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Breaking Down The Evolution To The Oasis D Tool. From Clinical Assessment To Data Collection, Why This Document Is More Important Than Ever!

ToolRemember the first Oasis tool? It seemed so cumbersome. Think stapled assessment tool that just made more work for clinical staff. Well, we had not seen anything yet! As the tool has evolved from its original to the current version, the industry has had to evolve too. If you aren’t sure if you are there, then look ahead at how to use the tool to your advantage. 

Well, It Is An Assessment Tool, BUT: 

The reality is that most clinicians see the Oasis as a form to fill out for Medicare. If this is the only way your agency uses it, then more education needs to happen. Lots of clinical information is jammed into that tool. If you think critically about it on a functional and clinical level, then the care plan is effectively created. How many therapists in your agency understand Oasis? Do your nurses critically understand Oasis?  Does therapy read the Oasis after it is completed by the nurse? Is the tool part of initial care coordination? These are all good questions to ask. If staff doesn’t use the tool to properly create a comprehensive care plan, then it is just a form to fill out for Medicare. 

Data Collection: 

Yes, it is a data collection tool for Medicare. So, it needs to be filled out correctly. Not just from a financial standpoint, but also for outcomes.  Oasis changes are made based upon prior years of data. So, if agencies do not take the effort to properly train staff, it hurts the industry. Ongoing errors trigger audits. In the course of a normal record review, how often do you see Oasis discrepancies with other parts of the clinical record? We live in a healthcare world where auditing is here to stay. Don’t set yourself up to fail your ADRs. 

Kenyon Can Help: 

At Kenyon Homecare Consulting, we have senior consultants who can assist with training and operational changes to make your Oasis come together as a tool to make you better. Call us today at 206-721-5091 or contact us online to talk about how we can help train and transition your staff. 

Changing Your Approach: Why Having An Organizational Assessment May Improve The Way Your Home Health Agency Functions And Cause Less Gray Hair In The Process!

home care consultantDo you feel like your home health agency is in a rut? You know you need something to change, but aren’t exactly sure how to make that change fly? If this is what keeps you up at night, then maybe you need to consider a comprehensive organizational assessment from a senior home care consultant.  Here, we will take a look at how an organizational assessment can help you get from A to Z.

What Will The Home Care Consultant Analyze?:

Well, the senior consultant has worked in senior home care management for a long period of time.  The extent to which your agency is analyzed will certainly depend on what you want to get from the experience.

  • Clinical Review: Having the appropriate clinical documentation is key in the world of healthcare today.  But agencies cannot afford to have every note reviewed and check every intervention along the way. Catching trends and where your agency may not comply with Medicare or Accreditation regulations is key.  An objective clinical review can help guide you to clear compliance.
  • Policy / Procedures: A thorough review of policy and procedure manuals will get you up-to-date and rid of outdated policies. Many consulting agencies have updated manuals available if it has been a long time since yours has been evaluated.
  • Financial Review: Senior consultants often work in conjunction with each other to evaluate the clinical alongside the financial.  Looking at cost reporting, visits per episode per discipline, cost per visit, and compare these items to state and national averages.  This can give you comparison data. Knowing what you pull per episode in comparison to others can tell you a lot clinically.
  • Oasis/ Coding Review: With financial, the clinical consultant will review Oasis and coding to see if you are really getting what you should for the care you provide.  If finance determines a high rate of visits per episode in comparsion to average HHRG, clinical will break it down.  The home care consultant will determine if you are doing too many visits or your Oasis and coding do not reflect the complexity of patient care.
  • Marketing: It is important for marketing to be targeted and focused on partnerships today.  Does your marketing plan really do this effectively?

What If I Don’t Need A Complete Review Of All Operations?:

The way you want the home care consultant to spend time is completely up to you.  It may be a specific need only.  Maybe, you need help with accreditation or plan of correction associated with a review.  If you need help intiating process changes, then an outside source to navigate can make the process a lot easier for you.  Maybe you want someone to teach staff on Oasis and to do coding for your agency as a partnership.  If your marketing plan is not successful, then the consultant can help marketing improve efficacy.

Let Kenyon Homecare Consulting Become Your Partner:

At Kenyon Homecare Consulting, we work with agencies to improve the quality of care and bottom line in the process.  Call 206-721-5091 or contact us online for your free 30 minute consultation.  Let us help!

Why ICD-10 Coding Needs To Be Your Home Health Holy Grail

Many know “The Holy Grail” from a certain Charleston Heston movie which shall go unnamed (involving a final “crusade” for the magical cup). The holy grail is found to deliver happiness, everlasting youthfulness, and unlimited supplies of food and other necessities. What is the holy grail in home health? One good answer would be ICD-10 coding.

The “Miraculous Powers” of Perfect (or near-perfect) ICD Coding

The homecare industry is growing by leaps and bounds. This creates opportunities for home health organizations and saves hospitals and taxpayers up to 50%. Home health is a competitive sector, and unless you are reaching your reimbursement potential, your agency is likely struggling instead of thriving. The remedy many times is to maximize reimbursements via improved ICD-10 coding. Here’s how:

  • Rely only on certified, homehealth-specific ICD-10 coders. Experienced coders simply code better and faster. Hospital and home health coding are not the same language.
  • Invest in continuing education for coders and clinicians alike. If you code in-house, you know ICD 10 changes can be monthly! Your coders need to keep on top of it.
  • Keep your coders and clinicians communicating well.  Collaboration before, during, and after documentation means all the difference.

Consider Outsourcing ICD Coding (your grail) to Industry Experts

ICD coding is so important to the success of homecare. Coding in-house can be a burden. Management time spent coding decreases time for case management . It can be difficult to find, hire, and keep good ICD-10 coders. Even if you have a great coding staff, back up coders for extended vacations, medical emergencies, or if someone leaves unexpectedly is necessary. Plus, outsourced coding can both save you money on employee salaries/benefits and potentially boost reimbursement rates by 29% to 48%.

At Kenyon HomeCare Consulting, we can protect your “holy grail” with outsourced coding which can: increase revenue, improve turnaround time for better cash flow, and prepare you for increased growth since staff can focus on clients instead of codes. To learn more about our Coding Plus Program, continuing staff education offerings, and other valuable services, contact Kenyon today by calling 206-721-5091.

Will Raising Minimum Wage, Overtime Rules Affect Home Care Companies?

What would a $15 per hour minimum wage do to your home care company?  If your state passed legislation requiring it, who would be the winners and losers?  What can you do about it?

We’ve been closely monitoring the rapidly growing trend of cities across the country passing laws requiring that minimum wages be increased, with the target being $15 per hour.Monimum Wage Increase Ahead

An article in the Washington Post dated October 21, 2015 revealed that the SEIU in California has given some money to create an organization called The Fairness Project.  According to their web site,

“In 2016, The Fairness Project will focus on ballot-initiative campaigns that seek to raise the minimum wage, working with partner organizations across the country to enact legislation through the ballot box to improve pay for millions of working people. Building this strong national platform will support our 2016 goal to win minimum wage campaigns in multiple states and localities and establish a base of support on other economic issues for years to come.”

Their targets are the states of California, Maine, and the District of Columbia.

Already we have seen laws passed in Seattle, Los Angeles, and several other cities. In 2014, minimum wage initiatives passed in Arkansas, Alaska, Nebraska, and South Dakota.

According to the Ballot Initiative Strategy Center, minimum wage measures have been tried 20 times in 16 states since 1996, and all but two succeeded. The earlier victories came in waves, starting with the “living wage” movement in the 1990s.

Watch This Trend

As the CEO of a Top Ten home care company, or a CEO who wants to be in the Top Ten %, you need to be watching this trend closely.  We’ve had a number of conversations with home care CEOs in the Seattle Area. One told us that the first reaction she got from caregivers when the minimum wage moved up to $13.00 per hour was that they wanted fewer hours because they were not making too much money and it was affecting their other benefits.  That means that workers make the same money, clients pay more, and companies make less.

While legislators and regulators think they are doing employees a big favor with these new rules, it is often the very people they want to help who are paying the biggest price.

Implementing Overtime Rules

Another example of how new laws and regulations hurt caregivers and clients is the recent ruling by the US Court of Appeals in the District of Columbia upholding the US Dept. of Labor’s new interpretation of the Companionship Exemption.  Effective October 13, 2015, home care companies will need to pay overtime for caregivers working more than 40 hours per week.

Our good friend, Marki Flannery, the Executive Vice President and Chief of Provider Relations for the VNS of New York wrote an article for the Huffington Post.  In her article, Marki pointed out how caregivers and clients will be hurt by the overtime rule.

“My organization, the Visiting Nurse Service of New York, believes strongly that the nation’s home health aides should be paid a living wage. In New York, these dedicated workers earn an average of $10 an hour for the work they do each week helping elderly and disabled individuals bathe, dress, eat and otherwise carry out their daily lives. For many elderly people, the daily care that HHAs provide is what allows them to continue living in their own homes, rather than enter a nursing home.

At VNSNY, we have always provided wages and benefits to our HHA employees that exceed the industry average. In recent years, however, this has become steadily more difficult, as both Medicare and Medicaid have reduced their reimbursement levels for home health services. Now, the Labor Department’s regulation (assuming it goes into effect) has taken a difficult situation and made it impossible. Why? Because while the desired effect of the regulation–to increase the income of the country’s HHAs–is laudable, it is missing one essential ingredient: a mechanism to pay for the increased cost.

The result, sadly, will be exactly the opposite of what was intended: Home health aides across the U.S. are likely to end up working fewer hours and earning less total income, while patients will have to endure fragmented care. We could even see a number of home healthcare agencies go out of business because they find it financially impossible to comply with the new state of affairs.”

While Marki’s points in this article relate to increasing Medicare and Medicaid reimbursement to cover the increased costs of providing care, we need to be thinking about how individual consumers will be able to avoid the increased cost of remaining independent at home.

Stay Tuned to the Home Care CEO Forum

For more up to date information on the latest trends in home care, stay tuned to Leading Home Care for the Home Care CEO Forum, a new membership network for CEOs in the Top 10% of the industry, and those who want to be in the Top 10%.

StephenTweedphotoStephen Tweed is an internationally known health care and business strategist, award winning professional speaker, and published author. He is the CEO of Leading Home Care … a Tweed Jeffries company.  He can be reached at

This article first appeared as Labor Union seeds “Fairness Project”on the Leading Home Care blog posted October 28, 2015 .