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| February 14, 2011 | Volume 17, Number 5 |
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ADVERTISEMENT Are You In or are You Out? Medicare Competitive Bidding is underway in the first 9 MSAs with round two not far behind. Many companies in these first round MSAs didn’t do the necessary reengineering and have closed their doors while others are selling. Then there are the bid winners who are still in the process of determining if they can survive at the NCB rates. You owe it to yourself and your employees to learn what your company can do to survive round one or prepare for round two. Contact AnCor today at 954-757-3121 or visit our website at www.ancorconsulting.com. Table of Contents - Complex Rehab Advocates Head to CELA, Hope for Separate Benefit - Medicaid Meltdown Brings New Slew of Worries for HME - Oxygen Questions Abound on CERT Call - Andrea’s 2011 Audit Outlook: Strategies for Surviving in a 'Guilty until Proven Innocent' Environment - Pride's Galaxy Division Offers Help for Cash-Strapped Mobility Providers - Lincare Reports 33 Percent Profit Jump - SleepQuest Fires Up Growth - AAHomecare Asks for Info on Purchase Option, Oxygen; AMEPA Gives New Reps the Bad News on Competitive Bidding; More News in Brief For more industry news, features and highlights from our latest issue, please visit our Web site at www.homecaremag.com. - Headline News Complex Rehab Advocates Head to CELA, Hope for Separate Benefit WASHINGTON—More than 300 complex rehab stakeholders will muster their muscle toward getting a separate Medicare benefit for the category during the Continuing Education and Legislative Advocacy Conference Feb. 16-18 in Washington. "We've got more than 200 appointments scheduled with attendees visiting their senators and representatives," said Don Clayback, executive director of the National Coalition for Assistive and Rehab Technology. NCART is co-sponsoring the CELA conference with the National Registry of Rehabilitation Suppliers. "The message," Clayback said, "is basically sharing the story for the need for a separate benefit for complex rehab. There are 100 new congressional men and women we need to be talking to." This year's conference features a roster of noted speakers, including Jean Minkel, PT, ATP, MSPT, of consulting firm Minkel & Assoc., and Jennifer Higgins, the policy expert-in-residence for the Washington, D.C.-based Capitol Health Group. The focus of the event, however, will be to kick off what organizers are calling a "marathon" effort to get complex rehab carved out as a separate benefit. In fact, the conference is purposely being held four months earlier than usual to take advantage of a longer legislative session, Clayback said. The hunt is on for congressional champions to take up the cause and author a separate benefit bill, and "CELA is really our kickoff for having these one-on-one discussions with the various offices and identifying where we have some strong interest," he added. Attendees will be outfitted with the newly revised (as of January) proposal for creation of a separate benefit and draft language for its legislation. The two components are vital for members of Congress get a sense of the issue so that "we can have some substantive discussions," Clayback said. In addition to CELA's face-to-face visits on Capitol Hill, a national call-in day will be held Wednesday, Feb. 16, for those who are unable to attend but want to campaign on behalf of the benefit. (Register at www.celaadvocacy.org.) NCART and NRRTS have been working toward a separate benefit for three years to distinguish the complex rehab sector from traditional home medical equipment. "We are different," said Clayback. The talking points provided to conference attendees spell out the "whys:" • Complex rehab technology is individually configured to people with complex disabilities. • Products and services are different than standard DME. • Outdated DME policies and codes do not address needs of people with disabilities. • CRT is similar to orthotics/prosthetics. • A separate benefit category would provide needed distinction and solutions. • Significant challenges threaten access to complex rehab technology products and services for individuals with disabilities. • These threats (coding, coverage, payment) will only increase unless meaningful changes are made. • The purpose of a separate benefit category is to improve and protect access to these products and services for these individuals. "We need to have some distinction, and as CMS or Congress looks through the proposal, hopefully we can point out things we think are pluses," Clayback said. He acknowledges this is a tough time to be launching the drive, considering the economic and financial difficulties the country is facing and the health care reform boondoggle. "It certainly is a challenging environment, but the dilemmas and the challenges that consumers, suppliers and clinicians are facing haven't decreased. We need to protect access and institute additional safeguards," Clayback said. "While it is a challenging path," he continued, "there are some things going on that are very concerning from an access level … If we don't do something that is not this comprehensive, we know things are not going to change at all." For information about CELA, see www.ncart.us or www.nrrts.org. Will your revenue increase, decrease or stay the same this year? To vote in HomeCare's monthly Web poll, visit www.HomeCareMag.com. Medicaid Meltdown Brings New Slew of Worries for HME ATLANTA—As if it weren’t enough to be hammered by competitive bidding and audits that squeeze the life out of Medicare reimbursements, HME providers across the country are also trying to fend off what looks to be a new round of debilitating Medicaid cuts. Just about every state in the Union is faced with overwhelming budget deficits—a cumulative $125 billion, according to estimates—and to close up those shortfalls, lawmakers are eyeing one of the states’ top expenditures: Medicaid. “States have implemented an array of Medicaid cost-containment strategies, including provider rate cuts, benefit restrictions, provider assessments and administrative cuts,” the Kaiser Commission on Medicaid and the Uninsured reported in January. Program enrollment is rising, projected at 6.1 percent in FY 2011, and expiration of the American Recovery and Reinvestment Act stimulus money on June 30 means the states’ share of Medicaid will increase by a fourth to a third in FY 2012. State Medicaid directors said it would be difficult to find options “that do not represent deep cuts to the program,” according to the Kaiser report. In addition to general cuts, providers are also grappling with a range of other Medicaid issues. Here are only some of the challenges reported last week by state associations: • Alabama: Faced with a huge shortfall without the government stimulus money that pumped $270 million into the state’s Medicaid program last year, Medicaid commissioner R. Bob Mullins Jr. is asking for $700 million—twice as much as 2011—to fund the program for 2012. However, since Alabama is under federal mandate to beef up the budget for its prisons, the outlook for Mullins’ request isn’t good, said Mike Hamilton, executive director of the Alabama Durable Medical Equipment Association. Between that and the fact that the state could move its accounts payable process back in house to save money, providers are on tenterhooks, the ADMEA director said. “It’s bad enough as it is,” Hamilton said. People can’t get anything paid, and what they do get hardly covers costs.” He said Alabama Medicaid pays 80 percent or less of Medicare’s fee schedule, “so we have no place to go. And with the economy that’s in the condition it’s in, anyone who is dependent on Medicaid is scared to death.” That includes providers. Just last week, Hamilton said, he got a call from a provider asking if he thought it was time to get out of the Medicaid business. “He was getting paid too late and too little,” said Hamilton. “I think the next big problem that people are going to have is that folks aren’t going to be able to find any kind of provider who will take Medicaid patients. “It’s just a shame that we are going to have the aftermath that’s going to follow this thing,” he added. “People won’t get cared for often enough and soon enough and problems will get worse and worse.” • California: In an effort to whittle the state’s $25.4 billion deficit, Gov. Jerry Brown wants to slice $1.7 billion off the Medi-Cal program by reducing Medicaid reimbursement by 10 percent, restricting the state’s 7.7 million beneficiaries to six prescriptions a month and limiting them to 10 visits to clinics and physicians per year. (Last month the U.S. Supreme Court in January agreed to hear the state’s appeal of a lower court ruling blocking some pay reductions for the Medi-Cal program; however, Brown’s budget proposal assumes the court will find for the state, allowing the cuts to go through.) Even more concerning to HME providers, however, is the effort to push more of the Medicaid burden onto counties by shoving about a half-million beneficiaries into county-run or managed care plans. Where a beneficiary ends up depends on which of the state’s 58 counties he or she resides in, said Bob Achermann, executive director of the California Association of Medical Product Suppliers. “It presents all kinds of issues for providers,” Achermann said, noting that the new system will be implemented throughout the year. Providers are fearful that reimbursement will drop precipitously and that managed care or county health plans will restrict the number of HME companies with which they deal. “They could say, ‘we don’t need 20 companies; we just want to deal with two,’” said Achermann. “That could leave a lot of providers in the cold.” In addition, authorizations might not be valid as beneficiaries transition from one system to another, Achermann said. Do providers then go out and reclaim their equipment? Under the new plan, access could become an issue just as there is an influx of new Medi-Cal enrollees from the Affordable Care Act, he said. “Do we have the capacity to treat all these people once they are eligible?” Achermann asked. “Some think we don’t.” The CAMPS exec finds some irony in the issue. “Here you have the Medi-Cal program changing its nature in terms of fee-for-service and getting ready for 2014 where they will expand enrollment [under ACA] and, at the same time, they’re slashing rates,” Achermann said. “You might get more patients. But you might not get paid much.” • Florida: Florida lawmakers are also eying a managed care proposal for the state’s 2.7 million Medicaid beneficiaries. With the 2011 legislative session only a month away, Executive Director Sean Schwinghammer of the Florida Alliance of Home Care Services reported last week that association officials had met with 15 state senators to voice opposition to a bill that would move all Medicaid patients into managed care. The group battled the same legislation in last year’s session. Among the association’s arguments: Managed care organizations have no experience with long-term care, which is the largest expense in Medicaid. The state’s proposal for its 2.7 million beneficiaries would transfer health care practices from multiple businesses to monopolies that then become too big to fail and can claim any cost they wish in the future. FAHCS is also pushing the point that if some version of managed care is moved forward, it should be tempered “with rational moves” such as securing full employment by passing “any willing provider” legislation. Medicaid reform is the most pressing item on the state’s legislative agenda, Schwinghammer noted in a newsletter to members, adding, “Our efforts are paying off. Senators are surprised by our facts and thankful for the information we offer.” • Midwest, Arizona: States in the Midwest Association of Medical Equipment Services are bracing for possible cuts as their legislators craft 2012 budgets, said Rose Schafhauser, executive director of MAMES, which covers Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota. Schafhauser is also executive director of the Arizona Medical Equipment Suppliers Association. “With the exception of North Dakota, every state has a huge budget deficit. So obviously in every single state we are in danger of being cut at the Medicaid level,” the said. She is hopeful, however, that the years-long effort to build relationships with Medicaid officials in each state will pay off. “We have a very good seat at the table with Medicaid with most of our states,” Schafhauser said. Missouri is a prime example, she noted, where “there is a little bright news.” In 2010, providers there were given an ultimatum: Come up with $10 million in savings or take a 20 percent cut in reimbursement. A MAMES committee went back to the state with a list of HME products that were paid at a higher-than-necessary rate and could be reduced, Schafhauser said, and they were able to sidestep the cut. Missouri Medicaid officials just had their first meeting in 2011, “and we’re told that they are on track [for meeting their goal],” said the MAMES executive director. “So we may not have to have additional cuts.” The situation isn’t quite as positive in the Southwest. “In Arizona,” Schafhauser said, “they did a straight-across-the-board cut. We really didn’t have an option because every single entity took those cuts.” But across-the-board-cuts aren’t always successful. In Kansas last year, Schafhauser recalled, complex rehab providers were severely affected by such a cut. “A lot of providers said, ‘we are not taking Medicaid patients,’” Schafhauser said. When the story emerged of a four-year-old who couldn’t get a wheelchair because no complex rehab provider would take Medicaid, advocacy and parent groups protested so loudly that the state “came back to the table and reinstituted the pay they had before,” she said. • New England: Providers in the Northeast have the jitters, too, according to Karyn Estrella, executive director of the New England Medical Equipment Dealers association, which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. “Right now, we are just bracing for the states to announce their coming budgets,” Estrella said. “They are facing enormous deficits. We’re anticipating [Medicaid] will be on the chopping block. It’s one of the biggest expenditures. There is no way they can avoid looking at it.” NEMED is taking a proactive position, however. “If they need savings, we’re going to help them find savings,” said Estrella, noting that NEMED has been successful in getting the states to stick with a fee schedule. “We understand where they are. We’ve always tried to be proactive and reach out to the states. We tell them, ‘Work with us before you implement something. It will be a lot smoother process.’” • Pennsylvania: The state budget for 2012 hasn’t yet been submitted, but HME providers already have Medicaid headaches, said John Shirvinsky, executive director of the Pennsylvania Association of Medical Services. Recently, Medicaid began disallowing prescriptions for HME if they were written by a physician’s assistant or a certified nurse practitioner, something it has long covered, he said. In Pennsylvania, Shirvinsky explained, HME does not have its own benefit category. “It falls under home health care, which requires a physician’s prescription [for HME]. So they connected the dots and said they couldn’t accept prescriptions from physician’s assistants and certified nurse practitioners.” CMS said it was the correct interpretation, PAMS’ Shirvinsky said, “but it is applied to no other state. We’re trying to get it righted.” Until then, stakeholders are running into difficulty. “Medicaid beneficiaries tend to rely fairly heavily on the clinics, and clinics tend to rely heavily on physician’s assistants and nurse practitioners,” Shirvinsky said, adding that without a physician’s prescription, they can’t get HME. Providers who are not aware of the change are also experiencing problems because their claims have been denied on that basis, he said. Another issue: Reimbursement of non-fee schedule items, such as power wheelchair repairs. Long paid at 85 percent of the MSRP, the rate has lately bounced all over the place, said Shirvinsky. Most recently, it has settled at cost plus 15 percent. “That’s not adequate,” he said, noting that it doesn’t begin to cover such things as shipping a wheelchair, delivering the repaired product or any other costs associated with repairs. “For a bureaucracy to take a long-term reimbursement schedule and turn it on its head, it just doesn’t work. The number really needs to be in the 30 to 40 percent range. That’s a big issue,” he said. Oxygen Questions Abound on CERT Call BALTIMORE—Getting paid for oxygen is no easy task these days, judging by the questions on a joint CMS-DME MAC CERT call last week. Members of the CERT (Comprehensive Error Rate Testing) Education Task Force held a teleconference Feb. 3 to answer questions on oxygen coverage, testing requirements, CMNs and documentation—and there was no lack of them. Representatives from the four DME MACs answered a dozen questions based on common claims errors, then spent the rest of the 90-minute call responding to live queries with help from Dr. Paul Hughes, the medical director for Jurisdiction A. According to officials, there are multiple requirements that must be documented in order to justify reimbursement. While many are listed in the local coverage determination, others come from the national coverage policy, CMS manuals, regulations and statutes. Oxygen suppliers must be knowledgeable about all of them, the MAC reps emphasized—and in the event of an audit, “all applicable reimbursement criteria must be met and sufficient documentation demonstrating eligibility must be present in the record.” Written answers to more than 60 questions submitted before the call included the following: Q: What is the responsibility of the provider for patients who are traveling outside the U.S.? Answer: The supplier is not responsible to furnish oxygen for a patient that travels or resides outside the U.S. Q: We received a medical review letter and denial because we don’t have documentation that the patient was seen 30 days prior to initial setup. We have tons of documentation, just not within 30 days. We had money taken back on this patient. Can we have them see their doctor and be retested to re-qualify? Would we start a new 36 months cap rental period or start with the next billing month that we would have billed? Answer: Yes, they can see their doctor and be retested to re-qualify. A new cap rental period would not begin in this situation. Q: If a patient wants to switch suppliers due to poor service, but 36-rental payments have already been paid, can the patient switch suppliers? Answer: Yes, the beneficiary has the option of switching suppliers; however, it may be difficult for the beneficiary to locate a new supplier willing to service them, given the new supplier will not receive any additional rental payments. However, if the beneficiary believes their supplier is not following supplier standards they have the option of reporting the supplier to 1-800-MEDICARE. Q: When a patient switches to my company from another, do I need to get a CMN or just an order confirmation if I have a copy of the original CMN? Answer: A revised CMN must be completed and kept in your files. Q: In an audit, is the CMN considered a detailed written order when section C is filled out properly? Answer: Yes, the CMN can be considered a detailed written order, but the CMN is not a substitute for Medical records from the treating physician. Presenters said a written transcript of the call would be posted on the CMS CERT web page at www.cms.gov/cert (under the “Providers” tab) two weeks after the call. A replay will also be available on the DME MAC web sites. Andrea’s 2011 Audit Outlook: Strategies for Surviving in a 'Guilty until Proven Innocent' Environment COLUMBIA, S.C.—Join DMEPOS consultant Andrea Stark on March 22 as she takes you inside the world of Medicare’s latest weapons in its audit arsenal–RACs and ZPICs. If you want to know what to expect in 2011 and are looking for proactive steps to protect your business, then this webinar is for you! Andrea will provide a complete explanation of how each auditing contractor operates, what they’re looking for, and how the audit landscape is changing in 2011. Time will be allotted for a live Q&A session at the end of the presentation. This webinar will provide a clear overview of: • Which DMEPOS supplies are most prone to audit and why. • The top reasons claims are denied. • How to avoid common billing errors that could be increasing your odds of being audited. • Your options if you find yourself caught in the throes of a ZPIC or RAC audit. • Simple procedures you can implement to protect yourself and your business. • What to expect from audit contractors in 2011. Co-hosted by HomeCare, this is NOT your typical “how to submit an appeal” webinar. Don’t miss out! Tuesday, March 22, 11 a.m. and 3 p.m. EST - two time slots! Register online at www.miravistallc.com. Questions? Call 803/462-9959, ext. 252. Pride's Galaxy Division Offers Help for Cash-Strapped Mobility Providers EXETER, Pa.—With elimination of the first-month purchase option, Pride Mobility Products announced Feb. 9 it has formed Galaxy Mobility Financial Services, a wholly owned subsidiary that will furnish inventory financing and working capital to help Pride providers transition to the power wheelchair sector’s new rental environment. New programs including fleet, inventory finance and customized programs will allow providers to manage cash flow by securing a source for capital and scheduling predictable monthly payments for inventory. The programs offer competitive interest rates, have a high number of credit approvals and “free up Pride credit lines for additional purchasing power,” according to a release. “Faced with a challenging economy and Medicare’s elimination of the first-month purchase option, we recognized the limited capital market for DME providers,” said Scott Meuser, Pride chairman and CEO. Creation of the new division “fills that void and empowers our providers to continue to operate dynamic and growing businesses,” he said. In January, the manufacturer announced that its Jazzy Select Elite has been adapted with rental-ready features including a seat with removable, replaceable foam and vinyl and an extended 13-month warranty. The chair also features new Jazzy Armor shroud and controller guards as protection from daily wear and tear. Michael O’Boyle has joined Pride as general manager of Galaxy sales following 12 years with Altec Industries. HME Company Newswire Lincare Reports 33 Percent Profit Jump CLEARWATER, Fla.—Lincare reported this week that net revenues for the quarter ended Dec. 31 were $422.1 million, a 4 percent increase over $405.8 million for the fourth quarter of 2009. Net income rose 13.4 percent in the quarter to $46.1 million, compared to $40.6 million in the prior year. Revenue for 2010 came in at $1.67 billion, a 7.7 percent increase over $1.55 billion in 2009. The company said the increase came from 9.9 percent internal and acquisition growth offset by a 2.2 percent negative impact from $34.9 million of Medicare payment changes. Net income for the year was $181.6 million, a 33.4 percent increase over $136.1 million in 2009. Analysts reported that Lincare’s market share has continued to grow against the backdrop of reduced Medicare reimbursements, and CEO John Byrnes said in a release the company is “committed to increasing our market leading positions in our core respiratory product lines and investing in the expansion of our service offerings through organic investment and selective acquisitions. “As the nation's leading provider of chronic respiratory disease management therapies in the home setting, we serve a growing population of chronically ill seniors that require our continuous support throughout the progression of their disease,” Byrnes said. “As a home-based provider of cost-efficient health care services to our nation's seniors delivered through our national network of local distribution and sales centers, we offer an attractive and preferred alternative that can avoid or delay higher-cost acute and facility-based care." The company currently has 1,090 branches in 48 states with more than 750,000 customers. Lincare holds two Round 1 contracts for oxygen in the Miami and Charlotte competitive bidding areas. SleepQuest Fires Up Growth SAN CARLOS, Calif.—Last week SleepQuest announced a 44 percent increase in 2010 fourth quarter earnings over 2009, citing growth in all areas of the business including diagnostics, titration, therapy and ongoing care for OSA patients. "2010 was an extraordinary year for SleepQuest as we continued our national expansion and expanded operations," Robert Koenigsberg, president and CEO, said in a release. To keep its expansion going, the company has appointed Gary B. Corbett as vice-president of business strategy and development. "With over a decade focused on delivering medical services and products directly to patients in their home, he has a wealth of experience and new ideas to make health care more efficient and affordable," said Koenigsberg. The company also announced that David L. Goldsmith and Donald G. Nelson have joined its independent board of directors. Goldsmith most recently served as chairman of the board for Apria during its $1.7 billion buyout by The Blackstone Group in 2008. Said Goldsmith, "SleepQuest is a transformational company with an advanced technological infrastructure and collaborative clinical model that joins physicians, patients and payers in a comprehensive program of early diagnosis and prompt, effective therapy that reduces the cost of health care." Nelson is an investment banker and venture capitalist who “has advised entrepreneurial and mid-sized companies in the completion of over $6 billion in mergers and acquisitions,” according to the release. In Brief AAHomecare Asks for Info on Purchase Option, Oxygen; AMEPA Gives New Reps the Bad News on Competitive Bidding; More News in Brief ARLINGTON, Va.—AAHomecare is conducting two surveys to help inform policymakers about power wheelchair and oxygen policies. To gauge the impact that elimination of the first-month purchase option has had on power mobility providers, the association is looking specifically for information on what has happened “regarding inventory, service area, staffing and patient services,” according to its Friday newsletter. Take the survey here. AAHomecare is also conducting a survey on the number of companies registered with the FDA to fill medical oxygen, and where the medical oxygen is distributed. Take that survey here. AMEPA Gives New Reps the Bad News on Competitive Bidding MIAMI—New Florida Republican Reps. David Rivera and Allen West heard about the impact of job losses under competitive bidding at their district offices' "grand opening" events, the Accredited Medical Equipment Providers of America reported last week. Jorge Coello told Rivera that he had been the warehouse manager at AMEPA member City Medical Services in Miami for over eight years, but he lost his job in December when the company laid off half of its staff—even though the provider won a Round 1 oxygen contract. "I thought my job was safe, because our company won the oxygen bid," Coello explained to his new congressman, "but because our company did not win the CPAPs, enteral feed, support surface, hospital beds, walkers or power wheelchair categories, our company was no longer purchasing inventory and so they no longer had a place for me." Coello also told the congressman that he has been looking for work in the DME field for two months but no one is hiring. VGM Associates Advocate for Brain Injury Awareness WATERLOO, Iowa—VGM Group was represented at The Brain Injury Association of Iowa’s Advocacy Day at the Iowa State Capitol in Des Moines Feb. 3. Kelly Turner and Beth Cox, both of People for Quality Care, VGM’s consumer advocacy group, and Steven Eilers from VGM Forbin joined other supporters, survivors and advocates at the annual event, which promotes brain injury awareness and brings funding and related issues to the attention of state leaders. Turner and Eilers are both members of the Northeast Iowa Traumatic Brain Injury Board. It Adds Up to Green at Maldonado Medical PHOENIX—Officials at Maldonado Medical believe a green initiative can help the company stay in the black. Company President Brandon Maldonado figures electronic signature capture saves over 10,000 sheets of paper annually for the company. In the Santa Monica, Calif., branch, the local delivery vehicle is a four-door GEM car, an electric car that can operate for up to 30 miles on one charge. And video conferencing among company managers saves on travel costs. "It's not just good for the environment, it's good for business," Maldonado said of the company's green program, noting that "the positive response from our clients, doctors and patients has helped our company grow during a time when many in our health care sector are downsizing." The eight-year-old company specializes in the TEC iceless cold compression/DVT prophylaxis system, continuous passive motion, CPAP and lymphedema therapy. With three locations in Phoenix, Santa Monica and Beverly Hills, Calif., Maldonado said the company is planning to add another office—and more GEM cars—in San Francisco by the end of the year. Brightree Buys Pacware ATLANTA—Brightree announced earlier this month that it has acquired Sacramento, Calif.-based Pacware Software Development, adding 800 providers and boosting its customer base to more than 2,000. The growing HME software developer will leverage Pacware’s investments “in capabilities such as advanced data conversion utilities for competitive software products in the market,” according to a release. Under terms of the agreement, Pacware President Byron Maynard will join Brightree as the executive vice president responsible for the Pacware product. Last August, Brightree added Harrisburg, Pa.-based CAU. China Sourcing Fair Coming Up HONG KONG—The new China Sourcing Fair: Medical & Health Products will be held at Hong Kong's AsiaWorld-Expo April 20-23, organizers announced. The inaugural event will showcase innovations in medical equipment and care supplies along with other products from exhibitors from mainland China, Taiwan, Hong Kong and other fast-growing Asian supply hubs. For information, go to www.chinasourcingfair.com. To revisit this news anytime during the week, check www.HomeCareMag.com. We welcome your comments. Drop a line to HomeCare Editor-in-Chief Gail Walker at gwalker@homecaremag.com. In observance of President's Day, HomeCare Monday will resume publication Feb. 28. ADVERTISEMENT |
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