Ops
What does KPI stand for and what counts as part of KPI?
Key Performance Indicator
It’s a standardized patient experience survey used across healthcare settings, including home health and hospice.
Pinnacle Insights is a company that provides CAHPS survey services, data analysis, and benchmarking specifically tailored for home health and hospice providers.
Does Pharmacy prefer to onboard ALs or LTC SNFs?
LTC SNFs
What does Hospice GIP stand for, how long can it be and when is it appropriate?
General Inpatient Hospice, 5 days. Used for acute symptom management that cannot be managed in other settings.
Name 3 Leadership topics at our Monthly meeting?
Service, impermanence, connection.
What is the Home Health GP goal?
40%
How does Hospice CAP affect bottom line?
If you stay under the cap- No impact—your hospice gets full Medicare reimbursement.
If you exceed the cap, You pay back the overage to Medicare out of your own revenue, which directly reduces profit. This hits your net income and can undo months of financial gains.
If a patient is in a SNF under their Medicare benefit do the meds belong to the patient or the SNF?
The SNF.
In home health, how is functional impairment typically assessed and documented, and why is it important for patient care and reimbursement?
Functional impairment is assessed using standardized tools like the OASIS assessment, which measures a patient’s ability to perform activities of daily living (ADLs). It’s documented by evaluating mobility, self-care, and other functional abilities.
Used to document improvement, and correlates with reimbursement.
What is the name of the Dog that peed all over the first office in SLC?
Lucy the Dog
Red Rock DME increased PPD price adjustment starting June of this year from what dollar amount to what?
$5.75 to $6
What does LUPA stand for? And what does it mean?
Low Utilization Payment Adjustment. If a patient receives fewer than the threshold number of visits in a 30-day period, Medicare pays a reduced, per-visit rate instead of the full episode payment.
What are the run times for Red Rock Pharmacy? Extra credit what time is the local run?
local Time- 6pm
What form must be issued when hospice services are being reduced or discontinued?
NOMNC (Notice of Medicare Non Coverage)
Who was recognized as May's Employee of the Month?
Colorado Intake team.
Canyon is Accrual based for accounting purposes. Explain what this means.
Accrual means recording revenues and expenses when they happen, not necessarily when cash actually changes hands.
If you provide a service in June but don’t get paid until July, under accrual accounting, you still record the revenue in June.
If you receive a bill in June but pay it in July, you record the expense in June.
What is the difference between an adverse event and a sentinel event?
An adverse event is any unintended injury or complication caused by healthcare management rather than the patient’s underlying condition.
A sentinel event is a serious adverse event resulting in death or serious injury, requiring immediate investigation.
Explain Formulary management.
It’s the process of creating, maintaining, and using a list of approved medications—called a formulary—that clinicians are encouraged or required to use when prescribing.
According to CMS regulations, how often must a Home Health or Hospice agency conduct a full-scale emergency preparedness exercise (EPP), and what is the minimum requirement for these exercises?
CMS requires that Home Health and Hospice agencies conduct an annual full-scale emergency preparedness exercise (EPP) or a tabletop exercise in alternating years, so at least one full-scale exercise every two years and a tabletop exercise in the alternate year.
How often must home health agencies conduct a comprehensive assessment for each patient?
At the start of care, every 60 days and at discharge.
What does EBITDA stand for? And why do we use it?
Earnings before interest taxes depreciation and amortization.
Measures companies profitability that focuses on operations and used to compare performance.
Define Elder Abuse
In Colorado, elder abuse is defined as the mistreatment of individuals aged 70 or older. This includes various forms of abuse such as physical abuse, sexual abuse, emotional abuse, neglect, and financial exploitation.
If a Hospice patient is in a pain crisis in the SNF and they need quick access to Morphine but do not have an Ekit, what do they do?
Access the Cubex. A secure, biometric-controlled access ensures that only authorized personnel can retrieve medications, reducing the risk of diversion and errors.
What are the three main criteria for home health eligibility under Medicare?
1. Homebound status, 2. Need for skilled care, and 3. Under the care of a physician with a valid Plan of Care.
What is the name and purpose of the group started by Loveland leadership to reduce rehospitalizations in the community?
Reduce rehospitalization rates by collaborating with all levels of care.