home health performance amedisys chooses achc fall 2008.pdf · amedisys chooses achc one of the...

Walgreens-OptionCare and American Home Patient now ACHC and AeroCare Holdings renewsWalgeens-OptionCare and American Home Patient have been ac-credited by ACHC. “This accreditation demonstrates our ongoing commitment to providing the highest level of patient care and clinical excellence,” said Paul Mastrapa, President of Walgreens-OptionCare. “We’re especially proud that this national accreditation was attained with no deficiencies or recommendations.”

Walgreens-OptionCare is the second-largest home care provider in the nation with nearly 100 facilities in 35 states. Services accredited included infusion pharmacy, home health nursing, clinical respi-

Home Health Performance Improvement TrackingBy Teresa Harbour, RN, MBA, MHA Harbour Health Services, Inc.

With all of the data available for home health agencies to review, it can be a daunting task trying to track and trend this vast amount of information. Performance improvement tracking should monitor and evaluate the quality of client care, safety principles, and clinical practices. It is essential that agencies track performance information to identify any actual or potential trends so action can be taken to correct or improve performance.

Surveyor Fal l 2008 1

AMEDISYS Chooses ACHCOne of the leading providers of home health care and hospice services in the United States and Puerto Rico has achieved ACHC accreditation.(Continued on 6)

501 (C)(3) Nonprofit Organization Volume 18, No. 2 CMS Deeming Authority for:An ISO 9001:2000 Certified Company DMEPOS and Home Health (Hospice Approval Coming Soon)

F A L L 2 0 0 8

INSIDE: Improve Your Financials (Part 3 of 5): by Richard Wetherell I Page 2

Home Care Merger & Acquisitions Update: by Dexter Braff I Page 6

Common Consumer Complaints: by Leslie Knuth I Page 7

Spotlight on Provider: Maxim Healthcare I Page 10

Breaking News: Hospice & Behavioral Health I Page 16

Surveyor

Continued on page 3

Continued on page 9

Beyond Benchmarking in Home HealthIt’s Time to Get Real!By Barbara Rosenblum, Founder and CEO Strategic Healthcare Programs, LLC (SHP)

We all know that the healthcare system was one of the later industries to embrace performance bench-marking. A decade later, the smallest sector of healthcare – home health – leads in the use of next generation business intelligence tools. Instead of relying solely on traditional benchmark reports that look at what already happened, agencies have found it necessary to move to real-time tools that look at what is about to happen, so actions can be taken immediately. This new generation of reporting was born out of a combina-tion of entrepreneurship and the industry’s need to manage a highly complex set of variables that ultimately affect both payment and public report cards.

Continued on page 4

®

®

Could you improve your orga-nizations’ understanding of the strategy and direction of your

business? Would you like to improve profits and reduce costs while delight-ing your customers? Would you like to improve employee morale and reten-tion and involve your employees in achieving the business objectives? WE HAVE A SOLUTION!

In the first two articles we described how to create and live your strategy map and balanced scorecard. We discussed the first two categories of a strategy map and balanced scorecard as the financial and customer perspec-tives. It is important to remember that there are three customer perspectives which include Operational Excellence, Product Innovation and Customer Intimacy. You must execute all three perspectives to be successful; however you must select and excel at one per-spective for business success.

In looking at our process perspective, we must determine what processes drive our strategic objectives which will help identify internal performance objectives and enable us to fulfill the expectations of our customers ac-cording to market demands. The processes must drive the key at-tributes we choose in the customer

perspective. Look at the chart below and make sure your team agrees what your firm’s customer value proposition is before you begin to define the key processes.

Defining key processes can be an exhausting effort if not approached correctly. For maximum conscious-ness and easier implementation, the task of brainstorming and agreeing to the processes that drive your business should be performed by your execu-tive team. The hard work begins with mapping the critical key processes

and defining the inputs and outputs for those processes. Each process step must be mapped and steps without value should be eliminated. Typically you should have time and quality measures for each of your key pro-cesses.

There are many quality tools for use when mapping your processes. Before you begin, it is important to train your team on flow charting and the

seven simple quality tools. A tech-nique called “information mapping” is also an effective tool to document procedures you may have to write. Information mapping is generally one to two pages as opposed to the typical 10-page procedure covering the same information.

Once the 3 to 5 key processes for your business are identified, you must de-fine the learning and growth (people) attributes needed to achieve business goals and improve those key pro-cesses. First, define the type of culture you want in your business. Second, define the skills and training needed by your employees along with a system to measure their effectiveness. Third, define the type of investments in automation your key processes should focus on. Should you automate one process or multiple processes? Back in the 1980’s, GM made the mistake of automating a process without first mapping and optimizing it. The lesson here is: when poor processes which bring poor results are automated, the only achievement is attaining poor results more quickly.

As you can see, the strategy map and balanced scorecard are an excellent framework that describe the strategy of an organization across four perspec-tives (Financial, Customers, Internal Processes and Learning and Growth). They are great communication tools that bridge the gap between the goals set by senior executives and the front line team members whose perfor-mance is ultimately responsible for reaching those goals. They are mea-surement systems that report on past and future performance and assist with implementing and managing change in your organization.

By Richard M. Wetherell

Strategy ImplementationImprove your Financials and Customer Satisfaction Through Strategy Implementation. (3rd of a 5 part series)

Strategy Key attributes you must achieve for results and to define key processes

Key attributes you must maintain

Brand

Operational Excellence

Price, quality, time, selection

Service, relationships Smart shopper

Customer Intimacy

Service, Relationship building

Price, quality, time, selection

Trusted Brand

Product Leadership

Unique products and services and time and functionality/Selection

Price, quality, service, relationship

The Best new product

Defining key processes can be an exhausting effort if not approached correctly.

2 Surveyor Fal l 2008


Home Health Performance Improvement Tracking (Continued from Page 1)

Home health agencies collect per-formance information daily through satisfaction surveys, complaints, infec-tion surveillance, adverse events, and unusual occurrences. Other perfor-mance information is usually captured on a monthly or quarterly basis. This includes ethical issues, unmet service and care needs, client record reviews, performance improvement activities, and OBQM/OBQI reports.

By developing a reporting format, agencies can ensure that performance information is collected and evaluated. A quarterly reporting tool is a simple way to capture data for tracking and trending purposes. This tool can also be used to relay and report findings and resolutions to the Professional Advisory Committee and Governing Board. ACHC standards require quar-terly reporting and involvement of the agency’s Professional Advisory Com-mittee and Governing Board in the performance improvement process.

Trended information can be used to reinforce positive trends or develop corrective action plans for undesir-able trends. This sample performance tracking tool may be used to assist agencies in tracking and trending performance information.

PERFORMANCE TRACKING TOOL

Quarter: ___________

Satisfaction Surveys: Positive Responses: _____ Negative Responses: _____

Complaints: Total Complaints: _____

Types of complaints: ___________________________________________________________________

Infection Surveillance: Total Infections: _____ Client Related: _____ Employee related: _____

Types of infections: ____________________________________________________________________

Adverse Events/Unusual Occurrences:

Total Occurrences: _____ Client Related: _____ Employee Related: _____

Total Falls: _____ Balance: _____ Trip Item: _____ Transfer: _____ Wet Surface: _____ Other: ______

Total Injuries: _____ Skin Tear: _____ Bruise: _____ Laceration: _____ Sprain: _____ Back Injury: ______

MVA: _____ Equipment: _____ Suicide Threats: _____ Other: ___________________________________

Total Medication Reactions: _____ Type: _________________________________________________

Total Medication Errors: _____ Type: _________________________________________________

Total Equipment Malfunctions: _____ Total Recalls: _____

Total Treatment Alterations: _____ Discipline: _____________________________________________

Total Property Incidents: _____ Theft: _____ Damage: _____ Other: _____________________

Total Exposures: _____ Types: ____________________________________________________

Ethical Issues: _____________________________________________________________________

Unmet Service/Care Needs: ___________________________________________________________

Client Record Reviews:

Results: ______________________________________________________________________________

_____________________________________________________________________________________

PI Activities:

Indicator: ___________________________________ Benchmark: _________ Results: _____________



OBQM/OBQI: ____________________________________________----________________________

____________________________________________________________________________________

Other:_____________________________________________________________________________

Trends: ______________________________________________________________________________

_____________________________________________________________________________________

Plan of Correction: _____________________________________________________________________

_____________________________________________________________________________________

Reported to: Staff _______ PAC _______ Governing Body _______

Strategy Implementation

Home health agencies collect performance information daily through satisfaction surveys, complaints, infection sur-veillance, adverse events, and unusual occurrences.

Beyond Benchmarking in Home Health (Continued from Page 1)


Clinical Benchmarking

Home health has a multitude of opportunities for bench-marking, thanks in large part to CMS’ (Centers for Medicare and Medicaid Services) development of OASIS (Outcome Assessment Information Set), a dataset specifically de-signed to systematically measure patient outcomes. OA-SIS is the “star player” in the home health benchmarking world for Medicare and Medicaid patients receiving skilled nursing or therapy services. This data is collected on admission or resump-tion of care and at various other time points including transfer or discharge from the agency, and then submitted to the State monthly and subsequently to CMS.

The accurate completion of this highly complex and often-changing OASIS dataset has mission-critical impact on payment and outcomes. Therefore, staff competency, data validity and timely submission are all crucial to an agency’s viability:

1. Select OASIS items are used for Medicare payment;

2. State coordinators monitor OASIS validation reports looking for suspi-cious variances;

3. State surveyors use case mix profile reports and outcome reports during certification visits;

4. Consumers and referral sources can view a subset of 12 quality measures from the OASIS dataset to guide selec-tion of a quality provider;

5. Agencies use OASIS data for clinical, operational, finan-cial and performance improvement activities;

6. The OIG (US Office of the Inspector General) includes OASIS integrity and validation in its 2008 work-plan;

7. Seven OASIS outcomes are presently used in the Pay for Performance pilot

Despite all the benchmarking data available to agencies by CMS and its website, surprisingly none provide real-time or immediately actionable information, thereby limiting the usefulness of the information.

1. State by state outcome results for specific risk or perfor-mance measures are available at the CMS OASIS site, but this data is old, very old. For example, to research the “percentage of patients who improve in the ability to bathe in state by state comparisons” in July 2008, the

latest available reports are from data completed January 2007 through December 2007.

2. Home Health Compare lists the performance of agencies in 12 outcomes from both the functional and clinical OA-SIS domains. These 12 items are a subset of the 41 out-come measures and are a reflection of what happened, and what happened many months ago, in a rolling 12 month presentation and it is set in stone and published on

the CMS website! If agencies have made positive changes to improve outcomes, they will not be reflected here for 12-18 months. Consumers looking for a home health agency in July 1, 2008, will find the data at Home Health Compare for the October 2006 - September 2007 reporting period.

3. In addition, agencies are able to confidentially access, benchmark and analyze their own adverse outcomes reports, OBQI (Outcome Based Quality Improvement and OBQM (Outcome Based Quality Management Reports). This data is not current or easily retrievable. While drill-down capabilities allow agencies to determine both positive and negative patient specific out-comes, chart reviews are needed to

identify staff members associated with these.

These reports present the following challenges:

a. Is the patient chart still on site or easily retrievable for review?

b. What action can you take on data 12-18 months old?

c. How can you monitor or correct staff documentation habits this remotely retrospective?

d. How can you determine if your corrective strategies have been effective, without distinguishable data since the correction was implemented?

e. How can you reward staff for performance improve-ment not yet identified?

Financial Benchmarking

While there are many opportunities for benchmarking and improvement in the clinical and operational arenas, finan-cial success is pivotal to the agency’s viability. As shown in Chart 1, the 200 top performing agencies in 2006 were successful both clinically and financially.

However, with PPS Refinement the financial outlook is daunt-ing. From the Medicare cost reports, CMS projects increas-ing number of agencies will experience negative margins through 2013 (see Chart 2).

Operational Benchmarking

In addition to patient outcome measures, agencies are interested in operational data, and in comparing operational data among their peers and competi-tors. Obviously, this data is not usually shared among competitors but other sources are available. Some agen-cies seek publicly accessible data from state regulatory agencies, albeit, with time, research and extrapolation involved. Professional associations and large consulting agencies often sell or provide this information…but like CMS data, there is usually a generous lag in reporting.

Operational data currently used for home health benchmarking includes: average census, admissions and dis-charges and visits per discipline per month or year, number of visits per patient episode by discipline, number of epi-sodes per patient admission, percentage of LUPAS for Medi-care episodes, average case mix weight, average episode

reimbursement at start of care and at discharge, and payer mix payment, and average miles per visit. This information assists in agency performance assessments, staffing projec-tions, and the budgeting process.

As is the case with outcomes data, for operational data to be usable and actionable, it should be consistently defined, real time, interactive, and provide capabilities to drill down to patient specific and staff specific parameters, including vari-ous time ranges.

Patient Satisfaction Benchmarking

Patient satisfaction measurement, for all segments of home care, has always been valued and participation has been high. However, many home care providers still use a home grown mea-surement tool that is untested (though dearly loved by their staff) and affords no opportunity for benchmarking. Without a consistent tool that can be benchmarked, providers attempt to fix their lowest scores, and oftentimes

the results are futile. Benchmarking would have shown the provider that most in its segment of the industry suffers with the same pervasive issue, or more importantly, areas where the agency is at variance with the industry. Without bench-marking, agencies are insulated and lack insight into their own performance. You may be very comfortable knowing that 92% of your clients would recommend your agency, until you find that you fall below the 50th percentile, and your competitors boast 96% in this category.

Chart 1:

Top Performance=Higher Profits

200 Home Health agencies demonstrate that the top outcomes can and will produce higher profits. These agencies also demon-strate fewer number of visits per episode.

Year Ending 2006:

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%

10.00%

0.00%Medicare Profit

Margin (based on completed)

15.70%

18.80%

Case Mix Weight (completed episodes)

1.10%

1.11%

Visits per Episode (all disiplines)

16.10%

15.10%

Percent of Patients discharged with

goals met

16.10%

15.10%

Average for all Agencies

Top 20% in Home Health Compare

Chart 2:

% Medicare Home Health Agencies with Negative ProfitMargins – 2008-2013

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

38%

54%

64% 64% 64%

74%

2008 2009 2010 2011 2012 2013


Continued on page 17

Home Health has moved beyond traditional bench-marking. Benchmarking data through reputable data services that provide timely information helps position agencies for present and future financial success.

Home Medical Equipment. Although the delay in competitive bidding is generally beneficial to the industry, at least as of this writing, it has not spurred any significant up tick in acquisition demand. As we have stated since the Deficit Reduc-tion Act of 2006 was passed, more than anything else, the 36 month cap on oxygen reimbursement – and continued threats by congress to reduce this cap to 18 months or less – has chilled the M&A market to the extent that transaction vol-ume is down more than 70% from the peak 2004-2005 periods. That said, some deals are getting done, including some big ones – notably Teijin Limited’s acquisition of Pacific Pulmonary and The Blackstone Group’s announced acquisition of Apria. Moreover, when they are getting done, though valuations are down, they have not plummeted as much as the extraordinary reduction in demand might suggest. Ac-cordingly, opportunistic and highly strategic opportunities remain. But unless the aforementioned cap is eliminated, we do not anticipate a return to the record setting, high volume, serial acquisition activity that characterized much of the past 10 years.

Home Health Care. With more than 100 transactions completed in 2007, and 51 completed in the first 6 months of 2008, home health care has become the hottest merger and acquisition sector in the broad home

care arena. Fueled, in part, by the steadily rising stock prices of the public players in the mar-ket and investments in the industry by private equity groups looking to capitalize on this wave of enthusiasm, the demand for acquisi-tion candidates continues to rise, propping up transaction volume – and valuation. Even with changes in the prospective payment system – notably reductions in payments at-tributable to reimbursement “creep” of nearly 11% factored over the next four years – the market remains confident in the long-term prospects for the industry. As such, we antici-pate a long period of consolidation activity – and opportunity – in home health care.

Home Infusion Therapy. Al-though the home infusion therapy sector, with decidedly fewer provid-ers, cannot match the volume of the home health sector, it is neverthe-

less, one of the most attractive M&A sectors today. While the underlying econom-ics of infusion have not changed dramati-cally over the past few

years, private equity – likely drawn to (a) expanded oppor-tunities in pharmaceuticals courtesy of the Prescription Drug Bill and (b) the higher margins service oriented infusion providers can command – “discovered” the sector two years ago, fueling a buying spree that contributed to record setting trans-action volume in 2007 (25 deals). We expect this trend to continue as these consolidators continue to build size (predominately through acquisi-tions) to secure a profitable exit via a sale or public offering.

Hospice. For the hospice sec-tor, from a merger and acquisition perspective, it’s all about supply, or more accurately, the lack thereof. While acquisition demand remains

Home Care Merger and Acquisition Updateby Dexter W. Braff

In an ever-changing reimbursement, regulatory, and investment market, the fates and fortunes of home care providers with respect to merger and acquisition demand, supply, volume – and valuation – is constantly in flux.

Below is a brief roundup of the primary home care sectors, and where they stand in today’s M&A market.

Continued on page 16.6 Surveyor Fal l 2008


Among the functions handled by ACHC’s Quality Assurance staff, one which has a direct

connection with customers relates to handling complaints against our accredited organizations. While the number of complaints we receive is a relatively small percentage, ACHC would like to provide insight on the types of issues reported to us most frequently, as well as information about our compliance process.

First and foremost, accredited organi-zations must have in place and follow their own customer satisfaction and complaint resolution procedures. Therefore, with limited exceptions, our organiza-tion does not intervene in a complaint unless the client/patient first reports it to their provider to discuss and possibly resolve any issues. Once a con-sumer has exhausted that process, he or she may contact ACHC.

Our job then is to collect and review information from the parties involved to deter-mine whether a violation has occurred relating to accreditation standards or Medicare Conditions of Participation (COPs). If the issue reported does not involve a potential violation of ACHC standards or COPs, then the complaint file is documented and closed. The fact that complaints often do not meet this initial non-compliance benchmark means many providers never hear from ACHC about such issues — stated simply, no news is good news.

If, however, an initial review does in-dicate a potential violation, we con-duct an investigation through either a request for provider documents, an

unannounced site visit, or other prac-tical methods. While our policy is to maintain client/patient confidentiality (unless issues can only be verified by disclosing their name), it’s important to realize we also have guidelines to protect confidentiality of providers. So while a complaint inquiry from our office may seem intimidating, we ap-proach this process the same as any other survey. Our mission is to follow our own procedures with fairness and respect to the consumer and provider, and avoid making this exercise intimi-dating wherever possible.

Of the grievances reported to our of-fice, the largest number emanates from equipment/product providers (e.g., HME, Complex Rehab, Medical Supply Provider). The second largest number is reported from recipients of home health/aide services. When issues are categorized by type, the list below reflects the top four categories:

1. Repeated problems with equipment: the same problem recurs or different problems occur.

2. Customer dissatisfaction over wait time: for initial receipt of equipment; completion of repairs; or for other service to be provided.

3. Telephone/customer communication issues: messages are left by custom-er on voicemail but not returned by the company; customer is on hold for an excessive time period; com-pany does not return calls or provide a status update when promised.

4. Billing issues: confusion regarding billing documents and/or assign-ment of benefits; customer not clear whether equipment is purchased or rented; customer concern over rental cost compared to purchase price.

While the above are more prevalent, other reported concerns include caregivers missing scheduled appointments, patients wanting new equipment versus repeated repairs, customer prefer-ence for a different mobility device compared to what they have, improper dis-charge, etc. Some issues can certainly be helped by diligent customer com-munication and education, while others can be a chal-lenge for even top notch organizations.

Our best advice is to follow your orga-nization’s stated policies and maintain clear documentation of service issues and/or complaint logs. Regardless of whether complaint issues result in stan-dards non-compliance, you should be cognizant of the trends of your custom-ers’ most frequent complaints, as these can become prime QI indicators. As a consultant once told our staff, com-plaints are like contributions - in the long run, they really do make compa-nies better.

Are Complaints Really So Bad?by Leslie Knuth, Quality Assurance Manager

MEET YOUR Board


Barbara Rosenblum

Barbara Rosenblum founded Strate-gic Healthcare Programs in 1996, and since then has grown it to be the lead-ing real-time outcomes, benchmarking and data provider to the continuum of home care (Medicare-certified agencies, Hospice, Home Medical Equipment,

Home Infusion and Private Duty). As a healthcare visionary, Barbara identified a need in the home care industry for more efficient, effective and accurate data collection and report-ing. Her commitment to providing innovative healthcare solutions resulted in her founding SHP, and in 1997 Barbara received the National Managed Healthcare Organization’s HITS Award for her ability to use technology for the im-provement of patient care.

Barbara continues to pioneer cutting-edge performance improvement solutions, finding ways to assist the home care industry and the patients who depend on it. SHP programs interface with most home care software applications using

proprietary technology that "sweeps" data from the host system to SHP's database. Results of the data analysis are returned to the healthcare organization within minutes.

Barbara serves as a member of the National Association for Home Care and Hospice (NAHC) Financial Manager’s Association. NAHC is the largest industry trade association representing the interests and concerns of home care and hospice agencies. In this position, Barbara will be instru-mental in guiding and supporting NAHC’s goals through data mining, research and information technology initia-tives.

Barbara holds a Master of Arts in Organization Manage-ment from Antioch University and a Bachelor of Science in Nursing from California Lutheran University. She is a prolific author and speaker on a variety of healthcare topics.

The same passion and energy Barbara brings to SHP, she also brings to her other interests. In 2006, Barbara won a United States ballroom dance championship along with her partner, a former British and World Champion.

Floyd Boyer

Floyd Boyer, BS, RRT, RCP has over 35 years' experience in multiple areas of Health Care. This experience includes Adult, Pediatric and Neonatal experience at NC Baptist Hospital, Winston-Salem, NC; Moses Cone Hospital, Greensboro, NC; Baptist Medical Center, Jacksonville,

FL; and Bladen County Hospital, Elizabethtown, NC.

Floyd’s experience includes 8 years in Respiratory Care Education as an Instructor and Program director at Forsyth Technical College, Winston-Salem, NC; and as an adjunct instructor at Jacksonville Junior College, Jacksonville, FL; and Medical College of Georgia, Augusta, GA. Floyd has over 12 years' experience as Director of Hospital Respira-tory Care Departments at Moses Cone Hospital, Baptist Medical Center, and Bladen County Hospital.

Floyd's experience in Home Health Care spans over 21 years and includes Respiratory Care, HME, Rehab Technol-ogy, and Fitter Services. He has been involved extensively in state and national Respiratory Care associations and HME associations. Floyd is a member of the American Associa-tion for Respiratory Care and the North Carolina Society for Respiratory Care.

Floyd was a Board member and Chairman of the North Carolina Respiratory Care Board from July 2000 to July 2002 and currently is the Executive Director of the Board.

He has been a Surveyor for the Accreditation Commission for Health Care since 1996. Floyd is a member of ACHC’s Standards & Accreditation Review Committee and Survey Review Committee. Floyd is certified by RABQSA as a Quality Management Systems Associate Auditor.

Although he stays very busy with regulatory matters and consulting he finds time to fly airplanes and ride his Harley-Davidson motorcycle for relaxation.


ratory and durable medical equip-ment. The company is a wholly owned subsidiary of Walgreen Co. (NYSE,NASDAQ:WAG), the nation’s largest drugstore chain with fiscal 2007 sales of $53.8 billion and operates 6,204 drugstores in 49 states, the Dis-trict of Columbia and Puerto Rico.

Also recently accredited by ACHC is American Home Patient. AHP, founded in 1983, is one of the nation’s largest diversified home health providers sup-plying home medical products and services to 249 centers located across

the United States. The company serves approximately 380,000 patients annually.

The company’s extensive offerings in-clude respiratory and infusion therapy; enteral and parenteral nutrition servic-es; respiratory diagnostic equipment; patient home medical equipment and related supplies.

Also renewing accreditation is Aero-Care Holdings, Inc., a provider of respiratory and durable medical equip-ment services throughout the United States. AeroCare has 106 locations in

15 states. Services include but are not limited to: rental and sale of oxygen equipment; liquid oxygen and con-centrator systems; Liquid and oxygen refills on portable equipment; same day service for items needed for the care of the respiratory patient; monthly follow-up visits on oxygen patients to ensure compliance; and rental and sale of durable medical equipment. Aero-Care obtained its initial accreditation in March of 2006.

Walgreens-OptionCare, American Home Patient and AeroCare Holdings, Continued from page 1

John Barrett

John Barrett has more than 20 years in quality management with over 13 years in the medical device industry with ex-

perience in quality assurance, quality systems, and regulatory compliance. His areas of expertise include quality systems (QSR, GMP, ISO, EU MDD), consent decree’s, auditing, training on quality concepts & tools, Six Sigma Tools, design controls, manufacturing processes, process validation, correc-tive action & preventive action, root cause analysis, supplier quality man-agement, benchmarking, team build-ing, Baldrige Criteria for Performance Excellence, strategic planning and balanced scorecards/strategy maps.

John is currently an independent con-sultant working with a variety of clients from very large medical device manu-facturers to small start up companies both in the USA and other countries. John has helped clients work through quality problems, prepare for FDA inspections, and achieve productivity improvements inside their organiza-

tions. He has developed and con-ducted training on quality and regula-tory topics including Design Controls, Corrective Action, Preventive Action, Supplier Quality Management, Process Validations, and standards and regula-tions for executives, managers and individual contributors. John has also been the Associate Director of Corpo-rate Quality Assurance for Siemens Medical Solutions, QA Manager/ISO Coordinator for Amana Refrigeration and as the Senior QA/RA Engineer for Siemens Energy & Automation.

John’s education background includes a BSEE in Systems Engineering from the University of Tennessee, and MBA from East Tennessee State Univer-sity and Graduate studies in Quality Management from Eastern Michigan University Online. John also holds numerous quality certifications that in-clude; RABQSA Lead Auditor for ISO 9001-2000, ISO 13485-2003 & FDA QS Regulation, ASQ Certified Quality Engineer (CQE), Certified Reliability Engineer (CRE), Certified Quality Auditor (CQA), Certified Biomedical Auditor (CBA), Manager of Quality/Organizational Excellence Certification – (CMQ/OE). John has also partici-pated in developing new examinations

for ASQ Certifications. He has been an ASQ Quality Press Publications Re-viewer & has contributed to the ASQ Quality Auditing Handbook, 1st & 2nd editions. John is also North Carolina State University Six Sigma Green Belt Certified as well as an Examiner for the New Jersey Governor's Excellence Award from1998 – 2005. John was also selected to be a Malcolm Baldrige National Quality Award Examiner for 2004 – 2006 and Member of US TAG TC 176, ASQ Z1 Subcommittee, and IEC 62A developing quality system standards.

John currently resides in Manalapan NJ with his wife who is a high school mathematics teacher at Rumson-Fair Haven High School in New Jersey. He has two sons; Patrick who is a Senior at Duke University and Robert a Soph-omore at Brookdale Community Col-lege who will be transferring to Rutgers University next year. John has been active in the Boy Scouts of America for 15 years and both of his sons are Eagle Scouts. John currently par-ticipates on the Manalapan Township Scouting Committee that identifies Girl and Boy Scout projects to work on that will benefit the community.


Spotlight on Provider

Established in 1988 to respond to the nursing shortage, Maxim Healthcare Services carries with it a rich tradition of providing superior service. Our

company has become one of the largest and fastest growing healthcare compa-nies in North America by providing innovative solutions that improve health and quality of life. As a full-service homecare, supplemental staffing, and wellness company, we have earned a reputation for our dedication to customer service and for the quality of our healthcare professionals. The success behind the evolution of Maxim’s growth is our demand for excellence in recruitment, retention, and customer care. Our performance history speaks for itself and our ongoing efforts to assess and refine our management, clinical, and support processes provide our clients and patients with comfort in knowing that the future brings with it new opportunities for continued success.

Physicians, Case Managers, and other referral sources rely on Maxim for our dedi-cation to compassionate skilled and unskilled homecare services. We understand the importance of providing care and support for loved ones, and as a trusted homecare provider, we deliver the highest level of clinical standards and services designed to ensure continuity of care in the comforting surroundings of home. Whether someone is living with a chronic condition, recovering from illness, or simply in need of daily assistance, Maxim Healthcare Services can help.

What Makes Maxim's Services Different?

Quality. Maxim has two decades of experience providing care for adult, geriatric, and pediatric patients. All of our caregivers are licensed, bonded, and insured, and undergo a thorough and extensive interview process. Furthermore, Maxim’s team of clinical managers continually supervises and evaluates each case to ensure complete satisfaction.

Convenience. We ensure our homecare service is provided for the entire time it is needed and require that our staffing and support services are available 24-hours a day, 7 days a week. Ensuring continuity of care and coverage, we provide around-the-clock access to some of the most talented clinicians in the industry.

Commitment. Maxim strives to deliver quality customer service at all times. In an effort to cultivate this attitude, we educate employees on customer service and leadership as well as offer our customers the opportunity to evaluate our services on a quarterly basis by completing client satisfaction surveys. At Maxim, we are dedicated to making healthcare more successful every day.

To learn more about Maxim Healthcare Services, please visit: www.maximhomec-are.com today!

Maxim’s Homecare Services Include, but are not limited to:

• Implementation of the clinical Plan of Treatment

• Attention to disabilities, chronic illness, and/or therapies

• Coordination of home medical equipment, pharmacy, and supplies

• Distribution of prescribed medications and/or therapies

• Assistance with mobility and transfers

• Performance of personal care (bathing, grooming, etc.)

• Preparation of meals and feeding

• Assistance with daily activities


Stephen Toy - HME, Rehab, Clinical Respiratory Care

Stephen Toy is a Respiratory Care Practi-tioner with 35 years' experience. After graduating from college and receiving his Respiratory license, he worked as Director of Respiratory Care in the acute care setting.

In 1979 he founded and operated Northeast Homecare in New London, NH where he makes his home with his wife Karyn. Stephen has been active in his community for many years as Director of The New London Baseball Club, Past Director of New London Rotary, is a member of The NH Baseball Umpires Assoc. and The National Federation of High School Sports Officials, as well as being an active member of AARC. After several successful years he sold his business and went on to manage several regional and national homecare companies in Northern New England.

Currently Stephen divides his time between HealthSouth Rehab Hospital in Concord, NH and ACHC.

Robert Wayne Blackburn PharmD, MBA - Pharmacy

Mr. Blackburn is currently the Director of Pharmaceutical Services at University Community Medical Center, San Diego, CA. Previously, he was Pharmacy Direc-tor and Clinical Coordinator at Maxicare

Health Plans, Inc., Los Angeles, CA. As Pharmacy Director, he was responsible for managing a $90 million drug budget. Other duties included managing PMPM costs for all lines of business, providing drug information for Utilization Management and Quality Management, participated in the Quality Improvement Committee, and provided analysis and resources for Disease State Management Programs and Interventions.

Mr. Blackburn has been a Pharmacy Director and Consultant for a number of MCOs, including First Choice Administrators PPO, Mills-Peninsula PPO Care 1st Healthplan (HMO), SCAN Healthplan – Senior Social HMO, Rx America/ Molina Medi-Cal HMO, as well as a consultant for acute care and outpatient clinics. Mr. Blackburn is a member of the American Society of Health Systems Pharmacists, American Society of Managed Care Pharmacists, and California Society of Health Systems Pharmacists.

Dr. Blackburn received his Doctor of Pharmacy from Creigh-ton University and Masters in Business Administration from Pepperdine University. Wayne has authored numerous articles in major peer review journals in the area of healthcare and pharmacy benefit management. He has also lectured on these topics for national, regional, and local convention meetings.

UPCOMING ExHIBITIONS

NAHC 27th Annual Meeting & Expo October 12-15 Fort Lauderdale, FL

MedTrade Fall October 28-30 Atlanta, GA

11th Annual Private Duty Conf. & Expo Nov. 17-19 Orlando, FL

Home Care Technology Expo Nov. 17-19 Orlando, FL

4th Annual Private Duty Leadership Summit & Expo

Jan 27-29 Scottsdale, AZ

NHIA National Conf. & Expo March 1-4 Baltimore, MD

MedTrade Spring March 24-26 Las Vegas, NV

Annual Assembly of Hospice & Palliative Medicine

March 25-28 Austin, Tx

Essentially Women, Focus on the Future March 30 to April 1 Charleston, SC

HME Expo & Conference April 21-23 Baltimore, MD

NHPCO 24th Management & Leadership Conf.

April 23-25 Washington, DC

WORKSHOPS Preparing for ACHC Survey,

DMEPOS/HME October 27, Atlanta, GA

Preparing for ACHC Survey, DMEPOS/HME

March 23, Las Vegas, NV

Go to www.achc.org to complete registration form.

MEET YOUR Surveyor

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ACHC Congratulates Its Newest Accredited LocationsThis list consists of organizations or branches that were accredited between December 1st 2007 and May 31st 2008

180 Medical, Inc.; OK MSP

A-1 Quality Lines Inc.; PA HME

AAAIP Pharmacy Corp.; NY Fitter, HME, MSP

Access Diabetic Supply, LLC (1 branch); FL Fitter, MSP

Advanced Home Health, Inc.; CA HH

Advanced Seating and Mobility Inc.; NC RTS

Advanced Service, Inc. (21 branches); NC CRCS, HH, HME, MSP, RX, RTS

Advantage Home Medical Company; SC HME

Aerocare Holdings, Inc. (5 branches); FL CRCS, HME

Aeroflow, Inc.(4 branches); NC HME

Affinity Distribution, Inc.; TX HME

Agape Home Health Care Inc.; IL HH

Airline Drug Inc.; MA HME

Albemarle Home Care (6 branches); NC HH, Hosp

AlternaCare Home Health Services Inc. (2 branches); KS Fitter, HME

Ambient Healthcare of GA, Inc (2 branches); GA IRN, RX

American Home Health Agency, Inc.; FL HH

American HomePatient, Inc. (244 branches); TN CRCS, HME, RX, RTS

Analgesic Healthcare, Inc.; FL MSP

Appalachian Medical Equipment Co., Inc. (2 branches); TN HME

Arcadia Products, Inc. (8 branches); NC HME

Ascentia Home Health Care, LLC (3 branches); FL HH

A-Z DME, LLC; TN HME

Baitan Enterprises, Co.; FL HH

Bay L's Medical Supply, Inc.; NY Fitter, HME

Bennett Surgical Supply Inc.; NY HME, MSP

BioRX (1 branch); IA RX

Blue Island Pharmacy, Inc. (1 branch); IL MSP

Boone Drugs, Inc. (13 branches); NC CRCS, Fitter, HME, MSP

Breathe Oxygen Services, LLC; TN HME

Brewer Medical Service, Inc; AL HME, MSP

Briarwood Pharmacy Inc.; NY HME

Buffalo Grove Drug Company, Inc.; IL HME, MSP

C&C Drugs, Inc.; LA RX

Care 1st Medical Solutions Inc. (2 branches); TN MSP

Carolina Diabetic Supply Group, Inc.; NC MSP

Carolina East Home Care & Hospice, Inc. (2 branches); NC HH, Hosp

Carolina Homecare Medical Equip. Cntr-Spartanburg; SC CRCS, HME

Carolina Homecare Medical Equipment Center, Inc.; SC CRCS, HME, RTS

Carolina Medical Sales, Inc.; NC MSP

Carthage Pharmacy Services, Inc. (4 branches); MO HME, MSP

Caswell County Home Health Agency; NC HH

Catawba County Home Health Agency; NC HH

Century Home Care, Inc; FL HH

Certified Respiratory Services, Inc.; GA HME

Chemique Pharmaceuticals Inc. (2 branches); CA RX

Cherokee Home Health; NC HH, PDA

Clay Home Medical, Inc. (2 branches); VA CRCS, HME

Closer Healthcare, Inc. (2 branches); FL MSP

Coile Inc.; TN HME

Community Health, Inc. (47 branches); NC Hosp

Condordia Medical Equipment; PA CRCS, HME, MSP

Consolidated Oilfield Rental, Inc. (4 branches); OK Fitter, HME

Cooley Medical Equipment, Inc.; (9 branches); KY CRCS, Fitter, HME, RX

Coram, Inc. - Corporate (14 branches); CO CRCS, HH, HME, IRN, RX, AIC

County of Person; NC HH, Hosp

Critical Homecare Solutions; PA CRCS, HH, HME, IRN, RX

D. A. Surgical Supply, Inc. (2 branches); NY Fitter, HME, MSP

Duval's Pharmacy; MA HME, MSP

ECU Med Inc; MD HME

Eldercare Convalescent Service; NC HH

Express Medical Supply; CA HME

Family Home Medical Equipment & Supplies, LLC (3 branches); FL Fitter, HME

Finnegan's Inc; AR MSP


First Choice Homecare. Inc - HME, MSP Broadview Heights, OH; OH

Five Lac, Inc.; Tx HH

Fox Med-Equip Services, Inc. CRCS, HME (3 branches); IL

Gary Surgical Supply; IN Fitter, MSP

Genesis Enterprise Inc.; TN CRCS, HME

Glendale Pharmacy; VA HME

Great Lakes Home Health Services Inc.; MI HME

Happy Home Health Care P.C.; IL HH

Health & Homecare of Erwin, Inc.; TN HME

Health Delivery Management, LLC; IL Rx

Healthcare Equipment, Inc.; NC RTS

Healthcare Support Services, Inc.; VA CRCS, HME, MSP

Hocks Pharmacy, Inc. (2 branches); OH Fitter, HME, MSP

Home Assist Medical Equipment, Inc.; NC CRCS, Fitter, HME

Home Medical Equipment, LLC ; KY HME (2 branches)

Horizon Home Care Supplies HME, RTS (4 branches); VA

Horizon Medical Equipment, Inc. CRCS, HME (2 branches); VA

Hospice at Greensboro, Inc. HH, Hosp (2 branches); NC

Hospice of Davidson County, Inc.; NC Hosp

Hospice of Randolph County; NC HH, Hosp

Illiana Medical Equipment; IL CRCS, Fitter, HME, MSP, RTS

Infectious Diseases Consultants & Travel IRN Medicine, P.C.; SC

Infinity HomeCare, LLC (3 branches); FL HH

K&K Rx Services; PA HME

Knueppel HealthCare Services, Inc. Fitter, HME, (4 branches); WI MSP, RTS

Lake Physicians & Hospital Supply Co., HME, MSP Inc.; NJ

LifeCare Solutions, Inc. - Corp CRCS, HME, (11 branches); CA IRN, Rx

Long Term Care, Inc. (3 branches); SC CRCS, HME, MSP, RTS

Longevity Pharmacy, LLC; NY MSP

Major Medical Supply, LLC (5 branches); CO HME

Maksoud Pharm Inc.; NY Fitter, HME

Maxim Healthcare Services, Inc. ; MD (216 branches) HH

MED EMPORIUM, LLC; NC CRCS, HME, MSP, RTS

Med Group Home Health; FL HH

Medical Equipment and Devices, Inc.; MA HME

Medical Necessities & Services, LLC; TN (3 branches) HME, MSP

Medical Technology Resources, LLC; OH HME

Melanie Home Care Corp; FL HH

Metro Rehab Services, Inc.; IL HME, RTS

MHH Inc.; Tx HH

Middle Tennessee Respiratory; TN HME

Mobility Solutions, Inc (2 branches); FL HME

Mt. Vernon Community Pharmacy, Inc.; IL HME, MSP

Nevaeh & Co, LLC; NC HME, MSP

Norbert and Leslie Gibola; CA Fitter, HME

Northampton County Health Department; NC HH

Northwest Medical, Inc.; OR HME

Nova Home Health; FL HH

O.G.S. Medical & Surgical Supply, Inc.; CA HME

Option 1 Nutrition Solutions (5 branches); AZ HME

Orbit Medical, Inc. (15 branches); UT HME

Oxy Care; TN Fitter, HME, MSP

P.I.C., Corp.; KY Fitter, HME

Park InfusionCare (3 branches); Tx IRN, Rx

Poudre Infusion Therapy, LLC; CO IRN, Rx

Prestige Homecare Services of Broward, Inc.; FL HH

Priority One Home Care; WV HME

PRN Medical Services, Inc.; AZ CRCS, HME, RTS

QualiMed Respiratory & Mobility, Inc.; FL HME

R. Bacon Enterprises, Inc. (3 branches); IN Fitter, HME, MSP

Ready Care Home Health, Inc.; FL HH

RehabTECH Supply Corporation; IL MSP

Reliable Medical Supply of the Midwest; IL HME

ReMarx Services, Inc.; PA HME

Remco Medical, Inc. 92 branches); IL Fitter, HME

Residential Home Health, Inc.; MI HH

Respiratory Sleep Associates, Inc; AL HME



Ross Home Health of Enid, LLC; OK HH

Rowan I.V. Therapy; NC Rx

Salem Mobility, Inc; NC HME

Saturday Partners, LLC (2 branches); CO HH

Simpol Respiratory & Medical Equipment, Inc.; IL HME

SleepMed Therapies, Inc. (1 branch); AZ HME, MSP

Sonoma Home Health Care, Inc.; NV HH

Source One Medical, Inc. (2 branches); CA HME

Southern Patient Care, Inc. (11 branches); AL HME

Specialty Oxygen Services, Inc.; TN CRCS, HME, MSP

St. James Hospital; IL HME

Star Medical Equipment, Inc (2 branches); Tx HME

State of Franklin Billing Services, Inc.; TN Fitter, HME

Stateline Medical Equipment (1 branch); OH HME

Summit Recovery Services, Inc.; NY MSP

Suncoast Pharmacy Inc. (3 branches); FL Fitter, HME, MSP, RTS

Sunview Medical Equipment & Supply; Tx HME

SYMKA, Inc (2 branches); CO HME

Tactile Systems Technology, Inc.; MN HME

TNJ Products, Inc.; IL Fitter, HME

Tom Jones Discount Drug Center of Garner, Inc.; NC HME

TriCounty Medical Equipment & Supply, LLC; PA CRCS, HME

University of Iowa Community HomeCare; IA IRN, Rx, HME, MSP

VNA DME, Inc.; MD HME

VNA Home Health of Maryland, LLC; MD HH

W S Associates (3 branches); MD Fitter, HME, MSP

W.C. Rose Drug Store, Inc; NC Fitter, HME, MSP

Walgreens OptionCare (140 branches); IL CRCS, HH, HME, Hosp, IRN, Rx, PDA, RTS

We Care Medical Supply Company, Inc.; GA HME

ACHC’s E-News Sign-upIf you would like to receive your Surveyor Newsletter, press releases, workshop information, The HME Educator and other important news from ACHC then sign up at www.achc.org. Simply click “E-News Sign-up”. From there you can customize what type of information you are interested in receiving. It’s quick, easy and your information stays private. Try it today!

Introducing: The HME EducatorDid you miss attending conference education sessions because there was just too many and not enough time to attend all of the ones you wanted to at the last convention you attended? We have the solution! ACHC has created a quarterly e-newsletter called the HME Educator that provides you with current articles by industry experts and access to their archives on topics that can benefit your business. With this new service for the industry, there is a list of educational tracks according to various topics that you can access. You simply click on your topic of choice and a list of industry experts will appear. You then make your choice and you will be connected with the authors list of articles. It’s that simple. Get on the HME Educator mailing list today by going to www.achc.org and click "E-NEWS SIGNUP".

Accreditation Checklist for SuccessACHC is pleased to announce that a new publication is now available to DME companies. The checklist includes practical questions about policies and procedures that will help providers understand and focus on what must be in the content of their policies and procedures. Sample interview questions and observations that are typically asked and looked at by the surveyor during the actual survey are included. It is designed as a workbook with ample space for comments and notes. The step-by-step guide helps the applicant walk through what is required for being accredited. This great tool can be used to conduct a company-wide mock survey. Contact ACHC to order your workbook.

What People are Saying about ACHC

We help make the accreditation process simple.

Primas Administrative Solutions successfully prepares our clients

to achieve and maintain accreditation.

Please visit us [email protected]

817-919-3895 or 817-235-4032


“We were very pleased with the accreditation process. Everything was just great and worked out well for us. Really, we had a very, very pleasing experience. We have been surveyed multiple times by another ac-creditation company and there is just no comparison. ACHC is the best by far. We just really had a great learning, educational ex-perience with ACHC. Our surveyor was absolutely great. It was a real plea-sure to work with him.”

Care Solutions, LLC; Hendersonville, NC

“This was our first time to go through this process and we were very nervous at first, but ACHC really helped us become a better company. Our Account Manager was excellent-she was very, very good to us and for us. If we had lots of questions, she was more than willing to help and guide us with explanations. She was always able to follow-up and we really liked how she took care of us. Our surveyor was just wonderful and we were very amazed by her demeanor, profes-sionalism and experience. She has a lot of experience so she was able to give us the strengths and weakness-es to make us better and make us improve.”

Silver State Home Health Care, Inc; Las Vegas, NV

“I've been through accreditation many times before with your competitors & ACHC is an educational process versus an adversarial approach. I think this is what defines and separates ACHC from the others–this unique way of providing accreditation services. ACHC approaches this as a "real world" situation and it shows. The surveyors know what to do and how we operate. They were here to help us become a better organization. They were always willing to answer ques-tions and provide a lot of helpful feedback. I could call my Account Manager anytime and she would call me right back. She was excellent with everything. I really can't say enough about the good service and response that I always received.”

Arcadia H.O.M.E.; Winston-Salem, NC

“I wouldn't change anything about ACHC's accreditation process- I think it went very smoothly. The survey ex-perience addressed so many different facets of what we deal with here in the running of our daily business activi-ties, and really looked at a lot of these areas in providing some best practice suggestions. The survey experience

itself was not disruptive to us and we considered it a very valuable learn-ing experience. I would recommend ACHC to anyone- I thought it added a lot of real value to our organization and we really enjoyed how smoothly you folks conducted the process. I really valued that we learned a lot from going through this process with ACHC.”

Great Lakes Home Health; Jackson, MI

“Everything went real well. Our Account Man-ager was great and every time I called her she always called me back. She did an excellent job for us and I think she helped with a lot of the on-going communication. Overall it was all about the great communication from ACHC--that was important to us and made a lot of impact during the entire process!”

Jeremiah Home Health Inc.; McAllen, Tx


The Accreditation Commission for Health Care, Inc. is pleased to an-nounce that Amedisys, a leading pro-vider of home health care and hospice services with agencies located across the United States and Puerto Rico, has applied to ACHC for accreditation. Amedisys chose to seek accreditation from ACHC because the philosophies regarding outstanding commitment to patient care and maintaining the high-est quality clinical standards are so closely aligned.

The Baton Rouge, LA based company was founded by Bill Borne in 1982. Mr. Borne is the Chief Executive Officer and Chairman of the Board. In 1994, the company became public and is listed on the Nasdaq Market under the symbol “AMED”. Amedisys operations focus on providing low-cost, outcome driven health care to homebound patients in homes through their 325 agencies.

“Hospice”, and “Behavioral Health” ACHC is pleased to announce that it has submitted application to CMS for Medicare Deeming Authority for Hospice. The process was delayed until the final revision of the Condi-tions of Participation was finalized by CMS. It is expected that by early 2009 approval will be made public in the Federal Register.

ACHC standards fit well with the philosophy and delivery of patient services for hospice organizations. And, the survey process is the only one of its kind. Surveys are conducted by a hospice nurse as well as a clinical support surveyor such as a medical social worker. ACHC’s hospice pro-gram standards are considered by many as the best fit in the industry which include standards for inpatient services.

New ACHC Behavioral Healthcare StandardsMany of the agencies that are ac-credited by ACHC provide behav-ioral healthcare services, which may include specific services to meet the needs of persons with mental health, developmental disabilities or substance abuse issues. This spring ACHC undertook the task of develop-ing behavioral healthcare standards that reflect evidenced based practices. The Board of Directors recently ap-proved the standards and plans are being made to conduct a pilot review of the standards then implement the process nationally. ACHC will be pro-viding more information to agencies about this exciting opportunity in the near future.

nearly as strong as during the 2002-2004 period when hospice was in the spotlight of home care consolidation, the supply of acquisition candidates, particularly those that are (a) for-prof-it, and (b) not in danger of exceeding reimbursement cost caps is extremely

limited. Accordingly, transaction volume in 2007 (10 deals) fell to its lowest point since 2001. The good news is that with the extraordinary imbalance of supply vs. demand, valu-ation remains quite attractive. Further-more, we expect volume to begin to tick upward over the next 24 months as the M&A pipeline “re-loads” with companies that, having begun opera-tions over the past two to three years – in part, to capture some of the returns seen during the market’s peak – ma-ture and get ready to test the market.

Dexter W. Braff is President of The Braff Group, the leading investment banking firm specializing in the home health care, hospice, infusion therapy, specialty pharmacy, health care staff-ing, and home medical equipment market sectors. The firm provides an array of transactional advisory ser-vices including sell side representa-tion, debt and equity recapitalizations, strategic planning, and valuation. Dexter can be reached at 888-922-5169 or [email protected].

Home Care Merger and Acquisition Update (Continued from Page 6)

AMEDISYS Chooses ACHC (Continued from Page 1)BREAKING NEWS:

The good news is that with the extraordinary

imbalance of supply vs. demand, valuation remains

quite attractive.

LINK Consulting Group, Inc.Wayne M. Link RCPT, RCPAccreditation Consultant

HME, Rehab, Respiratory, Sleep Labs, O & P & Pharmacy HME

Preparing for AccreditationAs accreditation surveyors and consultants, Link Consulting Group recognizes non-compliant area and provides solutions and results.Our goal is to assess and guide provider companies through the accreditation process and remain compliant on a daily basis. ACHC, CHAP & JCAHO

• PolicyandProcedureManuals• ComplianceManualsandAudits• Financial&AccountsReceivable• Representationduringsurveyprocess(if desired)• MockSurveys(Accreditation, State Inspections, etc.)• AccreditationAssistance• NewBusinessSet-Up• FormsManagement• Consultation

990MountainLaurelDrive•Columbus,NC28733Phone:828-894-8406•Fax:828-894-8006www.linkconsultinggroup.com•[email protected]

Summary

Home Health has moved beyond tradi-tional benchmarking. Benchmarking data through reputable data services that provide timely information helps position agencies for present and future financial success.

Timely benchmarking through repu-table data services shows an agency where it stands in relationship to peers and is essential to prepare for home health Pay for Performance, which will tie a portion of payment to delivery of quality care. Benchmarking can position agencies to be among the top 20% awarded financial incentives for stellar outcomes. Under the demonstra-tion project, being piloted in 2008 and

2009, 75% of the incentive pool will be shared with those agencies in the top 20% of the highest level of patient care and 25% percent of the incentive pool will be shared with the top 20% of those making the biggest improvements in patient care. As payment for services moves closer and closer to this value-based model, agencies need to create their outcomes and benchmarks, not fall victim to them.

Barbara Rosenblum is the Founder and CEO of SHP, the leader in real-time decision support and benchmarking for the entire spectrum of home care. Ms. Rosenblum was recently elected to the Board of Commissioners of ACHC.

Beyond Benchmarking (Continued from page 5)

AIHMES

Amerisource Bergen

Burlington Drug Co.

CAHSAH

D.A.B.G.

DME Train (Aspirant)

Dedicated Distribution

Electronic Billing Services

Essentially Women

Grove Medical

HCAV

HD Smith

HME Providers

Kinray

McKesson

Med Trust

Med Trust of Tampa Bay

Medline

Proclaim

SCMESA

VGM

ACHC offers discounts to members of the following groups:

For 23 years ACHC has been listening to providers by responding to your suggestions. We have taken away the fear of surveys with ones that are friendly and educational; created standards that are relevant and reasonable; and provided customers with personal account managers.

However, we are always seeking to improve our perfor-mance. So, we are asking you, the provider, to tell us what matters to you. What can we do to add more value and satisfaction with accredi-tation? Please visit our web site: www.achc.org and choose the prompt that says, “What do you care about?”

What Do You Care About?


We Need Your Email Address!Want to be in our email database?

Receive your Surveyor Newsletter, press releases, workshop information,

and more via email.

Visit www.achc.org & click on "E-News Sign-up"


August 9, 2007

Mr. Tim SafleyAccreditation Commission for Health Care, Inc.

Mr. Safley:

The purpose of this letter is to thank you for improving our small business. We received our Certificate and window sticker today, so we are now officially accredited. I wanted to write this letter several weeks ago, but I didn’t want to look like a brownnoser during the Accreditation process.

You may remember a comment I made at the introductory seminar you conducted in Atlanta this spring. The topic of the conversation was the dreaded QI plan. My comment regarding QI, as I remembered it, is as follows: “For the small business owner, what you call a Quality Improvement Plan is what we refer to as everyday decision making. All of this paperwork that you require just seems like one great big stack of documentation poo.”

Your response to this comment, in which you referenced the poo factor, was quite helpful. These are not your exact words, but as I remembered it. You encouraged the attendees to look for areas to monitor that have not been looked at before, especially those that impact profitability. You also stated that the need for QI for accreditation purposes stemmed from the need to be able to evaluate busi-nesses which vary greatly in size and nature, on a standard scale.

When we returned from Atlanta, we soon started our QI program with a nice luncheon. We discussed possible additions to the pro-gram, and I agreed to do a spot audit on product prices from suppliers verses the actual contract price we were supposed to be paying. I even spent more time creating a new audit form, so that it would look real nice in the middle of the poo pile.

To get it over with, we started the spot audit immediately. To my surprise, we found a mistake to our benefit of over $1,000 within two minutes. We continued for several hours and found another $7,000. Even though I am a small business owner without much QI experi-ence, I had enough sense to order myself to conduct a complete audit. Several weeks later, we finished our audit and found a total of $20,773.80 that was owed to us. Our supplier has agreed to refund the money, and we are expecting a check any day.

Humility often comes to those who need it the most, but it doesn’t usually have a $20,000 check attached. My comment, although sincere, was out of place. My initial perception of the QI program never looked at a possible benefit, only the work required to meet the minimum standard.

Thank you for your help in making our company better. Please accept my apology for not only my public comment, but also the other negative comments that you didn’t hear about the QI requirement in general.

Many Thanks,Timothy Kelley, PresidentMedtrac Solutions, Inc.

A small HME provider recovered $20,773.80 using an ACHC Quality Improvement (QI) Standard

Affordable Health CareConsultantsWe provide cost effective services for:

Home Medical Equipment (HME) Home Health Care Clinical Respiratory Care Pharmacy Providers Rehab Technology Suppliers Orthrotic and Fitter Service Providers Medical Supply Providers

Services Provided

Policy and Procedure Manuals Accreditation Assistance New Quality Improvement Program with Benchmarking Compliance Audits Mock Surveys Start Up Assistance Financial AR Consultation Competitive Bidding Application Assistant

Contact AHCC at:(919) 368-5565www.ahcc.come-mail: [email protected]


ACHC is currently seeking Full & Part-Time Home Health Surveyors. Qualified candidates must be a Registered Nurse with BSN (Master’s Preferred)

& appropriate home health management and/or accreditation experience.

Competitive pay and benefits. Go to ACHC’s website at www.achc.org and

click on “Careers” from the “About Us” tab for full details!

Stop by our booth (#902) at the NAHC Annual Convention to meet

management representatives!

®

4700 Falls of Neuse Road, Suite 280 Raleigh, NC 27609 (919) 785-1214 | www.achc.org

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