“Starting a Home Health Agency”
Comment Page 3

I am a health care business adviser with over 5 years of experience in the industry. I have references and have helped over a hundred clients. It would be an honor to walk anyone and everyone who is going through the process of licensure, certification, insurance enrollment and even accreditation of their health care facility. We have helped clients throughout U.S. and Puerto Rico. It's as simple as giving us a call at (305) 556-9776 and one of our consultants will be able to assist you.

I would like to take this opportunity to offer free general information on the process of starting a home health agency. Depending on the state for which you are applying, you can apply directly for licensing or you may have to go through an accrediting organization such as Joint Commission, ACHC or CHAP. Having worked with all three (3) and having vast experience with all three (3), my main choice for any client would be Joint Commission. The pricing is not that much different from the others, but their support throughout the process is a lot easier and helpful. As I stated, our consulting firm has worked with all three (3) accrediting bodies, and we are capable of getting you through the process with which ever one you choose. The next step is getting you licensed, which depending on your state, might require a survey conducted by your state regulating agency or the accrediting organization, in some states, such as Kansas, you will not be required an initial survey to receive licensure; however, you will be required to submit policies and procedures as part of your process. These steps just mentioned, are the overall process of getting licensed and will require policies and procedures to run your company, employee files set up and client file set up as well as the initial survey which varies in length or requirement by state. After you have received a license you can move on to certification which will require you to go through an accrediting body as CMS DOES NOT conduct those surveys anymore. You are required to receive a deemed-status accreditation certificate by any of the three (3) accrediting bodies mentioned above which were given deemed authority by CMS to conduct such surveys on their behalf. This will require compliance with your agency's policies and procedures both administrative and clinical, providing care to 10 charity patients, proper supervisions of your staff, and compliance with the COPs (Conditions of Participation). You have to transmit prior to this survey a test OASIS transmission as well and compliance with civil rights. Our consultants have undergone this process hundreds of times and will walk you through all of it from beginning to end. From giving you the cost estimate, to providing you with the start up plan, providing you with the policies and procedures, application packet, guidance through initial survey as well as accreditation survey, we are the one stop location for what you need. We even guide you through the process of providing care to your charity patients so that you invest as little $$$ as possible. Give us a call to get your business running today. (305) 556-9776.

I would like to take this opportunity and point out that I did post some general information regarding opening a home health agency for people to view. I am available Monday-Friday, from 9:00 a.m. to 5:00 p.m. to answer any general questions you may have as well as explain what it is my firm can do for you. Feel free to give us a call at (305)556-9776 and ask to speak to Lilian Bello and I'll gladly be of assistance. Good luck on your new endeavor.

I have run across articles and statements online teaching people in about 5-10 steps "How To" open and/or run a home health agency. The reality is, that neither starting nor running a home health agency is as easy as 5-10 steps... There are things to consider and these things take up time. With the baby boomers retiring, there will be great demand for home health services, as the government prefers to move away from hospital care (it costs them more money) and moving more towards the caring at home concept (saves them money and patients are more comfortable). The job of the home health agency is to provide effective health care at home so the amount of hospital stays are minimized. The combination of excellent patient care and overall (administrative and clinical) compliance is what determines whether or not you may start a home health agency and then remain in business (long term viability). Because all of this requires a combination of developing policies and procedures that are in compliance with your state's rules and regulations as well as the federal rules and regulations (CoPs), the process for receiving state licensure, the process for Medicare/Medicaid certification, Accreditation, and later on insurance enrollment (private insurance), it makes the process very time consuming. Not to mention, that the longer it takes for you to open for business, the more $$$ you are investing which delays you seeing a profit. What I just explained is for the start-up process. The actual management of the business goes back to what I mentioned above, ensuring excellent patient care and total compliance. Accomplishing this means your agency Administrator and Director of Nursing must have the background knowledge to handle employee supervisions (both field staff and office staff), employee evaluations (both field staff and office staff), data collecting (i.e. infection control, PI data, Q.A. data, etc.) hold different types of meetings, provide continuing education for all staff, etc. Owning a business such as a home health agency requires a lot of information but can be very fulfilling as you are helping individuals and are sensitive to their needs. This business can also be very lucrative. Profits range from 200k - over 1 million dollars. Start-up can run you between 20k-100k depending on the location. For the Medicare certification process we have seen contingency funding amounts of up to 98k. Now, this amount is not liquid, meaning you're not going to use it. This just sits in a bank account until your application is processed. Most people, if not everyone, hire consultants for part of the process and most cases for the whole process. This is to ensure they receive licensure and certification in the least amount of time possible so they cut down on costs. Certain states, for instance Arizona, do recommend that you find a knowledgeable consultant to walk you through this process effectively. Our job is to teach you the business and walk you through the process providing you with the tools (i.e. policies and procedures) so that you can learn the business and gain the experience while going through the process. So if you have no experience, don't worry, we do. Do your research, speak to different consultants prior to choosing one, as this process can take up to 1 year depending on the location you wish to open and developing a trustworthy relationship with your consultant is key. Our firm has many years of experience in this process offering help to clients across the U.S. and as you can see, we will not paint a pretty picture just to get your business. We give you the reality and help you make the decision that best fits your situation whether or not we make money. We don't want you to start a process and invest money you later down the road decide you cannot continue or you don't want to continue. Feel free to call me Monday-Friday, 9:00 a.m.-5:00 p.m. eastern standard time at (305)556*9776. I will personally speak to you and help you in any way I can. Good luck on your endeavor!

Koreen, in NY there is a moratorium since 1994 on Certified Home Health Agencies. Unfortunately, this means you are not allowed to open a certified home health agency allowed to provide services to Medicare recipients. You may however, open a Licensed Home Health Agency and there is a list of Home and Community Based Waivers, and other programs you can enroll in and provide services to recipients of those insurances. You can also look into private insurance enrollment and provide services to those such as Blue Cross and Blue Shield, Aetna, Vista, and so forth. You can call me and I'll gladly discuss this further with you. I can be reached at (305) 556-9776. I manage a consulting firm and our sole purpose is to help guide people that wish to start this type of business and other businesses such as pharmacies, DMEs, clinics, ADCCs, etc. We'll be glad to assist you.

Tricia, I have posted general information a bit higher up. It's really long to copy and paste it but I am sure it will give you an idea of what you would need to do to accomplish your endeavor. Feel free to call me if you have any questions. (305) 556-9776 and ask to speak to Lilian.

Jessica, you do not need an MD for your home health agency. An RN with one year of supervisory experience can fill in the Director of Nursing spot which replaced the Medical Director requirement a few years ago. This will save you LOTS of money! My firm is available to help you through this process if you need it, (305) 556-9776. Ask for Lilian.

Floriza, California unfortunately is one of the hardest states to deal with as they are very hard to get a hold of for guidance. My firm has vast experience in assisting people through the process of starting their own health care business. If you need general information, feel free to read some of my postings above to gain some understanding of the process. Feel free to reach me at (305) 556-9776, ask for Lilian.

S.A.G., Georgia is also one of those states who are very difficult to get a hold of for guidance. You must know exactly what you need in order to get somewhere with the state. Unfortunately, California is also very similar. Luckily, MA and TX are much easier to work with. But you are in luck, you are not alone as I am here to offer the guidance you need to save you time and money. Feel free to call me for more general information or read some of my postings above to gain general knowledge of the process ahead. We are available Monday-Friday, 9:00 a.m.-5:00 p.m. eastern standard time. Ask for Lilian. I do look forward to hearing from you soon!

hello Lovina, The time frame can vary on how accurate your application is. They are short staffed so it can take you some time. However, they shouldn't take more than 2-4 months to respond from Medicare. Feel free to call me for a personalized answer. (305) 556-9776.

Hi Mitch. Competition is a good thing. It is the basis for capitalism. This keeps us on our toes competing to provide the best services. However, you are correct; there shouldn't be too many as there are only so many people you can serve. But, what people don't realize is that home health agencies don't only have to provide services to Medicare beneficiaries, or to a specific age group. Home Health Agencies can provide services to children, provide hi-tech nursing that not all agencies get into. They can provide services to people with developmental disabilities as well as individuals affected by cystic fibrosis. I mean, there is a large population to work with, it is when you limit your business to an age group or insurance that you can find a bit of a struggle. Hope this clears up your concern. Good Luck!!

Good afternoon Vickie. Hope all is well with you. Unfortunately, you will not find the help you are seeking free of charge. Even on a website such as this one, there is general information but not any detailed information which is what determines whether you are allowed to open in your state of choice, whether or not you are in a state requiring a certificate of need, whether or not you need to go through initial licensure with the state or if you can deal directly with Medicare for certification. The timeframes for each of these mentioned. I mean, there is just so many details affecting this industry with regulations and compliance that most states even recommend hiring a consultant to take you through the process. The truth is, having so much experience in the industry, I can tell you that hiring a consultant will save you time and money. But be careful, choosing the wrong consultant can also take you nowhere and make you lose money. So it is important that you search and speak to different people prior to making a choice. Consider that this is a business you are starting and it will require investing money just like any other business would. It is also lucrative which means you should see a return on your investment during your first operational year. Notice I used the word "should" as this is not always 100% accurate. It all depends on how well connected in the community you are. This type of business feeds on referrals you receive from physicians, case managers, clients, and the overall marketing you do. Starting it in a location that has too many can also have some affect. I am available to speak to you and help guide you in the direction you seek. Give us a call! (305) 556-9776. I also have a posting above that might help you further, feel free to read it. As always, Good Luck!

Hi Brenda.... Our firm has knowledge and expertise in the start-up process as well as in management of the business once it is fully functioning. This means that we have to know the business both administration and clinical in order to effectively consult our clients. So yes, the start-up process is familiarizing the Home Health Agency officials/owners with the regulatory agencies as well as accrediting organizations. Learning the rules and regulations is involved in this process. This is where our Policies and Procedures come in to play. Once you are licensed, certified and accredited, it is the implementation process. How to implement the processes so that you remain compliant with the rules and regulations and therefore ensure long-term viability. This means, monitoring the care of your patients, the clinical records, HR policies, data collection, meetings, continuing education requirements, etc. These all work hand-in-hand together to ensure you don't lose your license or certification or accreditation status. I encourage you to call me to discuss what you consider limited funds as maybe for the state you wish to open, we can make something happen for you. I am very familiar with Ohio so I might be able to point you in the right direction. As for the waivers, yes, they do work based on case managers referring to you. There are a few things I'd like t discuss with you though regarding this, so I again encourage you to call me... (305) 556-9776. I wish you luck!!

Hi Miia, hope you are enjoying your weekend. Yes, definitely my company will help you from designing your business plan, registering your company, choosing a location, policies and procedures manual set, application to AHCA, set-up for initial survey, choosing an accrediting organization, application for certification, set-up of data collecting tools and utilization reviews, choosing the right software, set-up of charity patients, clinical records, HR records, compliance reviews prior to second survey (which lasts 3 days), until you accomplish licensure, certification and accreditation. Give us a call, (305)556-9776 and we'll be glad to help you. I look forward to hearing from you soon! In the meantime, please read the posts I have placed above for more information.

Pat, hello. There are two types of licenses in Florida to send home health aides to client's homes. One is called a Homemaker/Companion license and the other is a Home Health Agency license. They are both renewed bi-annual. However, the Homemaker/Companion license does not allow you to perform "hands-on" services such as personal care. The only patients you can provide services to are private pay clients and clients who have Medicaid Waivers and other programs such as Independent Living Systems. A Homemaker/Companion license will not be allowed to be Medicare certified and accreditation is not a requirement. As a Home Health Agency, you can send Homemakers and Companions as well; but you can also provide Nursing, Therapies, Medical Social Work, and your CNAs can also provide "hands-on" services such as personal care. As a home health agency, you can accept clients who are private pay as well as Medicaid Waivers and other Programs; but you can also enroll in HMOs and other Private Insurances such as United Healthcare. You can also enroll in Medicare and Medicaid, although Medicaid has a closed enrollment until further notice. Feel free to call me for more information, (305) 556-9776. Good Luck!!

SGA, hello again! I enjoyed speaking with you and regarding the references, I'd love to email them. We try to keep our website very general and our Clients confidential. So yes, I'd love to send you references, and we do so via email. I will definitely email them to you Monday. Have a wonderful Sunday!

Hello Victor, many years ago, the requirement for a home health agency was to have a physician fill the position of a Medical Director. This requirement was removed. This means, you have the choice of hiring a Medical Director (a physician) or hiring a Director of Nursing (Registered Nurse with 1 year supervisory experience in an approved facility such as a hospital or another home health agency). This lets you save on salary during the start-up process as well as the time the agency is fully operating. Since a physician is paid a higher salary than a registered nurse. If you are going for Medicare certification, you do have to have a physician serve as part of your PAC (Professional Advisory Committee) for guidance purpose. This physician is a volunteer, he/she does not receive salary and is not the agency's Medical Director. If you have further questions, feel free to let me know, and as always, Good Luck with your endeavor!

Tabitha, the consulting firm I am affiliated with handles the start-up process which includes the policies and procedures, rules and regulations, state licensure, CLIA, Human Resources records, clinical records, Medicare/Medicaid certification, Accreditation, strategically choosing your charity patients to save you time and money. We don't offer classes, we don't offer a training. Once we are hired, we work with you from start to finish walking you through every detail one on one, just you and my company. For established agencies, we offer Utilization Reviews, insurance enrollment, Accreditation, Medical Billing Services and Accounts Receivables services, etc. In choosing a consultant, you want to choose individuals that will be there for you throughout the process. We are there for you throughout the process and our Clients, most of which we have worked with year after year after year can confirm that. We have the knowledge both State and Federal to get you efficiently up and running as well as protect your business once it is up and running. I do look forward to your phone call tomorrow! Good Luck on your venture!

@Tabitha Fambrough, sorry if your comment is deleted. If you had a link in the comment then that went to the spam filter list and got deleted by the system, anyway i informed Lilian about your concerns. Hope you get some response soon.

Hi Tabitha, I am sure that question was deleted due to a glitch in the system. We can't predict everything that happens with computers. Regarding your questions, I always answer my Clients' questions and my potential Clients' questions. I didn't respond to the last one because as you noticed, the system deleted it... for a moment there, I thought I had gone crazy! But anyway, joining the Better Business Bureau is by invitation only and to be honest with you, I got invited a few months ago and I recently gave thought to joining. I have plenty of references (people that I have worked with and continue to work with after years of being my Clients) but yes, to answer your question, I am in process of getting accredited with BBB. Our company's work is reflected in the quality of service we provide. I can provide you with those references at any time, just let me know your email. I don't make them public because I respect their privacy. If you do business with my company you will see that is how we operate, we will respect your privacy as well. Hopefully I have answered your question regarding our credentials.

Thank you James for notifying me of the response. I appreciate that!

Hi Amber.... yes, last time we looked into the state of Georgia, it was a Certificate of Need state... which means you must prove that you have to prove there is a need for the agency you want to open in order for them to approve it. I need to double check if it is still a CON state. If not, you should be choosing your accrediting organization and begin the accreditation process since you will not be approved for Medicare certification unless you become accredited. You can reach us if you have any questions! Good Luck!!

Yes Amber, you will have to go through accreditation process.

Good morning Robin, there are very limited resources unfortunately. You have two choices, open a home health agency only to provide home health aides services such personal care (hands-on), homemaker and companion or you want to open a homemaker/companion service. The difference is a home health agency allows you to provide personal care which is a hands-on service but you have to go through the same licensing process as if you would provide medical services. Whereas, a homemaker/companion service cannot provide personal care (hands-on) services and in some states, it does not require a state license. You need to start by searching your state's rules and regulations and figuring out which type of business you are interested in. Second, give us a call so we can guide you on basic questions you may have. We offer a variety of services that include going through the process by yourself (which is least costly) or providing you with full services from start to finish. Our consulting firm has over 5 years experience in the industry and has helped hundreds of Clients through different processes. Give us a call!

Hello Levirakesh! I would definitely love to provide you with more information on how to establish your home health agency. I definitely need more information such as the location in which you wish to start. If it is in India, our consulting firm has never worked international Clients, but I am sure we would still be able to assist you. But we definitely do need to start by the location in which you are interested. The function and management of an agency is mostly the same where ever located, however, the regulations do slightly change with the location. I do look forward to your response. Good Luck Levirakesh!!

Good morning Marie... Being able to provide care for someone in a vent is withing your scope; nonetheless, the issue here is the following: an LPN requires the supervision of an RN when providing care in a hospital or in a home health agency setting; however, for an Adult Day Care Center, an LPN without RN supervision is allowed. Therefore, the real question here, is the following: Does the State of Michigan allow for an LPN to provide care without RN supervision? We unfortunately do not have that answer as our scope of knowledge is facility providers only. But you can definitely find out through the Department of Health and Human Services for Michigan. I get the feeling that the state of Michigan does not really regulate that as even for facilities, we deal with Medicare altogether for Home Health Agencies. Regardless, you should be clear in your understanding so that you don't get into trouble. My suggestions is write down every phone number and every name of who you speak to as back up if you are told you are able to provide care. The next place you can inquire in is the health professional licensing board. They should also be able to point you in right direction. This is interesting, if you could please post the outcome of your search, I'd greatly appreciate it... Good Luck!!!!!

You are welcome. That is the quality service we believe in. Good Luck and please let us know whether or not you were able to do it.

Hi Pamela. Unfortunately, there are no courses that can teach you that. There are consultants who charge for a "course" but in reality, you cannot learn the full function of a home health agency over a "course". From the consulting point of view, it is easy money for us, train you in one week, give you the policies and procedures and show you how to fill out the applications and boom, send you on your way. But it has been proven over and over again, The state and federal governments as well as accrediting bodies suggest people hiring a consultant because they are underpaid and have enough on their plates with the processing of hundreds of applications. In most states, you really have to invest a lot of time in getting a hold of someone to answer just a few questions. Time means money. And most of my "repair" clients, have already been through either consultants that didn't do their job correctly or consultants who put them through these "courses" that in the end, left them the same as they began. Simply because there are so many regulations and regulating agencies to deal with that it can be overwhelming and at times discouraging. I am not selling my services, I am simply bringing out why you should use a consultant. It doesn't have to be my company either as I am the first to tell you that you should research a reliable company that fits what you need. A company that can give you that knowledge, not in a course, but throughout the process so that you can truly learn through experience what owning a home health agency entails. Make sure they have administrative and clinical knowledge as well as regulation compliance. This business is not black or white, it has many colors unfortunately and not every agency is the same or offers the same services nor specialize in the same services. An agency can specialize in pediatrics, or in IV therapy, or wound care. The point is, there is so much information to master that cannot be provided in a simple course. The government does provide trainings on OASIS though, and some billing, but even those are vague. SO the best way to save your time and money, and get the most for your investment dollar is to seek the guidance of a company that will teach you what you need to know, but will do it throughout the period of time it takes to get you started. This way, you learn what someone is teaching you, but most importantly, you are learning it with the experience. Pamela, I wish you luck in your decision!

Pamela, in this next post, I am going to go into details about the business not in the start-up process, but in the existing process. I am going to mention what running a home health agency entails as I got inspired by your post:

Imagine you have been in business for 6 months. You can't complain, you have a decent amount of cases and you are well on your way to more growth. You have a quality assurance department, you have a human resources department, and you have a billing department. So far, you have all that you need to manage your agency. Your patients are happy with your services, you have an experienced Administrator working hand in hand with the Director of Nursing. These two mentioned are making sure the clinical files are being reviewed accurately: your OASIS data matching your POCs and your staff notes. The HR files are all up to date. One day, out of the blue. You receive a call from the State. They are saying one of your patient's was sexually molested by one of your staff members. How will you handle that??? Your agency's reputation is on the line and you are on the verge of being faced with a lawsuit as well as possibly losing your company. Guess what? These things have happened before. And how you handle it will determine whether or not you are found liable. I had a client once, who was forced to close his agency about 7 years ago, and blessed with the fact he didn't face jail time due to a similar incident. He had a staff member, who had been accused of sexually molesting an older lady who was a patient of his agency. My client then fired the staff member at such claim but didn't report it to higher authorities. About a year later, he received a phone call from the State conducting an investigation. And they were calling every agency that staff member had worked in. Sure enough not aware of the regulations, he did confess there had been a complaint in the agency about that staff member molesting one of the patients and that was the reason he was fired. Sure enough, my Client's agency was shut down on grounds that he did not report it, and because he did not report it, that staff member was free to repeat the offense while working at another agency. At that point, he had to collect letters from the owner of the ALF and other involved individuals, to prove that he was not aware this had taken place and he was not condoning it. He was forced to hire an attorney and so on, but that still got his agency shut down. Other situations you may be faced with is a RAC (Recovery Audit Contractor) conducting an investigation on your agency and your staff without you being aware. Until one day, you receive a letter asking to return $200,000.00 in non-justifiable billing practices. How will you handle that situation?? Well, hiring a knowledgeable consultant to monitor your agency periodically can help you not fall into that situation. I mean, they will investigate you without your knowledge and the law allows them to do so, but if your cases are kept correctly and your admissions are done following Medicare COPs, you should not have an issue. Not to mention, surrounding yourself with knowledgeable staff members who monitor this on a daily basis, will also avoid you facing this situation. For instance, the number one qualifying condition for a patient to receive home health care under Medicare benefits is not medical necessity, but Homebound Status. The sad issue is that Medicare Does Not have a detailed criteria for homebound status. So when you send a w-2 RN nurse, therapist or social worker (admissions must be done by a direct w-2 employee, not contracted) they have to be trained to determine that homebound status. If there is a doubt the patient is homebound, they have to make a note of it and in most cases, not admit them for services. You will be losing a patient, this is true. But you do not have to worry a year down the road, that Medicare will be recouping money for those services which ends up costing you more. Not only are you returning that money overpaid, but you are out on the salary you paid to those staff members for providing the care. Make no mistake, Medicare does not care you provided services, they believe you are liable for properly determining that homebound status for every patient. Staff members, well, it is to their advantage to admit as many patients they can, since they are receiving payments for those assessments as well as the services that get to provide. Make no mistake, these are not the only issues that can arise while running your company, there are many more. This is not to discourage people from going into this field, this is a wonderful field to be in and very lucrative. But, this is to open people's eyes as to the type of business this is. You have to dot your "i's" and cross your "t's" in everything you do. You can make a lot of money, but you also have to reinvest back into it on your staff primarily. Implementing a control system that will monitor every position in your corporation. This is where our company helps you establish a solid foundation to start building on. We simply know the system like the back of our hands. Throughout the years of helping our Clients on appeals, saving them on attorneys' fees, which prior to contrary belief, it is most of the times better to handle appeals without involving an attorney (depending on your case.) We have combined all our knowledge and resources to provide our Clients with the best consulting their money can give them. I wish you all the best of luck on your endeavor!

Hi Greg... I do agree with you 100% on "some" of what you are stating. That is why I always establish that this industry has a gray area.. it cannot be viewed as black and white. There are different processes and different ways to handle each event. And that is why I post a lot of this information. I want people who are interested in this to see that there is no cookie cutter way of handling things. When it comes to references, people who have had negative unsolved bumps along the way will not refer you; however, those clients that do have bumps along the way, not caused by the consultant of course, but yet are properly handled by the consultant then those are the Clients that will definitely refer you and stick by your side no matter what and will continue to hire you for different investment processes, as has been our experience. No one can control the certain events that arise from the State or Federal government 100%, for instance, I had a Client three years ago, located in Miami, and I was the consultant. He passed all surveys, went through the whole process successfully, yet, his provider number for Medicare for billing purposes got mailed to an address in Alaska. Was that his fault? Was it mine? No. However, I didn't say, "oh, you paid me, I am sorry, you can handle that on your own." Instead, I said, ok, I'll speak to your analyst, get to the bottom of it, which I did. And according to the analyst, the clerk that was inputting his information on the computer, chose the address in Alaska. It was the same exact address, with a different state and zip code. I was told by Palmetto (his fiscal intermediary) that we now had to redo the enrollment application... Can you believe that?!! After he had been accredited, licensed, and Medicare application processed, he had to resubmit his application. It is so simple to just make the correction on the computer, afterall, it was Palmtto's fault. Again, I was paid in full, I could have said "sorry Orelvis, handle that on your own, or charge him some more money". Instead, I took on the challenge, and I resolved the issue in less than 2 months. He is a Client that trusts me for every business endeavor he sets on. And Clients like those are my pride and joy. You see, I am a fighter in nature, and I have tackled quite a few issues with accrediting organizations such as ACHC, and CHAP, and Medicare and so I get an interest in challenges as it proves to me how far I can go. And as a correction to your above statement, my office does handle operational agreements, and files your entity for you, and not only "guide" you through the process, but completes the applications for the Client, handles the OASIS test transmissions, helps you choose the best software for you. I personally keep contact with my clients on weekends, and/or nights, not on a regular basis, but I do on those special occurrences or when there's a deadline of some sort. The point is, we cannot invest for the Client. We cannot make the decisions for the Client. But, we can make it easier for the Client and that is the point of hiring a consultant. The consultant engages in the process with the State, Medicare and Accrediting organizations. We give the tools to the Client, but we cannot control whether the Client follows it to the tea. But we are open to answer any questions the Client may have regarding implementation of those tools. And when we do our compliance reviews prior to your survey, during the time you are providing care to your charity patients, we will tell you where your mistakes are and how to correct them. Now, should you choose to continue to do them your way and it is incorrect, that is the part where we are not held liable, of course. And when it comes to attorneys, my firm actually works closely with health care attorneys. And I apologize if you don't agree, but no one is going to provide you with the job and wait to get paid 12 months later which is roughly the time it takes to go through the entire process from beginning to finish. Some states even take longer than that. But my firm at least does break down the pricing so Clients pay as they see the progress. This way everyone is happy. I do thank you Greg for your comments, it makes it all the more interesting. And this way people can see more of what's out there for them. I do wish you the best of luck!!

Hi again Greg... I am glad you have given your opinion as you have. I truly get appalled at reading some of my "competitors'" services... that's why I wanted to stress throughout my posts that there is no easy way of doing this. To not be fooled by "courses in a week" or "home health in a box". This is a business that requires steps in order to build that solid foundation so that when you do face difficult events, you are able to successfully overcome that. I want my readers to understand that there are no shortcuts. I am not the type to downtalk my "competition", it isn't my style. I enjoy hearing from my Clients that in their eyes, I am the best. However, they say it. No one will ever hear those words come out of my mouth, instead I tell my readers to research and find that consultant they feel will meet their needs. Listen to what they are saying, get different options in order to choose the right won for them. I assume there must be very good consultants out there. All I know is that I bring the best I can to the table because I love what I do. I am a retired teacher by profession and I have applied all my education into this industry. And you are right, people should never pay for services up front... many years ago, our company charged 1/2 to start process and then 1/2 when work was complete. That didn't work for us because some Clients fell through tje cracks. Sometimes partnerships would fall through and even if they were almost complete, we had provided everything, they would close the company and we wouldn't get paid. Or they would delay due to lack of money due to personal events they would face, and we wouldn't get paid. Wr would have to follow legal steps to get paid. So 4 years ago, we decided to break it into 3 payments. You pay as work gets done. This way, we don't work for free and the Client pays on the outcomes of the process. I totally agree with you. There are companies taking people's money promising them shortcuts, this and that, and there aren't. This isn't a business that works that way... if it were that simple, people wouldn't hire consultants and anyone could open this business. I just refrain from downtalking other consultants because as I stated, it is really not our style. We offer you help the best way we know works, giving you the most for your money. It is up to the Client to choose based on their own research what they feel works for them. Thank you again Greg and you do sound like you've done your homework... Good Luck!

I am sorry you went through that... I will definitely try my best to rescue your manuals once I review them so you really don't have to spend any additional money... It is truly sad how people can steal money from others so easily. But, part of my belief system is to refocus your positive energy on your ultimate goal. I think everyone ends up getting what they deserve sooner or later... I look forward to working with you!