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                                                                                     FA L L           2 0 0 8

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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)

Home Health Performance
                                                         AMEDISYS
Improvement Tracking                                     Chooses ACHC
By Teresa Harbour, RN, MBA, MHA                          One of the leading providers of
Harbour Health Services, Inc.                            home health care and hospice
With all of the data available for home health           services in the United States and
agencies to review, it can be a daunting task            Puerto Rico has achieved ACHC
trying to track and trend this vast amount of            accreditation.
information. Performance improvement tracking            (Continued on Page 16)
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.

Continued on page 3


Beyond Benchmarking in Home Health
It’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


Walgreens-OptionCare and                                                   INSIDE:
American Home Patient now ACHC                                             Improve Your Financials (Part 3 of
and AeroCare Holdings renews                                               5): by Richard Wetherell I Page 2

Walgeens-OptionCare and American Home Patient have been ac-                Home Care Merger & Acquisitions
credited by ACHC. “This accreditation demonstrates our ongoing             Update: by Dexter Braff I Page 6
commitment to providing the highest level of patient care and
                                                                           Common Consumer Complaints:
clinical excellence,” said Paul Mastrapa, President of Walgreens-
                                                                           by Leslie Knuth I Page 7
OptionCare. “We’re especially proud that this national accreditation
was attained with no deficiencies or recommendations.”                     Spotlight on Provider: Maxim
                                                                           Healthcare I Page 10
Walgreens-OptionCare is the second-largest home care provider in
the nation with nearly 100 facilities in 35 states. Services accredited    Breaking News: Hospice &
included infusion pharmacy, home health nursing, clinical respi-           Behavioral Health I Page 16

Continued on page 9
                                                                                         S ur veyo r Fa ll 2008 1
                                 Strategy Implementation
                                 Improve your Financials and Customer Satisfaction
                                 Through Strategy Implementation. (3rd of a 5 part series)
                                  By Richard M. Wetherell




C
        ould you improve your orga-           perspective. Look at the chart below      seven simple quality tools. A tech-
        nizations’ understanding of the       and make sure your team agrees what       nique called “information mapping”
        strategy and direction of your        your firm’s customer value proposition    is also an effective tool to document
business? Would you like to improve           is before you begin to define the key     procedures you may have to write.
profits and reduce costs while delight-       processes.                                Information mapping is generally one
ing your customers? Would you like to                                                   to two pages as opposed to the typical
                                              Defining key processes can be an
improve employee morale and reten-                                                      10-page procedure covering the same
                                              exhausting effort if not approached
tion and involve your employees in                                                      information.
                                              correctly. For maximum conscious-
achieving the business objectives? WE
                                              ness and easier implementation, the       Once the 3 to 5 key processes for your
HAVE A SOLUTION!
                                              task of brainstorming and agreeing to     business are identified, you must de-
In the first two articles we described        the processes that drive your business    fine the learning and growth (people)
how to create and live your strategy          should be performed by your execu-        attributes needed to achieve business
map and balanced scorecard. We                tive team. The hard work begins with      goals and improve those key pro-
discussed the first two categories of a       mapping the critical key processes        cesses. First, define the type of culture
strategy map and balanced scorecard                                                     you want in your business. Second,
as the financial and customer perspec-                                                  define the skills and training needed by
tives. It is important to remember that       Defining key processes can                your employees along with a system
there are three customer perspectives                                                   to measure their effectiveness. Third,
which include Operational Excellence,          be an exhausting effort if               define the type of investments in
Product Innovation and Customer                not approached correctly.                automation your key processes should
Intimacy. You must execute all three                                                    focus on. Should you automate one
perspectives to be successful; however                                                  process or multiple processes? Back
you must select and excel at one per-         and defining the inputs and outputs for   in the 1980’s, GM made the mistake
spective for business success.                those processes. Each process step        of automating a process without first
                                              must be mapped and steps without          mapping and optimizing it. The lesson
In looking at our process perspective,
                                              value should be eliminated. Typically     here is: when poor processes which
we must determine what processes
                                              you should have time and quality          bring poor results are automated, the
drive our strategic objectives which
                                              measures for each of your key pro-        only achievement is attaining poor
will help identify internal performance
                                              cesses.                                   results more quickly.
objectives and enable us to fulfill the
expectations of our customers ac-             There are many quality tools for use      As you can see, the strategy map and
cording to market demands. The                when mapping your processes. Before       balanced scorecard are an excellent
processes must drive the key at-              you begin, it is important to train       framework that describe the strategy
tributes we choose in the customer            your team on flow charting and the        of an organization across four perspec-
                                                                                        tives (Financial, Customers, Internal
 Strategy        Key attributes you must       Key attributes             Brand         Processes and Learning and Growth).
                 achieve for results and to    you must maintain                        They are great communication tools
                 define key processes                                                   that bridge the gap between the goals
 Operational     Price, quality, time,         Service, relationships     Smart         set by senior executives and the front
 Excellence      selection                                                shopper       line team members whose perfor-
                                                                                        mance is ultimately responsible for
 Customer        Service, Relationship         Price, quality, time,      Trusted
 Intimacy        building                      selection                  Brand         reaching those goals. They are mea-
                                                                                        surement systems that report on past
 Product         Unique products and           Price, quality, service,   The Best
                                                                                        and future performance and assist with
 Leadership      services and time and         relationship               new product
                 functionality/Selection                                                implementing and managing change
                                                                                        in your organization.
2 Sur v e yo r Fall 200 8
Home Health Performance Improvement Tracking (Continued from Page 1)

Home health agencies collect per-
formance information daily through                                          PERFORMANCE TRACKING TOOL
satisfaction surveys, complaints, infec-
                                           Quarter: ___________
tion surveillance, adverse events, and
unusual occurrences. Other perfor-           Satisfaction Surveys: Positive Responses: _____ Negative Responses: _____
mance information is usually captured
on a monthly or quarterly basis. This        Complaints: Total Complaints: _____
includes ethical issues, unmet service     Types of complaints: ___________________________________________________________________
and care needs, client record reviews,
performance improvement activities,          Infection Surveillance: Total Infections: _____ Client Related: _____ Employee related: _____
and OBQM/OBQI reports.
                                           Types of infections: ____________________________________________________________________

                                             Adverse Events/Unusual Occurrences:
Home health agencies                       Total Occurrences: _____ Client Related: _____ Employee Related: _____
collect performance                        Total Falls: _____ Balance: _____ Trip Item: _____ Transfer: _____ Wet Surface: _____ Other: ______
information daily through                  Total Injuries: _____ Skin Tear: _____ Bruise: _____ Laceration: _____ Sprain: _____ Back Injury: ______
satisfaction surveys,                      MVA: _____ Equipment: _____ Suicide Threats: _____ Other: ___________________________________
complaints, infection sur-                 Total Medication Reactions: _____    Type: _________________________________________________
veillance, adverse events,                 Total Medication Errors: _____       Type: _________________________________________________
and unusual occurrences.                   Total Equipment Malfunctions: _____ Total Recalls: _____

                                           Total Treatment Alterations: _____   Discipline: _____________________________________________

By developing a reporting format,          Total Property Incidents: _____      Theft: _____      Damage: _____ Other: _____________________
agencies can ensure that performance       Total Exposures: _____            Types: ____________________________________________________
information is collected and evaluated.
A quarterly reporting tool is a simple       Ethical Issues: _____________________________________________________________________
way to capture data for tracking and
trending purposes. This tool can also        Unmet Service/Care Needs: ___________________________________________________________
be used to relay and report findings
                                             Client Record Reviews:
and resolutions to the Professional
Advisory Committee and Governing           Results: ______________________________________________________________________________
Board. ACHC standards require quar-        _____________________________________________________________________________________
terly reporting and involvement of the
agency’s Professional Advisory Com-          PI Activities:
mittee and Governing Board in the
                                           Indicator: ___________________________________ Benchmark: _________ Results: _____________
performance improvement process.
                                           Indicator: ___________________________________ Benchmark: _________ Results: _____________
Trended information can be used to
                                           Indicator: ___________________________________ Benchmark: _________ Results: _____________
reinforce positive trends or develop
corrective action plans for undesir-         OBQM/OBQI: ____________________________________________----________________________
able trends. This sample performance
                                           ____________________________________________________________________________________
tracking tool may be used to assist
agencies in tracking and trending
                                             Other:_____________________________________________________________________________
performance information.
                                           Trends: ______________________________________________________________________________

                                           _____________________________________________________________________________________

                                           Plan of Correction: _____________________________________________________________________

                                           _____________________________________________________________________________________

                                           Reported to: Staff _______ PAC _______ Governing Body _______

                                                                                                                    S ur veyo r Fa ll 2008 3
Beyond Benchmarking in Home Health (Continued from Page 1)

Clinical Benchmarking                                              latest available reports are from data completed January
                                                                   2007 through December 2007.
Home health has a multitude of opportunities for bench-
marking, thanks in large part to CMS’ (Centers for Medicare      2. Home Health Compare lists the performance of agencies
and Medicaid Services) development of OASIS (Outcome                in 12 outcomes from both the functional and clinical OA-
Assessment Information Set), a dataset specifically de-             SIS domains. These 12 items are a subset of the 41 out-
signed to systematically measure patient outcomes. OA-              come measures and are a reflection of what happened,
SIS is the “star player” in the home health benchmarking            and what happened many months ago, in a rolling 12
world for Medicare and Medicaid patients receiving skilled          month presentation and it is set in stone and published on
nursing or therapy services. This data                                                   the CMS website! If agencies have
is collected on admission or resump-                                                     made positive changes to improve
tion of care and at various other time                                                   outcomes, they will not be reflected
points including transfer or discharge                                                   here for 12-18 months. Consumers
from the agency, and then submitted                                                      looking for a home health agency
to the State monthly and subsequently                                                    in July 1, 2008, will find the data
to CMS.                                                                                  at Home Health Compare for the
                                                                                         October 2006 - September 2007
The accurate completion of this highly                                                   reporting period.
complex and often-changing OASIS
dataset has mission-critical impact on                                                3. In addition, agencies are able to
payment and outcomes. Therefore,                                                         confidentially access, benchmark
staff competency, data validity and                                                      and analyze their own adverse
timely submission are all crucial to an                                                  outcomes reports, OBQI (Outcome
agency’s viability:                                                                      Based Quality Improvement and
                                                                                         OBQM (Outcome Based Quality
1. Select OASIS items are used for                                                       Management Reports). This data
   Medicare payment;                                                                     is not current or easily retrievable.
2. State coordinators monitor OASIS                                                      While drill-down capabilities allow
   validation reports looking for suspi-                                                 agencies to determine both positive
   cious variances;                                                                      and negative patient specific out-
                                                                                         comes, chart reviews are needed to
3. State surveyors use case mix profile reports and outcome        identify staff members associated with these.
   reports during certification visits;
                                                                 These reports present the following challenges:
4. Consumers and referral sources can view a subset of 12
   quality measures from the OASIS dataset to guide selec-         a. Is the patient chart still on site or easily retrievable for
   tion of a quality provider;                                         review?

5. Agencies use OASIS data for clinical, operational, finan-       b. What action can you take on data 12-18 months old?
   cial and performance improvement activities;                    c. How can you monitor or correct staff documentation
6. The OIG (US Office of the Inspector General) includes              habits this remotely retrospective?
   OASIS integrity and validation in its 2008 work-plan;           d. How can you determine if your corrective strategies
7. Seven OASIS outcomes are presently used in the Pay for             have been effective, without distinguishable data since
   Performance pilot                                                  the correction was implemented?

Despite all the benchmarking data available to agencies by         e. How can you reward staff for performance improve-
CMS and its website, surprisingly none provide real-time              ment not yet identified?
or immediately actionable information, thereby limiting the
usefulness of the information.                                   Financial Benchmarking
1. State by state outcome results for specific risk or perfor-   While there are many opportunities for benchmarking and
   mance measures are available at the CMS OASIS site,           improvement in the clinical and operational arenas, finan-
   but this data is old, very old. For example, to research      cial success is pivotal to the agency’s viability. As shown
   the “percentage of patients who improve in the ability to     in Chart 1, the 200 top performing agencies in 2006 were
   bathe in state by state comparisons” in July 2008, the        successful both clinically and financially.
4 Sur v e y o r F a l l 2 0 0 8
However, with PPS Refinement the financial outlook is daunt-                              reimbursement at start of care and at discharge, and payer
ing. From the Medicare cost reports, CMS projects increas-                                mix payment, and average miles per visit. This information
ing number of agencies will experience negative margins                                   assists in agency performance assessments, staffing projec-
through 2013 (see Chart 2).                                                               tions, and the budgeting process.
                                                                                          As is the case with outcomes data, for operational data to
Operational Benchmarking                                                                  be usable and actionable, it should be consistently defined,
In addition to patient outcome measures, agencies are                                     real time, interactive, and provide capabilities to drill down to
interested in operational data, and in comparing operational                              patient specific and staff specific parameters, including vari-
data among their peers and competi-                                                       ous time ranges.
tors. Obviously, this data is not usually
shared among competitors but other                                                                                 Patient Satisfaction
sources are available. Some agen-          Home Health has moved                                                   Benchmarking
cies seek publicly accessible data
                                           beyond traditional bench-                   Patient satisfaction measurement, for
from state regulatory agencies, albeit,
                                           marking. Benchmarking                       all segments of home care, has always
with time, research and extrapolation
                                                                                       been valued and participation has
involved. Professional associations and    data through reputable data                 been high. However, many home care
large consulting agencies often sell or
provide this information…but like CMS
                                           services that provide timely                providers still use a home grown mea-
                                                                                       surement tool that is untested (though
data, there is usually a generous lag in   information helps position
                                                                                       dearly loved by their staff) and affords
reporting.                                 agencies for present and                    no opportunity for benchmarking.
Operational data currently used for           future financial success.                Without a consistent tool that can be
home health benchmarking includes:                                                     benchmarked, providers attempt to
average census, admissions and dis-                                                    fix their lowest scores, and oftentimes
charges and visits per discipline per month or year, number   the results are futile. Benchmarking would have shown the
of visits per patient episode by discipline, number of epi-   provider that most in its segment of the industry suffers with
sodes per patient admission, percentage of LUPAS for Medi-    the same pervasive issue, or more importantly, areas where
care episodes, average case mix weight, average episode       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
Chart 1:
                                                              you find that you fall below the 50th percentile, and your
Top Performance = Higher Profits                              competitors boast 96% in this category.
200 Home Health agencies demonstrate that the top outcomes
can and will produce higher profits. These agencies also demon-                                                                       Continued on page 17
strate fewer number of visits per episode.

Year Ending 2006:
                                                                                          Chart 2:
    70.00%                                                                                % Medicare Home Health Agencies with Negative Profit
    60.00%
                                                                                          Margins – 2008-2013

    50.00%
                                                                                          100%
    40.00%                                                                                 90%
                                                                                                                                                   74%
    30.00%                                                                                 80%
                                                                                                                       64%      64%        64%
                                                                                           70%
                                                                                                             54%
    20.00%                                                                                 60%
                                                                                                      38%
                                                                                           50%
    10.00%
                                                                                           40%
      0.00%                                                                                30%
                   Medicare Profit Case Mix Weight    Visits per    Percent of Patients
                  Margin (based on   (completed      Episode (all    discharged with       20%
                    completed)        episodes)       disiplines)       goals met          10%
   Average for
   all Agencies       15.70%           1.10%          16.10%             16.10%             0%
                                                                                                     2008   2009     2010      2011       2012    2013
   Top 20% in         18.80%           1.11%          15.10%             15.10%
   Home Health
   Compare


                                                                                                                                 S ur veyo r Fa ll 2008 5
        Home Care Merger and Acquisition Update
        by 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.

        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         care arena. Fueled,                                    less, one of the most
        to the extent that transaction vol-       in part, by the                                        attractive M&A sectors
        ume is down more than 70% from            steadily rising stock                                  today. While the
        the peak 2004-2005 periods. That          prices of the public                                   underlying econom-
        said, some deals are getting done,        players in the mar-                                    ics of infusion have
        including some big ones – notably         ket and investments                                    not changed dramati-
        Teijin Limited’s acquisition of Pacific   in the industry by                                     cally over the past few
        Pulmonary and The Blackstone              private equity groups                                years, private equity –
        Group’s announced acquisition of          looking to capitalize on this wave of   likely drawn to (a) expanded oppor-
        Apria. Moreover, when they are            enthusiasm, the demand for acquisi-     tunities in pharmaceuticals courtesy
        getting done, though valuations are       tion candidates continues to rise,      of the Prescription Drug Bill and (b)
        down, they have not plummeted as          propping up transaction volume          the higher margins service oriented
        much as the extraordinary reduction       – and valuation. Even with changes      infusion providers can command
        in demand might suggest. Ac-              in the prospective payment system       – “discovered” the sector two years
        cordingly, opportunistic and highly       – notably reductions in payments at-    ago, fueling a buying spree that
        strategic opportunities remain. But       tributable to reimbursement “creep”     contributed to record setting trans-
        unless the aforementioned cap is          of nearly 11% factored over the next    action volume in 2007 (25 deals).
        eliminated, we do not anticipate a        four years – the market remains         We expect this trend to continue as
        return to the record setting, high        confident in the long-term prospects    these consolidators continue to build
        volume, serial acquisition activity       for the industry. As such, we antici-   size (predominately through acquisi-
        that characterized much of the past       pate a long period of consolidation     tions) to secure a profitable exit via
        10 years.                                 activity – and opportunity – in home    a sale or public offering.
                                                  health care.
        Home Health Care. With more                                                       Hospice. For the hospice sec-
        than 100 transactions completed in        Home Infusion Therapy. Al-              tor, from a merger and acquisition
        2007, and 51 completed in the first       though the home infusion therapy        perspective, it’s all about supply, or
        6 months of 2008, home health care        sector, with decidedly fewer provid-    more accurately, the lack thereof.
        has become the hottest merger and         ers, cannot match the volume of the     While acquisition demand remains
        acquisition sector in the broad home      home health sector, it is neverthe-
                                                                                                         Continued on page 16.
6 Sur v e y o r F a l l 2 0 0 8
Are Complaints Really So Bad?
by Leslie Knuth, Quality Assurance Manager




A
         mong the functions handled        unannounced site visit, or other prac-       3. Telephone/customer communication
         by ACHC’s Quality Assurance       tical methods. While our policy is to           issues: messages are left by custom-
         staff, one which has a direct     maintain client/patient confidentiality         er on voicemail but not returned by
connection with customers relates          (unless issues can only be verified by          the company; customer is on hold
to handling complaints against our         disclosing their name), it’s important          for an excessive time period; com-
accredited organizations. While the        to realize we also have guidelines to           pany does not return calls or provide
number of complaints we receive is         protect confidentiality of providers.           a status update when promised.
a relatively small percentage, ACHC        So while a complaint inquiry from our
                                                                                        4. Billing issues: confusion regarding
would like to provide insight on the       office may seem intimidating, we ap-
                                                                                           billing documents and/or assign-
types of issues reported to us most        proach this process the same as any
                                                                                           ment of benefits; customer not clear
frequently, as well as information about   other survey. Our mission is to follow
                                                                                           whether equipment is purchased or
our compliance process.                    our own procedures with fairness and
                                                                                           rented; customer concern over rental
                                           respect to the consumer and provider,
First and foremost, accredited organi-                                                     cost compared to purchase price.
                                           and avoid making this exercise intimi-
zations must have in place and
                                           dating wherever possible.                    While the above are more prevalent,
follow their own customer
                                                                                                    other reported concerns
satisfaction and complaint
                                                                                                    include caregivers missing
resolution procedures.
                                                                                                    scheduled appointments,
Therefore, with limited
                                                                                                    patients wanting new
exceptions, our organiza-
                                                                                                    equipment versus repeated
tion does not intervene
                                                                                                    repairs, customer prefer-
in a complaint unless the
                                                                                                    ence for a different mobility
client/patient first reports it
                                                                                                    device compared to what
to their provider to discuss
                                                                                                    they have, improper dis-
and possibly resolve any
                                                                                                    charge, etc. Some issues
issues. Once a con-
                                                                                                    can certainly be helped by
sumer has exhausted that
                                                                                                    diligent customer com-
process, he or she may
                                                                                                    munication and education,
contact ACHC.
                                                                                                    while others can be a chal-
Our job then is to collect                                                                          lenge for even top notch
and review information                                                                              organizations.
from the parties involved to deter-
                                           Of the grievances reported to our of-        Our best advice is to follow your orga-
mine whether a violation has occurred
                                           fice, the largest number emanates from       nization’s stated policies and maintain
relating to accreditation standards or
                                           equipment/product providers (e.g.,           clear documentation of service issues
Medicare Conditions of Participation
                                           HME, Complex Rehab, Medical Supply           and/or complaint logs. Regardless of
(COPs). If the issue reported does not
                                           Provider). The second largest number         whether complaint issues result in stan-
involve a potential violation of ACHC
                                           is reported from recipients of home          dards non-compliance, you should be
standards or COPs, then the complaint
                                           health/aide services. When issues are        cognizant of the trends of your custom-
file is documented and closed. The
                                           categorized by type, the list below          ers’ most frequent complaints, as these
fact that complaints often do not meet
                                           reflects the top four categories:            can become prime QI indicators. As a
this initial non-compliance benchmark
                                                                                        consultant once told our staff, com-
means many providers never hear from       1. Repeated problems with equipment:
                                                                                        plaints are like contributions - in the
ACHC about such issues — stated               the same problem recurs or different
                                                                                        long run, they really do make compa-
simply, no news is good news.                 problems occur.
                                                                                        nies better.
If, however, an initial review does in-    2. Customer dissatisfaction over wait
dicate a potential violation, we con-         time: for initial receipt of equipment;
duct an investigation through either          completion of repairs; or for other
a request for provider documents, an          service to be provided.
                                                                                                       S ur veyo r Fa ll 2008 7
MEET YOUR                          Board
                   Barbara Rosenblum                            proprietary technology that "sweeps" data from the host
                                                                system to SHP's database. Results of the data analysis are
                      Barbara Rosenblum founded Strate-
                                                                returned to the healthcare organization within minutes.
                      gic Healthcare Programs in 1996, and
                      since then has grown it to be the lead-   Barbara serves as a member of the National Association
                      ing real-time outcomes, benchmarking      for Home Care and Hospice (NAHC) Financial Manager’s
                      and data provider to the continuum of     Association. NAHC is the largest industry trade association
                      home care (Medicare-certified agencies,   representing the interests and concerns of home care and
                      Hospice, Home Medical Equipment,          hospice agencies. In this position, Barbara will be instru-
Home Infusion and Private Duty). As a healthcare visionary,     mental in guiding and supporting NAHC’s goals through
Barbara identified a need in the home care industry for more    data mining, research and information technology initia-
efficient, effective and accurate data collection and report-   tives.
ing. Her commitment to providing innovative healthcare
                                                                Barbara holds a Master of Arts in Organization Manage-
solutions resulted in her founding SHP, and in 1997 Barbara
                                                                ment from Antioch University and a Bachelor of Science in
received the National Managed Healthcare Organization’s
                                                                Nursing from California Lutheran University. She is a prolific
HITS Award for her ability to use technology for the im-
                                                                author and speaker on a variety of healthcare topics.
provement of patient care.
                                                                The same passion and energy Barbara brings to SHP, she
Barbara continues to pioneer cutting-edge performance
                                                                also brings to her other interests. In 2006, Barbara won a
improvement solutions, finding ways to assist the home care
                                                                United States ballroom dance championship along with her
industry and the patients who depend on it. SHP programs
                                                                partner, a former British and World Champion.
interface with most home care software applications using




                   Floyd Boyer                                  Floyd's experience in Home Health Care spans over 21
                                                                years and includes Respiratory Care, HME, Rehab Technol-
                 Floyd Boyer, BS, RRT, RCP has over 35          ogy, and Fitter Services. He has been involved extensively in
                 years' experience in multiple areas of         state and national Respiratory Care associations and HME
                 Health Care. This experience includes          associations. Floyd is a member of the American Associa-
                 Adult, Pediatric and Neonatal experience       tion for Respiratory Care and the North Carolina Society for
                 at NC Baptist Hospital, Winston-Salem,         Respiratory Care.
                 NC; Moses Cone Hospital, Greensboro,
                 NC; Baptist Medical Center, Jacksonville,      Floyd was a Board member and Chairman of the North
FL; and Bladen County Hospital, Elizabethtown, NC.              Carolina Respiratory Care Board from July 2000 to July
                                                                2002 and currently is the Executive Director of the Board.
Floyd’s experience includes 8 years in Respiratory Care
Education as an Instructor and Program director at Forsyth      He has been a Surveyor for the Accreditation Commission
Technical College, Winston-Salem, NC; and as an adjunct         for Health Care since 1996. Floyd is a member of ACHC’s
instructor at Jacksonville Junior College, Jacksonville, FL;    Standards & Accreditation Review Committee and Survey
and Medical College of Georgia, Augusta, GA. Floyd has          Review Committee. Floyd is certified by RABQSA as a
over 12 years' experience as Director of Hospital Respira-      Quality Management Systems Associate Auditor.
tory Care Departments at Moses Cone Hospital, Baptist
                                                                Although he stays very busy with regulatory matters and
Medical Center, and Bladen County Hospital.
                                                                consulting he finds time to fly airplanes and ride his Harley-
                                                                Davidson motorcycle for relaxation.




8 Sur v e yo r Fall 200 8
                    John Barrett            tions. He has developed and con-           for ASQ Certifications. He has been
                                            ducted training on quality and regula-     an ASQ Quality Press Publications Re-
                     John Barrett has       tory topics including Design Controls,     viewer & has contributed to the ASQ
                     more than 20           Corrective Action, Preventive Action,      Quality Auditing Handbook, 1st & 2nd
                     years in quality       Supplier Quality Management, Process       editions. John is also North Carolina
                     management with        Validations, and standards and regula-     State University Six Sigma Green Belt
                     over 13 years in       tions for executives, managers and         Certified as well as an Examiner for
                     the medical device     individual contributors. John has also     the New Jersey Governor's Excellence
                     industry with ex-      been the Associate Director of Corpo-      Award from1998 – 2005. John was
perience in quality assurance, quality      rate Quality Assurance for Siemens         also selected to be a Malcolm Baldrige
systems, and regulatory compliance.         Medical Solutions, QA Manager/ISO          National Quality Award Examiner for
His areas of expertise include quality      Coordinator for Amana Refrigeration        2004 – 2006 and Member of US TAG
systems (QSR, GMP, ISO, EU MDD),            and as the Senior QA/RA Engineer for       TC 176, ASQ Z1 Subcommittee, and
consent decree’s, auditing, training on     Siemens Energy & Automation.               IEC 62A developing quality system
quality concepts & tools, Six Sigma                                                    standards.
Tools, design controls, manufacturing       John’s education background includes
processes, process validation, correc-      a BSEE in Systems Engineering from         John currently resides in Manalapan
tive action & preventive action, root       the University of Tennessee, and MBA       NJ with his wife who is a high school
cause analysis, supplier quality man-       from East Tennessee State Univer-          mathematics teacher at Rumson-Fair
agement, benchmarking, team build-          sity and Graduate studies in Quality       Haven High School in New Jersey. He
ing, Baldrige Criteria for Performance      Management from Eastern Michigan           has two sons; Patrick who is a Senior
Excellence, strategic planning and          University Online. John also holds         at Duke University and Robert a Soph-
balanced scorecards/strategy maps.          numerous quality certifications that in-   omore at Brookdale Community Col-
                                            clude; RABQSA Lead Auditor for ISO         lege who will be transferring to Rutgers
John is currently an independent con-       9001-2000, ISO 13485-2003 & FDA            University next year. John has been
sultant working with a variety of clients   QS Regulation, ASQ Certified Quality       active in the Boy Scouts of America
from very large medical device manu-        Engineer (CQE), Certified Reliability      for 15 years and both of his sons are
facturers to small start up companies       Engineer (CRE), Certified Quality          Eagle Scouts. John currently par-
both in the USA and other countries.        Auditor (CQA), Certified Biomedical        ticipates on the Manalapan Township
John has helped clients work through        Auditor (CBA), Manager of Quality/         Scouting Committee that identifies Girl
quality problems, prepare for FDA           Organizational Excellence Certification    and Boy Scout projects to work on
inspections, and achieve productivity       – (CMQ/OE). John has also partici-         that will benefit the community.
improvements inside their organiza-         pated in developing new examinations




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

ratory and durable medical equip-           the United States. The company serves      15 states. Services include but are not
ment. The company is a wholly               approximately 380,000 patients annually.   limited to: rental and sale of oxygen
owned subsidiary of Walgreen Co.                                                       equipment; liquid oxygen and con-
                                            The company’s extensive offerings in-
(NYSE,NASDAQ:WAG), the nation’s                                                        centrator systems; Liquid and oxygen
                                            clude respiratory and infusion therapy;
largest drugstore chain with fiscal 2007                                               refills on portable equipment; same
                                            enteral and parenteral nutrition servic-
sales of $53.8 billion and operates                                                    day service for items needed for the
                                            es; respiratory diagnostic equipment;
6,204 drugstores in 49 states, the Dis-                                                care of the respiratory patient; monthly
                                            patient home medical equipment and
trict of Columbia and Puerto Rico.                                                     follow-up visits on oxygen patients to
                                            related supplies.
                                                                                       ensure compliance; and rental and sale
Also recently accredited by ACHC is
                                            Also renewing accreditation is Aero-       of durable medical equipment. Aero-
American Home Patient. AHP, founded
                                            Care Holdings, Inc., a provider of         Care obtained its initial accreditation in
in 1983, is one of the nation’s largest
                                            respiratory and durable medical equip-     March of 2006.
diversified home health providers sup-
                                            ment services throughout the United
plying home medical products and
                                            States. AeroCare has 106 locations in
services to 249 centers located across

                                                                                                       S ur veyo r Fa ll 2008 9
Spotlight on Provider
E    stablished 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-
                                                                                      Maxim’s Homecare Services
                                                                                      Include, but are not limited to:
nies in North America by providing innovative solutions that improve health and
                                                                                      • Implementation of the clinical
quality of life. As a full-service homecare, supplemental staffing, and wellness
                                                                                        Plan of Treatment
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     • Attention to disabilities, chronic
of Maxim’s growth is our demand for excellence in recruitment, retention, and           illness, and/or therapies
customer care. Our performance history speaks for itself and our ongoing efforts
                                                                                      • Coordination of home medical
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     equipment, pharmacy, and
opportunities for continued success.                                                    supplies

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

                                                                                      • Preparation of meals and feeding
What Makes Maxim's Services Different?
                                                                                      • Assistance with daily activities
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!


10 Sur v e yo r Fall 20 0 8
      UPCOMING                           MEET YOUR                       Surveyor
     ExHIBITIONS
                                                           Stephen Toy - HME, Rehab, Clinical
  NAHC 27th Annual Meeting & Expo
                                                           Respiratory Care
  October 12-15 Fort Lauderdale, FL
                                                           Stephen Toy is a Respiratory Care Practi-
           MedTrade Fall                                   tioner with 35 years' experience. After
      October 28-30 Atlanta, GA                            graduating from college and receiving his
                                                           Respiratory license, he worked as Director
11th Annual Private Duty Conf. & Expo                      of Respiratory Care in the acute care setting.
       Nov. 17-19 Orlando, FL            In 1979 he founded and operated Northeast Homecare in New
                                         London, NH where he makes his home with his wife Karyn.
     Home Care Technology Expo           Stephen has been active in his community for many years as
       Nov. 17-19 Orlando, FL            Director of The New London Baseball Club, Past Director of
                                         New London Rotary, is a member of The NH Baseball Umpires
  4th Annual Private Duty Leadership     Assoc. and The National Federation of High School Sports
           Summit & Expo                 Officials, as well as being an active member of AARC. After
       Jan 27-29 Scottsdale, AZ          several successful years he sold his business and went on to
                                         manage several regional and national homecare companies in
                                         Northern New England.
     NHIA National Conf. & Expo
      March 1-4 Baltimore, MD            Currently Stephen divides his time between HealthSouth
                                         Rehab Hospital in Concord, NH and ACHC.
         MedTrade Spring
     March 24-26 Las Vegas, NV
                                                            Robert Wayne Blackburn
                                                            PharmD, MBA - Pharmacy
    Annual Assembly of Hospice &
         Palliative Medicine                 Photo            Mr. Blackburn is currently the Director
       March 25-28 Austin, Tx              Unavailable        of Pharmaceutical Services at University
                                                              Community Medical Center, San Diego,
Essentially Women, Focus on the Future                        CA. Previously, he was Pharmacy Direc-
  March 30 to April 1 Charleston, SC                          tor and Clinical Coordinator at Maxicare
                                         Health Plans, Inc., Los Angeles, CA. As Pharmacy Director, he
      HME Expo & Conference              was responsible for managing a $90 million drug budget. Other
      April 21-23 Baltimore, MD          duties included managing PMPM costs for all lines of business,
                                         providing drug information for Utilization Management and
                                         Quality Management, participated in the Quality Improvement
     NHPCO 24th Management &
                                         Committee, and provided analysis and resources for Disease
           Leadership Conf.
                                         State Management Programs and Interventions.
     April 23-25 Washington, DC
                                         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

     WORKSHOPS                           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
     Preparing for ACHC Survey,          Health Systems Pharmacists, American Society of Managed
           DMEPOS/HME                    Care Pharmacists, and California Society of Health Systems
       October 27, Atlanta, GA           Pharmacists.

                                         Dr. Blackburn received his Doctor of Pharmacy from Creigh-
     Preparing for ACHC Survey,          ton University and Masters in Business Administration from
           DMEPOS/HME                    Pepperdine University. Wayne has authored numerous articles
      March 23, Las Vegas, NV            in major peer review journals in the area of healthcare and
                                         pharmacy benefit management. He has also lectured on these
   Go to www.achc.org to complete        topics for national, regional, and local convention meetings.
          registration form.
                                                                              S ur veyo r Fa ll 2008 11
ACHC Congratulates Its Newest Accredited Locations
This list consists of organizations or branches that were accredited between December 1st 2007 and May 31st 2008



180 Medical, Inc.; OK                       MSP                  Care 1st Medical Solutions Inc.
A-1 Quality Lines Inc.; PA                  HME                  (2 branches); TN                               MSP

AAAIP Pharmacy Corp.; NY                    Fitter, HME, MSP     Carolina Diabetic Supply Group, Inc.; NC       MSP

Access Diabetic Supply, LLC (1 branch); FL Fitter, MSP           Carolina East Home Care & Hospice, Inc.
                                                                 (2 branches); NC                               HH, Hosp
Advanced Home Health, Inc.; CA              HH
                                                                 Carolina Homecare Medical Equip.
Advanced Seating and Mobility Inc.; NC      RTS                  Cntr-Spartanburg; SC                           CRCS, HME
Advanced Service, Inc. (21 branches); NC    CRCS, HH, HME,       Carolina Homecare Medical Equipment
                                            MSP, RX, RTS         Center, Inc.; SC                               CRCS, HME, RTS
Advantage Home Medical Company; SC          HME                  Carolina Medical Sales, Inc.; NC               MSP
Aerocare Holdings, Inc. (5 branches); FL    CRCS, HME            Carthage Pharmacy Services, Inc.
Aeroflow, Inc.(4 branches); NC              HME                  (4 branches); MO                               HME, MSP
Affinity Distribution, Inc.; TX             HME                  Caswell County Home Health Agency; NC          HH
Agape Home Health Care Inc.; IL             HH                   Catawba County Home Health Agency; NC          HH
Airline Drug Inc.; MA                       HME                  Century Home Care, Inc; FL                     HH
Albemarle Home Care (6 branches); NC        HH, Hosp             Certified Respiratory Services, Inc.; GA       HME
AlternaCare Home Health Services Inc.                            Chemique Pharmaceuticals Inc.
(2 branches); KS                            Fitter, HME          (2 branches); CA                               RX
Ambient Healthcare of GA, Inc                                    Cherokee Home Health; NC                       HH, PDA
(2 branches); GA                            IRN, RX              Clay Home Medical, Inc. (2 branches); VA       CRCS, HME
American Home Health Agency, Inc.; FL       HH                   Closer Healthcare, Inc. (2 branches); FL       MSP
American HomePatient, Inc.                                       Coile Inc.; TN                                 HME
(244 branches); TN                          CRCS, HME, RX, RTS
                                                                 Community Health, Inc. (47 branches); NC       Hosp
Analgesic Healthcare, Inc.; FL              MSP
                                                                 Condordia Medical Equipment; PA                CRCS, HME, MSP
Appalachian Medical Equipment Co., Inc.
(2 branches); TN                            HME                  Consolidated Oilfield Rental, Inc.
                                                                 (4 branches); OK                               Fitter, HME
Arcadia Products, Inc. (8 branches); NC     HME
                                                                 Cooley Medical Equipment, Inc.;
Ascentia Home Health Care, LLC                                   (9 branches); KY                               CRCS, Fitter, HME,
(3 branches); FL                            HH                                                                  RX
A-Z DME, LLC; TN                            HME                  Coram, Inc. - Corporate (14 branches); CO      CRCS, HH, HME,
Baitan Enterprises, Co.; FL                 HH                                                                  IRN, RX, AIC
Bay L's Medical Supply, Inc.; NY            Fitter, HME          County of Person; NC                           HH, Hosp
Bennett Surgical Supply Inc.; NY            HME, MSP             Critical Homecare Solutions; PA                CRCS, HH, HME,
BioRX (1 branch); IA                        RX                                                                  IRN, RX

Blue Island Pharmacy, Inc. (1 branch); IL   MSP                  D. A. Surgical Supply, Inc. (2 branches); NY   Fitter, HME, MSP

Boone Drugs, Inc. (13 branches); NC         CRCS, Fitter, HME,   Duval's Pharmacy; MA                           HME, MSP
                                            MSP                  ECU Med Inc; MD                                HME
Breathe Oxygen Services, LLC; TN            HME                  Eldercare Convalescent Service; NC             HH
Brewer Medical Service, Inc; AL             HME, MSP             Express Medical Supply; CA                     HME
Briarwood Pharmacy Inc.; NY                 HME                  Family Home Medical Equipment &
Buffalo Grove Drug Company, Inc.; IL        HME, MSP             Supplies, LLC (3 branches); FL                 Fitter, HME

C&C Drugs, Inc.; LA                         RX                   Finnegan's Inc; AR                             MSP

  12 S u r v e y o r F a l l 2 0 0 8
First Choice Homecare. Inc -                HME, MSP          Maksoud Pharm Inc.; NY                        Fitter, HME
Broadview Heights, OH; OH                                     Maxim Healthcare Services, Inc. ; MD
Five Lac, Inc.; Tx                          HH                (216 branches)                                HH
Fox Med-Equip Services, Inc.                CRCS, HME         MED EMPORIUM, LLC; NC                         CRCS, HME,
(3 branches); IL                                                                                            MSP, RTS
Gary Surgical Supply; IN                    Fitter, MSP       Med Group Home Health; FL                     HH
Genesis Enterprise Inc.; TN                 CRCS, HME         Medical Equipment and Devices, Inc.; MA       HME
Glendale Pharmacy; VA                       HME               Medical Necessities & Services, LLC; TN
Great Lakes Home Health Services Inc.; MI   HME               (3 branches)                                  HME, MSP

Happy Home Health Care P.C.; IL             HH                Medical Technology Resources, LLC; OH         HME

Health & Homecare of Erwin, Inc.; TN        HME               Melanie Home Care Corp; FL                    HH

Health Delivery Management, LLC; IL         Rx                Metro Rehab Services, Inc.; IL                HME, RTS

Healthcare Equipment, Inc.; NC              RTS               MHH Inc.; Tx                                  HH

Healthcare Support Services, Inc.; VA       CRCS,             Middle Tennessee Respiratory; TN              HME
                                            HME, MSP          Mobility Solutions, Inc (2 branches); FL      HME
Hocks Pharmacy, Inc. (2 branches); OH       Fitter, HME,      Mt. Vernon Community Pharmacy, Inc.; IL       HME, MSP
                                            MSP               Nevaeh & Co, LLC; NC                          HME, MSP
Home Assist Medical Equipment, Inc.; NC     CRCS,             Norbert and Leslie Gibola; CA                 Fitter, HME
                                            Fitter, HME
                                                              Northampton County Health
Home Medical Equipment, LLC ; KY            HME               Department; NC                                HH
(2 branches)
                                                              Northwest Medical, Inc.; OR                   HME
Horizon Home Care Supplies                  HME, RTS
(4 branches); VA                                              Nova Home Health; FL                          HH

Horizon Medical Equipment, Inc.             CRCS, HME         O.G.S. Medical & Surgical Supply, Inc.; CA    HME
(2 branches); VA                                              Option 1 Nutrition Solutions
Hospice at Greensboro, Inc.                 HH, Hosp          (5 branches); AZ                              HME
(2 branches); NC                                              Orbit Medical, Inc. (15 branches); UT         HME
Hospice of Davidson County, Inc.; NC        Hosp              Oxy Care; TN                                  Fitter, HME, MSP
Hospice of Randolph County; NC              HH, Hosp          P.I.C., Corp.; KY                             Fitter, HME
Illiana Medical Equipment; IL               CRCS, Fitter,     Park InfusionCare (3 branches); Tx            IRN, Rx
                                            HME, MSP, RTS     Poudre Infusion Therapy, LLC; CO              IRN, Rx
Infectious Diseases Consultants & Travel    IRN               Prestige Homecare Services of Broward,
Medicine, P.C.; SC                                            Inc.; FL                                      HH
Infinity HomeCare, LLC (3 branches); FL     HH                Priority One Home Care; WV                    HME
K&K Rx Services; PA                         HME               PRN Medical Services, Inc.; AZ                CRCS, HME, RTS
Knueppel HealthCare Services, Inc.          Fitter, HME, (4   QualiMed Respiratory & Mobility, Inc.; FL     HME
branches); WI                               MSP, RTS
                                                              R. Bacon Enterprises, Inc. (3 branches); IN   Fitter, HME, MSP
Lake Physicians & Hospital Supply Co.,      HME, MSP
Inc.; NJ                                                      Ready Care Home Health, Inc.; FL              HH

LifeCare Solutions, Inc. - Corp             CRCS, HME,        RehabTECH Supply Corporation; IL              MSP
(11 branches); CA                           IRN, Rx           Reliable Medical Supply of the Midwest; IL    HME
Long Term Care, Inc. (3 branches); SC       CRCS, HME,        ReMarx Services, Inc.; PA                     HME
                                            MSP, RTS          Remco Medical, Inc. 92 branches); IL          Fitter, HME
Longevity Pharmacy, LLC; NY                 MSP               Residential Home Health, Inc.; MI             HH
Major Medical Supply, LLC (5 branches); CO HME                Respiratory Sleep Associates, Inc; AL         HME

                                                                                                  S ur veyo r Fa ll 2008 13
                                                                    ACHC’s E-News Sign-up
                                                                    If you would like to receive your Surveyor Newsletter,
                                                                    press releases, workshop information, The HME
Ross Home Health of Enid, LLC; OK               HH                  Educator and other important news from ACHC then
Rowan I.V. Therapy; NC                          Rx                  sign up at www.achc.org. Simply click “E-News
Salem Mobility, Inc; NC                         HME                 Sign-up”. From there you can customize what type of
                                                                    information you are interested in receiving. It’s quick,
Saturday Partners, LLC (2 branches); CO         HH
                                                                    easy and your information stays private. Try it today!
Simpol Respiratory & Medical Equipment,
Inc.; IL                                        HME
SleepMed Therapies, Inc. (1 branch); AZ         HME, MSP            Introducing: The HME
Sonoma Home Health Care, Inc.; NV               HH                  Educator
Source One Medical, Inc. (2 branches); CA       HME
                                                                    Did you miss attending conference education sessions
Southern Patient Care, Inc. (11 branches); AL   HME                 because there was just too many and not enough time
Specialty Oxygen Services, Inc.; TN             CRCS, HME, MSP      to attend all of the ones you wanted to at the last
St. James Hospital; IL                          HME                 convention you attended? We have the solution! ACHC
                                                                    has created a quarterly e-newsletter called the HME
Star Medical Equipment, Inc (2 branches); Tx HME
                                                                    Educator that provides you with current articles by
State of Franklin Billing Services, Inc.; TN    Fitter, HME         industry experts and access to their archives on topics
Stateline Medical Equipment (1 branch); OH      HME                 that can benefit your business. With this new service
Summit Recovery Services, Inc.; NY              MSP                 for the industry, there is a list of educational tracks
                                                                    according to various topics that you can access.
Suncoast Pharmacy Inc. (3 branches); FL         Fitter, HME, MSP,   You simply click on your topic of choice and a list
                                                RTS
                                                                    of industry experts will appear. You then make your
Sunview Medical Equipment & Supply; Tx          HME                 choice and you will be connected with the authors list
SYMKA, Inc (2 branches); CO                     HME                 of articles. It’s that simple. Get on the HME Educator
                                                                    mailing list today by going to www.achc.org and click
Tactile Systems Technology, Inc.; MN            HME
                                                                    "E-NEWS SIGNUP".
TNJ Products, Inc.; IL                          Fitter, HME
Tom Jones Discount Drug Center of
Garner, Inc.; NC                                HME                 Accreditation Checklist for
TriCounty Medical Equipment & Supply,
LLC; PA                                         CRCS, HME
                                                                    Success
University of Iowa Community HomeCare; IA       IRN, Rx, HME, MSP   ACHC is pleased to announce that a new publication
                                                                    is now available to DME companies. The checklist
VNA DME, Inc.; MD                               HME
                                                                    includes practical questions about policies and
VNA Home Health of Maryland, LLC; MD            HH                  procedures that will help providers understand and
W S Associates (3 branches); MD                 Fitter, HME, MSP    focus on what must be in the content of their policies
                                                                    and procedures. Sample interview questions and
W.C. Rose Drug Store, Inc; NC                   Fitter, HME, MSP
                                                                    observations that are typically asked and looked at
Walgreens OptionCare (140 branches); IL         CRCS, HH, HME,      by the surveyor during the actual survey are included.
                                                Hosp, IRN, Rx,      It is designed as a workbook with ample space for
                                                PDA, RTS
                                                                    comments and notes. The
We Care Medical Supply Company, Inc.; GA        HME                 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.




  14 Sur v e yo r Fall 20 0 8
What People are Saying about ACHC
“We were very pleased with the accreditation                       “I wouldn't change anything about ACHC's accreditation
process. Everything was just great and worked out well             process- I think it went very smoothly. The survey ex-
for us. Really, we had a very, very pleasing experience.           perience addressed so many different facets of what we
We have been surveyed multiple times by another ac-                deal with here in the running of our daily business activi-
creditation company and there is just no comparison.               ties, and really looked at a lot of these areas in providing
ACHC is the best by far. We just really had a great                some best practice suggestions. The survey experience
learning, educational ex-                                                               itself was not disruptive to us and we
perience with ACHC. Our                                                                 considered it a very valuable learn-
                                “Everything went real well. Our Account Man-
surveyor was absolutely                                                                 ing experience. I would recommend
                                ager was great and every time I called her she
great. It was a real plea-                                                              ACHC to anyone- I thought it added
                                always called me back. She did an excellent
sure to work with him.”                                                                 a lot of real value to our organization
                                job for us and I think she helped with a lot of
Care Solutions, LLC;                                                                    and we really enjoyed how smoothly
                                the on-going communication. Overall it was all
Hendersonville, NC                                                                      you folks conducted the process. I
                                about the great communication from ACHC-
                                                                                        really valued that we learned a lot
                                -that was important to us and made a lot of
                                                                                        from going through this process with
                                impact during the entire process!”
                                                                                        ACHC.”
“This was our first time to     Jeremiah Home Health Inc.; McAllen, Tx
                                                                                        Great Lakes Home Health;
go through this process                                                                 Jackson, MI
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                               We help make the
she took care of us. Our surveyor was just wonderful
and we were very amazed by her demeanor, profes-
                                                                         accreditation process simple.
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                       Primas Administrative Solutions
                                                                        successfully prepares our clients
                                                                            to achieve and maintain
“I've been through accreditation many times before                               accreditation.
with your competitors & ACHC is an educational
process versus an adversarial approach. I think this
is what defines and separates ACHC from the others–                                    Please visit us at
this unique way of providing accreditation services.                              www.primasadmin.com
ACHC approaches this as a "real world" situation and                               info@primasadmin.com
it shows. The surveyors know what to do and how we                             817-919-3895 or 817-235-4032
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

                                                                                                      S ur veyo r Fa ll 2008 15
                                           Home Care Merger and Acquisition            AMEDISYS Chooses ACHC
  BREAKING NEWS:                           Update (Continued from Page 6)              (Continued from Page 1)
                                           nearly as strong as during the 2002-        The Accreditation Commission for
“Hospice”, and                             2004 period when hospice was in the         Health Care, Inc. is pleased to an-
                                           spotlight of home care consolidation,       nounce that Amedisys, a leading pro-
“Behavioral Health”                        the supply of acquisition candidates,       vider of home health care and hospice
ACHC is pleased to announce that it        particularly those that are (a) for-prof-   services with agencies located across
has submitted application to CMS           it, and (b) not in danger of exceeding      the United States and Puerto Rico, has
for Medicare Deeming Authority for         reimbursement cost caps is extremely        applied to ACHC for accreditation.
Hospice. The process was delayed                                                       Amedisys chose to seek accreditation
until the final revision of the Condi-                                                 from ACHC because the philosophies
tions of Participation was finalized by      The good news is that                     regarding outstanding commitment to
CMS. It is expected that by early 2009       with the extraordinary                    patient care and maintaining the high-
approval will be made public in the                                                    est quality clinical standards are so
                                            imbalance of supply vs.
Federal Register.                                                                      closely aligned.
                                           demand, valuation remains
ACHC standards fit well with the                                                       The Baton Rouge, LA based company
                                                quite attractive.
philosophy and delivery of patient                                                     was founded by Bill Borne in 1982. Mr.
services for hospice organizations.                                                    Borne is the Chief Executive Officer
And, the survey process is the only                                                    and Chairman of the Board. In 1994,
                                           limited. Accordingly, transaction
one of its kind. Surveys are conducted                                                 the company became public and is
                                           volume in 2007 (10 deals) fell to its
by a hospice nurse as well as a clinical                                               listed on the Nasdaq Market under the
                                           lowest point since 2001. The good
support surveyor such as a medical                                                     symbol “AMED”. Amedisys operations
                                           news is that with the extraordinary
social worker. ACHC’s hospice pro-                                                     focus on providing low-cost, outcome
                                           imbalance of supply vs. demand, valu-
gram standards are considered by                                                       driven health care to homebound
                                           ation remains quite attractive. Further-
many as the best fit in the industry                                                   patients in homes through their 325
                                           more, we expect volume to begin to
which include standards for inpatient                                                  agencies.
                                           tick upward over the next 24 months
services.                                  as the M&A pipeline “re-loads” with
                                           companies that, having begun opera-
                                           tions over the past two to three years –
New ACHC                                   in part, to capture some of the returns
                                           seen during the market’s peak – ma-
Behavioral Healthcare                      ture and get ready to test the market.
Standards                                  Dexter W. Braff is President of The
Many of the agencies that are ac-          Braff Group, the leading investment
credited by ACHC provide behav-            banking firm specializing in the home
ioral healthcare services, which may       health care, hospice, infusion therapy,
include specific services to meet          specialty pharmacy, health care staff-
the needs of persons with mental           ing, and home medical equipment
health, developmental disabilities or      market sectors. The firm provides an
substance abuse issues. This spring        array of transactional advisory ser-
ACHC undertook the task of develop-        vices including sell side representa-
ing behavioral healthcare standards        tion, debt and equity recapitalizations,
that reflect evidenced based practices.    strategic planning, and valuation.
The Board of Directors recently ap-        Dexter can be reached at 888-922-5169
proved the standards and plans are         or dbraff@thebraffgroup.com.
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.




16 Sur v e yo r Fall 20 0 8
Beyond Benchmarking (Continued from page 5)
                                                                                          What Do You
Summary                                    2009, 75% of the incentive pool will be
                                           shared with those agencies in the top          Care About?
Home Health has moved beyond tradi-        20% of the highest level of patient care
tional benchmarking. Benchmarking                                                         For 23 years ACHC has been
                                           and 25% percent of the incentive pool
data through reputable data services                                                      listening to providers by responding
                                           will be shared with the top 20% of those
that provide timely information helps                                                     to your suggestions. We have taken
                                           making the biggest improvements in
position agencies for present and future                                                  away the fear of surveys with ones
                                           patient care. As payment for services
financial success.                                                                        that are friendly and educational;
                                           moves closer and closer to this value-
                                                                                          created standards that are relevant
Timely benchmarking through repu-          based model, agencies need to create
                                                                                          and reasonable; and provided
table data services shows an agency        their outcomes and benchmarks, not
                                                                                          customers with personal
where it stands in relationship to peers   fall victim to them.
                                                                                          account managers.
and is essential to prepare for home       Barbara Rosenblum is the Founder
health Pay for Performance, which will                                                    However, we are
                                           and CEO of SHP, the leader in real-time
tie a portion of payment to delivery                                                      always seeking to
                                           decision support and benchmarking for
of quality care. Benchmarking can                                                         improve our perfor-
                                           the entire spectrum of home care. Ms.
position agencies to be among the top                                                     mance. So, we are asking
                                           Rosenblum was recently elected to the
20% awarded financial incentives for                                                      you, the provider, to tell us
                                           Board of Commissioners of ACHC.
stellar outcomes. Under the demonstra-                                                    what matters to you. What
tion project, being piloted in 2008 and                                                   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,
    ACHC offers discounts to members of                                                   “What do you care about?”
    the following groups:
    AIHMES                                 HD Smith
    Amerisource Bergen                     HME Providers
    Burlington Drug Co.                    Kinray                                     LINK Consulting Group, Inc.
    CAHSAH                                 McKesson                                               Wayne M. Link RCPT, RCP
                                                                                                  Accreditation Consultant
    D.A.B.G.                               Med Trust
                                                                                             HME, Rehab, Respiratory, Sleep Labs,
    DME Train (Aspirant)                   Med Trust of Tampa Bay                                  O & P & Pharmacy HME
    Dedicated Distribution                 Medline
                                                                                       Preparing for Accreditation
    Electronic Billing Services            Proclaim                                   As accreditation surveyors and consultants, Link
    Essentially Women                      SCMESA                                     Consulting Group recognizes non-compliant area
                                                                                      and provides solutions and results.
    Grove Medical                          VGM
                                                                                      Our goal is to assess and guide provider companies
    HCAV                                                                              through the accreditation process and remain
                                                                                      compliant on a daily basis. ACHC, CHAP & JCAHO

                                                                                      •	 Policy	and	Procedure	Manuals
                                                                                      •	 Compliance	Manuals	and	Audits
                                                                                      •	 Financial	&	Accounts	Receivable
               We Need Your Email Address!                                            •	 Representation	during	survey	process	(if desired)
                                                                                      •	 Mock	Surveys	(Accreditation, State Inspections, etc.)
                      Want to be in our email database?                               •	 Accreditation	Assistance
                      Receive your Surveyor Newsletter,                               •	 New	Business	Set-Up
                    press releases, workshop information,                             •	 Forms	Management
                                                                                      •	 Consultation
                             and more via email.
                                                                                        990	Mountain	Laurel	Drive	•	Columbus,	NC	28733
             Visit www.achc.org & click on "E-News Sign-up"                             Phone:	828-894-8406	•	Fax:	828-894-8006
                                                                                        www.linkconsultinggroup.com	•	wml990@alltel.net

                                                                                                        S u r veyor Fa ll 2008 17
A small HME provider recovered $20,773.80 using an ACHC Quality Improvement (QI) Standard




August 9, 2007

Mr. Tim Safley
Accreditation 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, President
Medtrac Solutions, Inc.




18 Sur v e yo r Fall 20 0 8
    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!




                      Affordable Health Care
                      Consultants
                      We 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
                                                                Contact AHCC at:
                          Mock Surveys                          (919) 368-5565
                          Start Up Assistance                   www.ahcc.com
                                                                e-mail: info@ahcc.com
                          Financial AR Consultation
                          Competitive Bidding Application Assistant

                                                                   S u r veyor Fa ll 2008 19
                                      Non-Profit Org.
           ®
                                       U.S. Postage

                                 ®
                                         PAID
                                       Raleigh, NC
4700 Falls of Neuse Road, Suite 280   Permit No. 525
Raleigh, NC 27609
(919) 785-1214 | www.achc.org

				
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