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Help! Does It Feel Like Things Are Falling Apart At Your Agency? Now Is The Time To Let Interim Management Jump In The Deep End With You!

interim managementThe homecare industry is facing another big change with PDGM in 2020. As you revisit your current strategic plan, did you make goals to get ready for it? If not, then there is still time. You may feel so busy that fitting in changes seems impossible. Let’s look at how interim management can get you where you need to be! 

PDGM And Interim Management: 

While working through day-to-day operations, it can seem very overwhelming to initiate and educate on payment reforms. It becomes even more difficult when those changes also deal with a paradigm shift for clinical. As an administrator, you want staff to understand changes and operate efficiently. However, there is a fine line between enough and too much information. Clinical staff do not want overloaded with data that doesn’t impact how they work on a daily basis. For those of us who work in operations and administration, it goes hand-in-hand. So, the point is that you must make it relative to what they do. If you think this is a tough thing to put together with everything else you are trying to accomplish, then consider interim management.  

With the implementation of IPS/PPS, so many agencies went out of business. This is a reality moving into PDGM as well. There is a way to be prepared. Yes, it will cost you time and money, but much less than trying to muddle through changes without a clear game plan. As you know, organizational change is tough and requires a methodical approach and follow through. This is what you can expect from interim management. You can achieve the organizational change you need while still doing what you need to do daily 

Let Us Help: 

At Kenyon Homecare Consulting, we have interim management available from senior level administration with decades of experience. They can provide the education and organizational structure to help you move through successfully in a PDGM world. Call us today at 206-721-5091 or contact us online to see if interim management with Kenyon Homecare Consulting is right for you. 

 

Interim Management: Keeping The Pulse Of Your Homecare Beating During Extended Absences Of The Administrator.

interim managementRegardless the size of your home care, all pieces of the administration puzzle are key. The use of interim management during extended absences often overlooked. Let’s look at how interim management can help the ship continue running smoothly even with a large piece missing. 

UH-OH: 

It’s the call from a senior level administrator you never want to receive. There’s been an accident or sudden illness.  The anticipation is 3-6 months out or more. This is a good employee and you don’t want to lose him. Although you have worked at a cross-training program so everyone can fill in for each other, it has never been an issue. Maybe your agency is already spread so thin at the admin level that there aren’t enough hours in the day to cover the workload of the other. If you can already see yourself behind the 8-ball, then consider interim management before you are catching up from behind. This industry has too many changes on a yearly basis. You have to be in a constant forward motion and without an interim to keep things moving, your direction won’t be forward. 

Why Interim Management: 

The first reason people don’t consider interim management is the expense attached to it. If this has been your reason, then you need to reconsider. When administration is out, it usually means hourly employees are working longer to cover the holes. This means staff burnout, lots of overtime wage, and more chances for regulatory compliance to slump. The world of healthcare doesn’t have the luxury to let regulations slide. Ask anyone in their second or third round of probe and educate. Ask those in Illinois who have been through the pre-claim review process. Interim Management roles evolve with the needs of your specific agency. You may see that with interim management from the start, you may be able to utilize the service part-time to meet your needs effectively. 

Kenyon Homecare Consulting Has What You Need: 

Ay Kenyon Homecare Consulting, we have senior level interim managers with decades of experiences in all service lines. Whether you know exactly what you need or need to determine it, we can help. Call us at 206-721-5091 or contact us online for your free 30-minute consultation today. 

 

Interim Management: Looking Forward To The Future Of Home Care Administration. Do You Have 20/20 Vision Or Need An Adjustment?

interim managementYou have overseen your agency for years. So, maybe the idea of interim management has never crossed your mind. Maybe it is time to think about it. This includes seeing the interim manager functioning on a different level for your agency. 

20/20 Vision: 

No one has a crystal ball. We can’t say what the Medicare benefit will look like in ten years. If you haven’t anticipated well in the previous years, then you may continue to struggle. Based upon the transition of more home and community based care as opposed to institutional services, the medical home model will continue to progress. In order to have a successful agency, you need to look ahead effectively. 

Enter Interim Management: 

Sometimes, it is difficult to make changes in the world you live in daily. In other words, it becomes difficult to see the forest for the trees. If you are involved in so many pieces of the puzzle, you may not see the collective puzzle. Interim Management will enter the agency and work side-by-side to see the flow and evolution of your business. Have you tried to implement processes unsuccessfully? Do you need to step back and see why you aren’t functioning the way you want? Maybe, the vision isn’t there the way it normally is. These are all reasons an interim can work with you to help your agency improve and prosper. It isn’t a judgment on your ability. It is more an ability for objectivity with leaders in the industry who work throughout different states.

If you send staff to training to keep skills fresh, then why would you not consider the same for yourself? Now, you may counter and say you attend seminars or conferences, but those don’t work directly with you from an internal level.  You meet with your leadership and work directly on operational changes and vision internally, but no one works directly with you. 

Be The Change: 

At Kenyon Homecare Consulting, interim management has seasoned consultants who work all over the US to help businesses advance to future success. Let us help see if you are pointed in the right direction to succeed in a PDGM world and beyond.  Call us today at 206-721-5091 or contact us online to see if short term interim management is right for you. 

As An Employer, Do You Feel Like You Have The Right People In The Wrong Places? Now Is The Time To Make The Change!

organizational restructuringThat first sentence is a handful, isn’t it? Organizational restructuring is tough, but often necessary.  If now isn’t the time, then when? Let’s look at what some of the big hurdles are and how to overcome them.  

“We Have The Best Team” 

That’s fantastic. Not all agencies can make that statement. Long-term employees and bright new talent are a great mix. These are the teams that seem to go with the flow and work efficiently through bumps in the road. If you think you have that mix but aren’t working like a well-oiled machine, then it deserves another glance. Maybe you have all the talent in the world, but employees don’t function in roles that suit individual strengths. This is very common in agencies. It is the adage of putting a square peg in a round whole. Employees cannot function at optimal levels in every role within your agency. Employees can become discouraged and overwhelmed when given job roles that don’t fit them.  

“We Can’t Keep Staff” 

This is another big reason that employees get discouraged. You have your dedicated staff filling so many roles because new employees do not stay. You may have your core team, but for how long? Don’t take for granted that employees are ok with playing multiple roles long-term. This ultimately hurts your process too. Your core and dedicated staff can’t function at 100% at any of roles they are given.  

Organizational Restructuring: 

At Kenyon Homecare Consulting, we have senior associates that can help provide objectivity on workflow. A senior associate will look at staffing and how functioning on clinical and non-clinical levels affect your day-to-day and bottom dollar. Sometimes it becomes difficult to see staff objectively. You have worked with these people for years. You have seen them through good times and bad. An outside source can see things differently than someone deep in the daily routine. Call us at 206-721-5091 or contact us online to see how we can help with organizational restructuring.  

Can running my agency be easier?

Interim Manager helps frustrated nusiness ownerChanging government regulations and industry transitions make administration more challenging than ever. As a result, the past 5 years have put business owners on administrative overload! Sometimes, all you need is interim management to put a fresh perspective on the issues you face.

Streamlining Administration with Interim Management

Fortunately for owners and managers, there’s a solution to administration conundrum. Whether you’re understaffed or overwhelmed, interim management is an effective option for to simplify the areas listed below.

Clinical

Running a home care agency is a different ballgame than many other businesses. With home care, you must consider the well-being of your clients— they’re health is at least partially in your hands. An interim manager helps ensure caregivers and the organization are in compliance with regulations, etc. This is great news since keeping up with these ever-evolving requirements is especially difficult for the average owner.

Billing and Financial

Improper billing procedures leads to errors which potentially leaves money on the table. Unfortunately, finding these errors takes time and attention to detail. The good news? Interim management professionals can help streamline billing methods and what mistakes keep you from maximizing revenue.

Operations

Your agency’s success depends on how smoothly operations run. From client care to paperwork—and everything in-between—the way team members handle responsibilities can make or break your agency. With help from interim management, operations run more efficiently that what you thought. Why? These experts have been in the industry for years seeing agencies thrive or fail based on operations. So, they know what leads to success.

Growth

If your home care agency seems to be doing well, there’s always room for growth. Whether growth comes from diversification of services or branch expansion, interim management is a must. The right interim manager allows a smooth transition that leads to growth while maintaining daily operations. This way, you can operate with minimum interruptions.

Kenyon HomeCare and Interim Management

At Kenyon HomeCare Consulting, we know exactly what it takes to make running your home care agency easier. It doesn’t have to be a struggle every day, so reach out to us now to learn more.

How do I communicate agency needs to my Interim Manager?

Interim ManagementYou’ve hired an interim manager.  that’s great-a first step toward success.But what now? How do you communicate your agency’s true strengths and weaknesses? If you’re like many home health owners, you question where problems lie or where to begin. Don’t fret. Here are practical tips for communicating your agency’s needs to your consultant.

Communicating with Your Interim Management Consultant

First things first: be honest. Don’t try to hide your trouble areas or gloss over anything that potentially interferes with seeking outside help. Once you open up and lay it on the line, follow the six tips listed below.

1. Start with obvious concerns.

Maybe you don’t have a clue why certain things are going the way they are. That’s okay. You probably have at least one or two big concerns you want addressed.Start with those major issues, and with help of your interim manager, you can uncover the root causes for them.

2. Don’t be afraid to admit you don’t know something.

During the course time with you, your interim manager will ask lot of questions. It helps paint a picture where your agency is in growth and operations. In the midst of these questions, speak honestly if you don’t the answers. Conjecture can hinder consultant progress.

3. Reveal the goals for your agency.

This one’s obvious but neglected. Often, agencies become so focused on correcting weaknesses, that the goals are lost. Take time with your interim manager and discuss every goal, both short- and long-term. Doing so gives the consultant a clear direction.

4. Give an account of past attempts.

Discuss what what has been tried unsuccessfully in the past? Make a list for your interim management consultant of the marketing, operational systems, etc. you’ve put into place before. Then, you interim manager can evaluate why these strategies didn’t work and what to do differently.

5. Willingly accept constructive criticism.

Nobody enjoys being told they’re doing something wrong, but sometimes it’s necessary for improvement. Keep in mind interim management is there to help. Anything said is out of desire for agency success.

6. Be open to change.

Along those same lines, be open to change. If you follow the status quo, then nothing will change for the better.

Kenyon HomeCare Consulting and Your Interim Management Consultant

Follow the tips above and you’ll be well on your way to establishing a beneficial relationship with an interim manager. Reach out to our experts to learn more about our interim management program

5 Reasons Staffing Can Be Attached To Leadership

LeadershipIn today’s world, good leadership makes a huge difference. This means poor management can cause turnover, poor morale, and decreased productivity.

Working With Interim Management Companies

Management methods makes a huge difference for staff. Here are five reasons to assess management of your organization.

1. Home Health/Hospice Responsibilities

Home health care and hospice are very different from other healthcare organizations. Nurses in homecare also function as amateur physical therapists, nutritionists, occupational therapists, and often clergy. That’s a lot of pressure for nurses. Therefore, effective management is important to help handle it.

2. Financial Success

Even though a passion for the mission is so important, clinical staff also need to make a solid living. Strong leadership gives employees a sense of security. Strong leadership equals agency success, which equals employee success.

3. Critical Thinking Skills

Nurses must provide care solutions that are unique to each patient in their own surroundings. This differs from the controlled environment of a hospital or SNF.  Management needs to promote critical and comprehensive thinking skills.  Then, nurses can properly assess and make the best decisions.

4. A Feeling Of Support

In the day-to-day requirements of home and hospice care, nurses can quickly become overwhelmed. If leadership functions in an environment of fear, employees will struggle. On the other hand, employees who feel supported are likely to thrive—and stick around.

5. Education And Preparedness

Many times, an employee’s performance comes down to training. Leaders offering education beyond the basics have better prepared employees. Hence, less turnover and top-notch client care results.

Making It Happen: Finding Interim Management Companies

Sometimes, this level of leadership can seem impossible. This is where interim management is key. Consultants can fill a void or help you find what’s missing in agency leadership.

At Kenyon HomeCare Consulting, we understand the value of effective leadership. Our interim management program has the tools you need to improve management skill.  Reach out to us today to learn more.

Abandonment Or Termination Of Homecare Services For Violence?

Today’s article, written by Elizabeth Hogue, a well-known health care attorney provides guidance about how to terminate services to patients in the face of violence or threatened violence against field staff members. Homecare field staff who provide services on behalf of private duty agencies, hospices, Medicare-certified home health agencies and home medical equipment (HME) companies are extremely vulnerable. Contributing to their vulnerability is the fact that they work alone on territory that may be unfamiliar and over which they have little control. Staff members certainly need as much protection as possible.

In Part 1 of this series, exposure to workplace violence was reviewed from the point of view of requirements of the Occupational Safety and Health Administration (OSHA). Also, the previous article addressed the potential liability of all types of home care providers for negligence when employees are injured as a result of violence. This article provides guidance about how to terminate services to patients in the face of violence or threatened violence. Providers are at risk for legal liability of abandonment when they terminate services to patients. Violence or threatened violence, however, likely warrants immediate termination of services. Providers show concern understandably about the possibility of legal liability associated with the termination of beneficial services.Abandonment

Liability for Abandonment

Specifically, providers remain concerned about the possibility of liability for abandonment of patients. Practitioners often speak of abandonment as though it is equivalent to termination of services. On the contrary, patients who want to hold case managers liable for abandonment must show that:

  1. Providers unilaterally terminate the provider/patient relationship
  2. Without reasonable notice
  3. When further action was needed

Patients who fail to prove any one of these requirements are likely to lose their lawsuits against providers.

As indicated above, abandonment requires unilateral termination of the relationship between the patient and the provider by the provider. In instances of violence or threatened violence, this requirement of proof of abandonment may be met when providers decide unilaterally to discontinue services.

Requirements of Abandonment

The second requirement of abandonment means that providers who give patients reasonable notice prior to termination of services will not be liable for abandonment. The key question is: what is “reasonable” notice? Providers should view what is reasonable on a continuum. That is, on one extreme end of the spectrum are patients who are violent or threaten violence. Practitioners are likely justified in terminating services immediately to patients who fall into this category. Providers are also likely justified in ending services to patients whose family members threaten violence or are actually violent.

Statutes and/or regulations in some states govern how much notice must be given to patients prior to termination of services. Some of these statutes address the issues of violence or threatened violence and permit providers to terminate services to patients immediately under these circumstances. Providers must carefully review requirements for the state in which the patient resides before terminating services.

After staff members agree that immediate termination of services due to violence or threatened violence is reasonable, patients and attending physicians should receive notice verbally and in writing. Written notices should be hand-delivered to patients’ homes. Although it is desirable, it is unnecessary to obtain a signature verifying receipt. Written notices to physicians may be faxed or hand-delivered.

After giving notice, providers must terminate care as planned. Practitioners are sometimes tempted to continue services in the face of pleas from patients, physicians, and/or family members. Providers must bear in mind, however, that one of their most important responsibilities is to protect staff members from harm.

How Providers Defeat Claims of Abandonment

Finally, providers can defeat claims of abandonment if patients for whom services are discontinued need no further attention. How do providers know whether further attention is needed? Is this requirement as subjective as it appears? On the contrary, judges are likely to make retrospective determinations about whether further attention was needed. The basis for such determinations will probably be whether patients were injured as a result of termination. In other words, the law is likely to conclude that no further attention was needed, so long as patients are not injured as a result of termination of services.

What kind of injury must patients prove? Can patients who attempt to prove emotional damage only as a result of termination of services win lawsuits? The “good news” for providers is that courts generally require proof of physical injury or damage before they will find providers liable for abandonment. Providers must, therefore, take appropriate steps to make certain that patients are not physically injured as a result of termination of services.

In rare instances, appropriate action may include sending an ambulance to take a patient to the nearest hospital. Even if patients refuse transport by ambulance, providers may avoid liability because patients likely assumed the risk or were contributorily negligent when they refused transport via ambulance.

In Conclusion

It does not appear that the world is becoming a kinder, gentler place for anyone. Field staff members must face their vulnerability every day. Those who are behind the firing line must provide support by shielding them from threatened or actual violence whenever possible.

If you need to develop or implement a comprehensive program to prevent violence in the workplace, Kenyon HomeCare Consulting is here to help! Schedule an appointment to speak with one of our experts or give us a call at 206-721-5091.

For more information about this or other legal issues in homecare, contact Elizabeth as outlined below.

Elizabeth E. Hogue, Esq.

Office: (877) 871-4062

Twitter: @HogueHomecare

ElizabethHogue@ElizabethHogue.net

©2017 Elizabeth E. Hogue, Esq. All rights reserved.

 

Cybersecurity Issues: 4 Ways To Safeguard Your Home Care Agency

Issues of security breaches, resulting in the theft of credit card information or loss of access to systems are frequently in the headlines. The healthcare industry and home care are not immune.  We are all responsible for the protection of our patients’ and clients’ personal health information. These protections are mandated for home care organizations by HIPAA (Health Insurance Portability and Accountability Act), HITECH (Health Information Technology for Economic and Clinical Health) and other regulations. Today’s guest post is by Marcus Jensen who is a writer from Australia and the Editor-in- Chief of Technivorz blog. Besides working on Technivorz, his work has been featured on several prominent tech and business editorials. Although the examples cited by Marcus are not specific to home care, his cybersecurity recommendations are applicable to all of us.

Increase in Cybersecurity Issues for HealthcareCyber Security

The last couple of years have not been great cybersecurity-wise for anyone, healthcare organizations included. For instance, in 2015 alone, the Office of Civil Rights reported 253 healthcare data breaches which resulted in a combined loss of 112 million records. The vast majority of the biggest cyber security issues involved outside hacking in 2015.

In 2016, the situation is somewhat different, at least in the healthcare industry. Namely, a relatively large number of cybersecurity incidents included old-fashioned theft of devices such as laptops and simple human errors. In March, for example, Premier Healthcare had a laptop stolen from their billing department and since it was not sufficiently encrypted, data pertaining to more than 200,000 patients was stolen.

Moving away from healthcare for a while, 2016 has seen its share of hacking and other cybersecurity attacks from outside. Wendy’s, Oracle, Weebly and Snapchat are just some of the major players whose cybersecurity was compromised in one way or another in 2016.

According to security experts such as Securelink, 2016 saw an explosion in ransom-ware attacks, many of which aimed at healthcare, educational and even law-enforcement organizations.

If such big players are struggling to keep their data secure, what hope do small home care agencies stand?

Quite a bit of hope, actually. Namely, with a few smart practices and a comprehensive approach to cybersecurity, home care agencies can do a lot to keep their data and their patients safe.

Improve Cybersecurity With Education, Education, Education

It may seem like somewhat of a cliché, but when cybersecurity in any kind of an organization is in question, education truly is the cornerstone on which you build everything.

First of all, you as the home care agency owner need to learn as much as you can about cybersecurity, the different kinds of threats and the most common current trends. There are quite a few websites and blogs out there on this subject and it might be a good idea to acquaint yourself with them. This is a great list of cyber security blogs you might want to check out if you have the time.

The next step is ensuring that everyone who works for your agency has had at least the basic cybersecurity training. This will include talks on the importance of strong passwords, not sharing one’s credentials with anyone, not misplacing company devices and more. This training should also include something on social engineering, a practice where an attacker tricks an employee into thinking they are communicating with an official of some kind from some outside agency.

Use Proper Software to Expand Your Cyber security

There are plenty of cybersecurity software solutions out there, from firewalls to anti-malware software and more. Your agency is probably already using some sort of protection, but it never hurts to remind that using such software is a must.

It also has to be pointed out that cybersecurity software has to be allowed to update on a daily basis, sometimes even a few times every day. This provides the anti-malware software installed on your system with the ability to recognize the latest versions of malware.

In case you are employing third-party solutions such as any cloud-based software for other aspects of running your company, make sure that you are using the latest versions of the software and that it is secure. Every point of access to your system needs to be secured and monitored.

Cybersecurity Must Have-Back Up Everything Regularly

We should avoid junk food. We should try and keep our stress levels low. We should exercise every day. We should backup our systems. Most of the time, we follow such instructions. Every now and then, however, we forget about them or choose to ignore them.

When it comes to backing up your home care agency computer system, forgetting it may result in devastating complications.

For example, let’s say that you become a victim of a ransom-ware attack where someone encrypts your data and asks for money in return. Until you pay up (hoping they will actually let you decrypt your data) and decrypt everything, you have no access to your system, your data, anything really. By the time you are certain your system is once again “clean”, you will not have been 100% operational for days, perhaps weeks or even months.

Can you really afford this?

When you back up regularly (meaning every day or every second day at the least), such a situation is effectively prevented. You simply revert back to the most recent backup and the attacker cannot do a thing about it. Of course, this is not the only reason why you should back up your data regularly.

Ensure Physical Safety of Your Devices

In December last year, the Radiology Regional Center in Florida notified patients that some of their data was compromised due to their paper records literally getting lost in the street. Around that same time, a laptop belonging to Valley Hope Association was stolen from an employee’s car. We already mentioned a laptop being stolen from Premier Health’s billing department.

As you can see, patient and agency data can be easily compromised through basic physical access to the devices that store such data or that have access to such data.

Because of this, it is absolutely essential that you have strict policies in place, prescribing the physical safety and security of devices. All of the devices that can provide access to any sensitive patient information need to be accounted for at all times. Secure areas need to be limited to authorized individuals while equipment in less secure and high-traffic areas need to be additionally protected and monitored.

In short, know where your devices are and who has access to them.

Closing Word

In the end, it all comes down to a bit of education and using common sense. Keeping things simple and staying informed and vigilant will do the job in the majority of cases. If you are not 100% certain about what to do and how to behave, talk to professionals and heed their recommendations.

There is only one thing you must never do and that is to underestimate the importance of cyber security in the modern world.

For more food for thought, Ankota has a new e-book available for download called, Winning with the Home Health Value-Based Purchasing Program, that offers further insight on the discussion.  Just click the link here to download.

This article first appeared as “4 Ways Your Home Care Agency Can Safeguard Against Cyber Attacks” on the Ankota bloghttp://www.ankota.com/blog/4-ways-your-home-care-agency-can-safeguard-against-cyber-attacks on December 5, 2016. Ankota provides software to improve the delivery of care, focusing on efficiency and care coordination.  Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care.

 

What Providers Need To Know: Violence Against Homecare Staff

Much thanks to Elizabeth Hogue, our esteemed colleague and well-known health care attorney for this article. Homecare staff who provide services on behalf of private duty providers, hospices, Medicare-certified home health agencies and home medical equipment (HME) companies are extremely vulnerable. Contributing to their vulnerability is the fact that they work alone on territory that may be unfamiliar and over which they have little control. Staff certainly need as much protection as possible.

First, we will review exposure to workplace violence from the Occupational Safety and Health Administration’s (OSHA) point of view. And then explore the liability of home care providers of all types for negligence when employees are injured as a result of violence.

Agency providers may be liable when field staff members are injured as a result of violence. The Occupational Safety and Health Administration (OSHA) may, for example, take action against homecare providers when patients are injured as a result of violence. Likewise, agencies may be liable for negligence. Recent enforcement action taken by OSHA against a private duty agency illustrates the likelihood of liability for such violations by homecare providers of all types.

Agency Providers Learn From Recent OSHA’s RulingProviders

On July 5, 2016, OSHA issued a $98,000 fine for an alleged willful violation of applicable requirements related to exposure to workplace violence, including physical and sexual assault. The citation was based on an investigation that began on February 1, 2016, after a staff member was assaulted by a homecare client. In this case, a staff member who previously took care of the client had warned the Agency about sexual assaults by the client. OSHA concluded that the Agency failed to protect its staff members from life-threatening hazards of workplace violence. According to OSHA, the Agency also failed to provide an effective workplace violence prevention program.

Specifically, OSHA took issue with two types of conduct by the Agency:
• Staff members were exposed to physical assault.
• There was no system in place for staff members to use to report threats and instances of violence to the Agency.

If OSHA’s citation is upheld, OSHA will require the Agency to abate these findings by:
• Developing and implementing a written, comprehensive program to prevent violence in the workplace
• Implementing a hazard assessment of violence in the workplace
• Developing and implementing measures to control violence in the workplace. Example: an option to refuse to provide services to clients in hazardous situations
• Develop and implement a training program on violence in the workplace
• Developing procedures to follow in instances of violence, including making reports and conducting investigations of such instances
• Putting in place a system that allows staff members to report all instances of violence, regardless of severity

Homecare Providers Responsibility to Protect Staff

Homecare staff members provide increasingly important services under circumstances that can be difficult, to say the least. Perhaps the highest obligation of all homecare providers is to protect their staff members. Proposed action by OSHA described above provides a “road map” for providers to follow as they continue to work to address the issue of violence against homecare staff members.

Providers owe their employees a duty of reasonable care. That is, they are responsible to take reasonable precautions to protect their employees from harm. This obligation may be far easier to talk about than to fulfill due to increasingly threatening environments for home care personnel. A key question regarding this obligation is: what is reasonable?

Homecare Providers and Reasonable Precautions

Reasonableness is determined by what other providers are doing across the country. In other words, whether providers are taking reasonable precautions to protect workers will be judged by comparison to what others throughout the country would have done under the same or similar circumstances. This definition of reasonableness poses particular difficulty for home care providers. There is a lack of data or even anecdotal information about how other companies are dealing with a number of key issues in home care, including protecting workers from harm.

Failure of agencies to fulfill their obligation of reasonable care can be in the form of: (1) acts or errors, and (2) omissions. In other words, providers must show that nothing happened to harm workers because of something that the providers did or should have done. Providers will be found to have caused injury to employees if the damage to employees would not have occurred “but for” an act or omission by employers. Courts generally require proof that employees were injured physically, as opposed to only emotionally, in order to compensate them for their injuries.

What Providers can do to Protect Employees From Harm

From a practical point of view, it is important to ask what providers can do to protect their employees from harm. The most important answer to this question is that managers must listen and take action when staff members complain about safety hazards.

One of the strengths of the home care industry has always been that staff members are willing to go beyond the extra mile to care for patients. The perception of many who know the industry well is that workers tend to put up with safety hazards that others would not hesitate to avoid. It becomes essential, therefore, for supervisors to listen carefully to staff members who complain about safety hazards. Assessments by most staff members that they regard situations as unsafe are usually valid since their natural inclination is to continue to provide services to patients in unsafe situations.

It is also extremely important for managers to take action in response to complaints by personnel. There is an old legal adage that “every dog is entitled to one bite.” This means that, as soon as the dog has bitten one person, those responsible for the animal are on notice that the dog is dangerous. They must then take reasonable precautions to prevent further injury or damage. Consequently, once employees register even a single complaint regarding dangers associated with the care of particular patients, employers are likely on notice that further care may involve harm to workers. In view of this “first bite,” so to speak, providers must take appropriate action or face possible liability for injuries to their personnel. What kinds of actions are appropriate?

Defining Appropriate Actions for Providers

The use of so-called “escorts;” including armed, off-duty police officers; may be appropriate. Some home care personnel, however, object to use of escorts. The basis for their concern may be that the presence of escorts interferes with their relationships with patients. They point out that there is an essential inconsistency between the caring and nurturing relationships they wish to foster with patients and their families and the use of escorts. Some workers also express concern about their reputations in the community when escorts are used, especially if they live in the community in which they make home care visits.

Providers may, therefore, decide to implement a policy that staff may not reject escorts when management deems their use is appropriate. Refusal of escorts should be defined as insubordination in such policies and procedures, and appropriate disciplinary action, including termination of employment, should be taken in response to this type of insubordination.

Termination of services to patients is also an appropriate response to concerns regarding the safety of home care staff members.

Home care personnel knock on the doors of thousands of patients each day, unaware of what may be inside their homes. They regularly encounter unfamiliar terrain and unknown risks. These risks are likely to become even greater as the use of home care services continues to expand. Managers and field staff must be prepared to deal with the constant potential for compromised safety.

If you need to develop or implement a comprehensive program to prevent violence in the workplace, Kenyon HomeCare Consulting is here to help! Schedule an appointment to speak with one of our experts or give us a call at 206-721-5091.

For more information about this or other legal issues in homecare, contact Elizabeth as outlined below.

Elizabeth E. Hogue, Esq.

Office: (877) 871-4062

Twitter: @HogueHomecare

ElizabethHogue@ElizabethHogue.net

©2016 Elizabeth E. Hogue, Esq. All rights reserved.