When you want to start a hospice agency, there is a lot to consider. What are the regulations? How much will it cost? What are the steps to getting licensure and Medicare certification? Well, let’s look at this and see why it makes a lost of sense to invest in a consultant that can help you weed through the process.
Steps To Medicare Certification:
When you are looking to start, the first thing on your list of considerations should be cost. Realistically, it is going to cost you between $150,000-$350,000 to get your hospice agency up and running. So, if you do not have the resources to accommodate the cost, then don’t invest the time and dollars when it cannot come to fruition. In addition, you need to look at the regulations. You aren’t expected to understand it all going into the process, but many start the application never having looked at the regulations. Let’s look at the process to Medicare certification:
- 855a/ PECOS: All entities whether for profit or non-profit must fill out the 855a enrollment application or complete the PECOS online application. You will also need to apply for a National Provider Identifier/ NPI.
- Medicare Administrative Contractor (MAC): After you complete the enrollment application, it is sent to the MAC for approval or denial. If denied, it normally means there is additional information that needs submitted or something is missing from the enrollment and you will be able to add it and resubmit. The application is submitted with the $595 application fee.
- Survey: After receiving the approval of the application, the MAC forwards the information to your state agency. You need to contact your state agency to receive the Medicare and/or Medicaid certification materials for a hospice start-up. Ultimately, the survey process lies in the hands of the state agency. In the hierarchy of surveys, new agencies are generally completed last. Therefore, most new agencies opt for accreditation on the initial survey to expedite the approval process. Some state agencies now require new start-up agencies go through the accreditation process even if you desire the state to complete subsequent surveys.
Now, Get Your Agency Put Together:
During this process, you need to study the regulations and get your agency put together. You will need to make sure you have an up-to-date policy and procedure manual that includes both federal and state regulations. A big part of that is wading through what the requirements say and how you put them into place. You will need to get insurance in place, hire what staff is necessary to provide core services, and get clinical software or paperwork in place. You will need orientation requirements completed before you ever start to see patients. You will also need to consider your entire marketing plan including marketing materials. This is where your consultant and consulting agency can be huge in helping you succeed. Consulting agencies can offer up-to-date manuals and insurance coverage as well as assistance in hiring and software selection. Ultimately, the cost of doing it all alone is often much more costly and time-consuming in the long run. Let Kenyon Homecare Consulting help you start your hospice successfully. Call us today at 206-721-5091 or contact us online to see how we can help you get started today!