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2013 Annual Report

of the

Home Care Alliance of Massachusetts


Foundation for Home Health



Message from the President

Dear Members and Friends: How do you keep abreast of the latest challenges facing the home health care industry? Where do you obtain educational and other support services to improve your staff performance? How can you stand with others in home care behind a unified message that our expertise is the solution to so much of what our health system is grappling with today? At last years Annual Meeting, I spoke of people (and home care agencies) as being divided into three groups: those who make change happen, those who watch change happen, and those who ask what just happened? During our Year of Engagement this past year, the Alliances Board of Directors committed to being part of the first group those making change happen and keeping our members from falling into that latter group of those who discover change only after it happened. As the largest home care association in New England, with more than 200 certified home health and private care members, the Alliance played an active role in 2012/13 with state and federal lawmaking bodies, regulatory agencies, and fiscal intermediaries to interpret, challenge, and propose policy and regulations that affect the home care industry. At the same time, we expanded our efforts to establish and promote the value of home care to the public. Our message that our members provide evidence-based, cost-effective, high-quality services when patients need them in the place they prefer to live is becoming more openly accepted, as evidenced by the number and types of entities who are all now trying to do what we already do, and do well. As I complete my first year as the Alliances president, and look to embark on my second, I am committed to keeping the Alliance as the vibrant, forward-leaning organization that my predecessors shaped, and to making a positive difference for our industry each and every day.

Beverly Pavasaris President of the Home Care Alliance of Massachusetts 2

About the Alliance

The Home Care Alliance of Massachusetts is a statewide association of home care agencies and their allies, dedicated to promoting home care as an integral part of the health care system. Founded in 1969, the Alliance is the definitive voice for home care in Massachusetts and represents more than 200 agency providers from every corner of the state. It builds public awareness of home care, helping citizens of the Commonwealth understand the scope of home care services and how to make wise health choices. The Alliance works with government officials, legislators, and other advocacy organizations on legislative and policy initiatives. Some issues affect the entire home care industry, while others are more narrowly focused on specific matters such as telehealth and nurse delegation. The Alliance gives voice to members concerns by commenting on proposed legislation, the budget process, and health care reform initiatives. Additionally, it hosts and attends advocacy events across the state and in Washington, DC, and sits on policy-making committees to raise the profile of the entire industry. Another of the Alliances primary functions is to help its members refine and improve their service to their clients. For instance, in 2010, the Alliance created an accreditation program the only one of its kind in the state for its private pay members in order to establish standards for these agencies and provide them with a form of best practices. More than sixty such agencies are currently accredited. Also in this vein, the Alliance holds an annual awards ceremony to recognize excellence and innovation within the industry. Additionally, the Alliance fosters communication and sharing among its members by keeping them informed of regulatory and market changes through our professional interest groups, listservs, eNewsletters, and publications. Through its educational subsidiary, the Foundation for Home Health, the Alliance also supports its members efforts to continually improve their clinical excellence by offering workshops, teleconferences, and other educational events throughout the year. The Foundation also collaborates with the five other home care associations in the region to organize the annual New England Home Care Conference & Trade Show, the largest home care conference in the region. In addition to these services, the Alliance also publishes directories of its members to help referral sources make informed decisions, provides its members with group purchase programs, and hosts the New England Home Health Career Center website.

About the Alliance

Board of Directors 2012-2013
Beverly Pavasaris, Brockton VNA, President Shawn Potter, All Care VNA & Hospice, Treasurer Jeanne Ryan, VNA & Hospice of Cooley Dickinson, Vice President Wayne Regan, MetroWest HomeCare, Secretary Patricia OBrien, Hebrew SeniorLife, Past President Jann Ahern, South Shore VNA John Albert, Home Health VNA, Inc. Keren Diamond, VNA of Boston & Affiliates Meg Doherty, NVNA and Hospice Joanne Kramer, VNA Care Network Larry Levine, Home Care Assistance Kathleen McDonough, Comm Health Ntwk Laurie Rubin, Quality WORKS Elaine Stephens, Overlook VNA Robert Tonti, Vineyard Nursing Assoc Kathleen Trier, Community VNA Joan Usher, JLU Health Records Systems

Alliance Staff
Patricia Kelleher
Executive Director

Tim Burgers
Associate Director

Royce Tyree
Meetings & Education Manager

Colleen Bayard
Director of Regulatory & Clinical Affairs

Tom Meyer
Membership & Information Services Coordinator

James Fuccione
Director of Legislative & Public Affairs

Stephanie Drakes
Administrative Assistant

Jon Ezrin
Accountant 4

2012-2013 Financials
Support & Revenue
Membership Dues Workshops & Seminars Publications & Other Royalties TOTAL Support & Rev. $897,327 (64%) $450,561 (32%) $34,467 (2%) $8,996 (1%) $1,391,351

Operating Expenses
Salaries, Etc. Conferences & Meetings Consulting & Prof. Fees Occupancy Equipment & Operation Travel Printing & PR Dues & Subscriptions All Other Expenses TOTAL Operating Exp. $647,652 (49%) $328,811 (25%) $104,238 (8%) $99,424 (8%) $60,069 (5%) $25,010 (2%) $18,664 (1%) $11,586 (1%) $14,885 (1%) $1,310,339

Non-Oper Activities
Contributions Investment Return Total Non-Operating Activities $1,265 ($7,471) ($6,206)

Assets & Liabilities

Total Assets Total Liabilities Total Net Assets Beg. Net Assets Change in Assets $1,225,457 $348,459 $876,998 $802,192 $74,806

2012/13 in Review
The Alliance provided more than two dozen educational in-person and online workshops this past year. These programs promoted strong agency management, supported agencies in meeting or exceeding national quality or industry patient centered outcome measures; and promoted the competency of direct care staff, including home care aides. Clinical topics for these programs in 2012/13 included: Managing Audits and Appeals; Complying with Changes to HIPPA/HITECH; Rehospitalization Rate Reduction; Complying with Human Resources Provisions of the Patient Protection and Affordable Care Act; and Medicare Home Care 101. For home health aides, programs included: Treating and Managing Pain and Understanding Professional Boundaries. Additionally, the Alliance coordinated two regional events: The Northeast Home Health Leadership Summit, and the 2013 New England Spring Conference & Trade Show. It also hosted its annual Summit on Private Duty Care, as well as a Financial Managers Conference. The Alliance published 50 issues this year of its weekly eNewsletter, Update, providing current public policy, legislative, and industry information. This publication is supplemented by regular memoranda and legislative action alerts on both state and federal issues. Our online presence and traffic also increased this past year. Since July 1, 2012, received just over 101,000 page views (up 9.7% from last year) from 25,831 unique visitors (up 6.4%). During that same period, our newsfeed/blog received 22,812 page views (up 6.7%) and our followership on Twitter increased to a total of 1,209 (up 39.4%).

Promoting Inter-Agency and Cross Continuum Collaboration

2012/2013 saw a rapid rise locally in federally-funded demonstration programs testing new health care delivery models and payment incentives. Across the state, shared accountability for patient care goals is replacing silo-ed approaches to care. The Alliance has engaged in many collaborative efforts designed to put home care in a favorable place as systems become more fully or virtually integrated. The Alliance worked with the Massachusetts Hospital Association (MHA) to incorporate home health outcome data and information into the Patient Care Link website. In collaboration with the Mass Medical Society, the Alliance developed an online webinar and self-directed course for physicians on Home Based Palliative Care for Patients with Advanced Illness. 6

2012/13 in Review
In group and individual meetings, all of the states One Care Plan integrated care organizations for the states dual eligible demonstration project were briefed on home care programs and payment methodologies. The Alliance has represented the industry at various joint stakeholder implementation meetings. The Alliance has worked collaboratively with MHA, Mass Medical Society, Health Care For All, and others on efforts to assure that any new federal Medicaid dollars are dedicated to Medicaid rates and expansion rather than being dropped into the states General Fund. Through legislative advocacy, the Alliance won support from the Massachusetts Hospital Association and others for its Certificate of Need legislative language and retained a multi-organization coalition in support of the Nurse Delegation language improvement. The Alliances many listservs, committees, and regional membership forums continued to provide members the opportunity to share ideas, network, and raise awareness on issues pertinent to their agencies. The Alliance continues to co-chair the states Falls Prevention Coalition, was named to the advisory committee to the states Health Policy Commission, and has a named representative to the Community Health Worker Advisory Committee along with a seat on the Behavioral Health Task Force.

Promoting Home Cares Value

The Private Care Advisory Committee developed a 4 Reasons to Choose an Agency brochure to educate the public about the advantages of choosing an agency over an independent worker. Over 8,000 copies of the brochure have already been distributed to a wide range of information and referral sources as well as families, policy makers, and government officials. Working with ElderCareSKILLS, a Video Task Force of agency members developed a series of nine Home Care How-To videos and published them on the Alliances YouTube channel. Designed for families, these short videos explore some of the most commonly asked questions about home health care. The Alliance also sold or distributed over 2,800 copies of the redesigned Home Health Resource Directory (a new record) and over 9,000 copies of the Guide to Private Care Services to hundreds of councils on aging, hospitals, case managers, geriatric care managers, and state legislators, as well as a host of other referral sources.

2012/13 in Review
Member Operating Efficiency
The Alliance has partnered with The CIP Group as our preferred agent to provide health insurance and compliance advisory services for member agencies related to the Accountable Care Act. A task force of Alliance members worked with the MassHealth TPL Unit to redesign and expand the use of the Homebound Assessment form, significantly reducing the burden of TPL on member agencies who serve a high volume of dually-eligible patients. Alliance staff helped reduce research time for member agency staff, handling dozens of calls and emails monthly on state and federal regulations.

Supporting & Recognizing Innovations

Innovation requires leaders to articulate a new possibilities, to demonstrate their value, and then to encourage their integration into the work flow. The Alliance sponsored a number of opportunities for its members to hear, share, and be part of a broader health care innovation agenda. The Alliances work with the Mass E-Health Institute (MeHI) brought home care into the states plan for electronic health information exchange and helped several members to win grants to support interoperability. The 2012 Northeast Home Health Leadership Summit featured leading-edge perspectives on the industry from the leader of the nations largest freestanding, non-profit home health agency and the former leader of the Centers for Medicare and Medicaid. The Alliances Private Care Accreditation Standards continued to set the bar for a high quality private care agency. As of June 2013, 64 members are currently accredited. The 2013 Innovation Showcase Our Time to Shine featured new thinking on dementia care using video conferencing, achieving gains in population health through serving an entire community, and local partnering to provide enhanced care for the most at risk patients.

Star Award Winners

Manager of the Year: Sue Sullivan Community Nurse & Hospice Care

Manager of the Year: Barbara Brooks VNA Care Network & Hospice

Aide of the Year: Ginger Shugrue Home Instead Senior Care of Pittsfield

Physician of the Year: Dr. James Everett Hospice of the South Shore

Clinician of the Year: Shirley Lucier VNA Care Network & Hospice

Clinician of the Year: Patricia Darling VNA of Boston

Star Award Winners

Legislator of the Year: Rep. Kate Hogan Massachusetts Legislature, D-Stow

Home Care Champion: Val Halamandaris, National Association for Home Care & Hospice

Innovation Award Winners

Health Care Cost Containment
Winner: VNA of Greater Lowell Health Care Affordability Begins At Home

Innovation in Patient Care

Winner: NVNA & Hospice Alzhiemers Specialty Team Advanced Practice Hon. Mention: Home & Health Resources First Day Home

Excellence in Staff Development

Winner: HouseWorks First Ever Schwartz Center Rounds for Home Care Hon. Mention: Nashoba Nursing Service & Hospice Visiting Volunteers Program

Cross-Continuum Collaboration
Winner: Baystate Health/Bay State VNA & Hospice Reducing Avoidable Readmissions with a Cross-Continuum Partnership Hon. Mention: Partners Health Care At Home Private Care Skilled Nursing for Low Income Frail Elders

Excellence in Community Outreach

Winner: GVNA Healthcare The Face of Home Care on the Street Hon. Mention: VNA of Middlesex-East & Visiting Nurse Hospice HomeMed Monitoring Kiosk


24 Hours Care Abbott Home Health Care, Inc. ABC Home Healthcare Professionals Able Home Care, LLC ABP Best Home Care Agency Acclaim Home Health Care Ace Medical Services, Inc Acton Public Health Nursing Service Advantage Home Health Care Services All At Home Healthcare, LLC All Care Resources, Inc. All Care VNA & Hospice Allied Home Health Care, Inc. AlphaCare Home Health Agency Alternative Home Health Care, LLC Always Best Care Always Here Home Care, Inc. Amedisys Home Health of Agawam Amedisys Home Health of Waltham AmeriCare At Home, Inc. Apex Healthcare Services, Inc. Assisted Daily Living Inc. Associated Home Care, Inc. At Home Elder Care Inc. Auburn VNA Health Network, Inc. Aviv Homecare Ayah Caregivers for Homecare LLC Bancroft Private Care, Inc. (Auburn VNA) Bay State Senior Care, Inc. Bayada Assistive Care BAYADA Home Health Care Baystate VNA & Hospice Berkshire VNA/Berkshire Medical Center 11 Best Home Care Best of Care, Inc. BrightStar Care Boston North BrightStar Care of Milford & Worcester Bring Care Home Brockton VNA Brooksby Village Home Support Brooksby Village VNS Bullock's Nursing + Home Health Care Capuano Home Health Care, Inc. CARE @ HOME Care From The Heart Care Resolutions Care Resources CareGroup Home Care CareProviders Visiting Nurse Agency Caretenders Caring Companion Home Care, LLC Caring Solutions, LLC Celtic Angels, Inc. Central Home Health Care Centrus Premier Home Care, Inc. Charlesbank Home Care Chicopee VNA, Inc. Clark Care, Inc. Collective Home Care Inc. Colony Care At Home, Inc. Comfort Home Care LLC Comfort Keepers of South Shore, Cape Cod & Metrowest Comfort Keepers of the North Shore Commonwealth Caregivers, Inc. Commonwealth Clinical Services, Inc. Commonwealth Registry of Nurses, Inc.

Community Health Network, Inc. Community Nurse & Hospice Care, Inc. Community VNA Private Care Community VNA, Inc. Comprehensive Home Care Dodge Park At Home Elder Achievers Elite Home Health Agency, Inc. Emerson Hospital Home Care Excel HomeCare Services Excella Healthcare Ezra Home Care, LLC Family Care Extended Glenmeadow at Home GMVNA Great to be Home Care (Chicopee VNA) Guardian Angel Senior Services, Inc. Guardian Healthcare, LLC Guardian Home Health Care GVNA Healthcare, Inc. Habilitation Assistance Corp. Hahn Home Health Care, Inc. Hallmark Health VNA & Hospice, Inc. Hampden County Visiting Nurses and Home Care Services HealthAlliance Home Health & Hospice Hebrew SeniorLife Home Health Care Holyoke VNA & Hospice Life Care Home Again Health Care, LLC Home Care Assistance Home Health Mates Home Health VNA, Inc. Home Instead Senior Care Hearthside, Inc Home Instead S. C. of Berkshire County Home Instead S. C. of Boston North Home Instead Senior Care of Cape Cod Home Instead Senior Care of Lexington Home Instead S. C. of North Andover Home Instead S. C. of North Dartmouth Home Instead S. C. of N. Bristol County Home Instead Senior Care of Norwell Home Instead Senior Care of Norwood Home Resources, Inc. HomeCare, Inc. HouseWorks, LLC Independence Home Care, Inc. Integra Home Health Agency International Health Solutions Jewish Family & Children's Service VNA JHC HomeCare & Hospice Keystone Home Care Services Life Care at Home LivHOME, Inc. Living Wisdom Home Health Agency Loving Care Agency Pediatric Homecare Manuel R Grell Home Care Medical Resources Home Health Corp. Memorial Hospital of RI Home Care Mercy Home Care Metropolitan Home Health Care, Inc. MetroWest HomeCare & Hospice Multicultural Community Services of the Pioneer Valley, Inc. Multicultural Home Care, Inc. Nashoba Nursing Service & Hospice / Nashoba Assoc. Boards of Health Natick VNA, Inc. Neighborhood Home Care 12

New Century Homecare Services, Inc. New England Home Health Services, Inc. New England Homecare Solutions, Inc. New Outlook Homecare, LLC Nizhoni Health Systems Noble Visiting Nurse & Hospice Services North Hill Home Health Care Northeast Clinical Services, Inc. Northeast Homecare Nurses R Us, Inc. Home Care Services NVNA and Hospice O'Connell Professional Nurse Service, Inc. Overlook Visiting Nurse Association Parmenter VNA & Community Care, Inc. Partners HealthCare at Home Partners HealthCare at Home - Priv. Care Pathways Healthcare, LLC Patriot Home Care LLC PCP Extraordinary Homecare Personal Touch Home Care Pointecare Home Health Agency Porchlight Home Care Porchlight VNA Private Home Care, Inc. Profess. Nurse & Home Care of Cape Cod Rehab at Home Right at Home of Bedford Right At Home of Boston North Right at Home of Boston-South Shore Right At Home of Boston-Southwest Right at Home of E. Worcester County Royale Care, Inc. 13 RSSI Home Care Senior Bridge Family Companies Senior Comfort Services Senior Helpers - NortheastMass Senior Helpers of the South Shore Senior Helpers of Westford & Marlb. Seniors Helping Seniors of Reading ServiceNet Home Care/ServiceNet, Inc. South Shore Visiting Nurse Association Southcoast Visiting Nurse Association Spectrum Home Health & Hospice Care Steward Home Care Stoughton Public Health & VNA Suburban Home Health Care, Inc. T.L. Connections, Inc. Vine Home Care & Staffing Vineyard Nursing Association, Inc. Visiting Angels of Cape Cod Visiting Angels of Chelmsford Visiting Angels of Littleton Visiting Angels of Newburyport Visiting Angels of Newton and Canton Visiting Angels of North Attleboro Visiting Angels of West Springfield Visiting Nurse & Community Health, Inc. Visiting Nurse Assoc. of Greater Lowell VNS of Newport & Bristol Counties Vizion One VNA & Hospice of Cooley Dickinson VNA & Hospice of Northern Berkshire, Inc. VNA and Hospice of Greater Milford / Salmon VNA & Hospice VNA Care Network & Hospice

VNA of Boston & Affiliates VNA of Cape Cod, Inc. VNA of Eastern Mass., Inc. VNA of Middlesex-East & VNH VNA of Southern Worcester County, Inc. VNA Private Care (VNA of Boston) Walpole Area VNA Webster Light Home Health Agency, LLC Whittier Home Health Care Agency Winchester Home Care Wing VNA and Hospice Worldwide Staffing

Abbott Nutrition Alzheimers Assoc. MA/NH Chapter Anoto, Inc. Ansaphone Service Atlantic Charter Insurance Company Baker, Newman & Noyes Be Well Home Healthcare Services, Inc. BlackTree Healthcare Consulting Boston Business Systems Brad Borbidge P.A. Byram Healthcare Centers, Inc. Cap Consulting LLC Caregiver Homes of Massachusetts CHAMP Community Health Accr. Program (CHAP) Deyta, LLC Enos Home Oxygen & Medical Supply Enterprise / Fleet Management Fazzi Associates, Inc. Feeley & Driscoll, P.C. Fred C. Church, Inc. Geek Office Solutions Harvard Pilgrim Health Care Health and Home Care Training Center Healthcare Synergy, Inc. HealthTrust Software HMS Healthcare Management Solutions Home Health Line Honeywell HomMed Hospice & Palliative Care Fed. of MA IT Resources LarsonAllen, LLP LGC&D LLP MA Council for Home Care Aide Services MA Hospital Association Marcum LLP Masspro McBee Associates, Inc Medical Recruitment Specialists, LLC Medline Industries National Private Duty Association Perryville Marketing Associates, LLC


Philadelphia Insurance Companies Philips Home Monitoring PT Research Quality WORKS Sallop Insurance Simione Healthcare Consultants Southwest Technologies Staples Business Advantage Unemployment Services Corp. USI Consulting Group VNAs of New England

Jo Anne Aramini Lawrence Baker Karen Carney Richard Chesney Valerie Donnelly Sandra Mahoney Rachel McGourthy Cheryl Pacella Joan Usher Rod Weaver Ronald Wood David Wudyka





2013 Home Care Alliance of Massachusetts, Inc. 31 St. James Ave., Ste. 780, Boston, MA 02116 Ph: (617) 482-8830 Fx: (617) 426-0509