Simione™ Healthcare Consultants

Operations


Assessment & Financial Analysis Clinical Operations Process Engineering
Strategic Planning Value-Based Purchasing Start-up Services Survey Readiness

Our Operations consulting team provides the complement of services that enable organizations to improve quality, reduce cost, improve outcomes, and streamline operations. Key areas of focus include the following.

Assessment & Financial Analysis

We provide an in-depth review of your organizational structure, service delivery models and management of information, both operationally and financially, to identify opportunities for improvement in your organization.

Customized services may include:

  • Re-engineering of operational and organizational design

  • Mock state, federal and accreditation surveys

  • Competency assessment programs

  • Interim Executive Management Services

  • Assessment of performance in key indicators

  • Needs assessments for additional services

  • New service integration

  • Assistance with start-up activities for new product lines

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Clinical Operations

We assess all aspects of clinical operations from policy and procedures and quality programs to scheduling and staffing competencies. Our clinical team is highly experienced in agency management, quality improvement, process engineering, direct care provision and staff development.

Customized services may include:

  • OASIS review/audit and training

  • Clinical documentation studies

  • Tools and resources for value-based purchasing

  • Assistance with pre-claim review

  • Productivity and staffing analysis

  • Assistance with policy and procedure development

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Process Engineering

We provide a fundamental review of processes from referral management to claims generation with recommendations for achieving best practices to maximize resources and gain a competitive edge.

Strategic Planning

We facilitate the development of a strategic direction for many organizations every year, helping leadership teams and boards of directors identify priorities and potential opportunities for both short- and long-term business plans.

Our goals at Simione center on helping to position strategic-thinking organizations to thrive in changing environments and identify the resources needed for maintaining high quality and cost control, while working to achieve organizational growth.

Simione’s strategists provide insightful support to busy home care and hospice executives through these and other strategic services offerings:

Organizational Strategic Plan

  • Board development and strategy sessions

  • Research and interpretation of industry trends

  • Identification and analysis of existing opportunities

  • Strategies to capitalize on opportunities

New Business Development Plan

  • Market analyses

  • Feasibility studies

  • Business plans

Mergers and Acquisitions Services

  • Due diligence (clinical and financial)

  • Business valuations

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Value-Based Purchasing

Where do you stand with value-based purchasing? Have you performed a readiness assessment for your agency? Do you have the tools to succeed in an environment that rewards for value, not volume?

Simione Healthcare Consultants understands that home health agencies (HHAs) want and need more information about the requirements for Value-Based Purchasing (VBP). We will provide real-time strategies to operate within this developing CMS purchasing model designed to develop greater transparency regarding quality and align the market to deliver care based on value over volume. To be ready for these changes, HHAs will need to evaluate operations, ensure OASIS accuracy, and provide education to determine the most efficient structure and processes for demonstrating high-quality care and compliance in an integrated, streamlined and cost-effective manner.

As the largest consulting firm in the U.S. dedicated to post-acute providers, Simione has developed a Value-Based Purchasing Toolkit to prepare HHAs for success with the VBP model. The Toolkit includes resources and support to improve performance with quality measures and public reporting, including:

  • Snapshot Assessment: Simione will assess your HHA's currently reported measures and status to identify specific opportunities for improvement, and compare your performance to providers in your state.

  • Readiness Checklist & Analysis: Simione will help your team understand what VBP means, its potential impact on your agency, and what clinical and operational strategies will be necessary to improve outcomes.

  • Newly Reported Measures & QAPI Assessment: Simione will prepare your HHA for the measures not currently reported, and assess your QAPI program to help you incorporate these measures in an efficient manner.

  • Training & Support: Simione will provide training for OASIS and the Home Health CAHPS Survey to help your team understand these measures, and facilitate improvements for public reporting, survey readiness and VBP.

Let Us Help You Succeed with Value-Based Purchasing – Call 844.215.8823

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Start-up Services - Home Health and Hospice

Simione Healthcare Consultants provides comprehensive consulting support for the start-up of home health and hospice organizations, helping numerous agencies open and/or launch additional lines of business to support growth.

Essential first steps for home health or hospice start-up include the completion of a market assessment, business plan and budget proforma to ensure effective implementation and successful completion of licensure and certification to meet state and federal requirements. New owners/operators should expect the process to open a new home health or hospice organization to require:

  • a capital investment in the range of $200,000-$300,000 for start-up costs

  • approximately 12-18 months to obtain state licensure and Medicare certification

SCOPE OF START-UP SERVICES: HOW SIMIONE CAN HELP

Simione experts provide both on-site and off-site consulting, depending upon each client’s needs with respect to scope of work, budget and timetables. Services and support may include the following based on a specific work proposal and project estimate prepared for each client:

  • Market Assessment

  • Business Plan

  • Budget Preparation and Financial Proforma Review

  • Operations/Organizational Structure

    • Table of organization, staffing/service delivery models, staffing ratios, personnel functions, job descriptions

  • State, Federal and Accreditation Survey Preparation (application, documentation, CMS 855A, mock survey)

  • Policy & Procedure Manuals and Forms Development

  • Quality Assessment/Performance Improvement Planning

    • Measuring and improving quality outcomes

    • Staff Training/Competency Testing/Clinical Skills Validation

    • Reporting requirements, patient/family satisfaction, adverse events, safety, infection control

  • Implementation of Best Practices

    • Referral/Intake

    • Scheduling

    • Admission

    • Clinical Record Documentation/Documentation Review - EMR implementation

    • Back office implementation (billing, reimbursement, financial services responsibilities)

  • Hospice Specific (volunteer/bereavement programs, hospice vendor contract review, IDT meetings)

  • Benchmarking for operations and finance to assess and improve daily operations

STATE LICENSURE REQUIREMENTS

Licensure requirements, timetables, fees and survey frequency vary significantly from state to state for home health providers. Simione recommends that you visit the websites of your state health department and your state’s trade association for home care and hospice providers to determine state requirements and guidelines for home health, hospice and private duty agencies.

MEDICARE REQUIREMENTS

Medicare certification enables home health and hospice providers to serve the growing population of older Americans who require services at home. It remains a critical source of revenue for the majority of providers. Visit cms.gov to learn about the Medicare requirements for home care and hospice, including the Conditions of Participation, reporting of quality data, claims processing, and more.

ABOUT SIMIONE HEALTHCARE CONSULTANTS

Founded in 1966, Simione Healthcare Consultants embodies a diverse group of business talent across the U.S. to provide accessible, cost-effective business solutions for the home health and hospice industry. Key areas of expertise include operations, compliance and risk, finance, sales and marketing, cost reporting, and mergers and acquisitions. Simione supports performance improvement across the healthcare continuum, engaging agencies, hospitals and health networks for more effective delivery of home health and hospice care. More than 1,500 organizations use Simione’s experts and tools to improve quality, reduce costs, and minimize risk to drive business performance.

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Survey Readiness & Post-Survey Management

We provide comprehensive support for survey readiness, encouraging a long-term approach to support providers before, during and after the survey.  With a strong emphasis on annual mock surveys, expertise includes regulatory guidance, policy review, plan of correction development and implementation, training and other resources to ensure agencies maintain compliance with CoPs and staff competencies to support survey success.

 

Download the White Paper

Sept 6, 2018 - Changing the Survey Mindset in Home Health & Hospice

 

View the Webinar Recording

May 24, 2018 - The Surveyors Are Coming! Are You Sure Your Home Health/Hospice Agency is Ready?   

 

With the home health and hospice industry under increased regulatory scrutiny, survey deficiencies have increased significantly in both home health and hospice, even for providers with no prior issues. Simione Healthcare Consultants understands the most problematic survey issues impacting home health and hospice providers, including requirements with Home Health CoPs. The key to success is the establishment of an ongoing survey readiness culture and effective process within your organization.

We’re Ready to Help!

From initial survey to plans of correction and everything in between, Simione Healthcare Consultants excels in helping home health, hospice and non-medical agencies achieve state licensure, Medicare certification, and accreditation survey success. Our comprehensive support through all phases of survey readiness assists agencies in maintaining high-quality care and financial success.

Survey Readiness Support

  • Expert Regulatory Guidance

  • Policy Manual Review & Development

  • Comprehensive Mock Surveys: Licensure, Certification, Recertification, Accreditation

  • Plan of Correction Development, Follow-up & Implementation

  • State/CMS Independent Consultant Oversight

  • CoPs Training & Readiness Assessment

  • Survey Readiness Training

  • QAPI & Emergency Preparedness Program Review & Development

  • Initial Certification/Startup Assistance     

Common Survey Deficiencies

Home Health

Hospice

Standard: Initial Assessment Visit

Standard: Plan of Care

Standard: Content of the Comprehensive Assessment

Standard: Drug Profile

Standard: Plan of Care

Standard: Supervision of Hospice Aides

Standard: Conformance with Physician Orders

Standard: Timeframe for Completion of the Comprehensive Assessment

Standard: Review and Revision of the Plan of Care

Standard: Content of the Plan of Care

Standard: Promptly Alert Physician of Any Changes

Standard: Scope and Frequency of Services

Standard: Coordination of Care

Standard: Level of Activity

Standard: Written Instructions to Patient

Standard: Coordination of Services

Standard: Infection Prevention and Control

Standard: Prevention

Standard: Home Health Aide Assignments and Duties

Standard: Bereavement


Source: CMS

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