A Peace of Mind Training Academy

08/06/2023

https://twitter.com/shannonsharpeee/status/1688217322933432320?s=42&t=Gx7YJYcYBvf3aH1o8iPhMQ

Teamwork makes the Dreamwork….

What is the hell were they thinking!!!!

“Yo this is wild 😭 A group of white men attacked a black security guard after the security asked them to move their pontoon boat so the big Harriot can dock. They refused to & attacked the security guard. A group of black men seen & went defend him by beating the white men 💯🙌🏾....

07/01/2023

Does anyone know how to repair or remodel a ceiling to an rv???

10/20/2017

Out of anger and unresolved issues with a local business establishment, I stooped to a whole new level today. I dipped to the lowest level of my being and stepped out of character by writing and posting several scathing reviews of a minority business. This could have and should have been handled and resolved differently. I am offering a sincere public apology to Karen, as I spoke out against her publicly. My issue has not been resolved, but I am woman enough to admit to being wrong, and I am required to set an example for my children. I, nor any minority should ever expose another fellow brethren on social media, as that has always been my pet peeve. I will respectfully delete my scathing post.

05/16/2017

Adult and Pediatric CPR/AED Level 3 of 3

01/12/2017

Home Health Sector Faces Short Deadline for Sweeping New Rule
By Amy Baxter | January 10, 2017
The home health industry is about to be inundated with new regulations after a long-expected update of the Conditions of Participation (CoP) was released by the Centers for Medicare & Medicaid Services (CMS) Monday.

With the introduction of the final rule that defines what is needed to participate in the Medicare and Medicaid programs, home health agencies and industry groups are wading through numerous changes. With an effective date of July 13, 2017, agencies have roughly six months to comply. One area of concern is the implementation time, which is much shorter than what was requested by agencies and home health associations during the comment period.

“We asked for 12-18 months lead time,” Bill Dombi, vice president for law at the National Association for Home Care & Hospice (NAHC), told HHCN. “We are assessing whether the 6 months is sufficient, given the rule outcome.”

When the rule was introduced in proposal form at the end of 2014, industry associations, including NAHC and the Visiting Nurse Associations of America (VNAA), asked for more than a year after publication of the final rule for agencies to comply. VNAA also asked for a a one-year period during which CMS would not sanction home health providers that are not in full compliance. Now, with a short timeline, associations are prepping members on their new requirements.

“With the quick six-month implementation date, VNAA is working to ensure that our members are fully briefed and prepared to comply with the July 13th deadline,” Joy Cameron, vice president of public policy at VNAA, told HHCN.

Home health agencies agree that the six-month period may be too short.

“[A] six-month implementation date is too soon for such a dramatic change in the CoPs,” Ken Miller, clinical educator of New York-based Catholic Home Care, told HHCN.

Despite the short timeline, not all industry groups are bracing for burdensome changes.

“Given the very significant scope and nature of the changes, we hope CMS will exercise discretion and flexibility on enforcement for a reasonable period of time after July 13, 2017 in recognition of the need for significant structure, process and training changes that agencies will need to make to comply,” Teresa Lee, executive director at the Alliance for Home Health Quality and Innovation (AHHQI), told HHCN.

Positive Changes

In fact, AHHQI is generally supportive of the changes, which had not been updated in roughly two decades. The Alliance also noted that the final rule did take into account some of their comments from the proposal period in 2015.

“The Alliance supports the newly revised conditions of participation and the focus on patient-centered care, patient rights and value and outcomes-based care,” Lee said. “CMS’s final rule also incorporates several recommendations made by the Alliance.”

The final rule aims to change all conditions of participation and add several new ones, with the potential to cause additional administrative burdens and costs. One such area that association groups are looking into relates to organizational structure and additional communication requirements.

Fortunately, it appears that at least some concerns voiced by home health care groups have been heard in the final rule.

“We are please that CMS will permit HHAs to use any form of communication, including secure electronic communications, to facilitate patient knowledge and understanding of the care being delivered,” Lee told HHCN. “This is consistent with the Allaince’s recommendation to permit electronic transmission of the plan of care information to patients and allowing for the flexibility on the means one might use.”

One of the new CoPs mandates expanding care coordination between a patient’s physician with an “integrated communication system that ensures that patient needs are identified and addressed” and that care is coordinated across all disciplines, according to CMS. The expansion requires home health agencies are in “active communication” with the physician(s).

Introducing more regulations between physicians and home health agencies could prove to be tricky; regulations related to the Pre-Claim Review Demonstration (PCRD) that require documentation from a physician earlier in the claims process has been challenging for some participating agencies. The issue even became a focal point in CMS’ education outreach to improve PCRD affirmation rates.

Documentation Changes

Another major change in the final rule centers on documentation requirements. While home health agencies have already seen their documentation requirements change rapidly over the past few years, thanks to initiatives within the IMPACT Act and Pre-Claim Review Demonstration (PCRD).

Under the new CoPs, home health agencies are required to provide additional documentation to patients and caregivers, including written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a home health agency clinical manager.

Agencies also have to provide comprehensive patients’ rights that clearly enumerate the rights of home health patients and steps to ensure the rights are assured at all times.

“Of particular interest for us are the patient rights changes, which could be a significant implementation and operational burden for home health agencies,” Dombi said. “In addition, we are focusing on the changes related to infection control and the discharge summary.”

However, the language related to patient rights appears to have softened from the initial proposal. Specifically, CMS clarified that home health agencies are not expected to provide this in writing in every language, the Alliance told HHCN.

Furthermore, there is a new requirement for a data-driven, agency-wide quality assessment and performance improvement (QAPI) program that evaluates and improves agency care for patients.

“I think the biggest challenge is the development and implementation of the QAPI regulations,” Miller told HHCN. “New conditions that will likely be costly and burdensome are the QAPI.”

While it remains to be seen which is the most costly new provision, there’s no doubt that the new CoPs come with a significant pricetag: an estimated $293.3 million in the first year, according to the final rule.

Written by Amy Baxter

01/06/2017

Audits are on their way... If this is happening to the upper echelon of society's Health Care , where Does your future lie with non-compliance. Can any single HHA in Colorado afford a $10 million fine????

A federal audit by the Department of Health and Human Services Office of the Inspector General is recommending that Colorado's non-profit health insurance exchange give back nearly $10 million in grant money to the federal government.

01/06/2017

Back at work.... Pray for me...

APOM Training Academy & Clinical Lab

01/05/2017

A PEACE OF MIND TRAINING ACADEMY OFFICE & CLINICAL LAB for COMPETENCY TRAINING & DIRECT OBSERVATION

11/23/2016

Hello Everyone, I hope all is well. I am extremely late for my promised monthly subject, God willing, I will be more timely.

This month's topic will be as follows;

Criminal History Record Checks:
6 CCR 1011-1 Chapter XXVI Home Care Agencies of Section 6.3 defines Colorado requirements.
(Chapter XXVI Rules and Regulations apply to ALL LICENSED Home Health Agencies in the State of Colorado, this is inclusive of Class A/ Skilled and Class B/Non-Skilled Agencies, and EVERY Medicare/Medicaid Agency is required to be LICENSED).

Section 6.3(A) specifically states - On or after June 1, 2009 the HCA shall require any individual seeking employment with the agency to submit to a criminal history record check.
1) The verbiage "shall" dictates this is not an option, but must be done by the agency.
2) This clause does not dictate/indicate that an agency must conduct a multiple state record check ($40.00 plus), only a Colorado record check ($6.95). However, if the application reveals employment in other states or a gap in employment, a multi-state record check is personally recommended.
3) THIS IS A POLICY/PROCEDURE REQUIREMENT.

Section 6.3(B) specifically states - The criminal record check shall be conducted not more than 90 days prior to employment of the individual.
1) Honestly, most experienced agencies do not hire every individual that submits an application. Additionally, some applicants are placed in a file until the availability arises.
- In the above mentioned situation, this regulation applies to you. Example: Jane Doe applies in January, Agency has no openings- but you processed J. Doe for future availability including a CBI.
(Hopefully agency does not have an employee "hire" greater than ten (10) days without an active assignment).
Agency needs J.Doe in June. A new CBI is required because the processing and CBI are greater than 90 days of employment, If agency needs J. Doe in February, a new CBI is not required.
2) THIS IS A POLICY/PROCEDURE REQUIREMENT.

Section 6.3(C) specifically states - The cost of such inquiry shall be paid by either the home care agency or the individual seeking employment.
1) Agency P/P may dictate that said agency will pay for the cost of the CBI.
2) Agency P/P may dictate that said applicant will pay for the CBI.
- Number 2 is highly unlikely, as this is equivalent to the emotional distress associated with an apartments application fee. (neither one is guaranteed, but you want my money first...lol).
3) Agency P/P may dictate that "This requirement for payment will be determined on an individual basis,
- This can alleviate extra costs associated with an out of state applicant with a "book" for a record check, and the reporting agency charges by the page.
4)THIS IS A POLICY/PROCEDURE REQUIREMENT.

Section 6.3(D) specifically states - The HCA shall develop and implement policies and procedures regarding the employment of any individual who is convicted of a felony or misdemeanor to ensure that the individual does not pose a risk to the health, safety and welfare of the consumer.
1) Most agencies have begged, borrowed, &/or stolen P/P from other agencies and adopted them as their own. The above mentioned P/P and "generic" P/P purchased online or form consultants contain language that has NEVER been reviewed by said agency.
- This behavior/oversight usually results in a Deficiency &/or the inability to hire/secure appropriate employees.
- Most P/P suggest than an applicant with a criminal record are excluded from employment.
- Where can you find an applicant without a criminal record for approximately $8 - 10.00 an hour.
2) This regulation DOES NOT dictate the Non-Hiring status for employment.
- This regulation gives the agency control over employment hiring and considerations.
3) The first key word is "CONVICTED".
-Please request the disposition of a charge, if the CBI does not reflect it, as ;
- NOT every charge results in a Conviction.
4) The second key word is "FELONY".
- Most Felonies have a "Statue" on Limitations for continued exclusions.
- I believe EEO Laws require a Felony "Statue of Limitations" after a 7 or 10 year period when considering employment.
- Consider the nature of the felony, age of applicant at time of felony, circumstances of felony, plea deal(s), and etc.
- Must be a Felony Conviction. NOT a Felony Charge to be inclusive of the governing of said regulation.
5) The third key word is "MISDEMEANOR".
-Please be aware that running a red light, driving without insurance, littering, loitering, domestic violence, loud music, and etc. can be Misdemeanors, but should not prohibit a person from employment.
- Again, consider the nature, age of applicant, and circumstances when making a decision.
- This must be a Misdemeanor Conviction, NOT a Misdemeanor Charge to be inclusive of the governing of said regulation.
6) Last, but most important is "Ensuring that the individual DOES NOT pose a risk to the health, safety and welfare of the consumer".
- Agency must have a plan and P/P that addresses hiring, supervision, and tracking (if appropriate) of said individuals.
7) THIS IS A POLICY/PROCEDURE REQUIREMENT.

OPTIONAL P/P: 6.3(D) - Accepting an applicant for employment with a Felony and/or Misdemeanor conviction will be determined on an individual basis.
A Felony and/or Misdemeanor conviction DOES not automatically bar a person from employment.
1) Can I hire an applicant charged with Murder?
- Yes, regulation is not applicable.
-Should I ?
- Maybe, depending on circumstances = Self Defense.
2) Can I hire an applicant convicted of Murder?
- Yes, depending on P/P.
-Should I ?
- Maybe, depending on circumstances = Self Defense.
3) Can I hire a 38 year old applicant charged with theft at 18 ?
- Yes, regulation is not applicable.
-Should I ?
- Maybe, depending on circumstances = I would, applicant is 28 years free of any additional charges and was barely an adult when charge occurred.
4) Can I hire a 38 year old applicant convicted of theft at 18 ?
- Yes, depending on P/P.
-Should I ?
- Maybe, depending on circumstances = I would, applicant is 28 years free of any additional charges/convictions and was barely an adult when conviction occurred.
5) Can I hire a 50 year old applicant charged or convicted of stealing narcotics last year ?
- Yes, regulation is not applicable to charged, ad depending on P/P with conviction.
-Should I ?
- Maybe, depending on circumstances = I would not, unless court services are involved. I would then require assignments with clients absent of narcotics, monitoring of missing medications and pain control with assigned clients for a specific period of time, unannounced supervisory visits, and a specific agreement for drug testing with appropriate parameters.

FYI: Don't forget to have a standard CBI or criminal record check form completed and signed by applicant prior to requesting a CBI or criminal record check form.

If anyone in our "Beautiful State of Colorado" has any questions, please feel free to contact me.

If this material was helpful/beneficial, Please kindly "like" and/or write a positive review.

Sincerest Thanks,
Velma L. Gilbert.
Senior Instructor / Consultant for APOM.

07/27/2016

Hello, I hope everyone is in good spirits and awesome health. I am today... Much Luv to all of you.
The remainder of this post will be Home Health related, as this is my business page. Please feel free to read and ask questions.

I have had a lot of requests for a Home Health type Forum for questions and answers, so I will answer a frequently asked question or explain a Regulation on a monthly basis.

Question: What is the difference between Licensure and Certification ?

Answer:6 CCR 1011-1 Chapter XXVI Home Care Agencies of Section 3.11 defines Colorado requirements.

Section 3.11 (B)(3) specifically relates to the commonly asked question for Home Health = An individual who is not employed by or affiliated with a Home Care Agency, and who acts alone, without Employees or Contractors.

Colorado specifically requires every HHA to be Licensed per Chapter XXVI if the Agency has an (1) or more Employee(s) or Contractor(s).
Licensure mandates that an HHA follow the Rules & Regulations per Chapter XXVI and appropriate State Laws.
Licensure is Private Pay, Insurance, Veteran's, and Etc.
* Please be aware that this Regulation is inclusive of Private Pay
Agencies &/or Companies.
* Please be aware that If an HHA or Private Pay agency/company
hires an Employee &/or Contractor in any capacity becomes
subjected to this Regulation, as You are no longer acting alone.
Reality enforces that if an HHA has three (3) or more
Consumer visits per day with two (2) or more hours per
visit. YOU are an EMPLOYER.

Colorado requires every HHA to be Licensed, but every HHA is not required to be Certified.
Certification mandates that an HHA be Licensed per Chapter XXVI and Certified per Volume 8 Rules and Regulations.
* Volume 8 Certification is a Medicaid &/or Medicare Certification.
* Volume 8 Certification Rules and Regulations run parallel to
Chapter XXVI Licensure, but there are some notable
differences.
* If an HHA is Licensed and Certified, the HHA must follow both
set of Rules and Regulations.
If the Rule is parallel, the HHA must follow the most stringent
Rule.
If the Certification Rule deletes or prohibits. minimizes, or
restricts a task, the Certification Rule MUST be followed
for Medicaid / Medicare Consumers.

In conclusion, basically any established HHA has an Employee or Contractor, therefore the HHA is required to be LICENSED per Chapter XXVI Rules & Regulations.
EVERY CERTIFIED HHA IS REQUIRED TO BE LICENSED.

If anyone in the 'Beautiful State of Colorado" has any questions, please feel free to contact me.

Thanks,
Velma L. Gilbert.
Senior Instructor / Consultant for APOM.

03/20/2016

Hello beloved friends, I think I am getting the hang of this newfound attraction. I recently liked some of my friends by promoting them on my page, NOW, I need you guys to return the favor. Thanks & much Luv.

03/20/2016