PDGM Training Series and Financial Analyzer

8 Part Webinar Series

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1.) Intake Strategies for Success with PDGM (September 11, 2019)

The Patient-Driven Groupings Model (PDGM) will dramatically affect the way home health agencies are paid. It also will have a significant impact on agencies’ operations, from intake through discharge. During this session we will walk agencies through the significant home health changes under PDGM and detail how agencies should adapt their intake process as a result. This includes strategies for getting detailed documentation, questions intake staff can ask to gather additional details necessary for accurate coding, and best practices for increasing efficiencies within the intake department.


  • Identify the ways PDGM will affect agencies’ intake departments.
  • Increase efficiencies within their own intake department.
  • Educate their intake staff about how to gather additional detail so that the agency can code as accurately as possible.
2.) Case Management and PDGM (September 18, 2019)

PDGM preparation, Value Based environment and new CoP compliance demands a changing level of performance by our field staff. Updating your agency’s case management practice and associated leadership focus will increase the value of your service to your patients and the performance of your agency.

Leadership of process and people requires a focused understanding of PDGM Key Performance Indicators (KPIs), as well as underlying Key Performance Behaviors (KPBs) needed to move the metrics in the right direction! This training will establish these PDGM building blocks for successful leadership of effective case management and will reinforce KPIs needed for your leadership dashboard.


  • Reinforce KPIs for success (LUPA rates, hospitalization, productivity).
  • Discuss the tools needed to achieve them and the leadership techniques needed to guide and sustain top notch performance.
  • Identify key case management strategies to achieve best-practice clinician performance.
3.) OASIS-D1 and PDGM (September 25, 2019)

The PDGM Functional Impairment Level is based on 8 key OASIS items. Including:

  • M1800: Grooming
  • M1810: Current Ability to dress upper body safely
  • M1820: Current ability to dress lower body safely
  • M1830: Bathing
  • M1840: Toilet Transferring
  • M1850: Transferring
  • M1860: Ambulation/Locomotion
  • M1033: Risk for hospitalization

How your staff answer these 8 items could significantly impact your functional score, HHRG calculations, and ultimately your reimbursement. Never before has it been more imperative that your clinicians know how to accurately assess their patients in the home to ensure they accurately respond to these key items. This educational session explains the importance of OASIS as the foundation of goal directed, patient-centered care planning and best practices for assessing the patient’s functional abilities.


  • Discuss best practice strategies for answering the PDGM OASIS items accurately
  • Learn how to incorporate the OASIS Walk into the SOC/ROC assessment.
4.) Preparing Your Coders for PDGM (October 2, 2019)

One of the biggest changes with PDGM are the new guidelines for home health coding. In this session we review the twelve clinical subgroups and how comorbidities are impacting case mix in the PDGM. Discussion will focus on how coders can best prepare for the new model.


  • Recognize the twelve clinical sub-groups and unacceptable primary codes.
  • Identify common home health codes under each sub-group.
  • Describe the steps to prepare coders for PDGM coding.
5.) Coding Comorbidities with PDGM (October 9, 2019)

PDGM includes a comorbidity adjustment category based on the presence of secondary diagnoses. It will soon be especially important for coders to code all applicable comorbidities – as depending on a patient’s secondary diagnoses, a 30-day period may receive no comorbidity adjustment, a low comorbidity adjustment, or a high comorbidity adjustment. The comorbidity adjustment is impacted by the number of interacting secondary diagnoses.

Coders need to understand that additional coding will be needed to capture all the comorbidities but there is a delicate balance required as clinicians need to be addressing these diagnoses in the care plan. Using the PDGM Comorbidity Subgroups as a guide, we will review how to code comorbidities accurately.


  • Review the comorbidity categories & subcategories in PDGM.
  • Discuss the 11 comorbidity subgroups and included diagnoses.
6.) Care Management with PDGM (October 16, 2019)

PDGM changes the payment model significantly while the current Home Health Conditions of Participation including OASIS and eligibility criteria remain the foundation of our clinical practice. Efficient clinician workflows, proper utilization of all services and case management oversight are vital to success in PDGM.


  • Describe the PDGM case mix structure and key corresponding regulations.
  • Discuss effective and realistic case management practices.
  • Discuss key service utilization strategies, including LUPA management.
7.) Service Utilization Management Training (October 23, 2019)

Success in home health continues to require organizations to develop the core competency and capability of managing care in order to maximize quality patient outcomes and satisfaction scores at the lowest cost. With the onset of PDGM, agency leaders and clinicians must learn how to best assess their patients and plan goal-directed care using the most efficient and effective multi-disciplinary visits. Utilizing the appropriate services to meet care goals while remaining efficient is not only best practice, it’s imperative for the success of your organization.


  • Learn how to use data to drive successful utilization management.
  • Discuss strategies, such as frontloading and the use of signifigant change in condition, to develop patient centered plans of care.
8.) Billing and PDGM (October 30, 2019)

All live webinars are from 1-2pm Eastern.

Bonus PDGM Financial Analyzer

Click arrows to view reports.

Agencies who purchase the webinar series now will also receive free access to our interactive PDGM Financial Analyzer. Based on 2018 claims data, our PDGM Financial Analyzer gives you a comprehensive analysis of the projected financial impact of the Patient-Driven Groupings Model (PDGM) on your agency.

With the Financial Analyzer you’ll get detailed illustrations of your agency data – comparing the current Home Health Prospective Payment System (HHPPS) and the proposed PDGM model using 2018 claims data – including:

Primary diagnosis codes not tied to a clinical group and potential loss

Primary Diagnosis Codes Not Assigned to a Clinical Group

Nursing/Therapy visit ratios for agency top 5 primary diagnoses

Nursing Therapy Visits per Top 5 DX Per 30 Day Period

LUPA percentage of visits, payment, and LUPA payment by clinical group

Count showing LUPA Breakout

Payment and cost by functional group, admission source, comorbidity

Payment and cost by functional group, admission source, comorbidity

All provided with national and state benchmarks.

Combined with the training series, you’ll get the detail you need to understand what’s driving the projected change in your reimbursement and to create your PDGM Readiness plan. Be prepared with your PDGM data during the webinar series so that our presenters can walk you through your benchmarks.

Early Bird Pricing for the PDGM Training Bundle (Includes PDGM Live series and video recordings and PDGM Financial Analyzer): $799 per site/CCN. Discounted pricing ends August 30, 2019. 5-10 CCN Early Bird Discount $699 per CCN. 10 or more contact us for pricing.

Register Now

Understanding the Hospice Final Rule

Fazzi has partnered with WellSky to present this free webinar.

The Centers for Medicare & Medicaid Services (CMS) have published the 2020 Hospice Final Rule, which includes a significant rebasing of hospice payment rates. Rates for higher acuity levels of care are increasing, while rates for routine home care are decreasing. The 2020 final rule also includes a complex new requirement for an addendum to election statements that must provide details as to the care, services, and drugs that will not be covered under the Medicare hospice benefit.

Implementation of the election addendum has been delayed until October 2020, but other provisions of the 2020 hospice final rule go into effect on October 1, 2019, so your time to prepare is very brief. The time to begin is now.

In this important 60-minute presentation, Catherine Dehlin, RN, BSN, CHPN, CHCM, Director of Hospice Services for Fazzi Associates will help you understand the new requirements, evaluate their impact on your processes, and create an action plan to succeed.

 Watch to learn:

  • How rebased payment rates for CHC, IRC, and GIP levels of care will affect your hospice
  • Why rebased payments may signal a new level of compliance scrutiny for hospices
  • The new requirements for an addendum to the hospice election statement


What the FY 2020 Proposed Rule Means for PDGM and Coding

CMS has issued the FY 2020 Proposed Medicare Home Health Payment Rule which of course encompasses far more than the proposed payment rates. In particular, the industry has wondered what, if any, changes CMS would make to the Patient-Driven Groupings Model (PDGM) set to go into effect on January 1.

In this complimentary webinar, we provide an update on the portion of the Rule that encompasses PDGM and in particular what we believe to be the impact on agencies’ coding operations, challenges and imperatives.


Fazzi’s Summary and Response to the OIG’s Hospice Reports

As you probably know, the US Department of Health and Hospitals Office of Inspector General (OIG) recently released a two-part report that reviewed hospice deficiencies across the nation from 2012-2016.

These reports are long, and there has been a great deal of media attention about them. We thought it would be useful to you to have an objective and digestible summary, and so we’re pleased to provide just that. In this paper from Catherine Dehlin, our Director of Hospice Services, you’ll find:

  • An objective summary of the two reports released by OIG.
  • CMS’ responses to the OIG’s recommendations to CMS.
  • Fazzi’s response.

Simplified PDGM Look-Up Tool Updated from Proposed Rule

We’re pleased to tell you that we’ve updated the Simplified PDGM Impact Look-Up Tool – a fast and easy way to see CMS’ updated projection of the financial impact of PDGM on your agency.

This Look-Up Tool accesses CMS’ Agency Level Impact projections updated with 2018 claims and 2020 proposed payment rates incorporated into the Proposed 2020 Home Health Payment Rule released July 18, 2019.


Home Health Compare Updated

The Home Health Compare results were updated on July 24, 2019.

For the Quality of Patient Care measures, 11 measures improved and 3 remained the same. Improvement in bed transfer and improvement in management of oral medications saw the most improvement of 0.9%. Multifactor fall risk assessment conducted, depression assessment conducted and influenza immunization received for current flu season saw no change. (Data Collection October 1, 2017 – September 30, 2018).

Acute care hospitalizations and urgent, unplanned care in the emergency room both stayed the same at 15.8% and 13.0%. (Data Collection January 1, 2017 – December 31, 2017).

The national average for the Quality of Patient Care Star Rating remained the same at 3.5 stars. The percentage of agencies with 2,3 and 4 stars declined and the rest increased.

HHCAHPS measures also updated and the national averages remain the same for 3 measures. Patient willingness to recommend and overall rating of care given by HHA’s care providers improved by 1%. The data collection period for these measures and the Star Ratings is January 1, 2018 – December 31, 2018.

To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.

Registration Now Open for the August COQS Online Preparation Course and Exam

COQSCertified OASIS Quality Specialist (COQS) Online Preparation Course and Exam – with PDGM and D1 Preparation

The 8-week online course begins August 12- Register early to save!

Certifying OASIS proficiency is even more critical now that we have OASIS-D1 and with PDGM less than a year away! Developed by industry leading OASIS experts, the extremely popular COQS complete program includes:

  • A comprehensive, effective, engaging, convenient and affordable 8-week online preparation course and practice exam.
  • A 100-question proctored certification exam (or 80-question recertification exam) which can be taken online from the convenience of home or office. Certification demonstrates to employers and colleagues that an individual possesses the ability to accurately interpret assessment data and complete the CMS OASIS Item set in a compliant fashion.
  • A printed copy of Fazzi’s OASIS-D Field Guide to Data Collection.
  • Focused information for PDGM and OASIS-D1 Readiness.

Why is the COQS so Valuable?

  • Clinicians and other OASIS experts can obtain OASIS certification completely online with our online certification course and examination.
  • COQS certificants receive free annual competency testing, frequent webinars and “Ask Anita” sessions.
  • The COQS course and exam are unique in our industry to include concepts from The OASIS Walk® in certification, teaching and testing clinicians on the use of OASIS as an effective care planning tool in the home.
  • Clinicians with other OASIS certifications may take the COQS recertification exam at a discounted price.
  • Led by OASIS expert, instructor, enthusiast, devotee, coach and mentor, Anita Werner, the quality of the course instruction and materials is outstanding.

Certified OASIS Quality Specialist Bundle: Includes online preparation course, online exam and OASIS-D Field Guide – $449 per seat through August 6th (Regular Price $549)

If enrolling 10 or more clinicians, contact us for bulk pricing.

Register Now

How Many More Claims Will You Need to Bill Under PDGM?

One of the many sweeping changes under the Patient-Driven Groupings Model (PDGM) is the move to 30-day payment periods. Diane Poole, long time industry expert and the Director of Fazzi’s outsourced billing department, has created a position paper to address the implications of this change on billing capacity and cash flow. Specifically, in this position paper you’ll learn:

  • Predictions on increased claim submissions by agency size (based on CMS data) and how that impacts the associated workload in your billing department.
  • The impact on cash flow from “Half the RAP”.
  • How Fazzi will help our outsourced billing clients with these challenges.

Continue reading “How Many More Claims Will You Need to Bill Under PDGM?”

Informational Webinar: Why is the BCHH-C Credential so Important and Valuable?

Find out the answer to this question and more in our free 30-minute webinar session.
Thursday, Jun 27, 2019 1:00 PM – 1:30 PM EDT

We recently announced our new offering of the 8-week online Board Certified Home Health Coder (BCHH-C) certification program and the reception has been fantastic. Many of you have already signed up for the program and others have sent us some great questions, including:

  • Why is the BCHH-C Coding credential so important and valuable?
  • How does the 8-week training program work?
  • Who qualifies to take the program?
  • How does this certification differ from other similar programs?
  • How will this course prepare me or PDGM?

Find out the answers to these question and more in a complimentary 30-minute webinar on June 27th from 1:00-1:30PM EDT.

Register Now

Why is the BCHH-C so Valuable?

  • Coders can obtain BCHH-C coding certification completely online with our online certification course and examination.
  • BCHH-C certificants receive free annual competency testing, frequent coding udpates webinars and “Ask The Expert” sessions.
  • The BCHH-C course and exam are unique in our industry to include not just ICD-10-CM concepts but also test and train in those areas of OASIS (25%) required to become an expert coder.  In fact, some employers require no additional OASIS certification when holding the BCHH-C credential.
  • Coders with other coding certifications may take the 75-question BCHH-C recertification exam.
  • Led by a team of coding experts, the quality of the course instruction and materials is outstanding.

Need to start from the beginning? Purchase Fazzi’s Total Coding Bundle

For coders not familiar with the ICD-10-CM code set we recommend purchasing our Total Coder Bundle. In addition to the certification program, you’ll receive access to our 20+ hour complete ICD-10 training program. This is a self-paced course that covers the conventions and general coding guidelines, a review of how to use the coding manual, and a chapter-by-chapter review of the ICD-10-CM code set.

For Coders already familiar with ICD-10: 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $449 (Reg $549) ends July 3.

Purchase BCHH-C Certification Bundle

For Coders new to ICD-10: 20 hour ICD-10 complete program, 8-week targeted certification course, BCHH-C exam, OASIS-D Field Guide. Early bird pricing $749 (Reg $849) ends July 3.

Purchase the Total Coder Bundle

Hospice Compare Updated

CMS has posted the quarterly Hospice Compare refresh of quality data on May 23, 2019. All quality measures improved since the last quarterly posting or stayed the same. Pain Assessment showed the most improvement, from 87.8% to 89.2%, followed by Composite Process Measure.

Updates to the family caregivers’ survey results showed seven measures remained the same. However, ‘Willing to recommend this hospice’ decreased by 1%.

Quality measure results are from data collected July 1, 2017 – June 30, 2018, and Hospice CAHPS® survey results reported July 1, 2016 to June 30, 2018.

View State Level Hospice Compare Charts