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

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The Basis Of A Good Policy And Procedure Manual Is Making It Clear, Easy To Follow, And Accurate! Is Yours All Three?

policy and procedure manualWith home care regulations changing so frequently, having an updated policy and procedure manual is very important. In fact, if you are not evaluating the accuracy of your manual routinely, it probably isn’t up-to-date. This is a compliance and operational problem for agencies.

A Policy And Procedure Manual In The Past:

Manuals used to be something to tweak related to internal operations. You added a new position or employee benefits and changed your manual with it.  The policy and procedure manual didn’t require complexity. If you think this is how your manual is today, then it definitely needs to change.

And Today:

Your policy and procedure manual requires routine changes. Outdated manuals set you up for deficiency before your survey gets started. The industry faced so many changes with the new COPs and Emergency Preparedness. You thought you could take a breather. Then, CMS dropped the final rule at the end of October.  Whether you are dealing with the Review Choice Demonstration or trying to wrap your head around the PDGM, it is a lot.

So, How Do You Start?:

Where you start often depends on how old the majority of your policies are.  The more outdated, the more overhwelming, time-consuming, and costly it is .So, you need a manual that is easy to edit and doesn’t seem like a never-ending maze. Consider purchasing a Medicare Ready or Accreditation Ready Manual that allows for easy updating to make the manual specific to your staff and organization. It should be something you can download and edit directly at anytime. Make the manual available online for employees on an intrasite so all can easily see changes when the occur. A manual that only requires updates to your current agency allows you to focus on all the other changes.

We Have Many Manuals To Help You Get Compliant:

At Kenyon HomeCare Consulting, we have Medicare and accreditation ready manuals for CHAP and ACHC to get you up-to-date. They require changes only to what personalizes your organizational policy. It makes a big difference when you start with a manual updated with all the current regulations and COPS.  Call us at 206-721-5091 or contact us online if you would like to speak about our downloadable manuals. They are available directly from the website. Let us make your way to compliance a little easier.

Does Your Chronic Disease Education Program Make Honor Roll Or Just Pass The Test? Grade Your Agency Paper And Upgrade Your Teaching Model To Generate Happier Employees And Better Patient Outcomes!

Chronic Disease EducationThe most important thing in chronic disease education is the overall program evaluation. If you don’t know the overall efficacy of your chronic disease program, then you will miss the mark.  Let’s look at how to grade your own test and make the program better than ever!

5 Things Need To Be On Your Grade Card:

In order to evaluate your chronic disease education, you need to know what to put on your grade card. Here are 5 things that are a definite must to know if you pass the class.

  • What Clinical Disciplines Are Involved?: You should be able to say nursing, PT, OT, and Home Health Aide.  If you can’t, then your program won’t thrive.
  • How Often Do You Train?: If the answer is “on hire”, then you will also struggle. Even though this is important in the orientation process, it is a continual learning process.
  • Do You Connect The Education With Managing The Disease?: This is the key to the kingdom. All disciplines must understand how all pieces to disease management fit together. It is not about hearing symptoms and staff memorizing lists. That misses the point. It is about complex problem management.
  • Do You Include Contract Staff?: Agencies often invest in education for employees, but not the contracted entities that provide service to the patients. This costs you a lot more in the long run.
  • How Often Do Your Clinical Disciplines Communicate Between Each Other?: Is it once a week? Or, maybe it is at admission and discharge only? See how often and the quality of the communication? Is it based upon improvement and optimal functioning?

Let Us Help Put It All Together!:

At Kenyon Homecare Consulting, we can help you advance chronic disease education and management to the next level.  We offer online education at Chronic Disease University. Call us at 206-721-5091 or contact us online to see how our program can get you the grade card you want!


What’s In A Name? Does Your Policy And Procedure Manual Mean Different Things To Different Employees? Make It Easy And Straighforward. It Should Be An Easy To Follow Road Map And Not A Never-Ending Maze!

Lost-Very LostThere is a lot of focus on home care changes in the last several years. COP changes, the new pre-claim review, EMR intergration etc.  However, all these changes occur around what appears to be a stagnant policy and procedure manual.  As much as your day-to-day operations change, your manual should reflect the same. Most of the time, this is not the case. Let’s discuss how to make your manual a tool and not a potential hindrance.

What’s In A Good Policy And Procedure Manual?:

This is important.  If you do not know the integral pieces, then they are often missed. The first step begins with a full review of what you currently have in place.  Then, let’s look at 5 key areas that need to have ongoing updates in your policy and procedure manual.

  • Regulatory Changes: This is not just a copy and paste of CMS or state regulation. It also means that your agency needs to understand and be able to communicate how the regulation has been implemented.
  • Organizational Chart: Sometimes, agencies will have the same organizational chart on the manual, but certain positions no longer exist in the business. It is also common for changes to the name of a position, but no change to the org chart, which puts you at risk for survey citation.
  • Job Descriptions: Make sure your job descriptions depict what your staff are really responsible to do.  This makes accountability easier and eliminates questions as to what role the employee plays.
  • Performance Evaluations: Your evals should mirror exactly what the job description says. However, this is often not the case.  If the employer wishes to address accountability or reward performance, then the eval tool must be clear. If not, then it also becomes difficult to evaluate all employees objectively.  This can be a problem for you as an employer. The “yardstick” by which staff are graded cannot change lengths for an arbitrary or vague rule book.  Employees need a clear guideline for expectations.
  • Clinical Procedures: Are staff taught clinical operations according to clinical procedure and best practice? This is very important.  For example: many procedure manuals have outdated policies on wound care priniciples. Do you still see wet-to-dry dressings part of best practice in your agency? If so, then you are definitely in need of updating. Look specifically to those with expertise in the field to update your clinical policies as needed. Employees need clear clinical policies to guide practice in the field.

We Can Help!:

At Kenyon Homecare Consulting, we have Medicare accreditation ready manuals available on the website under Kenyon Marketplace. Whether you need private duty or a skilled policy and procedure manual, you can find it there for download. It has the abaility for you to edit anything you need specific to your state and your agency.  Call us at 206-721-5091 or contact us online with any questions.

You Know Oasis Is Important. This Isn’t New. But How Do You Keep Your Clinicians Excited About It? The Gold Is In Your Trainer!

win-winOasis… Oasis… Oasis… Do you ever find it hard to get staff excited about it?  Then, you are not alone. Keeping things fresh year after year can be frustrating. Let’s look at ways to make your training memorable.

Common Things That Can Make Training Ineffective:

After years of completing Oasis, it can be something that long-term nursing staff can dread. It can also be way too much for new nurses. Here are 3 common things that can make even the best intentions change the outcome of your training:

  •  New Nurses With Seasoned Nurses: This can be a really tough mix. You have long term nurses who have seen a question answered a certain way in one version answered differently in another. New nurses are a clean slate. It can be tough approach the nursing team with the exact same training.
  • Same Method Of Training: So many times, you can have a trainer that methodically reads guidance to staff. Staff begin to zone out and think about all the work they still have to get done that day.
  • No Real-Life Example: Nothing is better than having the nurses see the Oasis completed properly while objectively assessing a real patient. When it is possible to have this type of hand-on example used, it is so much better. When it isn’t, consider getting consent from a patient willing to have the assessment video-taped for training purposes.

Ok, So What Really Makes The Difference:

The proof is in the trainer. You need someone who understands the tool both clinically and financially.  That type of trainer is excited about how all the pieces of the puzzle fit together. If you approach staff with this trainer, then training looks so much better. That person needs to be a nurse. This makes the training more credible to those receiving it. This type of trainer puts everything together from the Oasis to how it all fits in the care plan. It becomes a win-win situation for nurses and for administration.

We Can Help!:

At Kenyon Homecare Consulting, we have onsite Oasis training by the nurse that loves the puzzle of Oasis and how everything fits together.  Our Oasis training nurses are certified coders that bring the coding piece into the mix effectively.  Call us at 206-721-5091 or contact us online to see if our trainers can make a difference for you!

Ring The Bell! School’s Back In! Making Your Chronic Disease Education UntouchableTo The Rest!

chronic disease educationHome care always changes. Agencies deal with changes in reimbursement and regulations all the time. There is one thing that doesn’t change; the need for chronic disease education.  Let’s look at some ways a great program can make you more marketable and help your bottom line.

Wait, Doesn’t Extra Education Cost Me Money?:

As an administrator, you constantly deal with the pressure of finances.  It comes with the territory. But, look at chronic disease education from the big picture. If you have an internal program that leads to better outcomes and better case management, then training cost is minimal compared to the alternative. So, the answer would ultimately be no. Education and incorporating disease management from your agency perspective is home health gold.

So, What Happens First?:

Pick your educational program and start with home care aides. This discipine is most often skipped in the process of chronic disease management. Aides spend the most time with the patient and yet are the least taught by agencies when it comes to chronic disease. This is the first thing that needs to change. The home care aide is much more capable of being part of the goal-oriented care plan regarding chronic disease. Here’s the other thing; the paradigm shift needs the buy-in from your skilled clinicians. If skilled disciplines know you have well-educated aides, then it is easier to make them part of multidisciplinary care plan goals.

Assess Communication:

This cannot be stressed enough when it comes to chronic disease management. Agencies struggle with coordination of care. Clinicians are busy trying to provide care, document in an EMR, and follow up with physicians. The increased communication will actually allot more time for the nurse and therapist in the long run. If communication increases, then additional visits are not completed.  Think about the difference in the number of visits when the therapist and nurse complete the cycle of care with the aide versus the alternative.  Have the aide complete all tasks within scope of practice. Make coordination of care a meaningful discussion of goals and how to get the patient there.  Each discipline needs to play a part.

Make The Investment And Let Us Help:

At Kenyon Homecare Consulting, we have comprehensive chronic disease education for your aides. This allows online use when it is convenient for each individual staff member. Check it out at Chronic Disease University or call us today at 206-721-5091 to see how it can work for you!

Are You Freaking Out About Pre-Claim Review? Are You Wondering How To Get The Docs On Board With Your Timeframes? You are Not Alone, But Don’t Be Afraid. Prepare Them Now!

stressed doctorMost agencies know the Review Choice Demonstration to be the new Pre-Claim Review. In order to make things flow smoothly, have all your ducks in a row first. However, you may feel getting your documents back from the MD may be impossible.  If so, let’s look at ways to ease the burden.

4 Ways To Streamline Your Pre-Claim Review Process:

If you do not have your act together internally, then it becomes tough to make it flow to others. Let’s look at 4 ways you can improve the process now so you are ready.

  • Tighten Your Own Timeline: Nothing is more frustrating to the docs then for you to push your timeline out to the very end and expect them to jump to your every need.  How long from admission to printed 485? How long until your face-to-face documentation is in place?
  • Look At Your Documentation Policies: Pre-claim may mean you need to change your workflow.  Are any steps unnecessary? Have you accounted for absences of clinical staff or coders? Pre-claim will absolutely hurt cash flow if you do not prepare properly.  If you complete in-house coding, have an outsourced provider contracted to prevent any gap in billing related to surge or absences.
  • Educate All Staff Involved In Process: As administrators, sometimes you struggle with how much information staff need to do a quality job. Ultimately, as home health spending increases, so has its scrutiny. Medicare must make sure that those providing care are doing so in the way CMS intended. Educate staff to know this is not a punishment from Medicare. Auditing has shown that many claims are paid improperly. CMS is trying to control money going out that shouldn’t.
  • Talk To Your Docs: Ultimately, they are going through auditing themselves. They are also dealing with every kind of provider with their respective audits and reviews. It is a lot. Recently, a physician approached me and stated, “I don’t care about this face-to-face stuff, but I have to do it”. No truer words have been said. Make the education simple. When we look back to face-to-face, it was extremely frustrating for everyone. Now, most agencies have a system that makes things easier for everyone.  Timeframe is the struggle. Illinois providers report better follow through and efficiency than before pre-claim review. So, it can improve.

So, How Do We Get What We Need For Pre-Claim Review:

Start with internal operations. Go to the docs with a system in place that makes things run as smoothly as possible. If you have docs that want to do things differently to help workflow, then do it. It will make the difference in your cash flow, turnover time, and ultimately, the satisfaction of your home care partners.  Don’t wait until you have a date on a calendar of go-time from CMS. Start now to alleviate pressure for everyone.

Let Us Help You Make Things Easier:

At Kenyon Homecare Consulting, we have senior consultants who have been through years of different auditing processes. Call us today at 206-721-5091 or contact us online for your free 30 minute consultation.

A Policy And Procedure Manual Is Much More Important Than What You Realize. Why Updating It In A Regular Basis Is Like Putting The Car In The Shop To Make Sure It Runs Like A Well-Oiled Machine.

policy and procedure manualYour policy and procedure manual is something that needs attention to be functional.  This should not be new information. But, looking at your manual with objective fresh eyes may be.  Let’s look at some things you may overlook in updating your manual, especially in the clinical realm.

Job Descriptions:

When you look at your policy and procedure manual, when was the last time you tweaked job descriptions? If you pull the one for your nurses, then you may see the same thing that has been there for years.  Well, think about that for a second. Is the job of the the RN in home health the same as it was 10 years ago? Absolutely not.  Although basic requirements remain, the day-to-day is very different. EMRs, ACOs, Value Based Purchasing and regulatory changes all make what your nurses must do today very different than the past. If you think about the job description today, it needs to match the performance requirements that go along with it.

Performance Evaluations:

As you work very hard for your agency, you want the same type of commitment from your staff.  Outdated performance evaluations don’t give you or the employees the feedback needed to be useful. Make your job descriptions clear and thorough to allow your evals to truly paint the picture of performance. Doing so allows you to address performance issues as well as commend employees when things have been done over and above the call of duty. If your agency provides performance bonuses, it is important to make the process consistent. This is difficult to do if evals don’t clearly define performance measures.  Evaluations should have a range for performance.  An exceeds, meets, or needs improvement scale doesn’t give you the flexibility of defining performance.  A 1-5 scale or something of the like gives the employer a better system for evaluation.

Clincal Procedures:

These are very important when you look at day-to-day operations. Do your current policies incorporate best practices? Do you know? A good example is wound care. Some manuals show policies that do not show up-to-date moist wound healing principles. These are all things to consider when updating clinical policies. With advancements in technology and product selection, an outdated manual may not even list particluar classes of product that are useful today. If your policy and procedure manual doesn’t distinguish the difference in care of a surgical wound versus a stasis ulcer, if isn’t useful to care. It also creates compliance issues.

Let Us Help Update You Manual:

At Kenyon Homecare Consulting, policy and procedure manuals are available directly on-site for download at the Kenyon Marketplace. There are accreditation ready manuals for both home health and private duty. Call us today at 206-721-5091 or contact us online to learn more.

Are You Missing Something In Your Home Care Partnerships? Do You Know Why? Look Through Objective Eyes At Your Own Program To See If It Does What You Think. You May Be Surprised!

Home Care PartnershipsIf your home care partnerships feel like a one-way street, then you need to look at how to change the process.  Partnerships don’t work well without the give-and-take expected from all parties involved.  Let’s look at why cleaning your own house is important while moving forward with a home care partnerhip.

ACOs, Value Based Purchasing, Contracts:

In order to survive in the future, you know partnerships are vital.  Whether you are currently part of an ACO or other partnership, performance is measured. You may see yourself in and out of partnerships due to changes in outcomes. It is tough to always feel like a grade card is being kept on the business you fought so hard to build. However, what better way to push for excellence? So, the moral of the story is to look inward first in order to be seen as the best.

4 Things To Consider In “Cleaning Your Home Care House”:

In order to be the best version of yourself, you have to constantly hold yourself to the highest of standards. It can become easy to step back when things are going well.  It is always these times that cause an issue for agencies and these items should always be forefront in your mind.

  • Turnover: You know when there is a big shift in staffing, but keep an eye out for smaller changes.  These often lead to the bigger swings and a larger problem.  Getting ahead of potential staffing issues helps address any issues prior to it becoming a big problem.  Patients and the community notice changes in long-term staff and confidence in administration can waiver in the eyes of staff.
  • Outcomes: Now, this may seem obvious, but it can never be overlooked. These items often flux you in and our of the ability to receive referrals from certain agencies. Staff need to understand the long range effect of continuous improvement of outcomes.
  • Time To Admission: With staffing shortages in most areas, this is key. Don’t see yourself as the agency who is there the same day if therapy can’t make it out for 2 weeks.  Size your agency up as a whole.
  • Communication: Sit in on your clinical meetings. Identify how communication about the patient is conducted. Is the communication goal focused? Are all disciplines giving input? Are nurses directing the aides specific to the patient?

Now, Be the Partner You Want To Have:

Looking at these items make you a better partner in the long run. Make sure your processes are clear and communication with your partners has flow and is relevant to goals and outcomes. Meet with your partners frequently to discuss both sides of the home care partnership.

Let Us Help You!:

At Kenyon Homecare Consulting, we can help improve processes, complete chronic disease education, and operations within your program.Call us at 206-721-5091 or contact us online for your free 30 minute consultation with a senior consultant today!

How Do You Really Approach A Large Home Care Aide Program When It Comes To Chronic Disease Management? If It Seems To Overwhelming, Then Start With Online Education!

Chronic DiseaseWhen asked about chronic disease education programs, smaller agencies often find the process easier to manage. When you start talking about large agencies with vast numbers, most agencies cringe a little bit.  It can seem overwhelming. And, also really expensive.  If you don’t know where to start, then you are at the right place.

Look First At How You Communicate:

Communication between disciplines is the most important function of a well developed chronic disease management program.  Before you throw money into education, start with opening up communication in a structured fashion.  Make it meaningful and routine between all disciplines. Use your clinical managers or case managers to guide the focused coordination of care. Now, because we are talking larger numbers of employees and potentially multiple branches, test it and perfect it first. Use it with one branch. Get the kinks out and roll it on to another before blasting it to everyone.

Review Outcomes Continually:

After you have developed guided communication, look at what it has done for your outcomes.  Do you see a spike in improvement? Do you see a change in hospitalization rate? You should see improvement in your big picture just from the mere fact that all the clinical players are better informed on each patient. Once communication is better, and staff sees positive outcomes from the effort, it becomes easier to move on to the next step.

Online Aide Educational Platform:

Now, all clinicians need chronic disease education, but often the home care aides are left from this equation.  Make them your target.  Using an online program that allows for access at different times and for different users is really helpful.  You want a program that allows you a number of views for a particular program. If you can use the program over a large period of time, then it is available for training new aides as well. Allow the flexibility for your staff to cover patients and go through the program as it works around a schedule.

What Now:

Alter your care plans to focus on truly managing chronic disease.  Your chronic disease education is a game changer for how every discipline looks at each other and each patient.  Putting all the pieces of the puzzle working together makes a big difference in how your team will work together and with your home care partners.

Let Us Help!:

At Kenyon Homecare Consulting, we have chronic disease education focused on aide engagement in your clinical process.  Call us at 206-721-5091 or contact us online to see how we can work to make this all come togther! At Kenyon Marketplace, you will be able to purchase the aide chronic disease education program if you have already decided to take that next step.

What’s In Your Policy And Procedure Manual? Is It The Nuts And Bolts Of Your Business? Why Or Why Not?

policy and procedure manualsPolicy and Procedure Manuals may be something you don’t think about in your day-to-day operation.  You run your business making decisions everyday. Maybe the idea of your manual is just for procedures and not about personnel management or development of a smooth running agency.  Let’s make sure you see the value of updated policy and procedure manuals.

Questions To Ask Yourself:

If you think about your policy and procedure manuals, then there are a few things to consider.  Ask yourself these things:

  • How Often Do You REALLY review policy?
  • How Often Do You Refer To Your Manuals In Day-To-Day Practice?
  • What Is Staff Perception Of The Policy And Procedure Manuals? Do You Know?
  • Is Your Manual Up To Date?

Problems With Policy And Procedure Manuals:

Too often, agencies do not use manuals in a way that helps to run the business.  If you are an agency that does, then that is super.  If your policy and procedure manuals are not used in a functional way, then decisions are not uniformly made throughout the agency.  Outdated manuals lead to issues with regulatory compliance and personnel management. If you do not refer to your manuals routinely, then your manual isn’t what it needs to be.  You need to have something that all employees refer to from administration down to line staff.

Making It Your Nuts And Bolts:

First and foremost, update your manual.  Agencies often work from outdated policies that have not been adhered to for years. Employees need to have a manual that functions as reference material. If it isn’t reference material, then mistakes are made. Surveyors look closely at policy manuals. Policy and Procedure manuals need  to be useful. If employees don’t know it is your agency bible for decision making, then your manual becomes a weakness as opposed to a strength.

Let Us Help You With New Policy And Procedure Manuals:

At Kenyon Homecare Consulting, we have policy and procedure manuals available for purchase online. There are home care, home health, and hospice manuals.  We also have updated manuals with accreditation policies in place as well.  They are easy to edit and add anything particular to your agency as you see fit.  Call us at 206-721-5091 or contact us online to see how we can help your agency run smoother with updated manuals. If we can help, then we would love to do it.