Beth Carpenter and Associates: Pathfinder Newsletter

THE PATHFINDER NEWSLETTER
Hello! Welcome to the May 2010 issue of THE PATHFINDER. First - my sincere thanks to all of you who took a moment to fill out the questionnaire regarding this newsletter which I sent out in March. I read every response. And I certainly appreciated the comments and suggestions. Overwhelmingly a monthly newsletter was the favorite frequency choice...well, I've kinda' blown that lately! We have been busy and I hope you understand that our work with clients takes priority over newsletter preparation. I will, however, try to be better organized and more timely with the newsletter in the future. I promise! And for those of you who expressed interest in writing an article for a future newsletter -- you'll be hearing from me! To continue our discussion on leadership: "Just because you're not paranoid doesn't mean they're not out to get you." ~Colin Sautar Don't get me wrong. I don't believe in scare tactics - although there are many agencies today who are frightened. I don't believe that "they" are out to "get" honest operations that focus on compliance, ensure excellent supporting documentation, self audit and respond to deficiencies quickly and completely. A significant leadership skill is to anticipate problems. You can correct mistakes after they occur, but that truly is an exhausting, frustrating no-win activity. Anticipation of issues to be examined and resolved is an important activity for a healthcare leader. I do believe that you should not wait until you have denials, an overpayment demand letter or a visit from a Medicare audit contractor to begin to look at your agency's documentation skills. It is more cost effective and anxiety reducing to review your own documentation and clinical files regularly -- and take action internally to resolve any issues. RAC--ZPIC--MIC--MCFU--OIG--HEAT--DOJ Lots of initials - lots of organizations who exist to make sure that documentation justifies payment, and that billing and coding practices are appropriate. As we work with agencies to help them prepare for the inevitable interaction with these entities, we find ourselves going back repeatedly to the basics of documentation. With that experience in mind our articles this month deal with documentation and corrections to clinical records. We've enjoyed a fairly warm spring with lots of rain here in the Upper Midwest. I hope that you are celebrating spring by spending some time outside working on garden preparation or observing the vegetation changes as you take a walk through a forest preserve. Doesn't the air smell wonderful? If we can provide you with any assistance, please do not hesitate to contact us. Best wishes, Beth Carpenter “Let us realize that the privilege to work is a gift, that the power to work is a blessing, that the love of work is success.” David O. McKay

THE OLD ADAGE: IF IT IS NOT DOCUMENTED, IT WAS NOT DONE By Elizabeth E. Hogue, Esq. The old adage, "If it is not documented, it was not done;" is unfortunately often true. The consequences of failure to document may be severe in terms of allegations of fraud and abuse. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services has repeatedly stated that providers carry the burden of proving that care was actually rendered to patients. If practitioners are unable to prove that they rendered appropriate care because it was not documented, the OIG and other fraud enforcers may conclude that claims submitted by these providers are false claims. To continue the article...

ARE CORRECTIONS/SUPPLEMENTS TO CLINICAL RECORDS ILLEGAL OR UNETHICAL? By Elizabeth E. Hogue Esq. Many providers are appropriately conducting a variety of retrospective reviews of patients' clinical records. These audits may reveal incomplete or inaccurate records. The records must be, therefore, corrected or supplemented, if possible, in order to help ensure quality of care, meet applicable regulatory requirements and avoid allegations of fraud and abuse. Please click here to read more...

WE ARE PLEASED TO ANNOUNCE A NEW SERVICE Accreditation Commission for Health Care Beth Carpenter and Associates is proud to announce the addition of a new service for its clients! We are now able to support your efforts to achieve accreditation through Accreditation Commission for Health Care (ACHC) whether you are a new or existing agency - home health, hospice or private duty. To assist you in your efforts to reach and maintain deemed status for Home Health and Hospice agencies as well as accreditation as a Private Duty Nursing and/or Private Duty Aide organization, the following are a sample of potential services currently available through Beth Carpenter and Associates: • Assistance in preparation of the ACHC Application and the Preliminary Evidence Report (PER). • Review of your Application and PER prior to submission to ACHC. • Assistance with any revisions to the PER requested by ACHC following initial submission. • Training and instruction to administration and staff to prepare for an on-site ACHC survey. • Assistance in creating a Plan of Correction, if necessary, following an on-site ACHC survey. Subsequent to successful accreditation, we are available to work with your agency to continue compliance with the ACHC standards. For further information, call 847-382-1035 or e-mail bcarpenter@bethcarpenterandassociates.com.

Beth Carpenter Beth Carpenter and Associates 847-382-1035 bcarpenter@bethcarpenterandassociates.com Beth Carpenter and Associates has earned a reputation as a company with deep industry experience and one that works closely with its clients to identify solutions that meet their business goals and strategic objectives. We do not simply advise. We partner with our customers to implement the solution and ensure its success. Sincerely, Beth Carpenter

ARE YOU ON THE RIGHT PATH? Since 1995 Beth Carpenter and Associates has provided its real-world experience to the management of healthcare companies, especially those organizations with a focus on home health, hospice and private duty, in the areas of operations, clinical services, sales and marketing. We work with management to identify the strategic direction of the organization and implement the necessary changes that allow health care providers to move forward in today's environment. We help you choose the right path to success and then we walk it with you.

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