Long Term Care Institute

Transcription

1 The Healthcare Financial Management Association of Western New York is pleased to present the following educational session: Long Term Care Institute 8.0 Hours CPE Credit When: Thursday, November 20, 2014 Registration: 8:00 AM Program: 8:30 AM to 4:30 PM Networking & Cocktails 4:30 PM to 6:00 PM Where: Classics V 2425 Niagara Falls Boulevard Amherst, NY Directions:

2 HFMA 2014 Long Term Care Institute Program Agenda 8:00 8:30 Registration 8:30 9:20 NYS & Federal Regulatory Update - Pat Cucinelli, LeadingAge NY Mr. Cucinelli will discuss Federal and New York State Regulatory issues impacting providers, current regulatory trends and what providers need to know about these issues. 9:20 10:10 Top Ten Opportunities In Nursing Homes - Kris Mastrangelo, CEO, Harmony Healthcare International This program provides a comprehensive training on the rules and regulations allowing Medicare Part A coverage during a Skilled Nursing Facility stay. The presentation highlights the areas that significantly impact Medicare Reimbursement as well as areas of opportunity including highlighting the RUG categories and MDS Coding guidelines. The speaker will review the key changes in the MDS coding, which will impact therapy case management and reimbursement. This forum will provide the audience with current regulatory updates. This program allows attendees to take a hands-on approach to SNF Medicare compliance. Ms. Mastrangelo will review strategies for rate insulation, preservation as well as accurate and compliant reimbursement. 10:10-11:00 Improving Performance and Quality through Effective Team Building and Conflict Resolution Michelle Dubner, CEO, Global Healthcare Associates LLC The session will explore we are and how we communicate and interact with one another through verbal and nonverbal cues which indicate variations of emotion. These concepts will be applied to teamwork as a form of organizational leadership and how participants can accentuate their connectivity in interpersonal relationships. Participants will explore how culture, expectations and perceptions influence effective communications, how to communicate positive and negative feedback to teammates and how to improve balance in the workplace.

3 11:00 11:50 Building the Bridge between Long-term care and Managed Care Deborah Gracey and Art Jones, Health Management Associates As more people move into Medicare Advantage plans, dual eligible demonstration projects and Medicaid managed care, LTSS providers are devising ways of creating value and viability in the new healthcare environment. Deb Gracey, a former Medicare Advantage executive and Dr. Art Jones, a former provider. CEO, will share insights on multiple aspects that need to be considered: Setting the stage for the development of a managed care strategy Current value-based payment models and where managed care organizations stand in the inclusion of LTSS and post-acute providers Value creation in the managed care environment Innovative models that are being considered, piloted or implemented Your role in the transformation of health care 11:50-12:40 Lunch / Presentation Post-Acute Care Current Legal and Compliance Issues Susan Benz, Damon and Morey Susan Benz, Senior Partner at the Law Firm of Damon Morey will discuss current Federal and State Enforcement Issues facing LTC Providers, including the following topical areas: Increased criminal prosecution for HIPAA violations RUG upcoding/gaming and therapist productivity Supervision of ancillary service providers Prosecution of staff for bad behavior and facility's role Challenges to Corporate Governance by the Reconfiguration of the Health Care Industry 12:40 1:40 Technology: Improving Quality and Performance in Post-Acute Majd Alwan, LeadingAge Center for Aging Services Technologies Mr. Alwan will discuss current trends in long-term and post-acute information technology and discuss industry best practices to improving provider quality and performance, as well as what providers need to know regarding financing healthcare information technology initiatives. 1:40 2:40 NYS Office of the Medicaid General Update Matthew D. Babcock, JD, New York State Office of the Medicaid Inspector General Mr. Babcock will address OMIG s current initiatives impacting long-term and post-acute providers and how providers can work more closely with the OMIG in improving industry compliance.

4 2:40 3:40 Financial Viability = Strong Culture Veronica Barber, EdD, LNHA Managing Partner, Elder-Strong As organizations struggle with impending mandates, an unstable economy and rapidly changing payment streams, they can easily lose sight of the purpose for their organization s existence. In order to succeed in this new environment, it has become even more important to create a strong and healthy organizational culture. Ultimately, the culture of the workplace is the foundation upon which change is built. Creating the desired culture is predicated on having a workforce that is mission-driven, has clear objectives, and is aligned and works as a team. Therefore attracting and retaining the right employees is critical. This session will depict strategies for creating and sustaining a new culture in the workplace. 3:40-4:30 Building Stronger Provider Affiliations and Collaborative Networks Carol Cassell, Freed Maxick Healthcare Enhancing and building collaborations among physicians, hospitals, post-acute care providers, emerging ACOs and managed care plans is essential in today s health care environment. What are the requirements and considerations for success in a transforming health system? 4:30 6:00 NETWORKING & HAPPY HOUR!

5 Registration Form Long Term Care Institute Classics V November 20, Niagara Falls Boulevard 8:30 AM to 4:30 PM Amherst, NY RSVP by November 10, 2014 Please Send Completed Form and Payment to: By Mail: Kristin M. Anderson, CPA kanderson@beechwoodcare.org Vice President of Finance and IT Beechwood Continuing Care 2235 Millersport HWY Getzville, NY $75 for Members and $125 for Non-Members *Organizations registering 3 or more attendees pay the HFMA Member price. Please make check payable to HFMA WNY Treasurer Facility Information Facility: Phone Number: Name Member # CPA (Y/N) CPE (Y/N) Fee

6 Speaker Biographies Patrick Cucinelli Vice President of Financial Policy LeadingAge NY Patrick Cucinelli is the Vice President of Financial Policy with Leading Age New York. He is responsible for analyzing all aspects of Medicare and Medicaid reimbursement and its impact on nursing homes. He has developed major memos on nursing home survival strategies, budgeting, consolidated billing, physician billing, therapy billing, Part A and Part B Medicare rate analysis, pharmacy billing, Medicaid rate analysis, and HIPAA. The policy team at Leading Age New York is responsible for providing guidance, advocacy, data analysis and general support for its membership across the spectrum of long term care services and housing in New York, and works closely with the national Leading Age affiliate on federal issues. Me. Cucinelli joined Leading Age New (formally NYAHSA) in 2002, as a Financial Policy Analyst. Mr. Cucinelli has 18 years of upper management level experience in health care administration, including 15 years as administrator-of-record in both proprietary and non-profit nursing homes. Mr.Cucinelli received his MBA from Cornell University and Bachelor s degree from the University of Rochester. Kris Mastrangelo Founder/CEO Harmony Healthcare International Kris Mastrangelo, President and CEO, owns and operates Harmony Healthcare International (HHI). HHI is a premier Healthcare Consulting firm specializing in Compliance and Reimbursement. Kris brings her long term care expertise with more than 20 plus years of experience in this industry as an Occupational Therapist, Licensed Nursing Home Administrator and a Masters in Business Administration. Kris leadership and vision have helped HHI become one of the most recognized and trusted consulting companies for Compliance and Reimbursement in the Healthcare industry. Kris single handedly developed a unique approach to perfecting Compliance practices as well as accuracy with Reimbursement, while simultaneously protecting the facility from Governmental Medical Record reviews resulting in refunding Revenue to the Medicare Contractor or Intermediary. Kris devised the HHI process aimed at positively impacting Patient Care, the facility s Reimbursement and Operational Systems. Kris is a nationally recognized speaker on SNF compliance and operational excellence in long-term care.

7 Michelle Dubner RN, BSN CEO Global Healthcare Associates LLC Michelle Dubner RN, BSN is the founder and CEO of Global Healthcare Associates LLC. As a registered nurse of over 32 years, she has hands-on experience as a homecare expert, nurse supervisor, and more recently as a Director of Patient Services. In 2005, with a wealth of administrative and clinical health experience under her belt, Michelle founded Global Healthcare Associates, which she continues to operate today. Michelle is also a well-regarded speaker in the field of healthcare, and presents seminars across the U.S. in Home Health care, compliance, cultural competencies, team building, management, and leadership. She has also served on boards of for-profit and non-profit healthcare companies, and has been contributing as a parttime site visitor for the national accreditation company Community Healthcare Accreditation Program, Inc. for the past ten years. Deborah Gracey Health Management Associates Principal A strategic and innovative leader, Deborah Gracey knows how to leverage performance management, organizational effectiveness and process improvement to boost effectiveness, drive innovation, and deliver results. Prior to joining Health Management Associates, Deborah was president of Humana s Medicare business for the Great Lakes Region, where she was responsible for profitability and growth of 35 Medicare Advantage plans in Illinois, Michigan and Wisconsin. She oversaw complex provider relationships, community relations, revenue enhancement and cost containment. While at Humana, Deborah also created and ran a new performance organization accountable for integrated, enterprise-wide Medicare performance management, process engineering and planning to create an exemplary consumer experience for 4.5 million Medicare members. Prior to joining the healthcare industry, Deborah enjoyed working in the airline industry. As director of airport administration, she was responsible for directing the administration of 100 airports and 10,000 employees. She held numerous leadership positions during her time with U.S. Airways. Deborah is certified as a Six Sigma Green Belt. She earned her Bachelor of Science degree in business administration from the University of Maryland University College. She recently completed an intensive 16-month program, Healthcare Leaders 2020.

8 Art Jones, MD Health Management Associates Principal A pioneer in the accountable care organization movement, Dr. Arthur Jones has 27 years of "boots-on-the-ground" experience as the founding physician and CEO of Lawndale Christian Health Center a large urban community health center on Chicago's west side. Dr. Jones helped establish Lawndale as a model managed care organization in the forefront of delivering Medicaid services under a near global capitation payment system. During his tenure, the organization earned top ratings for financial performance and invested in innovations to improve the health of the uninsured. Its redesigned delivery model capitalizes on the efficiencies of electronic medical records, and its care coordinators are creating fully integrated medical homes. Dr. Jones has also served as chief medical officer for a Medicaid managed care company. Work is his home, and community health is his passion. Dr. Jones has lived in the disadvantaged community he has served since He "moonlights" as the chief medical officer for Medical Home Network a foundation-funded demonstration project to improve the health status of low-income Chicago area residents by organizing providers to elevate quality, improve access, reduce costs and reinforce the medical home. Dr. Jones earned his MD from the University of Illinois and bachelor's degree from Taylor University. He completed his internal medicine residency, chief residency and cardiology fellowship and continues to serve as a clinical associate at the University of Chicago. At HMA, Dr. Jones focuses on advancing Medicaid accountable care organizations and helping federally qualified health centers transition to managing health care risk and reap some of the downstream financial benefits from operating as a well-functioning, patient-centered medical home. Susan A. Benz Damon Morey Senior Partner and Co-chair of the firm's Health Care and Human Services Practice Group Susan is Co-chair of the firm's Health Care and Human Services Practice Group and is a Senior Partner at Damon Morey. She is a member of the firm s Business & Corporate Department. Her practice focuses on regulatory, reimbursement, and compliance matters. Ms. Benz represents skilled nursing and assisted living facilities, home health agencies, hospices, pharmacies, and health care professionals. She also represents not-for-profit organizations that provide services to individuals with developmental disabilities, communication disorders, and behavioral health issues. Ms. Benz regularly advises clients on Medicare, Medicaid, and third party payor reimbursement matters (such as government audits and investigations, self-disclosures, fraud and abuse, and corporate compliance matters); government licensure issues (certificate of need,

9 transfers of ownership, certification, survey, and enforcement actions), and health information privacy concerns (HIPAA and state law compliance). She handles patient care matters (admission, discharge, treatment, and end-of-life decision-making issues) and the concerns of health care professionals (employment, licensure, credentialing, discipline). Ms. Benz also drafts and negotiates contracts involving managed care, employment, affiliation, and vendor relationships. Ms. Benz is admitted to practice in New York, Massachusetts, Vermont, and before the United States Supreme Court. She is a member of the American Health Lawyers Association, the Health Law Section of the New York State Bar Association and the Health Care Law Committee of the Bar Association of Erie County. Ms. Benz is also a member of the Western New York Chapter of the Women s Bar Association of the State of New York. A frequent lecturer, Ms. Benz has also authored numerous articles on health law issues. She was recently named to The Best Lawyers in America 2015 (Copyright 2014 by Woodward/White, Inc., of Aiken, S.C.) in the field of Health Care Law, a distinction she has held since In 2012, she was named to Business First of Buffalo's 2012 Who's Who in Law List. Prior to her employment at Damon Morey, Ms. Benz practiced health care law and litigation at a Boston, Massachusetts law firm, and served as a judicial law clerk to a justice of the Vermont Supreme Court, the state s highest court. Ms. Benz received her BA with honors from Harper College, University of Binghamton and her Juris Doctorate from Northeastern University School of Law. Majd Alwan, Ph.D. Senior Vice President of Technology, and Executive Director LeadingAge Center for Aging Service Technologies (CAST) Majd Alwan, Ph.D., received his B.S. in electrical engineering from Damascus University, Damascus, Syria in 1988, his M.S. in control engineering with distinction from Bradford University, Bradford, UK, in 1992, and his Ph.D. in electrical engineering (intelligent assistive robotics) in 1997 from Imperial College of Science, Technology and Medicine, University of London, London, UK. Alwan worked from for the Higher Institute of Applied Sciences and Technology (HIAST), as a Design Engineer and a Research Assistant. In 1997, he returned to HIAST as a Lecturer and Researcher. In the beginning of 2002, he joined the Medical Automation Research Center (MARC) at the University of Virginia, Charlottesville, Virginia, as an Assistant Professor and Director of the Robotics and Eldercare Technologies Program. His research interests encompassed designing, validating and evaluating the outcome of monitoring systems and assistive devices that address the needs of seniors and their caregivers. While at MARC, Majd published several articles on monitoring technology. He co-founded Home Guardian LLC, a start-up company that specializes in In-Home Functional and Health Status Monitoring Systems and Services. He is a member of the IEEE's Engineering in Medicine and Biology, and Robotics and Automation Societies. Dr. Alwan is also a member of IEEE-USA's Medical Technology Policy Committee (MTPC) and the Geriatric Care Workgroup (GCW).

10 Matthew D. Babcock, JD, FACHE Assistant Medicaid Inspector General Compliance New York State Office of the Medicaid Inspector General Matt Babcock is a 1982 graduate of Albany Law School, a 1979 graduate of LeMoyne College, and a Fellow of the American College of Healthcare Executives (2008). He became the Assistant Medicaid Inspector General in OMIG s Bureau of Compliance in May, Prior to joining OMIG, Mr. Babcock was an attorney in private law practice and held various legal and management positions in the hospital and health insurance/managed care industries. He served on hospital and nursing home governing boards as well as in positions as a hospital and insurance compliance officer. Mr. Babcock is an Adjunct Professor of Law at Albany Law School, where he taught healthcare finance and managed care law, and he has given numerous presentations since joining OMIG to trade and provider groups on topics that include Self- Assessment of Provider Compliance Programs, the Evolution of Compliance Officers and Compliance Programs, Best Practices in Compliance, compliance issues for Special Investigations Units in managed care companies, Corporate Integrity Agreements and Compliance Programs, and various OMIG Webinars on New York s mandatory compliance obligation. He is a member of the Bureau of National Affairs (BNA) advisory board for the Health Care Compliance Guide, which began publication in Mr. Babcock is responsible for managing OMIG s Bureau of Compliance and its regulatory activity, which includes conducting compliance program reviews of New York State Medicaid providers, negotiating and enforcing corporate integrity agreements, and drafting and issuing OMIG s Compliance Alerts and other compliance guidance. Veronica Barber, EdD, LNHA Managing Partner Elder-Strong, LLC Veronica A. Barber is the co-founder of the newly formed company, Elder-Strong, which specializes in helping leaders to create elder-directed communities by building strong organizations. Veronica is a visionary executive leader, with more than a decade of experience transforming nursing home organizational culture. Veronica previously worked as the Vice President/COO of a large nursing home in New York, where she lead the development of the first community Green House homes in the nation, and created a new organizational structure at the traditional nursing home, in which elder-directed teams existed in a department-less environment. During her tenure she also: lead the organization to become an Eden Alternative Home, implemented a new operational structure that aligned with an elder-directed mission, developed a leadership curriculum for managers, eliminated agency staff usage, decreased turnover to an average of 7% per year, increased occupancy to an average of 97-98%,

11 implemented organizational metrics such as SMART goals and scorecards/dashboards, developed an enhanced CNA training program with a person-centered focus, developed performance management processes & tools, and commenced a new QAPI structure. Veronica received her doctorate in executive leadership with a concentration in organizational change and change leadership, from St. John s Fisher College. She also obtained a master of science in health services management from New School for Social Research, and a bachelor of arts in mathematics from Syracuse University. Additionally, she has a diversified foundational work background: experience as a certified nursing assistant (in all healthcare settings), experience working with individuals with disabilities, and experience as a policy analyst for LeadingAge New York. Veronica has achieved a high-level of expertise in the following areas: strategic positioning & integration, transformational leadership, culture change, organizational development, team performance, change leadership, public policy & advocacy, board governance, financial stewardship, and public speaking. Veronica has provided educational programs on a variety topics as well as being a session presenter at state and national conferences. Carol M. Cassell Principal Strategy & Performance Improvement Freed Maxick Healthcare Carol M. Cassell is a Principal in Freed Maxick s Healthcare Practice with a focus on strategy and performance improvement. Carol has over 30 years of combined experience in health plan and healthcare delivery systems with leadership roles in provider network management, care management, Medicare Advantage and Managed Medicaid Product management, PCMH program implementation and information management. In addition Carol has served as a strategic advisor in the development and oversight of complex health strategy initiatives supporting population health management and value based payments. Carol s consulting experience includes developing a business sustainability plan for a federal BEACON health information exchange project, leading a New York State regional health planning grant, vendor selection of a care management system for several Medicaid Health Homes, financial modeling for a CMMI innovation grant, and coordination of a DSRIP Design Grant application. Carol has been at the forefront of understanding the New York State DSRIP program and its implications to all providers.

12 The Western New York Chapter of HFMA is pleased to recognize, and wishes to express its sincere appreciation to those who support our educational programs throughout the year our valued Sponsors! PLATINUM SPONSOR: GOLD SPONSORS:

13 SILVER SPONSORS: BRONZE SPONSORS: