Healthcare at Home: The Rowan Report

Sandata Secures Significant Growth Equity Investment from Accel-KKR

Sandata Technologies, LLC, a provider of Electronic Visit Verification (EVV) and home health technology solutions, announced on July 24, 2019, that it has secured a significant growth equity investment from Accel-KKR, a leading Silicon Valley-based investment firm.
[This partnership, according to Tom Underwood, Sandata’s CEO, is important. He says:]
“The home care market in the US is growing rapidly and is on a path to become a strategic component of the overall health delivery network. Sandata is focused on providing innovative solutions to our customers who serve this market including State Payers, MCOs and Providers. We could not be more excited to partner with Accel-KKR and leverage the firm’s experience and resources to help Sandata continue to execute on our vision and deliver value to our customers.”
[On the very same wavelength, Accel-KKR’s managing director Park Durrett says:] “We are excited to work with Sandata to accelerate the company’s journey…of Sandata’s market leading solutions have supported stakeholders in the home care industry for nearly forty years. We look forward to working hand-in-hand with management on this next phase of growth.” And, adds Andrew Abella, Vice President at Accel-KKR:
“As the EVV and broader homecare markets continue to evolve rapidly, we will invest in continued product innovation and customer support so that Sandata is best positioned to serve its customers.”

Company details are provided about Sandata Technologies, LLC, and about Accel-KKR (an investment firm with over $7.5 billion in capital commitments, and which focuses on software and IT-enabled businesses.
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A second item noted in this article is that its new leadership team will support its move into the U.S. home healthcare market. These new team players are: Patrick Charbonneau, Vice President of Product; and Neil Grunberg, Vice President of Strategy and Corporate Development.

Neil Grunberg, a member of AlayaCare’s founding team, now assumes the role of Vice President of Strategy and Corporate Development. He will help map AlayaCare’s market strategy, determine next steps for the company’s product development and partnerships, and identify, execute and integrate future acquisitions.” It’s also noted that he will help the company “execute its long-term strategic plan and continue its recent expansion efforts. AlayaCare now has over 200 employees and has attracted $50+ million in growth capital since its launch in 2014.”

A company news release stated that these senior team changes will help AlayaCare execute its long-term strategic plan and continue its recent expansion efforts. AlayaCare now has over 200 employees and has attracted $50+ million in growth capital since its launch in 2014.

Company details are provided about AlayaCare.

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

Sandata Secures Significant Growth Equity Investment from Accel-KKR
PORT WASHINGTON, N.Y., — July 24, 2019 — Sandata Technologies, LLC, a provider of Electronic Visit Verification and home health technology solutions, today announced it has secured a significant growth equity investment from Accel-KKR, a leading Silicon Valley-based investment firm.

Sandata Secures Significant Growth Equity Investment from Accel-KKR
PORT WASHINGTON, N.Y., — July 24, 2019 — Sandata Technologies, LLC, a provider of Electronic Visit Verification and home health technology solutions, today announced it has secured a significant growth equity investment from Accel-KKR, a leading Silicon Valley-based investment firm.

About Sandata
Sandata Technologies is a leading U.S. provider of home care solutions that enable government agencies, Managed Care Organizations, and home care providers to manage and optimize the delivery of services. Sandata’s suite of products includes Sandata Electronic Visit Verification™, a Cures Compliant EVV solution. among other technologies.

Montreal and Toronto – July 30, 2019 – AlayaCare has broadened its leadership team with the addition of Patrick Charbonneau as Vice President of Product. The Toronto-based home care software company also named Neil Grunberg as Vice President of Strategy and Corporate Development.

A company news release stated that these senior team changes will help AlayaCare execute its long-term strategic plan and continue its recent expansion efforts. AlayaCare now has over 200 employees and has attracted $50+ million in growth capital since its launch in 2014.
About AlayaCare
AlayaCare’s platform supports back office functions, client and family portals, remote patient monitoring, telehealth, and mobile care workers in one integrated, secure, cloud-based system. Its stated mission is to “transform the industry from a traditional fee-for-service model to one that is technology enabled, outcome-focused for patients, and delivers better experiences for caregivers.”

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

by Darcey Trescone. RN
Tim Ashe, Chief Clinical Officer WellSky and Andrew Olowu, Chief Technology Officer Axxess share how PDGM will impact our industry

In our ongoing commitment to bring awareness and insight about the new Home Health PPS payment system taking effect in January 2020, we spoke with two more industry leaders about the anticipated impact of PDGM and each of the two company’s plans to help clients adapt to the change.
Questions posed to both executives were:
1) What are the essential differences between PPS and PDGM?
2) How are you preparing your customers for PDGM?
3) How has PDGM spurred innovation?

Both executives answer these 3 questions fully and both offer extensive details in this HCTR article about ongoing online training for PDGM that each company is offering its customers.

Darcey Trescone, RN, is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at darcey@tresconeconsulting.com.

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

Axxess announced on July 23 that it has introduced several valuable tools within its software solution to help clients prepare for the Patient-Driven Groupings Model [PDGM] which goes into effect in January [2020].The company believes this release makes it the first software partner to deliver a full suite of tools for its clients to review and prepare for the impact of PDGM. According to Andrew Olowu, Axxess’ CTO: “PDGM is the biggest regulatory change for our industry in more than 20 years, so the features we provide to help our clients prepare for the changes under the new payment model are extremely important.”
Among several important features Axxess clients can use are tools that assess their own data over the past three years to analyze the revenue impact that PDGM will have on the agency for specific episodes of care. Another important feature is one that enables assessment of how the agency’s current case-mix will be impacted under the new payment model. Axxess also has provided a PDGM modeling tool that enables agencies to model key PDGM components during the intake process to assess what impact the new referral would have on reimbursements under PDGM. Other features that Axxess can provide to its clients are:PDGM Revenue Impact Analysis; PDGM Case-Mix Analysis;PDGM Modeling Tool; and No-Pay RAPs. See the HCTR article for specifics on each of these new tools.

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

by Tim Rowan, Editor & Publisher of Home Care Technology Report

Inspired by a need within his own family, Burt Shulman set out to find a way to save the aching backs of caregivers. The result is an innovation he calls the “Bottoms-Up SwingChair.” [Using a collection of videos from Shulman’s company website, at http://seniorlite.net/bu.html, the pictures depict a scenario of moving a patient from bed to toilet and then to wheelchair using a much reduced number of caregivers’ physical lifting. The aimed for result, as Shulman and all caregivers well know, is that each lift is an opportunity for injury, to patient or caregiver or both.

[Specific details about how the Bottoms-Up SwingChair can potentially limit toileting lifts to two, or eliminate them entirely. In all, the patient sits comfortably in the chair while the caregiver slowly rotates both chair and patient to the side — not fully lateral but at about 80 degrees — aided by an airlift spring. With the patient’s head resting on a pillow, the caregiver replaces the chair’s removable cushioned seat with a toilet-type seat, removes the patient’s lower garments and returns chair and patient to a sitting position. Adaptive Velcro undergarments and clothing facilitate this step. More specifics about caring for the patient after the toileting routine are provided
After toileting is finished, the caregiver rotates the chair again, removes the toilet seat, cleans the patient, replaces the undergarments, and reattaches the original cushioned seat. Again assisted by the airlift spring, the caregiver rotates the chair again, returning the patient to an upright position. Though this process includes several steps, Shulman assures us a caregiver can ready a patient for toileting in less than a minute, far quicker than current practice described above.

Features of the prototype Bottoms-Up SwingChair, when ready for manufacture, will include:
adjustable seat height, from 17″ to 22″; adjustable recline up to 15 degrees; among other comfort features for non-mobile patients. As of now, August 2019, inventor Burt Shulman is actively pursuing partners to help develop it into a market-ready product. Contact information is provided in the HCTR article.]

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

Analysis by Raymond Feierabend, MD

Just when I thought things couldn’t get much worse for the TennCare program, they did.
[The author traces the beginning of the TennCare program problems in 2018 by noting:”First, Medicaid has not been expanded under the Affordable Care Act in Tennessee. Despite public support in the state for expansion and the efforts of former Republican Governor Bill Haslam to pass such an expansion, it hasn’t happened. Consequently, Tennessee continues to forego significant amounts of federal funding that would go to providing coverage for new Medicaid enrollees; one estimate puts the lost net federal funding at $27.5-30.1 billion over ten years.
In addition, expansion would provide TennCare eligibility to an estimated 250,000 additional Tennesseans. [As the author notes: Most of those estimated 250,000 additional Tennesseans are individuals who are caught “in the gap”, with incomes too high for current TennCare eligibility, but too low to qualify for subsidies in the Affordable Care Act (ACA) Marketplace. Details are provided about instituting work requirements on TennCare recipients, following in the footsteps of a number of The application is in but has not been approved as yet, and in fact, “The future of Medicaid work requirements is uncertain at this point. A federal judge has put a hold on further implementation in Arkansas and Kentucky, ruling that these policies directly conflict with the original intent of Medicaid as established by Congress. The issue may go to the Supreme Court before finally being settled.”]

No other state, to date, has submitted such a waiver application.
[Details of Tennessee’s waiver request are yet to be determined to assess the most efficient ways to provide care to their own populations. Another movement underway is to transform TennCare into a block grant program through a federal waiver. Challenges would ultimately end up being decided by the U.S. Supreme Court. Meanwhile, Tennessee will spend precious State resources fighting for a change that would, in all likelihood, result in major harm to its own citizens. What a travesty.

Raymond Feierabend is Professor Emeritus, Dept. of Family Medicine at East Tennessee State University. His opinion piece on Tennessee Medicaid first appeared at Tarbell.org

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

Admin.PHI and Caring Across Generations release joint report outlining nine areas where LTSS social insurance programs at the state level can improve quality of direct care jobs.

NEW YORK — As states increasingly consider state-based social insurance programs to help offset the cost of long-term care for consumers, they should ensure that these programs also strengthen the direct care workforce, argues a new report from PHI and Caring Across Generations.

As consumers and their families struggle to afford long-term services and supports (LTSS), a growing number of states are beginning to consider social insurance programs that would offset these costs. [Early progress is noted: In May 2019, Washington State became the first state to enact legislation that helps finance LTSS for its residents, and a month later, the National Academy of Social Insurance released a blueprint for states to structure and finance these programs in LTSS, along with “universal family care” state policy frameworks for social insurance programs focused on childcare and paid family and medical leave.]

The report calls for policy reforms that raise compensation, enhance training, promote advanced roles, and improve supervision in this sector.

The other five recommendations focus on: funding innovative recruitment and retention strategies; building stronger data collection systems; commissioning state-sanctioned workgroups dedicated to this workforce; launching efforts that optimize the relationship between family caregivers and direct care workers; and constructing matching service registries that effectively connect consumers with workers online.

[It’s noted, importantly, that: “We cannot make care more accessible or affordable without solving the crisis that direct care workers face every day,” said Josephine F. Kalipeni, director of policy and federal affairs at Caring Across Generations.

Direct care workers–4.3 million workers who are the paid front line of long-term care–will be critical to the success of these new social insurance programs.

Unfortunately, jobs in this sector are too often characterized by low compensation, minimal training, and limited career paths, among other challenges. In January 2019, PHI estimated that the direct care sector will need to fill 7.8 million jobs by 2026–a need spurred in part by high turnover in this workforce.

“Our country is at a tipping point regarding long-term care–we need to make this system more affordable to families, and we need to boost workforce capacity to make it more accessible. The surge in states exploring social insurance options is a step in the right direction,” concluded Robert Espinoza, vice president of policy at PHI and the author of Workforce Matters.

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by Tim Rowan, Editor & Publisher of Home Care Technology Reportt

[A survey of post-acute agencies by Brightree found recently that only 4% of home health agencies and hospices are able to accept electronic referrals from a referral source EMR system. This survey revealed a significant gap between what referring providers and health systems want, and what home health and hospice providers are delivering, when it comes to interoperability. This survey is the first-of-its-kind in post-acute care, revealing a significant gap between what referring providers and health systems want, and what home health and hospice providers are delivering, when it comes to interoperability. This survey is the first to interview both home health and hospice providers (675 respondents) and their referral sources (440 respondents)

by Patricia Yeager, CEO of Hospital at Home program, Colorado Springs wing–

Two months before he was to graduate from high school, Darioun Y+eager was rushed to the Emergency Department at UCHealth Memorial Hospital in Colorado Springs, an arm of the University of Colorado Health System, with a gunshot wound to his abdomen. His story turned out to be a model for the power of in-home care when it partnered with a health system to improve patient outcomes and slash healthcare costs. [This article traces the development of the Co-based Hospital to Home program through which Darioun Y+eager was cared for at his home. A Full description of the program and its value is provided. One instance is noted by Mandi Strantz, Care Transition Coordinator for The [i.e. Transitional Care] who says that many people are transferred to a SNF instead of to their homes; and she says about this:”There’s a disturbing trend when people with complex cases are hospitalized and are not recovering quickly enough. They are often transferred to nursing homes, where many patients find themselves trapped.”

And she says: “That is how individuals get stuck there, and have a very difficult time getting back home, and end up losing everything they have. So we want to have a paradigm shift in thinking, to say ‘Let’s get people home’ — where it is better for them as a person, it is better for their health, and it is cheaper.”In short. the IC solution is much preferrsble==as Mandi Strantz concludes: “The IC provides a wide range of services for persons with disabilities in nine Colorado counties. The IC also operates a home health agency that specializes in the Medicaid waiver program known as In-Home Support Services, through which it employs in-home caregivers who care for their own family members under that state program.”

And then…Leading a mission-driven, not-for-profit organization, CEO Yeager pioneered a transitional care program named “Hospital-to-Home” to signal its intent to bypass a SNF admission on the way from hospital discharge to home care. After conversations with state Medicaid officials, outside consultants, and Joseph Foecking, Memorial’s Director of Rehabilitation, The IC staff began program design. One of its first moves was to bring its plan to the attention of the Colorado Health Foundation, which awarded The IC a startup grant.

In its first 15 months, H2H made it possible for 26 people to come home instead of spending months in a hospital or skilled nursing facility bed. Physicians estimates that every hospital day avoided saves the state — or the hospital itself in charity cases — at least $2,000.

Many more details are provided about how the effort moved successfully from pilot to program–see article for these details.

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

A July 24 CMS briefing sent a firm reminder to hospices and other Medicare providers, noting as follows:
Facilities that will be submitting reconsideration requests to CMS for the FY 2020 Annual Payment Update (APU) for Hospice, SNF, and LTCH or Annual Increase Factor (AIF) for IRF Quality Reporting Programs (QRPs) are reminded that any documentation submitted for review that includes protected health information (PHI) will not be accepted, nor reviewed for reconsideration.
Please redact any PHI prior to sending by completely removing all PHI from supporting documentation. If any of the documents included in a reconsideration request contain PHI, the entire request will be rejected and your reconsideration will not be reviewed. Facilities are encouraged to carefully review all supporting materials to ensure all PHI has been removed.
For more information visit:
Hospice Reconsideration Requests webpage

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com