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2010
Ending with a Flurry of Transactions
by David Berman, CPA, CVA, Principal, Simione Consultants
There has been a tremendous amount of M&A activity in both the home health and hospice markets during the second half of 2010. Specifically, we have seen the last quarter of 2010 shaping up to be the busiest quarter in years. You might be asking yourself, "Why the uptick in activity?" To answer this question, all you need to do is focus on what is, and is not, happening in Washington, DC. For starters, President Bush's tax cuts are set to expire on December 31, 2010. Included in these cuts are favorable capital gains tax rates. Currently, Long Term Capital Gains are taxed at 0% for the first two tax brackets and 15% for others. If President Obama does not act, the rates will increase to 10% for the first tax bracket and 20% for all others. This potential tax increase has had some sellers seeking to close deals before the end of 2010.
Now that the industry has some clarity on what payment rates will look like in the near future, buyers can prepare proformas with some level of confidence. This not only lets them project future growth and performance, but also lets them more accurately value their acquisition targets.
With this "yearend rush" of activity it is of the utmost importance to still perform proper Clinical/Financial/Information Technology Due Diligence.
To learn more about our Business Valuation and Mergers & Acquisition Consulting Services, click here or contact David Berman at dberman@simione.com
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Cost Report Important Reminders
by Maureen Laskowski, Director, Simione Consultants
Don't have your Medicare claims denied:
- December 31, 2010 is the deadline to file claims for the period 1/1/09 to 12/31/09.
- All claims with a date of service on or after January 1, 2010 must be received no later than 12 months from the claims date of service.
PS&R Information for filing the cost report.
- PS&R reports will not be mailed.
- You must register for IACS (Individual Authorized Access to CMS Computer Systems) to obtain the PS&R.
- Still need to Register? Go to http://www.cms.hhs.gov/IACS and click on CMS Application Portal
For more information about our Cost Report Consulting Services, click here or contact Maureen Laskowski at mlaskowski@simione.com.
To view our cost report presentation on the Home Health Cost Report, click here |
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Financial Monitor Tip of the Month
By Rob Simione, Senior Consultant, Simione Consultants
One of the "Key Indicators" to track on your Home Health Dashboard is LUPA episodes. A LUPA (Low Utilization Payment Adjustment) is defined as an episode with less than 5 visits during a 60 day episode. When a LUPA episode exists, Medicare reimburses based on a per visit rate rather than on an episodic rate.
According to the Financial Monitor, in Q3 LUPA episodes were 9.6% of total episodes. This is calculated by taking your LUPA episodes ended in the quarter and dividing it by the total episodes (Full, Outlier, LUPA and PEPs) ending in the quarter. It is important for your Nurse Managers to track this statistic and note any unusual trends versus industry benchmarks and/or agency past performance.
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By Robin Seidman, RN, BSN, MSN, MBA, LNCC, HCS-D, Director, Simione Consultants
On November 11th, 2010 the update to the final rule was published in the Federal Register incorporating the new legislative requirements for face-to-face encounters with providers related to home health and hospice care. These regulations are effective January 1st, 2011.
Summary of Face-to-Face Requirements:
Part 418-Hospice Care: §418.22 Certification of Terminal Illness
- A hospice physician or nurse practitioner must have a face-to-face encounter with each hospice patient:
o No more than 30 calendar days prior to the 3rd benefit period (180-days) and;
o No more than 30 days prior to each recertification thereafter.
o Include explanation of why the clinical findings of the face-to-face encounter support a life expectancy of 6 months or less.
Part 424-Condition for Medicare Payment: §424.22 Requirements for Home Health Services
- Physician responsible for performing the initial certification must document the face-to-face encounter which is related to patient's primary reason for home care.
- Encounter occurred no more than 90 days prior to start of care or within 30 days of the start of home health care.
- Approved non-physician practitioners that can perform the face-to-face include: Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants.
CMS is currently writing a manual update detailing face-to-face encounters. Designate someone at your agency to stay informed of future clarifications by CMS regarding compliance with the new face-to-face encounter requirements.
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 Marketing, Sales and Customer Service Tip of The Month
By Mike Ferris, Director, Simione Consultants
The Difference Between Being Millions in the Black or Red Begins and Ends at the Point of Contact!
If you don't know what's really going on down in the trenches - in vivid detail - then it's time to start. The sooner you know for sure whether your coordinators, nurses, and reps are using best practices and working as efficiently and smartly as possible, the better. Our Mystery Call program not only uncovers the mistakes and weak points that can plague an agency and keep referrals down, but it provides custom tailored strategies on how to redress those problems and reverse their detrimental effects.
We don't just point out what's broken - we fix it.
Are you listening in on your intake department's phone calls? Are you doing referral source surveys to find out what they REALLY think of your agency and your Reps? Are you doing patient and family follow ups? Whether you use our service or implement your own, these are just a few tools you need to implement in order to keep your numbers growing, your patients and referral sources happy, and your brand in the community intact and shining.
For more information about our Marketing, Sales and Customer Service Consulting Services, click here or contact Mike Ferris at mferris@simione.com. To sign up to receive your complimentary subscription to "The Legendary Sales Leadership Letter"
click here
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