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

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Trying To Decide If You Have The Money For New Home Care Start Up? Feel Like Your Head Is Spinning?

Home care start upNo one wants to go into a home care start up barely keeping a head above water. It is important to know what to consider before jumping in head first.  Let’s take a look at how you can begin successfully.

6 Things to Consider In Costs Of A Home Care Start Up:

It takes tine, and consequently, money, to have a home care start up.  Here are the items you need to consider before you hang a shingle and see your first patient.

1. Take A Look At Your Intended Service Area:

This is where you consider a feasibility study and competitive analysis.  If your market is saturated with home care, you will be fighting for potentially a very small share of the market.  You also need to consider if you are rural or urban.  If your costs of mileage and travel time will leave you in the hole every time you make a home care visit, you need to reconsider.  Now, this may mean opening shop in a different location or a unique service that other agencies in your area do not.

2. Legal Requirements To Get Started:

As part of a home care start-up, you will need to establish a Tax ID and NPI number.  You will need to decide whether you wish to seek accreditation.  Being an accredited provider means that the accrediting body will complete the survey process in lieu of a state survey providing deemed status.  Accreditation requires a higher level of quality standard and does have costs attached, but there is always a resource there for you to ask questions.  The accrediting body is there to provide education and help you meet the quality standards.  If you decide to become accredited, you will need to choose which organization to do so.  There is cost attached to working with an accrediting organization, but the initial survey will be completed much quicker than through the state.

3. Licensing Requirements:

Most states require licensure, so the completed forms will need done and submitted to the state.  This will include documents that need submitted with the application and fees are attached.

4. Recruitment and Hiring:

Hiring the right people is time-consuming and costly.  You will need to decide the easiest way to facilitate this process.  Hiring new people means background checks, fingerprinting, payroll management and training.  Once you have been given the green light to provide services, you will have to maintain 10 clients on services for survey to be conducted.

5. Policy/ Procedure Manuals:

Every agency needs policies in place for administrative purposes as well as organizational management.  You also need up to date procedures that include items for the clinical staff like infection control and safety measures.  Client service records will need established with a clear procedure of information management.  Starting from scratch on these is very time-consuming when vendors have established up to date manuals available on demand.

6. Marketing/ Sales:

This may seem like a self-explanatory category.  However, a marketing plan needs to be in place.  You should have a focused plan of attack to get your name out there and achieve successful sales.  Healthcare providers are inundated with marketing from providers.  You need to get your point across quickly and effectively let referral sources know what makes you different and better.

There Is No Need To Do This Alone:

We have only begun to give you some basic steps and they can seem overwhelming.  Let us help you do it.  We have been through this process countless times and helped agencies do it more efficiently while providing guidance and getting you prepared for survey.  Call Kenyon Homecare Consulting at 206-721-5091, or contact us online today for your free 30 minute consultation.



Forget About Six degrees Of Kevin Bacon! Become The Kevin Bacon Of Chronic Disease Education

chronic disease education

You have all played the game.  It is fun and everyone how to play six degrees of Kevin Bacon.  Chronic disease management is especially relevant today.  However, chronic disease education is not a priority in many home health agencies.  Let’s take a look at why it is so important.

What is Typically Taught:

There are standards to what must be involved in training home health aides.  Consequently, agencies do what is mandatory and not always what is necessary.  Everyday, you think about re-hospitalizations.  Nurses try to keep patients out of the hospital because it is detrimental for the patient and the agency.  So, it is pushed with the nurses and therapists, but why not the aide staff?  These employees are the front line to the patient.  Home health aides typically spend more time with the patient than the nurse and therapist combined.  Consequently, the home health aide is not trained to recognize early signs of trouble for the patient.

Seeing The Aide As A Key Member Of The Team:

In entering different agencies, often times a home health aide will refer to themselves as the “bath aide”.  Part of seeing the home health aide as a key in chronic disease management is not boxing themselves into a role that includes “just a bath”.  A good home health aide is so much more than that and certainly capable of more.  Consequently, agencies must also look at the home health aide this way.  Do you coordinate chronic disease education between the aides and nurses?

Better And More Specific Care Planning:

By providing specific chronic disease education to home health aides, the care plans for those patients can be more specific.  Any agency that has been through survey understands how much CMS looks at the importance of patient specific aide care plans.  If your aides don’t see a role more than providing a bath, the aide will not recognize how he or she can help prevent a re-hospitalization.  Agencies that provide chronic disease education to aides as part of the chronic disease management program can improve outcomes.  Nurses need to also understand how to incorporate the aide into management of that chronic disease.  The nurses are integral in care planning so the aide is included in the management of the patient.  Coordination of care between your nurse and aide becomes so important in chronic disease education and management.  Use all of your disciplines to be a part of the team effort.

Let Us Help You Transition To An Interdisciplinary Approach to Chronic Disease:

Now, you have decided to move forward with a full team approach to chronic disease education.  However, you aren’t sure how to make it all fit together.  At Kenyon Homecare Consulting, we work with agencies to integrate a comprehensive chronic disease education program that includes your home health aides.  Contact us today online or call 206-721-5091 for your free 30 minute consultation.

No More Pulling Out Your Hair! A Home Care Consultant Can Help You With The Software Issues That Make You Crazy

software implementationYou are a diligent home care owner.  You went to the sales pitches and weighed the pros and cons.  Now, you feel stuck.  You have either chosen a EMR system and implementation isn’t going well, or you don’t know if you made the right choice.  Maybe, you just want help to make that choice.  Using a good home care consultant who specializes in software can make a huge difference.

3 Ways A Home Care Consultant Can Make Choosing EMR A Much Easier One

The bottom line is when you attend a sales presentation from an EMR company, you always hear the wonderful things it can do.  You never seem to hear that it won’t work in certain scenarios or you can’t really customize the way you want.  Let’s figure out how a home care consultant can help.

1. Choosing The Software That Works For You:

A good home care consultant is well versed in different EMR software.  A home care consultant can look at your internal operations and help you choose software that allows you to continue to keep the same work flow.  Or, you may need to make changes in your flow.  A home care consultant can help you choose software that can optimize work flow.

2. Making Set Up Easier:

Anyone that has been through the set up and implementation process knows it is not easy.  It takes a lot of time and staff effort to program in everything correctly.  Since you don’t get a “do over” if you realize you made a mistake in set up, having a home care consultant keeps you from that costly error.  It will also help free up staff to continue with daily operations.

3. A Key Player In Implementation:

Education of staff is so important when it comes to new software.  Teaching clinicians how to accurately document in the new system is key.  It is key for proper patient care and for regulatory compliance.  The consultant can also help on the back-end with billing and finance to make that transition smooth between clinical and financial.  The alternative is key staff coming up with a teaching in-service.  This takes more time out of their busy schedules.  This is not the most cost-effective way to disseminate the education to staff.  So many times, staff has to tweak and change as they get more experience with the software.  The home care consultant already has the experience with the software, so the changes are minimal or unnecessary.

Don’t Do It Alone:

We have the software experts to help make this process easier.  They have years of experience with software implementation with different systems.  Picking the wrong one is too costly.  So, do what you can to make it easier and correct. At Kenyon Homecare Consulting, we can help you make this big transition. Contact us online or call 206-721-5091 for your free 30 minute consultation.

Documentation And ICD 10 Coding: Why They Are The Danny And Sandy Of Home Care

icd 10 codingWe all remember wishing and hoping for the ending we got in the movie Grease.  Danny and Sandy coming together in the end and our favorite mismatched couple riding off into the sunset.  ICD 10 coding and documentation work the same way.  They must learn how to work together to become that perfect couple.  Let’s look at why the reference to the film fits here.

ICD 10 Coding:

We look back on the simpler time when ICD 9 was around.  Just a few numbers told the story.  Nurses could code themselves, for the most part. Then, the industry is hit with ICD-10 coding and the next level coming with ICD-11.  At first, it may feel like just a way to complicate things.  However, it is a transition to make things better.  Having a better understanding of diagnoses paints a better picture of patient status and should allow clinicians to create more specific care plans.  This is the bottom line.


Reality is, ICD 10 coding cannot be correct and specific if the documentation isn’t there to back it up.  Nurses aren’t nurses because they love to document.  And, consequently, it is sometimes difficult to communicate why documentation is so important for coding and patient care.  If you speak to nurses, many will say verbal report is more important than information derived from the patient’s chart.  Why is that? Well, because most can communicate the nitty-gritty of what the next nurse needs to know much quicker than it is to review page after page of documentation.

Putting It All Together:

Ultimately, the most accurate codes and care plans come from complete documentation.  So, the goal is for the two to paint the picture of what is really going on with the patient.  Look closely at the coding process for your agency.  Do you outsource? Does the outsourcing company give you information you need to improve clinician documentation?  Does the clinical documentation back up the codes on your 485?

Now, if you complete coding in-house you also have questions to ask. Are your coders certified?  What type of check and balance is in place to evaluate efficacy?  Do you, as an owner, know that the documentation in the chart backs up the codes you are billing?  You may have the most dedicated clinicians that take the best care of patients. You may also have really good coders that code according to the documentation they receive.  The goal is that we need to dig deeper.  Look at whether or not the two entities are complete.  We need to analyze documentation to evaluate if those in charge of coding receive all the tools to code properly.

Take a close look at your HHRG codes.  Where do you stand in relation to your state and the nation?  Are they below the average, but the patients need a lot of service.  The mismatch has to come from somewhere.  You may want to complete some side by side coding to see if your coding staff matches an objective outside source.  If so, you can rest easy knowing you are at an optimum coding level.  If you outsource, you may want to have another vendor code to see the same.  In addition, outsourcing companies that do not provide education of documentation mismatches don’t help your agency improve.  There is a lot to consider.

Kenyon HomeCare Consulting:

We can help you look at your documentation and coding to see if you are getting all you need from both.  Our goal is to help you improve patient care by optimizing care plans, coding, and ultimately, reimbursement.  Call Kenyon Homecare Consulting today or 206-721-5091 or contact us online to receive your free 30 minute consultation.  We can do side by side coding and re-code 5 charts for free to see if you are on the right track.

Keeping Your Eye On The Ball: Succeed With A Home Care Consultant

Winning with a home care consultantWhether you are a fan of tennis, football, baseball or soccer, keeping your eye on the ball is key.  A home care consultant is in your corner to help you do that. Sometimes, the key to winning the game is to have right coach by your side.

Get Back To Basics

This world of home health is moving so fast.  Changes constantly happen and you can feel like a fish out of water.  When you own or run a smaller agency, it is very common for administration to wear so many different hats.  Things can easily slip through the cracks.  The saying that you can’t be all things to all people could not be more true than in home health.  Let’s look at a few ways a home care consultant can help to keep your eye on the ball and the trophy in your hands.

1. Education:

Making sure staff is educated towards regulations, goals, and documentation is hard.  There is staff turnover and different levels of learning.  You have staff that are big picture people and those that don’t see what does not affect the day-to-day for them.  How do you reach everyone and keep the focus where it needs to be?  Being a positive change agent and teaching tool is a huge part of what a home care consultant can do.

You may need help implementing regulatory changes.  A good home care consultant has worked with many agencies to implement changes and make sure that you are survey ready.  Whether there are big changes like the COPs and Emergency Preparedness or small changes that are specific to your agency, a consultant can make the job a whole lot easier.

2. Financial Issues:

An experienced home care consultant knows how to thrive in the environment of decreasing margins.  Drilling down to specifics in financial data and where your agency varies from others is important.  Working directly with your agency on costs per visit/ episodes and overhead can make a difference from being in the black versus struggling in the red.  Sometimes, you have tried many things to change costs and it has not been successful.  A good home care consultant is a true agency for change and can help you come up with the solution for your struggle.  Mother Teresa was once quoted as having said, “No margin, no mission”.  This is so true in this world of home health.

3. Documentation/ Clinical:

Documentation is always an ongoing struggle.  There is a fine line between documenting enough and documenting too much.  We try to make sure our clinical records have everything needed to paint a picture of what is going on with the patient.  However, making sure there is not double documentation or parts in the record that conflict with one another is difficult.  Nurses become nurses to take care of people.  No administrator ever says nurses love to be in home health because they get to document so much.  Streamlining clinical data whether it is an EMR or a paper record is important for patient care and compliance.  Working with nursing, therapy, and paraprofessional staff to reach common documentation goals is all part of what a good home care consultant does.

Pulling It All Together:

We have just talked about a few ways a home care consultant can work to improve your agency operations, but there are many more.  If you are interested in home care consulting contact Kenyon HomeCare Consulting either online or call 206-721-5091 today for your free 30 minute consultation.

6 Remarkable Advantages To Interim Management

Interim ManagementIf your home care agency is in a major staff change, this can cause some panic. Losing employees is never easy, whatever the reason. Fortunately, the transition can be smoother with interim management (IM).

Reasons For An Interim Change Manager

What’s the benefit of management over immediately hiring your new permanent manager? For one, hiring takes time. Rushing the process increases the chance you may just hire someone instead of the RIGHT one. Interim managers fill gaps during your search, but accomplish so much more.

1. Fresh Perspective On Growth Strategies

Using an interim manager is a lot more than filling a void.  It can provide a comprehensive and objective organizational assessment. Often, it’s difficult seeing challenge when it hits close to home. An unbiased evaluation often leads to new ideas for running more efficiently.

2. No Disruption Of Business Operations

The last thing you want when a manager leaves is for agency operations to slow down, become chaotic, or stop altogether. A temporary manager continues business as usual without interruption.

3. Assistance With Finding And Training The Right Person

As mentioned earlier, the hiring process is time-consuming; it can also be stressful. Wading through applications, holding interviews, choosing the right candidate—all things IM can help with.

4. Reduced Staff Overwhelm

What happens to workload when an employee leaves? Usually, it is in the hands of remaining team members. As a result, employees become overwhelmed. Hiring an interim manager prevents staff burnout as the interim manager takes on (or more efficiently delegates) that extra work.

5. Continued Client Satisfaction

A priority when running a home care agency is client satisfaction. The level of care provided to clients is integral for a thriving agency. Instead of client care slipping because of overworked employees, hire an IM so staff can continue providing the best care possible.

6. Stress-free Transition Time

Let the IM handle certain responsibilities for you because you’ve got enough on your plate.

Finding The Best Interim Manager

At Kenyon HomeCare Consulting, our Interim Management program helps facilitate success in the midst of change. Our consultants are experienced, well-trained, and knowledgeable. Reach out to us to learn more.

Conquering Chronic Disease Education Is A Team Approach

Chronic Disease Education TeamworkHealthcare today is all about increasing patient satisfaction while achieving quality outcomes and decreasing costs.  Chronic disease education is such a big part in doing so.  You team up with other providers.  Have you noticed that sometimes our own disciplines don’t work as a team?  Let’s look at how a “We Are Marshall” approach to a home care team makes a difference.

Current Chronic Disease Education:

How often do your disciplines talk about patient status and care?  If a nurse goes into a home and discovers a change with a patient, does that nurse report to the therapist and aide?  Does the nurse report to the supervisor and then it is reported to the therapist, aide, or social worker?  Maybe, it probably isn’t done all that much.  Too often, disciplines have tunnel vision and do not collectively consider all care.  Is your chronic disease management program doing what you want it to do for patient care?  Here is why chronic disease education needs to be for all staff and not just nursing. Clinicians all need teaching on chronic disease.

1. Home Health Aides Need To Be Key Players

Processes in agencies many times consist of the nurse doing teaching according to a disease management protocol put in place.  The nursing staff are educated on the need to properly manage “The Big 3” as these are the majority of healthcare costs.  However, aides are just as important to that process.  Often times, the home health aide spends more time overall with those patients than the nurse and therapists combined.  Without chronic disease education for aides, a key to catching early signs of trouble is lost.  If a nurse doesn’t hear about changes in patient status until the situation is urgent, it may be too late to avoid an ER visit.  The aide need to know what early signs cause issues to know how quickly to act on it.

2. Rehab Staff Is Not A Separate Entity

After many years in this business, all too often therapy functions independently and from a care plan specific to them.  Although CMS wants care plan interventions to be addressed throughout all disciplines, this often times is not the case.  The goal is rehab staff functioning towards the same goals as nursing and vice versa.  Therapy goals need to address chronic disease where it is appropriate.  However, if chronic disease education is not ongoing with therapy staff, early intervention has a big chance of being missed as well.  The processes must overlap between disciplines.

3. There Is One Patient And Ultimately One Careplan

The one patient, one careplan model is not new.  However, it is not always in practice.  A true case management model should not be nursing, therapy, and aide service as different entities.  In contrast, agencies need to look at is as one patient who we are providing care in multiple different ways.  The goals are the same and the interventions should flow from discipline to discipline as appropriate.  Nursing should run through home exercises while in the patient home for a scheduled nursing visit and address the items therapy reports are of issue.  Therapy should be recording what blood sugar readings have been for the unstable diabetic patient.  Therapy should know what the target goal for that patient is and what should happen if the patient is not within range.  Many times, monitoring isn’t there.  As an industry, we can no longer say that something is the job of the nurse, or therapist, or aide. Ultimately, it is the patient’s careplan and there is only one of them.

Home Care StartupWhere To Go From Here

If you want to look at your chronic disease education and how to improve your process, Kenyon Homecare Consulting can help.  Contact us online or call 206-721-5091 to schedule your 30 minute free consultation today!

5 Signs You Should Invest In A Home Care Consultant

Home Care ConsultantHiring a home care consultant may not be something currently in your mind.  However, if you are struggling, you may want to see if you should.  Sometimes issues are across multiple departments and can be difficult to change.  Take a look at signs you may need a good home care consultant.

5 Reasons You Need A Home Care Consultant

When examining your agency, these are 5 reasons you may need a home care consultant to right the ship and get you moving in the right direction!

1. Clinical Issues:

We all know this is huge.  Without reaching clinical outcomes and goals, agencies can’t thrive.  The struggle will be ongoing and can be overwhelming.  You may have issues with Oasis accuracy.  It may be follow through in the home.  Processes may not be where they should be to meet positive outcomes.  Clinicians may need additional training to meet the quality measures expected in home care today.   A home care consultant can help develop the strategic plan and move the agency forward with education and updated effective processes. This allows you to function at the optimal clinical level and know how to keep your agency there.

2. Software Struggles:

Software is made to function with the workflow developed by the software programmers.  A big mistake made by agencies is believing that all software is malleable to every individual work flow.  This is not the case.  Sometimes, agencies have struggles from the beginning because the software doesn’t fit work flow.  There are home care consultants that deal heavily in working with agencies to choose and implement software that works well with that individual agency.  Every software will say it can work with your agency, but you need to understand that you may have to change dependent upon what you choose.

3.  Financial Issues:

Every year, it seems like agencies have to work with less and less of a margin.  Regulatory mandates require more and more office staff that cannot generate revenue for you. This is so common that agencies work in the red when it comes to many payer sources.  Sometimes, it is easy to diagnose the problem, but not easy to develop the solution.   Whether it is inefficiencies clinically, AR, Billing, or turnover, finances are hit.  Working to drill down costs and develop solutions are in the financial home care consultant wheelhouse.  Instead of cutting pennies to lose thousands, let the consultant find a true solution.

4. Staffing Issues:

Staffing is often the reason administrators can’t sleep well at night.  Maybe there are multiple nurses or billing staff on medical leave.  That leaves you often asking people to put in long hours or wondering how to cover all your patients.  It’s tough sometimes.  Maybe, an influx of work has come to the agency and you quite simply don’t have all the clinicians you need.  That isn’t the worst problem to have.  However, it you don’t fix it quickly, those extra referrals will go elsewhere.  So, you are struggling to get the additional staff you need.  All these are issues that can be addressed with a home care consultant.  Sometimes, hiring can be tricky and incentives are needed.  Sometimes, benefits have to be reassessed.  Look to a home care consultant to help you conquer staffing and with real solutions to the problem.

5.  Role Changes:

Do you ever find yourself promoting staff who were amazing in a current position, but not in the new role.  Sometimes, we take the best clinicians and promote them to supervision.  While being wonderful in the field, transitioning into a supervisory role can be a whole different story.  The best nurses don’t always make the best managers.  This is something to really think about when you promote staff.  The same can happen within finance or clerical staff.  Once roles change, that employee may not be comfortable where they must hold others to a level of accountability.  Working with staff through those transitions can be tough.  A home care consultant can work side by side with new administrators and supervisory staff to transition into new roles effectively.

Let Us Make It Easier

Home Care StartupThese are just a few things where an agency needs to consider a home care consultant, but there are many more.  Contact Kenyon HomeCare Consulting  either online or call 206-721-5091 to receive your free 30 minute consultation.

Strategies For Educating Staff On ICD 10 Coding

ICD 10 CodingCoding education is as important as coding itself. With lots of ICD 10 coding updates, you cannot fall “behind the 8 ball” on staff education. Remember when ICD 10 coding started? Industry experts said all staff, not just coders, needed to learn the new system.

Options For Training And Re-training Your Homecare Staff

Whether updating on ICD 10 coding changes or Oasis, staff education is key. Some options for staff training include:

  • Regular staff meetings/ announcements and basic procedural training.
  • Hands-on practice coding sessions.
  • In-depth education on documentation for clinicians and coders
  • Distance education on coding, documentation, OASIS, and other related topics.
  • Developing your own “arsenal” of high-quality training and staff education tools.

Lighten The Training Load By Outsourcing ICD 10 Coding

Education and re-training staff is ongoing. Documentation will always be a part of client care. Outsourcing coding reduces the training load.  You will no longer have to keep in-house coders up to date or train new hires. Your outsource partner can take care of it for you. Outsourcing ICD 10 coding can produce extra revenue. You can reinvest the savings in training nurses and other staff. Staff will have more time for client care.  This, as a result, can lead to happier and loyal staff members. This also improve client care, agency’s reputation, client retention, and new growth.


Staff education helps your homecare agency provide better care.  Correct coding paints the picture of client needs. Consequently, it will improve revenue and cash flow when done efficiently. Investing in coding education is one path, while outsourcing is another. Each homecare is different, so the solution will vary. To learn more about coding and staff education or coding outsourcing services offered by Kenyon HomeCare Consulting, contact us via our online form.  You can also call 206-721-5091 today for your free 30 minute consultation.


Be Prepared To Hear This From A Good Home Care Consultant

Home Care ChangeA lot of things have been written about the positives of a home care consultant.  The knowledge and experience working for themselves and with other agencies can help with all aspects of your business.  Take a look at things you should be prepared to hear from them as well.

Four Things You Will Likely Hear From Your Home Care Consultant

It’s show time.  You made the commitment to have someone come in to be an agent of change.  Being new to the process, you may not know what you will hear.

1. The Successes Of Your Agency

The reality is you brought someone in because you care enough to be the best you can.  Focusing on what is positive allows you to expand on what is already good about your business.  Someone objectively recognizing what you do well can consequently be motivational for staff.

2. What Is Not Running Smoothly

Look, it is often difficult to really drill down to what is happening in your agency.  You live it.  You are so close to it.  It’s your baby.  However, sometimes seeing the flaws are tough.  A good home care consultant can help you understand what isn’t running well and therefore provide tools to progress.  Those tools are not a judgment of the way you do things.  They are years of experience spent with agencies of all kinds working to help impact successful change.

3.  Staffing Changes That May Need To Occur

Home Care is becoming more and more comprehensive.  This is no surprise because you do it everyday.  The complexities, the regulations, patient requests, documentation issues and more happen on a daily basis.  You can have really good employees that are dedicated to your mission and agency.  Those same employees may not be in roles that allow them to excel or your agency to prosper.  Sometimes, you have to look closely at what roles need tweaked because it will improve operations.  Health care is constantly changing.  Job roles have to progress and move with it in order to remain successful.

4.  Software Issues

We all know that no software is perfect.  They can all have positives and negatives.  However, the wrong software can cripple you financially.  This doesn’t mean you throw out your software because implementing is costly and time-consuming.  You don’t want to jump from system to system never really finding the fit.  A good home care consultant or company evaluates your system and determines if others are more compatible with your operations.  Each system is made to work the best using a particular work flow.  They are made to work that way and trying to change the work flow may cause you so much more time and money.  Pick your software compatible with your work flow or be willing to change how you do things.

Let Us Take A Look

Kenyon HomeCare Consulting is here to help you succeed.  Whether you want an organizational assessment, clinical education, or to implement change, we can help.  Contact us online or call 206-721-5091 for your free 30 minute consultation.