• Three new Licensed Home Care Services Agencies (LHCSAs) – these were downstate providers who established new agencies upstate
• Two other LHCSAs on board to open
• Three projects under policy and procedure (P&P) review
• Overall agency numbers:
  • 103 LHCSAs
  • 13 Certified Home Health Agencies (CHHAs)
  • Five hospices
  • This is the least amount of providers of all the regions. 
• Home Health Aide Training Programs (HHATPs) – 12 training programs, no new applicants. One application is for hybrid – first in the Capital Region. Programs must send their schedule each year, have at least one core training, and issue certificates.
• Health Electronic Response Data System (HERDS) submissions – The Department is aware that providers are tired of reporting. However, DOH does find the information valuable. DOH looks at who is not reporting (65 of 103 report), checks to see if new LHCSAs have patients and are reporting, the number of Level 1 cases, and CHHA and hospice capacity.
• Regional trends – The Department finds that Assisted Living Programs (ALPs) are still struggling. They are not 100 percent back, and the Department needs to support them. Agencies are having issues with Plans of Correction (POCs); DOH will host a Lunch and Learn on this. There has been a lot of turnover of staff; if DOH provides some education, there may be better compliance. Agencies are having issues with tuberculosis (TB) testing of staff, including having trouble onboarding with the two-step process. Expanded Transportation Assistance Levels (TALS), expanded Level 1, three levels. Agencies should have this especially when dealing with emergency preparedness. Patient info secure file transfer – agencies need to register for this. If you are not registered, the agency will not know that a secure file has been sent to it. Add it to Apps in the Health Commerce System (HCS).

Central NY Region – Colleen Clancy. Registered nurse (RN), clinical and admin positions in medical, medical day program, correctional facilities. Joined DOH in 2016; became program manager in February 2023.

• Counties – 15 – Canada to PA border
• Agency stats:
  • 120 LHCSAs – 2,500-3,500 patients based on HERDS reporting
  • Agencies are both opening and closing; PHD can do work without LHCSA license now per Dear Administrator Letter (DAL).
  • 23 ALP LHCSAs
  • 15 CHHAs – 3,800-4,800 patients per HERDS
  • Eight hospices with three hospice residences – 400-500 range census
  • 15 agencies with HHATPs, one app for new HHATP
• Rolling surveillance – new projects – expansions (seven requests to expand into added counties or in their region). Most are downstate agencies.
• Four brand new applications
• Several changes of ownership
• Regional trends – Agencies are having difficulty finding enough aides and TPs. Some agencies do not have updated HCS 24/7 role cell numbers. See DAL on roles required in HCS – some with more than one person. Seeing TB noncompliance and misunderstanding in the change of those regs. Clinical tags relate to plans of care, medical orders, supervising aides. Agencies need to review current reg.

Western NY Region – Karen Reichert. RN, nurse investigator, surveyor in hospitals and home care, current position since 2018, has experience in other clinical roles.

• Buffalo and Rochester areas 
• Regional stats:
  • 13 CHHAS – caring for 14,000-15,000 a year 
  • Nine hospices – Buffalo five, Rochester four, averaging 1,000-1,200 patients per year
  • 158 LHCSAs – Buffalo 92, Rochester 66. Serving 6,000-7,000 patients in the community a day. No census for ALP LHCSAs
  • HHATPs – 12 (approximately)
  • Five applications for HHATPs
  • Expansions – 34 – 12 new agencies expanding from Metropolitan Area Regional Office (MARO) Region to upstate, 11 new applications for LHCSAs, 11 changes in ownership, 1 new LHCSA
• Regional trends – P&Ps are not always being reviewed or kept current. If P&Ps are more stringent than State regulation or guidance, DOH will be holding provider to more stringent requirements. DOH is finding personal care aides (PCAs) and home health aides (HHAs) who are not certified or in the Home Care Registry. If they are not certified, they cannot work. Registry practices – Agencies need to add new hires, changes should be made timely, separation from employment changes need to be updated in the system. Criminal History Record Checks (CHRCs) – Agencies not conducting them, aides not being supervised during CHRCs, need to retain documentation. Agencies operating in multiple regions do not have an RN in every region in which they offer services. A supervising nurse must be available for home visit day or night. Agencies must also have 24-hour call line. Transfers should never be sent to voicemail. HCS roles need to be accurate and current.

MARO Region – La Verne Wooten, Program Director – RN, Master in rehab counseling, Office for People with Developmental Disabilities (OPWDD), 2005 surveyor in adult homes, 2009 transferred to home care surveillance.

• MARO covers five boroughs. They have three field offices and three survey teams, with all work processed by the NYC office. They are working through many applications for added areas/counties and services and changes of ownership. Lots of movement in this area.
• Regional stats:
  • Over 1,000 LHCSAs
  • 65 CHHAs
  • Roughly 50 hospices
  • 250 HHATPs
• Trends – Initial assessment visits and supervisions are still being done by telehealth via phone. This is very concerning. Also, there are sometimes multiple agencies in the home, and they are not talking/coordinating with each other. Care should be coordinated between agencies. MARO is seeing with expansions that agencies do not have a nurse who is local to the home care patient population. The backup nurse also needs to be local. Agencies without a local supervising nurse or backup nurse cannot appropriately offer support and supervision during emergency situations.

There was some discussion on change of ownership applications and closure plans. While such applications take only a day to review by Regional staff, Central Office approvals take a fairly long time.

The Lunch and Learn in late September regarding POCs will be announced via the Integrated Health Alerting and Notification System (IHANS). LeadingAge NY will be sure to share the registration link with members.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871