Kenyon HomeCare ConsultingGinny Kenyon, Author at Kenyon HomeCare Consulting (206) 721-5091

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Why ICD-10 Coding Needs To Be Your Home Health Holy Grail

Many know “The Holy Grail” from a certain Charleston Heston movie which shall go unnamed (involving a final “crusade” for the magical cup). The holy grail is found to deliver happiness, everlasting youthfulness, and unlimited supplies of food and other necessities. What is the holy grail in home health? One good answer would be ICD-10 coding.

The “Miraculous Powers” of Perfect (or near-perfect) ICD Coding

The homecare industry is growing by leaps and bounds. This creates opportunities for home health organizations and saves hospitals and taxpayers up to 50%. Home health is a competitive sector, and unless you are reaching your reimbursement potential, your agency is likely struggling instead of thriving. The remedy many times is to maximize reimbursements via improved ICD-10 coding. Here’s how:

  • Rely only on certified, homehealth-specific ICD-10 coders. Experienced coders simply code better and faster. Hospital and home health coding are not the same language.
  • Invest in continuing education for coders and clinicians alike. If you code in-house, you know ICD 10 changes can be monthly! Your coders need to keep on top of it.
  • Keep your coders and clinicians communicating well.  Collaboration before, during, and after documentation means all the difference.

Consider Outsourcing ICD Coding (your grail) to Industry Experts

ICD coding is so important to the success of homecare. Coding in-house can be a burden. Management time spent coding decreases time for case management . It can be difficult to find, hire, and keep good ICD-10 coders. Even if you have a great coding staff, back up coders for extended vacations, medical emergencies, or if someone leaves unexpectedly is necessary. Plus, outsourced coding can both save you money on employee salaries/benefits and potentially boost reimbursement rates by 29% to 48%.

At Kenyon HomeCare Consulting, we can protect your “holy grail” with outsourced coding which can: increase revenue, improve turnaround time for better cash flow, and prepare you for increased growth since staff can focus on clients instead of codes. To learn more about our Coding Plus Program, continuing staff education offerings, and other valuable services, contact Kenyon today by calling 206-721-5091.

Manage Chronic Diseases Properly Or Pay Royally

Chronic DiseasesThe home health system has grown in recent years, and is expected to continue. One factor driving growth is chronic diseases and their high cost. Heart failure, type 2 diabetes, asthma, arthritis, osteoporosis, and other chronic conditions are present in 80% of elderly. 2/3 of older adults have two or more chronic diseases. This led hospitals and other providers to rely on homecare to reduce inpatient stays and cost.

Chronic Disease Management Vital to Home Health’s Future

Effective chronic disease management (CDM)programs is important for home health agencies. This is an opportunity to expand client base, enhance reputation for high-quality care, and ultimately boost bottom line.

Opportunities to benefit patients and our healthcare system also lie in the following:

  • Reduction of re-hospitalizations and emergent care with proper daily chronic disease management.
  • Minimizing patient impact of chronic conditions the patient to enjoy more and suffer less. Care delivered at home provides more privacy and freedom for an active life.
  • Education is huge in the CDM program and provides patients the tools to self-manage chronic conditions. Caregivers are also integral to oversee aspects that cannot be self-managed.
  • Homecare remains the secret weapon to decreasing healthcare costs. This is true for costs incurred by providers and patients.

CDM Education Key to Homecare Success

Lack of quality CDM programs potentially eliminate revenue and profits. Poorly managed chronic conditions lead to higher service utilization cost, decreased reimbursement, and possible exclusion from future referrals. Thus, CDM programs are key to future success of every homecare provider.

Investing in CDM education allows agencies to provide positive outcomes to chronic disease patients. Clinicians with general RN, PT, and OT experience is just not enough. There are complexities in chronic disease homecare programs that need specific protocols and proper care coordination.

Disease management education can be in-house, online, or by class at a physical location. Once your clinicians are educated chronic caregivers, your agency patient can provide better outcomes and lower costs. High-quality care increases client retention and leads to referrals with opportunity for expansion.


To benefit from managing chronic disease instead of suffering from it, clinicians need intensive disease management education. Lower costs, higher revenues, better care, and increased growth depend on it.

To learn about educational opportunities in chronic disease management, contact Kenyon HomeCare Consulting today at 206-721-5091 or fill out our online contact form. (Also learn how to improve medical coding in-house or why outsourcing may be a better solution.)

Using Psych Nursing As A Specialty Service To Improve Patient Care And Profit Margin

Specialty ServicesThere are shortages of almost every type of specialty nurse today. This is very true in home health psych nursing. To improve patient care and boost your agency’s bottom line, offering pysch nursing as a specialty service, or other market specialty services that your competitors can’t offer, will  making your homecare organization stand out.

The right accreditationeducation for clinicians and management, partnering with an ACO and directly forming strategic partnerships with physicians, hospitals, and clinics, is only half the battle. The other half is hiring good specialty nurses. Developing a streamlined psych care program puts you in an elite class of home health groups.

Special Care Is Needed With Psych Patients

Mental illness needs to be treated like other disease. This means not assuming every nurse can effectively handle every type of care. You wouldn’t do that with other patient illnesses, so why consider it with psychiatric care? The issue becomes complex when a patient has both mental and physical problems.  This requires skill in developing a patient’s plan of care. Someone who has mental illness may be able to manage self care when stable.  However, they may be completely different when they are not.

Psych Nurses Are Not Psychologists

They are RNs, first of all, like all RNs. And they then go on to do years and countless hours of specialty training in how to treat patients both physically and mentally, who may have both types of problems. And there are state laws that limit the scope and practice of various types of psych nurses as well. They will need special credentials from the American Nurses Credentialing Center or another widely accepted credentialing organization. And they often get masters or doctorate degrees too.

A psych nurse is able to better develop care plans related to patient specific needs and diagnoses, administer medications, and monitor patients for improvements/reactions. Some will have sub-specialties in pediatric mental health, substance abuse issues, or various particular mental/physical problems. So it makes a big difference which particular psych nurse you add to your staff.

In the end, we adding one of more psych nurses to your homecare team will improve patient outcomes (of psych patients), boost these types of referrals, and increase agency profitability.To learn more, or for a free initial consultation, contact Kenyon HomeCare Consulting today by calling 206-721-5091 or by filling out our online contact form!

Maintaining Ongoing Successful Partnerships With Doctors

Forming and developing strategic partnerships with MD’s is key to success of today’s home health care agencies. In fact, competition is fierce in the arena of doctor-homehealth relationships.

And the rapid growth of the homecare industry in recent years has created a situation in which doctors and homecare practitioners must work in harmony for the good of patients.

Why Must Doctors and Homecare Agencies “Partner Up?”

The fact is, many patients have a strong desire to stay at home and live active lives, rather than be confined to a hospital or nursing home. They would also prefer to avoid unnecessary trips to hospitals, MD offices, clinics, and other medical facilities when possible.

But there are many services that require a doctor’s oversight, approval, or prescription to be both legal and safe. Even when patients are cared for at home, they often need to be under the umbrella of a local physician’s office as well.

This means your home health agency needs to be on the same page with other providers, especially licensed physicians, and always have the lines of communication open. In fact, you need a designated “relationships manager” to coordinate all the details of your agency’s ongoing relationships with MD practices.

Managing Your Ongoing Partnerships With Doctors

To ensure you can nurture and hold onto valuable partnerships with local doctors once you get them started, you’ll need to appoint an official “go between.” There must be someone assigned to the task of managing this potentially complex relationship.

Here are some tasks that your MD practice relationship manager should regularly engage in:

  • Serve as the contact person between the doctor and your homecare agency, and at times meet personally with physicians.
  • Organize a step by step operational flow and ensure both ends are aware of, comfortable with, and are following that same “flow chart.”
  • Ensure that you are communicating to doctors your agency’s true capabilities and full capacity, and that you are delivering on every promise made to patients and doctors alike.
  • Be alert for problems that develop and be quickly troubleshoot them, so you cultivate ongoing growth and boosted referrals.
  • Make sure you are on the same page as doctors when it comes to ICD coding and documentation.
  • Develop and implement specific care-protocols with each MD practice. This will minimize calls to the MD and empower nurses to work more independently without any risk to the patient.

Whether you are just starting up a new home health agency, or you are simply trying to hone and perfect your growth strategy, managing well your MD relationships cannot be ignored. You need to make the relationship beneficial to your agency, to the MD practice, and to the patient.

To learn more or for a free consultation on optimizing your homecare growth and your bottom line, contact Kenyon HomeCare Consulting today by calling us at 206-721-5091 or by filling out our online contact form.


Meta Description:

Learn why relationships between your homecare agency and local MD practices are crucial and how to better manage them!

Social Media Posts:

1. Homecare relations with local doctors need special attention from a designated coordinator.

2. Don’t let your homecare agency’s relationships with physicians be haphazard!

3. For homecare-physician partnerships to be successful, they need continual management.

4. Learn how to improve your homecare agency’s relations with MD practice partners.

Top 6 Ways to Begin Developing Strategic Partnerships

Developing strategic partnerships with other providers is not optional in the home health & hospice industry. Without them, you rely on “random” walk-ins and call-ups without any reliable source of new clients.

You might survive without strategic healthcare partnerships, but you will certainly not thrive. Partners help you improve care for patients, greatly boost referrals, and ultimately improve your community reputation and bottom line.

But how do you form these strategic partnerships, and what kind of partners are you looking to “team up with” anyway?

Selecting Partners (And Being Selected by Them!)

You first look for a wide variety of other providers as potential partners, from hospitals to doctor’s offices to assisted living facilities to outpatient clinics. Sometimes, which ones you seek partnerships with depends on your staff’s skill sets, as when you team up with wound care clinics when you have wound care nurses and a wound care program at your agency.

Other times, mere geographic proximity is a key factor in selecting a partner, depending on how many healthcare organizations (and of various types) are located in the area.

But otherwise, look for providers as a partner that are reputable, willing to work closely with you to improve care levels, and especially if you are accepted as a “preferred providers.”

In the past, for example, hospitals would just hand people a list of post-acute care options; but today, more and more hospitals choose a smaller number of preferred partners to work with. You need partners whose services you can complement, not duplicate. And remember, partners will affect each other’s reputation and bottom line, so choose wisely.

And don’t neglect to join an ACO, which might lead to referrals and partnerships!

Tips on Making the Partnership Work Well for All Involved

To gain new partnerships, as well as to manage them well and thus maintain them, you will want to follow these six strategic partnership development tips:

  1. Assign a “designated relationship coordinator” to be your official contact person for all your partners, and prospective new partners.
  2. Set up data exchange protocols with partners to facilitate efficient and accurate communication/billing.
  3. Ensure partners are aware of your capacity and capabilities, and can quickly get updated on the current situation.
  4. Establish transition-of-care milestones, and work to eliminate any glitches in inter-agency work flow issues.
  5. Have issue escalation procedures already in place to deal with emergencies. Know how/where/when to get help with critical conditions that go beyond your on-staff expertise.
  6. Make specific service level commitments with partners so they can count on you for such and such number/types of services.

Finally, let your managers and coordinators focus on their specific tasks and not get bogged down in other duties. And consider outsourcing your ICD coding rather than to tie down managers/clinicians with coding assignments.

To learn more about forming/managing key strategic partnerships for your home health organization, contact Kenyon HomeCare Consulting by calling us at 206-721-5091 or by filling out our online contact form.


Meta Description:

Strategic partnerships are key to home health growth. Find out how to form and develop optimal partnerships.

Social Media Posts:

1. Have a plan for establishing and developing your home health strategic partnerships.

2. Learn how to develop new strategic partnerships that will help your agency grow.

3. Learn what kinds of homecare partnerships to seek and 6 ways to develop them!

4. Don’t neglect homecare partnerships: they’re key to quality patient care and referrals.

Strategies For Educating Staff On ICD-10 Coding

Coding education is as important as coding itself. And with the periodic updates to ICD-10 coding, the eventual arrival of ICD-11, and the frequent industry changes, you cannot afford to fall “behind the 8 ball” on staff education.

Remember when ICD-10 was first implemented? Industry experts warned that all staff, not just coders, would need to adjust and learn the new system. Coders, clinicians who handle documentation, and managers who oversee the whole process need ongoing coding/documentation education to optimize coding and improve care.ICD-10 Coding

Options for Training and Re-training Your Homecare Staff

Whether updating coders on new codes and ICD-10 manual changes, training Medicare field staff on OASIS, or finding fun but effective ways to approach documentation training, staff education is a multi-faceted enterprise.

Some of your main options for an optimal staff training program include:

  • Regular staff meetings/ announcements generating awareness and and basic procedural training.
  • Hands-on practice coding sessions for coders, using common codes as well as newest changes to ICD-10.
  • In-depth documentation instruction where coders and clinicians closely collaborate.
  • Distance education seminars on coding, documentation, OASIS, and other related topics.
  • Developing your own “arsenal” of high-quality training and staff education tools that address industry and organizational needs.

Lighten the Coding and Training Load With Outsourcing

You cannot eliminate continually training and re-training your staff. Documentation, for example, will always be an integral part of proper client care. However, outsourcing all coding will greatly reduce the training load. After all, you will no longer have to keep in-house coders up to date or training new hires when applicable. Your outsource partner can take care of it for you. Outsourcing ICD coding can produce extra revenue. You can reinvest the savings in training nurses, managers, and all other staff in a more thorough manner. Staff will likely appreciate the attention and concern for improving their skill sets, which typically leads to happier, more productive, and more loyal staff members. This can translate to improved client care, enhanced agency’s reputation, improved client retention, and new growth.


Staff education helps your homecare agency provide better care which facilitates increased revenue with improved cash flow if you have efficient ICD coding. Investing in coding education is one path, while outsourcing all coding is another. Each homecare situation is different, and the solutions will vary accordingly.

To learn more about coding and staff education or coding outsourcing services offered by Kenyon HomeCare Consulting, contact us today at 206-721-5091 or via our online form.

Technology and Artificial Intelligence, An Age of Disruption Part III

Technology and Artificial Intelligence, An Age of Disruption Part III

Last month I wrote about the rapidly growing use of technology and AI (Artificial Intelligence) in our industry.  From Carebots to nanobots, we are seeing an evolution that human kind has never experienced.  We are told that the hunter/gather age lasted for several million years, the agricultural about 2 thousand years, the industrial age two centuries and the technological age about 4 decades.  We are now moving into an augmented/AI age much of it already upon us.

We all have heard of and now seen self-driven cars.  Groceries and other stores are beginning to experiment with cashier-less store.  Grocery delivery will also play a large part in the coming changes that allow compromised individuals to remain in their home and be as independent as possible.  Imagine the near future where your patient can call a self-driven care to take them to their appointments. They can order their meals or groceries from their phone, have an app on their phone that will call them with the results of their tests, and explain what they are, and if necessary make an appointment with the appropriate care provider.

“Artificial Intelligence “is rewiring our modern conception of healthcare delivery,” according to a new Accenture report that shows an array of clinical AI applications are already well on their way to saving the industry $150 billion over the next 10 years.”  Healthcare news 2017

The technology represents “a significant opportunity for industry players to manage their bottom line in a new payment landscape,” according to the report, which examined 10 different AI applications, ranked by their potential for cost savings:

  • Robot-assisted surgery – $40 billion
  • Virtual nursing assistants – $20 billion
  • Administrative workflow assistance – $18 billion
  • Fraud detection – $17 billion
  • Dosage error reduction – $16 billion
  • Connected machines – $14 billion
  • Clinical trial participant identifier – $13 billion
  • Preliminary diagnosis – $5 billion
  • Automated image diagnosis – $3 billion
  • Cybersecurity – $2 billion

“As these, and other AI applications gain more experience in the field, their ability to learn and act will continually lead to improvements in precision, efficiency and outcomes,” said Accenture researchers.

Click Hear To learn more in-depth about some of these changes.

I Have Specialty Nurses, But How Do I Successfully Utilize Them?

Adding specialty nurses to your homecare team provides great potential to optimize clinically and expand your horizons. Unfortunately, many agencies have specialty nurses on board, but fail in utilizing them to full potential. This happen in many ways and be easy for it to happen in your agency . However, not maximizing potential decreases quality of patient care and decreases outcome measures.

Below, we look at 4 pitfalls that potentially prevent you from making the most of specialty staff, and then mention some ways to avoid or get out of those pits you may have fallen in.Specialty Nurses

1. Letting Your Specialty Nurses Do Non-specialty Tasks

There are non-specialty RNs and other qualified practitioners who can handle tasks like in-home living assistance, taking/monitoring vital signs, or making assessment reports to physicians or a client’s family. If you have too many specialists with the same clinical background without the clients base to match, specialists may find themselves spending time on routine homecare assignments instead of what they were trained to do. Better to diversify and adjust your on-staff specialties to meet actual community needs. Or, you may need to do a better job marketing your specialty program to appropriate healthcare providers in order to increase this client population within your agency.

2. Your Specialists Aren’t Focusing on “Program Building”

Program development and education of other clinicians, focusing on complex or “at risk” clients, and coordinating with other providers about the most appropriate medications and care are the areas in which your specialist excel. If having too many nurses in a particular specialty lead to their handling tasks outside their field, having too few can squeeze out all the time needed to envision, organize, and implement an effective program. Regular staff meetings on cardiac care, for example, or a feedback system whereby non-specialist clinicians express their concerns to specialists who then act as guides and coaches, could be a part of a full-fledged program. But the key is, your nurse specialists must have time to perform their routine duties, oversee others, and to plan and tweak the overall program as it continues to develop and adjust to real client needs over time. In addition, nursing and administration need to objectively measure outcomes related to program success and oversee follow thru on all initiatives.

3. Not Including Outsourced Specialty Nurses in Your Strategy

One often overlooked aspect of utilizing specialty nurses. Nurses not employed by you may sound counter-intuitive, but here’s how it can benefit your agency and your clients: you can expand your offered services immediately without waiting to hire/train new employees; provides you a relatively low-cost “pulse” on which nursing specialties are most in demand over a period of time. This gives you clear direction moving forward while not losing clients in the mean time.

4. Not Having a Robust Marketing Program to Back Up Your Specialty Program

You can grow your programs to a degree by conscientious client care and “organic referrals” alone. But, not advertising your chronic disease management or other special programs adequately is going to “stunt program growth rates.” Needless to say, if virtually nobody knows about the specialized care within your homecare agency, you will only randomly have clients for your specialty programs to center around. In sum, we can say that it is more challenging to organize an efficient, high-quality, and cost-effective specialty nursing program than it is to simply hire specialty nurses. It takes time and effort to make the system work so everyone benefits, but the end-results include improved care, increased client retention and acquisition rates, and a boosted bottom line.

To learn more about how to implement a successful homecare specialty nursing program, contact Kenyon HomeCare Consulting online or by calling 206-721-5091.


Market Your Specialized Services Effectively To See Growth In Your Bottom Line

Having homecare specialty programs isn’t enough: the market has to know you have it. If not, programs are under utilized, agency growth doesn’t occur, and your bottom line suffers. Whether your agency is a new start-up or going through organizational restructuring, don’t neglect effective homecare marketing strategies, including programs that make your agency a better choice for patients.

The importance of “Market Differentiation”Specialized Services

With effective marketing, you must differentiate yourself from competitors in a positive way. Highlighting specialty services, like chronic disease management, can effectively differentiate yourself. If you back up claims with top quality care, marketing efforts create long-term, upward-spiraling agency growth.

4 Effective Ways to Market Your Specialty Programs

Ok, so if you know that differentiating your organization is your best marketing path, how do you move forward? Here are four ways to lay a foundation for effective marketing?

1. Utilize specialty nurses to sell your program.

You want your marketing campaign to be distinct, client-focused, and targeted at specific diseases and conditions. The nurse specialist is key to helping promote the program. Wound care nurses can communicate the benefits of your program better than anyone. And who puts “personal touch” into ads better than the very person caring for the target market? And who knows the details of your program’s outcomes better than the nurses running it? Harness their knowledge with marketing material that promotes the benefits of the program.

2. Networking and Building Relationships

Again, let your nurse specialists talk to doctors and other medical experts. They will be able to “speak the lingo” and why your agency is the right choice for patient’s homecare needs. Having that specialty nurse as a point of contact for the physician or other healthcare provider promotes better continuity of care. You can also attend networking events, send out email newsletters, advertise to MDs and hospitals on your website, and attend “health fairs.”

3. Maintain a Social Media Presence

If you don’t already have an agency Facebook and Twitter page as well as a presence on You Tube, establish them without delay. Social media offers opportunity to create online relationships that can “discover” new clients. This happens through those directly following you as well as those looking for a potential provider. It is a great forum for interacting with clients and potential clients to understand major concerns and answer healthcare related questions.

4. Establish Yourself as an Industry Expert

Use online blogs showcasing the detailed, high-level knowledge base your agency possesses, particularly in its specialty areas. Allow your specialists to be involved in writing material. Be sure your blogs are SEO-friendly so they are easily discovered in an organic search. Or, you can pay for your blog to appear at the top of the first page for keyword searches. The more people trust you, the more likely they are to entrust themselves or loved ones to you. Make sure your agency is worthy of that trust when your market! All of these approaches potentially lead to increasing referrals and “converting” new prospects. The more successful your programs are, the easier the strategy for marketing can be. To learn more or for timely advice on building your homecare specialty programs, contact Kenyon HomeCare Consulting online or by calling us at 206-721-5091.

How Do I Evaluate My Agency On ICD Coding?

Like a ship without a compass or carpenter without a tape measure, homecare agencies often have no way to evaluate ICD coding performance. By optimizing ICD coding for accuracy, specificity, turnover time on submission to CMS, your agency stands to both boost its revenues and improve cash flow.

OK… So, how does your agency know if it is doing this well or not? And in light that evaluation, how do you decide between in-house and outsourced coding?

Use KPIs to “Score” Your Homecare Agency on Diagnosis CodingICD Coding

Key Performance Indicators (KPIs) are provided by CMS to help you measure and track how well you are doing with ICD-10. Do a “self-test” of your agency, and test again after efforts to make improvements and meet quantifiable goals has been determined. Here are some questions based on the CMS KPI system:

  • How many days between service date and claim submissions?
  • What percentage of claims/claim-dollars are typically denied, diminished, or delayed?
  • What is the average reimbursement for each specific service? how does that compare to the industry average? How does it compare to the maximum possible reimbursement?
  • How productive are my coders? How many records are coded per hour?
  • How often must coders return documentation to clinicians because it is inaccurate, non-specific, or incomplete?
  • How often do coders fail to link clinical documentation and Oasis to proper code? How often do they struggle to do so?

Pros and Cons of Outsourcing vs. In-house Coding

Once you have evaluated the agency’s diagnosis coding, the question is how to improve? There are ways to improve in-house coding, but on the other hand, outsourcing might make more sense in your situation. Here are the pros and cons:

In-House Coding: Pros and Cons

Coding in-house gives more direct control, lets you work directly with employees, and allows managers to quickly interact with the coding office whenever it is needed. However, risks of sudden loss of coder, neglect of appealing denials, and sloppy submissions squelching your revenues are all higher in-house. Cash flow problems often occur in smaller offices during busy periods or when even one employee is sick or on vacation. Though some money may be saved upfront, in-house is generally less cost-effective overall in the long run.

Outsourcing: Pros and Cons

Some homecare managers may see outsourcing coding as a “loss of control” or fear it will be more expensive. In reality, a good outsource partner is able to increase reimbursement rates making out-sourcing more cost-effective than coding in-house. A client-focused outsourcing agency keeps you informed as well. A poor outsourcing group might “leave you in the dark,” but this need not be the case. Many ICD-10 coding providers are highly transparent about your billing and take time to answer all your questions. Outsourcing takes the coding “monkey” off clinician’s backs. This allows management a focus on case management instead of coding and clinicians to focus on client care.


Diagnosing your performance on ICD-10 diagnosis coding is a first step to optimizing coding. Follow-up action involves continuing education for in-house coders, documentation training for clinicians, or simply outsourcing all coding. At Kenyon HomeCare Consulting, we offer top-of-industry coding outsourcing and on-site training to homecare providers. To learn more about our services, call us at 206-721-5091.