Transitioning Your Clinical Manager Into PDGM Case Management. It’s A Whole New Ballgame And We Are In The Bottom Of The 9th!
Kenyon HomeCare Consulting • March 16, 2021
When the Conditions of Participation changed, what changed in the role of your clinical manager? Nothing? Maybe the name changed from nursing supervisor to clinical manager? This needs addressed prior to PDGM. Business as usual can happen, but you aren’t going to be paid for it. Let’s look at true clinical management the way CMS wants it to be.
The Nature Of Clinical Management:
The mistake seen often in agencies is the term clinical management being confused with case management. Case management models had a nurse with a caseload of patients he or she handled from admission to discharge. The nurse made her schedule of visits based on the visit frequency in the care plan. That same nurse called insurance companies and got visit authorization and made sure someone could cover if she was off work. The of the clinical manager is a different story.
As CMS completed and continues with ongoing auditing, there is still a disconnect with managing patient care as a whole. Enter the requirement of clinical manager. CMS wants to see the nurse manager being engaged in all forms of clinical care. The intention is the clinical manager critically works through care planning and care delivery. It is a hands-on process regarding every care plan. Don’t make the mistake that the best clinical manager is your best field nurse. It is a big difference between managing a patient load as a staff nurse to critically managing care of your patient census.
Ok, So How Do I Develop A Great Nurse Into A Great Clinical Manager?
Make sure your expectations are clear. Second, your clinical managers can’t be nurses in the field full-time. In so many small agencies, nurse supervisors or DONs are in the field daily. Clinical management requires time, coordination, changes to orders, and driving delivery of patient care. It is unrealistic for your clinical manager to do all of this while maintaining a patient load herself.
Have a great second person to assist with clinical management. We realize an assistant clinical manager has to be named, but often these individuals are not filling the full shoes of the clinical manager. You need someone as clued into the entire clinical management paradigm to make the system work consistently. The investment to train simultaneously will easily cover the cost. If you don’t invest now, then the cost of catching up will be much more than you thought.
Develop case coordination that makes sense for all clinical disciplines. Your clinical managers need to work well with therapy and the home health aides involved in care. Develop a system where all disciplines work together towards all the goals on the care plan so clinicians don’t have tunnel vision for just nursing, rehab, or personal care. It really needs to focus on a joint coordinated effort to be successful in PDGM world.
Let Kenyon Homecare Consulting Help You!
At Kenyon Homecare Consulting, we have senior consultants with decades of experience working to educate agencies and helping with organizational change. This is the time to get the help you need before PDGM starts. Call us today at 206-721-5091 or contact us online for your free 30-minute consultation to see if we can help with your clinical management goals!
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In an increasingly competitive healthcare and senior care landscape, providers are constantly searching for ways to differentiate themselves. Families looking for care, and the hospital discharge planners who guide them, are no longer satisfied with generic promises of "quality service" and "compassionate staff." They want proof of specialized capability. One of the most effective yet often overlooked ways to grow in this sector is to provide caregiving staff with thorough training in chronic disease care. In addition to improving patient outcomes and reducing hospital readmissions, this training also serves as a powerful marketing advantage and sales driver. Here is how turning your caregiving team into specialized chronic disease experts transforms your market positioning and accelerates revenue growth. 1. Transforming Specialized Care into a Unique Selling Proposition (USP) Most care agencies and senior living communities market themselves using the same language: "assistance with daily living," "meal preparation," and "medication reminders." When everyone says the same thing, care becomes a commodity, and pricing becomes the only differentiator. By equipping caregivers with advanced training in prevalent chronic conditions—such as Alzheimer’s/dementia, Parkinson’s, Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes—you shift your brand positioning from a general utility to a specialized medical solution . The Marketing Edge: Your marketing materials transition from passive descriptions of tasks to authoritative statements of capability . Instead of advertising "we help with seniors," you can market "specialized, evidence-based care protocols for advanced Parkinson's management." 2. Building High-Value B2B Referral Pipelines The lifeblood of senior care sales is the professional referral pipeline—hospital discharge planners, social workers, physicians, and elder law attorneys. These professionals risk their own reputation when they recommend a care provider. Discharge planners, in particular, are intensely focused on preventing 30-day hospital readmissions , a metric heavily tied to hospital funding and penalties. The Sales Edge: When your sales team meets with a hospital transition manager, they aren't just dropping off brochures and lip balm. They are presenting a clinical solution. The Pitch: "Our staff, nurses, PT, and Home Care Aides undergo a rigorous 8-hour certification program specifically for CHF symptoms, care, and tracking. We actively monitor daily weights and fluid retention to catch exacerbations before they require an ER visit." This level of specificity builds immediate trust, establishing your organization as a preferred partner capable of handling high-acuity, complex cases that other agencies might turn away. 3. Creating Authentic Trust in B2C Digital Marketing When a family member realizes their loved one needs help, their first stop is almost always a search engine. They aren't looking for broad corporate statistics; they are looking for answers to specific, frightening problems (e.g., "How do I stop my dad with dementia from wandering at night?" ). In-depth staff education provides a goldmine of content for inbound marketing strategies: Expert Content Marketing: You can leverage your staff's training to create highly targeted blog posts, downloadable care guides, and educational webinars. Thought Leadership: By hosting free community seminars on managing chronic conditions, you position your brand as the local authority. When families are ready to transition from self-care to professional care, your organization is already their trusted advisor. 4. Shortening the Sales Cycle Through Consultative Selling The consumer sales process in senior care is deeply emotional and fraught with guilt, anxiety, and confusion. Families are often in crisis mode. A standard salesperson who only speaks about room dimensions or hourly rates will struggle to close the deal. When your sales representatives are backed by a highly trained clinical and aide staff, the sales discovery call morphs into a clinical consultation . Traditional Sales Approach: Focuses on features, schedules, and pricing "We can send a caregiver on Tuesdays and Thursdays for four hours to help your mother clean and cook." Consultative, Education-Backed Approach: Focuses on disease progression, symptom management, and quality of life. "Because your mother is dealing with advanced COPD, our caregivers are trained to recognize early signs of respiratory distress, manage energy conservation techniques during bathing, and ensure proper oxygen optimization." The latter approach instantly alleviates family anxiety. It proves that you see their loved one as a person with specific medical needs, not just a line item on a ledger, effectively neutralizing price sensitivity and shortening the time it takes to sign a contract. 5. Maximizing Lifetime Value (LTV) and Word-of-Mouth In senior care, the best marketing is a glowing testimonial from a relieved family. In-depth chronic disease education directly correlates with higher client satisfaction and longer length of stay (or care retention). Preventing Care Burnout: Caregivers who lack training get overwhelmed by the behavioral or physical symptoms of chronic diseases, leading to high staff turnover and disrupted care. Trained caregivers handle difficult symptoms with confidence and skill. The Ripple Effect: Stable, high-quality care leads to happy families. Happy families write powerful 5-star online reviews and passionately recommend your services to friends and neighbors, creating an organic, self-sustaining sales loop. Conclusion: Education as an Investment, Not an Expense In-depth chronic disease education for caregiving staff should never be viewed as a mere regulatory compliance box to check. It is a foundational business strategy. By investing in the clinical intellect of your frontline workforce, you feed your marketing engine with authentic, high-value content, arm your sales team with an undeniable competitive advantage, and build a brand reputation that commands premium pricing. In a crowded market, the most educated care team wins the deepest trust—and ultimately, the client. At Kenyon Homecare Consulting , we focus on high-quality home care, home health, and hospice services. In doing so, we provide in-depth chronic disease education on the conditions that affect our clients population the most. If you are interesting in development of a true competitive advantage, visit Kenyon's Chronic Disease University for your educational needs. Call us at 206-721-5091 or at gkenyon@kenyonhcc.com with any questions.