Last October, Palmetto, one of the nation’s largest Medicare Administrative Contractors to the federal government, released their Electronic Comparative Billing Report (eCBR) for 2018 data between April 1 – September 30 that focused on hospice providers’ Non-Cancer Length of Stay (NCLOS) rates.

The home care provider was experiencing a high LUPA rates that consistently exceeded 15%. A staffing shortage, particularly with nurses, combined with communication challenges throughout made it difficult to achieve positive patient outcomes.

The health system was unable to successfully fill several key leadership roles within their home care agency after a loss of leadership. Eleven critical positions were vacant within the clinical, quality assurance, and finance departments. As a result, leadership, strategy, quality performance, and compliance profoundly suffered...

This agency was experiencing inaccuracies in OASIS scoring due to recent clinician turnover. Agency leadership found that dedicating ample resources to thoroughly train new staff in OASIS accuracy was necessary, but beyond what their internal resources could provide at the time.

This agency faced a LUPA rate consistently more than 13%, which reflected room for improvement in patient care and in reimbursement. A nursing and therapy staff shortage combined with high patient volume made it difficult to achieve proper visit utilization.

The provider had more than $428,000 in aged receivables, 39% of which was aged over 360 days, and struggled to resolve the aged receivable before the timely filing deadline.