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In This Issue:  President's Final Message TEAM TALKS 2008 2008 Key Initiatives
My Perspective Present on Admission (POA) Indicator LTC Practice Council Completes 2007 Work
LTC Practice Council Completes 2007 Work
Long Term Care Insights Consulting in Long Term CarePresident's Final Message DCHIMA Transforms DCHIMA, we have had a great year! This year I believe we have met our goals to move forward as an organization and transform our industry! All though there is much more for us to do, this year we have reached to keep our members, community, providers and the health care industry in Washington, DC informed of the importance of quality healthcare through quality information. In March we co-hosted the Regional Coding Seminar with AHIMA & VHIMA. This was an exciting event. We also had representatives from our organization at this year Team Talks and Hill Day. I want to thank those who chaperoned members of AHIMA to Capital Hill to meet there state representatives and the Legislative & Advocacy Committee for coordinating the event with our Volunteer Buttons. I know we made a difference. I also want to recognize our own Theresa Foley who was selected by her peers of AHIMA at Team Talks to be a member of the Fore Triumph Awards Committee. Now it is time for us to look to a new year for DCHIMA! I want each of us to remember, as you can see we are very busy and there is so much more that could be done, but an association is only as good as its members so, DCHIMA Members we are counting on you! We need each of you to take time to volunteer for at least one event a year, or for one committee. We will have a new President, who will need your support. As the Co-Chair of the AHIMA Volunteer and Leadership Development Team for the House of Delegates I want to encourage each of the members DCHIMA to make a difference in our profession. I want to challenge you to volunteer to mentor a student, speak to your community about the PHR, become a speaker and share your experiences with implementing change. Log on to: http://www.ahima.org/directory/call_for_vols.asp Remember you are the Transformers! Summary of 2008 Team Talks – Washington DC “Ready for Success” The President of AHIMA, Wendy Mangin, MS, RHIA, and Mark Dietz, RHIA, First Year Director, summarized the “Drivers of Change: Impact on 2009.” Their reviews included the following areas: 1. Health Care Industry: Real Change or Continued Decline? Health care is a tremendous strain to our economy. While we focus on improving our information system improvements, it is only one of a number of strategies which taken together could help stem this rate of growth in spending. Summary: Due to public sector budget constraints, reforms in information will be under-resourced and will count on private sector investments. Standardization and standards will continue as a central challenge. 2. Reframing Health Information Management In 1990, AHIMA changed its name from American Medical Record Association to American Health Information Management Association. This removed artificial boundaries on HIM roles and the scope of association activities. AHIMA made these moves believing technology would profoundly impact the HIM work. In reality, many associations chose the term “health information management.” AHIMA asks the question: “Is the field advancing in its skills and competencies at a fast enough pace to take leadership roles?” 3. The Changing Face of Membership The change from 2002 when our members worked in 40 settings with 125 job titles. In 1993, 75% of AHIMA members held AHIMA certification. In the past few years, that number dropped to 68%. Membership is 93% female. Education levels of AHIMA membership are declining. Today, ten percent of our members are over the age of 60; by 2014 that number will grow to 34%. The industry sees us as coders. Question facing AHIMA: Is AHIMA effectively organized to serve the diversity of its membership and can AHIMA ? 4. AHIMA as a Multi-National Association AHIMA currently has over 300 international members representing 21 countries. Trends in the industry of health information are becoming more transnational, telehealth, medical tourism and offshore outsourcing. AHIMA will began a multinational program in 2008. Is AHIMA structured to deliver to its members around the globe? 5. Creating Future Strategy In Winter Team Talks on 7 Apr 08, Vera Rulon, RHIT, CCS, President-elect of AHIMA summarized implications of Future Drivers to AHIMA. Implications are: evolving changes in HIM practice; dual mission (service to members vs. advancing practice; unknown value of entry-level academic-based credentials); align education/training with industry changes/needs; need to implement ICD-10; transition of coding to new roles; uncertain future for federal IT initiatives; leadership and succession planning; how to organize to serve diversity of our membership. Vera reviewed the AHIMA’s 2008 Strategic Framework which included vision, mission, values, key piorities and strategic initiatives. Key priorities are e-HIM, Leadership Engagement/Impact, Building value and grow and strengthen AHIMA. She emphasized “Quality healthcare though quality information.” AHIMA’s mission is to be the professional community that improves healthcare by advancing best practices and standards for health information management and the trusted source for education, research and professional credentialing. The 2009 AHIMA Strategic Objectives include: Industry leadership, workforce readiness, membership value and grow and strengthen AHIMA. AHIMA has a monthly strategy to accomplish the 2009 Plan. 2008 Key Initiatives 2008 Winter Team Talks “Ready for Success” 2008 Key Initiatives AHIMA had launched several key initiatives for 2008. 1. Improved Communications • New profile update on ahima.org – we encourage you to update your profile if you have not already done so. • Expanded links and resources Visit http://www.ahima.org/emerging_issues The HIM Resources and Emerging tab will link you to other resources and links such as e-HIM, PHR, Coding, Continuum of Care plus many more. This new initiative further includes e-Newsletter to cover a wide variety of topics such as education, coding, LTC and volunteer. It will also include the latest and greatest Blogs, Wikis, Pod casts and other new technologies. 2. Brand Initiative • The integrated branding initiative includes the following Updated Trade Show Graphics Awareness Campaign 3. Membership Growth To help grow and retain membership AHIMA has put in place several tools to help facilitate this: • Standard Register – resource for CSA’s • Membership Development Manager – support for existing and new programs • New programs throughout 2008 – improved retention and new recruitment activities 4. Workforce – Spread the Word • What: In 2006, more than 13,000 HIM professionals participated in the first AHIMA salary study leading to the most comprehensive information to date related to industry compensation - 2008 = Round two • How you can help: Success is dependent on the depth of the data set; Participation is the key Get the word out: email, CoP messages, newsletter, meetings; therefore, encouraging participation is key. Workforce Development • CourseShare for Educators • Virtual Lab Expansion • “User” Competencies 5. Provide Practice Resources • Standard practice for Release of Information for Continuity of Care • Tools for levels of HER adoption Visit www.ahima.org for all 2008 Initiative and Emerging events. My Perspective The Team Talks and Hill Day was a great success with the help and support of our members who attended and volunteered with showing AHIMA members how to get to the subway and to Capitol Hill. Team Talks was on April 7 and Hill Day was April 8, 2008. We had the opportunity to meet representatives and members of Congress including the Legislative aide to Rep. Eleanor Norton. We had the opportunity to share our views and ideas regarding HR 4105 Medicare Recovery Audit Contractor Program Moratorium Act, HR 493 Genetic Information Nondiscrimination Act and many other legislation pertaining to our profession. On 5/1/08, the Genetic Nondiscrimination Bill passes the House and will go the President Bush for his signature! My PHR Program The PHR Practice Council developed an action plan for 2008. We are asking members to pass out the My PHR.com brochures to the community. The MyPHR.com website has been updated! Please visit the updated website. Each member who attended team talks received the new promotional PHR desk clock. The AARP will host their convention in Washington, DC in September 2008. AHIMA will have a booth and there will be promotional material regarding AHIMA and PHR. If anyone is interested in volunteering to help at the booth to pass out materials; please contact Jeanne Mansell at 202-269-7207 or Jeanne87@hotmail.com. If any member is interested in giving presentations on how to the Personal Health Record; please contact Jeanne Mansell. The following members attended Team Talks and Hill Day: Patience Amartey,Pamela Caesar,Tiffany Edwards,Michelle Engelmann,Teresa Foley,Tasha Green, Mikia Heard,Jannie Lindsay, Jeanne Mansell,Susan Pierce, Aneesa Sharper, and Amanda Uherek Present on Admission (POA) Indicator With the revision of ICD-9-CM Official Guidelines for Coding and Reporting, Present on Admission guidelines were added as Appendix I in November 2006. Note these guidelines are national, as some states require their own present on admission reporting. This indicator is a data element used to provide information on whether a diagnosis was present at the time of a patient’s admission. Coding Clinic Third Quarter 2007 clarified that Medicare will begin to accept this POA Indicator for every diagnosis on INPATIENT ACUTE CARE HOSPITAL claims only effective October 1, 2007. Critical access hospitals, long-term care hospitals, cancer hospitals, psychiatric hospitals, inpatient rehabilitation facilities, children’s inpatient facilities as well as nursing homes are examples of providers who are exempt from this requirement. As a general rule, staffs in nursing home facilities do NOT utilize the POA guidelines, Appendix I, located at the end of these official guidelines, unless mandated by state requirements. The ICD-9-CM Official Guidelines for Coding and Reporting is updated at least annually but may be more frequent if deemed necessary. Coding staffs are responsible to access this document to insure that they are using the most current set of guidelines. These are available at the National Centers for Health Statistics web site at http://www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm. Revised guidelines, effective October 1, 2007 have been posted to the LTC CoP. The MDS 3.0 is coming; the MDS 3.0 is coming … check the LTC Community of Practice Resources for more information! Be prepared! LTC Practice Council Completes 2007 Work We would like to take this opportunity to say thank you to the LTC Practice Council members and liaisons that have served so willingly during 2007. The members are listed as follow: Deborah Johnson, Rhonda Anderson, Monica Baggio Tormey, Deb Dethlefsen, Charlotte Lefert, Mary Ann Leonard, Jeanne Mansell, Barbara Michaelis, Mary Ann Michau, Sue Mitchell, Cathryn Moore, Sally Ann Pearl, Michelle Sims, Debra Sperry, Christina Toolan-Banaszak, Suzanne Weaver. Staff liaisons are Michelle Dougherty and June Bronnert and Board liaison Lynn Kuehn. The LTC Practice Council met monthly during 2007 to work on items listed on the strategic plan, to discuss practice issues, and to conduct environmental scanning. Some of the work that was accomplished during 2007 includes the following items listed below: • Held LTC Spring conference in St. Charles, MO • Published LTC Insight newsletter • Incorporated CEU opportunities into LTC Insight newsletter • Re-Organized the LTC CoP Community Discussion section in two forums • Suggested LTC HIT Summit agenda ideas • Suggested LTC online course topics • Posted flyer about a new ICD-9-CM coding book for LTC • LTC Practice Council member and AHIMA LTC Practice Council staff liaison working on LTC EHR functional profile workgroup • Suggested ideas for AHIMA products for LTC for 2008 • Placed various resources on the LTC CoP • Monitoring CMS LTC Open Door Forum • Coding articles written for HCPro • Face to face CoP at the AHIMA convention • Monitoring CMS LTC regulation changes • Recommended topics for LTC track of the AHIMA convention • Conducted environmental scanning routinely • Updated strategic plan and identified tasks for 2010 • Brainstormed ideas for ongoing education for LTC HIM staff. We celebrate a productive year and look forward to 2008. 2008 Long Term Care Spring Meeting Embassy Suites St. Charles Convention Center St. Charles, Missouri May 1-2, 2008 We are excited to let you know that the 2008 Long Term Care Spring Meeting will be held again this year in St. Charles, MO on May 1-2, 2008. To review the agenda and to register online, please visit http://www.mohima.org/LTCmeeting.html. We hope that you can join us again this year! Consulting in Long Term Care Thinking of becoming a Consultant in Long Term Care? As with any life-changing decision, a thorough examination of the requirements, expectations, disadvantages, advantages, opportunities and outcomes should be carefully considered. Requirements for a Consultant in LTC Those of thinking of becoming a Consultant in long term care should have specific job related experience. It is critical that you have at least one year experience in the long term care field and be credentialed as a RHIA or RHIT. Consultants should also have high energy, be a self-starter, self-motivated, ability to work with different types of personalities, able to work independently, able to solve problems and give advice, make specific recommendations, be a sounding board, able to implement change and specific systems, excellent written and verbal skills, and the ability to communicate as a speaker and educator. Expectations and Responsibilities of the LTC Consultant * Develops job descriptions for the Health Information Management Coordinator * Develops policies and procedures for the HIM Department * Develop and/or assist in forms designs and implementation * Assist with the Quality Assurance Committee * Conduct chart reviews based on the needs of the facility * Train/educate HIM personnel * Provide seminars and/or educational tools * Prepare written reports Make specific recommendations and plan of corrections * Communicate state, federal and HIM standards to specific disciplines * Meet with the facility Administrator and/or Director of Nursing of findings and recommendations Advantages and Disadvantages In order to successfully make the right decision, you should review the advantages and disadvantages of taking on this new adventure. I have listed some that have personally affected me, but may also affect you once you take on this new role. Advantages Flexibility in making work schedule Able to independently make decisions/own boss Holidays/weekends off Long vacations if desired Business expenses are tax deductible Sense of accomplishments Grow secure and confident in profession Knowledgeable of long term care rules and regulations Ability to travel and meet different people Able to network Able to spend more time with family and friends Disadvantages Irregular hours at times The need to work on special projects at length No paid holiday, vacation, sick or personal days May go months without a paycheck Previous positions does not guarantee clients Disagreements with others Pay more in federal, plus state taxes Maybe held liable for professional action Responsible for own malpractice insurance Responsible for own continuing education Responsible for own educational tools/seminars Start-up costs for business I have personally found that my advantages outweigh my disadvantages. If you really want to become a LTC Consultant, your advantages will also outweigh your disadvantages too. Getting Started Once you have determined what your advantages and disadvantages are and you are willing to meet the expectations and responsibilities, then it is time to get started on your business plan. Marketing plan As with any business, you will need to successfully market yourself. Your job offers and your clients will greatly depend on it. Marketing yourself is not as hard as it may sound. True, will you need lots of patience; however, in order to successfully grow your business, you will need to have the right marketing tools. These include, but not limited too: Professional business cards Professional letterheads to write reports/recommendations Brochures Attend association seminars (have extra business cards to give out) Write articles or newsletters Contribute your time and expertise to volunteering with your state association Volunteer your time to AHIMA Attend seminars in healthcare related topics Network, network, network!!! Contract/Business Associate Agreement Because you will be considered an Independent Contractor, you will need to have a contract signed between you and your facility prior to or on the initial visit. Also, according to HIPAA, you will be considered a Business Associate and therefore will need to have a Business Associate Agreement. It is imperative to your position that you have these two documents. Samples of these documents can be obtained from the AHIMA website. Start up Costs As with any business, you will have start up costs. These costs will depend on what equipment you already have and what marketing tools you may need. I have listed a few examples of what you may incur as a cost. Professional fees (CPA, Attorney, and Accountant) Professional liability insurance Annual medical examinations and TB testing Business cards, letterhead, printing expenses Office equipment: PC, fax, scanner, printer, internet, phone Professional dues, books, subscriptions Education and training needs Will you need to obtain benefit expenses? (Life insurance, health etc) Hourly Rate Your hourly fee will be based upon your billable rate. Your billable rate will also include time of writing/preparing your report, printing costs, postage, travel expenses, and telephone time. I also recommend that in your hourly rate you include non-billable time. This time consists of time that you would normally take for vacation or personal days. You must keep in mind that your hourly rate will need to be competitive with the market. This rate plus your billable and non-billable rates should be accurately written explained in your contract. AHIMA has wonderful tools to help you decide what hourly rate to charge. Taxes for the Self-Employed Consultant Oh, the dreaded word: TAXES. Yes, as a Consultant, you will still need to pay taxes. Because you are considered an Independent Contractor, you will need to pay federal, social security self employment and state taxes. You will need to work with a CPA who is familiar with self-employment. Your CPA can help you set up the right amount of payment to make for your taxes. As required by the IRS, you will also need to make estimated tax payments in quarterly sums. Please keep in mind that if you make over $600.00/yearly, you are also obligated to receive a 1099 (like a W-2) from your contracted facilities. Because taxes for the self-employed can become tricky, it is extremely important that you keep accurate and organized records. Again, finding a good CPA will be worth your cost and your sanity! Outcomes As mentioned earlier, becoming a Consultant can be a life-changing event. However, with the right mind-set, the ability to abide by the expectations, the dream of making your goal a reality, you will find that your decision of becoming a Consultant in long term care will be one of the best decisions that you will make! If you are interested in additional information or have questions about becoming a Consultant, please feel free to contact me at mjmcbreen@aol.com Good luck on your new adventure! |