2013 Annual Report - Home Care Association of Florida

2013 Annual Report
w w w. h o m e c a r e f l a . o r g
The Voice for Home Care in Florida.
OUR VISION
OUR MISSION
GUIDING PRINCIPLES
To be the foremost resource and
advocate for Florida’s home care
industry and the patients it serves.
As the voice for home care, our
mission is to advance the interest
and meet the needs of our members,
enabling them to provide the highest
quality and most cost-effective
services throughout Florida.
}Member-Focused
“
}Excellence & Best Practices
}Integrity & Ethics
}Unified Industry
“Join an industry association, and not just so you have something to put
under Professional Affiliations on your resume. The payoff in terms of
networking opportunities, early insights on industry developments, and
heads-up on emerging opportunities will be invaluable.”
– careerrealism.com
2013-14 Board of directors
EXECUTIVE COMMITTEE
anthony clarizio MARY ANN KNEE
President
Shands home care
Gainesville
Vice President
Access Nurse Care
Aventura
DENISE BELLVILLE
GLENDA BURKE
Treasurer
Comprehensive Wellness
Services, Palm Harbor
Secretary
Alternatives
Panama City Beach
board of directors
JON FOHRER
CINDY LAVOIE
KARIN BLAQUIER
DEBORAH BARKER
COLLEEN THERIAULT
GLENDA KELLER
DENNIS HEIDE
PAULA REICHEL
LEE DOBSON
BARBARA SHARIEF
BOBBIE D’ANGOLA
District I Director
Maxim Healthcare Services
Pensacola
District V Director
Ace home care
Clearwater
District IX Director
BAYADA Home Health Care
Boca Raton
District III Director
District II Director
Interim Healthcare of North- Lake Centre Home Care
Leesburg
west Florida, Tallahassee
District VI Director
Gentiva Health Services
Tampa
District X Director
South Florida Pediatric
Home Care, Pembroke Pines
District VII Director
Pinnacle Home Healthcare
Orlando
District IV Director
Welcome home care
Jacksonville
District VIII Director
Innovative Senior Care
Fort Myers
District XI Director
United Home Care
Miami
SUZANNE JOHNSON BRAD CALDWELL
Private Duty Director
Bayshore Health &
Homemaker Services
Largo
Associate Director
ContinuLink
Boca Raton
Staff
Kyle Simon
Government Affairs &
Member Advocacy Director
BOBBY LOLLEY, rn
MONICA SMITH
PATTI HEID, mspt, cos-c
JULIA HEATH
Executive Director
Director of Membership
Growth & Development
Deputy Director
Associate Director of
Membership Services
A MESSAGE FROM THE
EXECUTIVE DIRECTOR
W
We are pleased to provide you with the 2013 Annual Report. The following report attempts to
provide you with meaningful information in several key areas; we hope this brief synopsis gives
you a sense of your association, of its focus, its purpose, and intent.
In these times of challenge, change and opportunity, HCAF exists for but one purpose and that is
to move you and your buisness forward. Forward is where the future lies for us all! The time for
handwringing, sweaty palms and anxiety attacks, are all but over. We live in times that abound
with opportunities. These opportunties are immediate, stark, and present for those who are will- BOBBY LOLLEY, RN
Executive Director
ing to sieze the day. There will indeed be winners and losers but there will be far more winners
than you might expect. The winners will have gotten very good at renewing, adapting and transforming themselves.
They may not like the direction that this industry has gone and I will not use the word “embrance” along side the word
change, but the winners will have most certainly “accepted” the changes that are being forced upon us all. We all realize
that change has this, not so funny way, of becoming reality, whether we like it or not. So it is indeed a time where critical choices must be made and the first most critical one is the approach and the mind set one adopts to this new world.
The trick to renewing, adapting and transforming ones self and your buisness is to choose the best direction “moving”
forward, but forward we all must go or we go under!
HCAF is your association, and it too walks this same path of transition and transformation. However, we remain steadfast, always here to aid you and to be helped
by you. We are in this together and we will be together for the long haul through
these uncertain times well into the golden years to come. As HCAF explores its
opportunities and finds its own way, we will not waiver from our focus on what
you need most in the areas of education, advocacy, resources and support. We will
continue to strive to meet your needs in the most efficient cost effective manner.
It is the best and the only way to insure that you find value and relevancy in this
organization.
I am thankful for the resilent home care providers who have choosen to be members of HCAF, thankful for the outstanding Board of Directors who lead and guide this organization, appreciative of all the volunters and committee
members who work tirelessly, and so grateful to work with the amazing HCAF staff. All are working and striving to
move forward, meeting every challenge and taking advantage of each and every opportunity that presentes its self, in
order that the tomorow we share will be all that it can be!
resources, education, advocacy. SINCE 1989.
T
The home care industry’s legislative endeavors saw a mixture of successes and setbacks this past year, including the passage of a bill to reduce providers’ regulatory
burdens as well as the first Medicaid rate increase in a generation.
PUBLIC POLICY
+AdvoCACY
HCAF kicked off the year’s legislative efforts with the annual Legislative Day at
the Capitol in Tallahassee, at which more than 50 home care professionals showed
up to discuss state issues with more than 70 legislators. In fact, the industry met with every
lawmaker who serves on a health care committee! HCAF pushed two initiatives: a bill to reduce
the Agency for Health Care Administration’s quarterly report, and Medicaid rate increases for
home health visits and private duty nursing visits. By the end of the annual 60-day legislative
session, the quarterly report bill successfully passed its five committees and passed unanimously
in both the Senate and House of Representatives. The industry also achieved a ten percent increase in reimbursement for Medicaid home health visits and private duty nursing – the first
increase since the Reagan administration – but was unexpectedly vetoed by Governor Rick
Scott at the end of session.
Florida home care professionals comprised the largest number of attendees at the National
Association for Home Care & Hospice’s annual March on Washington, where the Florida
delegation met with Florida’s 29 members of Congress. Sequestration, additional cuts, rebasing
and the impending employer mandate consumed discussions with lawmakers. On the advocacy
front, HCAF conducted home care visits with U.S. Representatives Rich Nugent (R-Brooksville), Kathy Castor (D-Tampa) and Joe Garcia (D-Miami), and worked with lawmakers such
as Senator Bill Nelson and Representative Gus Bilirakis (R-Palm Harbor) on issues impacting
Medicare providers. HCAF also worked with the U.S. Senate’s Special Committee on Aging
regarding concerns about Medicare Advantage and how the program is impacting Medicare
beneficiaries and health care providers.
HCAF’s Governmental Affairs Committee recognized four lawmakers with the Home Care
Legislative Advocate Award, an annual award to recognize state lawmakers who exhibit energy,
dedication and steady leadership on behalf of providers and patients. The four honorees for
2013 were Senator Anitere Flores (R-Miami) and Representative Jose Felix Diaz (R-Miami),
the sponsors of the quarterly report bill, and Senator Denise Grimsley (R-Sebring) and
Representative Matt Hudson (R-Naples) for their efforts to increase Medicaid reimbursement.
Throughout the year, HCAF called on home care providers to contact lawmakers by phone,
fax, postal mail and email in order to advance relevant legislation and encourage lawmakers
to oppose burdensome and expensive regulations. In all, members sent nearly 4,200 pieces of
correspondence.
HCAF’s public policy and advocacy initiatives brought about significant gains for the industry,
but there’s still more work to be done to take advantage of opportunities and ovecome challenges.
Over the next year, HCAF will further reform the Agency for Health Care Administration’s
quarterly report fine and will continue to seek an increase in Medicaid private duty reimbursement, while continuing our campaign against Medicare home health copays and Medicare
cuts. Stay tuned and get involved at www. home carefla.org/advocacy, and take action at
www. home carefla.org/takeaction.
Photographs (top to bottom): U.S. Rep. Kathy Castor visits with a constituent receiving physical therapy at home; HCAF representatives meet with
U.S. Sen. Bill Nelson at the U.S. Capitol to discuss industry concerns; Industry representatives meet with U.S. Rep. Daniel Webster in his Washington
office; U.S. Rep. Rich Nugent visits with a constituent receiving skilled nursing at home; HCAF and BAYADA Home Health Care representatives
meet with U.S. Rep. Gus Bilirakis in his Palm Harbor office to discuss rebasing of Medicare rates
MEMBERSHIP
T
The Home Care Association of Florida continues to demonstrate the ability to attract new members but that growth rate
as slowed considerably and to compound the problem we have also seen a decline in renewals. These negative trends stem
from continuing reductions in reimbursement and ever increasing levels of scrutiny through various auditing bodies that
have lead to record numbers of denials. These forces have forced closures and or consolidations for some large providers
and small, but the actual fear of this outcome has been far more destructive to our industry and to the association.
As the new fiscal year gets under way, and our industry continues to struggle
with many challenges and the goal remains to increase membership by bringing
on more of those Florida home care providers that are not currently members
of HCAF. As you can see in the following grafts there is a large pool of possible
new members in the state. For this association to realize its fullest potential
and best serve the Florida home health community, HCAF will need to represent a far greater number of the home health providers in our state. Growth is
paramount to the future success and viability of the Home Care Association of Florida. To reach these providers we must
determine why they are not members and then help them see that membership actually helps to prevent what they may fear
the most. Any feedback from current members on what you appreciate most about being a members would be most helpful.
HCAF has continued to reach out to the Private Duty sector. This segment of home care providers is critically important to
the future of HCAF and the home care industry in total. Most believe in a few short years the private sector will be were the
vast majority of home health is being purchased and delivered. We at HCAF take great pride in the fact that we were able
to introduce legislation and have it passed that removed the burdensome AHCA quaterly report requirement from Private
Duty providers. This is just one of the many initiatives that HCAF has undertaken for that sector.
If you are a provider member who is pleased with our services, please help us spread the word to other providers. If you are
provider member who sees room for improvement in our services, please provide us with your feedback or ideas as to how
we can improve our offerings and service to you. In the end you are the reason we do all that we do.
Ready to Serve You in 2014!
HCAF takes pride in offering quality and reliable service for members needing assistance with membership renewal,
setting up website accounts, event registration, password changes, billing and more.
For assistance, please contact us by phone Monday through Friday, 8:00am-5:00pm at (850) 222-8967 and visit us
online any time at www. home carefla.org.
Membership At-A-Glance
June 2002
}Providers: 267
}Associates: 41
May 2005
}Providers: 412
}Associates: 86
March 2009
}Providers: 621
}Associates: 111
June 2012
}Providers: 615
}Associates: 128
May 2003
}Providers: 319
}Associates: 59
April 2006
}Providers: 482
}Associates: 83
June 2010
}Providers: 609
}Associates: 109
July 2013
}Providers: 615
}Associates: 128
June 2004
}Providers: 340
}Associates: 71
June 2007
}Providers: 513
}Associates: 92
December 2010
}Providers: 615
}Associates: 103
June 2008
}Providers: 574
}Associates: 109
June 2011
}Providers: 689
}Associates: 125
Help HCAF Grow Stronger in 2014
As a member, you already know about the numerous membership benefits, but many
agencies are still unaware of the resources, education and advocacy that HCAF offers!
Please help us spread the word about HCAF so we can increase our industry’s influence and
offer more educational opportunities and resources…after all, there is strength in numbers! Download a membership seal for your website at www. home carefla.org/seal.
MEMBERSHIP
Breakdown of Florida’s 2,667 Licensed Providers
AGENCY FOR HEALTH CARE
ADMINISTRATION statistics
HCAF MEMBERSHIP
STATISTICS
Note: Data as of July 2013. Certified group includes Medicare and/or Medicaid certified providers
Growth Trends by Provider Type
Percentages reflect HCAF’s current market share for each respective provider type
resources, education, advocacy. SINCE 1989.
education
H
HCAF continues to preset a broad range of educational programs
year-round. Our programs target an array of home care industry
positions, including administrators, financial managers, nurses,
therapist, home health aides, marketing specialist, human resource supervisors and private duty managers. Our programs are
dedicated to helping you deliver high quality, cost effective services to patients and clients in their home as well as helping your
business grow. HCAF members enjoy reduced prices and any
proceeds are used to support our other membership and advocacy activities. Every minute and every cent is directed and allocated
toward helping members.
The continuing tough economic times and the pending complete
overhaul of Medicare’s reimbursment methodology, through “rebasing,” has accelerated the pace of new information and what will
be new regulatory requirements. Your need for useful up-to-date
information that will help you make the best business decisions
possible has never been greater. Trends in membership behavior
continue to indicate that many providers have tightened their “finacial” belts and can no longer afford to send several staff members to all day training sessions. HCAF understands that providers need to have more information and have it delivered quickly
to the right individuals in their organizations so those individuals
can respond and react appropriately.
HCAF’s new eLearning platform is an example of our commitment to addressing all these critical competing needs in one location. HCAF onDemand is an easy-to-use website where you can
instantly purchase and take affordable home care education and
training. It features an extensive, growing library of over 150 home
care courses, more than 450 CEUs, with automatic reporting to
CE Broker. A care-free shopping experience is created wherein
you can create an account, browse the catalog and purchase with
ease, all with just a couple of clicks. It provides no fuss, 24/7 education access from any internet enabled device by offering unparalleled convenience accessibility.
As great as this offering is we will continue to search and explore
every available option and opportunity that would allow us to deliver exactly what you need to know, when you need to know it
and at the best possible price.
We held 20 District Meetings this year and sadly saw decreases in
attendance to every meeting. However, the web version offering
continues to grow exponentially and again indicates that providers are searching for the most convenient and economical way
to get their information. non-hotel sites in order to reduce cost.
This initiative was successful for the most part with the majority
of sites being considered again for the next round of meetings.
We also surveyed board members about what they felt should
be discussed and emphasized those topics at the various district
meetings and subsequently the participant evaluations from the
last district meeting series had some of the highest marks ever
achieved.
} HCAF maintained its approved CEU provider designation for
key constituent groups including nurses, accountants, occupational therapist, and speech therapist. In addition all educational
offerings that HCAF submitted for physical therapist CEUs were
approved.
} This past year through diligent efforts on the part of HCAF staff,
the opportunities for vendors to gain exposure and recognition at
our various events was more consistent and more numerous with
over 60 vendors generously donating their expertise or providing
much needed sponsorship funding. This high level of vendor support and participation is critical to keeping the cost of these events
low for members.
} You are probably reading this report at HCAF’s 25th annual
conference. This year’s annual conference is one of the most focused and streamlined events that HCAF has every organized.
This conference will strive to not only give you what you need to
know in order to be successful but it will be delivered in a positive
manner, pointing us all in the direction of a challenging but bright
future. Pat yourself on the back because you choose wisely and are
here at a “must attend” event! This experience will certainly help
you overcome the obstacles and fully realize you’re potential.
} We ask all attendees to the conference and at the various educational offerings to complete an evaluation form which allows
them to rank all aspects of the event. This year the overall ranking
was superior and participants commented frequently of the value
they received from attending HCAF events. Feedback is crucial
for continued improvement; however, we also need to hear from
those who are not participating so that HCAF can further tweak
or develop our curriculum to meet their needs as well.
As we embark into a new fiscal year, we again see many challenges
and opportunities that will undoubtedly demand that we are at
the top of our game so that you can be at the top of yours. In
2013-14 look for more targeted on-demand education, more information packaged quickly to address pressing needs and critical
updates that are right around the corner. Speed is of the essence
and so high quality, value laden content delivered quickly in the
most economical manner will continue to be our primary objective. As always, we welcome your comments and suggestions for
how to serve you better.
RESOURCES
O
Over the past year HCAF has strived to provide the resources you
want to enhance your agency’s potential to grow and the tools
you seek to help you and your staff provide high quality, cost effective services to the patients and clients you serve. With each
of our initiatives and publications, we look to serve the needs
concurrently of Medicare-certified, Medicaid-certified and
Private Duty agencies alike. Over this past year we have added
the following new membership benefits:
}HCAFeNews – News is always happening. The days of a printed
monthly newsletter have come and gone for those timely topics
where you cannot afford to wait and know. For these topics and
more, we have developed a blog that is updated on an ongoing
basis. This blog is open to the public online although some of the
included links and details are reserved as a members-only benefit.
The topics are categorized for easy reference and all posted news
items are cataloged and searchable at any time.
}HCAFeHighlights is our weekly e-newsletter. It provides a recap
of the week’s news-you-can-use items that have been posted to
HCAFeNews as well as highlights upcoming events and calls to
action for advocacy needed issues. This e-newsletter is emailed
directly to interested members.
}The Home Care Agency Directory & Referral Guide is our
annual print member directory featuring member agencies
listed by service area and county. The directory is distributed to
discharge planners at every hospital in Florida in order to boost
referrals.
}The Florida Home Care Connection is a HCAF’s magazine
that is published twice a year that covers major topics facing our
industry. The magazine format provides an opportunity to provide more in-depth, contemplative reactions to these types of
issues by home care experts across the country and is distributed
to all licensed agencies in the state.
}In-Home Aides – Partners in Caring Newsletter is a publication that we distribute occasionally as a special benefit to
members to distribute to their home health aides. These issues
provide education for home health aides in a clear and concise
manner. A post-test is included so that home health aides can
demonstrate their understanding of the topic to their supervisors
and they can earn one hour towards their 12 hours per year Medicare requirement. This past year we posted seven of these issues.
and fringe benefits. The survey report is free to member participants. This past year we expanded the scope of the questionnaire
and the report to provide specific data for private duty members.
}Affinity Programs provide discount pricing on products and
services that are available to members while at the same time
help support HCAF. This past year we added a number of new
contracts with Associate Members.
}Benchmarking Reports are custom reports emailed to HCAF
Medicare-certified members that compare their own agency’s
outcomes and data as compared with the industry. This past year
we transitioned to a new company to provide these reports as
the prior company was sold.
}HCAFeForum list-serve is one of several benefits of HCAF
membership. The HCAFeForum is designed for members to
communicate with each other as well as for HCAF staff to post
about and respond to regulatory, legislative and clinical issues
and news that impacts the home care industry.
}HCAFeLearning is the on-demand resource center with a
growing number of educational opportunities for today’s onthe-go home care professional. Educational content covers an
array of regulatory, business and clinical topics presented in
multiple formats, including recorded webinars, PowerPoint presentations, audio files, etc. In addition to a convenient learning
platform, some HCAF elearning courses offer continuing education credits!
}HCAFeConnect – This newest platform is HCAF’s resource
for members to discuss clinical and regulatory matters relevant
to your business. Review frequently asked questions and discussions for the following categories: Breaking News and Vital
Information; Business Development and Management; Clinical
Inquiries and Information; Home Care Rules and Regulations;
and Private Duty.
HCAF’s website has been revamped significantly over the past
year and is still undergoing a significant make-over as we add
appreciatively more comprehensive tools and resources to help
our members’ businesses.
}Salary & Benefits Survey is our membership survey of what
agencies are providing their employees in terms of wages, salary
resources, education, advocacy. SINCE 1989.
Learn Online
With Us!
HCAF eLearning allows home care professionals to
access dozens of regulatory, clinical and business
webinars and telecourses at your fingertips!
featuring...
Home Health Billing: Tackling Medicare
Advantage/HMO Claims
Nurtritional Intervention to Prevent
Hospital Readmissions
Financial & Management Aspects
of OASIS-C
The Next Stage of Healthcare:
Embracing the ACO Model
Health Care Reform: The Impact
on Home Care
Therapy in Home Health: A New Day
Identifying Geriatric Depression in
Home Health
State, Federal & Nurse Registry Home
Care Regulations: What You Don’t
Know, What You Thought You Knew &
Everything in Between
ACHC: Compliance Simplified
Hit it Out of the Park: Connect OASIS
Data for More Therapy Referrals
Magnetic Marketing: Six Surefire
Ways to Boost Your Referrals in
60 Days or Less
Getting the Facts About the HHABN
Innovative Compensation
Practices for the Home Care
Provider of Tomorrow
Dissecting Documentation:
Exceeding a Surveyor’s Expectations
What Every Home Care
Professional Needs to Know
About Lawsuit Protection, Tax
Reduction & Estate Planning
HCAF’s Latest District Meeting
On Target With ICD-10
An Overview of the Medicare
Cost Report
Home Health Medicare PPS Billing
Are You Leaving Money on the Table?
The 10 Most Common (and Costly)
Mistakes Sellers Make When Selling
Their Agencies
...and many more!
online & on-demand & on-the-go
www. home carefla.org/learn
FINANCIAL
STATEMENT
fiscal year ending june 30, 2013
H
HCAF’s fiscal year runs July 1 through June 30. At the end of each fiscal year, an independent professional certified
accounting firm completes a detail audit of the association’s year-end financial statements. The independent accounting
firm then presents the findings to the HCAF Board of Directors. This process is typically completed around September
of each year and the report is available upon request. The excerpts below are taken from the most recent complete audit
for the fiscal year ending June 2011. The 2012 report will be ready in or around September 2012.
Report of Independent Auditors
Provided by Thomas Howell Ferguson, P.A.
We have audited the accompanying statements of financial position of Home Care
Association of Florida, Inc. (the Association) as of June 30, 2012 and 2011, and the related
statements of activities and changes in net assets and cash flows for the years then ended.
These financial statements are the responsibility of the Association’s management. Our
responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with auditing standards generally accepted
in the United States of America. Those standards require that we plan and perform
the audit to obtain reasonable assurance about whether the financial statements are
free of material misstatement. An audit includes examining, on a test basis, evidence
supporting the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by management,
as well as evaluating the overall financial statement presentation. We believe that our
audits provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material
respects, the financial position of Home Care Association of Florida, Inc. as of June 30,
2012 and 2011, and the changes in its net assets and its cash flows for the years then
ended in conformity with accounting principles generally accepted in the United States
of America.
September 11, 2012
resources, education, advocacy. SINCE 1989.
Statements of Financial Position
2012
Assets
Current assets:
Cash and cash equivalents
Accounts receivable
Prepaid expenses
Note receivable
$
Total current assets
Other assets:
Property and equipment, net
Investment
Total assets
$
June 30
2011
686,660 $
45,462
162,930
–
872,406
653,100
46,562
34,109
16,000
748,671
14,300
–
888,706 $
16,760
4,000
769,431
17,600 $
27,444
5,118
515,556
420,235
43,257
48,873
–
328,105
576,198
320,988
888,706 $
329,196
769,431
Assets
Current liabilities:
Accounts payable
Accrued expenses
Accured tax expense
Unearned revenue
$
Total current liabilities
Unrestricted net assets
Total liabilities and net assets
$
Statements of Activities & Changes in Net Assets
Years ended June 30
2012
2011
Changes in unrestricted net assets:
Revenues and other support:
Member dues
Educational programs
Conferences and meetings
Royalties and other
Interest income
$
Total revenues and other support
609,308 $
601,581
305,184
289,410
71,967
445,111
54,614
49,780
742
1,648
1,041,815
1,387,530
Expenses:
Total revenues and other support
259,997
31,445
66,981
493,968
5,423
204,081
8,118
1,070,023
203,745
285,768
66,000
506,289
5,841
253,591
(1,600)
1,322,834
Change in unrestricted net assets
(28,208)
64,696
Net assets at beginning of year
349,196
284,500
320,988 $
349,196
Educational programs
Conferences and meetings
Legislative
Salaries and benefits
Depreciation and amoritzation
Other general and admin expenses
Income tax expense
Net assets at end of year
$
resources, education, advocacy. SINCE 1989.
Home Care Association of Florida
RESOURCES, EDUCATION, ADVOCACY
1363 East Lafayette Street, Suite A
Tallahassee, Florida 32301
phone (850) 222-8967 • fax (850) 222-8967
www. home carefla.org