LHCSA Statistical Report Workgroup May 11, 2017

Transcription

1 LHCSA Statistical Report Workgroup May 11, 2017 Rebecca Fuller Gray, Director Division of Home and Community Based Services

2 May 11, Goals

3 May 11, Goals Goals for this Workgroup Increase the compliance rates for the LHCSA Statistical Report Capture data relevant to service delivery Ensure quality data is collected in a timely manner Ensure terminology in the report is used universally across the industry Streamline data reporting

4 May 11, LHCSA Statistical Report

5 May 11, Dear Administrator Letter Dear Administrator Letter was issued on August 16, 2016 Informed LHCSAs of the requirement to submit a statistical report annually Informed LHCSAs that non-compliance would result in: Enforcement DOH inability to make an affirmative statement to the LHCSA operator s character and competence Licensure applications not being processed

6 May 11, Survey Information The 2015 Statistical Report was issued to 1,347 LHCSAs on the Health Commerce System (HCS) The survey was opened on August 22, 2016 The deadline to submit the survey was October 15, 2016 Alert s were sent several times during the this time period to remind agencies to submit the statistical report. Alert s included: Dear Administrator Letter Instructions on finding the survey FAQ document Program staff were available by phone and through to respond to questions

7 May 11, Non-Compliance The 2015 Statistical Report was issued to 1,347 LHCSAs: 614 LHCSA did not submit ALL of the forms Enforcements have been initiated against the 350 LHCSAs that: Did not submit ANY of the forms; or ONLY submitted form LSR1- Agency form - collecting contact information

8 May 11, Summary of Submissions by Form Form # Submitted Statewide Upstate Downstate % of 1,347 # Submitted % of 373 # Submitted % of 974 All Forms % % % LSR1 Agency Form % % % LSR2 Patient Form % % % LSR3 Contract Revenue Form % % % LSR4 Direct Revenue Form % % % LSR5 Cost Form % % % LSR6 Staff and Wages Form % % % LSR7 Services by County Form % % % LSR8 Contract Form % % %

9 May 11, Frequently Asked Questions Where can I find the survey forms? Why can t I submit the survey forms? Our agency has multiple sites, do we need to submit separate surveys for each? On LSR 2 - What is the difference between case, patient, and unduplicated patient count? On LSR5 What is the difference between Direct and Indirect costs? What is included in Fringe Benefits? On LSR 6 - What is meant by statutory fringe benefits vs non-statutory fringe benefits? What is meant by Wellcare Services vs Disease and Disability Services?

10 May 11, Form LSR 1 Agency Form 900 Agencies submitted LSR 1 (66.8%) The Agency Form collects demographic information about the agency such as agency location and a contact person.

11 May 11, Form LSR 2 Patient Form 857 LHCSAs submitted LSR 2 (63.6%) The Patient Form collects demographic information about the patient population, including: Census Number of cases Unduplicated patient count Length of Stay (LOS) information Referral sources Discharge destinations Total Unduplicated Patient Total Census on 12/31/15 Total Cases for 2015 Count 380, , ,761

12 May 11, Form LSR 2 Patient Form (continued) 857 LHCSAs submitted LSR 2 (63.6%) 1 30 Days Length of Stay Totals Days Days Days Days 366+ Days No. of Discharged Cases 87,088 32,408 21,086 37,951 55,108 44,053

13 May 11, Form LSR 3 Contract Revenue Form 842 LHCSAs submitted LSR3 (62.5%) The Contract Revenue Form collects information about revenue derived from contracts with other agencies to perform services for their patients, or provide equipment to their patients. Service Total Hours Reported Total Revenue Reported Calculated Revenue Dollars per Hour Nursing Home Health Aide Personal Care Aide Waiver 2,541,818 $98,900,739 $ ,545,111 $1,183,869,414 $ ,491,811 $7,795,859,571 $ ,328,245 $21,503,913 $16.19 Other 6,203,437 $139,171,631 $22.43 Durable Medical Equipment $1,193,535

14 May 11, Form LSR 4 Direct Revenue Form 828 LHCSAs submitted LSR4 (61.5%) The Direct Revenue Form collects information on revenue received from services and/or equipment provided directly by the agency. Service Total Hours Reported Total Revenue Reported Calculated Revenue Dollars per Hour Nursing 10,183,336 $410,182,619 $40.28 Home Health Aide 150,811,971 $2,301,970,882 $15.26 Personal Care Aide 384,888,417 $3,583,020,626 $9.30 Waiver 20,830,532 $471,790,111 $22.65 Other 6,355,624 $149,590,061 $23.54 Durable Medical Equipment $8,157,530

15 May 11, Form LSR 5 Cost Form 817 LHCSAS submitted LSR5 (60.7%) The Cost Form collects direct and indirect costs associated with the delivery of services. Wages are not counted on this form. Total Direct Costs Reported Total Indirect Costs Reported $4,568,988,029 $1,864,437,849

16 May 11, Form LSR 6 Staff and Wages Form 794 LHCSAs submitted LSR6 (58.9%) The Staff and Wages Form collects information on staffing, wages and fringe benefits for specified employee types. Month Total No. Full Time HHAs Total No. Part Time HHAs Total No Full Time PCAs Total No. Part Time PCAs January 1, ,146, , , ,028 April 1, ,242, ,391 1,226, ,352 July 1, ,313, ,211 1,379, ,569 October 1, ,418,346 1,067,104 1,531, ,874 Average 1,280,329 1,002,168 1,278, ,206 Minimum Maximum 502, , , ,882 No. of W2s 4,423,697 3,601,643 The IRS defines a full time employee as an employee employed on average at least 30 hours of service per week, or 130 hours of service per month. Employees that work less than this should be considered part time.

17 May 11, Form LSR 6 Staff and Wages Form (continued) 794 LHCSAs submitted LSR6 (58.9%) Staff Total Hours Total Wages Calculated Wages per Hour All Titles 461,421,455 $5,998,628,218 $13.00 HHAs 262,627,344 $3,014,431,896 $11.48 PCAs 133,924,113 $1,697,899,950 $12.68 Nurses 4,531,787 $160,132,865 $35.34 Nursing Supervisor 1,019,952 $34,252,274 $33.58 Administrators 1,910,558 $115,394,800 $60.40

18 May 11, Form LSR 7 Services by County Form 800 LHCSAs submitted LSR7 (59.4%) The Services by County Form collects information at the county level on services provided to all patients. The information is collected includes: Type of Service: Disease and Disability or Wellcare Service: HHA, PCA, OT, PT, etc. Type of Employee: Contract or Direct Patient Gender: Male or Female Patient Age cohorts: Less than Age 21, Ages 21-64, Age 65+

19 May 11, Form LSR 8 Contract Form 795 LHCSAs submitted LSR8 (59.0%) The Contract Form collects information on the contracts that the LHCSA has with other organizations to provide services on behalf of those other organizations. Total HHA Contracted Hours Rate Per Hour for HHA (paid to Agency) Total PCA Contracted Hours Total 44,196,628 89,202,955 Rate Per Hour for PCA (paid to Agency) Average 23,509 $ ,645 $19.32 Median 1,386 $ ,780 $18.99 Minimum 1 $ $9.25 Maximum 8,139,617 $40 4,122,914 $40

20 May 11, Data

21 May 11, Data Issues with Data Quality Missing data forms submitted without all data entered Internal Inconsistencies: Hours of Service Unduplicated Patient Counts Reasonableness Failures: Negative numbers in the wages column Zeros Very large numbers Agencies reported large numbers for the number of W2s issued

22 May 11, Data Characteristics of the Survey HERDS Survey tool is not designed to collect this kind of information The survey is cumbersome The survey tool does not support tables Weak Edits Data from multiple centers in an agency: Fiscal Payroll Clinical Unaudited

23 May 11, Data How is the Data Used? DOH staff use the data to: Formulate Policies Identify potential worker shortages Track trends: Patient Demographics Age/Gender/Disability Utilization of Services Wages and Staffing (Contract Staff vs. Direct Staff) Determine if agencies are serving all counties they are authorized to serve Determine if agencies are providing all of the services they are authorized to provide

24 May 11, Data Issues to be Considered Is the right data being collected? What data is needed? What types of statistics would be helpful for State Staff? Associations? Providers? Aides? Does it all need to be captured in one place?

25 May 11, Discussion