1. LHCSA Statistical Report Workgroup
Rebecca Fuller Gray, Director
Division of Home and Community Based Services

2. Goals

3. Goals Goals for this Workgroup
Increase the compliance rates for the LHCSA Statistical Report
Capture data relevant to service delivery
Ensure quality data is collected in a timely manner
Ensure terminology in the report is used universally across the industry
Streamline data reporting

4. 2015 LHCSA Statistical Report

5. 2015 LHCSA Statistical Report
Dear Administrator Letter
Dear Administrator Letter was issued on August 16, 2016
Informed LHCSAs of the requirement to submit a statistical report annually
Informed LHCSAs that non-compliance would result in:
Enforcement
DOH inability to make an affirmative statement to the LHCSA operator’s
character and competence
Licensure applications not being processed

6. 2015 LHCSA Statistical Report
Survey Information
The 2015 Statistical Report was issued to 1,347 LHCSAs on the Health Commerce System (HCS)
The survey was opened on August 22, 2016
The deadline to submit the survey was October 15, 2016
Alert s were sent several times during the this time period to remind agencies to submit the statistical report. Alert s included:
Dear Administrator Letter 16-06
Instructions on finding the survey
FAQ document
Program staff were available by phone and through to respond to questions
The survey remained open on the Health Commerce System for an additional week – through October 24, 2016.

7. 2015 LHCSA Statistical Report
Non-Compliance
The 2015 Statistical Report was issued to 1,347 LHCSAs:
614 LHCSA did not submit ALL of the forms
Enforcements have been initiated against the 350 LHCSAs that:
Did not submit ANY of the forms; or
ONLY submitted form LSR1- Agency form - collecting contact information
Enforcement
CO Staff submit the enforcement referrals to DLA in batches.
Of the current batch of 10 being enforced, 6 have request to have the survey opened for submission, 1 is surrendering their license, and 3 have not responded (as of 4/27/17)

8. 2015 LHCSA Statistical Report
Summary of Submissions by Form
Statewide
Upstate
Downstate
Form #
Submitted %
of 1,347
of 373
of 974
All Forms
733
54.4%
242
64.9%
491
50.4%
LSR1 – Agency Form
900
66.8%
281
75.3%
616
63.2%
LSR2 – Patient Form
857
63.6%
266
71.3%
590
60.6%
LSR3 – Contract Revenue Form
842
62.5%
265
71.0%
576
59.1%
LSR4 – Direct Revenue Form
828
61.5%
259
69.4%
568
58.3%
LSR5 – Cost Form
817
60.7%
557
57.2%
LSR6 – Staff and Wages Form
794
58.9%
255
68.4%
539
55.3%
LSR7 – Services by County Form
800
59.4%
544
55.9%
LSR8 – Contract Form
795
59.0%
256
68.6%
The Agency Form collects demographic information about the agency – such as agency location and a contact person.
The Patient Form collects demographic information about the patient population, including:
Census
Number of cases
Unduplicated patient count
Length of Stay (LOS) information
Referral sources
Discharge destinations
The Contract Revenue Form collects information about revenue derived from contracts with other agencies to perform services for their patients, or provide equipment to their patients.
The Direct Revenue Form collects information on revenue received from services and/or equipment provided directly by the agency.
The Cost Form collects direct and indirect costs associated with the delivery of services. Wages are not counted on this form.
The Staff and Wages Form collects information on staffing, wages and fringe benefits for specified employee types.
This Services by County form collects information at the county level on services
provided to all patients. The information is collected includes:
Services provided as the result of a diagnosed disease or disability
Well-care services
Type of service (i.e. HHA, PCA, OT, PT, etc.)
Contract or Direct
Patient gender and age cohorts
The contract form collects information on the contracts that the LHCSA has with other organizations to provide services on behalf of those other organizations

9. 2015 LHCSA Statistical Report
Frequently Asked Questions
Where can I find the survey forms?
Why can’t I submit the survey forms?
Our agency has multiple sites, do we need to submit separate surveys for each?
On LSR 2 - What is the difference between case, patient, and unduplicated patient count?
On LSR5 – What is the difference between Direct and Indirect costs?
What is included in Fringe Benefits?
On LSR 6 - What is meant by statutory fringe benefits vs non-statutory fringe benefits?
What is meant by Wellcare Services vs Disease and Disability Services?
The Dear Administrator letter had two attachments:
The FAQ document (which is in your packet)
and instructions on how to navigate the Health Commerce System and access the survey.

10. 2015 LHCSA Statistical Report
Form LSR 1 – Agency Form
900 Agencies submitted LSR 1 (66.8%)
The Agency Form collects demographic information about the agency – such as agency location and a contact person.

11. Total Unduplicated Patient Count
2015 LHCSA Statistical Report
Form LSR 2 – Patient Form
857 LHCSAs submitted LSR 2 (63.6%)
The Patient Form collects demographic information about the patient population, including:
Census
Number of cases
Unduplicated patient count
Length of Stay (LOS) information
Referral sources
Discharge destinations
Total Unduplicated Patient Count
Total Census on 12/31/15
Total Cases for 2015
380,198
264,130
485,761

12. 2015 LHCSA Statistical Report
Form LSR 2 – Patient Form (continued)
857 LHCSAs submitted LSR 2 (63.6%)
Length of Stay - Totals
1-30
Days
31-60
61-90
91-180
Days
366+
No. of Discharged Cases
87,088
32,408
21,086
37,951
55,108
44,053
On LOS of 366+ Days – the highest amount was thrown out due to the amount being unreasonable.

13. Total Revenue Reported Calculated Revenue Dollars per Hour
2015 LHCSA Statistical Report
Form LSR 3 – Contract Revenue Form
842 LHCSAs submitted LSR3 (62.5%)
The Contract Revenue Form collects information about revenue derived from contracts with other agencies to perform services for their patients, or provide equipment to their patients.
Service
Total Hours Reported
Total Revenue Reported
Calculated Revenue Dollars per Hour
Nursing
2,541,818
$98,900,739
$38.91
Home Health Aide
64,545,111
$1,183,869,414
$18.34
Personal Care Aide
288,491,811
$7,795,859,571
$27.02
Waiver
1,328,245
$21,503,913
$16.19
Other
6,203,437
$139,171,631
$22.43
Durable Medical Equipment
$1,193,535

14. Total Revenue Reported Calculated Revenue Dollars per Hour
2015 LHCSA Statistical Report
Form LSR 4 – Direct Revenue Form
828 LHCSAs submitted LSR4 (61.5%)
The Direct Revenue Form collects information on revenue received from services and/or equipment provided directly by the agency.
Service
Total Hours Reported
Total Revenue Reported
Calculated Revenue Dollars per Hour
Nursing
10,183,336
$410,182,619
$40.28
Home Health Aide
150,811,971
$2,301,970,882
$15.26
Personal Care Aide
384,888,417
$3,583,020,626
$9.30
Waiver
20,830,532
$471,790,111
$22.65
Other
6,355,624
$149,590,061
$23.54
Durable Medical Equipment
$8,157,530

15. 2015 LHCSA Statistical Report
Form LSR 5 – Cost Form
817 LHCSAS submitted LSR5 (60.7%)
The Cost Form collects direct and indirect costs associated with the delivery of services. Wages are not counted on this form.
Total Direct Costs Reported
Total Indirect Costs Reported
$4,568,988,029
$1,864,437,849

16. 2015 LHCSA Statistical Report
Form LSR 6 – Staff and Wages Form
794 LHCSAs submitted LSR6 (58.9%)
The Staff and Wages Form collects information on staffing, wages and fringe benefits for specified employee types.
Month
Total No. Full Time HHAs
Total No. Part Time HHAs
Total No Full Time PCAs
Total No. Part Time PCAs
January 1, 2015
1,146,745
980,965
975,807
674,028
April 1, 2015
1,242,704
993,391
1,226,904
764,352
July 1, 2015
1,313,520
967,211
1,379,474
868,569
October 1, 2016
1,418,346
1,067,104
1,531,019
977,874
Average
1,280,329
1,002,168
1,278,301
821,206
Minimum 1
0.25
0.92
Maximum
502,476
640,018
929,646
309,882
No. of W2s
4,423,697
3,601,643
The IRS defines a full time employee as an employee employed on average at least 30 hours of service per week, or 130 hours of service per month. Employees that work less than this should be considered part time.
There are several instances where, we believe, the person filling out the form entered a money amount in the blank field entitled “Number of W2s issued”

17. Calculated Wages per Hour
2015 LHCSA Statistical Report
Form LSR 6 – Staff and Wages Form (continued)
794 LHCSAs submitted LSR6 (58.9%)
Staff
Total Hours
Total Wages
Calculated Wages per Hour
All Titles
461,421,455
$5,998,628,218
$13.00
HHAs
262,627,344
$3,014,431,896
$11.48
PCAs
133,924,113
$1,697,899,950
$12.68
Nurses
4,531,787
$160,132,865
$35.34
Nursing Supervisor
1,019,952
$34,252,274
$33.58
Administrators
1,910,558
$115,394,800
$60.40

18. 2015 LHCSA Statistical Report
Form LSR 7 – Services by County Form
800 LHCSAs submitted LSR7 (59.4%)
The Services by County Form collects information at the county level on services
provided to all patients. The information is collected includes:
Type of Service: Disease and Disability or Wellcare
Service: HHA, PCA, OT, PT, etc.
Type of Employee: Contract or Direct
Patient Gender: Male or Female
Patient Age cohorts: Less than Age 21, Ages 21-64, Age 65+

19. 2015 LHCSA Statistical Report
Form LSR 8 – Contract Form
795 LHCSAs submitted LSR8 (59.0%)
The Contract Form collects information on the contracts that the LHCSA has with other organizations to provide services on behalf of those other organizations.
Total HHA Contracted Hours
Rate Per Hour for HHA (paid to Agency)
Total PCA Contracted Hours
Rate Per Hour for PCA (paid to Agency)
Total
44,196,628
89,202,955
Average
23,509
$18.73
41,645
$19.32
Median
1,386
$18.40
5,780
$18.99
Minimum 1
$9.25
Maximum
8,139,617
$40
4,122,914
Minimum and Maximum rates – the lowest rate and the highest rate were thrown out – due to unreasonable amounts reported.

20. Data

21. Data Issues with Data Quality
Missing data – forms submitted without all data entered
Internal Inconsistencies:
Hours of Service
Unduplicated Patient Counts
Reasonableness Failures:
Negative numbers in the wages column
Zeros
Very large numbers
Agencies reported large numbers for the number of W2s issued
Internal Inconsistencies - When we ask the information more than once – for example Unduplicated Patient count is reported on LSR2 and again reported (by County) on LSR7 – the numbers often do not match.
Very large numbers – examples –
One agency reported 117,186 patients discharged in 2015 with a length of stay of 366+ days
One agency reported issuing 18,500,000 W2s in 2015

22. Data Characteristics of the Survey
HERDS Survey tool is not designed to collect this kind of information
The survey is cumbersome
The survey tool does not support tables
Weak Edits
Data from multiple centers in an agency:
Fiscal
Payroll
Clinical
Unaudited

23. Data How is the Data Used? DOH staff use the data to:
Formulate Policies
Identify potential worker shortages
Track trends:
Patient Demographics – Age/Gender/Disability
Utilization of Services
Wages and Staffing (Contract Staff vs. Direct Staff)
Determine if agencies are serving all counties they are authorized to serve
Determine if agencies are providing all of the services they are authorized to provide

24. Data Issues to be Considered Is the right data being collected?
What data is needed?
What types of statistics would be helpful for
State Staff?
Associations?
Providers?
Aides?
Does it all need to be captured in one place?
Is some of this information redundant?
Is some of this information captured elsewhere?
Is there an easier way to collect wage benefits information (i.e. separate report)?

25. Discussion