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

Kenyon Connects

In Chronic Disease Education, Don’t Forget Your Contracted Therapies. Without Making Them A Part Of The Disease Management Picture, Outcomes Will Suffer.

changeLike many agencies in the United States, you may use contracted therapy services.  It is very important that contracted services are considered no different than employees when it comes to education.  Let’s look at why your chronic disease education is worth the investment to contracted entities.

Promoting Partnerships:

This is a day and age where partnerships are vital to home health survival.  If you do not invest in your therapy partnerships, then how do you they become invested in your success? Chronic disease education can be key here.  Anything that makes your own staff better will also make your therapy better.  So, it only makes sense to extend your educational process out to them.  It allows them to receive better information in caring for patients and will promote communcation with staff.

Streamlines Careplanning:

In chronic disease education, there needs to be a multi-disciplinary approach to patient care. Meaning, all disciplines need to work towards the goals of the care plan.  Interventions are going to be different between disciplines, but the majority of the goals should be universal.  This is where the industry still struggles.  When you work with contracted staff to understand the link for all disicplines together, a visit from a therapist is more than a home exercise plan.  It becomes a coordinated effort to address what is truly meaningful to patient outcomes.

Improves Coordination Of Care:

Your disease education and management program allows the therapists to work proactively with aide staff too.  A contracted therapist may not even feel like the aide has anything to do with them. When, in reality, the therapists can provide specific coordination to improve the content of aide visits as well.  If your therapy staff are part of chronic disease education and your chronic disease management, it will enhance all levels of service.  If therapy staff needs for specific education to be reinforced, nursing should be doing that on visits.  However, if contracted therapy isn’t involved is disease management, it won’t happen. Whether it is something specific to therapy or something nursing needs to have therapy address, coordination of care is more than report.

Patient Outcomes:

If everyone functions toward the same goals, then outcomes will improve.  Goal specific interventions completed by all discplines increase the chances of success.  Whether you are part of an ACOs or looking to join one, the outcomes are key to getting referrals. If you don’t see state and national averages on your functional status improvements, you need to take a hard look at your teamwork with therapy.

Ok, So How Do You Make It Happen:

Kenyon Homecare Consulting can help you on chronic disease management and how to shift your agencies work flow to improve outcomes between disciplines. Call us at 206-721-5091 or contact us online for your free consultation.

Are you Ready For Your Home Health Survey? Here’s Why A Mock Survey From A Senior Consultant Can Save You Money And Headache In The Process Of Figuring Out The Answer!

regulatory complianceThe Conditions of Participation have been in full swing for a little while now.  However, those in the process of being surveyed with the new COPs are finding out it is tougher.  Let’s look at why is makes sense both financially and from a compliance standpoint to have a home care consultant mock survey your agency prior to the real thing.

Changes That Can Can Cause Problems:

As an industry, when something allows more flexibility on the part of the agency, it seems like a good thing.  However, this can be where mistakes are made.  Here are a couple of things that are misinterpreted and cause citations:

  • Supervision Of LPNs And Rehab Assistants: It is no longer listed in the COPs as required by a specific timeframe.  Agencies often misinterpret this as no longer being necessary.  The difference now is just that the agency determines the frequency.  If you don’t have it listed in policy as to how often and how you complete the supervision process, then you are out of compliance.  There still needs to be a standard to your supervision and it has to make sense.
  • “Record Review”: Agencies may have jumped up and down at the idea that a formal “record review” process quarterly was no longer required.  If you don’t review the records, how do you know if you meet standards of practice? If you don’t look at medication reviews, intervention completion, or visit frequency, then how do you show compliance? There still needs to be a format in your QI that shows you have ensured the quality of the care is being met and measurement is relevant to your agency.  Again, the timing of how often you review for compliance is what has changed here.
  • No More Margin Of Error: In the past, an agency was allowed a margin of error. Now, one chart missing an order or one aide supervision missing can cause the citation.  This is huge for potential of multiple site visits.

How Does A Mock Survey Save You Money?:

Ultimately, whether or not you are looking at state survey or accreditation, a mock survey goes a long way in getting your compliance into shape prior to survey.  A senior home care consultant will approach your agency like the surveyor would.  Giving you detailed information as to where and where you don’t meet the regulations.  These items can be corrected prior to survey and allow the actual survey to become less stressful.  It is not new that less citations mean decreased risk for re-survey. Additional surveys mean additional plans of correction and more time of office and clinical staff to complete the certification process. This is expensive for an agency.

Let Us Help You Get Ready For Survey:

Whether you need help with a new accreditation or need someone to make sure you are compliant ahead of survey, Kenyon Homecare Consulting can help! With a home care consultant who has experience with CHAP, JCO, and ACHC, we can help make the process smoother and get you survey ready.  Call us today at 206-721-5091 or contact us online to set up your free consultation.

Chronic Disease Education: If You Consider It A Work In Progress, You Have a Much Better Shot Of Crossing The Finish Line In First Place!

WinningThe title of this article may seem like a contradiction.  How can you always be a work in progress, but still cross the finish line? In home health, the industry and operations are continually changing.  Since this is the case, why does the majority of the industry approach chronic disease education like a class as opposed to a process? Let’s look at why chronic disease education needs to be on a continuum for your agency.

Nursing Roles:

As the industry evolves with the rest of health care, the role of the nurse continues to get bigger. Nurses have so many things to document and address with patients that the role becomes less of a skilled clinician and more based on tasks. If the pendulum swings too far towards the task aspect of operations, then disease management with true outcome improvement gets lost. You need to consider all skilled disciplines for what is within scope of practice and utilize it to achieve goals.  Chronic disease education as a process between disciplines working toward a one patient, one care plan model will move the pendulum in the right direction. Nurses need to case manage, not be responsible for every detail.

Chronic Disease Education To Every Discipline:

Often times, agencies teach disciplines on chronic disease at hire.  Aides learn the very basics. Nurses are taught chronic disease by showing them how your agency policy relates to chronic disease management.  Therapy may not even play a role in chronic disease management.  It can be confusing to clinicians.  Plus, if you function this way, then everything continues on the shoulders of the nurses.

Any education given to staff must be applicable to day-to-day patient care.  It needs to include how the roles of each skilled clinician work together as a piece of the puzzle.  If disciplines don’t know how each other fits in the puzzle, then it only makes sense that the program won’t work as well.

Chronic Disease Education On A Continuum:

Managing chronic disease is ongoing education and processes that are part of quality improvement.  Old or unchanged approaches with limited outcomes need changed.  Case conferencing is so often under-utilized between disciplines.  True effective case conferencing involves the flow of information as a constant driver towards functional goals and outcomes. Is this where your agency falls short? “Report” is not a case conference.

If your chronic disease education program focuses on outcome management and functional goals, it will be ongoing.  You will address your program as you monitor outcomes.  Education will become more frequent and you should definitely be hearing how your agency works together.  If you pull the therapist, the aide, and the nurse together, would they all have the same goal for the patient? If there is a one patient, one care plan model there should be.  More importantly, there can be.

We Can Help Your Chronic Disease Management Program:

Kenyon Homecare Consulting offers chronic disease management teaching and can help with program development. Call us at 206-721-5091 or contact us online today for your free 30 minute consultation.

What’s Really In ICD 10 Coding? Let’s Pick Your Clinician’s Brains To See Their Perspective. Will It Be The Same As What You Think?

Ask StaffIn the world of ever-changing home health and hospice, clinicians have so much to put together.  The pieces of the home care puzzle can often leave clinical staff feeling like a mouse in a maze.  When you consider ICD 10 coding, it needs to be much more than some numbers on a piece of paper.  To get the most from your coding solution and your care plans, you need to assess how your clinical people view those codes as a part of care.

How Do You Assess Clinical Perspective Of ICD 10 Coding?:

That is a loaded question. You have to talk to skilled disciplines about what different diagnoses do to change a care plan.  Whether it is a nurse or a therapist, the pathophysiology behind the diagnosis is very important in determining the care plan.  If the specificity of the diagnosis is not considered when clinicians work with patients, then how do you optimize a care plan? You really can’t. A knee replacement is not the same care plan as a knee replacement for someone with a history of uncontrolled diabetes. If that seems basic to you, it may not be in what you see in a care plan.

Here’s A Challenge For Your Agency:

Consider the example in the previous paragraph and find different charts that would be comparable to it.  Then, compare the care plans.  There should be a difference in how the patient is assessed and interventions are carried out based upon the addition of that chronic disease.  It needs to be more than just recording a blood sugar.

Now, compare several charts that both have knee replacements with diabetes.  Can you tell the difference in those or do the care plans mirror each other?  Can you tell the difference between patient “A” and Patient “B”?  If the answer is no, then clinicians need to dig deeper into making the care plan fit the diagnoses specific to the needs of the patient.

How Does My ICD 10 Coding Fit In To Make This Better:

Your coding solution and care planning can be a well-matched couple if you structure the two working together as a team.  The silo of coding to clinical is problematic.  A well-trained certified coding expert who also is certified in Oasis or as an Oasis instructor can make a big difference to bridge that gap.  Your Director Of Nursing or Supervisor can work directly with field staff on taking the information from the coder into the next level of care plan development.  You know why the two are so important, but make sure your field staff are on the same page.

Let Us Help Be Part Of Bridging The Gap:

Whether you outsource your coding or have certified coders yourself, Kenyon Homecare Consulting can help bridge the coding and clinical portion together.  If you would like us to become your ICD coding solution, call us at 206-721-5091 or contact us online.  We can be your entire solution or bring the educational support to improve your current system.

Extra! Extra! Read All About it! Why A Home Care Consultant May Be Exactly What Kind Of A Friend You Need In Business.

Home care consultantHealthcare is in an age of collaboration and transparency between providers. However, it is also very competitive.  So, there is often a tug-of-war between fighting for referrals and working well together.  Let’s take a look at a few ways a home care consultant can be the guidance you need to increase referrals and still work well with partners.  A senior home care consultant has years of experience and works with agencies all over the country.  This means perspective outside of just your own geographic territory.

Struggling With Referrals?:

This is a tough thing sometimes.  As part of the industry, you are accustomed to the ebb and flow of referrals.  But, reality is you may often spin your wheels to get the referrals you need to stay afloat.  A home care consultant can help with creative marketing to increase your referrals.  If you are trying to get the referrals the same way every other agency is, then how do you differentiate yourself from the rest? Maybe you aren’t.  A home care consultant can help set up a strategic marketing plan for your agency.

Episode Management:

As administrators, it may seem difficult sometimes to bridge the financial with the clinical.  Medicare margins should allow your agency to function in the black, but this is often not the case. All clinical disciplines need to work in conjunction to not make unnecessary visits. Although this is not a new concept, it is something agencies struggle to do.  Working with a home care consultant can help you bridge that gap and create appropriate visit structures based upon clinical data.

Staffing Management:

Staffing and personnel is a very time-consuming effort for administration in home care.  It is crucial to have enough staff to manage patient care and day-to-day operations, but it is a fine line between not enough and too much.  Home care consultants work with so many agencies to develop efficiency standards appropriate to the patient case mix. Sometimes, the outside source providing the information after reviewing clinical data can help to justify the adjustments to staffing you need.  A senior home care consultant can also be crucial in times where an interim manager is needed.

Strategic Partnerships:

In this world of ACOs , strategic partnerships are so important for long-term viability.  A senior home care consultant can help develop partnerships and help you through becoming the partner everyone wants. Again, with the experience with agencies from all different locations, the perspective is different from just working with one organization.

Helping You For The Long Term:

Kenyon Homecare Consulting has been in the homecare industry for decades.  The goal of the organization is to help you through your immediate need and be present for the future. We have only given a few examples of ways a home care consultant can help you, but Kenyon is comprehensive and able to help with any aspect in the home care spectrum.  Call us at 206-721-5091 or contact us online for your free 30 minute consultation today.

The Minute Your Home Care Agency Quits Learning Is The Minute You Begin To Lose Your Edge! Always Keep Ahead of The Game.

EducationHome care has always been an industry where you have to look forward.  Whether it is patient care, regulation changes, or the job market, home care is always on the move.  Education in the industry is no different.  As CMS focuses on chronic disease education and management of care through ACO’s, agencies must be in a constant state of learning.  If you aren’t learning as the industry changes, then your long-term viability is at risk.

How To Know If Chronic Disease Education In The Agency Works:

Manage your outcomes.  That means, really manage your outcomes.  These should not be a numbers given in a dissertation to staff on a quarterly basis.  That just becomes about numbers on a spreadsheet.  Look back over when you began to focus more on chronic disease education or when you initiated a new disease management protocol.  What improvements did you see in outcomes?  Were the numbers satisfactory? Do you see that numbers improved only to level off or decline.  If this was identified, then what was done after that to give improvement another boost?  If you say it was reported to clinical staff and that is it, you have to do more.

How Do You Keep Chronic Disease Education Relevant?:

The point of chronic disease education is not memorizing symptoms or pathology.  It is about changing the behavior of the clinicians and the patients.  You want clinicians regardless of discipline to address disease management proactively. Task oriented visits are a thing of the past. A visit cannot be about completing a task and leaving the home.  So, this means that chronic disease education must focus on how to change outcomes on an ongoing basis.  Teaching the patient is also different.  The education provided to patients needs to focus on early detection and intervention as well.  This may seem like a common sense statement, but it means a lot more.  How often do staff go into a home and teach a patient with CHF 5 things to report and then leave? Visit is documented and all the boxes are checked. Does that patient really have any better understanding of how to manage chronic disease than he or she did prior to that visit? Make teaching about something that changes the day-to-day with the patient to understand what is happening.  If a patient has had CHF for a long time, rattling off those 5 things is nothing new.

Make Your Chronic Disease Education Comprehensive For All Clinicians:

Everyone who sees the patient has to see why the visit is not about checking the boxes and more about relevant patient change for your program to be effective.  You clinicians need to understand the numbers in your outcomes. It is also important to know that interventions need to focus on what will change daily life for the patient.  All clinicians need to have that focus when they enter a home.  Patients need to understand where you are going with the care plan.  If the patient understands that you are there to do more than a task, the majority will want to reach that goal.

Kenyon Homecare Consulting Can Help:

At Kenyon Homecare Consulting, we have seasoned consultants what work with you to achieve your long-term goals.  Call us today at 206-721-5091 or contact us online to see how we can help you achieve your goals!

Are You Making Sure You Are Good Enough Now Before ICD 11 Comes At You Like A Ton Of Bricks? Streamline Your ICD 10 Coding So You Are Prepared.

Coding AccuracyRemember when ICD 10 coding hit?  Wow, what a huge change for clinical as well as coding staff.  Since the industry is not far away from ICD 11, make sure your ducks are in a row now.  Functioning well in ICD 10 coding will make everything easier for the transition.

What? ICD 11?:

ICD 11 is the next update from the World Health Organization in diagnosis coding.  It has been years in the making.  The timeline for implementation is January, 2022.  This may seem like forever away, but the industry is almost a year into the new COP’s.  It is just around the corner.  It is important to look ahead to what is coming with the changes in the coding system to know how it will impact your agency.

Are You Good With ICD 10 Coding?:

We have spent a significant amount of time writing about the importance of doing ICD 10 coding right. Coding and documentation are important from a regulatory standpoint, but the financial is just important.  Your agency should never leave money on the table for the care you provide.  You earn those dollars.  If your documentation is there and you don’t code properly, you can easily lose hundreds of dollars per episode.  Claim the money your agency is entitled to receive.  Now, if you don’t know whether or not you are on target this way, you need to find out.

How To Evaluate:

There are many ways to keep your agency up-to-date on in-house coding practices and here are just a few:

  • Provide ongoing education including resources to your coding staff
  • Do a side-by-side comparison with staff coders with an outside source
  • Certify your coding staff
  • Tighten your documentation guidelines with clinical staff; make sure all clinical data is there
  • Educate clinical staff on coding where coding guidelines and clinical documentation meet; Connect those dots in a clear way

What If You Currently Outsource?

The guidelines on being up-to-date don’t change regardless of whether or not coding is done by your staff.  Your outsourced coding provider should be able to communicate what resources are used to keep coders functioning at a top-notch level.  Side-by-side comparisons are still a good thing.  It is not uncommon to see that one type of service is not equivalent to another.  You may think your provider is doing well only to see you are not getting your money’s worth.  Your documentation guidelines to staff still need to be clear and the dots connected.  If you do not see clinical documentation improve with coding and Oasis review, then internal education is needed.

Kenyon HomeCare Consulting Can Be Your Help!:

At Kenyon Homecare Consulting, we can be your side-by-side comparison or your full coding and billing provider.  You may just want additional teaching online to staff from the coders that connect the dots between clinicians on a daily basis.  Call us at 206-721-5091 or contact us online today to see how we can help make sure your ICD 10 coding is ready to move forward when it is time for ICD-11!

Are You Looking At A Home Health Specialty Service? Here Are Some Things To Consider Before You Jump In With Both Feet!

specialty servicesOK, so here you are in a world of specialty services in healthcare.  You want to make your home care agency stand out, but maybe you aren’t sure exactly which specialty to provide or the best way to begin the process.  Let’s take a look at homework to do prior to determining your niche’ service.

5 Things To Consider In Adding A Specialty Service:

In any specialty service, time and consideration are necessary to be successful.  Adding specialty services before checking these 5 things is like jumping in the pool without dipping your toes in the water first!

  • Competition: How many in your service area can provide this? It is great to add a service to make yourself more marketable, but not when there is already market saturation. You need to pick the right specialty for your area.
  • Program Development: Do you have the staff and time available to them to develop a specialty program within the organization.  It takes time.  If not well constructed, staff will be frustrated.  Then, it is tough to gain buy-in from your own clinical people.  You must make the goals and procedures involved in the program clear and work through changes when necessary in a determined process.
  • Patient Population: Dependent upon the specialty, you need to consider how many cases you will potentially receive from adding the service.  You want an agency that meets the needs of the community. If you can’t forecast a patient population from the specialty, then it doesn’t make sense.
  • Marketing: Your marketing staff need to understand the program well to communicate it properly.  This is key for any of your home care services, but especially when it comes to making a niche’ for your agency.  Other providers need to know how you can make things better for their patients and for their process. They need clinical people to help with promotion until they are able to confidently present the program.
  • Financial Investment: Just like anything in your agency, it costs money.  Do background on the cost for your agency.  Remember, this does not just include the training of one nurse in the specialty. It includes all costs associated with all the bullet points represented here.

 Now, You Are Ready To Add A Specialty Service; What’s Next?:

At Kenyon Homecare Consulting, we can help with an organizational assessment that can focus based upon your goals of adding specialty services.  Call us at 206-721-5091 or contact us online to set up your free 30 minute free consultation with a senior associate.

How Do You Even Begin To Tackle Chronic Disease Education? Why Online Education Can Eliminate The Bumps In Your Agency And While Working With Other Other Providers!

So, if you have been looking for how to improve your agency processes, then you have inevitably considered how you handle chronic disease education.  It is at the forefront of outcomes as well as episode management.

Why Online Chronic Disease Education?:

There are so many approaches to educating staff and standardizing information given out is key.  Now, if you consider how any classroom works, then you understand that the flow and information disseminated can vary.  Class size, questions, individual competency in the material, and time all make a difference.  Ask any experienced professor or teacher! The main concepts are always the focus, but things can branch to multiple relevant topics and change the overall course of a lecture.

When you consider these items, online education allows for staff to all receive the same information.  It is presented the same way and with questions being addressed collectively. It also allows administration to determine where knowledge deficits continue to exist after receiving the training.  Standardizing your chronic disease education becomes very important when striving to speak the same language within your organization.  It also allows you to better determine what your quality improvement program needs to focus on if everyone approaches the management of chronic disease the same way.  The flow from the classroom to the patient home needs to remain consistent.

Can Home Care Really Standardize?:

From day one, home care has been different that other types of providers.  So, standardizing how we function becomes tough when home care doesn’t exist in a controlled environment.  Right? Each patient has a different home situation and it has to be considered when a plan of care is created.  In order to succeed in provision of chronic disease care, these things have to be considered.  So, your internal programming considers patient variables while your education remains the same.  This is how you standardize.  Make sure all clinical staff are involved in the process.

How Does This Help With Outside Providers?:

Chronic disease management is something all providers deal with regardless the venue. So, if all types of providers focus on a standard approach to education, then everyone can be taught the same.  If you, the local hospital system, and SNF use the same educational tool to include staff in chronic disease management, then each can care planning similarly.  This allows the patient to transition to a different level of care without changing the  focus of each individual discipline.

We Can Help With The Transition:

At Kenyon Homecare Consulting, we have chronic disease education to help move staff in the right direction.  Call us at 206-721-5091 or contact us online for your free 30 minute consultation today.

Does Your ICD 10 Coding Need A Check Up? Why A Scheduled Side-By-Side Comparison By An Outside Source Can Tell You So Much!

back upToday, if you know how important a back-up plan for ICD 10 coding in your home health agency is, then you also know how important it is to consider the right one for your agency. Let’s look at some simple factors and why you need to pick the outsourced company that best works with your home care.

5 Things To Consider When Choosing Your Back-Up Or Full Coding Provider:

There are reasons why all home care companies are not created alike and the same rings true for coding solutions.  Here we take a look at the important things to consider in ICD 10 coding outsourcing:

  • Education: Consider the requirements you have for your own coders.  Make sure you look at companies employing only certified coders.  How do the coders keep themselves educated on changes?  These are questions your provider needs to answer before you sign on board.
  • Oasis Training: Oasis training is not only a necessity, but consider whether or not your coders are certified in Oasis.  Are they certified to instruct in Oasis?  This type of credibility in knowledge of the Oasis tool is important.  It not only justifies the knowledge base of the coder, but the ability to communicate with the clinical staff who complete the Oasis in the home.
  • Experience: You know that home care is in a whole different world than other types of healthcare.  If you want someone to be your back-up coder or outsourced solution, then you need someone who knows how to code specifically for home care.
  • Format/Information Provided: Reality is, not all ICD 10 coding formats give an agency the information they really want and need to make the staff better.  Your coding solution should make your clinicians better at filling out Oasis properly.  The report you receive from ICD 10 coding should provide teachable information for clinical staff.  You should see changes in error rate decline over time.  If you don’t, then you need to figure out why.
  • Ability To Teach Clinical Staff: You may not be a clinical administrator and need an objective teacher for your clinical staff.  Those coding solutions that have certified Oasis instructors can be invaluable to your ongoing educational needs.  These coders can provide one-on-one, class based, or online learning solutions to advance your clinical staff.  If you are a new start-up, then you may want to have those certified coders go on-site with clinical staff as admissions are completed.  This allows education to be patient based and not just in the classroom.

Let Us Help Be Help Your ICD 10 Coding Program As The Solution Or Back-Up:

At Kenyon Homecare Consulting, we can complete any or all your coding needs.  Our coders are certified and we have Oasis Certified Instructors.  Call 206-721-5091 or contact us online to receive your free 30 minute consultation with a senior associate.