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

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You’ve Lost A Key Administrator. You Are Overwhelmed. Consider Interim Management To Seal The Deal And Keep Things Running Smoothly.

interim managementInterim Management is not often considered in a strategic plan. Why not? In the homecare industry, we must plan and do drills for other types of emergencies. Why isn’t an unexpected change in administration taken into consideration? If you don’t have an emergency plan to keep your agency running, then it could cost you a lot of time and much more money than an Interim would. 

Interim Management In Your Strategic Plan: 

Make this an entry in your strategic plan. If you have a long-term stable administrative team, then it’s hard to envision being without your entire admin team. Most don’t consider that unexpected car accident or medical absence that can make people down a team member in the blink of an eye. We plan for it with clinical and/or office staff.  So, why not administration? What about the workload as well as the employees if there is a sudden death? These things happen all the time, so why haven’t you planned to cover your agency? Here are several reasons Interim Management isn’t considered. 

  • Who to choose? 
  • Cost 
  • Length of time 
  • Lack of knowledge of interim management role 
  • Lack of planning 

Choosing An Interim Management Company: 

Vet not only the agency, but the individual consultant who would be in your agency. Make sure the background of the interim manager fits the knowledge set you need. Consultants have many different areas of expertise, but interim managers are also those that have high level administrative experience. Your agency may be in the middle of a start-up business line. Or, maybe you just initiated new software. You need someone with operational expertise to keep things running smoothly. Maybe, you knew there would be a position to fill. Your senior admin is retiring. You need someone to continue the flow from day-to-day while you look for someone else. You could need the interim to help in the training process of the new administrator. Regardless the need, it will come up even in smaller businesses. 

Kenyon Homecare Consulting:

At Kenyon Homecare Consulting, we specialize in interim management from top-level administration with decades of experience. Call us today at 206-721-5091 or contact us online today to see how we are the addition to your strategic plan. There is a free 30-minute consultation for you to discuss your current interim management or agency need. If you aren’t sure, then call any we can have one of the senior consultants help guide your interim management focus. 

In The World Of Homecare, Do You Still Plan Care Like It Is Public Health And Not Home Health? Make Sure You Don’t Miss The Forest For The Trees In The PDGM Picture!

MedicareThe saying that someone can’t see the forest for the trees has been around a long time. With Home Health PDGM, this is important to consider in your agency. It may sound counteractive to all you read regarding specificity of patient care, but it isn’t. Let’s break down this well known saying to how it relates to your agency.

Forest For The Trees In Your Agency:

We have become a very detail-oriented industry, haven’t we? The proper wording is listed in your EMR. All The boxes are checked before you finalize the visits. Here is the issue, we have become so focused on so many details, we don’t see the forest. We only see a bunch of smaller trees. In the process, agencies run more like the public health department of yesteryear. Meaning, patients are held for a long time and everything is managed from A to Z. With PDGM, there is a hyperfocus and intensity of care over a shorter period of time. If you are in the PDGM world, then care planning can’t be 1 week 9.

The Care Plan In PDGM:

If you are an agency that still has a bunch of 485s seeing the patient one time a week consistently, then you need to address this “routine” care before PDGM gets here.  This means eduction to staff about intensity of services. Frontloading care is not the number of visits. It’s about the intensity of the care provided by each discipline each visit. It’s time to put some visit protocols in place and make sure staff is completely coordinated regarding care planning. Consider help to change the care planning paradigm in your agency.

Kenyon Homecare Consulting:

At Kenyon Homecare Consulting, we help you reach clinical and financial goals. Whether staff need clinical education on care planning and Oasis or you need coding support, we have it. In PDGM, agencies that do not function efficiently both clinically and operationally will have a difficulty suviving. Call us today at 206-721-5091 or contact us online to see what services get you to your goals.

What Services Move You From Standing To Outstanding? Jump Into The Deep End Of Diversification To Keep Your Head Above Water.

Cliche’ dictates not to exist with all your eggs in one basket. Service diversification is scary to some. You think of the work and expense to develop new programs. It’s just easier to do what you have and not step out on that ledge. Right? If you want to be solid in the homecare/ hospice future, then you must do it. There is no option to avoid all risk here. A medical home model will require all types of service provision.  

Workflow:

If you are a small agency that has grown over time, then you know how workflow is often fluid. Individuals are cross trained and do multiple job positions. It’s often the reality when the agency is small. Today, do you still have your agency functioning this way even though it is not the same agency landscape? This can lead to inefficiencies you didn’t realize you had. Make sure you aren’t struggling because of how you work. 

Diversification of Services: 

Whether you need to provide a specialty service in your skilled home health or want to branch into Private Duty or hospice, now is the time to consider. As our home and community-based world of care continues to expand, agencies will need to provide more to sustain a long-term business model. Diversified services provided in a continuum allows for more coordinated care. Transitions from private duty through skilled and into hospice with the same agency allow the patient to maintain clinical staff.  

Hit The Start-Up Lanscape In An Organized Way: 

While maintaining your current business, make sure to systematically move forward with your start-up. Often, the start-up portion becomes secondary and the process stalls. As administration, there must be realistic timing and framework allowing staff to move the process forward. At Kenyon Homecare Consulting, we specialize in agency start-ups and diversification. We provide the education and support needed to move your plan forward. Whether you need side-by-side education to clinical staff or administrative support, we can help. Call us today at 206-721-5091 or contact us online for your free 30-minute consultation.  

ICD 10 Coding: What’s Really In A Diagnosis? Using It Properly Can Make You The Cadillac Of The Careplan! Don’t Miss The Opportunity To Hit The Nail On The Head!

ICD-10 CodingICD 10 Coding is so much more than a number in the PDGM world. Understanding and investing in proper coding and care planning can’t be minimized as you move your agency into the future. If you haven’t looked at outsourcing or hiring your own certified coders, now is the time. If you are already at this step, then it is time to see where it takes you clinically and how it helps financially. 

Outsourcing Or In-House Certified ICD 10 Coding: 

It is well documented why having certified coders complete this work is a must regardless the size of your Medicare program. Agencies often discount the importance of accurate coding when it come to a small Medicare census. Ultimately, improper coding leaves your agency open for financial loss as well as denials when ADRs come your way. The time to make that commitment is now before you are knee-deep in PDGM. Don’t miss the big picture here. Understand what you lose by not investing in proper ICD 10 coding. 

The Next Step: 

Regardless of your certified ICD 10 coding solution, the next step is about making the code translate to the care plan. Consider this question: Does your current EMR decrease the critical thinking that used to be involved in developing a care plan? Many times, the answer is yes. Does clinical staff have specificity enough in coding to go back to basics? Regardless the professional clinical background, the basics deal with writing out care plans in college. Every clinician remembers it, just ask them! If you are not a clinician, then talk this through with your clinical administrator. It meant digging into the disease process and developing interventions based upon that deep dive into clinical care. Nursing and therapy students had to understand the disease for which interventions were based. Look closely at the diagnosis and not just the body system affected. 

Ok, So You See What We Mean: 

At Kenyon Homecare Consulting, there is a commitment to helping agencies bridge the gap between administrative and clinical. Whether you need to improve financial outcomes or clinical ones, we help get you there. We have coding and billing solutions to see if your current system really maximizes your accuracy along with reimbursement. Call us today at 206-721-5091 or contact us online today and let us provide a free 5 code side-by-side comparison of your current system. 

Do You Focus On Mental Health As Part Of Your Care Plan? Don’t Be Araid To Take A Risk And Discover The Key To Replacing Outdated Care. You Can’t Consider What Happens In The Heart And Discount What Is Going On In The Brain.

Care planIt is no secret that society is more open to mental effects on physical health today than in the past. However, there is still a lot to be done. Addressing the mental health is often missed unless that patient has a history of mental disease or defect. Those become easy in the minds of clinicians. Let’s look at how mental status really needs to be key in every care plan regardless the primary diagnosis. 

Tunnel Vision In Care Planning: 

There is so much focus on chronic disease management. There should be and we all know it’s because of cost. But we make the mistake of not considering mental roadblocks to success with outcomes. Let’s think through a couple specific case scenarios dealing with congestive heart failure: 

  • Patient A: 59-year-old female recently diagnosed with CHF resulting from chemotherapy taken over 20 years ago. At the time, the chemo was so strong that the patient was in isolation for 3 months in a facility. She was married with two young children. Family was aware there was a 50% chance she could pass from the treatment itself. There was only a minimal chance for remission.  She beat the odds.
  • Patient B: 70-year-old morbidly obese male patient diagnosed with CHF over 25 years ago. No significant lifestyle changes have occurred to combat the exacerbations of illness along the way. Patient is known to smoke 1 pack of cigarettes daily for most of his life. He is divorced and never had children. 

What do these care plans look like in your EMR? They are probably more similar than you think. They may be identical except formaybe some specific weight loss goals for the gentleman? 

Why Do They Need To Be Different? 

The care plan picture for both patients are different. Therefore, the mental state of the patient is so important here. It impacts every aspect to promote success in your care plan interventions. Do these patients suffer from anxiety or depression? How does anxiety manifest itself for one versus the other? Are these items addressed on an ongoing basis?  If there isn’t critical thinking about how this affects the care plan daily, then patient potential for improvement is hindered. Without anxiety under control, how can the patient focus on teaching and interventions to improve? Also, it is important to understand the limitations of the clinicians in recognizing the difference in anxiety responses versus signs of exacerbation. Education and evaluation is key here. 

Mental Health Care Planning: 

Mental health education and its implication on physical health is so important. Clinicians can’t address patients as though we are just the physical. Clinicians need a meaningful way to address these items as a part of routine assessments and not just for an Oasis or medication. Having a trained psych nurse on staff can help so much with your care planning to address psychological issues and mental health while helping to improve outcomes of a physical diagnosis. Chronic disease management isn’t just about the heart it is also about the mind. To exclude one minimizes the efficacy of the other. 

Kenyon Homecare Consulting: 

At Kenyon Homecare Consulting we have senior consultants who know how to paint the entire clinical picture into effective care planning. Call us today at 206-721-5091 or contact us online to see how to help you reach your agency goals. 

Does Your Oasis Assessment Paint The Picture Of Patient Care Needs? Or, Is It An Abstract Piece Of Art No One Understands? Time To Make A Change!

QuestionsFrom the inception of Oasis, it was presented as an assessment tool. If this was its purpose, then why did it evolve to data collection with no clinical implication? The Oasis assessment tool expanded documentation requirements in a huge way. It was long and cumbersome and “took away from patient care” in the minds of clinicians. The industry must move forward with an Oasis that drives the care plan. It can’t be a data collection tool. If it is not integral to clinical function, then you aren’t using it at all. 

Arguments To Use Of The Oasis Assessment: 

Now, you’ve had these meetings in your agency. You hear the tool is used, but don’t see documentation to match it. If you are a clinical administrator, then you can verify. If you aren’t, then we will discuss steps to educate yourself to be more effective addressing clinical items. Here are 4 things you have probably heard from your clinicians: 

  • “We Use It”: In your review of records, there are clearly items of relevant concern in the Oasis that are not addressed in the care plan. 
  • “We Know What The Care Plan Needs Based On Diagnosis”: Since we live in the world of the EMR, canned interventions often leave out patient specificity. And, interventions are often body system-specific and not diagnosis- specific. 
  • “Therapy Does Their Own Care Plan And Doesn’t Pay Attention To Oasis”:  A well-developed care plan executed properly makes everything better including the patient. If therapy isn’t part of the care planning process, then operational change is necessary or PDGM therapy visits will sink any profit margin. 
  • “We Can’t Tell The Aides To Do That”: In a PDGM world, you can’t utilize aides just for baths. Agencies must expand the role of the home health into within the scope of practice. Many agencies still refer to the home health aide as a “bath aide”. This minimizes the resource that usually spends more time with the patient than any other discipline. 

I’m Not A Clinical Administrator: 

Educate yourself. Don’t underestimate the value of a medical terminology course. You will make life much easier if you understand what clinicians are saying. We are not suggesting you need a Bachelor’s level anatomy and physiology course. As in any industry, not knowing the lingo will affect your ability to make decisions. Work with your clinical people to understand operations. 

Moving Forward: 

At Kenyon Homecare Consulting, we work with agencies struggling to mesh the clinical process and produce positive meaningful patient outcomes. The Oasis assessment is key here. We have programs to teach and review Oasis/ ICD-10 Coding and make sure care plans match the clinical process moving forth from admission to discharge. Call us today at 206-721-5091 or contact us online to see how we can help you bridge the gap and make your Oasis assessment useful! 

 

Homecare Education: How To Shift The Paradigm In Your Agency To Manage Chronic Disease Like A Champion!

SWOTIf you want to manage chronic disease properly, then you must start with a paradigm that works. Homecare agencies often spend the dollars on education, but don’t achieve the desired outcomes. Agencies must look at current work flow and determine what needs to change. Let’s look at how to analyze your agency to be the change you want. 

Perform A SWOT Analysis: 

This may seem like a simple task, but to truly perform a SWOT analysis properly, you need to look at your agency objectively. Consider a consultant to put a fresh set of eyes on operations. This allows you a chance to come to staff with an organized approach to your educational program. A true SWOT takes time. If you can whip through it, then it probably needs someone else to take a closer look.  Every aspect from start to finish in the clinical process needs addressed. First and foremost, how is clinical data exchanged? How often do disciplines address the care plan collectively? Does each discipline make the visits on a schedule and when orders are up just discharge? 

Manage Chronic Disease: 

The first step for this process isn’t teaching about chronic disease. Educate clinical staff as to the findings of the SWOT. Strategically, you may have staff involved in the SWOT process. Staff need to understand changes to operational flow. It doesn’t make sense to teach a program before staff have any idea how to integrate it collectively. 

Choosing The Program: 

Consider programs that educate the individual discipline as well as from the complete clinical standpoint. This will help solidify your paradigm shift. All disciplines must have an equal shake and case management depends upon the needs of the patient. Now, let’s look at what the equal shake means here. A truly integrated program where staff work together as a team means the therapist should be your case manager at times. Under a PDGM model, coordinated care that has a game plan for every visit is necessary. It may seem like you already do, but all disciplines should know what the next visit holds for each other. This way goals are addressed collectively. 

Kenyon Homecare Consulting Can Help Manage Chronic Disease: 

At Kenyon Homecare Consulting, we can help through your organizational process to address work flow. We also have a chronic disease management program available online for agencies as well as clinicians. The path the homecare success is management of chronic disease. Make sure you know how to do it well. Call us today at 206-721-5091 or contact us online to speak with one of our senior consultants on a plan that works for you. 

When Is ICD-10 Coding Just A Number? Make Sure Your Homecare Agency’s Answer Is Never!

ICD-10 codingICD-10 coding is often overlooked in agencies with a small Medicare census. This leads to inaccuracy and documentation that doesn’t fit the diagnosis. If you aren’t focused on coding, then you need to be. As we move into 2020, agencies need to focus more on accuracy in coding and documentation in order to maximize use of resources and avoid audit.  

“We Have Very Little Medicare, So Our ICD-10 Coding Doesn’t Matter”: 

Yes, it does. ICD-10 coding isn’t just a piece of the reimbursement puzzle. It is about clinical accuracy moving forward in a PDGM world. It’s also about avoiding audits and understanding how your diagnosis affects the care plan visits. Sometimes agencies think because their census is small that they are off the radar. This is untrue. Cycles of ADRs without a true understanding of compliance puts you more at risk. For small agencies, multiple auditing rounds can lead administrators to sell or completely close up shop.  

Get It Right The First Time: 

Small agencies often have someone internally code. If you have invested in a certified coder, then that is great. If your certified coder is also your office manager and jack-of-all-trades, then can you really expect coding accuracy? ICD-10 coding requires ongoing skills. It also requires the coder to be on alert for changes to coding rules and knowledge of how to tie coding into Oasis data. Getting it right the first time allows clinicians to guide the care planning process for a Medicare beneficiary. Without it, you miss reimbursement and clinicians function separately from understanding the code. It happens all the time.  

Let Kenyon Be Your Coding Headquarters:

At Kenyon Homecare Consulting, our ICD-10 coding team are certified in Oasis as well as coding. We have senior consultants that guide the care planning process. This allows for efficiency in use of resources while linking the codes to the care plan. Call us today at 206-721-5091 or contact us online to see how we can improve your processes and become your coding headquarters. We will complete 5 free recodes free of charge. See what you are missing. 

The Veteran At Home: Does You Homecare Have What It Takes To Properly Serve This Demographic?

Veteran at homeYou may read this and immediately want to say yes. This is really the time to think of the veteran at home. At different times, this blog has focused on different patient demographics and how to specialize in them. However, the veteran at home is a demographic often not considered. The needs are different. The experiences are different than others in your community. It is time to consider how to be the provider of choice for these special men and women.  

What Does The Veteran At Home Look Like? 

Often, agencies will see the elderly veteran who was in Vietnam or a discharged soldier with physical limitations. What about your local pharmacist who was activated for the first Iraq war? When that pharmacist has cardiac surgery, should his care plan look the same as someone who hasn’t served? If the answer is yes, then it is time to rethink the care plan. The military comes with a whole different mindset. They are trained to think differently than those of us in a private sector. The experiences of our veterans may mean that illness reminds them of soldiers lost in battle. It may trigger PTSD previously under control. When assessing the veteran, ask about the experience to help guide care planning.  

What About Your Staff? 

Do you have military spouses or veterans on staff? You can learn so much about the mindset, lifestyle, and what it is like for the family unit of a soldier. Take the time to sit down and see where you can train staff on proper assessment and care of the veteran at home. We can specifically target things that aren’t necessary the primary reason for homecare, but absolutely affect the patient’s return to prior level of function. As we in the healthcare industry better understand the effects of mental illness, we can better treat those that suffer from it. If you have never had a panic attack, do you understand how paralyzing it is? Maybe the anxiety has been present, but not to the extent that your heart feels as though it is beating out of its chest and you are sweating profusely. Uncontrolled anxiety alone can be a huge issue for the veteran at home.  

Opportunities: 

Many of you may already service VA patients under contract. If you don’t specialize care, then you won’t achieve goals for this soldier. On the other hand, care of the veteran at home can become a niche’ like no other. Considering the years at war, the demographic will continue to increase. Teach clinicians sensitivity to soldier interaction. Imagine your nurse or aide outwardly opposes something in government or from the military. That individual may have been overseas with his or her life on the line. This is where our personal opinions need to stay that way. How offensive to someone having been in active combat or potentially lost those who were.  

Kenyon Homecare Consulting:

At Kenyon Homecare Consulting, we focus on strong educational and operational planning for agencies. If you need help with either or would like to discuss an educational plan for your agency, then please call us today at 206-721-5091 or contact us online. 

 

Continuing Education: What’s Your Gameplan? Are You Looking To Blow The Competition Away? Start With Nurses And Make Them The Quarterbacks..

teamThe concept of a great team begins with great leadership. This is the way we think of our businesses. Yes? Take it one step further now. In homecare, the leadership of your care team begins with nursing. This should be your approach for continuing education as well. Let’s look at why promoting the leadership in education to nurses converts to the care team that wins. 

How Do Your Nurses See Themselves In The Clinical Picture? 

Do your RNs really manage your care plans? Do they see themselves as management of care planning or just the ones creating the plan? There is a big difference. Challenge your agency to review care plans at the beginning of the cert and at the time of DC. How many things changed? Managing the care plans should show an evolution throughout as the patient situation changes. Is the start of care the same as 3 weeks later? As we move into the world of PDGM,the first 30 days in care planning is more important than ever. 

Changing The Mindset: 

Before you approach clinical education attached to a new payment system, approach your nursing staff. True chronic disease care and clinical success won’t happen without care management. Not in the same sense of the last several years, but a progressive move to give nurses the ability to coordinate and manage care in the sense it is intended. Get them on board with the vision of a successful care management model. This is back to bedside nursing at its finest. 

Continuing Education Moving Forward: 

Consider the last paragraph. You have worked to set the minds of the nursing staff. They are your quarterbacks. They are on board. Now, how do you educated all clinical staff moving forward? Your agency needs to choose chronic disease education that encompasses all clinical staff. You need agency specific and discipline specific. This will guide your agency to continuing education that makes sense in a care management model. It is the step towards a medical home model still missing. If you don’t see your agency as a prime mover in the patient care world, then home health won’t make it there. This model includes hands-on care and frontloading like you own the position of prime mover. The continuing education must be something that promotes a care team and forgets the care plans that don’t work! 

We Can Help Get You There:

At Kenyon Homecare Consulting, we have the chronic disease education for individuals and agencies. Call us today at 206-721-5091 or contact us online today. Let’s talk about how online and additional support for your agency from Kenyon can prep you for success today and tomorrow!