risk Management

Palmetto GBA: Meet Your Medicare Regional Home Health Intermediary

Palmetto GBA will host an informative session to provide an update on the latest Medicare information for home health and hospice providers. This is a wonderful opportunity for providers to present their questions and concerns directly to the intermediary.

Objectives:

Faculty: RHHI Staff ;

Course Level: Not Applicable;

Legal, Regulatory & Risk Management

CAHABA GBA: Meet Your Medicare Regional Home Health Intermediary

CAHABA GBA will host an informative session to provide an update on the latest Medicare information for home health and hospice providers. This is a wonderful opportunity for providers to present their questions and concerns directly to the intermediary.

Objectives:

Faculty: RHHI Staff ;

Course Level: Not Applicable;

Legal, Regulatory & Risk Management

Associated Hospital Services: Meet Your Medicare Regional Home Health Intermediary

Associated Hospital Services will host an informative session to provide an update on the latest Medicare information for home health and hospice providers. This is a wonderful opportunity for providers to present their questions and concerns directly to the intermediary.

Objectives:

Faculty: RHHI Staff ;

Course Level: Not Applicable;