Version 6.0.0.42 is now available for download. The biggest change in this update is a new feature that our customers have asked for - automatic update checks.

With this option turned on, the program will automatically check for available updates when you log in. If your program is already up-to-date, then nothing else will happen and you'll continue to work as usual. If your program needs an update, you'll be prompted to download and install it.

By default, this feature is turned OFF. If you want to turn it ON, simply go to the "Help" menu, select the "Updates" option and click "Auto check for updates at Login." That's it!

We've also added administrative control over who can check for updates. If you would like more information about these administrative features, contact support@ppsplus.com.  

We hope you like this feature. If you have any questions about any of this, please don't hesitate to call your Account Executive or our Support Staff. We'll be happy to lend a hand.

-Glenn

The post acute care market has undergone significant changes in the last fifteen years and all indications are that those changes will continue and be exacerbated as healthcare dollars become more precious and the glut of aging post war baby boomers put added pressure on existing infrastructures. The favorable economic factors associated with delivering healthcare in the patient's home, coupled with the fact that most patients would prefer to receive care in their own home, has and will continue to propel considerable growth for home healthcare entities. A recent study by a national concern provides an excellent example of this impending growth. Two of the three fasting growing job categories by percentage between 2006 and 2016 were in the home healthcare arena - home health aides and personal / homecare aides.

What is even more compelling about this study is that both those job categories started with by far the largest base number of job holders (approximately 765,000 in each of those two categories) and both grew to in excess of 1,150,000 - for percentage increases of 48.7% and 50.6% respectfully. A total gross job growth of in excess of three quarters of a million workers are and will be entering the ranks on homecare employees by 2016.

Telephony documentation by HHA's, personal care staff, and homemakers has a multitude of benefits, which put it in the lead above other documentation methods.

• 1.) Legislatures confronted with ever tightening budgets are looking at ways of minimizing fraudulent and abusive documentation associated with visits, especially alleged visits or visit lengths by non professionals. Telephony documentation systems provide hard to spoof electronic records verifying both the visit and the visit length. Numerous jurisdictions either already have or are contemplating mandating documentation systems, such as telephony, that minimize fraud and abuse.
  
  2.) Home care agencies face budget constraints as well. They must find ways to do more with less. Telephony systems offer unique advantages when utilized with non skilled workers.
  
  
  • a.) There is generally no initial capital outlay associated with telephony systems, making them most attractive to capital strapped home care agencies. Other systems utilizing laptops and hand held devices come at a considerable initial expense. Those costs do not end with the initial purchase however. Maintenance and replacement costs associated with such devices can often be considerably more over time than the initial capital outlay.
  • b.) Numerous detailed cost benefits analyses have repeatedly demonstrated that properly employed telephony systems save agencies in excess of twice what said systems cost. Savings are garnered in numerous areas, including but not limited to:
    
    • i.) Greater productivity by central office staff - the same core of central office staff can accommodate many more field staff visits
    • ii.) Real time visit data from the field means quicker turn around on billing
    • iii.) Cost savings associated with the elimination of paper notes can be substantial
    • iv.) Other costs associated with paper notes, such as files, file drawers, office space and off-site storage costs can be virtually eliminated with the telephony electronic visit note;
    • v.) Timely payroll for field staff enhances employee relationships and helps minimize turnover, a significant cost that few agencies consider but all can ill afford
    • vi.) Because telephony systems offer real time analysis of field staff activities or non-activities, agencies can, upon implementation of fairly basic processes and procedures, minimize or eliminate missed visits. In today's market environment agencies can ill afford to forego billing opportunities as a result of missed visits;
    • vii.) For those agencies that reimburse mileage, postage or other costs associated with employees returning visit notes to the office, the savings can be dramatic.
• 3.) More sophisticated systems often fail in key areas when applied to the non skilled workforce in the home healthcare arena.
  
  
  • a.)Training a home health employee on telephony can be completed in 30 minutes, and prepares them to utilize the system in the field immediately vs. training on laptops, handhelds and related devices which can entail multiple and lengthy training sessions. As a rule, turnover in employment within the non skilled ranks is considerable and thus time consuming and costly training within that segment of the workforce is wasteful.
  • b.) Training for central office staff when telephony is employed for home health aides, homemakers and companions is generally not intense. Many telephony systems seamlessly integrate with an agency's existing backend system performing billing, payroll and scheduling functions. Accordingly, training for central office staff is minimized to unique telephony features such as announcement capabilities and unique reports associated with the telephony system. In most cases, central office staff training can be performed in less than two hours
  • c.) In many cases non skilled workers will shun employment if required to employ devices they fear are too technical for their capabilities
  • d.) Studies indicate that patients often sense more technical devices employed by non skilled workers in the home create a barrier to their personal care
  • e.) Unfortunately due to the high turnover and related issues faced by agencies relative to non professional staff, expensive devices are often lost or never returned to the agency
  • f.) Unlike telephony, often the more technical devices do not provide a means or cost effective approach to verifying the caregiver was actually in the home or was there for the length of time being billed, thus exposing the agency to fraud and abuse claims.
  • g.) Often to be effective, such sophisticated technical devices require infrastructure, like wi fi or G3 connectivity to function as designed and to-date those infrastructure systems are not uniform or come at a significant additional monthly cost.
• 4.) Several telephony systems offer an effective means of communicating with non-skilled field staff. Those telephony vendors offer an announcement feature that allows the central office to create and deliver messages for their field staff. At least one system offers a mechanism whereby unique messages germane to the patient's care can also be cost effectively delivered to workers in that patient's home. No cell phones and costly monthly contracts are necessary to effectuate that solution.

For these and other reasons, homecare agencies wishing to benefit from the rapid growth being experienced by the industry, especially in the areas of home health aide, homemaker and companion visits, would do well to consider utilizing a telephony system for the documentation of such visits.

©2010 Don O'Rourke. All rights reserved.

Don O'Rourke has been the President of Dial-N-Document® since the company's founding in 1997. He graduated from law school in 1973 and served as a law clerk to the senior judge for the US Fourth Circuit Court of Appeals and thereafter enjoyed a successful career as a senior partner for a law firm. In 1984 Mr. O'Rourke started focusing exclusively on activities involving the healthcare industry and in 1997 became a cofounder of Dial-N-Document®, a telephony-based clinical documentation system focused primarily on the home healthcare industry. Dial-N-Document® has partnership relationships with several of PPS Plus Software partners, including HealthMEDX and Sansio.

The revenue increase is just the tip of the iceberg, though. The article, found in the June 28 edition of DecisionHealth's weekly publication, Home Health Line, also includes Snider's testimony of increased case mix scores and decreased OASIS review time.

"All of the nurses and certified coders here at PPS Plus Software have dealt with OASIS review and coding first-hand," said VP of sales, Mark Scott, RN. "We are very familiar with the complexities involved in ensuring that each OASIS is accurate before submission. It is extremely gratifying to us when we hear from our customers that our software has made this process much easier and that they are now receiving the reimbursement they deserve."

"This is what it's all about," added John Shinn, president of PPS Plus Software. "It feels good to know that what we do in our office every day is having such a positive impact on this and other agencies all over our country -- especially in these challenging times."

Click here to read the Home Health Line article.
Click here to read the follow-up blog written by Jennifer Warfield, RN, BSN, HCS-D, COS-C.

DecisionHealth's weekly publication, Home Health Line, is the nation's leading independent authority on home health care business, regulation and reimbursement. Click here to subscribe to Home Health Line.

Note: Click here for CMS' Table 4 mentioned in this video blog.

As PPS Plus Software's education director, I often speak to agencies that are frustrated with the decrease in their average case mix weight since the implementation of OASIS-C. So why is this a problem? Well, a decrease in case mix weight is ultimately going to result in a decrease in reimbursement. And loss of reimbursement in conjunction with recent proposed Medicare cuts can have a severe impact on an agency's financial status.

Agencies can take these proactive measures to ensure OASIS accuracy which will then result in financial accuracy:

1.) Implement in-depth and ongoing training for field and office staff on OASIS-C, as CMS frequently gives us new guidance or clarifications

2.) Develop a QA/PI program that includes software that allows you to check for coding or OASIS errors and/or inconsistencies

Training is the easy part. Assuring coding and OASIS accuracy can be a bit more challenging unless you have dedicated staff that will review EVERY OASIS with a fine-toothed comb. Finding the expert staff to do this job is hard enough, not to mention the time involved to accomplish this effectively (as we all know, gathering all of the needed information and making all the necessary changes to just one OASIS can take up valuable man hours).

That's why I (and everyone else here at PPS Plus Software) was so pleased to be informed that the proof of our software's effectiveness is in the pudding (or should I say ‘in the program'?) according to a recent article featured in DecisionHealth's weekly publication, Home Health Line.

In the article, Sharon Snider, director of Nason Hospital Home Health Agency in Roaring Spring, Pa., credits PPS Plus Software's Home Health Edition for helping to not only increase her agency's average case mix weight, but also her agency's revenue by an average of $900 per patient (while also dramatically decreasing the average time her staff previously spent reviewing the OASIS)!

Click here to read the article.

Home Health Line is the nation's leading independent authority on home health care business, regulation and reimbursement. Click here to subscribe to Home Health Line.

A Biloxi native, Mary is a true Southerner. She loves to be outdoors and enjoys everything the coast has to offer -- great food and lots of fun on the water.

As die-hard Saints fan and a woman who knows her way around ICD-9 coding and the OASIS, she will definitely be an asset (not to mention a great addition to the mounting number of black-and-gold devotees) here at PPS Plus.

Welcome, Mary!

Very seldom do you find an agency operating where the clinical and marketing departments communicate effectively. Clinical and marketing departments often operate in parallels without coming together in pursuit of a common goal. The tension created between these very important aspects of your business can be unhealthy for your organization unless treated with care. Healthy debate between marketing and clinical is normal and can benefit the company with increased communications and understanding.

Break the barriers that can keep your agency from reaching substantial heights by bringing these two parallels together for a common goal. Here are seven things you can do to help bring these teams together to make sure that tension does not build into conflict, ultimately getting in the way of growing your business:

Set Clear Goals for Growth
Set SMART Goals - Specific, Measurable, Achievable, Relevant, and Time-based - for your marketing team and activities. Involve your Clinical Managers in the development of goals. Realize that they need to support the sales and marketing team in achieving those goals.

Recruit, Recruit, Recruit
Always be recruiting nurses and therapists, even when you don't have an opening. If you find a great clinician, hire them immediately. Then turn your marketing team loose to find new patients to fill the visits that will keep the nurses busy. In this day of nursing shortages, you will rarely be overstaffed with nurses by this proactive approach. If you can find the nurses, your marketing team will find the patients.

Define Clear Admission Standards
Work with your clinical managers to clearly define your admission standards. Communicate the standards to your marketing staff so they are clear about which patients you will and will not admit. It's their job to educate physicians, discharge planners, and other referral sources about the criteria for patient admission to home care.

Team Builder Training
As part of your sales training process, teach your marketing representatives how to create teamwork with the intake department and the clinical managers. If they are bringing in referrals that are not being admitted, they have a responsibility to work with intake and clinical to find ways to get more referrals that can be admitted. They need to sit side by side focusing on the problem, not arguing back and forth about who is to blame.

Track Referral Conversions Rates
Set up a system to track every referral that comes into the agency, and the % of patients that are admitted. Use this information to meet with marketing and clinical to work out issues that are getting in the way of growing the business. If your marketing team is bringing in a large number of referrals that are not admitted, then you need to get both clinical and marketing together to look at the specifics. What is keeping those patients from being admitted? Not enough staff? Patients don't meet the requirements? Marketers are targeting the wrong referral source? Clinical is getting too picky about the cases they'll take?

Create Accountability
Hold both sales and clinical accountable for growth. If you are not getting referrals that turn into admissions to meet your growth goals, bring the two sides together. Work to get them in alignment and focused on the goal. Don't let them move in the direction of placing blame on the other side. They need to be working side by side to achieve the mutual goals.

Celebrate Small Victories
Celebrating small victories in pursuit of the ultimate goal will not only help maintain the energy necessary to keep the team engaged, but it will also provide an avenue for the valuable team building between clinical and marketing. Celebrate each step in climbing that ladder towards reaching the team's goal.

Breaking down the walls and eliminating the two parallels will ultimately result in your agency performing as a fine tuned machine. Utilizing these seven steps and bringing these departments together can bring you rewarding results.

©2010 Carl Ganter. All rights reserved.

Carl Ganter is the President and CEO of the Ganter Group, a leading provider of planning, development and management to the homecare industry, including home health, hospice, home medical equipment and private duty nursing. Mr. Ganter is a Certified Homecare Executive with over 15 years of experience in management, development and executive leadership in homecare. His company, The Ganter Group provides consulting and assistance with marketing, regulatory, reimbursement, operational, financial, interim management, policies and procedures, training and more. To learn more visit www.thegantergroup.com.

Jan Favre, Account Executive, and I just returned from the Iowa Association in Home Care's 2010 Annual Conference in Altoona. I had the honor of being select to give two presentations while there - "Are You Social?" and "Marketing in the 21st Century," where I had the pleasure of speaking to attendees from all over the state of Iowa.

Also during the conference, I had the opportunity to attended Arnie Cisneros's presentation on "Rehab and Home Health Audits." Arnie gave an excellent presentation. He is one of the best speakers on the home health circuit. If you have a chance to catch one of his presentations, take the time to hear him speak.

Congrats to Mark Wheeler, Executive Director, and Amy Huisman for putting together an excellent annual conference. We have attended this event the past four years and it just keeps getting bigger and better.

Let's continue the wound discussion by focusing on arterial ulcers. These wounds will be found in patients with arterial disease. Because of the partial/total occlusions or calcification of the arteries, circulation to the extremities is impaired.

These patients have very unique characteristics.
* Their legs will be thin, pale and shiny.
* Due to the lack of perfusion to the hair follicles, their legs will also be hairless.
* They will usually have thick toenails which are susceptible to fungal infections.
* These patients also suffer from dependent rubor (extreme redness when in a dependent position) and elevation pallor (paleness when the extremity is raised).

Lack of perfusion can become so severe at times, it causes an arterial ulcer. Characteristics of arterial ulcers are pretty standard.
* They are sharp-edged, full-thickness wounds which often times have tendons or bone visible.
* Because of the lack of blood flow, necrotic tissue is a common occurrence with these wounds.
* These wounds will be dry and have very little exudate.
* They are also painful and are prone to infection.
* The most distinguishing characteristic of these wounds is their location. They will be located in "end of the line" locations, such as the toes. This is because the further away the body part is from the heart, the more diseased vessels the blood has to flow through to feed the tissue, increasing the risk of ulceration.

Now that the arterial ulcer has been correctly identified, let's talk treatment. The wounds have a poor prognosis of healing. Greater means such as surgical intervention for revascularization or hyperbaric treatments are needed for healing. As a home health nurse, your focus should be on pain control and infection prevention.