Recap of presentation day!
Successful program MUST HAVE
1. Services that are consistent with the needs of the participants and community
- Socialization – ACTIVITIES!!
- Personal care
- Nutrition
- Transportation
- Optional services: enhancement of daily living skills, use of supplies, family involvement etc.
2. Administration Standards
- Policies and Procedures
- Qualified Personnel
- Program Director
- Service staff – Ratio staff to client (1:6)
- Volunteers
3. Active Membership with NYSADSA
4. Focus on your referral sources – Get the word out!
- Physicians, Social workers, nurses, therapists, religious groups, other aging disease organizations, etc.
MLTC Contracting
- Select & Contact as many MLTC listed in your County
- Prepare letter of intent with supporting documents
- Be ready for site visit – Get the facility ready
- Establish good relationship with provider representatives
- Complete application and Contract
- Be on top for follow ups and keep ongoing log of all calls
- Keep in mind all time frames
Today’s Challenges
1. Increased competition for Adult Day Care Providers
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- No set regulations for operating centers
- Define your target population
- Demonstrate Demand for Services
- Hours and Days of Operation
- Customer Satisfaction
2. Lengthy Contracting process
- 6-8 Months before you can start billing
3. Panel are closing
- Effects new providers & established providers planning expansion
4. Fraud & Abuse
- Reporting false claims!!!!
- Overbilling visits
- Billing wrong location
- Billing for services not rendered
- Billing for services for another adult day care center
- Illegally soliciting patients
- Paying for patients referrals
- Paying bribes to get into MLTC panels
