At The Table With CAHSAH

Home health and hospice just got a regulatory shake up, and the agencies that wait to react are the ones most likely to get burned. Mark Wilson and Annette Lee break down the 2027 home health proposed rule and the new hospice final rule through a practical lens: what changes, what matters, and what you need to do before the next audit lands on your desk. Annette Lee, founder and president of Provider Insights, brings decades of experience in patient care, Medicare Medical Review, appeals, and provider education. In this conversation, she cuts through the noise and explains where CMS is offering some unexpected upside, where reimbursement still falls short, and where the real danger is hiding in the fine print. You'll discover:

- Why home health may finally see a slight payment increase, and what CMS is signaling about palliative care under the current benefit

- The hidden "ugly" in the proposed rule, including far reaching program integrity provisions that could affect home health, hospice, SNFs, and more

- Why affiliation rules, business relationships, and even long-past history could suddenly matter more than ever

- What the hospice final rule now requires within five days of admission, and why that shift creates a major operational challenge

- How the new SSVI measure, live discharge scrutiny, and outside spending are changing the way hospice agencies are judged

In this final episode of At the Table with CASA’s California Hospice Emergency Regulations series, Mark Wilson is joined by Cindy Hatton, Annette Lee, and Sharon Fredericks for a practical conversation on admissions, assessments, plan-of-care updates, quality compliance, and survey readiness. The panel breaks down what the new regulations mean in real-world hospice operations, how to document appropriately, and what leaders should focus on to stay compliant while improving patient care.

From cyberattacks and wage-and-hour claims to auto exposure and the fine print in EPLI, Steve Parkhurst Heffernan Insurance breaks down the coverage gaps that can catch home health, hospice, and home care agencies off guard and what smart operators do before an incident forces the conversation. Mark Wilson and Steve Parkhurs dig into what it really takes to run a safer, stronger organization when employees are working independently in patients’ homes, not under a single roof. The discussion goes beyond “do we have insurance?” and into the more important question: what risks are you actually managing, and which ones are still sitting in the blind spot? You’ll discover:

- Why lack of supervision in home-based care creates risk that office-based organizations never face

- The top claims hitting providers right now, including cyber, wage and hour, EPLI, and auto

- How documentation, login/logout records, and written processes can make or break a wage-and-hour defense

- Why timing matters after an incident, and how waiting even 2-3 days can drive claims costs up fast

- How insurers think about expansion, acquisitions, geography, and rising auto costs in a changing market

Steve also shares practical guidance on when to involve your broker, how often to review coverage, and why risk management should be treated as an ongoing business strategy, not a once-a-year renewal chore. If you lead a home health, hospice, or home care agency, this episode will help you think less like a buyer of insurance and more like a builder of resilience. Essential listening for agency CEOs, operators, and administrators who want to protect their team, their patients, and the long-term health of the business.

Hospice leaders cannot afford to guess at California’s new reporting rules. The state is no longer waiting to be notified, and the consequences of missing a trigger event - from a move or leadership change to ownership transitions, licenses, and voluntary closure - can be serious.

Mark Wilson is joined by Cindy Hatton, Annette Lee, and Sharon Fredericks, three nationally recognized hospice experts, to break down what changed, what now has to be reported in advance, and who inside your organization should actually own the process. If you are responsible for compliance, operations, quality, or leadership, this conversation gives you the practical roadmap you need before the webinar. You’ll discover:

- Why CDPH is tightening oversight and why “we’ll tell them later” is no longer a safe strategy

- The reporting changes that require advance notice, including the 120-day requirement for change of ownership

- How to build accountability with a clear internal owner, backup coverage, and daily or weekly follow-up

- Why license renewals should never be left to the last minute and why the state will not remind you

- How exclusion list, OIG, Medicare, and licensure checks can be automated with monthly scrubs and flags

- What to know about voluntary license cancellation, including the 60-day written notice requirement and what must be included

- How multiple layers of oversight - CDPH, CMS, and accreditors - all have to be kept in the loop

California home-based care providers are seeing major policy wins, and Tanya Bautista is helping lead the charge. In this episode, Mark Wilson talks with CAHSAH’s Director of policy, advocacy, and public affairs about the advocacy behind the private duty nursing budget victory, the home health moratorium, and the latest CMS hospice rules. Learn how provider stories turn into legislative change, what Tanya’s week looks like behind the scenes, and why strong relationships in Sacramento matter for the future of care at home in California.

California has changed the playbook for hospice leadership. If you run a hospice agency, you need to understand what the new emergency regulations mean for management orientation and annual education.

Mark Wilson is joined by Cindy Hatton of Hatton Consulting, Sharon Fredericks of SNS Home Care Consulting, and Annette Lee of Provider Insights to turn complex regulations into a practical roadmap for California hospice leaders.

In this episode, we cover:

What “first-time” means under California’s new requirements, including leaders who are new to the state

Orientation requirements for administrators, designees, medical directors, and management teams

The new 12-hour annual education requirement and how to build it into a manageable schedule

How internal training, webinars, and hybrid education models can satisfy requirements

What surveyors may look for regarding completion, competency, and documentation

Competency testing, audit readiness, and practical ways to avoid an annual training scramble

The conversation goes beyond checking compliance boxes. The panel discusses how stronger leadership education can improve organizational performance, staff understanding, and ultimately patient care.

If you’re responsible for hospice leadership, compliance, education, or survey readiness in California, this episode provides practical guidance for putting the new requirements into action.

AI is already creeping into home health and hospice, but if you use it wrong, it can put your agency, your staff, and your compliance at risk. Scottie Strong breaks down where AI actually helps, where it absolutely does not belong, and why the biggest danger may be leaders treating it like the authority instead of the assistant. Mark Wilson sits down once again with Scottie Strong, founder of Strong Consulting Group Services and a veteran advisor to home health and hospice agencies since 1993, for a blunt conversation about the real-world use of AI in post-acute care. From hospice documentation and decline indicators to home health charting, OASIS support, QA, and reimbursement pressure, Scott explains exactly where the technology can create efficiency - and where it can create serious trouble. You'll discover:

- Why AI has no place replacing the human connection in hospice care

- How it can still help with documentation, decline tracking, and compliance guardrails

- The biggest home health opportunity: making sure clinicians capture the right data in the field

- Why AI-generated clinical notes and patient-specific prompts can cross legal lines fast

- The hidden compliance risk of employees uploading protected health information into AI tools without approval

Scott also warns about the unintended consequences of using AI for referral screening, patient selection, and performance metrics, including the risk of cherry-picking easier cases and creating unfair government benchmarks. He explains why agencies need clear AI policies now, what those policies should prohibit, and why vendor transparency matters more than slick promises. If you're leading a home health or hospice organization, this episode is essential listening. It’s a practical, cautionary guide to using AI without losing compliance, judgment, or humanity.

The Real Cost of Incomplete Medical Files: How This Impacts Your Survey Readiness

Unlock the secrets to ensuring your hospice is ready for new California regulations. In this episode, hospice experts Sharon Fredericks and Eric Peterson share practical ways to strengthen your records, infrastructure, and compliance workflows so you can stay prepared for the next survey. You’ll learn:

How recordkeeping gaps can lead to citations

Why real-time documentation matters

How to use AI responsibly in compliance workflows

Key regulatory updates affecting discharge documentation, data integrity, and disaster planning

If you’re a hospice administrator, clinical director, or compliance leader, this episode gives you clear, actionable guidance to help protect your agency, staff, and patients.

Artificial intelligence isn't just approaching…it's here. Transforming how home health and hospice agencies operate today. Should you embrace it fully or proceed with caution? In this eye-opening episode, industry expert Scotty Strong joins Mark Wilson to cut through the hype and reveal what’s actually happening at the front lines of healthcare. From AI’s powerful role in automating documentation, coding, and scheduling, to its potential pitfalls like inaccurate decision-making and unintended data mishaps, this discussion explores the fine line between efficiency and risk. Scotty shares insights from over 1,000 legal reviews and his 30 years of industry experience, illustrating how AI can be your greatest asset or your biggest gamble if misused.

Discover how AI can streamline clinician workflows, improve compliance before audits, and even identify coding errors — all while emphasizing the vital importance of human judgment. You’ll also learn why smaller agencies can keep pace with larger competitors if they leverage AI wisely, and how to get started without falling into common traps.

This episode is perfect for agency owners, clinicians, and administrators eager to understand AI’s real potential while avoiding its dangerous chasms. In a landscape where “the wild west” is the rule, knowing where the guardrails are can make the difference between thriving or just surviving. Capitalize on the opportunity that AI offers and join us as we explore the future of healthcare. Whether you’re skeptical or excited, you’ll walk away with actionable insights to protect your agency and optimize your team’s time.

Stay tuned for a part two, where the conversation goes even deeper. Dive into the reality of AI in home health and discover how to harness its power without sacrificing safety or quality.

Support for this episode comes from Healthcare Synergy, helping agencies operate at peak performance with innovative EMR solutions, billing, and expert guidance. Are you ready to navigate the AI revolution in healthcare? Hit play now. Your future self will thank you.

Most hospice providers underestimate how deeply policies impact compliance and patient care until a regulatory audit turns into a reality check. In this eye-opening episode, industry veterans Sharon Fredericks and Eric Peterson reveal why having written policies isn’t enough. True success lies in routine implementation, real-time audits, and team-led updates.

Discover how California’s new Hospice Emergency Regulations challenge hospices to move beyond static manuals and foster a culture of continuous improvement. We'll explore practical strategies to ensure your policies reflect actual practice, including effective senior leadership ownership, staff competency checks, and engaging team meetings that foster buy-in. You’ll learn how to translate complex legal language into day-to-day operations that staff understand and follow, reducing costly citations and elevating care quality. You’ll also hear specific tactics to streamline policy updates amid tight timelines, prioritize the most critical changes such as geographic service areas and patient acuity systems, and involve your team in the creation and review process.

Plus, find out how structured ongoing education and audits escalate compliance from a checkbox exercise to a core organizational value. If you’re a hospice leader, compliance officer, or clinical manager feeling overwhelmed by the regulatory maze, this episode is your blueprint for turning policies into a practice that supports staff and impresses surveyors. With insights from respected California experts and real-world frameworks, you’ll leave equipped to build a resilient, compliant organization committed to exceptional patient care. Join us to transform policy from a dusty binder into a living, breathing tool that drives operational excellence. Your next survey success depends on it.