fall 2010 urveyor - achc fall 2010.pdf · payers: view the specialty market from a perspective of...

Surveyor

ACHC is an Exclusive Sponsor at NAHC!

ACHC is proud to be the exclusive sponsor of the hospice education track at NAHC’s annual meeting October 2-6 2010. Please join us at booth #415 as we celebrate our upcoming anniversary of CMS Deeming Authority for Hospice and show support for the industry.

Sur veyor Fal l 2010 1

501(c)(3) Non-Profit Organization Volume 20, No. 2 CMS Deeming Authority for:An ISO 9001:2008 Certified Company Home Health, Hospice & DMEPOS

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INSIDE: Specialty pharmacy industry review: “The need for accreditation grows!” | Page 2

Quality Connection | Page 3

Spotlight on Provider: Loma Linda University Medical Center Home Care Services | Page 9

What People Are Saying About ACHC | 3

ACHC Congratulates Its Newest Accredited Locations | Page 14

A Closer look at ACHC Account ManagersWhat do ACHC Account Managers do and why do their customers appreciate them so much? The answer is simple: they work everyday with their customers to help ensure accreditation success. Just take a look at our customer testimonials for proof.

“Our Account Manager did a remarkable job of answering our questions, walking us through the process and assuring us that we could be successful. Indeed we were!” Hemophilia of Georgia, Inc.

When an organization registers to download ACHC accreditation standards, they are assigned a dedicated Account Manager, even though the organization is under no obligation to pursue accreditation with ACHC. The Account Manager will be ready and available to help with the entire process from start to finish.

The following are a few of the many ways ACHC Account Managers help ensure accreditation success.

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®

Glory Goes to the Best: Using Accredita-tion as a Home Care Marketing ToolMerrily Orsini, MSSWHome health care has become an overcrowded marketplace. Ten years ago, you might have been one of three agencies in your area; today you are more likely one of ten, or maybe even more. With Medicare reimbursements threatening to be cut, making sure you are getting and keeping clients is crucial. So how do you push your agency ahead of the home care pack?

One way is to use accreditation as a marketing differentiator. Put yourself in the consumer’s position: in this case, the adult children who influence the decision about home care. They might be referred to each of the ten agencies in the area near their ill parent. The service lists appear the same, the caregiver selection process is the same and the brochures even look similar. If one of those agencies were accredited, your client has a basis for selection. Today’s home health care space is survival of the

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Visit us Online!

ACHC OffersAccreditation For:•Home Health•Hospice•DMEPOS•Pharmacy•Private Duty•Sleep Lab/ Center•Behavioral Health (coming soon)

ACHC is pleased to announce the release of updated standards for Specialty Pharmacy. The reorganization of ACHC standards meets or exceeds other specialty accreditation organization’s requirements, eliminating the need for multiple accreditations for pharmacy and managed care providers. ACHC was one of the first accreditors to offer disease management Specialty Pharmacy Accreditation. Please contact your Account Manager or Tim Safley at [email protected] or 919-785-1214 ext. 235 for more information.

Editor-in-Chief

Deric Rutledge Marketing Communications [email protected]

Managing Editor, Designer/Layout Artist

Tracy HinmanMarketing & Graphic Design [email protected]

Managing Editor

Stacey HahnMarketing Event [email protected]

ACHC Board Officers

Dick Wetherell – ChairVice President for Quality, Telefl ex Medical, Inc.

Chris Clasen, BS, RRT, RCP – Vice ChairDirector of Respiratory Care, Blue RidgeHealth Care Center

Denise Fletcher, Esq. – SecretaryBoard Certifi ed Health Law, Texas Board ofLegal Specialization, Brown & Fortunato

Rick Ferris – TreasurerDirector of Operations, Drug Crafters

Gibbie Harris, MSPH, FNPAssistant TreasurerBuncombe County Health Director, Buncombe County Health Center

ACHC Board Members

John BarrettSenior Consultant, Quality Systems Engineering

Floyd Boyer, RRT, RCPExecutive Director, NC Respiratory Care Board

Richard Bulich, Pharm. DIndependent Pharmacy Consultant

Barbara Stover Gingerich, RN MSFACHE, CHCEPresident, Advantage Consultants, Inc.

Barbara RosenblumFounder & CEO, Strategic Health Care Programs

Tom TuckerVice President Sales & Marketing, AttentusMedical Sales, Inc.

Susan Niewenhous, Ph.D, RN, CHCE, COS-CPresident, Niew Solutions, Inc.

Marshelle Thobaben, RN, MS, PHN, APNP, FNPProfessor, Humbolt State University

Denise LippyVice President Systems Operations, Proton Therapy Center-Houston, Ltd.

Matthew WhittingtonBrigadier General, USAR (Retired)

2 Sur veyor Fal l 2010

Mission: To educate health care providers through relevant, industry/program specific standards and surveys

that lead to successful business practices and improved patient services.

Vision: Accreditation Commission for Health Care will be the accreditation organization of choice that

inspires excellence in health care.

Values: Integrity, relevance, innovation, enhancing outcomes, excellence in all things, flexibility without

compromising quality, concern for the entire health care continuum

ACHC Announces Updated Specialty Pharmacy Standards

Feedback & Suggestions? We are constantly listening to providers, and have been since 1986. We're open to any suggestions, questions or comments that you have about our company, our services to you, our policies or anything that can help us improve. We invite you to visit ACHC.org, click on Feedback/Suggestions and let us know what you think!

The specialty pharmacy industry continues to grow in size and scope and it is estimated that specialty products account for over 20% of the total US pharmaceutical market. The term “specialty pharmacy” is used to describe a very broad sector of drugs used to treat both chronic and acute illnesses that are characterized by high cost ($5,000 to $250,000 per year of treatment), mostly biologics, require special handling and patient monitoring, and can be infused, self injected or oral products. The term “specialty pharmacy” however is broadly used and is often interpreted differently by payers, drug manufacturers, pharmacy providers and most certainly confusing to the end user or patient.

Payers: view the specialty market from a perspective of spiraling costs and are trying to contain these escalating costs with formulary restrictions, utilization controls and higher patient co-payments. Many payers are rapidly switching many high cost specialty drugs from the medical benefit to the pharmacy benefit to gain tighter controls.

Drug Manufacturers: are focusing research and development toward “biologic pharmaceuticals”, as demonstrated by a robust biologic drug pipeline. Over 250 biologic drugs are in various stages of the US FDA approval process, and it is expected that many of these products will gain approval over the next 3 to 5 years.

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Specialty pharmacy industry review: “The need for accreditation grows!”Richard Bulich, Pharm. D., ACHC Board Member, Independent Pharmacy Consultant

ACHC has continued to participate within the community.

Back to School with Pride Project- Currently, the project we’re concentrating on is the “Back to School with Pride Project” sponsored by The Friends of the Guardian ad Litem Program. By donating backpacks filled with school su pplies, ACHC is working toward ensuring that children are ready to start school with the supplies that they need to succeed.

KaBoom!- Since there was such a large response from our last playground build, we decided to help build another one with KaBoom!, a national non-profit that creates playspaces within communities.

Susan G. Komen Race for the Cure- Many staff members also participated in the Susan G. Komen Race for the Cure and helped raise money to save lives, empower people, ensure quality care for all and energize science to find the cures.

Adopt a US Soldier (AAUSS)- Working with AAUSS, ACHC has adopted a Solider. This program allows us to offer our deployed soldier friendship, support, needed supplies and certain goodies.

We look forward to continuing our volunteer efforts within our community. If you have a cause you care about please let us know!


CCQualityonnection

Tom Cesar, PresidentACHC has provided patient-centered, relevant and clearly written accreditation standards since 1986. Our standards have required utilization of evidence-based health care along

with documented and demonstrated quality improvement activities for business operations and clinical practices.

It is our belief that accountability of health care leaders is required as never before. Initiating strategies for quality programs and products through use of ACHC standards help our customers develop and improve their own key processes and protocols.

ACHC holds itself to the same high standard of outside peer review as its own customers. We have continued to maintain ISO 9001:2008 certification since 2004 when we became the first health care accrediting body in the world to receive this international distinction.

In 2007, ACHC was named one of the fastest growing private companies in America on the Inc. 5000 list. According to Inc. Magazine, companies on this list represent the backbone of the U.S. economy.

Additionally, in 2009 ACHC received the North Carolina Awards for Excellence Commitment (Level 2) Award. This milestone marks the first step toward applying for the Malcolm Baldrige National Quality Award.

In order to compete in today’s accelerating industry, organizations must be driven to achieve competitive objectives and improve health care services for the persons that you serve. Partnering with ACHC will give you the resources to successfully manage and compete in today’s health care world.

ACHC IN THE Community

"Volunteers don't get paid, not because

they're worthless, but because they're priceless".

~Sherry Anderson

2009 Private Duty Home Care Benchmarking and

State of the Industry Report

ACHC is a proud sponsor of the Private Duty Home Care Benchmarking and State of the Industry report. This report includes information such as industry benchmarks, industry best practices, accreditation, and more. Order your copy today at:http://www.privatedutytoday.com/benchmarks/index.htm


Every industry has its “unsung heroes”; those key hands-on employees that are essential to daily operations and hold the hearts of our customers.

When I was a young graduate nurse working at a large metropolitan hospital, the unsung heroes were the Unit Secretaries. The doctors relied on them to solve mysteries like: where misplaced charts could be hiding, how to order multiple labs or how to retrieve a surgical report off the computer. Patients were relieved when the Unit Secretaries promptly answered their call-lights, could locate their nurses and ordered late meals for them. In those days, we didn’t have HIPAA laws that dictated who the Unit Secretaries could talk to. Families would call them all evening questioning if their loved ones were back from surgery or sleeping soundly for the night. They knew it all and did it all.

A decade later, I entered the home health arena. Immediately, I discovered that the unsung heroes were the Home Health Aides. Sure, the patients had favorite nurses, but the treatment their primary nurse did could be performed by any nurse. The relationship they developed with their Aide was sacred. There is

a revered bond developed when one person works so intimately with another. Frequently patients would make sure they knew in advance when their Aides were planning vacations. They would ask family members that lived across the country to take vacations at the same time to care for them while their aides were gone. It was traumatic for them to be without their Home Health Aides. I watched the Aides dote over their patients; a mutual admiration existed.

In the accreditation business, the unsung heroes are the Account Managers. If you are currently accredited by ACHC (or any other accrediting organization), you understand exactly why. This summer we received a letter from the owner of a DME company.

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Unsung HeroesBarb Sylvester, VP of Clinical Compliance and Accreditation "There is a revered bond

developed when one person works so intimately

with another."

Barb SylvesterVP of Clinical Compliance and Accreditation ACHC is pleased to announce Barbara Sylvester as the VP of Clinical Compliance and Accreditation. Barb joined ACHC in June of 2010. She has over thirty years of nursing experience, including 19 years working in home health and hospice. Her areas of

expertise are in quality and compliance activities, performance improvement initiatives and accreditation for home health,

hospice, DME and infusion pharmacy. She has provided leadership in clinical ethics on an agency and corporate level and taught principles of parish nursing ethics at Marquette University in Milwaukee, WI. She has researched, designed, managed and measured effectiveness of several nontraditional home care programs. She has written a historical book and authored several articles for professional journals, including a research study on staff safety in the home care arena.

Barb received her BBA and MSOLQ from Marian University in Fond du Lac, WI. Having recently moved to Raleigh, NC, she and her husband are enjoying exploring the area, getting acquainted with southern cuisine, experiencing the local hospitality and visiting historical sites.

Britt WelchBehavioral Health Clinical ManagerBritt began his career with ACHC in 2009 as the Behavioral Health Manager. His focus is on the development, implementation and oversight of ACHC’s Behavioral Health Accreditation Program. He has over twenty years experience in the behavioral health field, providing individual therapy,

psychological testing, treatment planning, and case management.

He also worked with the Quality Improvement and Contracts / Administration Branches of the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services. He has also served as the Director of Business Development and Marketing, and as the State Director of Operations, for a multi-state, behavioral health care company, providing services to persons challenged with developmental disabilities, mental illness, and/or substance abuse issues.

Britt received his Bachelors degree from Louisiana State University and Master of Science in Counseling Psychology from the University of Southern Mississippi. Britt and his wife enjoy participating in activities at church, playing golf, fishing, watching college athletics (especially LSU sports), reading, exercise, and working in the yard.

ACHC Welcomes:


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He did more than offer a compliment about his Account Manager. He wrote us a “personal story” about the struggles his company and his employees had endured. This CEO grappled with his ability to maintain accreditation with ACHC even though this had been a great source of pride for him. He conversed with his ACHC Account Manager. The information she provided was essential, but it was her sincere empathy and wholehearted encouragement that sealed his decision to stay with ACHC rather than switching to a less stringent accreditor.

The Account Managers relay important information to customers. Sometimes they are detailed and serious. Other times they are laughing or cheerfully congratulating customers. They diplomatically de-escalate conversations when providers have significant deficiencies. The team diligently processes paperwork, schedules surveys and summarizes survey findings. Most

importantly, it is the Account Managers that are the voice of ACHC to the public.

There is no way to adequately affirm the Unit Secretaries (now renamed Health Unit Coordinators), Home Health Aides, Account Managers and countless other industry heroes. It is with deep appreciation and sincerity that I write this column. Thank you for representing your organizations. Your humble approach is noble and inspiring.

I don’t often get the opportunity to speak directly with our ACHC customers. I am proud to provide you with something better…the privilege to work with our Account Managers. Through their expertise and conscientious efforts, I know that you are getting outstanding service from the best unsung heroes in the business.

Fee estimates- ACHC Account Managers are trained to evaluate accreditation fees on an individual basis so that they can ensure every organization will receive the best pricing option available. ACHC does not use automatic pricing quotes because an Account Manager who knows the organization can often find creative ways to reduce their total costs.

Answer questions- ACHC Account Managers spend plenty of time everyday answering questions from their customers on the phone and via e-mail. This one-on-one, personal communication with a dedicated person is greatly appreciated by ACHC customers.

“Our Account Manager was wonderful. I can not say enough about the value of her assistance throughout this reaccreditation process. She was always available to answer any questions or concerns we had and always wanted to make sure we understood the process”. MiniMed Distribution Corporation

Clinical support & expertise- ACHC Account Managers are very knowledgeable about the accreditation process. However, if they don’t know the answer to your question they have access to

clinical experts and other resources to ensure they have the most timely and accurate answers for even the most difficult questions their customers ask.

Guidance, coaching & support- ACHC was founded by a small group of home care providers in North Carolina 25 years ago as an alternate choice for accreditation. The philosophy then was, “By Providers for Providers,” to ensure a supportive and collaborative process. ACHC Account Managers still adhere to that philosophy today. They understand that it can be intimidating to prepare for an on-site inspection of everything a company does. Their customers occasionally need some reassurance that they are on the right track. ACHC Account Managers do everything they can to provide guidance and support in an understanding, caring way.

“On a scale of 1 to 10, I would give her a 10+. She was very sweet, nice and professional to us. I really appreciated how much she was able to comfort us when we were worried about things.” Covenant Home Health Care

These are just a few of the things that ACHC Account Managers do for their customers everyday to ensure their accreditation success. If you have not already experienced the difference a personal Account Manager can make, we invite you to download ACHC’s free accreditation standards at www.achc.org today. When you have a question, simply give us a call and ask to speak to your personal Account Manager to experience the ACHC difference for yourself.

A Closer look at ACHC Account Managerscontinued from page 1

Sheryl Johnson Home Health & Hospice Corporate SurveyorSheryl has been a surveyor with ACHC since February, 2010. She grew up in the suburbs of Philadelphia. She earned her BSN and MSN from Bloomsburg University, Bloomsburg, PA and lived there for 22 years raising her daughter, Chelsea.

Prior to becoming a surveyor, Sheryl was the director of an agency that provided home health, hospice, and private duty care. When she took the job as director, her agency was non-profit hospital based. It was bought out and became for-profit, free-standing, and relocated, so she definitely knows how to survive change! Her nursing career has allowed her to work in a variety of health care settings, including, case management, ER, and medical/surgical. She worked as the Director of Patient Services for the state of Pennsylvania, with the American Cancer Society for eight years and was a home

health supervisor for ten years. Throughout her career, she has tried to challenge herself, learn as much as she can, and enjoys the people she meets. ACHC has provided her an opportunity to grow professionally, meet a variety of people, and learn about many cultures. She gets excited about every agency she is going to survey and hopes they learn from her as she learns from them. She recently moved from PA to Hollywood, Florida where she lives with her boyfriend and her chocolate lab, Mousse. In her free time, she enjoys snow skiing and anything outdoors.

MEET YOUR Surveyor


Susan Thorn Home Health & Hospice Corporate SurveyorSusan began her nursing career in 1981 and has been in Home Health and Hospice for 15 years and in Ambulatory Care/Community Nursing for 10 years. Her passion is sparked whenever she is provided the opportunity to participate with others in being champions for improvements

in the industry as it relates to the delivery of health care and resulting outcomes. In any spare time, she seeks opportunities to be involved in health care at various state and regulatory levels. She is a Registered Nurse and earned her Bachelor of Science in Nursing, and Legal Nurse Consultant Certificate from the University of Central Florida. Susan lives in Northern California and her interests are spending time with her family and a lifestyle of health and wellness. She loves to exercise and share the knowledge and benefits with others. Susan loves to travel, enjoys meeting new people, and as a life long learner by nature, there is never enough time to read!

Q.Q. What is the most common deficiency that you see?

A. A. I would say, especially with new agencies, it is in their personnel files. Agencies are checking patient charts for documentation, visit frequency, and supervisory visits but forget to audit personnel files to make sure required information such as performance evaluations, TB tests, etc. are current.


Want to be an ACHC Surveyor? We are currently recruiting Pharmacists to be surveyors. New surveyor training is scheduled on an as-needed basis. If you would like to become an ACHC Surveyor, please send your resume & letter of interest to the e-mail or postal address below. We will notify all qualified candidates as soon as the next training is scheduled.

Accreditation Commission for Health Care, Inc.4700 Falls of Neuse Rd., Suite 280Raleigh, NC [email protected]: 919.785.1214 | Fax: 919.785.3011

Q.Q. Which areas should I focus on for Quality and Performance Improvement?

A. A. 1. Let your data drive your activity. We so often fall into the trap of collecting data without the follow through. Choose areas that are high risk, meaning your patients could experience significant negative outcomes, and high volume, meaning you often provide a service that may be affected by this.

2. The second step is to do a thorough analysis of the data. If you don’t determine the root cause, you will not find successful outcomes- your arrow is sure to miss the mark.

3. Third and last, and the part I find to often be the weakest, is in the ownership and education of the staff.

ASK YOUR SurveyorHere at ACHC, we receive many questions from our customers. Is there anything that you've been wanting to ask your Surveyor? Now is your chance! Please send your questions to [email protected]. If your question is chosen, the two featured surveyors in the issue will share with you their knowledge, expertise and answers.

ASK Sheryl Johnson

ASK Susan Thorn

This will be your key to success. If you contain all of the information to leadership and don't share it with the rest of your staff, your efforts will be lost. The success you find will be in the sharing of the process with your front line providers, in clear and measurable goals and outcomes for your staff, and in the edu-cation of the clients you serve.


fittest, and flexing your marketing muscle with accreditation is an effective strategy.

Accreditation is a great advantage for your agency, but to maximize your competitive edge, your potential client has to be informed. Make sure your agency touts its accreditation at every opportunity so that your potential client knows how you stand out. Here are some ways to use this powerful endorsement in your marketing arsenal:

Shout it from the rooftops – When you receive your accreditation, tell everyone. Send a letter to current clients and anyone on your contact list. Create a press release for publication in your local business newspaper. Don’t forget your referral sources; send them a letter as well. Make sure to explain in this communication how this accreditation will benefit them.

Obtain logos – All accreditation programs will provide logos which can be put into your existing marketing materials and websites. If you haven’t received them, inquire about them.

Maximize online visibility – We all know that the website is the first place many go to learn about your agency. Display your accreditation logo prominently on the home page with a short caption beneath it. Consider creating a page on your site dedicated to explaining the benefits of this accreditation to your clients and their families.

Stamp it on all printed materials – If you send out postcards, newsletters or brochures, don’t forget to include the accreditation

logo here as well. Home care collateral tends to run together visually, filled with images of caregivers and seniors. Something different, like an accreditation logo, will really stand out!

Include it in your sales presentations – Educating your community liaisons to include this endorsement in their one-on-one presentations is another way to integrate accreditation as a differentiator to your discriminating customers. Teach your sales people to relay these benefits to referral sources and potential clients. Additionally, they will have a reason to re-touch old leads and something new to present to their current leads.

By using accreditation as a tool in your marketing program, your agency can stand taller, speak louder and win more business!

About the author: Merrily Orsini, MSSW, is an expert home care marketer with a unique ability to pinpoint what a business should do to get the most out of a marketing effort. Orsini founded corecubed, an interactive marketing company, providing design services to clients in many stages of business development and growth. Orsini’s insights to marketing make certain that client dollars spent for strategy pay off in increased client revenues. Orsini was named Digital Entrepreneur of the Year by Louisville Magazine in 2008. Earlier in her career she was appointed a 1995 delegate to the White House Conference on Small Business, and in 1996 the National Association of Women Business Owners named her a Woman Business Owner of the Year for Kentucky. For more information, please visit www.corecubed.com.

Glory Goes to the Best: Using Accreditation as a Home Care Marketing Toolcontinued from page 1

[email protected]


As a department of a large teaching facility, we had always assumed we had no choice but to be included in the accreditation process with the same accrediting agency as the medical center. However, after several frustrating and disappointing issues arose in relation to our specific department needs that were not being met by that agency, including their very complicated, always changing and difficult to interpret standards, our executive director asked me to research if other options were available to us for accreditation.

I had no experience or knowledge of any other home care accrediting agencies when I took on the task. I quickly found out that there were only two other options available that could provide accreditation for our home health, private duty and infusion pharmacy services. I contacted both agencies and was very impressed when ACHC immediately responded, allowed me access to their standards and provided an initial cost estimate. (The other agency did not respond to my call or email for several days, and did not give me access to their standards.)

When I shared the ACHC information with my executive director, he was interested…but dubious since I could not answer the question if we could split from the medical center for accreditation purposes. The potential ramifications to both our department and the medical center were daunting. I spent several weeks researching the issues through multiple phone and email conversations with ACHC and CMS, having guarded conversations with our current accrediting agency, wading through rumors, interpretations, opinions, etc.

I could not have done it without ACHC’s help and support, directing me to other organizations in similar circumstances and providing contact information to key people. Most importantly, everyone at ACHC was wonderful during this time, putting up with all my

questions, frustrations and fears of the unknown. Whenever an issue arose and I needed help, they responded. Looming over all of these activities was our deadline to complete the new accreditation process before our current accreditation expired in less than eight months!

I finally believed I had enough information to confirm that we could be accredited separately from the medical center, and we took that information to the medical center CEO, executive director overseeing accreditation, our compliance liaison and

legal counsel. After reviewing the information, the decision was made to move forward with ACHC for the Home Care Services Department.

I am thrilled to report that we were fully accredited before our current accreditation expired. Due to the clarity of the ACHC standards and the Preliminary Evidence Report process that helped us be well prepared, we were in good shape for our survey. (I don’t deny the PER is a lot of work, but it was definitely worthwhile.) One of the best experiences of the

survey is that we felt comfortable asking questions because the surveyors kept emphasizing “best practice” opportunities. With our old accreditation surveys, we were afraid to ask questions for fear it would result in another negative finding. Some of the best practice recommendations have been incorporated into our operations, and positive results are already being realized.

After the survey was completed, other department managers asked me how I would summarize our ACHC survey. I responded that we all thought it was an enlightening and positive experience. When was the last time you could say that about your accreditation survey?

Mindy Beaumont RN, MSN Quality Improvement Coordinator Loma Linda University Home Care Services

Spotlight on ProviderLoma Linda University Home Care Services

"I could not have done it without ACHC’s help and support, directing me to other

organizations in similar circumstances and providing contact information to key people. Most importantly, everyone at ACHC was wonderful during this time, putting up with

all my questions, frustrations and fears of the unknown"


Several of the major US drug manufacturers have recently acquired smaller “biotech” drug companies to position for this rapidly emerging market. These complex biologic drug molecules are disease modifying in their action rather than just controlling disease symptoms. An example of a disease modifying class of drugs are the newer class of “biologic response modifiers” for rheumatoid arthritis, which alter the body’s immune system response to the disease; and are delaying and in some instances stopping the progression of disease. The drugs are not without side effects and require very stringent patient monitoring systems for prescribers and specialty pharmacy providers.

Specialty Pharmacy Providers: range from small local niche providers to large national specialty pharmacies. Due to the rapidly growing number of specialty biologic products, broader disease applications, as well as newer oral and self injected drug formulations, an increasing number and types of pharmacy providers are entering the specialty pharmacy market segment.

This proliferation of specialty pharmacy product distribution, especially to the retail pharmacy setting, has caused a great deal of confusion among payers, providers and patients requiring specialty pharmacy drugs. Some drug manufacturers limit the distribution of their products to specialty pharmacies meeting very strict patient dispensing, patient monitoring and data collection requirements. Many of the more recently released biologic drugs are controlled and regulated by strict FDA “REMS” (Risk Evaluation and Mitigation Strategies).(www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111350.htm). Readers can refer to FDA link for program details and list of approved REMS drugs. Many payers limit coverage and distribution of high cost specialty drugs to a very small network of specialty pharmacies or in some cases their own specialty pharmacies.

Specialty Pharmacy “specialization” is required to be an effective

and cost efficient provider of high cost, chronic or acute biologic therapies. “A pharmacy cannot just dabble in specialty pharmacy”, but rather dedicate clinical expertise, disease monitoring personnel and patient monitoring systems. Most biologic pharmaceutical drug manufacturers require sophisticated patient level data collection and reporting systems for drug contracts and in some cases even access to limited distribution drugs. Traditional dispensing and billing software systems for retail or home infusion pharmacies often lack the disease specific patient level data collection and tracking mechanisms required by specialty pharmacies. These traditional systems either need to be modified, or separate systems need to be purchased or developed.

Specialty pharmacy accreditation is gaining momentum! Payers use accreditation as a very important differentiation among providers. As more specialty pharmacies become accredited in “specialty pharmacy”, it will be more difficult for those not accredited to compete. Many specialty, home infusion and community (retail) pharmacies are seeking “specialty accreditation”, and ACHC has recently updated their standards to meet this need. As in other classes of trade, the ACHC specialty accreditation process prepares the pharmacy provider for this emerging and changing market. The ACHC accreditation process now includes standards for Risk Evaluation and Mitigation Strategies (FDA REMS) and patient level data collection and reporting systems.

Richard Bulich, Pharm. D., ACHC Board Member, Independent Pharmacy Consultant Richard has been in the home infusion and specialty pharmacy industry for 25 years. He is currently a consultant in the pharmaceutical industry, for drug manufacturers, pharmaceutical providers and payers.

Specialty pharmacy industry review: “The need for accreditation grows!”continued from page 2

Pipeline Driving Complex Market Segment Overlap

Traditional Specialty Pipeline Growth

Community Pharmacy

Oral Biologics

Mail OrderOral Biologics

Home InfusionSpecialty infusion

Therapies

Long Term Care

Chronic diseases

DMETRAIN, in cooperation with ACHC, has developed an online module to facilitate broad-based training on ISO 9001:2008 requirements. While this

information was developed for ACHC, it is now available to DMETRAIN’s customers through

its website. Look for DMETRAIN to be creating more quality assurance courses in the future. For further information about this feature, you

may contact DMETRAIN at 877-872-4633.


“Simplify the Process”

1-877-287-1894www.SolutionsForCare.net

in all aspects of operations.

Nancy Allen RN, BSN, CMC, CFormer State Surveyor, Medicare Hearing Officer and Author of

Survivor! Ten Practical Steps to Survey Survival

Preparing for Accreditation

Accreditation Start-upsMock Surveys (Accreditation, State & Federal Inspections, etc.)Representation during survey process (if desired)

Operations, Systems Analysis and on-going quality assuranceDue Diligence for AcquisitionsPlan of CorrectionsPolicy and Procedure ManualsMarketing Strategy

Consulting

Our mission is to successfully guide companies through the accreditation process, eliminate

the stress, wasted resources and compliance

Don't forget to sign up for our Educators!

ACHC sends out our Educator e-newsletters on a quarterly basis. We currently publish two Educators: The Home Health & Hospice Educator and the HME Educator

These Educators contain articles writ-ten by industry experts on topics that matter to you. Don't miss out on in-teresting and important information provided by consultants and experts in the industry.

Sign up at www.achc.org!

UPCOMINGEXHIBITIONS

Kansas Home Care Association

September 22-23, 2010 | Wichita, KS

BRPT Annual SymposiumSeptember 23-25, 2010 | Denver, CO

National Association for Home Care & HospiceOctober 2-6, 2010 | Dallas, TX

Carolinas Center for Hospice & End of Life CareOctober 3-6, 2010 | Myrtle Beach, SC

Washington State Hospice & Palliative Care Organization

October 4-5, 2010 | Lake Chelan, WA

California Hospice & Palliative Care AssociationOctober 4-6, 2010 | Las Vegas, NV

New Hampshire Hospice & Palliative Care OrganizationOctober 6, 2010 | Bedford, NH

Jersey Association of Medical Equipment ServicesOctober 6-7, 2010 | Long Branch, NJ

Alabama Hospice OrganizationOctober 11-13, 2010 | Montgomery, AL

Association for Home & Hospice CareOctober 18-19, 2010 | Atlantic Beach, NC

New York State Association of Health Care ProvidersOctober 26-29, 2010 | Uniondale, NY

Home Care Association of LouisianaNovember 2-3, 2010 | Baton Rouge, LA

Home Care Association of New York State November 3-4, 2010 | Albany, NY

Midwest Regional Conference on End of Life CareNovember 8-9, 2010 | St. Louis, MO

Medtrade FallNovember 16-18, 2010 | Atlanta, GA

Northeast Home Health Leadership SummitJanuary 19-20, 2011 | Boston, MA

Focus on Respiratory Care and Sleep ManagementMarch 24-26, 2011 | San Diego, CA

NHPCO Management and Leadership April 7-9, 2011 | National Harbor, MD


UPCOMINGWORKSHOPS

Home Health & Hospice Accreditation WorkshopHome Health- Monday Nov. 8, 2010 | 7:30 a.m.-4:30 p.m.Hospice- Tuesday, Nov. 9, 2010 | 7:30 a.m.-4:30 p.m.Hilton Garden Inn- RDU Airport, Morrisville, NC

Nita Fowler will guide you through the accreditation pro-cess, review the ACHC standards, including the crosswalkfor CMS (Medicare) Conditions of Participation and allow ample time for questions and answers

Home Health and Hospice Accreditation Workshop Sponsored by Interim HealthcareWednesday, October 13, 2010; 8:00 a.m. -4:30 p.m. Sheraton Suites- Orlando Airport, Orlando, FL

DME Workshop: Make Your Accreditation Work for YouMonday, Nov. 15, 2010 | 9:00 a.m.-1:00 p.m.Georgia World Congress Center, Atlanta, GA

This DME workshop, designed to help you prepare forACHC Accreditation, is perfect for renewing your accredita-tion or if you’re just getting started. Tim Safley willguide you through the accreditation process and also show you that accreditation isn’t just a requirement.

Please visit www.achc.org for more information, or to register for our workshops

Would you like to receive your Surveyor Newsletter, the NEW Home Health & Hospice Educator, the HME Educa-tor, press releases, workshop information, and other im-portant news from ACHC? Sign up at achc.org- simply click “E-News Sign-up”. From there you can customize the type of information you are interested in receiving. It’s quick, easy and your information stays private. Sign up TODAY!


What People are Saying about ACHCWhat People are Saying about ACHC

“I want to express that our experience with ACHC has been exceptional and the information, advice as well as guid-ance demonstrates true quality. We have worked well with all ACHC associates and desire to continue to attain true success. The survey was good and the surveyor provided good insight and performance scales to enhance the service of our program. The process was extremely thorough and well collaborated!” Hospice in the Pines; Lufkin, TX

“Very professional and provided us with the education on how to be a good home health care in the fu-ture. ACHC has an outstanding pro-cess and prepares applicants to give out the best patient care in the future. We would highly recommend it.” Nuestra Salud Our Healthcare Services LLC

“I was so glad that I have picked your company as our accrediting agency. We could not have asked for more kindness, expertise and advice from your survey-or. Thank you for the opportunity and we look forward to our next accredi-tation for Private Duty and Hospice.” St. Gregory Healthcare Services

“ACHC comes highly recommended by people with prestigious and reputable names in Home Care. My overall feeling with ACHC is comfort and reassurance. Not only because I was heard with my opinion but also because ACHC acknowledges organiza-tions that are willing to be a part of the clean, high standard. My experience with ACHC is awesome and can be described as extraor-dinary.” VWellwest,Inc.

“Our surveyor made the accreditation process a pleas-ant and learning experience. She was knowledgeable, help-ful, and instructive. During our visit, she provided valuable in-sight that will improve both our administrative process and patient care. We have been very pleased with ACHC’s accredi-tation process and your standards were an excellent and practi-cal guide. Thank you again for all your assistance in this process.” Angel Touch Home Health Care, Inc. Chicago, IL

“Everyone at ACHC has treated us with the upmost respect. They have been very professional and help-ful at all times. I would definitely recommend ACHC to all my col-leagues in the Medical community.” Rio Grande Valley D.M.E, Inc


MSP

Insight Medical Supply | HME

Jacob's DME, LLC | HME

Kids DME, Inc. | HME

L & M, Inc. | HME

Legacy Durable Medical Equipment | CRCS, HME

Los Nietos, LLC | HME

Lynncore MedGroup, Inc | HME, MSP

M.P. Healthcare Medical Supply LLC | HME

Madison Medical Supply, LLC | MSP

Maria Samudia | HME

Martha L. Arango | HME

Mediwell, Inc. | HME

Monte Cristo DME & Supplies | HME, MSP

OrthoRx, Inc. (9 branches) | HME

Oscar Benavides MDPA | HME, MSP

Patient Support Services, Inc. | HME, MSP

Pharmworks L.L.C | Fitter, HME

Pinnell Medical Center CWO LLC | HME

PM Kennemur Enterprises | HME

Professional Mobility and DME, Inc. | HME

Rehoboth Medical Supply | HME

Rosek Medical Equipment & Supply | HME

Silva, James, & Vela, Inc. | HME, MSP

Southlake Medical Supplies, Inc | HME, MSP

St. Gregory Healthcare Services LLC | HH

Step By Step DME Inc. | HME, MSP

The SCOOTER Store, Ltd. (65 branches) | HME, RTS

United Rehab Specialists, Inc. (1 branch) | Fitter, HME, MSP, RTS

Vista Home Healthcare, LLC | HH

Wheelchair & Scooter Express, LC | HME

Zion Durable Medical Equipment, LLC | HME

UTAHAffi nity Medical Group, Inc. | HME, MSP

Diabetes Specialty Center, LLC (3 branches) | Fitter, MSP

Orthopedic Services of Utah, Inc. | HME

VIRGINIA

ACT Nursing Services, Inc. | MSP, RX

Advantage Medical, Inc. | HME

BMR-2 VA, LLC | HH

Ellis Home Health Supplies, Inc. | Fitter, HME, MSP

Friendship Home Health Inc. (6 branches) | HME

Home Nursing Care, Inc | CRCS, HME

Medical House Supply Group, Inc. (1 branch) | Fitter, MSP

Nightingale Home Health Services | HH

Richmond Apothecaries, Inc. (2 branches) | MSP, RX

South Boston Manor, LLC | HME

WASHINGTONCascade Medical Supply, Inc.(2 branches) | MSP

Jensen Medical, Inc. (1 branch) | HME

Stat Medical, Inc. (6 branches) | Fitter, HME, RTS

WISCONSINAmedisys Wisconsin, L.L.C. | HH

Amedisys Wisconsin, LLC | HH

Ministry Home Care, Inc. (5 branches) | AIC, CRCS, HME, IRN, RX

WEST VIRGINIA

Choice Respiratory & Medical Equipment, Inc. (1 branch) | CRCS, HME

Health Facilities Inc. | HH

Nicholas Pharmacy, Inc. | Fitter, HME

Valley Medical Equipment, Inc. | HME

WYOMINGHome Health Care Inc. | HME

South Lincoln Hospital District | HME

West Park Hospital Home Oxygen | HME

This list consists of organizations or branches that were accredited between December 1, 2009 and May 31, 2010.

Looking for an organization in

particular? If you're looking for a particular

organization and can't find them on this list, search

for them on our website at http://achc.org/accredited_

organizations.php.

Group Discounts● AmerisourceBergen Drug Company ● D.A.B.G.● DME Train (Aspirant Education, Inc.)● EBS● Essentially Women● Grove Medical● H D Smith Wholesale Drug Company● HME Providers● Kinray, Inc.● Medline Industries● National Private Duty Association (NPDA)● ProClaim● SCMESA● VGM

Known for forging paths in home health,

hospice and private duty, our Associates are

skilled navigators of ACHC Accreditation.

Trust us to keep you on the right path.

www.bethcarpenterandassociates.com (847) 382-1035

Chart Your Path to Accreditation

4700 Falls of Neuse Road, Suite 280Raleigh, NC 27609919-785-1214 | www.achc.org

Non-Profit Org.U.S. Postage

PAIDRaleigh, NC

Permit No. 525®

ACHC Accredited Locations

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