Kenyon Connects

The Invisible Salesman: How a Single Button Can Double Your Revenue

Sat, 11 Apr 2026 15:48:20 GMT

In the world of digital marketing, we spend thousands on SEO, high-end photography, and professional copy. Yet the most critical moment of the entire customer journey often comes down to a tiny rectangle: the Call-to-Action (CTA) button .

A well-crafted button is more than just a design element; it’s a psychological trigger. Research shows that clear, specific CTAs can increase conversion rates by as much as 161% . If your "Buy Now" button isn't performing, you aren't just losing clicks—you’re losing revenue.

Here is the anatomy of a website button that actually sells.

If you are a home care or home health agency, and the phone isn’t ringing, consider the following:

1. The Psychology of Color: Contrast is King

There is no "magic" color for sales, but there is a magic principle: Contrast . Your button must stand out from the rest of your site’s palette. This is known as the Von Restorff Effect , which suggests that the eye is naturally drawn to the element that "stands out like a sore thumb."

Red: Creates a sense of urgency and excitement , often used for flash sales or clearing out stock.

Green: Communicates safety and growth , making it ideal for financial services or eco-friendly brands.

Orange/Yellow: Friendly and energetic, these colors attract attention without the "danger" associated with red.

Pro Tip: If your website is mostly blue, try an orange button. If it’s white and grey, a bold black or red button will grab the most focus.

2. Copywriting that Converts: Benefits Over Actions

The biggest mistake businesses make is using "friction words" like Submit , Register , or Buy . These words imply work or a loss of money. High-converting buttons focus on the reward.

Instead of Submit: Try Get My Free Guide as it f ocuses on the value received.

Instead of Buy Now: Use Add to Cart. This lowers the psychological pressure; implies browsing

Instead of Register: Try Start my Free Trial as this uses first-person language to create ownership.

Using "My" instead of "Your" (e.g., "Start my free trial" ) has been shown to boost click-through rates by up to 90% because it makes the user feel like they already own the benefit.

3. Strategic Placement: Follow the Eye

If a user has to search for your button, you’ve already lost them. Effective placement follows the natural "flow" of how humans read:

Above the Fold: Ensure at least one primary CTA is visible without scrolling . This captures the "impulse" visitors immediately.
The F-Pattern and Z-Pattern: Users scan pages in predictable paths. Place buttons at the end of these paths—usually the center or bottom right of a section.
The "Point of Action" Assurance: Place a small trust signal directly under the button, such as "No credit card required" or "30-day money-back guarantee." This reduces "buyer anxiety" at the exact moment of decision.

4. Design for the Thumb

With more than half of all web traffic coming from mobile, your button must be "tappable."

Size Matters: Buttons should be at least 44px tall to ensure they are easy to hit with a thumb.

White Space: Surround your button with "breathing room." Clutter around a CTA confuses the brain and leads to "choice paralysis."

Key Takeaway

A button is the final gate between a visitor's interest and your business's profit. By combining high-contrast design , benefit-driven copy , and low-friction placement , you turn a simple UI element into a powerful engine for successful sales.

If you need assistance with your website buttons, contact Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com

The Soul of the Role: Crafting Subjective Content for Agency Job Descriptions

Tue, 07 Apr 2026 20:02:38 GMT

When you're recruiting talent for your agency finding people with the required technical skills is the baseline, but vibe and vision are the differentiators. While the "objective" part of a job description (JD) covers the what (tools, years of experience, degrees), the "subjective" content gets at the how and the why.

Subjective content defines your agency’s cultural DNA. It’s the difference between hiring a "Graphic Designer" versus hiring a "Visual Storyteller with a penchant for disruptive minimalism."

By highlighting your agency's corporate values, you may get fewer applicants, as many will not match your cultural requirements. But attracting the "right" people is a long-term strategy that builds a team that works in the long run.

1. Define the "Agency Archetype."

Every agency has a personality. Are you the scrappy underdog, the polished global powerhouse, or the eccentric boutique? Your subjective content must reflect this.

· The Tone of Voice: If your agency culture is relaxed, don't use corporate jargon like "leverage synergies." Use "collaborate to win."

· The Mission Statement: Move beyond "We provide marketing services." Try "We help ethical brands speak louder than their competitors."

· Match the values of the organization: The core values of an organization are established by the owner or administrator. Personality trait compatibility is critical to building a cohesive and productive workforce. To determine these core traits, first, list all the traits that the owner possesses. For example "caring and compassionate, reliable, honest," etc. Then evaluate each candidate against the list using Stephen Tweed’s Personality test . When all your hires match the core values of the organization, you achieve worker coherence.

· Job descriptions should all express the same subjective (core values). Field staff and office staff who share the same core values create a corporate culture that thrives.

2. Hire for "Soft Power," Not Just Software

In an agency, the ability to navigate a difficult client meeting is often more valuable than knowing a specific shortcut in your electronic medical records (EMR) system. Focus on these subjective traits:

· Emotional Resilience: Instead of saying "must handle stress," try "provides calm and direction in the productive chaos of a patient intake."

· Intellectual Curiosity: Ask for "a chronic learner who stays up late reading about innovation in the home care industry because they actually care."

· Adaptability: Use phrases like "adept at wearing multiple hats and switching them mid-sentence."

3. The "Day in the Life" Narrative

Objectively, a job is a list of tasks. Subjectively, it’s an experience. Paint a picture to help candidates self-select.

Example: "On Tuesday, you might be brainstorming a new program that better meets our patients' needs and wants. How would you evaluate the proposal, and what would you add?"

4. Crafting the "Who You Are" Section

This is where you move from requirements to identity. Use evocative language to describe the ideal candidate’s mindset.

Objective Requirement: "Subjective Evolution" (The "Agency Way")

5 years of PR experience: "You have a vast number of media contacts and the persistence of a detective."

Detail-oriented: "You’re the person who spots a mispelling in the home care services brochure and can't rest until it's fixed."

Good communicator: "You can explain a complex strategy to a client as if you’re telling a personal story over coffee.

5. Sell the "Un-Benefits."

In any agency, the "perks" are often subjective. Don't just list the generous mileage reimbursement policy; list the intangible growth opportunities.

· Access: "You won't be just an order taker; you’ll have a seat at the table with the clinical staff."

· Impact: "Your exceptional work won't be taken for granted; it will be recognized and celebrated by everyone on the care team."

· Culture: "We value 'radical candor'—i.e., we agree to disagree openly so we can work together better."

6. Use "Negative Filtering."

Subjective content is also a great way to discourage the wrong people. If your agency is high intensity, say so.

· "If you prefer a predictable 9-to-5 where every task is predefined, this isn't the place for you. But if you love thinking on your feet and providing care whenever and however it's needed, you’ll fit right in."

Key Takeaway

A job description is your first piece of marketing for attracting the right new hire. If your subjective content is dry, the candidate will assume your agency is dry. If it’s vibrant, human, and maybe even slightly provocative, you’ll attract passionate talent that actually wants to build something with you.

Should you need help with recruitment and retention, call Kenyon Homecare Consulting at 206-721-5091 or contact us at gkenyon@kenyonhcc.com .

Crafting Your Business's Future: Essential Planning Insights

Wed, 01 Apr 2026 18:11:39 GMT

Starting a business is a marathon, not a sprint, and a solid plan is your hydration station. Whether you're pitching to investors or just trying to keep your own head on straight, a professional business plan usually follows this logical flow.

1. Executive Summary

This is the "elevator pitch" in written form. Write it last.

Mission Statement: What do you do, and why?

The Problem: The specific pain point you are solving.

The Solution: Your product or service.

Financial Goals: A high-level snapshot of what you expect to earn.

2. Company Overview

Legal Structure: (e.g., LLC, C-Corp, Sole Proprietorship).

History: If you are already in business. When you start up, and the milestones you've hit so far.

Location: Where you operate (brick-and-mortar vs. remote).

3. Market Analysis

Target Audience: Detailed demographics of your ideal customer.

Market Size: Is this a niche hobby or a billion-dollar industry?

SWOT Analysis:

o S trengths

o W eaknesses

o O pportunities

o T hreats

4. Products & Services

The "What": A deep dive into what you’re selling.

Competitive Advantage: Why is yours better than the current options?

Pricing Strategy: How much you’ll charge and how that compares to the market.

5. Marketing & Sales Strategy

Customer Acquisition: How will people find you? (SEO, Social Media, Cold Calling).

Sales Funnel: The process from "never heard of you" to "here is my credit card."

Retention: How you’ll keep customers coming back.

6. Operational Plan

Logistics: Supply chain, manufacturing, or software development.

Technology: The tools and platforms required to run the business.

Staffing: Key roles you need to hire immediately.

7. Management & Organization

Leadership Team: Bios of the founders and advisors.

Org Chart: Who reports to whom.

8. Financial Plan

Startup Costs: Exactly how much cash you need to get the doors open.

Revenue Projections: Estimated income for the next 1–3 years.

Break-even Analysis: The point where you stop losing money and start making it.

If you plan to start a home care or home health business, creating a solid business plan is essential to success. Creating a business is like planning a vacation. You would not go on vacation with a planned destination without a map on how to get there. It is the same for building a business.

This guide helps you create a business plan for new or existing ventures, but further assistance can be gained by calling Kenyon HomeCare Consulting at 206-721-5091 or emailing gkenyon@kenyonhcc.com .

Beyond the Resume: A Strategic Guide to Hiring the Right Talent

Wed, 01 Apr 2026 17:37:44 GMT

In a competitive market, a company is only as strong as its headcount. However, hiring the "right" person isn't just about finding someone who can do the job; it's about finding someone who makes the rest of the team better.

The cost of a bad hire can be staggering, often estimated at 1.5 to 2 times the employee’s annual salary . To protect your bottom line and your culture, you need a hiring process that filters for both technical excellence and cultural alignment.

1. Define the "Outcome," Not Just the "Role."

Most job descriptions are a laundry list of chores. To attract top-tier talent, shift your focus from responsibilities to outcomes.

Instead of writing "Must manage social media accounts," try "Increase organic lead generation via social channels by 20% in the first six months." This clarifies what success looks like and attracts high performers who are motivated by clear goals rather than just tasks.

2. Prioritize Cultural "Add" Over Cultural "Fit."

The term "cultural fit" can often lead to homophily —the tendency to hire people just like ourselves. This kills innovation. Instead, look for a Cultural Add .

· Culture Fit: "Would I want to grab a beer with this person?" (Leads to bias).

· Culture Add: "What unique perspective or skill does this person bring that our current team lacks?" (Leads to growth).

Pro Tip: Identify your core values (e.g., "Radical Candor" or "Bias for Action") and create specific interview questions to test them.

3. The Multi-Stage Filter System

A robust interview process should feel like a funnel, gradually narrowing down to the most qualified candidates.

This consists of 4 stages, each with its own goal and tool/method to reach it. The stages are a follows:

Screening: The goal is to filter for basic requirements by way of 15 minute Zoom or phone call.
Technical Assessment: The goal is to verify they can actually do the work and is done by a paid "take home" or live assignment/ writing.
The "Deep Dive": The goal is to explore past behaviors and problem-solving by method of behavioral interviewing (STAR method)
Team Meet: The goal is to assess interpersonal dynamics by way of casual coffee or group interview.

4. Master the Behavioral Interview

The best predictor of future behavior is past behavior. Avoid hypothetical questions like "What would you do if...?" and replace them with "Tell me about a time when..."

5. Don’t Ignore "Soft Skills" (Power Skills)

Technical skills can be taught; temperament usually cannot. During the process, keep a sharp eye out for:

Coachability: How do they react to feedback on their technical assignment?

Curiosity: Do they ask insightful questions about the company’s future, or only about the benefits?
Emotional Intelligence (EQ): How do they describe former colleagues or difficult bosses?

6. The "Reverse Sell."

Remember, in a talent-driven market, you are being interviewed, too. Once you find the right person, you must sell them on the vision. Explain not just what the company does, but why it matters and how it will specifically contribute to that legacy.

Final Thought

Hiring is an investment, not a chore. Slowing down the process to ensure a candidate aligns with your mission will save you months of headaches and thousands of dollars in turnover costs.

Industry data show that caregiver turnover in 2024 was 75.2% , and insights from Activated Insights, formerly Home Care Pulse, suggest that 57% of turnover happens in the first 90 days . Additionally, further data shows that if you have around 100 employees, the annual cost to replace those vacancies is around $178,000.

If you are struggling with hiring the right staff, contact Kenyon HomeCare Consulting at 206- 721-5091 or email gkenyon@kenyonhcc.com .

Sales 101: Unlocking the Secrets of Successful Exchanges

Sat, 28 Mar 2026 14:53:57 GMT

At its simplest level, sales are the process of providing goods or services in exchange for money. However, in the modern business world, sales have evolved far beyond a mere transaction. It is a sophisticated blend of psychology, problem-solving, and relationship management.

To understand sales, you have to look past the "pitch" and focus on the value .

1. The Core Philosophy: Solving, Not Selling

The most successful salespeople don't view themselves as "sellers." They view themselves as consultants .

Modern sales are built on the idea of Problem/Solution Matching . If a customer has a problem (a "pain point") and your product can solve it, the sale is simply the logical conclusion of that discovery. If you try to sell something to someone who doesn't need it, you aren't doing sales; you're doing a disservice.

2. The Sales Pipeline (The Journey)

Most sales follow a structured path known as the Sales Funnel or Pipeline . While the names change depending on the industry, the stages generally look like this:

· Prospecting: Identifying potential customers who might need your product.

· Qualifying: Determining if the prospect has the budget, authority, and actual need to buy.

· Discovery: Asking deep questions to understand the client's specific challenges.

· Presentation/Pitch: Showing exactly how your product solves those challenges.

· Handling Objections: Addressing concerns about price, timing, or competitors.

· Closing: Finalizing the agreement and signing the contract.

· Follow-up: Ensuring the customer is happy (which leads to referrals).

3. Common Sales Methodologies

There isn't just one way to sell. Different products require different strategies:

Always remember you are there to help the referral source with their problems. Learn what they do and where their pain points are. E.g., if the organization is in the senior housing business, the goal is always to keep the apartments full. If a resident needs more care than the building is licensed to provide, you can help by providing the needed services and keeping the resident renting the apartment. Look to be a partner with the referral source. Hard sales (talking about your agency) turn off potential referral sources.

If you are having difficulty with your sales, call Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com .

Home Care Sales 101: Building Trust in the Most Personal Space

Thu, 26 Mar 2026 13:28:07 GMT

Selling home care isn't like selling software or a car. You aren't just peddling a service; you are asking for permission to enter someone’s private sanctuary and care for their most vulnerable loved ones. Success in home care sales requires a unique blend of empathy, persistence, and clinical literacy. Here is your foundational guide to mastering the "soft sell" of senior services.

1. Understand Your "Two-Headed" Customer

In home care, the person paying or making the decision is rarely the person receiving the care. You must speak to two different sets of needs:

· The Adult Child (The Gatekeeper): Usually a daughter or son in their 40s–60s. They are stressed, guilty, and looking for reliability and safety .

· The Senior (The Client): They are often resistant. They fear a loss of independence. To them, you must sell autonomy and companionship, not "supervision."

2. The Power of "Discovery."

The biggest mistake new sales reps make is "feature dumping,” listing every service from meal prep to medication reminders before listening.

Instead, use Open-Ended Questions :

· “What does a typical morning look like for your mom right now?”

· “What is the one thing keeping you up at night regarding her safety?”

· “If we could help with one task to make your life easier, what would it be?”

Pro Tip: In home care, the person who asks the best questions—not the person with the best brochure—wins the contract.

3. Building a Referral Powerhouse

While digital marketing is great, home care is fueled by professional referrals. You need to build a "Inner Circle" of partners who see the client before you do:

Referral Source and Why They Matter:

Elder Law Attorneys: They deal with long-term planning and asset protection.

Rehab Centers (SNFs): Patients transitioning home often need "bridge" care.

Hospice Providers: They focus on comfort; you provide day-to-day support.

4. Handling the "I Can Do It Myself" Objection

This is the most common hurdle. When a senior says they don’t need help, don’t argue with them.

Validate and Pivot.

· The Script: "I completely agree that you’ve been doing a great job managing things. Our goal isn't to take over; it’s to handle the 'busy work' like laundry and cooking so you can spend your energy on the things you actually enjoy doing."

5. The "Speed to Lead" Rule

In the home care industry, the first agency to pick up the phone or arrive for the assessment wins about 70% of the time. Families usually call when they are in a state of crisis (a fall, a hospital discharge, or a caregiver burnout). If you wait 24 hours to return a call, they have already signed with your competitor.

If you are struggling with sales, call Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com .

Stay Ahead: Essential Tips for Policy and Procedure Compliance

Sat, 21 Mar 2026 19:11:48 GMT

In the rapidly evolving landscape of home care and home health, a current and complete Policy and Procedure (P&P) manual is more than just a regulatory requirement; it is the fundamental blueprint for operational safety and organizational excellence.

As healthcare continues to shift toward the home, these manuals provide the necessary framework to ensure every visit meets high clinical standards and respects the unique environment of a private residence.

Ensuring Patient Safety and Quality of Care

A comprehensive manual standardizes care practices to minimize variability, which directly reduces the risk of medical errors and accidents.

· Standardization: According to American HHM , clear policies on hand hygiene and medication administration ensure that all caregivers provide consistent care, reducing the likelihood of infection or dosage errors.

· Evidence-Based Practice: Regularly updated manuals incorporate the latest medical and industry standards and knowledge, ensuring patients receive the most effective, current treatments.

· Emergency Preparedness: Detailed procedures for fire, severe weather, or health crises guide staff in high-stress situations, safeguarding both the client and the professional.

Regulatory Compliance and Legal Protection

Home health agencies (HHAs) must navigate a complex web of federal and state laws. A current manual acts as a shield against legal and financial repercussions.

· Meeting Mandates: Documentation must align with the CMS Conditions of Participation and state licensing laws to maintain operational licenses and avoid costly penalties.

· Audit Readiness: A complete manual provides evidence that safety parameters and training protocols were in place, which is vital during state inspections or litigation.

· Staff Liability: By following established protocols, healthcare professionals protect their individual licenses from disciplinary actions.

Operational Efficiency and Staff Training

A well-structured manual serves as a "single source of truth," fostering a culture of accountability and professional growth.

· Onboarding: According to Medbridge, clear guidelines accelerate new employee integration and reduce turnover by outlining exact roles and responsibilities.

· Decision-Making: P&P manuals remove ambiguity, allowing administrative and clinical staff to make quicker, more confident decisions in daily operations.

· Uniformity: Standardizing tasks like billing, intake, and incident reporting ensures the business runs smoothly and transparently.

Best Practices for Maintenance

Because the healthcare environment is dynamic, a static manual quickly becomes a liability.

· Annual Reviews: Agencies should conduct annual reviews at a minimum, or every six months in high-risk areas, to stay current with changing laws.

· Stakeholder Input: Involving frontline staff and leadership in the review process ensures that policies remain practical and reflective of real-world care delivery.

· Digital Accessibility: Utilizing digital platforms allows for instant updates and ensures all staff have 24/7 access to the most current versions of procedures.

Policy and Procedure Resources

For agencies looking to establish or update their manuals, Kenyon HomeCare Consulting offers comprehensive, national, and some state-specific templates:

Product Price

· Accreditation Ready Medicare Certified Home Health or Hospice P&P manual: $980

· Skilled Home Health P&P Manual Template: $940

· Non-Skilled P&P Manual Home Care Template: $750

· Admission Packets: Medicare Home Health, Hospice, Skilled Home Health, and

Non-Skilled Home Care $175

· Employee Handbook: $500

· Operations Manual (all agencies): $500

· Aide Test Kit: $175

· Forms Manual: $175

· Clinical P&P Manual: $175

If you are starting an agency or already have one, but your manuals are out of date, consider buying an updated manual. Consider the Kenyon HomeCare Consulting manuals to meet your needs. If you need assistance in preparing your manuals or assistance with the general agency practices, Kenyon HomeCare Consulting is here to help. Call 206-721-5091 or email gkenyon@kenyonhcc.com .

The Dos and Don'ts of Starting a Home Care Agency

Fri, 13 Mar 2026 11:00:16 GMT

Starting a home care agency is a rewarding business venture that meets the growing demand for aging-in-place services. Whether you plan to offer non-medical companionship or skilled medical care, the process requires careful navigation of state-specific legalities, staffing, and operational infrastructure.

Define Your Service Model

Before diving into paperwork, decide what level of care your agency will provide:

· Non-Medical Home Care: Includes companion care, meal preparation, and help with activities of daily living (ADLs).

· Skilled Home Health Care: Requires licensed medical professionals to provide nursing, physical therapy, or wound care.

· Payment Sources: Determine if you will accept private pay, long-term care insurance, or seek Medicare and Medicaid certification.

Legal Registration and Structure

Establish your agency as a legal entity to protect your personal assets.

· Business Entity: Register your business as an LLC or Corporation through your Secretary of State.

· Tax ID: Obtain an Employer Identification Number (EIN) from the IRS for tax and hiring purposes.

· Certificate of Need (CON): In 14 states, you must prove there is a community need for a new agency before you can apply for a license.

Licensing and Insurance

Licensing is the most critical hurdle. Each state has unique requirements, often managed by the Department of Health.

· State Licensing: Submit a formal application, which often includes a review of your organizational structure and criminal background checks for leadership. · Policy Manuals: You must draft formal policies and procedures covering client intake, care plans, and emergency protocols, etc.

· Insurance: Secure professional and general liability insurance, as well as workers' compensation and cybersecurity coverage.

Creating a Business Plan

A solid plan is essential for securing funding and guiding growth. Key sections should include:

· Market Analysis: Research local competitors and the demand for specific services in your area.

· Financial Projections: Forecast startup costs, revenue targets, and cash flow for at least the first three years.

· Operations Plan: Detail your office location, required medical equipment, and software for scheduling and billing.

Staffing and Recruitment

Your caregivers are the face of your company.

· Hiring: Recruit caregivers, nurses, or administrative staff who meet state-mandated training and certification levels. · Compliance: Implement mandatory background checks (like Live Scan) and health screenings, such as TB tests.

· Retention: Focus on a positive culture and ongoing education to reduce high industry turnover rates.

Marketing, Sales, and Growth

Building a client base requires a mix of digital and community outreach.

· Online Presence: Build a professional, SEO-optimized website and claim your Google Business Profile.

· Sales: Referral Networks: Cultivate relationships with local hospitals (if a Medicare Agency), rehabilitation centers, and discharge planners who can refer patients to your agency. If you are a non-Medicare agency, Senior Housing, Adult Day Care, or Local Fire and Police Departments

· Quality Assurance: Establish a Quality Assurance and Performance Improvement (QAPI) program to monitor care standards and remain audit-ready

Regardless of the type of agency you are starting, be sure you have all the elements that you will need to be successful. If you are unsure of the correct steps and need assistance, call Kenyon HomeCare Consulting at 206-720-5091 or email gkenyon@kenyonhcc.com .

Help Wanted: Addressing the Medicare Home Health Workforce Crisis

Wed, 11 Mar 2026 12:59:34 GMT

In 2026, the home care industry is navigating what many experts call a "perfect storm." While demand for “aging in place “is at an all-time high, the industry is struggling with a widening gap between that demand and the operational capacity to meet it.

The biggest issues currently facing the industry fall into four primary categories:

1. The Workforce Crisis

Staffing remains the "Achilles' heel" of home care. It is no longer just a recruitment problem; it is a structural capacity bottleneck.

· Extreme Turnover: Frontline turnover rates are routinely hitting 70% to 80%, forcing agencies to spend between $2,600 and $5,000 per new hire.

· Competition for Talent: Agencies are competing not just with each other, but with retail and hospitality sectors that often offer similar wages with less physical and emotional strain.

· Burnout: Schedulers and office staff are facing high burnout rates due to "firefighting" daily shift callouts, which disrupt 5% to 15% of all scheduled visits.

2. Regulatory and Reimbursement Pressure

For 2026, the Centers for Medicare & Medicaid Services (CMS) has finalized significant changes that squeeze provider margins.

· Medicare Payment Cuts: CMS finalized a net aggregate payment reduction of 1.3% for 2026. While less than the 6.4% initially proposed, it still represents a $220 million drop from 2025.

· "Behavioral" Adjustments: CMS continues to apply permanent and temporary cuts to offset what it views as overpayments from previous years under the Patient-Driven Groupings Model (PDGM).

· Aggressive Audits: There is a heightened focus on fraud and compliance. CMS is increasingly using its authority to retroactively recoup payments for documentation errors, such as failing to justify a patient’s "homebound" status.

3. The Medicare Advantage "Margin Squeeze"

Medicare Advantage (MA) plans now cover more than half of all Medicare beneficiaries, but they often present a financial challenge for home care agencies.

· Lower Rates: MA plans typically pay significantly less than traditional Medicare.

· Administrative Burden: Providers are struggling with "payer friction," including complex prior authorization requirements and delayed payments that destabilize cash flow.

4. Rising Patient Acuity

Hospitals are discharging patients "quicker and sicker" to free up beds, meaning home care agencies are now managing much more complex medical cases than they did five years ago.

· Specialized Care Needs: There is a 3x increase in demand for specialized dementia and Alzheimer's care.

· Clinical Gaps: Many agencies lack the specialized nursing staff required to handle these high-acuity patients, leading them to turn away referrals even when they have general capacity.

If you are struggling with workforce issues and could use some assistance with retention strategies, call Kenyon Home Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com

Mastering Home Health Correction Plans: A Step-by-Step Guide

Mon, 16 Feb 2026 17:50:17 GMT

A Plan of Correction (PoC) is a formal response to a statement of deficiencies (often from a health care or regulatory audit). It outlines how you will address identified issues and ensure they don’t recur. To be effective, a PoC must address the "Who, What, Where, When, and How" of the correction.

1. Address the Immediate Correction

Detail the specific actions taken to fix the individual deficiency cited in the report.

· Identify the specific instance: State exactly what was corrected for the particular patient, record, or area mentioned.

· Timeline: Include the date the immediate fix was completed.

2. Identify Other Vulnerable Areas

Regulators want to know you looked beyond the one mistake they found.

· Conduct a sweep: Explain how you checked other similar records, residents, or equipment to ensure the problem isn't widespread.

· Example: "On [Date], the Director of Nursing audited all medication carts to ensure no other expired vials were present."

3. Implement Systemic Changes

This is the "root cause" section. Explain what new processes or training will prevent a recurrence.

· Policy updates: Mention if you revised an existing policy or created a new one.

· Staff Education: Detail who was trained, what they were taught, and when the training occurred.

4. Monitor for Quality Assurance (QA)

Explain how you will verify that the fix is working.

· Auditing schedule: State how often you will audit (e.g., weekly for 4 weeks, then monthly).

· Accountability: Name the specific job title (e.g., "The Quality Assurance Manager") responsible for overseeing the audits.

· Thresholds: Define what happens if the audits show the problem is returning.

Tips for Success

· Be Concise: Use clear, professional language. Avoid "fluff" or defensive explanations.

· Include Dates: Every action must have a specific completion date.

· Avoid "We Will": Use "The facility has..." or "The [Title] updated..." to show that action is already underway.

· Include education for staff as appropriate: T o make sure the “fix” is permanent, education must be specific to the issue found in the citation and demonstrate that staff understand the issue and the corrections. Routine audits will need to be conducted to ensure that staff are compliant with the corrections.

Plans for correction can seem overwhelming and difficult. If you are struggling with creating a plan of correction for findings in a survey, contact Kenyon HomeCare Consulting at 206-721- 5091 or email gkenyon@kenyonhcc.com .

Master Medicare Surveys: The Essential Binder for Home Health & Hospice

Tue, 10 Feb 2026 20:12:23 GMT

Preparing for a CMS survey in home health or hospice requires shifting from "crisis mode" to a culture of continuous compliance. Because surveys are unannounced, agencies must be ready every day.

1. Build a "Survey Readiness Book."

Create a central digital or physical Survey Book that contains everything a surveyor will request within the first hour. This prevents panic when the receptionist announces, "The surveyors are here." Key items include:

· Organizational Essentials: Current organizational chart, all state licenses, and CLIA waivers.

· Patient Data: A list of active patients with admission dates, diagnoses, and their scheduled visit dates during the survey week.

· Reporting: Unduplicated admission counts for the past 12 months and a list of discharges/transfers.

· Contracts: Current agreements for pharmacies, DME, and contracted staff.

2. Focus on "High-Deficiency" Areas.

CMS data shows that most citations fall into a few predictable categories. Proactively audit these areas:

· Individualized Plans of Care: Ensure care plans are specific to the patient's unique needs (e.g., specific swallowing techniques for dysphagia) rather than "cookie-cutter" templates.

· Medication Management: Review medication profiles for potential adverse reactions and ensure they match the current physician orders exactly.

· Infection Control: Surveyors frequently cite hand hygiene and improper PPE use during home visits. Demonstrate continuing education that ensures compliance with these requirements. ALWAYS WASH IN AND OUT OF A HOME AND ACCORDING TO YOUR POLICY AT A MINIMUM!

· Aide Supervision: Verify that hospice/home health aides are supervised according to the required 14-day cycle.

3. Conduct Mock Surveys and Staff Drills.

Simulation is the best way to identify gaps before the state agency does.

· The First 30 Minutes: Practice the entrance conference and ensure multiple staff members know how to pull records from your EMR.

· Staff Interviews: Ask field staff typical surveyor questions: "How do you know this patient is eligible?" or "What do you do if you suspect patient abuse?"

· Tracer Audits: Follow a "patient’s story" through their chart to ensure interdisciplinary team (IDG) notes support the plan of care and document the patient's decline or progress.

4. Maintain Environmental and Safety Compliance.

· Emergency Preparedness: Ensure your Emergency Preparedness Plan (EPP) includes a site-specific risk assessment and proof of annual training and drills.

· Physical Office: Check that supplies are not expired and that exit signs and fire extinguishers are maintained.

5. Leverage Quality Programs (QAPI)

Use your Quality Assessment and Performance Improvement (QAPI) program to provide evidence that you are self-correcting. If you found an error in the past year, show the surveyor how you identified it, the plan of correction you implemented, and the data proving it’s now resolved. As with your ongoing survey readiness, someone is required to ensure that all elements of the survey readiness book are completed.

If you need assistance with survey readiness, contact Kenyon HomeCare Consulting . We can provide an organizational assessment/ mock survey with a report of areas that require immediate corrective action to ensure survey success. For assistance, call 206-721-5091 or email gkenyon@kenyonhcc.com .

Essential Medicare Home Health and Hospice Checklists for Survey Readiness

Sat, 07 Feb 2026 20:42:22 GMT

CMS survey readiness for home health and hospice agencies is centered on compliance with the Conditions of Participation (CoPs). Surveyors use specific "task" protocols to evaluate care quality through home visits, record reviews, and staff interviews.

Below are the primary checklists and required materials for both home health and hospice agencies.

1. Administrative & Logistics Checklist

These items should be organized and ready to present within the first 30 to 60 minutes of a surveyor's arrival:

· Agency Identification: Current State License, accreditation certificates, and CLIA Certificate of Waiver (if applicable).

· Leadership Structure: An up-to-date organizational chart including designated alternates for key roles.

· Service Area: A map or list of all geographical areas served, including branch locations.

· Meeting Minutes: Governing Body and QAPI committee minutes for the last 12 months.

· Contracts: Current agreements for all contracted services (e.g., pharmacy, DME, therapy).

2. Required Patient Reports (Last 12 Months)

Surveyors will use these lists to select their sample for review:

· Census Reports: Current active patient census including start-of-care dates, diagnoses, and assigned disciplines.

· Unduplicated Admissions: Total number of patients admitted over the past year.

· Discharge/Transfer Lists: Detailed listing of discharges, transfers, and revocations (for hospice).

· Visit Schedules: A schedule of all planned patient visits for the duration of the survey.

3. Clinical & Personnel File Audit Items

· Personnel Files: Must include current professional licenses, orientation checklists, annual competencies, and background checks.

· Education: Proof of 12 hours of annual continuing education for aides.

· Infection Control: A current Infection Control Plan and logs tracking infections for both patients and staff.

· Emergency Preparedness: Documentation of an all-hazards risk assessment and evidence of annual testing/drills.

4. Hospice-Specific Survey Materials

· Bereavement Records: Access to records for expired patients from the last year.

· Volunteer Logs: Documentation of volunteer hours and recruitment efforts.

· Election Forms: Signed hospice benefit election forms for the selected sample.

5. Home Health-Specific Survey Materials

· OASIS Reports: Most recent Agency Patient Related Characteristics and Error Summary reports.

· Plan of Care (Form 485): Evidence of physician-signed verbal orders and timely updates

Creating a survey readiness list is only the first step. SOMEONE must be responsible for each step. If everyone is responsible, no one is responsible! Assign appropriate individuals to survey each element and ensure all are accurate and timely. These reports should be provided monthly at the managers' meeting, and any discrepancies should be addressed for correction.

If you are having difficulty making sure you are always ready for a survey, contact Kenyon HomeCare Consulting for assistance. We can complete a virtual review or on-site mock review and provide a report of findings to ensure you are always prepared for a survey visit.

For assistance, contact Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com .

From Red Tape to Relief: Barriers to Licensure for Home Health, Hospice and Home Care Agencies

Wed, 04 Feb 2026 15:01:32 GMT

In 2026, the home health care industry faces a critical intersection of rising demand and increasingly complex regulatory hurdles. As the population ages, the home care workforce must expand to meet the needs of millions, all while agencies and individual workers are finding it increasingly more difficult to secure and maintain the necessary licenses.

These barriers range from administrative backlogs to new federal mandates that threaten the viability of smaller providers.

1. New Federal and State Mandates

Recent regulatory shifts have introduced stricter requirements for agencies to remain eligible for reimbursement.

Medicare Certification Alignment: Effective July 1, 2026, states like Indiana are implementing rules requiring all home health agencies to be Medicare-certified to receive Medicaid payments . This forces agencies that previously operated only under Medicaid to navigate the rigorous and expensive federal certification process.
Suitability and Financial Reviews: New legislation in states like Massachusetts now requires suitability reviews for any individual with at least a 5% ownership stake in an agency, along with proof of significant financial capacity to provide care.

2. Administrative and Testing Backlogs

For individual workers, the path to becoming a home care aide or nurse is often stalled by "credentialing lag."

Processing Delays: State departments are currently struggling with high volumes of pending applications, with some regions reporting thousands of supplemental materials awaiting review.
Disjointed Testing: In many areas, workers cannot test where they train . This geographic and logistical gap between education and certification has led to high candidate drop-off and prevents qualified staff from entering the field quickly.

3. Financial and Operational Obstacles

The cost of entering the home health market has become a significant barrier for startup agencies .

Prohibitive Costs: Beyond licensing fees, agencies must invest in costly infrastructure , such as electronic medical records (EMR) systems and specialized insurance (General and Professional Liability), before they can secure a license and even begin seeing patients.
Reimbursement Cuts: The 2026 Medicare Home Health Final Rule includes significant payment adjustments and cuts. For many small agencies already operating on thin margins, these financial pressures make the cost of maintaining regulatory compliance unsustainable.

4. Limited Professional Mobility

Despite the Nursing Licensure Compact (NLC) , which aims to allow nurses to practice across state lines, several barriers remain:

Inconsistent Training Standards: Federal law requires 75 hours of training for home health aides, but individual states can set much higher bars—some as high as 180 hours—making it difficult for workers to move and re-license in new states.
Immigration Hurdles: Immigrant healthcare workers often face licensure bans due to a lack of social security numbers or the lengthy, complex approval process for international certifications

As evidenced above, barriers to care are increasing from regulatory rules for agencies and the increased requirements for workers. While daunting, it is possible to be successful in the home health environment. If you need assistance with starting up an agency or maneuvering around new regulations, Kenyon HomeCare Consulting is here to help. Call 206-721-5091 or email gkenyon@kenyonhcc.com

8 Key Factors to Find the Perfect Home Care Consultant

Thu, 29 Jan 2026 13:00:17 GMT

The home health and home care industry is highly regulated, competitive, and constantly evolving. Whether you are starting a new agency, expanding services, preparing for accreditation, or improving operations, a qualified home health home care consultant can save you time, reduce costly mistakes, and accelerate your success. Choosing the right consultant, however, requires careful evaluation. Here’s a practical guide to help you make an informed decision.

1. Clearly Define Your Needs and Goals

Before searching for a consultant, identify exactly what you need help with. Home care consultants often specialize in specific areas, such as:

· Agency startup and licensing

· Medicare or Medicaid certification

· Policy and procedure development

· Accreditation (ACHC, CHAP, Joint Commission)

· Clinical compliance and audits

· Operations, billing, and reimbursement

· Staff training and leadership development

· Growth strategy and mergers or acquisitions

Clarifying your goals ensures you select a consultant whose expertise aligns with your priorities.

2. Look for Relevant Industry Experience

A strong consultant should have direct, hands-on experience in home health or home care operations. Ideal backgrounds include former administrators, directors of nursing, compliance officers, or executives within successful agencies.

Ask about:

· Years of experience in the industry

· Types of agencies they’ve worked with (home health, non-medical home care, hospice, private duty)

· Familiarity with your state’s regulations and payer requirements

Experience in your specific service model and geographic area is a major advantage.

3. Verify Credentials and Professional Qualifications

While experience is critical, credentials add credibility and reassurance. Look for consultants with:

· Nursing or healthcare administration licenses (if applicable)

· Accreditation surveyor experience

· Compliance or quality certifications

· Proven knowledge of CMS, state, and payor standards

Request references or case examples that demonstrate measurable outcomes, such as successful surveys, improved compliance scores, or revenue growth.

4. Assess Their Approach and Methodology

Not all consultants work the same way. Some provide standardized templates, while others offer highly customized solutions.

During initial discussions, ask:

· How do you assess an agency’s needs?

· Do you provide hands-on support or high-level guidance only?

· Will you train staff or focus solely on leadership?

· How do you measure success?

The best consultants act as partners—educating your team and building sustainable systems rather than offering one-size-fits-all solutions.

5. Evaluate Communication and Compatibility

Your consultant will work closely with your leadership and staff, so communication style and cultural fit matter.

Consider whether they:

· Explain complex regulations clearly

· Are responsive and accessible

· Listen to your concerns and goals

· Respect your organization’s values and vision

A consultant who collaborates effectively and builds trust will deliver far greater value than one who simply “checks boxes.”

6. Understand Pricing and Scope of Services

Consulting fees can vary widely depending on expertise, scope, and duration of engagement.

Be sure to clarify:

· Hourly vs. project-based pricing

· What deliverables are included

· Timeline and milestones

· Additional costs for travel, revisions, or ongoing support

Avoid choosing solely based on price. A higher-quality consultant often delivers a stronger return on investment by preventing compliance issues and improving performance.

7. Check References and Past Results

Always ask for references from agencies similar to yours.

When speaking with past clients, ask:

· What challenges did the consultant help solve?

· Were timelines and expectations met?

· Did the agency achieve its intended outcomes?

· Would they hire the consultant again?

Real-world results are the strongest indicator of future success.

8. Ensure Ongoing Support and Knowledge Updates

Regulations and best practices in home health care change frequently. A strong consultant stays current with industry updates and offers continued support when needed.

Ask how they:

· Track regulatory changes

· Provide updates or follow-up guidance

· Support agencies after project completion

This ensures your agency remains compliant and competitive long after the initial engagement.

Conclusion

Selecting the right home health/home care consultant is a strategic decision that can significantly impact your agency’s success. By clearly defining your needs, evaluating experience and credentials, assessing communication and methodology, and verifying results, you can choose a consultant who truly adds value. The right partner won’t just help you meet regulations—they’ll help you build a stronger, more efficient, and sustainable home care organization.

If you have had an unexpected vacancy or a critical unplanned position open, contact Kenyon HomeCare Consulting. All of our Senior Consultants are tenured administrators with in-depth clinical experience and agency management. To find out more, call 206-721-5091 or email gkenyon@kenyonhcc.com We are here to help.

Why Precision in OASIS and ICD-10 is Your Best Advantage for Home Health Success

Mon, 26 Jan 2026 17:10:56 GMT

In the home health setting, accurate documentation is more than a regulatory requirement—it is the foundation of quality patient care, compliance, and financial sustainability. Two critical components of this documentation are the Outcome and Assessment Information Set (OASIS) and ICD-10 diagnosis coding. Together, they influence clinical decision-making, reimbursement, quality reporting, and agency performance. Ensuring accuracy in both is essential for every home health organization.

Understanding OASIS and ICD-10 in Home Health

As most individuals in home health know, OASIS is a standardized data set required for Medicare-certified home health agencies. It captures a patient’s clinical status, functional abilities, and service needs at specific time points in the episode of care. OASIS data directly affects care planning, quality outcome measures, and reimbursement under the Patient-Driven Groupings Model (PDGM) .

ICD-10 coding translates the patient’s diagnoses into standardized codes that describe the medical conditions being treated. In home health, ICD-10 codes must support medical necessity, align with the plan of care, and accurately reflect the patient’s primary and secondary conditions.

While distinct, OASIS and ICD-10 are deeply interconnected. Inconsistencies between them can lead to compliance risks, payment errors, and inaccurate quality reporting. Previous survey findings indicate that the major error in the OASIS scoring is under scoring which leads to the above noted risks.

Impact on Patient Care and Clinical Outcomes

Accurate OASIS assessments provide a clear, comprehensive picture of the patient’s condition. This information guides clinicians in developing individualized care plans, identifying risks (such as falls or hospitalization), and tracking progress over time. When OASIS responses truly reflect the patient’s status, care teams can make better clinical decisions and intervene appropriately.

Similarly, precise ICD-10 coding ensures that all relevant diagnoses, especially those impacting function and care needs, are recognized and addressed. Missing or incorrect diagnoses can result in incomplete care plans, overlooked comorbidities, and suboptimal outcomes.

Reimbursement and Financial Integrity

Under PDGM, both OASIS data and ICD-10 codes play a direct role in determining reimbursement. Functional levels, clinical groupings, and comorbidity adjustments are all driven by the accuracy of these elements. Errors such as upcoding, under coding, or mismatched documentation can lead to underpayment, overpayment, or costly payment reviews and recoupments.

Accurate coding and assessment protect an agency’s financial health by ensuring appropriate reimbursement for the complexity and intensity of care provided—no more and no less.

Compliance and Audit Readiness

Home health agencies operate in a highly regulated environment. Inaccurate OASIS responses or unsupported ICD-10 codes can trigger red flags during audits by Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), or other oversight bodies.

Consistent, accurate documentation demonstrates compliance with Medicare guidelines, supports medical necessity, and reduces the risk of denials, penalties, and allegations of fraud or abuse.

Quality Measures and Public Reporting

OASIS data feeds directly into publicly reported quality measures, such as functional improvement, hospitalization rates, and patient satisfaction. Inaccurate data can distort an agency’s performance metrics, negatively affecting star ratings and referral relationships.

High-quality, accurate data ensures that reported outcomes truly reflect the care provided and the agency’s commitment to excellence.

The Role of Education and Collaboration

Achieving accuracy in OASIS and ICD-10 coding requires ongoing education, interdisciplinary collaboration, and strong internal processes. Clinicians, coders, and quality staff must work together to ensure documentation is clear, consistent, and supported across all records. Regular audits, feedback, and training help reinforce best practices and keep teams aligned with evolving regulations.

Conclusion

Accurate OASIS and ICD-10 coding is not simply an administrative task—it is a cornerstone of effective home health care. It supports better patient outcomes, ensures fair reimbursement, strengthens compliance, and enhances an agency’s reputation for quality. By prioritizing accuracy and investing in education and collaboration, home health agencies can deliver care that is both clinically sound and operationally strong. If your reimbursement rates are lower than the national standard for each diagnosis, it is quite possible that the OASIS was scored inaccurately leading to lower ICD-10 coding, and reimbursement. If you are struggling with these issues, contact Kenyon HomeCare Consulting at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help.

Boost Profits and Patient Outcomes with Chronic Disease Education

Thu, 22 Jan 2026 11:00:10 GMT

Chronic diseases such as diabetes, heart disease, asthma, arthritis, and COPD account for the majority of healthcare utilization and spending worldwide. In the United States alone, patients with chronic conditions drive a disproportionate share of hospital admissions, readmissions, emergency visits, and long-term medication use. While these realities strain health systems, they also reveal a powerful opportunity: chronic disease education .

When designed and implemented effectively, chronic disease education programs do more than improve patient outcomes—they can also increase your staff retention, increase revenue, reduce avoidable costs, and strengthen the financial sustainability of your healthcare organizations. Rather than being a “nice-to-have,” education is increasingly a strategic asset.

The Care Gap in Chronic Disease Management

Most chronic diseases are managed outside clinical settings. Patients make daily decisions about medication adherence, diet, exercise, symptom monitoring, and when to seek care. Yet many patients leave appointments without fully understanding their condition, treatment plan, or warning signs.

This gap leads to predictable consequences:

Poor adherence to medications and lifestyle recommendations
Higher rates of complications and disease progression
Increased emergency department visits and hospital remissions
Lower patient satisfaction and trust

Education directly addresses these issues by equipping patients with the knowledge, skills, and confidence to manage their conditions effectively between visits.

Improving Care Through Education

Better Clinical Outcomes

Well-structured education programs help patients understand the “why” behind their care.

For example:

Diabetes education improves glycemic control and reduces complications.
Heart failure education lowers readmission rates by helping patients recognize early warning signs.
Asthma education reduces exacerbations and emergency visits.

When your staff and your patients understand their condition and treatment plan, outcomes improve—not because care is more complex, but because it is more consistent.

Enhanced Employee and Patient Engagement and Activation

Education transforms your staff and patients from passive providers/recipients of care into active participants.

Engaged staff and patients:

Ask better questions
Follow care plans more closely
Monitor symptoms proactively
Communicate earlier when problems arise

Higher employee patient activation is strongly associated with improved outcomes, lower costs, and better experiences of care.

Continuity and Quality of Care

Education supports continuity by reinforcing care plans across settings—primary care, specialty care, and home. This consistency reduces fragmentation and improves quality metrics, including preventive care adherence and chronic disease control benchmarks.

Revenue Growth Through Chronic Disease Education

While education improves care, it also creates multiple revenue and financial performance benefits.

Organizations that invest in structured education programs are better positioned to capture this revenue, particularly when education is integrated into care workflows and properly documented.

Performance in Value-Based Payment Models

As healthcare continues to shift from fee-for-service to value-based care, outcomes matter more than volume. Education improves performance on key metrics such as:

Hospital readmissions
Emergency department utilization
Disease control measures (e.g., A1C, blood pressure)
Patient satisfaction scores

Better performance leads to shared savings, bonuses, and reduced penalties—directly impacting the bottom line.

Preventable hospitalizations, readmissions, and complications are costly. Education helps reduce these events, preserving revenue that would otherwise be lost to penalties, uncompensated care, or inefficient utilization.

For integrated systems and accountable care organizations, preventing avoidable utilization is not lost revenue—it is retained margin.

Strengthening Patient Loyalty and Lifetime Value

Chronic disease patients often interact with the healthcare system over many years. Education builds trust and long-term relationships by demonstrating that the organization is invested in patients’ daily lives, not just episodic visits.

Educated patients are more likely to:

Stay within a health system for ongoing care
Use recommended services and follow-up visits
Recommend providers to family and friends

This increases patient lifetime value while supporting stable, predictable revenue streams.

Operational Benefits for Care Teams

Education also benefits clinicians and care teams:

Fewer crisis-driven visits and urgent calls
More productive appointments with informed patients
Reduced burnout from preventable complications
Better alignment across multidisciplinary teams

When patients understand their care plans, clinicians can focus on higher-value clinical decision-making rather than repeated basic explanations.

Conclusion: Education as a Strategic Investment

Chronic disease education sits at the intersection of better care and better business. By empowering patients to manage their conditions more effectively, healthcare organizations can improve outcomes, reduce avoidable utilization, and unlock new revenue opportunities, especially in value-based care environments.

In an era where chronic disease drives both cost and complexity, education is not just an intervention. It is a strategic lever that improves care quality, strengthens patient relationships, and supports sustainable financial growth

Kenyon HomeCare Consulting has multiple 8 hour certified chronic disease courses that will improve the knowledge base of your staff and patients and remarkably increase your revenues while diminishing staff turnover. For more information, go to the education dropdown in the Kenyon Store. If you need more assistance or have questions, call 206-721- 5091 or email gkenyon@kenyonhcc.com We are here to help.

How to Select and Hire the Right Interim Manager for Home Health and Hospice

Tue, 20 Jan 2026 19:16:59 GMT

Periods of transition are inevitable in-home health and hospice organizations. Leadership departures, rapid growth, regulatory challenges, census fluctuations, or operational turnarounds can leave agencies vulnerable if not addressed quickly and strategically. An experienced interim manager can provide stability, expertise, and momentum—if the right individual is selected.

Hiring an interim leader is not the same as hiring a permanent executive. The criteria, timeline, and expectations are different. Below is a practical guide and steps to selecting and hiring an interim manager who can deliver immediate impact in a home health or hospice setting.

1. Clearly Define the Need and Scope:

Before beginning the search, clarify why an interim manager is needed and what success looks like.

Common reasons include:

Sudden departure of an administrator, DON, or executive director
Regulatory survey preparation or remediation
Financial or operational turnaround
Rapid growth, mergers, or acquisition integration
Temporary coverage during a permanent search

Define the scope in writing:

Specific role and authority
Key priorities for the first 30, 60, and 90 days
Expected duration of the engagement
Decision-making autonomy and reporting structure

Clarity upfront prevents misalignment and accelerates results.

2. Prioritize Industry-Specific Experience

Home health and hospice are highly regulated, clinically complex environments. An effective interim manager must understand:

CMS Conditions of Participation (CoPs)
State and federal survey processes
PDGM (home health) or hospice reimbursement models
Clinical, operational, and financial workflows
EMR systems commonly used in post-acute care
General healthcare or corporate turnaround experience is not enough. Look for candidates with direct leadership experience in home health or hospice—and ideally in situations similar to yours.

3. Look for “Hit-the-Ground-Running” Leaders

Interim managers are expected to deliver impact quickly. Unlike permanent hires, they do not have the luxury of long onboarding periods. The best interim leaders demonstrate:

Rapid assessment skills
Decisive, confident leadership
Ability to stabilize teams during uncertainty
Comfort making difficult decisions early
Strong communication with staff, owners, and regulators
Ask candidates to describe situations where they entered a troubled or unfamiliar organization and produced measurable results within weeks—not months.

4. Evaluate Change Management and People Skills

In transitional periods, staff morale is often fragile. Resistance to change, survey anxiety, and burnout are common. A successful interim manager must balance authority with empathy.

Key traits to assess include:

Emotional intelligence
Conflict resolution skills
Experience leading through crisis or change
Ability to quickly build credibility with clinicians and staff
Behavioral interview questions and references focused on leadership style—not just outcomes—are essential.

5. Consider Cultural Fit and Organizational Maturity

Even short-term leaders must align with the organization’s culture, values, and level of operational maturity. An interim manager who is too rigid or too aggressive can destabilize an already stressed environment.

Assess whether the candidate:

Adapts leadership style to the organization
Respects existing staff while holding them accountable
Understands the difference between temporary fixes and sustainable improvements
The goal is progress, not disruption for its own sake.

6. Use Specialized Interim Staffing Firms When Possible

Given the urgency and specialization required, many organizations benefit from working with firms that focus exclusively on interim leadership in post-acute care.

These firms can:

Pre-vet candidates for regulatory and industry expertise
Match leaders based on specific challenges
Provide faster placement
Offer backup support if the engagement needs to pivot

This approach often reduces risk and shortens time to impact.

7. Establish Clear Metrics and Communication Cadence

From day one, define how performance will be measured.

Common interim success metrics include:

Survey readiness or deficiency resolution
Financial stabilization or improved margins
Improved census or referral relationships
Staff retention or engagement improvements
Implementation of standardized processes

Schedule regular check-ins with ownership or the board to ensure alignment and transparency throughout the engagement.

8. Plan the Transition Out—Early

An effective interim engagement includes planning for the exit.

Whether transitioning to a permanent leader or handing operations back to internal staff, the interim manager should:

Document processes and improvements
Mentor internal leaders
Provide a transition report with recommendations
Ensure continuity of leadership and strategy

A well-planned transition protects the organization from regression once the interim role concludes.

Final Thoughts

Selecting the right interim manager for a home health or hospice organization can mean the difference between prolonged instability and rapid recovery. By clearly defining needs, prioritizing industry expertise, and focusing on leadership effectiveness, not just credentials—organizations can leverage interim leadership as a strategic advantage rather than a stopgap.

In times of change, the right interim leader doesn’t just fill a gap—they move the organization forward.

If you find you need an interim manager to not only keep the ship upright, but also move it ahead while preparing your agency for a new or returning manager, consider Kenyon HomeCare Consulting . All of our Senior Associates come with at least 20 years’ experience in the senior management level. Contact us at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help you succeed.

Elevate Your Home Health Care: Mastering the OASIS Impact

Sat, 17 Jan 2026 16:54:14 GMT

The Outcome and Assessment Information Set (OASIS) is a standardized data collection tool required for Medicare-certified home health agencies. It plays a critical role in patient care planning, quality measurement, reimbursement, and regulatory compliance. Accurate OASIS assessment is not simply a documentation task—it is foundational to the success and integrity of Medicare Home Health services.

What Is OASIS?

For most of you in Medicare Home Health you know that OASIS is a comprehensive set of standardized questions used to assess adult patients receiving skilled home health care. It is completed at specific time points, such as start of care, resumption of care, recertification, transfer, and discharge. The data collected reflects a patient’s functional status, clinical condition, and service needs. It is a head-to-toe ASSESSMENT, not a survey tool.

The data from the OASIS is submitted to the Centers for Medicare & Medicaid Services (CMS) and is used to measure outcomes, calculate reimbursement under the Patient-Driven Groupings Model (PDGM) , and monitor your agency performance.

Impact on Patient Care and Outcomes

Accurate OASIS data is essential for developing an effective, individualized plan of care. The assessment provides a detailed snapshot of the patient’s abilities, limitations, and risks at a given point in time. When completed correctly, OASIS helps clinicians:

Identify safety risks such as potential or medication issues
Determine appropriate therapy and nursing interventions
Track patient progress over time
Ensures continuity of care across disciplines

Inaccurate or incomplete OASIS responses can lead to care plans that do not fully address patient needs, potentially compromising safety, recovery, and overall outcomes, and result in inaccurate payments to your agency.

Influence on Medicare Reimbursement

Under PDGM, OASIS data directly affects payment. Specific OASIS items help determine clinical grouping, functional impairment level, comorbidity adjustment, and timing classification. Errors in assessment can result in:

Underpayment for services provided
Overpayment, which may trigger audits and recoupments
Increased claim denials

Accurate OASIS coding ensures that agencies are appropriately reimbursed for the complexity and intensity of care they deliver, while remaining compliant with Medicare regulations.

Quality Reporting and Public Ratings

OASIS data feeds into CMS quality measures and Home Health Star ratings. These publicly reported metrics influence referral patterns, consumer choice, and agency reputation. Accurate data collection is critical because:

Quality scores reflect actual patient outcomes rather than documentation errors
Star ratings impact competitiveness in the marketplace
Value-based purchasing adjustments are based on reported performance

Poorly completed OASIS assessments can make an agency appear to provide lower-quality care than it actually does.

Regulatory Compliance and Audit Risk

CMS, Medicare Administrative Contractors (MACs), and other oversight bodies rely on OASIS data to monitor compliance. Inconsistencies between OASIS, clinical notes, and physician orders are a common focus during audits. Inaccurate OASIS documentation can lead to:

Medical review findings
Payment recoupments
Civil monetary penalties
Increased scrutiny from regulators

Maintaining accuracy protects agencies from unnecessary risk and demonstrates adherence to Medicare Conditions of Participation.

Clinician Responsibility and Training

OASIS accuracy depends heavily on clinician knowledge and critical thinking. It is not enough to answer questions based on habit or assumptions. Clinicians must:

Understand CMS guidance and scoring rules
Perform thorough assessments and observations
Base responses on the patient’s actual ability at the assessment time point
Ensure consistency between OASIS answers and narrative documentation

Ongoing education, competency assessments, and auditing are essential to support clinicians and maintain high standards.

Operational and Financial Benefits

Beyond compliance and reimbursement, accurate OASIS data supports better operational decision-making. Agencies can use reliable data to:

Identify trends in patient acuity
Allocate resources effectively
Improve clinical outcomes through targeted interventions
Support strategic growth and contracting

Inaccurate data, by contrast, undermines analytics and weaken organizational performance.

Conclusion

Accurate OASIS assessment is a cornerstone of successful Medicare Home Health operations. It directly affects patient care quality, reimbursement, public reporting, and regulatory compliance. Agencies that prioritize OASIS accuracy through training, oversight, and a culture of accountability are better positioned to deliver high-quality care while maintaining financial and regulatory stability.

In Medicare Home Health, accuracy is not optional, it is essential!

If your agency is having financial difficulties or struggling with clinical staff on accurate OASIS scoring and efficiency, Kenyon Home Care Consulting is here to help. We can assist with the education to staff and have and experienced coding department with certified OASIS and ICD coding clinicians. Call 206-721-5091 or email gkenyon@kenyhonhcc.com .

Stay Ahead: How Updated Manuals Transform Agency Operations

Thu, 15 Jan 2026 16:50:18 GMT

In any organization, whether a non-skilled home care, home health or a Medicare Home Health or Hospice —policies and procedures serve as the foundation for consistent, fair, and effective operations. A policy and procedure manual is more than a reference document; it is a living guide that shapes decision-making, behavior, and accountability. Keeping this manual updated is not optional—it is essential for organizational success, compliance, and growth.

Adapting to Change:

Health Care Organizations operate in environments that are constantly evolving. Laws and regulations change, technology advances, and internal structures shift as organizations grow or reorganize. An outdated policy and procedure manual may reflect practices that are no longer legal, efficient, or relevant. This can expose an organization to legal risk, confusion, and inefficiency. Regular updates ensure that policies align with current laws, industry standards, and organizational goals.

Ensuring Consistency and Fairness:

Clear, up-to-date policies promote consistency in how tasks are performed and how decisions are made. When employees or members rely on outdated guidance, similar situations may be handled differently, leading to perceptions of unfairness or favoritism. An updated manual provides a single, authoritative source of truth, helping everyone understand expectations and responsibilities. This consistency is especially important in areas such as discipline, safety, and performance management.

Supporting Training and Onboarding:

A well-maintained policy and procedure manual is a powerful training tool. New employees or members use it to understand how the organization operates, what is expected of them, and how to perform their roles correctly. If the manual is outdated, onboarding becomes confusing and inefficient, requiring additional explanations and corrections. An updated manual accelerates learning, reduces mistakes, and helps new team members integrate more smoothly.

Improving Efficiency and Accountability:

Procedures outline the most effective way to complete tasks. When these procedures are current, they reflect best practices and lessons learned over time. Updating the manual allows organizations to remove redundant steps, clarify responsibilities, and incorporate improvements. This leads to greater efficiency and clearer accountability, as individuals know exactly what they are responsible for and how success is measured.

Reducing Risk and Enhancing Compliance:

One of the most critical reasons to keep policies current is risk management. Outdated policies may fail to address new risks, technologies, or compliance requirements. For example, changes in data protection, workplace safety, or employment law can have serious consequences if not reflected in organizational policies. An updated manual helps protect the organization by demonstrating due diligence and providing clear guidance on compliant behavior.

Reinforcing Organizational Culture:

Policies and procedures also communicate an organization’s values and culture. Updates provide an opportunity to reinforce priorities such as inclusion, safety, integrity, and professionalism. When policies reflect current values and realities, they strengthen trust and credibility among employees, members, and stakeholders.

A Living Document, Not a One-Time Task:

An effective policy and procedure manual should be treated as a living document. Regular reviews—annually or whenever significant changes occur—ensure that it remains accurate and useful. Involving leadership and relevant stakeholders in the review process increases buy-in and helps identify gaps or areas for improvement.

Conclusion:

An updated policy and procedure manual is essential for clarity, consistency, compliance, and organizational health. It supports daily operations, protects against risk, and helps people understand how to work effectively within the organization. By committing to regular updates, organizations demonstrate responsibility, adaptability, and a commitment to continuous improvement.

If you have not kept your policy and procedure manual up-to-date as regulations and rules change, you may need to purchase one for your agency or get help to update your existing manual. Kenyon Homecare Consulting is here to help. If you are looking to purchase a new manual, click here and contact Kenyon Homecare Consulting to help ensure you have chosen the proper manual to cover your agency. Please note that some manuals already have specific state regulations added. So, you may be able to have one with state rules already integrated. If you need assistance with your manual, please call us at 206-721-5091 or email me at gkenyon@kenyonhcc.com .

Unlocking Essential Skills: Chronic Disease Education for Home Care Aides

Wed, 07 Jan 2026 20:24:19 GMT

As populations age and more people choose to receive care at home, home care aides play an increasingly vital role in supporting individuals with chronic diseases. Conditions such as diabetes, heart disease, arthritis, asthma, dementia, and Parkinson’s disease are long-term, often complex, and require consistent, informed care. For home care aides, education in chronic diseases is not just helpful, it is essential for ensuring safety, dignity, and quality of life for the people they serve.

Understanding the Person Behind the Diagnosis:

Chronic diseases affect far more than a single organ or symptom. They influence a person’s mobility, mood, energy levels, and daily routines. When home care aides are educated about these conditions, they are better able to understand why a client may move slowly, experience pain, become confused, or need frequent rest. This understanding fosters empathy and patience, helping aides provide care that is respectful and person-centered rather than task focused.

Improving Safety and Preventing Complications:

Many chronic illnesses carry risks that can escalate quickly if not recognized early. For example, changes in blood sugar levels, breathing difficulties, or signs of infection can become emergencies if overlooked. Educated home care aides are more likely to notice early warning signs and respond appropriately—by adjusting daily routines, notifying supervisors or family members, or seeking medical help when needed. This proactive approach can prevent hospitalization and serious complications.

Supporting Daily Disease Management:

Chronic disease management often depends on daily habits: taking medications correctly, following dietary guidelines, staying active within safe limits, and monitoring symptoms. Home care aides who understand the basics of chronic conditions can reinforce care plans and help clients stay consistent with these routines. Even simple support—such as recognizing why medication timing matters or why hydration is important—can have a significant impact on long-term health outcomes.

Enhancing Communication with Healthcare Teams and Families:

Education empowers home care aides to communicate more effectively with nurses, therapists, doctors, and family members. When aides understand chronic diseases, they can provide clearer observations about changes in a client’s condition and ask more informed questions. This collaboration strengthens continuity of care and ensures everyone involved is working toward the same goals.

Promoting Independence and Quality of Life:

Well-informed aides can help clients maintain independence for as long as possible. By understanding disease progression and limitations, aides can encourage safe activities, adapt the environment, and support clients in making choices about their own care. This not only improves physical well-being but also supports emotional health, confidence, and dignity.

Professional Growth and Better Care Outcomes:

For home care aides, education in chronic diseases is also an investment in professional growth. Knowledge builds confidence, reduces stress, and improves job satisfaction. Agencies that prioritize ongoing training often see better care outcomes, stronger client relationships, and lower staff turnover.

Conclusion:

Chronic diseases are a defining challenge of modern home care. Home care aides are on the front lines, providing daily support that directly affects clients’ health and quality of life. Educating aides about chronic diseases equips them with the knowledge, awareness, and compassion needed to deliver safe, effective, and respectful care. In home care, education is not optional, it is a critical foundation for excellence.

Kenyon Home Care Consulting has a Chronic Disease University with coursework designed for all your field staff. By using this training, our statistics show that you have better retention of staff and an advantage over the competition in you area. All courses are completed online and are disease specific. This allows you to focus on diseases specific to your patient population and client needs. If you have questions, call 206-721-5091 or email gkenyon@kenyohcc.com .

Unlock Hidden Insights: How the HHCAHPS Survey Drives Clinical Excellence

Tue, 23 Dec 2025 17:21:49 GMT

Yearly, companies employed by CMS call a selected number of patients from every agency in the country. The findings are part of the Medicare Star Rating and consequently directly impact reimbursement. There are currently 34 questions in the survey and staff need to be trained to what the questions are and what it means for their practice in the home of patients.

Some of the questions are:

o How often did the home health team communicate well with you?

o How often did the home health team listen carefully to you?

o How often did the home health team explain things in a way you could understand?

o How often did the home health team treat you with courtesy and respect?

o How often did the home health team spend enough time with you?

o How would you rate the overall care from the team?

o How likely are you to recommend this home health agency to friends and family?

o Did you receive information about your medications?

o Did you receive help with your personal care needs?

o Were your home health care needs met during your time with the agency?

The 2026 draft updated HHCAHPS Survey is shorter than the current survey and includes new questions on topics suggested by interested collaborators. Specifically, proposed changes to the survey include:

Addition of three new questions to assess topics of importance to patients:

o Whether the care provided helped the patient take care of their health

o Whether the patient’s family/friends were given sufficient information and instructions

o Whether the patient felt the staff cared about them “as a person"

In addition to the three questions added, others are amended or deleted all together.

It is proposed the following be removed but has not yet been approved by CMS. It includes the removal of questions or topics of less importance to patients (i.e., six questions

about medications were reduced to two questions).

The following four questions were removed:

o Whether someone asked to see all the prescription and over the counter

medicines the patient was taking

o Whether the patient is taking any new prescription medicines or whether

the patient’s medicines have changed

o Whether home health providers talked to patients about the purpose for

taking new or changed prescription medicines, and

o Whether home health providers talked to the patient about when to take

the medicines

Proposed removal of questions not currently used in public reporting composites (i.e.,

three questions on which type of staff served the patient—nurse, physical or occupational therapist, and home care aide).

Additional removal of one question that did not perform well in testing to stand alone or fit into one of the modified composite measures is:

o Whether the patient got information about what care and services they

would get when they first started getting home health care.

There are also minor text changes to some existing questions to help clarify the question or

response options, based on feedback from patients. A crosswalk detailing the changes between the original HHCAHPS Survey and the draft updated HHCAHPS Survey is available on the HHCAHPS website through the “Survey and Protocols” menu in the “Planned Survey Materials” view .

As stated in the Home Health Prospective Payment System (HH PPS) Rate Update

Proposed Rule for calendar year (CY) 2026, CMS is proposing that the HHCAHPS

Survey vendors begin fielding the updated HHCAHPS Survey instrument with April

2026 sample month. Make sure you have the latest questions and educate your staff to the questions so they remember that their performance is measured by the patients and will be reflected in the survey findings.

If you have questions about the HHCAPS and are unsure of training needs, contact Kenyon HomeCare Consulting at 206-721-5091 or email to gkenyon@kenyonhcc.com We are here to help.

Your Ultimate Checklist for Mastering Home Health Surveys (Part 2)

Fri, 19 Dec 2025 16:07:16 GMT

Surveys are heavily focused on data, which serves as evidence of your agency's practices. Create a "Survey Book" (physical or electronic master index) that contains all required documents for immediate access.

Key Documents to Have Ready:

Patient Census Lists:

o Currently active patient census (with start-of-care, diagnosis, and disciplines).

o Unduplicated census list for the past 12 months.

2. Staffing & Personnel:

o Active staff list (including contractors) with titles, disciplines, and hire dates.

o Complete and current Human Resources (HR) files for all personnel, including evidence of background checks, up to date licensure, competency evaluations, and annual training. All personnel files should be up to date with supervision visits and evaluations.

3. Operational & Compliance Records:

o Current licenses/permits and organizational chart.

o Quality Assessment/Performance Improvement (QAPI) plan and associated performance improvement projects (PIPs), with evidence of tracking, trending, and analysis.

o Infection Control Program logs, policies, and the Annual Agency TB Assessment, Employee Hepatitis B immunization, and yearly flu vaccine (if required by your agency)

o Emergency Preparedness Plan (EPP), including documentation of training and drills/exercises. These drills are unannounced prior to the Administrator declaring the emergency. The After Action Report lists the emergency, selected members of the team, and timing of the staff response to the activation of the Emergency Plan/

o Minutes from governing body and QAPI meetings.

The Power of Policies & Procedures (P&Ps)

Ensure your P&Ps are not only up to date with current state and federal regulations (especially the Conditions of Participation - CoPs), but are also understood and followed by all staff.

Common areas of focus include:

Patient Rights (including complaint procedures)
Comprehensive head-to-to-toe assessments and care planning that reflects the findings in the assessment and patient’s wishes for services.
Infection Control and Prevention
Skilled Professional Services (e.g., nurse/aide supervision)

Any time changes are made to the policies and procedures that impact the caregivers in the field, there should be evidence of the changes and that all staff were informed of what is now expected. To ensure compliance, it is recommended that all staff receive a copy of the new policy and procedure and sign they have been instructed and understand the changes in practice that are now expected. Always document these sessions as training and education and make sure that copies are in all the personnel files.

This concludes Part 2 of the survey master list for survey success. Should you need additional assistance with survey preparation, please contact Kenyon Homecare Consulting online or call us at 206-721-5091

Your Ultimate Checklist for Mastering Home Health Surveys (Part 1)

Thu, 18 Dec 2025 17:00:19 GMT

For home health agencies, a regulatory survey is not just an inspection—it's a high-stakes assessment of your commitment to patient safety, quality care, and operational compliance. Since repeat surveys are unannounced, the goal is to cultivate a culture of "survey readiness every day." Preparing your agency for a successful survey requires proactive planning, meticulous documentation, and full staff engagement.

Below are the steps to build for continuous compliance.

1. Develop a Survey Team:

Preparation starts with designating a core team responsible for the survey response. Clear roles ensure a calm, organized, and efficient process when a surveyor walks through the door. Each person needs to know exactly what they are responsible for and what metrics they need to track to be sure the agency is always ready for a survey.

The Administrator/Survey Lead: Must be present for the entrance conference. This person is the main point of contact, handles high-level questions, and maintains a professional atmosphere for the organization with the agency staff and with any surveyors.
Director of Clinical services/ Supervisor: This team member is responsible for assuring all documentation is reviewed and appropriate. This includes OASIS accuracy, that the plan of care matches the OASIS findings, and visit documentation follows the plan of care.
ICD-10 Coders: This team member reviews the OASIS and matches it with the discharge summary to assure accuracy of OASIS (along with DCS or Supervisor). The coders also verify the ICD-10 code accurately reflects findings of the OASIS.
Clerical Support: Staff is responsible to all personnel records monthly review for required documents and all new employees for same while reporting any missing documents (e.g. updated license, auto insurance, driver’s license etc.). Create plans and have operations in place to communicate at least a month in advance to employees when items need updated. This person is also responsible for managing the logistical needs when the surveyors are on site (e.g., Wi-Fi password, workspace, etc.) to create a buffer for management. They also discreetly communicate critical questions to the Survey Lead.

The team member acting as Survey Lead is considered the survey readiness team leader. Promoting survey readiness should include regular monthly meetings with all of the survey readiness team members. Each team member should be ready to report on the status of their responsibilities and any data to support their findings.

These findings include:

a. Status of OASIS accuracy and any staff who need training.

b. Planned OASIS training that provides regular updates on areas where staff continue to struggle.

c. Plan of care with matching visit notes

d. Personnel files and any updates when employees are not responding to the request for documents

e. Status of continuing education per state or federal requirements

f. Yearly evaluations with supervisory visits to support evaluation. Supervision needs to pay particular attention to hand washing according to policy and standard infection control procedure when getting in an out of bag, with client contact, or coming in and out of the home. This remains one of the primary findings by surveyors.

g. Evidence of yearly required continuing education such as:

• Infection control

• Patient Rights and Advocacy to uphold dignity and autonomy

• Emergency Preparedness with response protocols; evidence of bi-yearly practice drills for a potential emergency

• Medication Management and safety to prevent errors

• Updated relevant health care regulations and policies

• Cultural competency to enhance communication and care for diverse populations.

All data collected by the team members may need to be sent to the compliance manager and may become part of a plan of correction for the Quality Assurance program.

Should you need assistance with survey readiness, please continue to part 2 of this series and then call Kenyon Homecare Consulting at 206-721-5091 to help you get there!

Transforming Healthcare: Why Oasis Integrity and Accurate Coding Matter

Tue, 25 Nov 2025 17:24:49 GMT

In the complex, regulated world of Medicare home health, two documentation elements, the Outcome and Assessment Information Set (OASIS) and ICD-10-CM Coding , are foundational. They are not merely regulatory hurdles; their integrity and accuracy are non-negotiable drivers of patient care quality, compliance, and, critically, an agency’s financial health.

The Crucial Role of OASIS and ICD-10

The OASIS Assessment is the standardized patient assessment tool used by Medicare-certified home health agencies to collect data on patient conditions, functional status, and care needs which contributes to:

Care Planning: The OASIS Assessment provides a comprehensive clinical picture, serving as the basis for the patient's personalized Plan of Care (POC) and guiding all clinical disciplines (nurses, therapists, social workers).

Quality Reporting: OASIS data is the primary source for the majority of measures in the Home Health Quality Reporting Program (HHQRP) . This data is publicly reported on Medicare’s Care Compare website and directly determines an agency's Home Health Star Ratings and performance under the Home Health Value-Based Purchasing (HHVBP) model.

ICD-10 Coding: The Clinical Language of Home Health and Hospice

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes provide the standardized, granular language used to report patient diagnoses. The coding for home health and hospice is unique to this part of the health care industry and therefore only certified OASIS and ICD-10 coders should be providing these services for your agency.

Medical Necessity: Accurate ICD-10 codes establish the medical necessity ( one of the required elements required by Medicare eligibility for services) to support the services outlined in the POC.

Clinical Alignment: Coding must align with the physician’s documentation and the clinical story captured in the OASIS assessment to ensure consistency and support for the services provided.

Financial Implications of Inaccuracy/ Reasons for failure to capture money rightly due

Inaccurate OASIS scores and ICD-10 codes can have major financial consequences for home health agencies, primarily under the Patient-Driven Groupings Model (PDGM).

Reduced Reimbursement: Understated functional impairment levels (e.g., lower scores on mobility or grooming items) lead to a lower Case-Mix Group. Case mix in home health care is a complicated system used by the Centers for Medicare & Medicaid Services (CMS) to classify patients based on their clinical condition, functional status, and resource needs for the purpose of adjusting payment to Home Health Agencies (HHAs). The goal of a case-mix system is to ensure that home health agencies are paid an appropriate amount that reflects the complexity, diversity, and severity of the patients they treat.  

The current case-mix system used for Medicare home health payment is the Patient-Driven Groupings Model (PDGM) , effective since January 1, 2020. Under the PDGM, a 30-day period of care is categorized into one of 432 Home Health Resource Groups (HHRGs) based on key patient characteristics:  

Admission Source (Institutional vs. community)

Timing (Early vs. late 30-day period)

Clinical Group (The primary reason for home health services, based on the principal diagnosis)

Functional Impairment Level (Low, medium, or high, based on OASIS assessment data)

Comorbidity Adjustment (Three-tiered adjustment for selected secondary diagnoses)

Each of the 432 groups has an associated case-mix weight that is used to adjust the national, standardized 30-day payment rate. The final payment is higher for more complex, resource-intensive patients (a higher case mix) and lower for less complex patients.  

Missed Revenue Opportunities:

As noted above, using a general code when a more specific one is available can lower the CGM, particularly missing potential comorbidity adjustments that can increase payment significantly.

Claim Denials and Audits:

When coding is inaccurate as a result of poor OASIS scoring, discrepancies occur (e.g., a coded primary diagnosis that isn't supported by the OASIS assessment's clinical documentation). These are major red flags for payers, Additional Documentation Requests (ADRs) , denied claims , and heightened risk of costly audits and takebacks.

Financial Penalties: Poor OASIS accuracy can deflate an agency's Quality Star Ratings, potentially hurting referral volume and resulting in financial penalties under the HHVBP model, which ties payment adjustments to quality performance.

Best Practices for Ensuring Integrity

To protect financial stability and ensure high-quality patient care, agencies must prioritize accuracy in both data sets:

Integrated Quality Assurance: Implement concurrent or pre-billing reviews by certified professionals for both ICD-10 coding and OASIS responses, ensuring alignment between the diagnosis, the patient's functional status, and the plan of care.

Targeted Education: Provide ongoing, specific training to clinicians and coders on the official ICD-10-CM Coding Guidelines and the latest OASIS Manual guidance (such as the new OASIS-E items), focusing on key areas that impact PDGM case-mix.

Leverage Technology: Utilize Electronic Health Record (EHR) software with built-in validation tools to catch inconsistencies and errors before claims are submitted, minimizing the administrative burden of corrections and appeals.

The integrity of OASIS data and the accuracy of ICD-10 coding are the central pillars supporting the success of a home health agency. By making a continuous commitment to high-quality documentation, agencies can optimize reimbursement, maintain compliance, and, most importantly, deliver the best possible care to their patients.

If you are receiving less income than you think you should or are unsure how to determine the correct reimbursement that you should be getting, contact Kenyon Home Care Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com We are here to help.

The Power of Personal Connection: "Foot on the Ground" Sales in Home Health

Wed, 19 Nov 2025 14:18:50 GMT

In the competitive landscape of home healthcare, where trust and personal relationships are paramount, one strategy continues to be a cornerstone of success: "Foot on the Ground" sales. This approach, often referred to as "boots on the ground," emphasizes direct, in-person engagement to build the crucial referral networks that fuel home health agencies.

While digital marketing, SEO, and targeted ads certainly have their place, the core of home health relies on referrals from medical professionals. This is where "feet on the ground" sales prove invaluable.

The Heart of this Strategy: Relationship Building

Unlike transactional sales, "Foot on the Ground" in home health is fundamentally about cultivating deep, reliable relationships with key referral sources. These sources primarily include:

· Hospital Discharge Planners and Social Workers: Often the most lucrative allies because they manage the immediate transition of patients from the hospital back to their homes. Hospitals have a Medicare requirement that the organization provides safe and effective referrals at discharge. Failure to do so may result in fines against the hospital. You are there to make sure that does not happen.

· Physicians and Clinic Staff: P rimary care, geriatrics, and specialty practices who regularly treat patients needing in-home services should be the main focus for marketing and sales. Many are not aware of the services and ability/ need for the referral to come from them.

· Nursing Home and Rehabilitation Facility Personnel: Planners who manage post-acute care transitions are also a prime source of referrals. They have the same Medicare requirement as the hospitals on safe and effective discharges.'

· Complementary Businesses: Non-medical home care agencies, hospice providers, assisted living facilities, fire departments and police in each of your communities are also key to helping the patient population remain safe in homes. These complementary services can be integral referral sources for your business.

The goal is to become the trusted, preferred provider for these professionals. This trust is earned not through mass emails, but through consistent, quality personal interaction. Sometimes, it takes weekly contact for two to three months to earn their trust. To keep that trust, ALWAYS GIVE THEM FEEDBACK ON THE PATIENTS THEY HAVE SENT TO YOU!!

Key Components of an Effective "Foot on the Ground" Approach

A successful "Foot on the Ground" strategy goes far beyond simply dropping off brochures. It is a multi-faceted approach centered on solving the referral source's pain points.

Building rapport with the potential referral sources keeps your at the forefront of the referral source's mind. It allows for face-to-face problem-solving and updates.
Your sales staff are your representatives who act as consultants, educating staff on your agency's specialized programs (e.g., heart failure, wound care) and how it leads to better patient outcomes (like reduced readmissions).

While in-person meetings form the foundation, the modern home health market demands a blending of physical and digital efforts. "Foot on the Ground" representatives can significantly leverage their digital tools to reinforce their personal connections such as:

Data-Backed Pitches: Using agency data, such as timely opening (within the 3-day requirement) of cases to prevent hospital penalties, low re-hospitalization rates, high client satisfaction scores to prove the value proposition during a sales call.
Online Presence Reinforcement: Directing referral partners and clients to a robust online presence (client testimonials, staff credentials) to build credibility outside of the meeting.
Targeted Digital Follow-up: Utilize email and personalized digital content to support the information shared during a visit to ensure the message is reiterated. ALWAYS FOLLOW UP AND DELIVER ANY THING THAT HAS BEEN PROMISED!

The Long-Term ROI

The investment in a high-quality "Foot on the Ground" team may seem substantial, but the return on investment (ROI) is often higher than purely digital avenues in this relationship-driven industry. A solid referral relationship yields a predictable, high-volume flow of patients who are often the perfect fit for the agency's services. Referral sources send the referrals to people they trust, just as you do.

In an industry dedicated to the personal, intimate act of caring for patients in their homes, the sales approach must reflect that same commitment to personal connection. "Foot on the Ground" sales ensures that while technology advances, the human element and ultimate currency of home health remains the driving force for growth.

If you are not sure about your sales approach or struggle to see the outcomes of your current approach, contact Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com We are here to help!

The Heart of Home Health: How a Positive and Caring Culture Drives Recruitment and Retention

Sat, 08 Nov 2025 18:27:14 GMT

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In the high-touch, emotionally demanding field of home health , the quality of care provided is intrinsically linked to the well-being and engagement of the staff. A positive and caring corporate culture isn't just a feel-good initiative; it's a critical business strategy that directly impacts an agency's ability to recruit and retain top-tier talent in an increasingly competitive labor market.

The Recruitment Advantage: Attracting the Right Caregivers

Home health aides, nurses, and therapists are drawn to organizations that reflect the compassionate nature of their work. A company's reputation, built on a foundation of respect and support, becomes its most powerful recruitment tool.

Reputation as a Magnet: News travels fast within professional communities. When an organization is known for treating its staff well , providing ample support, and valuing their contribution, it significantly lowers the barrier to attracting new applicants. Prospective employees are actively seeking agencies where they feel they won't be overworked or undervalued.
Emphasis on Support, Not Just Workload: High-quality candidates look for evidence that their employer understands the emotional and physical demands of the job. A culture that prioritizes manageable caseloads, provides easy access to clinical and administrative support, and offers resources for mental wellness stands out. This demonstrates that the company cares for the caregiver, who, in turn, can better care for the patient.
Values Alignment: Home health professionals are typically driven by a strong sense of purpose. A caring culture that visibly celebrates patient successes, emphasizes ethical practice, and promotes a team-first mentality— aligns with the core values of those entering the field. This makes the job offer more compelling than a competitor's.

The Retention Factor: Keeping Your Best People

The true cost of staff turnover in home health, including recruitment fees, onboarding, and reduced quality of care during transition, is staggering. A positive and caring culture is the most effective defense against this constant drain.

Fostering a Sense of Belonging: In a field where staff often work independently in patients' homes, the corporate culture must actively counteract isolation. Regular check-ins, team meetings, clear communication channels , and mentorship programs create a "work family." When employees feel connected and know they are part of a supportive team, they are far more likely to stay, even when the job gets tough.
Recognition and Appreciation: A caring culture ensures hard work and dedication do not go unnoticed. This goes beyond annual reviews; it involves frequent, meaningful recognition for excellent patient outcomes, handling difficult situations with grace, and simply showing up consistently. Acknowledging the often-invisible labor of caregiving validates the staff's efforts and reinforces their value.
Investment in Growth and Well-being: Retention soars when employees see a future with their current employer. This involves providing opportunities for professional development , specialized training, and career laddering. Crucially, a caring culture also focuses on the work-life balance of its staff, advocating for flexibility and showing empathy during personal challenges. This focuses on treating employees as whole people, not just resources.

The Bottom Line: Better Care and Business Success

Ultimately, a caring corporate culture transforms the employee experience into a superior patient experience. Staff who feel respected, supported, and valued are more engaged, exhibit lower stress, and are empowered to provide the highest quality of compassionate care . In home health, where trust and consistency are paramount, this positive internal environment becomes the external mark of a successful and reliable agency.

Should you need assistance with your recruitment and retention strategies, let us help. Call Kenyon Homecare Consulting at 206-721-5091 or contact us online at gkenyon@kenyonhcc.com.

Unlocking the Future of Home Health: Prioritizing Chronic Disease Knowledge

Mon, 03 Nov 2025 16:47:01 GMT

The home health environment is rapidly becoming the epicenter of chronic disease management. While healthcare systems prioritize keeping patients out of costly hospitals and effectively managing long-term conditions, the burden and opportunity falls directly upon field staff. For nurses, physical therapists, and aides visiting patients in their homes, a fundamental understanding of chronic illnesses is no longer optional; it is the single most critical factor determining patient outcomes, quality of life, and the prevention of costly hospital readmissions.

The Complexities of the Home Setting

In a hospital or clinical setting, medical resources and immediate supervision are constantly available. In contrast, the home environment presents unique challenges. Patients with conditions like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or diabetes mellitus often live alone, lack easy access to transportation, and struggle with medication adherence or complex dietary restrictions.

A home health professional acts as a lifeline, bridging the gap between clinical orders and real-world execution. This role demands more than just performing tasks; it requires diagnostic vigilance. Field staff must be able to recognize subtle, pre-crisis changes that indicate an impending disease exacerbation. This is a vital skill that relies entirely on advanced understanding each chronic disease's pathophysiology.

Knowledge as a Tool for Early Detection

For many chronic conditions, early intervention can prevent a full-blown emergency. This is where specialized chronic disease knowledge pays dividends:

Congestive Heart Failure (CHF): Staff must understand that a sudden weight gain of 2 to 3 pounds overnight is not just fluid retention; it is a critical sign of worsening heart failure that requires immediate communication with a supervising physician. Knowledge of sodium restrictions and fluid limits is essential for daily teaching and monitoring.
Chronic Obstructive Pulmonary Disease (COPD): Understanding the difference between baseline shortness of breath and acute respiratory distress is paramount. Field staff must monitor sputum color, frequency of nebulizer use, and changes in mental status (which can signal hypoxia) to prevent an urgent trip to the emergency room.
Diabetes Mellitus (DM): Beyond administering insulin, staff must recognize the early, non-specific symptoms of both hypoglycemia and hyperglycemia. They must be equipped to teach basic foot care, identify a non-healing ulcer, and understand how concurrent illness impacts blood sugar control.

Without this specialized knowledge, staff risk missing critical warning signs as typical day-to-day fluctuations. This results in delayed care and poor patient outcomes.

Elevating Patient Education and Empowerment

A significant goal of home health is empowering the patient and their family to manage the condition independently. Field staff who truly understand chronic diseases are far better educators. They can:

Customize Teaching: Instead of relying on generic handouts, they can explain why a medication needs to be taken at a specific time or how a certain food affects blood pressure. This links the instruction directly to the patient's individual body and symptoms.
Build Confidence: By explaining disease progression in an understandable way, they reduce patient anxiety and foster a sense of control. Empowering the patient in the treatment regimen increases the change of improving adherence to complex regimens.
Act as an Interpreter: They translate complex medical jargon from doctors and specialists into actionable, practical steps the patient can follow in their living room.

The Economic and Quality Imperative

From a systems perspective, chronic disease management is directly tied to value-based care models. Rehospitalization is costly, disruptive, and often avoidable. Agencies and staff with high chronic disease competency are more likely to achieve low readmission rates.

This expertise transforms the field staff's role from providing basic custodial care to delivering high-level, preventative health management. They become the primary sensor network for the medical team, ensuring that a minor fluctuation is caught before it spirals into an acute crisis. Investing in the continuous education of home health staff on pathophysiology, common exacerbations, and management strategies for the most prevalent chronic diseases is thus a critical business decision, directly impacting clinical quality, reputation, and financial viability.

The importance of home health field staff understanding chronic diseases cannot be overstated. They are the essential link in the chronic care chain, operating in the most challenging and least supervised setting. Agencies must treat chronic disease competency as a foundational requirement which ensures continuous professional development and training. By equipping field staff with this expert knowledge, home health care transitions from merely providing assistance to delivering genuine, life-saving, and preventative health partnership.

Kenyon HomeCare Consulting recognizes the importance of all field staff (aides, nurses therapists and social workers) in caring for individuals with chronic diseases. For that reason, Kenyon HomeCare Consulting has created 8-hour Chronic Disease Education courses. For more information go to Kenyon's Chronic Disease University for the list of courses. If you need additional assistance, call 206-721-5091.

How OASIS Transforms Home Healthcare: Enhancing Quality and Financial Gains

Thu, 30 Oct 2025 14:46:53 GMT

Since its introduction in 1999, the Outcome and Assessment Information Set (OASIS) has served as the cornerstone for Medicare-certified home health agencies. This standardized assessment tool requires clinicians to collect comprehensive data on a patient's clinical status, functional abilities, and care needs at various points during their home health episode.

Initially developed to help monitor patient outcomes, OASIS has evolved to become inextricably linked with both the financial health of agencies and the quality of patient care. Under the Patient-Driven Groupings Model (PDGM) , which determines home health reimbursement, and the expanded Home Health Value-Based Purchasing (HHVBP) model , the accuracy of OASIS documentation is more critical than ever.

Direct influence on reimbursement

Under PDGM, Medicare reimbursement rates are directly influenced by the case-mix adjustment factors derived from OASIS assessments. The data collected from the patient's assessment helps determine the Home Health Resource Group (HHRG), which ultimately sets the payment level. This means that accurate OASIS documentation is essential for ensuring agencies are appropriately compensated for the level of care provided.

The financial repercussions of inaccurate documentation can be substantial. A single missed or incorrect assessment item can result in significant financial losses over time. Inaccurate coding can lead to underpayment, claim denials, and potential compliance issues or audits, which places financial strain on providers.

Impact on quality of care and reporting

OASIS data is a vital tool for improving and measuring the quality of patient care.

Targeted care planning : The comprehensive data provides a detailed view of a patient's condition, allowing care teams to develop personalized treatment plans and monitor progress effectively.
Outcome measurement : OASIS measures patient outcomes, such as improvements in functional abilities like mobility and self-care. This data is used to calculate performance metrics for agencies and guide quality improvement efforts.
Public reporting and transparency : Performance ratings derived from OASIS data are reported on Medicare's "Care Compare" website. Higher scores can enhance an agency's reputation and competitiveness in the market, while lower scores can be a red flag for potential patients and regulators. Low scores also render agencies ineligible to contract with certain insurance providers.

Common challenges for agencies

Despite its critical role, the OASIS assessment and documentation process presents several challenges for home health agencies and clinicians.

Assessment complexity : OASIS assessments are detailed and can be difficult to complete accurately, especially for patients with complex medical conditions. The introduction of updated versions, such as OASIS-E in 2023, and OASIS-E1 and all-payer requirements in 2025, requires continuous education to keep staff current.
Administrative burden : The need for extensive and precise documentation adds to the administrative workload of clinicians already facing time constraints and high patient volumes. This can lead to rushing assessments and potential errors.
Training deficiencies : Many clinicians lack a thorough understanding of OASIS, including the importance of accuracy and its impact on reimbursement and quality measures. This can result in inconsistent documentation and incorrect coding.

Strategies for navigating the OASIS landscape

To address these challenges, many agencies are focusing on strategic investments in documentation quality.

Continuous staff training : Agencies must provide robust, ongoing training that helps clinicians understand not only how to complete the OASIS but also its broader implications for patient care, quality scores, and financial outcomes.
Leveraging technology : Specialized software solutions are helping agencies streamline OASIS workflows, improve accuracy with built-in validation rules, and facilitate real-time, point-of-care documentation.
Investing in expert review : Some agencies choose to invest in expert review services to ensure documentation is accurate, complete, and optimized for both financial performance and compliance.
Implementing quality assurance : Regular internal audits and quality assurance processes can help identify common errors and provide targeted feedback to clinicians.

The future of OASIS and reimbursement

As home health care continues to evolve, the link between OASIS data and reimbursement will only strengthen. The mandatory all-payer OASIS data collection , which took effect in July 2025, means that agencies must apply these rigorous standards to every patient, regardless of payer. This shift signals an industry-wide move toward standardized, quality-driven care across the board, making accurate and consistent OASIS documentation an even more critical strategic imperative for all home health agencies.

If your reimbursement is not at or above either the state and federal level of reimbursement for a selected cohort of diagnosis, it may well mean that your staff need additional education on the OASIS tool and correct scoring . Kenyon HomeCare Consulting specialists are here to assist your staff and your agency in achieving the financial outcomes you need to thrive.

To learn more call 206 721 5091 or email gkenyon@kenyonhcc.com . We are here to help.

Chronic Disease Education: Better Prepared; Better Care; Better Outcomes

Tue, 28 Oct 2025 13:38:46 GMT

Home health and home care professionals are vital to supporting clients living with chronic conditions such as heart disease, diabetes, and COPD. Effective management of these long-term illnesses is critical to maintaining a client's quality of life, preventing complications, and reducing the need for costly hospital visits. For this reason, investing in chronic disease education for home care and home health staff is essential.

Benefits for clients and providers

Chronic disease education provides home care staff with the knowledge to make informed decisions and better recognize potential problems. For providers, this translates into improved outcomes and a stronger reputation.

Improved client outcomes

Education is shown to improve client health outcomes and quality of life.

Reduced complications:  Properly trained staff can help prevent serious complications that may arise from chronic illnesses, such as kidney failure from uncontrolled diabetes or heart attacks from mismanaged heart disease.
Fewer hospitalizations:  Home care that includes educational interventions for self-management can significantly reduce hospitalizations and emergency department visits.
Enhanced client engagement:  Empowered clients are more likely to participate actively in their care and make informed decisions, leading to better adherence to treatment plans.
Increased independence:  By learning to monitor symptoms and manage their conditions effectively, clients can preserve their independence longer.

Better staff performance and satisfaction

Education benefits not just clients, but also the home health and home care staff themselves.

Increased confidence:  With a deeper understanding of chronic diseases, staff can feel more confident and competent in their caregiving abilities, which can lead to greater job satisfaction.
Enhanced skill set:  Chronic disease education transforms aides into more skilled caregivers who can provide specialized services, setting them and their organization apart from competitors.
Improved retention:  Staff who feel knowledgeable and empowered are often happier in their roles, which can improve employee retention rates for home care agencies.

Key areas for education

For home health and home care staff to provide the most effective care, training should cover several critical areas.

Condition-specific knowledge

Staff need a clear understanding of the specific chronic conditions they are managing, such as heart failure, COPD, and diabetes. This includes:

Disease progression:  The signs, symptoms, and potential complications of the illness.
Treatment plans:  The purpose and function of medications, as well as potential side effects.
Self-management techniques:  How to monitor vital signs and other health metrics.

Lifestyle and behavioral support

Chronic disease management requires behavioral changes and consistent lifestyle adjustments. Staff can assist clients by providing education on:

Nutrition:  Dietary restrictions and guidelines specific to the client's condition.
Exercise:  Safe and appropriate physical activities.
Safety:  Modifying the home environment to reduce risks like falls.

Communication and collaboration

Home health staff play a crucial role in coordinating care between the client and the broader medical team. Training should focus on:

Effective communication:  Listening to clients' concerns and explaining complex health information in an accessible way.
Recognizing warning signs:  Detecting subtle changes in a client's condition that could signal a worsening issue and when to report these changes.
Working with families:  Involving and training family caregivers to create a supportive team environment.

The future of chronic care at home

As healthcare shifts toward more patient-centric, home-based models, the role of educated home health and home care staff becomes increasingly important. Integrating technology, such as remote patient monitoring and telehealth, can further enhance these services by providing real-time data and enabling timely interventions. With proper training and support, these professionals can empower clients to take control of their health, promoting better outcomes and a higher quality of life

To learn more about Kenyon Chronic Disease University visit Kenyonhcc.com, call 206-721-5091 or email gkenyon@kenyonhcc.com .

Avoid Costly Mistakes: The Importance of Accurate ICD-10 Coding in Home Health and Hospice

Fri, 24 Oct 2025 20:41:11 GMT

Accurate ICD-10 coding is more than a billing requirement for home health and hospice agencies—it is a critical pillar of clinical integrity, financial health, and regulatory compliance. In these settings, where patient conditions are often complex and care is delivered across evolving environments, coding accuracy has a far-reaching impact on proper reimbursement, audit preparedness, and the ability to provide high-quality, patient-centered care.

The consequences of inaccurate coding

Incorrect ICD-10 coding creates a ripple effect of negative consequences that can threaten an agency's operations and sustainability.

Delayed or denied claims:  Coding errors, such as using outdated or unspecified codes, lead to rejections and denials from payers like Medicare. This forces staff to spend time on manual appeals and resubmissions, creating administrative bottlenecks and delaying cash flow.
Audit risks and penalties:  Inaccurate coding can flag an agency for scrutiny by the Centers for Medicare & Medicaid Services (CMS). This can trigger audits, payment recoupments ("takebacks"), and penalties under regulations like the False Claims Act.
Under- or overpayment:  Under payment can result from coding that fails to capture the full complexity of a patient's condition and the services they receive. Conversely, overpayment can occur when improper coding inflates a claim, which later may be pulled back by CMS.
Compromised patient care:  In home health, inaccurate coding can negatively impact the Patient-Driven Groupings Model (PDGM), which categorizes patients and affects payment. An incorrect primary diagnosis can lead to inaccurate payment and influence the calculation of comorbidity adjustments. For hospice, inaccurate coding can result in poor care planning by failing to properly characterize the patient's terminal condition and related diagnoses. Ultimately, inaccurately capturing what you should receive to provide patient care potentially compromises it.

Unique coding complexities in home health

Home health coding is highly sensitive to the patient's evolving condition and regulatory changes, particularly the PDGM.

PDGM reliance:  Under PDGM, the primary diagnosis determines the clinical group, and secondary diagnoses affect the comorbidity adjustment. An error in either area directly impacts the 30-day payment period.
Complex patients:  Home health patients often have multiple comorbidities, requiring coders to meticulously document each diagnosis with the highest possible specificity.
Evolving conditions:  A patient's condition changes over time, requiring coders to update codes frequently. Inaccurate or incomplete documentation can lead to the overuse of vague, unspecified codes.
Provider documentation gaps:  Inconsistent or ambiguous documentation from referring physicians can complicate the coding process, making it difficult for coders to select the most specific and accurate codes.

The distinct challenge of hospice coding

Hospice coding has its own set of challenges, specifically tied to documenting the terminal illness and a patient's prognosis.

Terminal illness focus:  Unlike other settings, hospice coding must focus on the terminal illness and related conditions that support a six-month or less prognosis.
Sequencing matters:  The primary hospice code must be the terminal illness, while secondary codes detail comorbidities and related conditions. Incorrect sequencing can misrepresent the patient's condition and lead to claim denials.
Related vs. unrelated conditions:  Coders must differentiate between conditions related and unrelated to the terminal diagnosis. This distinction is crucial for both eligibility and billing.
Clinical documentation:  Precise documentation is essential for justifying the terminal diagnosis and prognosis to Medicare and other payers.

Best practices for accuracy and compliance

Agencies can adopt several strategies to ensure coding accuracy and protect against the associated risks.

Invest in certified coders:  Agencies should employ certified home health and hospice coders who receive ongoing training to stay current with annual ICD-10 updates and regulatory changes from CMS.
Foster clinical-coder communication:  Open communication and strong coordination between clinical staff and coders are vital. Clinicians should be trained to document clearly and thoroughly, providing coders with the specific details needed to assign the correct codes.
Regular internal audits:  Performing regular, proactive internal audits can identify coding errors and documentation gaps before they result in rejected claims or external audits. This process can help refine billing methods and serve as a valuable learning tool.
Leverage technology:  Utilizing advanced electronic health record (EHR) systems with integrated coding capabilities can improve efficiency and reduce manual errors. However, technology should be used to support, not replace, a skilled coder's expertise.
Analyze claim denials:  Agencies should regularly review denied claims to identify patterns and address the root causes of rejections, turning each denial into a learning opportunity.
Thorough documentation:  The foundation of accurate coding is clear, complete, and specific clinical documentation that fully supports the services provided.

In the specialized fields of home health and hospice, accurate ICD-10 coding is indispensable for maintaining financial stability, ensuring regulatory compliance, and upholding clinical standards. As agencies navigate complex payment models and intensive regulatory oversight, a proactive and detail-oriented approach to coding is no longer a choice but a necessity. By investing in certified personnel, fostering strong documentation practices, and leveraging technology, agencies can safeguard their operations, secure proper reimbursement, and, most importantly, dedicate their resources to providing exceptional patient care. Call Kenyon Homecare Consulting today at 206-721-5091 or email at gkenyon@kenyonhcc.com for further assistance with Oasis and coding accuracy.

Unlocking the Secrets: Perfect OASIS Scoring in Home Health is Non-Negotiable

Tue, 21 Oct 2025 16:14:14 GMT

In the complex world of Medicare home health, the Outcome and Assessment Information Set (OASIS) is a foundational component that profoundly affects agencies, patients, and the entire healthcare system. Far from a simple regulatory burden, accurate OASIS scoring is the bedrock for proper reimbursement under the Patient-Driven Groupings Model (PDGM). PDGM is a key driver of quality measure performance, and a direct determinant of an agency's public-facing Home Health Star Ratings. In today's highly scrutinized healthcare environment, the importance of precise and compliant OASIS documentation has never been more crucial.

OASIS and the bottom line: Impact on PDGM reimbursement
Under PDGM, the OASIS assessment directly influences an agency's financial health. OASIS scores on functional impairment levels and clinical groupings while comorbidity adjustments are used to calculate the case mix group. This case mix grouping (previously HHRG) determines the agency's reimbursement rate for each 30-day period.

Inaccurate scoring leads to financial loss:  Both overestimating and underestimating a patient's functional abilities can result in inappropriate care plans and significant financial losses. An understated patient condition leads to a lower case mix group and reduced reimbursement in the PDGM payment model, while an overstated one risks compliance flags and claim denials.
Minor errors have major consequences:  Even seemingly small documentation errors, when multiplied across an agency's patient census, can lead to substantial lost revenue over time.

The measure of quality: OASIS and the Quality Reporting Program
OASIS data is the primary source for the majority of measures used in the Home Health Quality Reporting Program (HH QRP). These quality measures are reported on Medicare's Care Compare website and are an essential component of the Home Health Value-Based Purchasing (HHVBP) model.

Measuring patient improvement:  OASIS-based outcome measures track a patient's progress over time by comparing their status at the start of care (SOC) to their status at discharge. Inaccurate scoring at the SOC assessment makes it nearly impossible for an agency to demonstrate the patient's true improvement, effectively denying the agency credit for providing high-quality care.
Influencing public perception:  The HH QRP measures and data from patient surveys directly contribute to an agency's quality of patient care rating , a public-facing metric that consumers use when selecting a provider. Incorrect OASIS scoring can deflate an agency's Star ratings, potentially hurting its reputation and referral volume.

A framework for care: Impact on patient outcomes
Beyond finance and quality metrics, accurate OASIS documentation is fundamental to providing effective and patient-centered care. The assessment provides a comprehensive clinical picture that allows care teams to:

Develop effective care plans:  Proper OASIS scoring ensures that a patient's specific needs are identified and addressed, allowing clinicians to tailor interventions and services for the best possible outcome.
Monitor progress:  Accurate and consistent documentation at every assessment point allows clinicians to effectively track patient progress, adjust the plan of care in real-time, and ensure continuity of care.
Enhance team communication:  OASIS provides a standardized language for all disciplines—including nurses, physical therapists, occupational therapists, and social workers—to communicate a patient's condition and needs effectively. If your agency is not using your Oasis data for coordination, an opportunity is missed.

Best practices for scoring accuracy
Home health agencies can protect their financial stability, improve their public quality scores, and most importantly, deliver better patient care by prioritizing OASIS accuracy. Best practices include:

Robust clinician training:  Agencies should invest in regular, ongoing training that covers not only the technical aspects of OASIS but also its relationship to PDGM and HHVBP.
Objective and specific documentation:  Clinicians should avoid vague, generalized language. Documenting the "why" behind a patient's score, such as "patient requires standby assistance for transfers due to poor balance and fatigue," provides clear and objective rationale.
Interdisciplinary collaboration:  No single clinician has the complete picture. Encouraging collaboration among all disciplines involved in a patient's care ensures a more accurate and holistic assessment.
Internal quality audits:  Regular internal audits using credentialed OASIS professionals can identify potential errors and inconsistencies before they become compliance issues or negatively impact quality scores.
Leveraging technology:  Electronic health record (EHR) software with built-in OASIS validation tools can help minimize errors and improve efficiency during documentation.

The integrity of OASIS scoring in Medicare home health is not merely a bureaucratic requirement, but a vital function that supports the entire system. Accurate and comprehensive assessments are the cornerstone of delivering quality patient care, maximizing reimbursement, and maintaining a competitive edge through strong quality ratings. By committing to ongoing education, clear documentation, and interdisciplinary review, home health agencies can ensure their OASIS data truly reflects the high-quality care they provide. Kenyon Homecare Consulting has a team of Oasis certified clinicians who teach, review documentation, and help agencies capture the dollars they deserve to care for the patients. Don't miss out. Let Kenyon complete 5 free chart reviews and re-codes from our certified Oasis and certified ICD 10 coders to make sure you are on the right track. Call us at 206-721-5091 or contact us at gkenyon@kenyonhcc.com.

Retention Revolution: Building Rewarding Paths for Home Health/ Home Care Aides

Sat, 18 Oct 2025 19:40:50 GMT

The homecare and home health aide field is a rapidly growing area of healthcare, offering a rewarding entry point for those passionate about helping others. While often seen as an entry-level position, a job as an aide can be the first step on a dynamic and flexible career path. By focusing on continued education, specialization, and strategic planning, agencies can help aides advance into higher paying, more responsible roles within the agency. The foundation of career paths is one of the building blocks for retention. ALL AGENCIES THAT WANT A STRONG RETENTION PROGRAM MUST HAVE DEDICATED CAREER DEVELOPMENT PROGRAMS IN PLACE.

THE FOUNDATIONAL ROLE OF A HOME HEALTH AIDE

A home health aide (HHA) provides essential, personalized care to clients in their homes, helping them maintain their independence and well-being. Responsibilities typically include:

Assisting with personal care, such as bathing and dressing.
Helping with mobility and transfers.
Performing light housekeeping and preparing meals.
Monitoring vital signs and client conditions.
Providing emotional support and companionship.

The valuable experience gained as an HHA provides a strong foundation for exploring other opportunities within the medical field.

MAPPING A CAREER TRAJECTORY FOR AN AIDE

A career path for a homecare or home health aide doesn't have to be a rigid ladder. Instead, it can be a "lattice," with many different directions for growth. The career path for each aide should be developed at orientation and followed with every yearly evaluation as to advancement on career goals and success.

COMMON CAREER LADDER PROGRESSION

Career paths, as noted above can be a specialty or traditional. The most traditional pathway involves moving through increasingly complex nursing roles:

Certified Nursing Assistant (CNA):  This is a natural next step for many HHAs. With additional, state-approved training and a certification exam, CNAs can work in a wider range of settings. These include hospitals and nursing homes, and have a broader scope of responsibilities.
Licensed Practical Nurse (LPN):  An LPN provides more direct medical care than a CNA and performs basic nursing tasks under the supervision of doctors and registered nurses. This requires completing a twelve to 18 month LPN training program.
Registered Nurse (RN):  Becoming an RN offers the highest level of direct care, with opportunities to specialize and take on advanced practice or leadership roles. This requires a two to four year nursing degree and passing a national licensure exam.

SPECIALIZATION AND UPSKILLING

For aides who prefer to stay in direct care but want to deepen their expertise, specialization is an excellent option.

Specialty certifications:  Additional training in areas like dementia, palliative care, or chronic disease management can significantly increase an aide's skills and earning potential. Additionally, many states now offer CNAs advanced training to become med-techs.
Micro-credentials:  Some agencies offer smaller, condition-specific credentials that allow aides to develop expertise in focused areas, such as behavioral health, diabetes, CHF COPD etc.

MOVING INTO ADMINISTRATION

Experienced caregivers with strong organizational and communication skills can transition into administrative roles.

Care Coordinator or Case Manager:  These roles involve managing client cases, coordinating services, and ensuring care plans are followed. This may require further education in healthcare administration or social work.
Staffing Coordinator:  This position focuses on the day-to-day operations of managing and retaining caregiving staff.
Caregiver Trainer or Mentor:  Aides who enjoy sharing their knowledge can move into a role that trains new caregivers on topics like communication skills and specialized care.

ESSENTIAL STRATEGIES FOR CAREER ADVANCEMENT

No matter the path, several key strategies can help an aide achieve their career goals. This should be part of the yearly evaluation where opportunities are made clear to the aides and help plan for future achievement and growth.

Establish a formal career paths program:  Provide employees with clear career advancement pathways available to them.
Provide continued education:  Pursue certifications, online courses, and workshops to help staff stay current on best practices. Community colleges offer programs for caregivers to expand their skills and may be a partner for an agency to help build career paths for all staff.
Help the aide build a professional network:  This allows the aide to build relationships with colleagues, attend industry events, and join professional organizations. Strong relationships can provide mentorship and open doors to new opportunities.
Provide the opportunity to gain diverse experiences: Provide staff with different patient populations, such as pediatric or geriatric care, maternity or doula training that help build advanced knowledge and skills. This diversification creates a more robust skill set for the aides and the agency.
Provide a mentor: Provide guidance from more experienced aides or healthcare professionals. Their insights can be invaluable for navigating the career journey.
Become a mentor: Provide experiences that will help an aide become a mentor
The future of the field: The demand for home health and personal care aides is projected to grow significantly due to an aging population that prefers to receive care at home. This demand ensures a strong job outlook and creates numerous opportunities for professional growth. By providing advanced training, education, and specialization, your homecare and home health aides can turn a compassionate career into a fulfilling and dynamic lifelong profession.

Should you need help with recruitment/ retention of aide staff as well or education/training in disease management certification , call Kenyon Homecare Consulting at 206-721-5091 or contact Ginny Kenyon at gkenyon@kenyonhcc.com.

Finding Your Home Health Client: A Guide to Targeted Marketing

Thu, 16 Oct 2025 18:16:14 GMT

In the home health care industry, attracting clients is more than just advertising; it is about building trust and reaching the right people with a message that truly resonates. The most effective marketing strategies begin with a clear understanding of your ideal client and the specific needs you can fulfill for them and their families.

By tailoring your approach to your target audience, you can transform your marketing from a guessing game into an efficient and effective client acquisition machine.

Step 1: Define your target client

Before you can reach your ideal clients, you must first identify who they are. The home health market includes a few key audiences, and your messaging needs to speak to each one differently.

Seniors:  This is the most significant demographic, consisting of individuals over 65 who want to maintain their independence at home. For this group, emphasize how your services provide dignity and a comfortable living environment.
Adult children of aging parents:  This segment is often the primary decision-maker, researching and vetting agencies for their loved ones. They want reliable, compassionate care and peace of mind. Your marketing should highlight caregiver credentials, safety protocols, and client testimonials to address their concerns.
Individuals with disabilities or chronic conditions:  These clients may require specialized or long-term support. Highlight how your agency provides tailored, expert services to improve their quality of life.

You may also want to differentiate between private-paying clients and those who rely on programs like Medicaid. For agencies targeting specific specialties, such as Alzheimer's or post-surgical care, it is crucial to identify and focus on those niches.

Step 2: Build a robust online presence

With most families beginning their search for home care online, a strong digital footprint is essential.

Create an optimized website:  Your website is often the first impression a potential client has of your agency. It should be easy to navigate, mobile-friendly, and clearly outline your services, qualifications, and contact information. Pay attention to the colors on your website. The colors help on a subconscious level to convey the message of calm and helpfulness.
Develop a Google Business Profile:  Set up a free Google Business Profile to ensure your agency appears in local search results and on Google Maps. Complete your profile with photos, hours, and service details. You should also proactively encourage satisfied clients to leave positive reviews. Studies show that a complete profile is twice as likely to be viewed as reputable.
Publish informative content:  Use a blog to answer common questions and concerns your target clients have, positioning your agency as a trusted, knowledgeable resource. Topics could include "Choosing the Right Home Care Agency" or "Navigating Long-Term Care Insurance".
Leverage social media:  Maintain an active presence on platforms like Facebook, which has a higher usage rate among older demographics while often being used by their adult children. Share helpful caregiving tips, client success stories, and educational content to build community and trust.

Step 3: Cultivate referral networks

Word-of-mouth remains one of the most powerful marketing tools in home health care. Building strong relationships with other health care professionals can create a steady stream of referrals. These referral sources include discharge planners at hospitals and nursing homes and marketing staff at senior housing and assisted living facilities as well as adult family homes and adult day care.

Connect with healthcare professionals:  Forge partnerships with hospital discharge planners, social workers, physicians, occupational therapists, and staff at rehabilitation centers and assisted living facilities. Send them regular updates on your services and outcomes to stay top-of-mind. Additionally, when you get a referral from an agency or discharge planner remember to send a thank you and to keep them updated on the client/patient. This is particularly important for physicians.
Partner with complementary businesses:  Form mutually beneficial referral relationships with businesses that serve the same population, such as medical supply stores, physical therapy centers, and pharmacies. Additionally, remember to include emergency response teams (fire departments) and other businesses such as construction companies for ramps and home modifications to meet changed needs, traveling hairdressers/barbers, mobile blood draw labs, and mobile dog bathing companies.
Create a client referral program:  Incentivize your happiest clients to spread the word to their friends and family. According to one study, current and past clients are the top source of new referrals for home care agencies. Have a program of routinely asking your happy customers to leave a review on your google website.

Step 4: Engage your local community

Building a visible and trusted reputation within your local area is key to attracting clients and differentiating your agency.

Sponsor and attend community events:  Participate in local health fairs, senior expos, and charity events to meet potential clients and families face-to-face.
Offer educational seminars:  Host free workshops or webinars at senior centers, libraries, or online. Topics on caregiving stress, healthy aging, or navigating home care options can showcase your expertise and build trust.
Advertise in local publications:  Place ads in local newspapers and community magazines to reach seniors and their families who may not be as active online.

Successfully reaching targeted clients in home health requires a multi-pronged approach that combines defining your ideal client, building a strong digital presence, cultivating professional and personal referral networks, and engaging with your local community. By consistently implementing these strategies and focusing on a message of compassionate, reliable care, your agency can build a strong reputation and a thriving client base. If you need to increase market share in your area, call Kenyon Homecare Consulting at 206-721-5091 or contact us at gkenyon@kenyonhcc.com.

Prepare Like a Pro: Essential Tips for Home Health and Hospice Survey Success

Sat, 11 Oct 2025 14:42:01 GMT

Navigating the complexities of Medicare compliance is a constant challenge for healthcare providers. The stakes, including financial penalties, reputational damage, and loss of accreditation are higher than ever. While many facilities strive for year-round readiness, a proactive mock survey conducted six months ahead of an official inspection offers a strategic advantage that can significantly improve outcomes.

The Centers for Medicare & Medicaid Services (CMS) and state agencies conduct unannounced surveys to ensure that providers meet the Conditions of Participation (CoPs) for home health and hospice . In recent years, surveyors have intensified their scrutiny, leading to a rise in deficiency citations compared to pre-pandemic levels. Factors like healthcare's increased complexity and ongoing staffing shortages have left many teams less familiar with survey processes, making preparation more critical than ever.

This unpredictable environment necessitates a proactive approach beyond simply reacting to deficiencies. A mock survey is a systematic, internal audit that replicates the official inspection process, including documentation reviews, staff interviews, and patient care observations.

We suggest that six months prior to the expected official survey is the ideal lead time for a mock survey. A six-month timeline allows for a comprehensive, objective review of operations, providing ample time to address any gaps.

The extensive benefits of this approach are:

1. Identifies and corrects deficiencies proactively: A mock survey identifies high-risk, problem-prone areas that may not be apparent during daily operations. This provides a clear-eyed assessment of where practices may have strayed from official policies. A consultant can provide a detailed report of potential deficiencies and recommendations which gives the provider time to implement a corrective action plan long before the real survey.

2. Enhances staff confidence and engagement: The mock survey process is a powerful training tool that familiarizes staff with the interview and tracer methodology used by actual surveyors. It removes the anxiety of a high-stakes, unannounced visit, allowing team members to practice explaining policies and demonstrating compliance in a low-pressure setting. This "practice makes perfect" approach builds confidence and ensures staff are prepared to perform effectively under pressure.

3. Fosters a culture of continuous improvement: Using a mock survey to find and fix issues reinforces the importance of compliance as an ongoing, organizational-wide effort. It moves the focus from a "check-the-box" mentality to a sustained commitment to patient safety and quality of care. Engaging staff in this process gives them a sense of ownership which reinforces best practices year-round.

4. Improves patient care and outcomes: Beyond simply avoiding citations, the ultimate goal of a mock survey is to enhance the quality of care. By bringing in a fresh set of objective eyes, facilities can identify weaknesses that may affect the patient experience. Addressing these issues proactively leads to better patient outcomes and satisfaction, reducing liability and reputational risk.

5. Strengthens organizational processes and communication: The mock survey reinforces the need for interdepartmental communication and collaboration. It can reveal areas where processes are inefficient or inconsistent, allowing leadership to streamline operations and provide guidance on best practices. For example, a mock survey can reveal that while policies exist, they are not consistently implemented across all departments, leading to focused improvement efforts.

While internal mock surveys are beneficial, engaging an external consultant can be more effective. External consultants offer an unbiased perspective, identifying "blind spots" that internal staff may overlook due to familiarity. They are experts on the latest CMS regulations and can replicate the experience of an official survey more accurately, providing practical and targeted guidance to get the facility back on track.

A mock survey before an official inspection is a strategic investment in a facility's long-term success. It is an opportunity to not only meet compliance requirements but to fundamentally improve patient care, boost staff morale, and strengthen organizational processes. The six-month window provides the essential time needed to implement meaningful changes, ensuring that when the real survey arrives, the facility is not just ready, it is primed for success.

If you are not sure that you are ready for an upcoming survey by either your state or one of the accreditation bodies, Kenyon HomeCare Consulting Associates are here to help. Experts in both Home Health and Hospice, our consultants are available to conduct an organizational assessment to identify the areas that need attention to ensure a clean survey. Call Kenyon HomeCare Consulting at 206-721 -091 or email gkenyon@kenyonhcc.com We re here to help.

Are You Leaving Money on the Table?

Mon, 06 Oct 2025 19:08:44 GMT

Home health episode payment varies ranging from approximately $2,000-$5,000 per Medicare standardized 60 day period with adjustments based on patient condition and location.  Inaccurate scoring of the Outcome and Assessment Information Set (OASIS) and incorrect ICD-10 coding lead to significant financial losses for home health agencies. Under the Patient-Driven Groupings Model (PDGM), reimbursement rates are directly tied to these assessments, meaning errors directly affect revenue. 

How errors lead to "money left on the table"

Lost reimbursement

Case-mix misclassification:   Missed or improperly scored item on an OASIS assessment can move a patient into a lower-paying case-mix group which results in underpayment for the services provided. A single error can reduce reimbursement by hundreds of dollars per 60-day episode of care.
Inaccurate ICD-10 codes:   Overlooking relevant secondary diagnoses or selecting unspecific ICD-10 codes can lead to under-reporting a patient's overall clinical complexity. Since reimbursement under PDGM is influenced by comorbidities, this results in lower payments.
Missed diagnoses:   Failure to document all diagnoses supported by the clinical record can lead to a lower reimbursement rate or a claim denial.
Incorrectly classifying episodes:   The PDGM pays differently for early and late episodes of care. Misclassifying these can lead to payment errors.

2. Claim denials and audits

Denied claims:   Insurance companies may deny claims that contain coding errors or insufficient documentation. If eligibility details are missed, the entire claim can be denied, leaving the agency to absorb the cost of care.
Audit penalties and recoupments:   Regulatory bodies, such as the Centers for Medicare & Medicaid Services (CMS), scrutinize home health claims. Repeated OASIS errors or inaccurate coding can trigger audits, which may lead to financial penalties and forced repayment of previously billed claims.

3. Operational inefficiencies

Additional clinician hours:   Clinicians must spend time correcting documentation and coding errors instead of focusing on patient care. These hours add up, especially in large agencies.
Revenue cycle disruption:  Denied claims create billing bottlenecks and delay cash flow, diverting administrative staff time to track and resubmit claims.
Training burdens:   The complexity of ICD-10 and frequent updates to OASIS (such as OASIS-E1) require continuous staff training, which can be a significant cost.

4. Marketplace disadvantages

Lower quality scores:   OASIS data is used by CMS to determine an agency's Star Rating. Inaccurate data can lower an agency's rating, which can reduce referrals from hospitals and physicians.
Reduced value-based purchasing (VBP) score:  Under the Home Health Value-Based Purchasing (HHVBP) model, payment is adjusted based on an agency's quality of care. Inaccurate OASIS scoring (particularly on measures like the Discharge Function Score) directly impacts VBP scores and can result in reduced payments.

Examples of common mistakes that cost money

Inaccurate functional scoring:  Incorrectly rating a patient's ability to perform daily activities on the OASIS can negatively affect both payment and quality scores.
Missing or incomplete data:  Failing to document all relevant clinical information, including comorbidities, can lead to inaccurate coding and missed reimbursement opportunities.
Lack of coordination:  When clinical documentation does not fully support the codes assigned by the billing department, it can lead to coding errors and denied claims.

Kenyon HomeCare Consulting understands the significant of the appropriate OASIS scoring and the subsequent ICD-10 coding. With the assistance of Berg Data Solutions , Kenyon HomeCare consulting can assess an agency's financial health and identify the causes of decreased financial reimbursements. Kenyon HomeCare Consulting has a robust ICD-10 Coding department with RN home Health Certified OASIS and ICD-10 coding experts. If you are struggling with reimbursement issues, call Kenyon HomeCare Consulting at 206 721 5091 or email gkenyon@kenyonhcc.com

How Education is Transforming Home Care: Successful Business Strategies

Fri, 03 Oct 2025 14:33:06 GMT

The demand for home care services is on the rise as aging populations prefer to "age in place." At the same time, the need for personalized educational support, from childhood tutoring to professional development, remains a constant. For entrepreneurs, these two growing sectors present a unique opportunity to create a successful, innovative business. By combining the compassionate, hands-on services of a home care agency with the structured, knowledge-based support of an educational provider, a new kind of business can emerge—one that addresses both the physical and intellectual needs of its clients.

This article explores the key elements of building a successful business that integrates education and home care.

1. The Unique Value Proposition: A Holistic Approach to Wellness

A traditional home care agency focuses on providing support for daily living activities, such as personal care, meal preparation, and transportation. An educational service, like a tutoring business, focuses on academic or skill-based growth. The intersection of the two creates a powerful value proposition: a holistic service that nurtures both the body and the mind.

This integrated model can serve a diverse clientele:

· Seniors: A home care aide might not only assist with daily tasks but also engage a client in brain-stimulating activities like reading, learning a new language, or using educational software. This can be especially valuable for those with memory care needs.

· Children with Special Needs: An aide can provide physical assistance while also implementing a tailored educational plan, working with the child on homework, social skills, or developmental exercises.

· Post-Surgery or Rehabilitation Patients: A client recovering at home might receive physical therapy support from an aide, who can also help them stay mentally engaged with hobbies, puzzles, or online courses to prevent feelings of isolation and boredom.

By offering this dual-focused service, the business differentiates itself from competitors and appeals to families seeking a more comprehensive approach to care.

2. Crafting a Comprehensive Business Plan

As with any new venture, a solid business plan is the foundation for success. This plan must go beyond the standard home care or tutoring model to address the complexities of the integrated service.

Key components of the business plan should include:

· Market Analysis: Research the demand for both home care and educational services in your target area. Identify a specific niche, such as "educational care for seniors with dementia" or "in-home academic and physical support for children with disabilities."

· Services and Pricing: Clearly define the services you will offer and how they will be priced. Will you charge a flat hourly rate for combined services, or will educational time be an add-on? Consider offering different packages based on client needs.

· Legal and Regulatory Compliance: This is a critical step. Home care agencies are subject to strict state and federal regulations, including licensing, insurance, and caregiver certification requirements. Tutoring services have their own legal considerations, such as business registration and liability. Be sure to consult with a legal professional to ensure you are compliant with all laws in your state.

· Recruitment and Training: Your caregivers must be more than just compassionate; they need to be capable educators. Develop a rigorous screening and training program that vets candidates for both their caregiving skills and their teaching aptitude. Ongoing professional development is essential to maintain high standards.

· Marketing and Sales Strategy: Your marketing should clearly communicate your unique value. Target key referral sources, such as hospitals, senior centers, schools, and local physicians. Use digital marketing and social media to highlight client success stories and the benefits of your integrated model.

3. Operational Excellence and Technology

Efficient operations are key to profitability and client satisfaction. Technology can be a powerful tool for managing a business with multiple service lines.

· Scheduling Software: Use a platform that can manage complex schedules, ensuring caregivers with both caregiving and educational skills are matched with the right clients.

· Care and Education Management: I mplement a system to track care plans and educational progress. This ensures consistency and allows you to demonstrate the value of your services to families.

· Training Platform: An online learning management system can be used for both initial onboarding and ongoing training for your aides, covering topics from dementia care to teaching techniques for specific subjects.

4. The Path to Profitability

The combined business model can be highly profitable due to its premium service offering and strong market differentiation. Clients are often willing to pay more for a service that addresses multiple needs, reducing the need to hire separate professionals for care and education. By focusing on quality, continuous improvement, and a strong, ethical brand, this type of business can build a loyal client base and a reputation for excellence.

The convergence of home care and education is more than a business trend—it's a response to a fundamental human need for connection, growth, and independence at every stage of life. For entrepreneurs with a passion for both care and learning, this integrated model offers a path to building a truly successful and meaningful enterprise.

If you are struggling to build your business and seem to be stuck, call Kenyon HomeCare Consulting at 206-721-5091 or contact Ginny Kenyon at gkenyon@kenyonhcc.com . We are here to help.

Boost Your Agency's Financial Success By Managing Its Biggest Obstacle: Chronic Disease

Sat, 27 Sep 2025 19:08:23 GMT

Educating home health and home care aides in chronic diseases is a strategic move that significantly boosts business success. By providing clinical staff and home care/health aides with specialized knowledge, agencies can enhance the quality of care, improve patient outcomes, and gain a competitive edge in a growing market. This focus on education is a key differentiator that benefits the business, its employees, and its clients.

The Growing Need for Chronic Disease Management

Chronic diseases, such as diabetes, heart failure, and dementia are a leading cause of death and disability in the United States, and they account for a substantial portion of healthcare costs. The management of these conditions often extends beyond the hospital or clinic and into the home, making home health and home care agencies critical players in the healthcare continuum. However, a standard home care aide's training may not be sufficient to effectively manage the complexities of chronic conditions. This is where specialized education comes in.

Business Benefits of educating staff with Chronic Disease Expertise:

Investing in chronic disease education for your clinical staff and home/health aides offers a number of direct and indirect business benefits.

Improved Patient Outcomes

Field staff who understand the nuances of chronic diseases can provide more effective and proactive care by:

Monitoring Vitals and Symptoms: An aide trained in heart failure management can accurately monitor signs of fluid retention and alert a nurse or family member which potentially prevents costly and stressful hospitalizations.
Encouraging Adherence to Care Plans: Aides with knowledge of diabetes can help a client with meal planning, blood sugar monitoring, and understanding the importance of medication timing. This leads to better patient compliance and health outcomes.
Empowering Patients: Education empowers patients to take an active role in their own health. An aide can serve as a health coach, helping clients to set and achieve self-management goals. This shift from passive recipient to active participant is crucial for long-term health.

2. Increased Competitive Advantage

In a crowded market, an agency's commitment to specialized training sets it apart. By offering certified, highly skilled aides, an agency can market itself as a premium provider of chronic disease care . This can lead to:

Higher Reimbursement Rates: Under value-based care models, such as the Patient-Driven Groupings Model (PDGM), agencies that demonstrate better patient outcomes and manage complex cases can earn higher Medicare reimbursements.
Stronger Referral Relationships: Physicians and hospital discharge planners are more likely to refer patients to agencies they trust to provide high-quality, knowledgeable care for complex conditions.

3. Enhanced Employee Retention

Home health and home care agencies face a significant challenge with high employee turnover. Providing specialized training is a powerful tool for retention.

Professional Growth: Aides who receive chronic disease education feel more valued and see a clear path for professional growth. They are more likely to be engaged and motivated in their work.
Job Satisfaction: By equipping aides with the skills to handle more challenging cases, you increase their confidence and sense of purpose. This leads to higher job satisfaction and a more stable workforce.
Higher Pay: Offering advanced training can justify higher wages, which further incentivizes employees to stay with your company.

Implementing a Successful Education Program

To reap these benefits, agencies must be deliberate in how to implement and manage successful training programs. Focus on these key steps:

Assess Needs: Identify the most prevalent chronic conditions in your community. Tailor your training to focus on the conditions your clients most often face, whether it's Alzheimer's, COPD, or chronic pain management.

Develop Curriculum: Partner with healthcare professionals, such as nurses or certified educators, to create a comprehensive curriculum. The training should cover the pathophysiology of the disease, symptom management, medication side effects, and communication skills for working with patients and families.

Use Technology: Utilize online learning platforms to make training accessible and flexible for your clinical staff and home care/health aides. This can include on-line modules, with quizzes, and virtual simulations to test their knowledge and skills.

Offer Certification: Provide a clear path to certification or specialization. This not only validates your aides' expertise, but also serves as a strong marketing tool for your business.

Chronic disease education is not just an added benefit; it is a foundational element of a successful and sustainable home health and home care business . By investing in your clinical staff and home care/health aides, you are investing in better patient care, a stronger business reputation, and a more dedicated workforce. This creates a win-win for everyone involved.

We know it is costly to develop chronic disease education for all your field staff. To assist with this challenge, Kenyon HomeCare Consulting has developed Chronic Disease University that covers many of the leading causes of disability and death. All courses are certified by DSHS as 8 hours of continuing education. The courses are broken into 2-hour segments with a test after each segment. The courses are take it till you make it, not pass/fail so the test can be repeated as often as needed to help the aide truly comprehend the material. If you have questions, contact us at 206-721-5091 or gkenyon@kenyohcc.com .

Home Care Aide Retention: A Critical Issue with a Human Cost

Thu, 25 Sep 2025 18:12:40 GMT

The home care industry is facing a staffing crisis with home care aide retention remaining a serious challenge for agencies nationwide. High turnover rates inflict significant costs on home care agencies and put vulnerable patients at risk of interrupted, low-quality care. For agencies seeking stability and success in an evolving market, addressing retention is no longer just an HR issue; it is a strategic imperative.

The scope of the retention problem:

Recent data highlights the severity of the home care aide turnover crisis:

· In 2023, the median turnover rate for home-based caregivers reached 79.2%.

· Approximately four out of five caregivers leave their jobs within their first 100 days of employment.

The consequences of high turnover:

The revolving door of staff has serious repercussions for patients, caregivers, and agencies.

Impact on patients

Disrupted continuity of care: Patients, many of whom are ill or frail, often build close relationships with their caregivers. A constant cycle of new faces can cause stress, anxiety, and a feeling of instability.
Poorer health outcomes: Frequent staff changes increase the risk of medication errors, miscommunications, and other health issues. Studies have linked high turnover to increased emergency department visits and hospital admissions.
Decreased satisfaction: Patients who experience inconsistent care are more likely to be dissatisfied and may seek services elsewhere.

Impact on agencies

Increased costs: Recruiting, hiring, and training new employees is a resource-intensive process. Replacing a single caregiver can cost an agency between $2,000 and $5,000.
Operational inefficiency: Short staffing can lead to missed visits, increased overtime, and ultimately, risk burnout for remaining staff. Many agencies have been forced to turn away new clients due to workforce shortages.
Damaged reputation: High turnover and client dissatisfaction can damage an agency's reputation and impact on its ability to attract new business and secure referrals.

Root causes of the turnover problem (systemic)

Low wages and limited benefits: Caregivers are among the lowest-paid workers in the healthcare sector, with many earning low wages and receiving few or no benefits.
Burnout: The work is physically and emotionally demanding. Aide work often involves long hours and high-stress situations. Inconsistent and unpredictable schedules contribute significantly to employee burnout.
Lack of support and communication: Poor communication from management is a top complaint among caregivers. Many feel isolated and undervalued which leads to job dissatisfaction.
Limited career growth: Many caregivers view their jobs as having limited opportunities for advancement, further discouraging them from staying with an agency long-term.

Proven strategies to boost retention

While the challenges are significant, agencies can implement strategic initiatives to build a more stable and dedicated workforce.

Invest in competitive compensation and benefits: Offer competitive wages, health insurance, and paid time off to attract and retain quality caregivers.
Prioritize a positive work environment: A supportive culture built on respect and open communication is critical. Regular check-ins and listening to feedback can help caregivers feel heard and valued.
Provide robust training and career development: A strong onboarding process is crucial as many new hires leave within the first few months. Offering ongoing chronic disease training and opportunities for career advancement can empower employees and increase job satisfaction.
Leverage technology for better scheduling and communication: Modern home care software can help address key pain points by offering flexible scheduling and improving communication. Technologies can also match caregivers with clients based on compatibility and proximity, which reduces travel times.
Create a culture of recognition: Implementing programs to recognize and reward employees for their hard work and dedication can boost morale and loyalty. Recognition doesn't always have to be monetary; heartfelt appreciation can go a long way.
Protect caregivers from difficult situations: A commitment to safety and providing adequate support in challenging situations can build trust and reduce turnover.

The home care industry is at a critical juncture. By focusing on caregiver retention, agencies can improve their financial performance and, more importantly, ensure that vulnerable patients receive the compassionate, consistent, and high-quality care they deserve. Investing in home care aides is an investment in the future of home-based care.

If you are currently experiencing the industry average of about 80% turn over a year, contact Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com We are here to help.

Unlock Profit Growth and Boost Employee Engagement!

Fri, 19 Sep 2025 12:17:55 GMT

Every home care/home health agency is in the business to make a profit. To do so one must increase retention of staff you already hired. In previous blogs, I wrote about the cost of recruitment, hiring, orientation and training. It is estimated that it costs an agency around $2000 to $5000 to hire and replace an aide. We also see that the turnover rate is still close to 80% a year. Therefore, it is estimated an agency is spending on average $171,600 per year for an agency per 100 aides.

What if most of that money spent on recruitment could go to your bottom line? The key to increased profits is increased referrals and retention of staff. Over the years running agencies, I learned that to increase my referrals I had to have the best staff of any other agency in my territory. And, I had to retain that staff. The key was listening to and investing in the staff.

For that reason, I created a Chronic Disease University. Each disease process is an 8-hour course divided into 4 modules. There are tests after each module and when someone completes the course material. The courses are “take it until you make it”. They are designed to educate, not pass or fail! The courses are certified by DSHS as 8 hrs. of continuing education for field staff.

Two of the courses were tested in the acute wing of a nursing home. The facility, in a 6 month time period, had 13 CHF and 3 COPD patients readmitted to the hospital in the first two weeks of admission to the SNF. This resulted in financial penalties to the nursing home. All 32 staff were required to take both of those Kenyon chronic disease courses. It took 3 months for all the staff to complete and become certified. The results were beyond what we had anticipated. Readmission for these two chronic diseases dropped to 0 and 0 not only on the acute wing but for the entire 164 bed building, as the MDS nurses worked the entire building.

When the hospitals discovered that there were no readmits for these two diagnosis, referrals increased by 30% and the SNF was invited to participate in A Robert Wood Johnson study on CHF. The surprise was the increase in retention. Retention climbed to 80% with those leaving only because they were hired by the area hospitals who paid more than the SNF. Increased referrals, increased retention and increased profits! A win, win, win!!

If you want to win, win, win, go to Kenyon Education under the store tab. Make your agency truly stand out among the rest. Hire the best, train the best, retain the best and let the profits grow! If you need assistance, please contact Ginny Kenyon at gkenyon@kenyonhcc.com or 206-721-5091.

Elevate Your Home Care Game: Secrets to Success

Tue, 09 Sep 2025 12:41:07 GMT

As a national consultant, I have the privilege of engaging with companies all over the country. One of the biggest challenges I see with agencies is their inability to differentiate themselves from the competition. Many have no clue what other agencies offer and how it makes them different and more marketable in the community.

There are several steps to help determine what your community agencies look like and what you might do to set your agency apart from the competition:

• First: Shop your competition to see what they offer and what they charge. Having done this many times, I find that after the 20th call (or more), all of the agencies sound the same. I cannot tell one from the other. No one stands out! if this is you, why would a potential customer go with you? You must be memorable and different than your competition.

• Second: W ho answers the phones? This person is your number one salesperson and the one who leads to closing the sale for your agency. That person must be a good listener, personable and engaging. This is your only opportunity to make a good first impression for your agency!

• Third: What are potential customers asking for? Every phone should have a phone log by the phones. Frequently, the person taking the intake calls is on the line when another potential customer calls. Make it the rule all calls are picked up within the first 3 rings. Train all your staff on how to answer the phone and to log all calls whether it is something you can offer or not. An unwritten rule of business is, “If they ask for it, they are willing to pay for it”. Weekly gather the phone logs. See if there are trends in requests that you do not offer. Some requests are not in your “wheel well” but offer an opportunity to partner with others in your community to provide services to your customers. Others are a service that you could create to meet requests such as concierge day surgery support program

• Fourth: Are you educating and training your staff to the prevailing diagnosis of your caseload. If you are doing this, you stand out with not only potential clients/patients, but with referral sources as well.

If you are struggling to get clients/patients and are not sure how to improve your referrals and increase your revenues, call Ginny Kenyon at 206-721-5091 or email gkenyon@kenyonhcc.com . We are here to help at Kenyon Homecare Consulting !

Master the Home Care Compliance Strategies You Need Today!

Thu, 28 Aug 2025 22:31:42 GMT

Mastering regulatory requirements in home care, home health, and hospice is no simple feat. To maintain compliance, your businesses must actively identify relevant regulations, assess current compliance, develop a compliance plan, implement and monitor it while continuously improving efforts to maintain it. This involves staying informed about changes, providing employee training, conducting regular audits, and documenting procedures.  Any findings that indicate noncompliance with rules and regulations should automatically become part of your QI problems and solutions.

Here is a more detailed breakdown:

1. Identify and Understand Relevant Regulations:

Know your industry: Different industries have specific regulations (e.g., healthcare, home health, and hospice).

Identify applicable laws and standards: Review government websites, industry associations, and consult with legal experts when needed.

Understand the specifics: Go beyond just knowing the regulation exists;  understand the specific requirements that apply to your agency.

2. Assess your Current Compliance position:

Regularly Conduct Internal Audits:
Be sure to regularly access the state rules for any relevant changes, at a minimum of yearly.
Conduct a thorough assessment of your current policies, procedures, systems and complaint logs to identify gaps in compliance.

Risk Assessment
At least yearly, identify potential compliance risks and prioritize them based on severity and likelihood of occurrence. 
Develop a plan for correction of those issues and be sure to notify all staff who will be affected by any changes. Document all the work done and who was notified.
Ensure your documentation (policies, procedures, training materials) is up-to-date and accurate.

3. Develop and Implement a Compliance Plan:

Create a compliance roadmap:
Outline specific steps, timelines, and responsibilities for achieving compliance. 
Be sure to assign a specific position the responsibility of monitoring compliance. The old rule “if everyone is responsible, no one is really responsible” is a very true statement.

Establish clear policies and procedures:
Develop written policies and procedures for all areas of compliance. 
Develop the steps for each area of compliance with quarterly reports of actions and outcomes.

Implement controls:
Implement controls (e.g., access controls, monitoring systems) to prevent non-compliance.

Provide employee training:
Ensure employees understand relevant regulations and their roles in maintaining compliance. 
Incorporate the training into orientation and at least yearly reminders at Inservice training of the critical areas of regulations and practices, e.g., handwashing in the homes, when and how.

4. Monitor and Maintain Compliance:

Regular audits:  
As referenced, quarterly reporting and actions and outcomes for ongoing compliance are necessary to make regular auditing valuable and to initiate real compliance changes.

Ongoing monitoring:  
Use automated tools or other methods to monitor compliance in real-time. 
Use phone logs and complaint logs to identify potential compliance issues.
Again, be sure to assign a specific position to the monitoring process to assure it reviewed and reported on a regular basis.

Continuous improvement:  
Remember, regularly review and update your compliance plan and procedures to adapt to changing regulations and agency needs.

Documentation:  
Maintain detailed records of compliance activities, audits, and training. 
Establish a site where all documentation can be found.

Seek expert advice:  
Consult with industry consultants or legal counsel for guidance on complex regulatory issues.

5. Utilize Technology:

Compliance management software:  
Consider using specialized software to automate tasks, track compliance status, and manage documentation.

Risk assessment tools:  
Use tools to assess and prioritize compliance risks.

Training platforms:
 Utilize platforms to deliver and track employee training on compliance.

By implementing these steps, agencies can proactively manage their regulatory compliance, minimize risks, and avoid complaints to governing bodies, potential penalties, and legal issues. 

If you are unsure on how to proceed with developing and maintaining an effective compliance program, contact Kenyon HomeCare Consulting at kenyonhcc.com or call 206- 721-5091. We are here to help!

How a Looming Healthcare Crisis in the Making Could Affect You

Wed, 20 Aug 2025 19:37:17 GMT

We have a healthcare tragedy in the making in our country. A significant reduction in federal Medicaid funding is expected which will potentially impact various states differently. One estimate projects a reduction over 10 years totaling 14% of federal Medicaid spending. This could lead to increased state spending to maintain current levels of coverage or necessitate cuts in services. States that expanded Medicaid under the ACA , particularly those with higher rates of expansion, are expected to be disproportionately affected. This brings us to the impact on rural hospitals. For those living in rural America, the health care system built over decades to ensure care for all is seriously threatened. Let's look at what we currently know

Estimated Cuts:

A 10-year reduction of $911 billion in federal Medicaid funding is projected.

Impact on States:

The impact will vary by state, but those with Medicaid expansion are likely to face greater challenges due to potential loss of federal matching funds. Some of the most heavily impacted states include Louisiana, Illinois, Nevada, and Oregon.

Potential Consequences:

States may need to increase their own spending, cut benefits, or reduce enrollment.

Rural Areas:

Rural hospitals and communities are expected to be particularly impacted by Medicaid cuts, especially in states that expanded Medicaid.

Specific Examples:

Louisiana, Illinois, Nevada, and Oregon: These states are projected to experience spending cuts of 19% or more over the 10-year period, according to KFF .

Expansion States: States like Kentucky, North Carolina, Virginia, and New York could see significant reductions in rural Medicaid spending, according to the National Rural Health Association.

Non-Expansion States: States that did not expand Medicaid under the ACA, like Texas, may also experience cuts, but the impact may differ due to variations in eligibility and enrollment.

Rural hospitals:

Rural hospitals in the US are facing significant financial challenges as many are projected to lose substantial revenue and potentially face closure. A key driver of these losses is the reduction in Medicaid funding, which is a major source of revenue for these hospitals. Cuts in Medicaid reimbursement, including both federal and state funds, could lead to billions of dollars in lost revenue for rural hospitals over the next decade. This could accelerate closure for those already facing financial struggle.

Key Factors Contributing to Losses:

Medicaid Cuts: Federal Medicaid cuts, particularly those related to the One Big Beautiful Bill Act, are expected to significantly impact rural hospital revenue. According to a report from the National Rural Health Association, these cuts could lead to billions of dollars in lost revenue, impacting hospitals' ability to provide services and potentially leading to closures.

Uncompensated Care: Increased uncompensated care costs, due to a rise in the number of uninsured individuals, are also contributing to revenue losses for rural hospitals.

Lower Patient Volume: Rural hospitals often face lower patient volumes due to declining rural populations and patients seeking care at urban facilities.

High Operating Costs: Delivering healthcare in rural areas can be more expensive due to the need to maintain facilities in remote locations and higher transportation costs.

Limited Other Revenue Sources: Many rural hospitals rely on local tax revenues or government grants to offset losses, but these sources may not be sufficient to cover rising costs or compensate for Medicaid cuts.

Closing Facilities:

Since 2005, 195 rural hospitals have closed nationwide, with an additional 742 at risk of closure.

Sheps Center for Health Services Research at the University of North Carolina has an interactive map showing 87 rural hospitals that have closed completely since 2010 and an additional 65 that "no longer provide in-patient services but continue to provide some health care services."

Consequences of Losses and Potential Closures:

Reduced Access to Care:

Closures or service reductions in rural hospitals can force patients to travel farther for care. This potentially impacts access to emergency services, specialty care, and other essential healthcare services.

Economic Impact:

Hospitals are often major employers in rural communities, so closures can lead to job losses and economic hardship.

Increased Travel Distance:

Patients may have to travel longer distances for care, potentially increasing costs and delaying treatment, particularly in emergencies.

Reduced Competition:

Closure of a local hospital can reduce competition among providers. This potentially leads to higher prices and reduced quality of care.

Specific Examples:

Manatt Health:

Manatt Health projects rural hospitals to lose 21 cents out of every dollar they receive in Medicaid funding due to the One Big Beautiful Bill Act, according to the National Rural Health Association. Independent rural hospitals could lose an estimated $465 million in total patient revenue in 2026 due to federal Medicaid cuts , according to InsuranceNewsNet.

55 additional independent rural hospitals across 26 states could experience negative net incomes due to cuts, putting them at serious risk of closure.

According to HealthCare Quality & Payment Reform, we as a nation are at risk for over 700 rural hospitals across America closing. This is a tragedy of major proportions!

If you are an agency in a state affected by these changes to funding, call Kenyon HomeCare Consulting at 206-721-5091 or email gkenyon@kenyonhcc.com and lets talk about what you can do to care for your clients or patients.

Transforming Lives: The Rise of Patient-Centered Care

Mon, 11 Aug 2025 16:25:26 GMT

We have heard a lot in the past about patient centered care(PCC), but little is taught and used in the day-to-day care of patients in the the home. With the pressure to provide care, be timely with reports and documentation among other demands, PCC sometimes is lost in practice.

In order to understand patient centered care, we need to first define and understand key terms by CMS's definition:

· Integrated Care: An approach to coordinate health care services to better address an individual’s’ physical, mental, behavioral and social needs.

· Person-Centered Care: Integrated health care services delivered in a setting and manner that is responsive to individuals and their goals, values and preferences, in a system that supports good provider–patient communication and empowers individuals receiving care and providers to make effective care plans together.

· Value-Based Care: Designing care so that it focuses on quality, provider performance and patient experience.

CMS also states that person-centered care includes :

· Care that’s guided and informed by patients’ goals, preferences, and values

· Success measured by patient-reported outcomes

· Integrated and coordinated care across health systems, providers, and care settings

· Managing chronic and complex conditions

· Relationships built on trust and a commitment to long-term well-being

Therefore, PCC is a healthcare approach that prioritizes the individual patient's needs, preferences, and values in all healthcare decisions. It emphasizes a collaborative partnership between the patient and their healthcare providers. This is moving away from the traditional model where providers make all the decisions.

PCC is built on several key principles:

· Respect for Patient's Values, Preferences, and Needs: Recognizing and honoring each patient's unique background, knowledge, and desires.

· Information Sharing and Education: Ensuring patients receive timely, clear, and comprehensive information to make informed decisions.

· Patient and Family Participation: Actively involving patients and their families in discussions, planning, and decision-making about their care.

· Coordination and Integration of Care: Facilitating seamless transitions and communication between different healthcare providers and settings.

· Physical Comfort: Prioritizing and addressing the patient's physical comfort and pain management.

· Emotional Support and Alleviation of Fear and Anxiety: Providing empathy, reassurance, and psychological care to address the emotional impact of illness.

· Continuity and Transition: Supporting smooth transitions between care settings and ensuring ongoing support and information after discharge.

· Fast and Reliable Access to Care: Ensuring patients can easily access the care they need, when they need it, without undue delays.

These concepts align with the eight Picker principles of patient-centered care , widely adopted in healthcare settings.

Benefits of PCC

Implementing PCC has several advantages for patients, providers, and the healthcare system as a whole:

· Improved patient outcomes: Studies have shown a positive correlation between PCC and better health outcomes.

· Increased patient satisfaction: Patients are more satisfied with their care when they feel respected, heard, and involved in the decision-making process.

· Stronger patient-provider relationships: PCC fosters trust and open communication, leading to better relationships between patients and their care team.

· Reduced healthcare costs: By preventing unnecessary procedures and streamlining care, PCC can contribute to cost savings.

Patient-centered care in practice:

So how does it look in practice? You must first complete the assessment to make sure you understand all the issues facing the client/patient. Once that is done, you know the protocols for care based on the diagnosis determined by your assessment. While all of these are wonderful and needed, they are only the background for your plan of care.

The focus of the care plan should be based on THE PATIENT'S GOALS FOR CARE .

So, what does that mean? For instance, if the patient is a long-standing diabetic with co-morbidities of CHF and severe arthritis, do you add medication and diet education as well as CHF protocols for management? Maybe, if it fits what the patient wants. What if the patient's ultimate goal is to be comfortable and able to do some minimal activities like playing cards or going for rides. Then comfort from pain and easier breathing to accomplish the patient goals becomes your care plan. Do you work in the standard protocols to accomplish this? Yes, but it changes the focus from protocol centered to patient goal centered. If you want success in your care, always make the patient the center of your care so both the patient and you are winners.

If you need assistant with your agency operations to include patient centered care with better outcomes and patient satisfaction, call us at 206-721-5091 or email at gkenyon@kenyonhcc.com .

References:

CMS.gov

AI Research response

The Hidden Struggles of Home Health: Ensuring Quality of Care

Sat, 02 Aug 2025 15:56:50 GMT

Quality of care in home health presents challenges related to providing effective and safe care in a patient's home.  Issues include inadequate staffing and training (chronic diseases in particular), communication breakdowns, difficulty assessing patient progress, and logistical challenges (unfamiliar environments and equipment). Plans of care that are not centered around the patient’s wishes for care (patient centered care), lack of resources, and the need for robust safety protocols contribute to these issues.  While the comforts of home are a clear benefit, home health care faces unique challenges that can impact the quality of care provided. These issues often arise from the inherent differences between the home environment and more controlled clinical settings. 

Here's a breakdown of common quality of care issues:

1. Medication management:

Complexity: Patients often manage numerous medications, potentially prescribed by multiple providers, leading to confusion about dosages, schedules, and potential interactions.
Errors: Up to 30% of older home health patients experience potential medication problems including taking the wrong medication or dose, missing doses, or using incorrect administration routes.
Caregiver burden: Caregivers, especially family members, may lack the training and oversight to effectively manage complex medication regimens,  according to regencyhcs.com.
Patient factors: Cognitive impairments, multiple health conditions, and complex medication schedules further elevate the risk of medication errors in the home setting.

2. Communication and coordination:

Lack of understanding of what “Patient Centered Care” really means and how to implement and communicate a plan that is centered around the patient’s wishes for care.
Communication gaps: Ineffective communication among healthcare providers (including nurses, aides, and physicians) directly and between providers and patients/families can lead to misunderstandings, fragmented care, and increased safety risks.
Care transitions: Poor communication during care transitions, such as hospital discharge, can result in patients not receiving essential information or follow-up instructions.
Coordination challenges: The involvement of multiple individuals and organizations in a patient's care can create difficulties in coordinating services and ensuring everyone is on the same page,  according to NYU .

3. Infection control:

Unique environment: Maintaining strict infection control measures can be more challenging in a less controlled home setting compared to a hospital.
Exposure risks: Home health workers face increased exposure to infectious agents when caring for patients who may have infectious diseases.
Compliance and training: Compliance with hand hygiene and appropriate use of Personal Protective Equipment (PPE) may be inconsistent, and inadequate training can contribute to infection risks.
Patient vulnerabilities: Patients with chronic conditions, wounds, or medical devices are at higher risk for infection, and caregivers' lack of training can further exacerbate this risk.

4. Workforce and staffing issues:

Staff shortages and turnover: High turnover rates among home health workers can lead to staffing shortages which impact the agencies' ability to meet patient needs and while potentially compromising care quality.
Training and competency: Challenges arise in training caregivers to meet complex patient needs and ensure they have the required skills for home care. Education in disease specific issues is crucial especially when there are several impacting diagnoses.
Work environment and support: Difficult working conditions, including workload pressures, unpredictable schedules, and potential lack of support can contribute to stress and burnout among home health workers.

5. Technology integration:

Interoperability and outdated systems: Many home health agencies struggle with integrating various IT systems, leading to inefficiencies, errors, and communication gaps.
Digital literacy: Patients and caregivers may have varying levels of technological literacy, requiring training and support to effectively utilize digital health tools for care management and communication.
Infrastructure limitations: Inadequate internet access or outdated hardware in some homes can hinder the effective implementation of technology-based care solutions.

In conclusion, addressing these challenges requires a multifaceted approach, including improved medication management strategies, enhanced infection control measures, efforts to improve staff recruitment and retention, better communication and coordination among all parties. It is particularly important to have the patient/client involved in the care plan with consideration of technology integration to ensure high-quality and safe care for patients in their homes. 

Resources:

Patient Safety and Quality in Home Health Care - NCBI

Sep 15, 2014 — Nearly one-third of older home health care patients have a potential medication problem or are taking a drug considered inappropriate for older people.

National Institutes of Health (NIH) | (.gov)

How Is Quality of Care in Home Healthcare Created?

May 31, 2022 — Abstract. The demographic challenges with an increase in older adults in need of nursing care have put home healthcare services under pressure. However, research...

National Institutes of Health (NIH) | (.gov)

The Challenges Home Health Care Aides Face in Medication

Mar 15, 2019 — Medication Management: Coordination and Communication * Lack of trust between caregivers and patients. * Lack of relationships/communication between providers

Whether it is the Federal Government, a state agency, or the patients/clients we serve, we are all governed by and responsible for the quality of care provided. If your quality measures are below the standards or you have numerous complaints about care and are struggling with corrective measures, Kenyon Home Care Consulting can help. We are all senior managers with at least 20+ years in administrative or management positions. We are here to help. Call 206-721-5091 or email gkenyon@kenyonhcc today.

Why Infection Control Remains a Top Concern in Home Health

Sat, 26 Jul 2025 17:23:54 GMT

Infection control is a crucial area of focus during  home health accreditation  surveys. Surveyors assess written policies and procedures and shadow clinicians on patient home visits to observe implementation of the practices that prevent infections and reduce risk. Depending on severity, infection control breaches may be reportable to state public health authorities, and these issues have been among some recently cited survey deficiencies. Understanding where home health agencies may fall short and actively addressing issues is essential for compliance and quality care.

Observed infection control breaches

Errors in hand hygiene: Surveyors have observed clinicians failing to perform hand hygiene before and after patient contact or after touching potentially contaminated surfaces. Inconsistent availability of appropriate hand washing supplies can also lead to citations. Examples include using a patient’s bar soap and cloth bath towel rather than liquid soap and paper towels or alcohol-based hand sanitizer.
Lack of personal protective equipment (PPE): Surveyors expect PPE use to align with agency policy and patient care needs. Common findings include failure to wear gloves (e.g., during wound care), absence of masks during respiratory procedures, or incorrect donning and doffing of PPE.
Incorrect bag technique: How clinicians manage their bag of supplies and equipment—placement, use of necessary barriers, disinfection of multiuse items like blood pressure cuffs, stethoscopes, and thermometers—relates directly to infection prevention. If staff cannot correctly demonstrate these practices, it can result in survey deficiencies.
Wound care: This high-risk area receives significant attention during surveys. Surveyors are likely to observe dressing changes and review documentation. Expired supplies, incorrect or missed dressing changes, and lack of proper technique for wound care often trigger citations.
Improper handling of sharps: Surveyors check that clinicians follow safe injection practices for single-use items, disposal of sharps in approved containers, and relevant safety education for patients when sharps are used in the home.

Tips for improved compliance

Review your policies and procedures: Verify that your infection control policies are up to date, reflecting the latest industry guidance, and comprehensive, addressing the scope of services you provide. Ensure that your staff has access to the policies and can demonstrate compliance through actual field practice.

Train your staff : Provide infection control training at orientation and at least annually. Document the training for each individual staff member.

Stock supplies: Provide clinicians with the proper PPE, hand washing materials, disinfectants, and sharps containers. Surveyors may ask to see your office supply or staff members’ car stocks.

Use mock surveys: Direct observation of clinicians in the field or through simulated home visits in the office provide opportunities to verify compliant hand hygiene, PPE use, bag technique, wound care, and sharps handling. Provide immediate feedback and reinforce correct techniques.

Infection control compliance goes beyond policies, procedures, and clinical record documentation. It requires demonstration of adequate, observable, infection control practices in the home setting. By addressing common issues proactively, with ongoing staff education and regular internal audits, home health agencies can promote survey success while reducing risk for patients  and  clinicians, while improving quality of the care they provide.

ACHC

By: Becky Tolson, RN, BS

Manager, Survey Operations

Posted: June 20, 2025

If your agency is cited for failed infection control practices, call Kenyon HomeCare Consulting at 206 721 5091 or email gkenyon@kenyonhcc.com for assistance.

Strategies for Retaining Top Talent in the Home Care Industry

Thu, 17 Jul 2025 19:20:45 GMT

While recruiting home care staff can be challenging and costly, losing and replacing staff is more frustrating and expensive. Not only do you incur recruitment and orientation/training costs, but you must also consider and factor in the lost opportunity costs. Together, they are considerably higher than the recruiting and onboarding costs. It is estimated by some experts in the industry that the turnover of health care staff can be as high as 80% a year.

Replacing an employee can cost roughly 6 to 9 months of the departing employee’s salary, according to SHRM.

Some sources suggest a range of 50% to 200% of an employee’s annual salary, depending on the role’s level and specialization. A common formula used for budgeting is to estimate between 1.25 and 1.4 times the employee’s base salary to cover recruitment, onboarding, training, and lost productivity. It’s important to note that these are general estimates, and the actual cost will depend on factors like industry, location, and the specific role being replaced.

TURNOVER COSTS

According to Google AI, the indirect costs of turnover are:

Lost Productivity comes from: Reduced output from the departing employees, time it takes to onboard and train a new employee to full productivity, and potential disruptions to projects and deadlines.
Impact on Morale: The departure of colleagues can create uncertainty and negativity among remaining staff, potentially leading to disengagement and lower productivity.
Knowledge Loss: Departing employees take with them valuable institutional knowledge and expertise, which can disrupt workflows and customer relationships.
Potential for Further Turnover: Low morale and increased workloads can lead to burnout and even more departures, creating a cycle of high turnover.

With this kind of cost to the agency, why would you not spend at least half as much on retention programs to prevent this undesirable cost to your agency?

RETAINING HOME CARE AIDES

In order to develop retention strategies for a group of providers, you must first determine the cause of turnover. According to Google AI, the reasons for aides leaving a health care agency are:

Low Wages and Lack of Benefits: Home health aides often earn low wages and may not receive benefits like health insurance or paid time off which makes it difficult to attract and retain qualified staff.
High Physical and Emotional Demands: The job can be physically demanding with tasks like lifting and transferring patients. It can certainly be emotionally taxing, especially when dealing with clients' health declines or end-of-life care.
Lack of support and recognition: The jobs in the field are difficult and do not have the support of other colleagues on site. The staff need to do the best they can. They leave because no one seems to recognize the hard work they do.
Limited Career Advancement Opportunities: Some agencies may not offer clear paths for career growth or professional development which leads aides to seek opportunities elsewhere.
Burnout and Stress: The combination of physical demands, emotional challenges, and high workloads can lead to burnout and increased stress among aides.

You need to dig down deep and analyze you agency. Why do your aides leave? Is it all of the above? Are there different reasons you need to consider that are specific to your agency?

RETAINING CLINICAL STAFF: RNS, LPNS, PTS ETC

The cost of replacing skilled staff in home health can range from 16% to 200% of the employee's annual salary, according to several reports. For a nurse, this could be around $56,300, according to a Medbridge report. For a position like a home care worker making less than $30,000 per year, it could be around $2,600, according to a report from the Center for American Progress. A report by PHI suggests that replacing allied health personnel can cost at least $6,368; including lost productivity he total cost includes direct expenses like recruitment and training, as well as indirect costs like lost productivity and potential negative impacts on client care.

Here's a breakdown of the cost factors:

Direct Costs: These are expenses associated with finding, hiring, and onboarding new employees. This involves advertising job openings, conducting background checks, providing training, and covering the costs of physicals or drug tests.
Indirect Costs: These are more difficult to quantify but can be significant. It includes the loss of productivity while a position is vacant, the potential for errors due to inexperience, and the negative impact on employee morale when turnover is high.
Specific Roles: The cost of turnover varies depending on the role. Replacing a specialized healthcare professional can be very expensive, potentially reaching 200% of their annual salary, says Oracle .

High turnover rates can significantly impact home health agencies, leading to increased costs and potential disruptions in care. Reducing turnover through improved employee retention strategies is crucial for maintaining a stable workforce and providing quality care.

Given the high cost of turnover in an agency, we would suggest that spending 20% of the potential lost cost on retention strategies would be well worth the expense. As noted, every agency is different depending on the client/patient caseloads and the state and communities in which you operate. If you have high turnover in your agency and are struggling with developing effective retention strategies, contact Kenyon Home Care Consulting by email or call 206 721 5091. We are here to help.

Recruitment in Home Health and Home Care Staff is Urgent, not just an Issue

Sat, 12 Jul 2025 16:13:53 GMT

One of the biggest challenges for home care and home health agencies is the recruitment of staff to provide care for the clients/patients. Whether the agency is skilled or non-skilled, the high cost of recruitment and hiring is only exceeded by the severe problem of retention of staff.

RECRUITMENT:

The health care industry as a whole is struggling with recruitment of care giving staff. As I wrote in last week’s blog, Navigating the Supply and Demand Challenges in Home Care, there are reasons for the short supply of caregiving staff. As a result, there is significant competition for all levels of caregivers, whether RNs, LPNs or aides. The recruitment strategies will vary based on the caregiver types below:

For home care aides, there are many diverse methods such as online job boards, employee referrals, sign on bonuses and the use of recruitment software. Whether it is one of the above recruitment strategies or a combination, the process can prove to be costly. When you add to the additional costs of onboarding, an agency is looking at a costly investment. To determine total costs, you must look at the cost of recruitment dollars spent and onboarding (screening, interview time, criminal background checks, reference checks, TB screening and HPB vaccination, orientation, skills lab, additional training needed and orientation to your population served). Cost can be as high as $2,600 to $5,000 per aide depending on strategies used.

The average annual caregiver turnover cost for home care agencies is approximately $171,600. This cost encompasses expenses such as job postings, interviews, screening, hiring time, training, management time, and lost productivity until a new hire becomes proficient. Another estimate states the average home-based care provider spends around $174,174 on turnover annually. [ AI mode Google]

As you can see, it is expensive to recruit and hire and even more to replace those who resigned. You must consider and account for lost opportunity costs to the agency when you do not have enough staff to fill shifts. According to the Home Care Association of America , turnover rates are exceeding 79%. This means that roughly four out of every five caregivers may leave their positions within the first year. This high turnover rate significantly impacts the continuity and quality of care provided to individuals in need of home-based support.

2. Home health agencies face several significant challenges in recruiting and retaining Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). Some contributing factors are:

High Demand vs. Low Supply: There's a national shortage of qualified nurses across various healthcare settings, including home health. This was discussed in an earlier blog on supply and demand and as of this writing, continues to be a major issue for recruiting RNs and LPNs.
Aging Workforce: A substantial portion of the current nursing workforce is nearing retirement, exacerbating the shortage.
Insufficient Educational Capacity: Limited access to nursing education programs due to faculty shortages, lack of clinical sites, and resource constraints restrict the number of new nurses entering the field.

3. Other issues reported by AI Google as barriers to attracting nurses to home health are:

Competition: Home health agencies often compete with hospitals and SNFs for talent, both of which may offer higher salaries, sign on bonuses, and more comprehensive benefits.
Lower Compensation and Benefits: Home health care can struggle to offer competitive wages and benefits due to factors like Medicare and Medicaid reimbursement rates. This will only get worse in the following years as the newly released CMS reports that CY 2026 is estimated contain a $1.13 billion cut in payments with an additional 10 new regulations to comply with.
Some perceptions of home health: Some nurses may perceive home health as less prestigious or challenging compared to hospital-based positions. Hospital nursing is still seen as more glamorous than working from your car and in different homes. It takes a special kind of nurse to do home health.
Lack of Structure is another cited reason for difficulty in getting nurses to work in home health. Nurses often work independently with little contact with other nurses or professionals. This lack of structure and immediate peer support found in hospital settings is lacking and for some nurses not as attractive.

While recruitment for both professional and paraprofessional workers in home health is sometimes difficult, there are strategies that can help your agency overcome these barriers. If you need help with these issues, Kenyon Home Care Consulting senior consultants are tenured in the industry and able to assist you in achieving success. Call 206 7251 5091 or email gkenyon@kenyonhcc.com

Navigating the Supply and Demand Challenges in Home Care

Thu, 03 Jul 2025 21:23:17 GMT

Over the years, there has been a growing issue with the supply of nurses and home care aides. This is particularly true for home care agencies. With the increased competition from hospitals, skilled nursing homes, Medicare home health and hospices for these workers, it has become increasingly difficult to recruit and hire.

There are multiple reasons for this decline in workers which dates back to the 1980’s when President Regan hired the Pew Commission to determine the number of nurses in the country. The findings indicated that there were plenty of nurses, but they were maldistributed. In other words, there was no recognition that nurses, like doctors had specialties. As a result, the federal government withdrew funding support for nursing schools across the country. This decreased funding from over $100.3 million in 1980 to $46.4 million in 1982. In the next year, enrollment opportunities at universities diminished considerably and in California, 34 schools of nursing closed. Other contributing factors were the shift toward the academic settings for nursing education, the recessionary pressures of the 70s and 80s, general decline in enrollment in the schools, and perhaps the decrease in career days in high schools where nursing and other professions were promoted.

Due to the decrease in nursing schools and enrollment, the US depends heavily on nurses from the Philippines, India, Mexico, Jamaica, Nigeria and Haiti to bridge the healthcare needs in the country. With the current immigration situation, there is a realistic potential for further recruitment issues in the home care industry.

Potential Solutions for Nursing:

Improve working conditions: Address the demanding nature of the job while providing better training and support to improve job satisfaction. Provide support to the field workers via text and zoom or with in-person meetings to promote help for and in recognition of the employees.
Visa backlogs: Recent visa freezes have created a backlog and prevented thousands of qualified international nurses and aides from entering the US workforce impacting patient care at all levels. Advocate for the release of the blocked visas through the national associations and your elected officials. Provide data to support the needs of the industry.
Promoting the profession of nursing involves several key strategies: Emphasizing the vital role nurses play in healthcare, highlighting the growing demand and job security, promoting professional development/ training opportunities, and advocating for improved working conditions all play a vital role. We suggest that agencies work with local high schools to promote a career day for the seniors. Nursing as well as home care aides need to be promoted as viable career options.

Regarding Home Care Aides:

The shortage for home care aides is a bigger issue than nursing shortages. The Bureau of Labor Statistics projects nearly 718,900 job openings for home health and personal care aides annually through 2031, according to the Bureau of Labor Statistics . In the United States, immigrants make up approximately one-third (32%) of the home care workforce, according to a KFF issue brief . This percentage is higher than their statistics of the overall direct care workforce at 28% (which also includes nursing facilities and residential care settings).

In 2023, KFF reports over 500,000 naturalized citizens and over 300,000 non-citizen immigrants were working as direct care workers providing long-term care in the U.S. according to KFF. Immigrants are particularly crucial in the home care sector, where they represent a larger share of the workforce compared to other long-term care settings.

Potential Solutions for Home Care Aides:

Highlight the rewards: Emphasize the positive impact home care aides have on their clients' lives by helping them to maintain independence and quality of life in their own homes. Share stories of how aides provide companionship, support daily tasks, and offer peace of mind to both clients and their families.
Focus on career growth: Home care aide positions offer a strong career outlook with high demand projected for the future. Showcase the potential for advancement within the field such as becoming a certified nursing assistant (CNA) or specializing in specific care areas.
Advocate for Better Pay and Benefits: Publicize the importance of fair wages and comprehensive benefits for home care aides to attract and retain qualified professionals. Advocate for policies that support higher pay, health insurance, paid time off, and other benefits that recognize the value of their work.
Investing in training and professional development: Support initiatives that provide high quality training and ongoing professional development opportunities for home care aides. This includes specialized training such as dementia care, end-of-life care, managing chronic conditions, and leadership training for those seeking advancement.
Raising Public Awareness: Launch public awareness campaigns to educate the public about the vital role of home care aides and the challenges they face. This can involve sharing personal stories, highlighting the benefits of home care, and promoting a positive image of the profession.
Addressing Burnout: Acknowledge the potential for burnout among home care aides and implement strategies to support their well-being such as providing access to mental health resources and promoting work-life balance.
Promoting Diversity and Inclusion: Ensure that the home care profession is welcoming and inclusive of individuals from diverse backgrounds and experiences.
Strengthening Collaboration: Foster collaboration between home care agencies, healthcare providers, policymakers, and community organizations to create a supportive ecosystem for home care.

Kenyon Home Care Consulting works diligently with agencies to solve the supply and demand issues by providing chronic disease, culinary arts. housekeeping, home PT, and end of life care education for nurses, PTs and Aides in the industry. Kenyon also works with organizational management to mentor and support the development of a corporate culture that helps address these issues in creative ways that meet the needs of the individual agencies. If you are experiencing turnover greater than 30%, Contact us at Kenyonhcc.com or call 206 721 5091.

RESOURCE ALERT: HOPE Assessment Tool Q&A Repository

Fri, 10 Jan 2025 21:26:30 GMT

HOPE Question and Answer Repository

The CHAP accreditation body has published a repository of questions and answers that will help you understand and prepare for the implementation of the new Hospice Outcomes and Patient Evaluation (HOPE) assessment tool going into effect on October 1, 2025.

Kenyon HomeCare Consulting recommends you refer to this resource in conjunction with the HOPE program information that is available on the CMS website:

CMS.gov Hospice Quality Reporting Program HOPE info:

https://www.cms.gov/medicare/quality/hospice/hope

CHAP HOPE Assessment Tool – Question and Answer Repository:

https://chapinc.org/blog-news/hope-assessment-tool-cms-question-and-answer-repository

How Do You Reward Employees At The End Of The Year? Does It Hurt You If You Don't?

Fri, 09 Jun 2023 19:14:43 GMT

Today, this article will look at little different than out typical articles. We all know the costs of losing employees and trying to hire and train new ones. It is exhausting and expensive. So, we think about our wages and benefit packages all the time. What can we do differently that makes people stay? We can’t change the job and we don’t want to keep people that don’t like the work itself. So, how do we acknowledge employees in a way that is valuable to them and that our businesses can afford to do?

5 Things To Consider About Employee Recognition At Your Christmas Party:

1. Years of Service: These can be based on milestone work anniversaries (5, 10, 15 yrs, etc.). If a person has been at your agency 11 years, you pull them up and acknowledge them in the group of employees who have been there at least 10 years up until the time they hit the 15 years landmark. This way longevity is recognized yearly.

2. Special Employee awards: Now, this may be difficult if your staff is very small, but acknowledge the employee who has gone the extra mile in the job they do. Tell the story. The employee needs to know when the employer is proud of the work that has been done. Consider a plaque or certificate. Don’t minimize the value of the employee having them to display.

3. Acknowledge all employees in the mix: Because we are a clinical industry, the administrative staff is often overlooked on day-to-day operations. Ultimately, don’t miss the chance to acknowledge the employee who was able to catch billing errors or collect on a large account. Staff doesn’t like to hear about money, but those types of collections keep Christmas bonuses in place! So, make sure the other staff knows the accomplishments of the finance department or the office manager that every caller loves to speak to. Don't ever forget the IT staff that is on call more than any clinical person in your agency!

4. Letters from the administration: Add a personal note to your staff either collectively or individually depending on the size of your agency. If you are larger, there are employees you don’t often see or get to talk to on a regular basis, so take the time so send a note with that Christmas bonus.

5. Consider the Christmas bonus: Listen, some of you can afford to do substantial monetary bonuses and that is fantastic. However, if you are not in that position, consider something in its place. Maybe small gas cards go with the letter from administration. With the cost of groceries, consider something that helps with the costs of daily living for employees. Big box gift cards in your area will always be used.

You may do a lot of these things on a yearly basis to employees. All this being said, it doesn’t mean there aren’t reasons for acknowledgement throughout the year. However, your annual Christmas party is a good way to do it collectively. Between your annual party, write the individual cards to employees when you hear a patient interaction worthy of praise. Or, maybe you buy a gas card for the employee who has picked up extra shifts and always shows up on time. Ultimately, employees will feel valued. You will not regret the time, effort, and energy put into these efforts. Merry Christmas!

If you want help with recruitment and retention strategies for your agency, please call Kenyon Homecare Consulting at 206-721-5091 or contact us online today.

ICD 10 Coding Through The Eyes Of The Clinician

Fri, 09 Jun 2023 19:14:42 GMT

When you think in practical terms, what does your ICD 10 coding mean to the clinicians in your agency? It probably isn't as important as you would like. Realistically, your nursing staff cares about hands on patient care. If you want the code itself to be more meaningful, then you need to attach the concepts of patient care to the ICD coding. You may think the code itself goes hand-in-hand with the care, but this is not always true.

As a clinician, there are concepts within the nursing care plan that are automatic and some that are instinctual based upon the body system causing the need for care. It's a given that medication, diet, and disease process teaching are going to be in the care plan (or should be). When you get to disease process, our experience shows the clinician doesn't always run deep into the specifics of the disease when it could lead to valuable interventions being included in care. For example, when clinicians do a care plan related to cardiac disease, are the interventions very broad to include all things related to any type of cardiac disease? If you have a patient with right sided heart failure versus left sided heart failure, how many nurses would assess the patient differently? Would your nurses change the frame of mind to look for distended neck veins or anorexia and nausea if the patient had right sided failure? Would they be in the head space of considering whether the patient's appetite changes are more about just having been in the hospital than about potential venous stasis in the abdomen? The point is that although there are certain interventions that would be the same regardless the type of heart failure, picking up on different symptoms and critically thinking through the cause is often missing in the hustle and bustle of the day-to-day. This is not a judgment on the capabilities of the nurses but more about how our nurses are trained to consider care planning and assessment.

We have people for ICD 10 coding now. Most nurses are not in the ICD coding manual looking up their own codes anymore because of the specificity that wasn't the same 25 years ago. So, the nurses go out with an H&P from the hospital or doctors office and develop a care plan. It isn't necessarily with the coding in mind. So, we need to get back to basics when it comes to coding and clinical care. We need to train out staff to look harder at the coding. Our coding departments need to have open communication with clinicians and understand the concepts of care planning to understand if things are missing in the care plans. What about your clinical manager's role? Are these things considered when reviewing care plans? What about your record review process? Are your ICD 10 coders nurses that understand care planning and is it part of the coding process to review the care plan? These are things to consider when you look at your clinical practice as well as your coding solution.

At Kenyon Homecare Consulting , we have a comprehensive ICD 10 coding department that can provide education to clinicians, accurate ICD 10 coding, care plan and Oasis review. Call us at 206-721-5091 or contact us online to see if we can help you merge the code with the clinical practice in a way to improve your outcomes and your bottom line. We will offer 5 free recodes to any agency that would like us to check the efficacy of their current coding system or talk about becoming your coding solution.

Is Survey Around The Corner? Is Your Eyeball On Your Policy And Procedure Manual?

Fri, 09 Jun 2023 19:14:40 GMT

When your survey is done, is there a collective sigh of relief at your agency? Is it because it was successful and you can continue as usual? Is it because you have so much to do and now you don’t have to be at the surveyor’s beck and call? Or, maybe your policy and procedure manual just got annihilated and you are going to have a huge plan of correction with an overhaul of your manual? The latter means we need to talk about fixing your manual and what way to do it.

Do I Buy An Online Manual Or Fix Mine?

Well, that truly depends on you and your business. If you only have a policy or two that gets cited, updating your manual may be a quick fix for your agency. This is normally the case if someone is routinely updating it and the manual is used to run your business. Ultimately, your agency needs to keep the document a living breathing manual or it will not serve its purpose.

If your policy and procedure manual is not typically updated other than for survey, then you need to consider buying a manual. Your rule of thumb should be if your agency has not updated the manual within the last 3 years, you should consider purchasing a new one. There are many benefits to purchasing on online manual:

Customization: Pick a manual that allows you to fully customize policies to fit your operations. You should not buy a manual that doesn’t provide this option. You need to be able to prove to the surveyor how your agency complies with the regulation. If the policy is written a certain way and you don’t change it to meet how you operate, you will still be cited.
Forms/ Documents: Certain online manuals also provide forms that coincide with the policies. This makes it easy for you to implement changes because forms are already generated. There is no reason to reinvent the wheel by making your own. Most of these forms allow you to place your logo and any specific personalization within the document.
· State Rules: Several vendors have incorporated specific state rules into manuals. For instance, Kenyon Homecare Consulting offers skilled, non-skilled and hospice manuals as well as ones that have incorporated California and Washington state rules. This eliminates the individual business having to go back in and add state rules to the manual.
Consulting Services: Pick a vendor that also has consulting available should you need assistance in customizing your manual to meet your state rules or specific program rules. This makes the process easier especially if you are new to the policy writing and editing.
Up-to-date: This is the biggest advantage. These manuals have been updated to include the rules you need. We have seen so many agencies over the last several years not keep up with COP changes and it cost them at survey and with compliance. These manuals are routinely updated with changes so when you purchase your manual it will have the current federal regulations.

Ultimately, you have to decide whether it makes sense to rewrite your manual with updates or purchase one that is currently up-to-date. At Kenyon Homecare Consulting , we offer customizable manuals for all service lines, accreditation, and incorporated with certain state rules. Please call at 206-721-5091 or contact us online before purchasing your manual so we can ensure you have chosen the correct one to meet your needs. We also offer consulting services to help incorporate your state rules should you need assistance.

Home Care Growth Kit: Measurements That Drive Growth

Fri, 09 Jun 2023 19:14:39 GMT

By Jed Hammel:

I started my career in the 1990s working for GE, a company led by one of the greatest business leaders ever to have lived, Jack Welch. Jack left GE in 2000 (and so did I - haha). One of his great quotes was "What you measure is what you get."

In that theme we've been exploring a lot about measurements. When we first started building home care software it was all about transactions: Onboarding a client, scheduling, clocking in and out, billing, etc. This is the work we do to run the business, but what do we do to grow our business - measure!

Home Care Growth Measurements - The Most Important Ones!

Our customers told us that the most important measures are as follows:

Growth: Hours per week and revenue are the key ones. Note that you might think that number of clients should be on that list as well, but remember that an agency with 5 24x7 clients has more revenue than an agency with 80 10-hour per week clients.
Gross-Margin: One of the most troubling statistics in the Home Care Pulse Home Care Survey has shown that the profit margins of home care agencies have been dropping in the past two years. It's not surprising because there's increased demand for home care and there have been fewer available caregivers so the amounts we're paying caregivers have gone up. To combat this, agencies need to charge more and look hard at the cases where the caregiver pay or overtime is eating up all the revenue.
Operations: Most of our agencies use electronic clock-ins and clock-outs. On the Medicaid side this is called Electronic Visit Verification (EVV) but essentially all of our clients (including agencies who mostly support private pay and long-term care insurance) are doing it to have real time status and to streamline billing and payroll.
Billing for All Available Hours: One metric that some but not all agencies track is whether they're delivering and and getting paid for all of their available hours. Again jumping to the Medicaid side, most Medicaid agreements come with a specifically authorized number of hours (or units) per week or month and the way Medicaid works is that you are encouraged to deliver all the hours be penalized if you go over. Most of you private duty folks are probably counting your blessings that you don't have to deal with that, but a nice thing about it is that it establishes a target number of hours for the agency and let's you know that you're getting it done.

What Metrics are Recommended by Home Care Growth Champs like HomeCare Evolution by Steve the Hurricane?

Coincidentally, we recently we were joined by Melissa Bagley, one of the expert coaches from Home Care Evolution, on our Home Care Heroes Podcast. You can listen to her episode here: https://podcasts.apple.com/us/podcast/adapting-your-home-care-agency-for-the-future-with/id1548408985?i=1000551422539

Two follow-up thoughts:

If there's no way you're going to listen to the podcast, Melissa's recommendations are totally in line with the list above :)
If you think Podcasts aren't your thing, you might want to reconsider for the reasons that A) Home Care leaders spend a good amount of time in the car visiting prospects, referral partners and clients, and B) Rather than listening to news (which is mostly bad news), podcasts are educational and uplifting.

Best Practices: Dashboards should summarize information so you can get an immediate sense of how things are going.

Your dashboard should answer the question "Are we delivering and getting paid for all the services we've been asked to deliver." It's a powerful end to end measure of operational efficiency.

Best Practice: Summaries are great, but you need drill down to see where the problems are.

Referring to the same dashboard, note that it's great to see a summary, but you also need to be able to drill down to see where the issues lie.

Best Practice: Graphs are Nice but Managers generally prefer numbers.

A good view of caregiver compliance lets management know at a glance how their caregivers are doing with clock-ins and clock-outs. In this case the pie charts are very useful.

By contrast, managers generally prefer numbers and pride themselves on knowing their numbers off the top of their head. Overall business owners can usually tell you their number of clients and weekly hours, whereas recruiters can tell you their number of applicants, number of hires, percentage of candidates attending interviews and percentage hired. Here's a pure numbers dashboard with week by week data.

Best Practice: Manage by week, but be prepared to provide data by month, quarter, and other ways.

There are weekly summaries of growth with week over week comparisons, but monthly results should be accessible with the touch or a button.

Similarly, you want to be able to look at pretty much any time period, but we recommend not looking at less than a week's worth of data because most agencies have fewer visits on the weekends.

Takeaways:

My church pastor once told me that no matter what sermon they were writing, the initial outline was "What?, So What? and Now What?" So, what should you do after reading this article. Here it is:

Identify your key metrics - if you're not sure where to start go with weekly clients, weekly hours of care, gross margin, and recruiting
Find an easy way to see the data - hopefully via dashboards with drill down as explained above (if you don't have this, we'd be happy to help - here's how to contact Ankota).
Assign leaders to own and drive each of your key metrics
Review them regularly, ideally week by week

If you have any questions about dashboards or how Ankota's home care management software can help your business, please click below to contact us !

Ankota provides software to improve the delivery of care outside the hospital, 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. To learn more, please visit www.ankota.com or contact us .
Kenyon Homecare Consulting can help you with all of your agency's needs. Whether you need assistance with your start-up, recruitment and retention, clinical or operational issues, regulatory compliance, or financial concerns, we can help. Call us today at 206-721-5091 or contact us online to see how we can help you reach your goals

Kenyon Homecare Consulting reposted this article with permission of Jed Hammel who authored it and originally posted it to the Ankota Blog.

Seven Steps to Building Your Company Culture

Fri, 09 Jun 2023 19:14:37 GMT

By Stephen Tweed

As the home care caregiver shortage continues, we recognize that there is no short-term fix. If you want to be successful in home care over a long period of time, you will need to develop a long term strategic initiative to attract and retain the caregivers you need. That means working diligently to create a great place to work.

Crafting Your Company Culture:

Creating a great place to work for caregivers means crafting a company culture that is in alignment with the needs and wants of your best caregivers. The most recent Best Caregiver Study from Leading Home Care and the Home Care CEO Forum showed that the most reliable workers in home care want:

To do meaningful work
To feel valued and respected by their clients, their supervisors, and company owners
To have a flexible schedule
To receive the proper education and training to do their work
To feel fairly paid

We define company culture as … “The way we do things around here.” Your culture is influenced by four factors; the leadership style of the CEO, the core values that guide your decisions and actions, the behavior you expect, and the behavior you permit.

Building a company culture that will enable you to systematically find and keep the caregivers you need is a long-term commitment.

Seven Steps To Crafting Your Company Culture:

Crafting your culture is not easy, but there is a system that works. After studying dozens of companies that have crafted amazing cultures, and after interviewing CEOs of these companies, we have developed seven specific steps that are necessary to build a strong culture over the long haul:

Define your Core Values
Define the behaviors you expect for each Core Value
Communicate your values and expected behaviors
Train your leaders to Live Your Values
Engage your Caregivers
Promote Your Culture
Reinforce Your Culture

After leading this process for a number of home care companies, we’ve found that this seven step process takes at least a year to get through, and you are never done. The largest, privately owned home care company in the world has spent over 40 years working on their culture, and they are not done yet. The good news is, you can start today.

Where To Start:

The place to begin this process is defining your core values. When we lead this process of crafting your culture, we begin by brainstorming a list of values that members of the leadership team believe are important. Then we discuss each value, and define its meaning. We talk about what it means to live this value.

Then, we narrow the list of values down to three. Why three values? Because people can’t remember more than four. If you have seven core values, and people can’t remember that last four then why have them? Pick the three that are most important and that your team members resonate with. Begin there.

Top Tier Home Care Companies Are Working on Their Company Culture:

As you know by know, through the Home Care CEO Forum and our Home Care Mastermind Groups , we work with companies in the very top tier of our industry. One of the common characteristics of our Top 5% Mastermind Group and our Top 7% Mastermind Group is that they are all working on crafting their company culture. They are working through the steps in this process in varying degrees. The fastest growing companies in these groups have built on their company culture to develop systems to recruit and retain caregivers. We’ve learned that you can only grow your home care company when you are able to attract and retain high quality caregivers, and crafting your company culture is part of that process.

This article is being re-published with permission of the writer, Steven Tweed:

Stephen Tweed, CSP, 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 and the Founder of The Home Care CEO Forum® and Caregiver Quality Assurance®.

If you need assistance in your recruitment and retention efforts as well as looking at company culture, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help.

What Does ICD 10 Coding Mean To An Administrator? Potentially 20% More In Your Pocket.

Fri, 09 Jun 2023 19:14:36 GMT

ICD 10 coding is probably not something consistently on your mind. Normally coding runs like a well-oiled machine unless you find there is a problem. Let’s look at those potential issues and whether or not you are getting the most from your ICD coding dollars.

Evaluate Your ICD 10 Coding Solution:

The problem with many coding solutions is that they don’t fit the needs of the individual agency. Believe it or not, we still see agencies using ICD 10 coders who are not certified in coding and Oasis. Since the items go hand-in-hand, the people reviewing your charts need to be certified in both. In order to evaluate your current coding solution, you need to ask what the solution actually provides your agency.

1. An ICD 10 Code: If this is all your solution provides, then you need to look at other alternatives. An ICD 10 coding solution should improve your Oasis accuracy, give you useful data in terms of education and documentation, and help increase the dollars you receive for the care you provide.

2. Oasis Review: The individual coding your charts should be reviewing Oasis for accuracy. Your reviewer should identify trends in Oasis errors for the individual clinician and the agency as a whole. This should drive your educational efforts related to Oasis accuracy. In addition, it should also let your agency know if you have clinicians that aren’t making errors in the Oasis tool. If you have an individual nurse or therapist with 95% or greater accuracy on the Oasis, then you can decide if you need to have the tool reviewed by the coder. Look at what the price tag is between having someone code and review the Oasis for accuracy or just code the chart based upon the documentation. Your solution should provide you the data you need to make these decisions.

3. Back-up Plan: Are your coders in-house or outsourced? If in-house, do you have a back-up plan in place should one or more of your coders suddenly be out for an extended period of time? What about your outsourced solution? Many are unaware of the answer to that. If your outsourced provider suddenly loses staff, do they provide a guarantee that your codes won’t be late getting to you? Along the same lines, have you inquired what level of surge your outsourced or in-house solution can provide? The answer is to have a back-up plan in place either way. Even an in-house coding program should have an outsourced provider ready to assist in times of surge or extended absence of your staff.

4. Keeping Up-to-date: How does your solution keep up on coding changes? Ask them. What websites do they search to keep connected? What correspondence is received and what educational offerings do they attend?

5. Compare Your Providers: Look at multiple providers of coding whether you currently have in-house coding or not. Compare and contrast costs versus what is provided by each. Have the outsourced coders recode charts that have already been reviewed. See if the codes match. If they don’t, then find out what one provider sees differently than the other when looking at the same chart. Does one provider’s coding elevate the dollars you receive while still holding true to the rules of coding? The truth is that Kenyon Homecare Consulting has been able to provide agencies up to 20% more in reimbursement than the current coding provider. This is the reason we say for agencies to evaluate the solution they currently use and make sure it continues to consistently meet the needs of your organization.

ICD-10 coding is complex and its importance is sometimes overlooked because there are so many other things to do as an administrator. Ultimately, don’t lose dollars or accuracy by going with the wrong coding solution. If you would like Kenyon Homecare Consulting to provide 5 free recodes of charts as a check and balance of your current coding solution or you need us to provide your coding, call us today at 206-721-5091 or contact us online .

Thinking About Discharging A Client For Cause? Sometimes The Only Answer Is To Do It Now.

Fri, 09 Jun 2023 19:14:35 GMT

As a home care agency, you work so hard for clients. Your goal is to get the referral, provide the requested care, and then have a satisfied customer for years, right? Realistically, you normally spend more time on those who are not satisfied than the ones who are. If you are at wit's end, then you need to consider if it is time for the client to go somewhere else. Ultimately, it may be the best thing for your agency as well as the client.

Reasons To Discharge A Client For Cause:

Abuse of Caregivers: We have all had these clients. There is certainly a difference between the client who can be grumpy at times versus those clients that have caused your agency to lose good staff. Now your abusive client has caused you staffing issues across the board because caregivers resigned. There is no question that we cannot afford to lose good staff because they are treated poorly in client homes. Caregivers do not have to endure physical or verbal/ emotional abuse and agencies should not tolerate it.
Client Needs do not fit agency expertise: If you determine the client has needs your staff does not have the skill set to provide, don't take the client. If you already have, then work with the client to find an agency able to provide the services that meet their. There is nothing wrong with communicating to your client that your specific specialty is different and that the client would be better served elsewhere.
You do everything as asked, but it is never enough: All of you are currently picturing a particular client, aren't you? These individuals take up a ton of staff time without a true resolution to "problems". As soon as you fix one thing, it is something else. Ultimately, you have to ask yourself if you actually lose dollars by continuing to serve the client. You may have a lot of time invested versus the reimbursement you receive. Plus, you have to ask what kind of complaining this individual does in the community and whether servicing them hurts your business.
Accusations against staff: Of course, any accusation against a caregiver needs investigated. In working with agencies, we have seen those clients who accuse multiple caregivers of the same infraction such as theft of medication or items of value. These same caregivers may be in many homes with never a complaint from anyone. One wrong accusation throughout the communities you serve can hurt your businesses.
Expect Discounted Services: We have found that agencies offering discounts for services often have the clients who are never satisfied. If the client has gotten discounts related to complaints, then the client is potentially incentivized to complain. We understand the client may have financial concerns, but discounting your services minimizes your value.

We understand your agency wants to keep as many current clients as possible, but not all clients help you build your business, retain employees, and have a positive profit margin. For these clients, there may be an agency that is a better fit or the client may need to have different and realistic expectations from the caregivers in the agency.

At Kenyon Homecare Consulting , we help agencies achieve clinical, operational, and financial goals while providing high quality care. Call us today at 206-721-5091 or contact us online to see how we can help you get there.

Now Is The Time To Consider Your Agency To Be In Full Blown Competition. Value Based Purchasing Puts It There.

Fri, 09 Jun 2023 19:14:34 GMT

For those of you who have been in home health for decades, the idea of competition between agencies revolved around how to get market share. You did marketing, developed relationships, maintained visibility in your communities and gave good care. With the nationwide expansion of Value Based Purchasing, competition has a whole new meaning to our industry. Let's look into the expansion.

CMS began the original VBP project in 9 states on January 1st, 2016. It had 3 basic reasons listed for the project:

Provide incentives for better quality care with greater efficiency;
Study new potential quality and efficiency measures for appropriateness in the home health setting; and
Enhance the current public reporting process.

The goal was to show that quality scores could improve while there was a potential for significant savings to the Medicare program in dollars. The program showed that VBP did just that. CMS reports savings of $141 million annually with improvement of quality scores by 4.6% in those states originally involved. By this, it should be no surprise to our industry that CMS announced a nationwide expansion.

CMS started the pre-implementation this year and has offered education to agencies to prepare for the full implementation on January 1, 2023. Agencies will see that payment rates will change beginning in 2025 based upon the performance numbers in 2023. You can register for the next scheduled CMS training entitled Navigating Performance Feedback Reports: Interim Performance Report (IPR) and Annual Performance Report (APR) which is scheduled for August 25th at 2pm ET. CMS also has many of the pervious recordings of trainings available for you here , so you can utilize the education and sign up for the listserv associated with Home Health Value Based Purchasing.

The expanded Home Health Value Based Purchasing Model is set to base reimbursement on your performance in relation to other agencies like yours. It will look at certain quality measures each calendar year. Your OASIS, HHCAHPS surveys, and designated claims measures will calculate performance. An agency can expect between a -5% to 5% change in Medicare fee for service payments.

So, what all this means for your agency is that you are not just competing for market share but for maximum reimbursement too. Agencies that do not perform will be hit for another loss to overall dollars. This could mean a transition of agencies no longer looking to provide Medicare services. It will be anticipated that certain agencies will not do well in the HHVBP model and not survive. The good news is that agencies focused on quality measures and patient satisfaction will thrive in HHVBP. Agencies need to keep the focus on Oasis accuracy, acute care hospitalization, and ER visits without hospitalization.

Should you need consulting for your agency, Kenyon Homecare Consulting has senior level consultants with comprehensive knowledge and experience within the industry to help you navigate your clinical, operational, and financial needs. Call us today at 206-721-5091 or contact us online to see how we can help you succeed!

Busy Working On Recruitment And Retention Of Employees? Maybe The Secret Is Who Is Working To Keep You?

Fri, 09 Jun 2023 19:14:32 GMT

How many nights are you awake trying to figure out the recruitment and retention puzzle? You changed your benefit package, tried sign-on bonuses, raised salaries and still employees leave. Are you completely frustrated facing Value-Based Purchasing (VBP) and more budget cuts? Are you feeling burned out as an owner and/or administrator? Maybe it is time to take a look at you and where you are in taking care of the person responsible for everyone else.

What's Going On With You?

On a scale of 1-10, how engaged are you in your agency? Compare today to a year ago, 5 years ago and 10 years ago. What is the difference? Have you moved agencies more than once in that timeframe? The thought process is that we are there to take care of everyone else as well as the agency itself. That’s what we are paid to do, right? Well, yes and no.

If you are at wit’s end, then how can you possibly be effective to to keep your employees engaged? That isn’t a judgment, but a legitimate moment to step back and ask who is taking care of you? If you have a very engaged board of directors, then you may have someone actively working on your recruitment and retention. If you don’t, then you need to recognize your own needs to make sure you are as effective as possible for the long haul.

Do you have employees with an “A” scorecard who now consistently perform at a “C” level? Ask yourself what has changed? If they are coming into the same job and same conditions, same leadership etc., then something else is happening. Normally, we take the time and ask. We learn of things that may not have anything to do with the job that still affect it. It is usually situational and short term. These are things as administrators we work through with employees. What about your situation? My team are called into agencies where the leadership is frustrated whether it is financial or clinical or both. Agencies aren’t calling a consultant if everything is going well. You try to do everything not to pile more responsibility on everyone else often at your own expense. Have you evaluated your own breaking point?

Who's Looking Into Your Recruitment And Retention?

This is the big question, right? And just like employees, it may not be about the money. There may not be enough money for you to miss another child’s ballgame or family get together. So, what do you do to find the balance?

Disconnect when you aren’t at work: This is the biggest “easier said than done” statement of them all. However, it is the most important. Ask yourself what happens to your agency if you don’t check your phone and email for the next 8 hours? Do you fail your agency if you don’t answer every email that comes through during the evening? How many times are you interrupted by things that could wait until the next morning? Here’s the tougher question: How much of it do you do to yourself?
Have limits as to what you jump and run to do: You will not regret time spent with family, but you may regret vacation time talking with the office unnecessarily. Disconnect and develop reasonable boundaries so you don’t end up resenting going to work in the morning.
Maybe you need additional vacation time: Let’s face it, the job isn’t the same as it was 5, 10, or 20 years ago. If you sit at the same vacation time you did 10 years ago, maybe it is time for more. Maybe the ability to disconnect hinges on the ability to truly get away from your physical location. Go somewhere with a different time zone. It doesn’t mean you aren’t available to employees, it just means they may be more willing to problem solve before calling if it is 4 AM your time.
Get the right person to cover in your absence: We see a lot of agencies where the administrator and the back-up work well together. If your number 2 in charge doesn’t have autonomy and confidence to make decisions independently, then you don’t have a good number 2. Your back-up administrator needs to be confident to make what decisions are within his or her wheelhouse. If you go away for a week and get called several times, then you need to work with those in charge in your absence. There are certainly times where contact is necessary, but it needs to be the exception and not the rule. Successful recruitment and retention strategies for your agency have to consider you in the process too.
What do you do to change your focus: I have to admit that this one was a tough one for me. How many times do you find yourself engaged in something else and realize you are right back to work in your mind? It is one thing to disconnect from something physical like your phone or your laptop, but a whole different story when it comes to your brain. Find what works for you. Podcasts (that have nothing to do with work), guided meditation, exercise, music, and time with friends/family all take you actively focusing on something else. Learning to keep your mind focused on something other than your business takes time.

Everything Starts With Operations:

You can know the regulations, have a great policy manual, maintain optimal recruitment and retention and onboarding , and yet still struggle. Being able to put the pieces together for operational efficiency and excellence is a different issue and skill set. So, understand your limitations and get the people around you that have the talents to complete the things you struggle to do well. We see it with employees everyday. Employees gravitate to the tasks they are good and thrive doing, so why would you be any different? You can have the best plan but need to have people around you that can help with the execution of it.

At Peek Consulting , we work with homecare, home health, and hospice agencies who are looking for clinical, financial, and operational solutions for their agencies.

This article is being republished with the permission of the writer, Shelly Barrett.

Call Kenyon Homecare Consulting To Help With All Your Consulting Needs:

If you need assistance with your homecare. home health or hospice agency or are looking to start and agency, Kenyon Homecare Consulting can help. Please call us today at 206-721-5091 or contact us online to see how we can make things easier for you! We have a comprehensive line of products and services to help you with all your need.

Are You A Medicare Certified Home Health Agency Who Doesn't Really See Medicare Patients? Could You Be Targeted For Deactivation?

Fri, 09 Jun 2023 19:14:31 GMT

If you are members of the National Association for Home Care and Hospice or your respective state associations, then you may have already heard of the "Organization Deactivation Project 2022". If not, then your agency may be at risk if you haven't been servicing Medicare patients in the last year.

Many states without licensure require agencies to be Medicare certified in order to meet state requirements for providing services to Medicaid and other non-Medicare payers. So, Medicare certification was a necessity and servicing Medicare patients was not necessarily your target for market share. It appears some agencies have already received letters from their Medicare Administrative Contractor (MAC) if they have not submitted Medicare claims in the past 12-13 months. Ultimately, those organizations in business to serve only Medicaid will want to consider marketing for some Medicare patients. Now, an agency that never plans to bill Medicare may not see an issue with deactivation of Medicare billing privileges. It becomes an issue if CMS wants to potentially revoke enrollment in the Medicare system which would negatively impact those states that have no choice but to be Medicare certified. An agency would then potentially need to submit a new 855 and start the enrollment process for Medicare all over again to bill for services. This would be costly for providers who would be going through additional survey and providing care for free during the interim. Ultimately, this may a be hard push from CMS for states without licensure to put it in place. From the federal level, you can see how this would make sense. It makes the states wholly responsible for those Medicare certified agencies billing for only for Medicaid and non-Medicare payers within the state.

If CMS is looking into this, then agencies servicing only Medicaid and Medicaid waivers need to look closely at their patients. Are your dually-eligible patient qualifying for the Medicare home health benefit at different times but not being discharged from a Medicaid plan of care? Now, we have no confirmation that this is something CMS is looking at, but it could potentially show the states that Medicaid dollars are going to patients who qualify for Medicare services. At Kenyon Homecare Consulting, we encourage all agencies to belong to their respective state associations as well as NAHC. There is a wealth of education, advocacy, and resources for agencies. If you need individual consulting or education, please call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see if we can help you achieve your clinical, operational, and financial goals.

Strategic Planning: If It Feels Like And Obligation Today, Then Turn It Into An Opportunity Tomorrow

Fri, 09 Jun 2023 19:14:30 GMT

When you think about strategic planning, do you see it as a positive for your agency? Does your strategic plan bring about necessary change and improvements to your organization? If you can’t say yes, then it is time to change it. We are in agencies throughout the United States and see many different ways agencies approach a strategic plan. So, let’s consider the approach and things that will sabotage your plans coming to fruition.

5 Hindrances to Effective Strategic Planning:

In our experience, many ways to focus your plan can be successful. The failure of the plan focuses on these five elements:

1. How do you break down your focus?/ How you spend the time you have?

Do you normally break down each department to determine changes? Obviously, you need to put out the biggest fires in your organization first, but we find there often isn’t a structure to how agencies conduct the planning process. Have you given your agency enough time to effectively create the plan or is it done very quickly just to get it finished?

2. Who is involved?

Is just the administration? Are a couple people deciding the entire plan without input from others key within the organization? Is the entire process done collectively with department heads, admin and operational leadership involved? Our experience is that those agencies with closed planning processes are not as effective as those who include people who are in the field or in the office doing the day-to-day operations. If you have issues with your accounts receivable, why wouldn’t you include those employees in order to understand what isn’t working? In that exact scenario, we have seen that certain payers change stipulations about billing in a contract and those with signing authority didn’t see it. Therefore, suddenly your department goes from having 6 months to collect on a claim down to 90 days. If you bill insurance monthly and anything is wrong with the claim (wrong insured ID number, name wrong in claim, etc.), you don’t find out until your 90 days clock is almost gone. In this scenario, including the right people allows administration to make changes to the current contract or the billing process to be successful in preventing lost claims.

3. Do you complete an objective SWOT analysis?

This may seem obvious, but it really is lacking more than what you think. We often forgot our own biases and relationships we have to our organization and the people in it. We have to be able to see our agencies with fresh eyes. If you need to, consider an operational assessment from an outside source to help you move forward with an effective strategic plan today that will help you provide yourself a basis for development of future plans.

4. How often do you address the plan?

The worst thing that can happen to a strategic plan is for it to collect dust in a drawer. A good strategic plan is an ongoing process with goals addressed and achieved and changes made when it is deemed necessary.

5. Who are your change agents?

Another land mine to effectively carrying out your strategic plan is putting the wrong employee in charge of executing the change. This happens so often in our agencies. The most logical job title is not always the most effective in carrying out the change. Look to your employees that want a new challenge or those that can be real change agents for other staff. Maybe the supervisor isn’t the one to change a clinical practice in your organization. Maybe a staff nurse that is influential and respected within the organization is in charge of that. Incentivize staff and see what change can look like in your agency.

These are our top 5 at Kenyon Homecare Consulting . You potentially can see others within your current strategic planning structure. Give your agency the time it takes to create and develop your process. If you need an operational assessment or some help through your strategic plan, give us a call at 206-721-5091 or contact us online today!

Best Practices And Future Insights: Where Do You Land In The Sea Of Data And How Can You Do Better In Employee Retention?

Fri, 09 Jun 2023 19:14:29 GMT

If you follow this blog, you will know that our last post dealt with some information obtained in the National Healthcare at Home Best Practices and Future Insights Study . There are so many excellent data points and today we want to look a little more into expectations for new employees and retention of staff as well as legacy planning. If you have not downloaded the entire report, then please do. When you read the items we reference from the report here, then consider where your agency culture could potentially change to improve retention of staff.

Recruitment of Nurses to the Industry:

It is no surprise that topping the list of barriers is compensation being higher in other healthcare venues than home health and hospice. This is not new considering our our reimbursement in comparison to hospitals, etc. However, within the top 3 barriers was a misinformed or wrong perception of the industry. This was true for Home health and Hospice Centers of Excellence reporting as well. Our industry is somewhat handcuffed on the reimbursement issue, but what does that tell us we need to do to help those nurses understand the industry differently? How can we reach people to change it? After a few years working in the industry, I had several nurses communicate to me a feeling that they did not believe their assessment skills were good enough to be in home health or hospice. I communicated the opposite. When working with other staff directly around me, I always felt I didn't need to figure things out on my own. My assessment skills got much better working independently in home health and hospice. How many nurses shy away for this exact reason?

Recruitment of Aides to the Industry:

Again, the biggest barrier lies in reimbursement. This is a tough thing, but we as home health and hospice agencies don't utilize aides to their fullest capacity most of the time. If we did, then what resources in terms of additional visits made by higher cost employees could be decreased. Doesn't this allow us to train, increase expectations of certain skilled aides and change rates of pay because of the advanced care provided by these staff? The biggest take home here is that the Centers for Excellence agencies are more likely to utilize colleges/ universities and preceptor programs as sources of recruitment than those non Centers for Excellence agencies. Are you looking into this in your area?

Legacy Planning:

This data point was very interesting from a consulting standpoint. We all know that major changes to leadership can be very disruptive to employee job satisfaction as well as recruitment and retention. Hospice agencies reported the effect of leadership changes in the next 3-5 years as having a 64.13% neutral impact. Meanwhile, when home health was surveyed, it reported a negative impact of 62.57% and very negative impact at 35.50%. Only 2.23% of home health agencies reported leadership changes as a neutral impact. Although the industries have differences, the stark contrast to the impact of leadership changes is drastic. It is clear why over 89% of the 1,000 home health agencies involved have formal legacy planning. Meanwhile, only 11.41% of hospice planned for change. As far as best practices, 99% of Home Health Centers of Excellence agencies have formal legacy planning.

Kenyon Homecare Consulting can Help:

Our next article will focus on another portion of this report. We would suggest agency leadership use the metrics involved to understand their own agency strengths, weaknesses, and need for planning. Ultimately, there is so much data here to digest and so much of it can help you look at your agency through a different lens. At Kenyon Homecare Consulting , we help agencies improve clinically, financially, and operationally to function the best way they are able. If you would like assistance with your agency, then call us today at 206-721-5091 or contact us online to see how we can help!

National Healthcare At Home Best Practices: What Did The Study Show And Where Do We Go From Here?

Fri, 09 Jun 2023 19:14:28 GMT

The results of the National Healthcare at Home Best Practices and Future Insights Study recently released its results. With over 1,000 agency sites, the study results were comprehensive for home health, homecare, and hospice. This type of research can help our industry solidify itself as a prime mover of care to the aged and infirm communities we serve and help us improve how we do it. Let’s take a look at some of the results from the study.

Home Health and Hospice Results:

This study pulled best practices from over 40,000 data points. It looks at clinical, operational, and financial best practices while addressing the staffing, recruitment and retention issues that continue to hurt our industry’s ability to provide all the care needed. Here are some of the interesting findings from the report:

1: Sales force used to generate referrals: Those considered in this part of the study were agencies in the top 10% for quality and patient satisfaction while also performing well financially in PDGM. The study showed there was no difference in quality scores for those agencies who utilized a clinical versus a non-clinical employee in sales. However, there was a difference small difference in patient satisfaction. The patient satisfaction was improved for those using non-clinical employees.

2. Referral to admission conversion rate: Ultimately, for those agencies converting over 80% of referrals to admission, there was a 4 Star or better rating. Those agencies with 70% conversion rate or less ranked with only 2 ½ to 3 stars.

3. Missed visits metric: Agencies who evaluated missed visits in relationship to LUPA thresholds had a 20% average profit ratio. This is in stark contrast to those who don’t that only show 1% profit ratio.

4. Start of Care Scheduling: In this metric it showed that none of the agencies in the Home Health Centers for Excellence base used the clinical team for scheduling. The majority used a non-clinical scheduler at 65% and non-clinical intake personnel at 35%. These agencies did not sacrifice quality to utilize this approach.

5. Reimbursement: 56% pay RN per diem/per visit while 42% pay salary. Those agencies utilizing this model have an average Star Rating of 4.0. 92% pay rehab staff and social workers salary.

6. Average visits per day: The study showed no correlation between productivity and quality. Over 62% of agencies average 5 visits or more unweighted visits per day. Over 35% average less than 4 unweighted visits per day. Therefore, those doing over 5 visits a day still had the same quality ratings of those at 4 or less.

7. Outsourced ICD 10 Coding And Oasis Review: In the last year, 92.18% of Home Health Centers of Excellence agencies report outsourcing ICD 10 coding. 5.59% of these agencies report outsourcing both Oasis and ICD 19 coding. 0.56% do Oasis, ICD 10 coding and plan of care review through a third party. The primary reason for doing so related to lack of resources. The other reasons listed were for cost and improvement of quality outcomes.

8. Outsourced Billing: Those agencies with outsourced billing showed an average profit ratio of 20% while those who didn’t outsource were at 6% profit .

This blog post lists only a fraction of the findings in this very comprehensive report. It is worthwhile for all agencies to review the results and consider what you could and should do differently to improve clinical financial and operational outcomes. The full report can be found here . If you need help to achieve your goals, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help you get there.

How Much Surge Is Your ICD 10 Coding Prepped To Handle? Stop And Get A Back-up Plan

Fri, 09 Jun 2023 19:14:27 GMT

Things go quickly in home health. You receive the referral, see the patient, and develop the care plan typically within 48 hours. So, where does ICD 10 coding fit into the mix? Well, it should be an integral cog in your clinical wheel. To keep the process flowing through to billing, ICD 10 coding cannot fall behind. One of the biggest issues we see; Agencies are not prepared for surge. So, how do you make sure you can handle it when things really get busy?

In-House ICD 10 Coding:

For those of you with in-house coding, do you know what surge your current staff can handle without falling behind? We know that employees can increase productivity to accommodate for a brief period. The question is whether the quality of coding during surge declines. If your staff increases productivity by 20% during a surge time, have you measured the data to determine if HHRG decreases? Are you missing things in the coding because the staff does not have time to dig into the clinical documentation? If so, then what dollars are you missing and what potential coding errors have been made in the process?

Outsourced Coding:

For those of you that currently outsource, you should know your coding provider’s ability to manage surge. If you come to them tomorrow with an increase in charts that need ICD 10 coding, how many can they handle before they are behind? If you do not know, then you should find out.

Using Outsourced Coding as A Surge and Back-Up Plan:

Your ICD 10 coding solution does not have to fit into a cookie cutter format. An in-house solution does not mean an outsourced contract is not necessary or beneficial at times. You need to consider surge as well as planned and unplanned absences of current coding staff. If a coder walks into your office and states he or she must be off for the next 3 months for surgery, what will that mean for productivity in that department? What about planned vacations? In the past, you may have just gotten behind and it took some overtime pay to catch up. We do not have that luxury in our timelines anymore. So, put a backup plan in place so you do not miss anything when you are down a coder, or your agency has surging numbers. In the agencies we have worked with, having a backup plan in place helps decrease stress among staff and keep timelines moving in the right direction. Get something in place now before you are in the middle of an issue.

Kenyon Homecare Consulting can be your full-time outsourced coding solution or your backup in times of surge or in-house coding absences. We have nurses certified in Oasis and ICD 10 with years of experience in the field. We partner with you to help clinicians improve Oasis accuracy and clinical documentation in the process. Call us today at 206-721-5091 or contact us online to see how we can help you be prepared!

Are You Setting Yourself Up For Litigation? Why Wound Care Is Becoming The Biggest Risk For Home Health Agencies

Fri, 09 Jun 2023 19:14:26 GMT

Over the years, Kenyon Homecare Consulting has been asked to provide nurse expert witness work in cases involving malpractice, fraud and abuse, and negligence. In the last several years, we have been most often asked to review cases involving wound care negligence and malpractice. So, consider your own wound care practices and decide if you are at risk of litigation or safe from malpractice.

What We Normally See In Negligence Cases:

The recurring theme in these cases is a patient who had a wound or develops a pressure ulcer that becomes infected and passes from sepsis. These patients are under the care of a home care, home health, or hospice provider. Let’s look at the list of things to consider in your clinical practice, operations, and documentation to assess your risks:

Yes, we said hospice provider: Please note that the terminal status of the patient does not change the potential risk for litigation regardless of the patient being more susceptible to skin breakdown and to succumb to complications from it. Families expect the patient to pass from their terminal illnesses, but not to wound infection. This is always a potential blind spot for hospice agencies. If you have not followed your policies and maintained the proper documentation, then you will still lose a lawsuit even if there is nothing you could have done to prevent the development of the wound.
Look at your policies: Are they up to date? We see a lot of policies with treatment now considered to be contraindicated. So, if you are sued and have policies that show you do things potentially detrimental to those in your care, you are at risk. A good example is the use of donut rings as a pressure reduction device. These are now known to cause pressure injury as opposed to prevent it. When you look at the topical treatment, is it synonymous with current industry standards for best practices? Does your policy show protocol for initiation of support surfaces when indicated? What about nutritional support and lab work to monitor nutritional status? If you aren't doing it, then don't mandate it in your policy.
Procedures: This is the big one. If your policies are good, then you need to follow them. Now, this is true for everything in our industry, but when you have treatment and prevention measures in policy and do not follow what it says, you will likely lose the case. There are many cases settled because of agencies not following policies and procedures. The minute you are sued, everything about the provision of care goes under the microscope. You need to make sure policies are not so intricate that it is unrealistic for your staff to follow them. You also need to make sure clinical staff knows and understands your policy related to caring for these wounds. We have had cases where a nurse calls the physician and documents asking for the use of a certain treatment that is not in your protocol.
Education/Assessment/ Documentation: Having a nursing degree does not mean every nurse can walk into every department and provide competent care in all situations. You cannot assume your nursing staff and therapists are skilled at assessment and know how to recognize the etiology of every wound if you have not provided the teaching. We have seen the documentation that lists a wound as a pressure ulcer and then the next week it is listed as venous stasis. If your staff is not skilled at defining what caused the wound based upon the characteristics, location, and patient medical background, you have not shown competency of staff to provide safe care to the patient. Documentation and interventions need to match the diagnosis. If you have a venous stasis ulcer and interventions are related to pressure relief, you are at risk. You may say this is something that does not happen at your agency, but we see it all the time.
Who is responsible?: The answer needs to be everyone who sees that patient. This is often a responsibility delegated just to nursing, but this should never be the case. When you have a patient at risk for skin breakdown, every clinician needs to address it. This means every aide visit, every nursing visit, and every visit made by a therapist. When pulled into the courtroom, you will be asked why no one looked or documented on skin between nursing visits even through the patient had 2 aide visits and 2 therapy visits. You have no protection against the nurse documenting no skin breakdown last Monday but walking into a stage 3 pressure ulcer the next week.

These are just some of the considerations for your agency when it comes to keeping your agency safe from a negligence claim related to wound care.

At Kenyon Homecare Consulting , we focus on high-quality, patient centered care and helping your agency provide it. Call us today at 206-721-5091 or contact us online and let us help you and your agency achieve the outcomes you desire.

Educating Staff On Oasis E: If You Don't Educate ICD 10 Coders, It Is Like Only Utilizing One Side Of The Brain.

Fri, 09 Jun 2023 19:14:26 GMT

While working with agencies throughout the United States, we have the opportunity to see how many operate. This leads us to talk today about the new Oasis E tool being implemented January 1st 2023. For those who have been in the industry for decades, the implementation of a changed tool is not unusual. In our experience, when agencies educate on Oasis changes, it is normally limited to clinical staff who complete the tool. We need to look at this from the standpoint of ICD 10 coders. It is imperative for your ICD 10 coders to know the assessment tool inside and out.

What Are The Changes From Oasis D to Oasis E?

CMS updated the Oasis E tool on May 16th, 2022 and provided a PDF to the changes from the February 1, 2022 version. The changes are in line with expansion of Home Health Value Based Purchasing (HHVBP). So, it aligns with outcome based reimbursement. Now more than ever, the Oasis must be marked properly. We see the implementation of 3 different assessments within the tool: Brief Interview for Mental Status (BIMS),Signs and Symptoms of Delirium from the Cognitive Assessment Method (CAM), and the Patient Mood Interview (PHQ 9) which allows for expanded screening for depression. McBee and Associates offers a nice visual crosswalk tool to illustrate the changes from the Oasis D to E.

What Does This Do For ICD 10 Coding?

It means your Oasis needs to paint the actual clinical picture. Your ICD 10 coding isn't accurate if the documentation doesn't align. This isn't new. Now, HHVBP is going to need to see the outcomes on our patients come to fruition or your reimbursement will suffer. The check and balance of the certified coder means they need to understand the assessment tool as well or better than the nurse who does the assessment. The nurses look at the tool in a different way than the certified ICD 10/ Oasis coder. This is the analogy of the 2 sides of the brain. Putting both of these clinical pieces together is the whole picture and therefore, the whole brain completes the Oasis and coding puzzle. The coder is able to catch discrepancies or address items that don't fully align with the diagnoses based upon other documentation. You may currently have your agency doing coding in-house and if your coders are Oasis and ICD 10 certified, then great. Check their ongoing accuracy and whether it makes financial sense to keep it in-house. Spend the time and money to make sure your ICD 10 coders keep up-to-date on changes. If you don't have certified coders in place, then outsource your coding and Oasis review or you may really be penalized for errors in the tool. If you are looking to outsource, then make sure the person doing the coding is certified in ICD 10 and Oasis. Agencies Can't afford to have Oasis or ICD 10 coding errors cost them money. If you are looking to check the accuracy of your current coding system, outsource your coding, or need someone to provide educational assistance on the new Oasis E tool, Kenyon Homecare Consulting can help. Call us today at 206-721-5091 or contact us online to see how we can help!

The Blanket Waivers Aren't Forever. One Word From The Federal Government And You Have 60 Days To Comply. You Ready?

Fri, 09 Jun 2023 19:14:24 GMT

The COVID-19 public health emergency gave our industry a break from increased administrative burden and some increased flexibility in regards to home health aide supervision and initial assessments. Although the waivers are still in place as of this post, the time is coming for that to end. The question is whether you are prepared to comply if the switch is flipped tomorrow?

The Current PHE Waivers:

The full list of healthcare waivers can be found on the CMS website under COVID-19 emergency declaration waivers . For the purposes of this article, we won’t focus on the entire list, but certain bullet points and how your agency would be able to comply if the Federal Government changed it today. The bullet pointed items are directly pulled from the COVID-19 emergency declaration waivers pdf.

Initial Assessments: CMS is waiving the requirements at 42 CFR §484.55(a) to allow HHAs to perform Medicare-covered initial assessments and determine patients’ homebound status remotely or by record review. This will allow patients to be cared for in the best environment for them while supporting infection control and reducing impact on acute care and long- term care facilities. This will allow for maximizing coverage by already scarce physician, and advanced practice clinicians, and allow those clinicians to focus on caring for patients with the greatest acuity.
Waive Onsite Visits for HHA Aide Supervision: CMS is waiving the requirements at 42 CFR §484.80(h), which require a nurse to conduct an onsite visit every two weeks. This would include waiving the requirements for a nurse or other professional to conduct an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan, as this may not be physically possible for a period of time. This waiver is also temporarily suspending the 2-week aide supervision by a registered nurse for home health agencies requirement at §484.80(h)(1), but virtual supervision is encouraged during the period of the waiver.
12-hour Annual In-service Training Requirement for Home Health Aides: CMS is modifying the requirement at 42 CFR §484.80(d) that home health agencies must assure that each home health aide receives 12 hours of in-service training in a 12-month period. In accordance with section 1135(b)(5) of the Act, we are postponing the deadline for completing this requirement throughout the COVID-19 PHE until the end of the first full quarter after the declaration of the PHE concludes. This will allow aides and the registered nurses (RNs) who teach in-service training to spend more time delivering direct patient care and additional time for staff to complete this requirement.
Detailed Information Sharing for Discharge Planning for Home Health Agencies: CMS is waiving the requirements of 42 CFR §484.58(a) to provide detailed information regarding discharge planning, to patients and their caregivers, or the patient’s representative in selecting a post-acute care provider by using and sharing data that includes, but is not limited to, (another) home health agency (HHA), skilled nursing facility (SNF), inpatient rehabilitation facility (IRF), and long-term care hospital (LTCH) quality measures and resource use measures. This temporary waiver provides facilities the ability to expedite discharge and movement of residents among care settings. CMS is maintaining all other discharge planning requirements.
Training and Assessment of Aides: CMS is waiving the requirement at 42 CFR §418.76(h)(2) for Hospice and 42 CFR §484.80(h)(1)(iii) for HHAs, which require a registered nurse, or in the case of an HHA a registered nurse or other appropriate skilled professional (physical therapist/occupational therapist, speech language pathologist) to make an annual onsite supervisory visit (direct observation) for each aide that provides services on behalf of the agency. In accordance with section 1135(b)(5) of the Act, we are postponing completion of these visits. All postponed onsite assessments must be completed by these professionals no later than 60 days after the expiration of the PHE.
Quality Assurance and Performance Improvement (QAPI): CMS is modifying the requirement at 42 CFR §418.58 for Hospice and §484.65 for HHAs, which requires these providers to develop, implement, evaluate, and maintain an effective, ongoing, hospice/HHA-wide, data driven QAPI program. Specifically, CMS is modifying the requirements at §418.58(a)–(d) and §484.65(a)–(d) to narrow the scope of the QAPI program to concentrate on infection control issues, while retaining the requirement that remaining activities should continue to focus on adverse events. This modification decreases burden associated with the development and maintenance of a broad-based QAPI program, allowing the providers to focus efforts on aspects of care delivery most closely associated with COVID-19, and tracking adverse events during the PHE. The requirement that HHAs and hospices maintain an effective, ongoing, agency-wide, data-driven quality assessment and performance improvement program will remain.

Why Are We Talking About This?

Things can change any day. Some of the current waivers have already been removed for other health care facilities. Let’s consider the home health aides. Many agencies have not resumed the routine 2 week supervisions of aides. It is clear that CMS recognizes virtual supervisions may be necessary at times, but it was intended to be an exception and not normal business operation. If your agency has not resumed in person home health aide supervision, what does this do to scheduling tomorrow if you have to make it happen?

The same holds true for the annual onsite supervisory visit for direct observation. If the federal government removes this waiver tomorrow, you have 60 days to complete the onsite for all your aides. If you are a small agency, this may not be a problem. If you are well-staffed, then it may not be a problem. For a lot of agencies, it will be tough. The same rings true for the 12 hours of aide in-service. You will have through the first full quarter after the end of the public health emergency. You need to consider the time you will have to devote back to QAPI, discharge planning, and timing of initial assessments and Oasis submissions. It will change the availability of staff for other things and you may have push back and requests to add more employees. Implement these things back to your normal day-to day operations so staff is accustomed when the waivers are removed. Do it methodically and with certain pieces added one or two at a time.

If your agency needs assistance with a mock survey, operations management, ICD 10 coding, Oasis, or interim management, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help you today!

The Behavior You Permit You Promote

Fri, 09 Jun 2023 19:14:24 GMT

By Stephen Tweed

This month is Company Culture Month for the Home Care CEO Mastermind Groups, and our Mastermind Town Hall will focus on creating a “Caregiver First” Culture.

You’ve read our posts before so you know that we define company culture as “The way we do things around here.” And you also have heard me talk about the four elements of your company culture:

The Leadership Style of the CEO
The Core Values the Guide Your Decisions and Actions
The Behavior you Expect
The Behavior you Permit

Using our Values Worksheet, we’ve guided dozens of home care companies through the process of defining their core values, describing the behaviors that to with each of the values, and communicating those expected behaviors to all members of the team.

Holding Team Members Accountable

My wife and business partner, Elizabeth Jeffries, RN, CSP, CPAE is a world class Executive Coach. She coaches CEOs in large hospital systems, and she coaches Physician Leaders in academic schools of medicine at several esteemed universities. Elizabeth works with these executives on their leadership skills, and helps them develop relationships with the members of their leadership teams. Here favorite coaching is on-boarding new leaders as they move into a new role in the organization.

One of the elements of leadership that Elizabeth works with is accountability, and helping her coaching clients hold people accountable for what they committed to do. She has even developed a Seven Step Accountability Script that leaders can use to prepare that conversation. The seven steps are:

Describe – the opportunity for developmental coaching
Express – how you feel about this situation
Question – what questions do you want to ask?
Suggest – what outcomes you want
Explain – the benefits to the person for this course of action
Ask – for commitment
Account for : – what you will say to hold the person accountable

You can read the details of this process in Elizabeth’s newest book, What Exceptional Executives Need to Know.

The Behavior You Permit You Promote

In developing her coaching process over the years, Elizabeth has developed a mantra that holds true for most situations. “The Behavior You Permit you Promote.”

This is very true when it comes to crafting your company culture. And when you are crafting an “Employees First Culture,” you will need to be observing the behavior of leaders toward their team members, and holding them accountable for demonstrating the behavior you expect.

We have learned over the years that it is very easy for leaders to speak the words that describe the company culture. It is much more difficult to demonstrate the behaviors that go with living your values. What do you do when a member of your team behaves in a way that is outside of your expectations? What do you say? What do you do? What are the consequences?

How do you hold Caregivers Accountable?

In today’s world of high turnover, no call – no show, and unreliable caregivers, how do you hold caregivers accountable for the behavior you expect?

While it is not easy, there are some steps you can take to increase the probability that your caregivers will behave the way you want them to, and they’ll stay with you.

Here are some specific concrete steps you can take to get your caregivers to buy in to your company culture and demonstrate the behaviors that you expect:

Communicate your company values in to your job ads
Build “Culture Fit” into your selection process
Use behavioral interview questions to determine how the applicants core values align with your company values
Focus on company culture in your on-boarding process
Train your office team members on the values and behaviors of your culture
Be very specific with caregivers about the behavior that is expected and the consequences
Make sure that your supervisors and managers are holding caregivers accountable
Ask very specific questions when having conversations about behavior.
Build your values and behaviors into your reward system. Reward caregivers for living your company values and expected behaviors
Enforce your expected behaviors and implement the consequences for bad behavior.
Use the Seven Step Accountability Script when having those conversations.

There is no magic answer to the process of implementing your culture and getting your caregivers to behave the way you want them to. But the companies we work with you are really focused on crafting their company culture are seeing measurable improvements in their ability to attract high quality new hires, and in retaining those new hires.

Another Mantra that has come out of our work:

“People who want to work, want to work with people who want to work.”

When you build an amazing culture of attraction and accountability, you’ll find that these suggestions really do work to find and keep the people you need to grow your business.

Discuss These Ideas with your Peers

One of the great ways to test these principles is to discuss them in depth with your peers, and learn from OPE – Other People’s Experience . You can do that by becoming a member of a Home Care CEO Mastermind Group . Nobody really understands what you are going through as a home care company owner except another owner of a home care company your same size.

This article is being re-published with permission of the writer, Steven Tweed:

Chronic Disease Education: What Are the Game Changing Benefits?

Thu, 08 Jun 2023 17:25:24 GMT

Running an organization can be a lot like playing the game of football. You compete, you train, you break a sweat. Sometimes you score amazing touchdowns, and sometimes you miss easy field goals.

Chronic disease education is that extra push you need to win the game of homecare. It gives you lightning feet to outrun your competitors and a strong defense to protect your best players which, in homecare, are your clients. Let’s look at three game-changing benefits of chronic disease education.

Chronic Disease Education Prevents Penalties

In football, a penalty can cost you the game. And the cause behind most penalties – simple mistakes! A player on the line moves too soon, interferes with a pass or gets caught stepping out of bounds. There are a million easy-to-make errors in football that can cost a team valuable yardage.

The same is true of the homecare industry. When your caregivers aren’t adequately educated, numerous mistakes can be made. Only, those affected are your frail clients, not some tough football players. And the results are far more detrimental than a lost game. Client hospitalizations, legal repercussions, fines and lost revenue occur as a consequence of poorly educated homecare aides.

With advanced aide education, you can rest assured that the majority of these penalties won’t happen. Your caregivers will have the knowledge to handle even the most difficult situations.

Chronic Disease Education Scores New Clients

There are several ways to score in the game of football, from the obvious touchdown to the not-so-obvious safety. And don’t forget about field goals. Coaches spend significant time and effort strategizing with their teams about the best way to score the most goals in each game. Doesn’t it make sense to do the same with your homecare agency?

Chronic disease education meets goals and scores new clients for your organization with client satisfaction and professional referrals.

Client Satisfaction – Even in today’s digital age, word of mouth continues to be the best method of advertisement. Chronic disease education gives your caregivers the knowledge and experience they need to provide superior care, which improves client satisfaction. And who better to spread the word about your agency than happy clients?

Professional Referrals – In homecare, it’s important to foster mutually beneficial relationships with other medical professionals in your community. When these referral sources know you make the extra effort to provide advanced education, they become more trusting in your ability to deliver specialty care required by their patients.

Scoring is just as crucial in homecare as it is in football. With advanced education for aides, your chances of scoring big increase significantly.

Chronic Disease Education Creates a Competitive Edge

To be as competitive as possible, football teams watch replays of their opponents’ games. They study the other team’s strategy, best players, and weaknesses. By taking the time to educate themselves on these vital aspects, they develop a deeper competitive edge. When game time comes, they’re ready.

The same can be said for chronic disease education. Studying worsening symptoms, treatment methods and potential warning signs for specific diseases gives your caregivers a knowledge that others in the field don’t have. What does this mean for your agency? You can advertise and offer specialized services, thus outplaying your competition.

Why Choose Kenyon HomeCare Consulting’s Aide University

As the only online continuing education program of its kind, Aide University teaches specific chronic disease care enabling organizational success. Aides gain the knowledge to become competent and provide quality care while furthering their careers and outshining their competition.

Courses provided at Aide University include the following topics:

Recognizing red flags

Decreasing hospitalizations

Lowering healthcare costs for clients

Proactively intervening on a client’s behalf

When you’re ready for a game-changer that will take your organization to the next level, consider the benefits of chronic disease education provided through Aide University. Contact us to learn more!

Best Practices And Future Insights: Where Do You Land In The Sea Of Data And How Can You Do Better In Employee Retention?

Sat, 09 Jul 2022 19:44:00 GMT

Recruitment of Nurses to the Industry:

Recruitment of Aides to the Industry:

Legacy Planning:

Kenyon Homecare Consulting can Help:

Having Trouble Putting All The Pieces Of Puzzle Together In Your Agency? An Operational Assessment Helps You Find Out What You Are Missing

Tue, 03 May 2022 13:32:00 GMT

As administrators, very few us of have all the pieces of the business puzzle in our wheelhouse. It is why we have people with strengths different than our own on the administrative team. The reality is that putting the clinical, financial, and operational parts of our businesses together can be tough sometimes. Plus, we are deep in the thick of the day-to-day that it often becomes difficult to see a problem clearly or know the way to fix it. We are often too close to the situation. In so many ways, this closeness to our businesses and staff is a good thing. However, it can also be a hindrance. These are times to consider an operational assessment by an objective and neutral expert.

What Is An Operational Assessment?

There is so much data involved in a comprehensive operational assessment. For the purposes of this article, we will break down the three components of the assessment by showing what some of the things we look at in order to evaluate the successes and need for improvements within the agency.

1. Here are some of the things we pull in the financial component:

- Annual financial statements, current year-to-date financial statements, quarterly statements for last 5 quarters, detailed trial balance, detailed chart of accounts, last 2 years of most reporting

- Assets: cash accounts and significant cash investments, detailed aged accounts receivable , list of inventory, fixed asset and depreciation schedules, property tax appraisals, copy of notes receivable

- Liabilities: accounts payable listing, accrued liabilities, notes payable and other interest-bearing debt

- Revenue: visits rendered by episode completed for 3 years, visits rendered every fiscal period for 3 years, revenue by payer, by month, and by fiscal period for 3 years, identification of PEP, LUPA and outliers by month for last 3 years.

- Taxes: federal and state returns for last 3 years

- Contracts: includes service contracts, leases, and personnel contracts

- Management and employee data : organizational charts, compensation rates, benefit plans, payroll methods, insurance plans, Worker’s compensation, life insurance plans for key personnel

2. Here are some things we pull for the clinical component:

- Review of clinical policies and procedures, forms, ADR review/ denials, record retention/ protection, productivity review, operational flow admission to rap, comprehensive patient assessment review, plan of care review, order review, visit determination, care coordination, documentation review

- Oasis: audits, ICD 10 coding audit, Oasis late lock review, top HHRG, top 3 diagnoses

- CQI: adverse events, initiative and outcomes, satisfaction surveys (patient, physician, referral sources), infection control, incident reports (follow-up/ resolution), complaint process (follow-up/ resolution), home health compare data

3. Here are some of the things we pull for the operational component:

- Agency qualifications: license verifications, medical director qualifications, administrative review

- Regulatory compliance: last 3 surveys, interviews with key personnel, patient rights, Oasis confidentiality and submission, emergency preparedness plan including training and implementation

- Organizational/ Service/ Administration: administrative oversight, line of authority, delegation, services offered, governing body, clinical management, personnel records, performance evals, background checks, competencies, orientation, education, operational/administrative policy manual review

- Legal: Bylaws, amendments, Secretary of State registration, board of directors meeting minutes, financial committee meeting minutes, all buy-sell agreements, all reports of examination by government agencies such as OSHA, IRS, EPA, and EEOC, details of litigation including pending or threatened lawsuits, attorney invoices.

- Marketing: list of 5 largest customers, business plans, benchmarking data, brochures, pricelists, catalogs and other service information

Now, as we stated, this list is not complete. It is also part of the information used when completing a due diligence for someone looking to sell their business or buy someone else’s. After compiling all the data, the next step is for the clinical and financial consultant to put the data together and come up with an operational plan that improves patient outcomes, financial health, and clinical functions. It is a process and allows the agency to take a deeper look into making real change that head you in the direction of success and better problem solving. Many times, the process measures to complete day-to-day activities need streamlined to improve efficiency and eliminate unnecessary steps in your operational flow. Other times, we have staff mismatched in the roles they play within your agency and restructuring the work is necessary.

If you are struggling or want to look at ways to improve your operations, Kenyon Homecare Consulting can help. We offer senior level consultants with decades of experience in the home health and hospice industry. Call us today at 206-721-5091 or contact us online to see how we can help you reach your agency goals.

Seventeen Reasons to Serve the Top of Your Market in Home Care

Mon, 18 Apr 2022 17:20:00 GMT

By Stephen Tweed

A few years ago, my friend and professional speaking colleague, David Newman , wrote an article for professional speakers about why we should serve the top of our market. This fits perfectly with a conversation we were having in our Home Care CEO Mastermind Groups about clients, referral sources, minimum hours, prices and pay for caregivers.

Here are 17 things to consider in serving the Top of the Market:

Apply the 80th Percentile Principle

These seventeen insights dovetail precisely with two articles we wrote in 2021 about how you can grow your business using the 80th Percentile Principle, and how you can reduce caregiver turnover with this same principle. If you want to bill your clients at or above the 80th percentile, and you want to pay your caregivers at or above the 80th percentile, you need to be serving clients at the top of the market.

Grow Your Company with the 80th Percentile Principle – June 22, 2021

Benchmarking Data Show Reduced Turnover with the 80th Percentile Principle – July 7, 2021

Research we conducted with a number of our clients helped us define the dollar value of a client, and the referral sources that often send us new clients who buy the most hours per week for the longest period of time. When you are serving the top of the market, you get much less fee resistance, and many fewer clients who only want or need a few hours per day a few days per week. When you serve fewer clients who buy more hours per week for longer periods of time, you reduce stress on your scheduling coordinators, on your recruiters, and on yourself. Everything is easier in your business.

Discuss this Principle with other Owners

If you are curious about how you can apply these ideas to your business, you may want to discuss them with some other owners of similar sized home care companies who do not compete with you. The only place the can do that comfortably in inside a Home Care CEO Mastermind Group . If you are an independent home care company that generates between $3 million and $50 million in annual revenue, there is a Mastermind Group for you.

This article is being re-published with permission of the writer, Steven Tweed:

Many Agencies Pay A Lot For In-House ICD 10 Coding. Meanwhile, Your Profit Margins Continue To Shrink. Make The Change Today. (Part 2)

Sat, 16 Apr 2022 16:00:00 GMT

In part 1 of our ICD coding series, we looked at an overview as to why smaller agencies can’t afford to do in-house coding. In part 2, we will look at the dollars and cents of coding in-house. If you currently have employees in this role, have you broken down the true cost to your agency and determined productivity standards?

Cost And Productivity Of In-House ICD 10 Coding:

When we think of productivity in our agencies, we normally talk about clinical employees. Many agencies to not track the number of charts individual coders complete or monitor accuracy in a meaningful way. An RN who is certified in Oasis D and ICD 10 coding should be able to code 12 charts per day or 60 charts per week. If your in-house coders aren’t completing 240 charts a month, you may need to ask why. Our numbers come from a nationwide outsourcing company with many nurse coders on staff. It should also make you ask why you have multiple coders if your admission numbers don’t justify it. It is not uncommon for us to see several in-house coders for agencies with 200 admissions or less. So, let’s do math on cost.

The national average according to Zip Recruiter for an RN who is Oasis D and ICD 10 coding certified is $67,571 base salary. If you consider the average overhead rate of 34% of salary ($22,974), then your overall cost per coder is $90,545. Now, this is just the average. So, we realize there are agencies paying less and agencies paying a whole lot more. The same nationwide agency providing productivity numbers stated it is not uncommon for their coders to be paid $78,000 for base salary. Based upon this number, an in-house coder would cost a total of $104,520 ($78,000 base salary + $26,520 overhead). Now, let’s break these costs down for your agency numbers.

Based on the national average of $90,545 ($67,571 base salary + $22,974 overhead):

1. An agency averaging 100 admission per month is actually paying $905.45 per chart for a coder of this caliber.

2. 150 admissions per month cost the agency $603.63 per chart for the coder.

3. 200 admissions per month cost the agency $452.72 per chart for the coder.

4. 250 admissions per month cost the agency $362.18 per chart for the coder.

5. 300 admissions per month cost the agency $301.81 per chart for the coder.

If we look at these same numbers based on the $78,000 base pay with overhead to total $104,520, the numbers look like this:

1. 100 admissions= $1045.20 per chart for coding

2. 150 admissions= $696.80 per chart for coding

3. 200 admissions= $522.60 per chart for coding

4. 250 admissions= $418.08 per chart for coding

5. 300 admissions= $348.40 per chart for coding

Kenyon Homecare Consulting charges $65 for ICD coding and Oasis analysis/ review. Based upon those numbers and the level of expertise and certification, you need to do the math for your agency. If your RN coder is doing 240 admissions per month and is certified and accurate, your in-house coding may work well for you in a cost analysis. In our experience, agencies doing 240 admissions per month with in-house coding normally have several coders on staff. So, the costs for your coding department go up drastically. You may be paying the national average of $90,545 for three or four coders to handle your admissions. Suddenly, you are paying between $271,635- $362,180 per year just to keep your ICD 10 coding in- house. Those same admissions done by Kenyon Homecare Consulting's RN Coding Specialists will save you anywhere from $76,635-$167,180 per year to complete 250 admissions per month.

Let Us Be Your Choice For ICD 10 Coding:

At Kenyon Homecare Consulting , our ICD 10 coding department works with agencies to help them improve documentation and get the dollars they deserve to service patients. All our coding staff are Oasis and ICD 10 certified RNs who know our industry and the requirements in documentation. Call us today at 206-721-5091 or contact us online to see how we can help you save money and still receive excellent coding accuracy and efficiency.

Caregivers Leave Managers, NOT Companies

Tue, 12 Apr 2022 15:12:00 GMT

By Stephen Tweed

I became of fan of Marcus Buckingham with when he worked with the Gallup Organization and wrote his first book, First Break All the Rules . He shared lots of facts and data from Gallup surveys of employees, and came to some conclusions that can help companies grow. One of those conclusions was the quote above.

We got a sneak peak at the 2022 Home Care Benchmarking Study from Home Care Pulse, and the turnover number for last year was 64%. That’s a little better than the 65.2% in 2020, but not much. Turnover has basically been flat for the past six years.

We also learned that 57% of turnover happens in the first 90 days of employment. That’s a refinement on the number we have been using for a while that said that 80% of turnover happens in the first 90 days.

WHAT CAUSES CAREGIVER TURNOVER?

Every month, Home Care Pulse surveys thousands of caregivers. From that data, they have identified the five big reasons caregivers leave :

We see that four of the top five causes are related to the action, or inaction, of managers and office team members.

“Caregivers leave managers, not companies.”

WHAT ROLE DOES YOUR OFFICE TEAM PLAY IN CAREGIVER RETENTION?

This month of February 2022, the Mastermind Groups in our Home Care CEO Forum has been discussing the role that their office team plays in retaining caregivers. Members have had open discussion about what they are doing to help their office staff be more responsive to their caregivers. We have seen that companies with the highest growth rates in 2021, companies with the lowest turnover, and companies with the highest 90-day retention have some things in common.

It is pretty clear from the data and from anecdotal examples that the home care office team plays a huge role in finding and keeping high quality caregivers. Here are some things high performance home care teams are doing to reduce turnover and improve caregiver satisfaction:

It is pretty clear from our research that the best caregivers stay with a home care company when they are doing meaningful work, when they feel valued and appreciated, and when their take-home pay matches their financial needs.

PUT CAREGIVERS FIRST

We’ve been working with home care companies across the US, Canada, the UK and Australia for over three decades. In all of that time, most companies we know have had a “customer-first” mind set where they do everything they can to create a high level of client satisfaction. And that has worked amazingly well for many companies.

In 2022, the tide has turned and larger, faster-growing companies have proclaimed a “Caregiver-First Mindset.” That doesn’t mean that client satisfaction and customer service are no longer important. But it means that in this world where you can’t bring on new clients if you don’t have the caregivers, the company priorities and mindset are shifting. It means getting our office team members involved in working together to understand the needs and wants of caregivers first, and putting in place people and processes to meet those needs. It means using caregiver satisfaction data, recruiting data, and retention data to help office team members work together more effectively to keep our best caregivers.

This shift from Clients First to Caregivers First is quite difficult for company leaders and team members who have been in business for many years and have constantly focused on client needs. It is taking some major shifts in thinking and in actions to make that shift.

CREATING INCENTIVES FOR OFFICE TEAM MEMBERS.

Just before the outbreak of COVID, we were doing a site visit to one of our Top 5% Mastermind members. As they discussed their growth % in 2019 over 2018, they shared some data on what they had done to improve 90-day retention. The results were very impressive. As we discussed their process, we heard the CEO repeat back the mantra that we have been promoting for years:

“What gets measured gets managed, what gets rewarded gets repeated”

This company had set up a new incentive plan for each of their office team members. The incentive plans varied from department to department, but everyone was incentivized based on three performance Metrics:

The were able to show each of their team members how they contributed to those three numbers, and how they would be rewarded when the numbers moved in the desired direction. It became pretty clear from talking with them about how tracked the metrics, and how they calculated their incentives, that nearly every member of the team had bought into working together to grow the business, improve client and caregiver satisfaction, and keep good caregivers.

ENGAGE IN CONVERSATION WITH PEER COMPANIES ABOUT KEEPING YOUR CAREGIVERS

A significant number of our in-depth conversations in our Home Care CEO Mastermind Groups are about keeping high quality caregivers. Developing managers and team members so they have the knowledge and skills to nurture those relationships is part of the process.

If you would like to have regular conversations about issues like this with leaders of other companies your same size who do not compete with you, you may want to consider becoming a member of a Home Care CEO Mastermind Group in the Home Care CEO Forum .

This article re-published with permission of the writer, Steven Tweed:

Should you need assistance with your home care, home health, or hospice agency, then call Kenyon Homecare Consulting at 206-721-5091 or contact us online . We help agencies develop practical solutions for success in the home care industry.

Many Agencies Pay A Lot For In-House ICD 10 Coding. Meanwhile, Your Profit Margins Continue To Shrink. Make The Change Today. (Part1)

Thu, 07 Apr 2022 16:23:00 GMT

Over the years, ICD 10 coding has continued to increase in complexity. The days of 3 for diagnosis coding are long gone. Some of us remember those days and how much nicer it seemed. That being said, it is absolutely necessary to have coders who are Oasis and ICD 10 certified. The question then becomes whether or not you keep your coding in-house or whether you should outsource.

Reasons To Keep ICD 10 Coding In-House:

We don't like change. That's a given, right? We like having coding staff right there alongside everyone else. Access is nice. We like knowing our staff is keeping up-to-date on education and certification. We have peace of mind knowing our staff are trained the way the should be. Often times we have several coders to make sure we don't get behind in times of surge. Here is the biggest issue with all of it: too many agencies can't afford the ICD coding staff they have.

Why Can't You Afford It ?

Let's face it. profit margins aren't suddenly increasing. For many of you, it is the opposite. Many of you have not considered outsourcing coding. As a part of this series on ICD 10 coding, we will look at when the numbers shows you can fiscally afford to have coders on staff and when you can't. If you are a large regional agency or a national chain, then absolutely. If you do any less than 200 Medicare admissions per calendar month in your agency, then you probably lose money on coding in-house. You need to do a dollars and cents comparison. You need to consider the dollars you put into staff such as insurance benefits , vacation, sick leave, and personal time, etc. When you have long-term staff, these benefit dollars can really add up and cut into your bottom line.

Call Kenyon Homecare Consulting:

We have a comprehensive coding program that allows you to outsource ICD 10 coding and save you money in the process of providing high-quality coding and Oasis review. We have nurses who complete the coding process while helping your nurses and agency improve Oasis scoring so you don't miss the dollars and outcomes you deserve. Call Kenyon Homecare Consulting today at 206-721-5091 or contact us onlin e to see how we can help you save money. We will complete 5 free recodes to help you check compliance of your current coding solution. We will continue in the next part of this series to break down the dollars of coding in-house versus an outsourced solution, so stay tuned!

Home Care Growth Kit: Sales Tips to Blow Away the Competition

Wed, 23 Mar 2022 22:30:00 GMT

Today's Home Care Growth Kit chapter is all about finding manageable ways for your agency to increase sales as effectively and easy as possible. Most of our "Growth Kit" series shares our own best practices and advice from multiple industry experts, but for this topic we're relying heavily on content from Steve the Hurricane , including his famous slogan "Blow Away the Competition."

These tips move from easier to harder:

Everyone who answers your phone needs to be able to elegantly handle a sales call

Let's face it, there are lots of phone calls that come into your home care agency, ranging from "where's my caregiver." to "my mom went into the hospital today," to "I quit [from a caregiver]" and more. The team members answering the phone need to handle each of these calls differently. Sometimes the needed response is compassion. Sometimes it's "sense of urgency." Other times you need to sternly but fairly get caregivers to do what they're supposed to be doing.

But the bottom line is that the "My mom needs care" call is different and anyone who answers the phone needs to handle the call the right way. There's an adage that "You only get one chance to make a good first impression."

Here's a great video on how to handle the incoming prospect call:

How to Handle Incoming Prospect Calls from Steve the Hurricane

Get the Right Kind of Home Care Clients

The decision for a family to get home care for the first time is a tough one. The family may have been putting it off because of mom's protests, or maybe because they don't know how to deal with the long term care insurance, etc.

Going back to the well with Steve, he has defined a way of finding the best clients that will result in the most growth for your agency. He calls them NERDs.

Learn more in this Video:

The Four Part Target Customer from Steve the Hurricane

Tips for Breaking Through Your Home Care Agency's Revenue Plateaus

Next up is some advice from Home Care Pulse about how to break through revenue plateaus .

The article starts by sharing a number of rad flags that your agency should be monitoring for. Some of them are obvious like seeing a reduction in hiring levels or inquiries, but others are more subtle. Your staff should review these regularly and put plans in place to address them.

But then it gives you a strong play book for how to overcome the hurdles. Here are a few of the ideas:

Here's a link to the full article .

Get More Google Reviews

Following upon the suggestion to increase your Google Reviews, Home Care Marketing Pros (formerly Providentia Marketing) shared a great article on exactly how to do that. The title is Effective Techniques to get more Customer Reviews on Google . As a preview, the article tells outlines the following strategy:

Here's a link to the full article .

Big Idea: Field Coordinators

Another really big idea we learned at a recent conference with Steve the Hurricane whose company has recently been rebranded as Home Care Evolution , is the idea of field coordinators.

We'll do a full article about this, but here's a preview:

We hope that these tips help you and your team accelerate sales and help your business thrive!

If you have any questions about how Ankota's home care management software can help your business, please click below to contact us!

Let's Talk About Home Care Software!

Kenyon Homecare Consulting can help you with all of your agency's needs. Whether you need assistance with your start-up, recruitment and retention, clinical or operational issues, regulatory compliance, or financial concerns, we can help. Call us today at 206-721-5091 or contact us online to see how we can help you reach your goals

Kenyon Homecare Consulting reposted this article with permission of Jed Hammel who authored it and originally posted it to the Ankota Blog.

Navigating The Decision Into Interim Management: Knowing The Who, What, When, Where, and Why. Part 2

Sun, 20 Mar 2022 14:15:00 GMT

If you read part 1 of this series, you know the role, benefits, and core competencies of interim management. In part 2, we want to delve into job responsibilities, researching and finding the right interim manager, and succession planning/ strategic planning. At the end of this series, you should have the basis for determining if interim management is the service you need and how to find the right one for your agency.

Job Responsibilities Of An Interim Manager:

Specific job responsibilities of an interim manager are determined by you and your agency. You need to look at the role and decide if the person is a place holder or a change agent. Do you want him or her in an autonomous role or that of shared responsibility? Is the interim manager to report to the Board or to an owner? What expectations do you have as an organization for this individual and what outcomes do you want to see? Here are typical interim manager job responsibilities to consider:

1. Full organizational assessments to address critical issues first

2. The interim manager models behavior expected of staff

3. Provides positive and supportive leadership

4. Designs and implements improvement to procedures/protocols for a project or personnel

5. Sets deadlines for assigned projects and hold employees accountable to it

6. Oversees patterns in productivity to improve efficiency

7. Replaces individuals/ eliminates positions that no longer meet the needs of the corporation

8. Verifies equipment is functioning properly/ makes repairs if needed

9. Verifies that staff have needed equipment and supplies

Researching The Role And Finding The Right Interim :

Interim managers are put into place as temporary positions when there is no one in the current corporation to successfully take the position. It occurs most frequently when a manager abruptly quits or leaves their position, or a new program is added to the organization that needs a manager. The interim serves as a place holder until a candidate fills the position permanently.

You need to consider certain items when researching the role for your agency. Here are the 4 things to consider when researching who you choose for the role:

1. Do you need someone on site full time?

2. What is your agency focus for the year (internal or external)?

3. Do you need someone more skilled in clinical, financial, or operations (or a combination of all)?

4. Make contacts now to choose the right fit for your agency

The next step is finding the right person and that begins with really defining the need you have in that position. When you call to speak with a consulting company that offers interim management services, they will be able to help guide you in the process. You will need to look at specific duties, personality fit, background experience, area of expertise needed and independent function versus working as part of a team.

Succession Planning/ Strategic Planning:

In so many agencies, succession planning is often not done well. When you consider you current position with your agency, do you think you are too far from retirement to have a succession plan in place? Well, you need to consider if something makes you unexpectedly incapable of filling your role. You have to consider things like sudden health changes or a spouse changing jobs that causes a sudden need for relocation. These need to be things that come into your routine strategic plan.

Interim Management should be a discussion as part of yearly strategic planning. It starts with open communication to staff about all positions including your own. Consider all department heads in the process. Cross train staff to cover portions of each other’s roles to help fill the void where it is possible. Interim Management becomes part of that ongoing conversation along with touching base with companies to make sure you have a contact in place should you suddenly need it.. Expect the unexpected to be as prepared as possible.

At Kenyon Homecare Consulting , we offer the industry experts to fill the role of interim managers in your agency. We have those with expertise in clinical skills, operations, and financial matters. Call us today at 206-721-5091 or contact us online and let us help you find the interim manager that meets your needs.

Navigating The Decision Into Interim Management: Knowing The Who, What, When, Where, and Why. Part 1

Thu, 17 Mar 2022 16:12:00 GMT

So, you have a sudden vacancy or a planned one in your agency. Maybe this is new territory when it comes to replacing administrative positions. If so, then you need to understand the role of an interim manager and why not considering one may be a costly move. Let’s look at roles, benefits, and core competencies of an interim manager.

Why An Interim Manager?

First of all, this isn’t a permanent position. You consider interim management because your new executive cannot be found soon enough to cover the role. It also applies when you don’t have someone within the organization with the skills or time to function as acting manager while someone else is found. Typically, interim management is 3-9 months in length, but shorter and longer scenarios are also common depending on the agency. The interim manager is present to help an agency undergoing a major change, implementing a critical strategy, or to plug a critical management gap.

7 Benefits Of The Interim Manager:

If this is a brand new concept for you in your agency, then you need to know what a interim manager brings to your agency’s table. Here are our top 7:

1. High Level Agency Review: The interim manager can provide an unbiased review of the organization with plans for correction where needed.

2. Speed: Those individuals who fill these roles are available quickly. Most are available to start within days with minimal recruitment or termination formalities.

3. Experience: Typically, these individuals are overqualified for the roles they fill. This means they can operate autonomously if necessary with very little guidance.

4. Results: Track records and performance really count, so interim managers are used to being judged by results. Therefore, they know to deliver.

5. Knowledge Transfer: With experience comes skill, contacts, and knowledge transferred to your team that become long-term.

6. Objectivity: While sensitive to the company’s ethos, they are not constrained by company politics, personalities, or protocols. This includes recommendations for “right-sizing” the agency. This may include elimination of staff that is underperforming or positions that are unnecessary because of inefficiency.

7. Delivery: Interim Managers can act as counsel to the Board of Directors while rolling up their sleeves to help deliver the strategy as well.

Core Competencies:

In order to be considered for a role in interim management, there are certain core competencies that have to be in place. Here are the 6 things to expect in an interim manager:

1. Independent worker that can function and produce without direction.

2. Strategic thinker

3. Innovative

4. Broad and deep understanding of the industry

5. Process planning/ Plan management skills

6. Works well under pressure while managing personalities and other management staff with ease and calm

Part two of our interim management series will focus on job responsibilities, researching and finding the right interim manager, and succession planning/ strategic planning with interim management.

Home Care Growth Kit: The Best Marketing Tips for Growth

Mon, 14 Mar 2022 17:35:00 GMT

This chapter of Ankota's Home Care Growth Kit focuses on marketing. With that in mind, we've compiled four great resources for you to kickstart your agencies growth. Let's jump right in:

Optimize your Digital Marketing Success

First up, we have a fantastic piece from Home Care Marketing Pros (formerly Providentia Marketing) where they focus on the following key fundamentals:

The article is called How to Grow your Home Care Agencies Digital Marketing Reach, and you can access it here:

https://www.homecaremarketing.com/marketing-tips/home-care-agencys-digital-marketing/

Weekly Activities for your Home Care Marketing Reps

Next up is a video from Steve "The Hurricane" Weiss wherein he outlines a series of weekly activities for your home care marketing reps:

https://youtu.be/v7_C-TV1Zxo

A Complete Methodology for Increasing Home Care Agency Revenue :

There's a relative newcomer on the scene, called AidQuest, who provide a unique service of live home care experts who chat with visitors to your website 24-hours a day. Before starting AidQuest, its founder, Kamran Nassar, ran one of the fastest growing agencies in the country.

Here is his three part series of home care revenue growth (click the 3 titles below):

Installment 1: Understand what it takes to increase revenue by $1M

Installment 2: How many leads do you need and where will you get them?

Installment 3: Understand how Google finds you and juice up your website

Marketing Strategies to Grow Clients from Valerie Van Booven

This video provides another interesting angle on marketing for client growth:

https://youtu.be/xLGBvVVXQnw

Thanks for reading and for working toward jumpstarting your agency's growth journey. Home care is a vital to the health and happiness of so many, so thank you for the work that you do!

If you'd like to receive future chapters of the Home Care Growth Kit, just click the button below:

CLICK HERE
TO SIGN UP FOR THE GROWTH KIT!

For a quick and shameless plug, Ankota wants to be your home care software provider. We consider home care professionals to be heroes, and our mission is to take care of the home care tech so you can focus on the "hero stuff" like providing great care, recruiting and retaining great caregivers and growing your business. If you'd like to connect, please click here.

Ankota is the Software for the Heroes of Home Care. We truly embrace the notion that caregivers and home care companies are heroes. Our top priorities simplicity, caregiver retention and outstanding service. Visit us at https://www.ankota.com.

Kenyon Homecare Consulting reposted this article with permission of Jed Hammel who authored it and originally posted it to the Ankota Blog.

Home Care Growth Kit: Recruiting + Retaining = Growth

Tue, 08 Mar 2022 15:03:00 GMT

" Small home care agencies believe that they are small because they can't get client referrals. Big agencies KNOW that they're big because they can recruit and retain caregivers ."

The top challenge in home care is having the staff to fill cases. The agencies who can take the phone call, meet the prospect today, and staff the case tomorrow are growing astronomically. The agencies who think they can suggest a home visit next week and then take two weeks to recruit a caregiver are being left in the dust.

With all that in mind, today's focus in the home care growth kit is recruiting and retention.

How to Attract More Caregivers

Below we provide a curated collection of some of the best advice we've found from industry leaders on the topic of caregiver recruiting and retention:

From Home Care HR Expert Anne-Lise Gere:

Home Care HR Expert Anne-Lise Gere offers Six Strategies to Improve Recruiting and Retention .

The top strategies are as follows:

We recently chatted with Anne-Lise on the Home Care Heroes Podcast.

From Home Care Growth Expert Steve "the Hurricane" Weiss

Here's a great video from Steve the Hurricane on "How to Attract Caregivers.":

https://youtu.be/zQ6Q8jC3A2k

From Home Care Marketing Expert Jason Chagnon

Since the Internet is the first place that everyone searches for everything, check out this article from home care website expert, Jason Chagnon, at Providential Marketing. He offers 10 Creative Suggestions in this article , including SnapChat, Reverse Career Fairs, Leveraging Holidays and Current Events, and asking your caregivers how they found you.

From Home Care Expert Ginny Kenyon

Ginny Kenyon reminds us that many caregivers entering the marketplace today are Millennials or from "Generation Z" and that they have a different mindset when searching for fulfillment in their lives. You might enjoy her article about recruiting tips for Generation Z.

How to Ask Great Caregiver Interview Questions

Home Care Pulse has a two article series where they give advice on interview questions. The first article suggests that you should ask four types of questions , as follows:

But then an expanded article adds a 5th category which might be the most important one. They call it "Questions to Help You Understand Their Needs as an Employee." Don't be intimidated, but this second article gives you 65 questions to choose from .

How to Provide Excellent Caregiver Training

In a home care business, your caregivers are your product, and caregiver education is a key way to develop a high quality product. Caregiver education is also a key ingredient in your caregiver education program. Home Care Pulse shared an article entitled The Top 10 Topics You Should be Training Your Caregivers On . Please read the full article for all of the detailed insights that are shared, but here's the top 10 list:

How to Safeguard Against Attrition in the First 90 Days

In the article , Overcoming the Biggest Obstacle to Growing Your Home Care Business , Home Care Pulse focuses in on improving your 90 day retention rate. Sadly, caregiver turnover averages over 60% per year and when caregivers leave in the first 90 days, your costs to recruit and train the caregiver will never be recuperated.

Note that the biggest reason that caregivers leave is that they don't get assigned enough hours, or they lose their case and don't get reassigned quickly enough. The top 3 suggestions are as follows:

Here's anothe r link to the full article.

How to Continue to Learn Home Care Best Practices

Stephen Tweed is one of the preeminent consultants in the home care industry. Stephen joined the Home Care Heroes podcast and shared the foundations of a Caregiver Quality Assurance Program, and the value of growing and learning in Mastermind Groups. Here's a link to the episode .

Recruiting and Retention Training Suggestions

There's a very robust recruiting and retention course called Momentum that is taught by Home Care Results expert Steve "the Hurricane" Weiss and Home Care HR Expert Anne-List Gere. Plus, we're able to give you a $1,000 discount on that program. Be sure to use code "ANKOTA1000" for the discount. Click here to learn more.

Additionally, Valerie VanBooven from Approved Senior Network was kind enough to offer a 4 part online training course on recruiting and retention that you can access by clicking here:

Home Care Recruiting Ideas for When You've Tried Everything Else

We're sure that you've found numerous valuable ideas in this installment of the home care growth kit, but as an added bonus, here are some further guides and resources for you:

From Home Care Pulse: How to Recruit & Retain Caregivers When You’ve Already Tried Everything.

From Ankota: CAREGIVER RECRUITING AND RETENTION BIBLE (HOME CARE STAFFING)

From Providentia Marketing: The Ultimate Guide to Caregiver Recruiting

CLICK HERE TO SIGN UP FOR THE GROWTH KIT!

Thanks for reading this article and jumpstarting your agency's growth journey. For a quick and shameless plug, Ankota wants to be your home care software provider. We consider home care professionals to be heroes, and our mission is to take care of the home care tech so you can focus on the "hero stuff" like providing great care, recruiting and retaining great caregivers and growing your business. If you'd like to connect, please click here.

Kenyon Homecare Consulting reposted this article with permission of Jed Hammel who authored it and originally posted it to the Ankota Blog.

Grow Your Home Care Business in 2022 with Data Oriented Decision Making

Fri, 04 Mar 2022 16:37:00 GMT

“Without the data, you are just another person with an opinion.”

W. Edwards Deming.

By Stephen Tweed

You’ve heard me say it, or you have seen it in my writing.

“What gets measured gets managed, what gets rewarded gets repeated.”

It’s become the mantra that I have used with home care company leaders who want to grow their business and get ready for the future. And it has come true in our Home Care CEO Mastermind Groups. The largest companies in our groups are led by owners and CEOs who have a firm understanding of the data from their businesses.

Let’s start with the first phrase. “What gets measured gets managed.”

What you track in your business determines your priorities. If you only track dollars, that shows us where your priorities are. If you track sales and marketing results, that shows that you put an emphasis on attracting new clients. If you track caregiver recruiting and retention, that shows that you put an emphasis on finding and keeping the caregivers you need to grow your company.

Leaders in the largest, fastest growing companies in home care track metrics, analyze results, and make strategic decisions based on their analysis. They evaluate programs, gather new data, and change directions when their analysis shows that what they have been doing is no longer working.

LET’S LOOK AT SOME INDUSTRY DATA POINTS

For over a decade, we have worked closely with Home Care Pulse on their annual Home Care Benchmarking Study . This annual report gives us the best available data on most elements of a successful home care business. Let’s look at a few interesting data points from the 2021 Report. What could you learn about your business if you captured these same data points from your own company and analyzed the data?

I suspect that most of you reading this newsletter are subscribers to the annual Home Care Benchmarking Study , and you have probably compared your numbers to these data points. There are some other data points that perhaps you have not looked at.

What do you know about your sales and marketing activities from looking at your own data? How has that data changed over the past two years since the Pandemic began? How have you adjusted your sales and marketing activities based on what you have learned from your own data?

One of the things we have learned by examining case studies from specific Home Care CEO Mastermind Members is that not all referral sources are created equal. New clients coming from certain categories of referral sources have a much higher lifetime dollar value of a client than clients coming from other referral sources. For example, we know that clients referred by Bank Trust Officers and other Trusted Advisors generate more hours per client per week, and long lengths of service, than clients referred by hospitals, home health agencies, and skilled nursing facilities.

What do you know from your data about the dollar value of your clients by referral source category? Would it be valuable if you could direct your sales and marketing efforts at those referral sources that bring the most valuable clients?

WHAT CAN YOU LEARN ABOUT CAREGIVER RECRUITING AND RETENTION FROM LOOKING AT YOUR OWN DATA?

Here are some interesting data points from Home Care Pulse about caregiver recruiting and retention:

What could you learn from analyzing your own data about recruiting that would help you attract more new caregivers?

LEARN ABOUT YOUR COMPANY BY DISCUSSING YOUR DATA WITH YOUR PEERS

One of the most valuable activities in our Home Care CEO Mastermind Groups is our internal benchmarking process. On a regular basis, our members submit financial and statistical data. We create a table of that data so that members can see the mean and median for their entire group, and they can compare their own data to the group. Then we have in-depth discussions about each category so that members can learn what other members are doing that works, and the numerical results they are getting.

As Edwards Deming said, without the data, you are just another person with an opinion. You can have a conversation with other home care owners about various aspects of your business but without the data your are just discussing opinions. When members share data, results, and best practices, everyone in the group can learn and grow from the discussion.

If you would like to have this opportunity to examine confidential benchmarking information with other owners of similar sized home care companies who do not compete with you, then explore becoming a member of a Home Care CEO Mastermind Group.

This article re-published with permission of the writer, Steven Tweed:

The Dollars And Cents/ Sense Of Starting A Homecare Or Hospice Agency: Evaluate Your Best Options To Proceed

Sat, 19 Feb 2022 21:52:00 GMT

We frequently get calls about those looking for help starting a home care, home heath, and hospice agency. It’s part of what we do. However, it is important that those looking to jump into the homecare and hospice arena understand the process, the cost, and whether it is a good fiscal move. Here are some things to consider ahead of time to help determine if you are prepped for success.

1. What’s Your Background? Have you worked in the industry? Have you have been on the business end or the clinical end of an agency. This doesn't mean that you cannot start a successful homecare agency without it, but you will have more education on the industry standards and regulations than those already versed in them.

2. What Competition Do I Have? This is something you definitely have to consider. If there is market saturation in your area, you may be climbing a really steep hill to get any market share.

3. Differentiation: After compiling the data from the competitive analysis, do you need to look at providing a niche’ service or product to fill a gap in your community? These are the types of things that can someone in a saturated market obtain market share.

4. Leadership: If you come from a strong business background, then you need a strong clinician working with your agency. The same holds true for those who are clinicians. If you don’t have strengths in both departments, then get the right people around you to support your start-up.

5. Finances: Look, starting an agency takes money. Depending on where you are located in the country, here is what it typically takes to get yourself up and running:

Homecare: $40,000-$80,000

Non- Medicare Home Health: $60,000-$100,000

Medicare Certified Home Health/ Hospice: $150,000-$350,000

Those numbers may appear to be more that what you anticipated, but you have to look at the costs to provide services to patients up front before you are allowed to bill for reimbursement. It includes costs of overhead that will also accrue while you await survey. There are licensure fees, software, EMR fees, training costs and more. Then, for those considering Medicare certification, you have the capitalization requirements needed in order to get your 855 approved and move forward. That money has to remain in place to show CMS you have the necessary dollars required to operate. This is not to discourage someone from moving forward, but to make sure someone goes into the process ready to succeed and not begin a process they do not have the funds to complete. .

Kenyon Homecare Consulting Can Help You Start-up Successfully:

At Kenyon Homecare Consulting , we offer a comprehensive list of products an services to help those starting an agency as well as those currently in the industry. Our senior level consulting staff can help you with solutions to your business and start-up needs. Call us today at 206-721-5091 or contact us online to see how we can help you!

Still Losing Staff? Have You Seen What Beefing Up Your Educational Programming Can Do For Retention?

Tue, 15 Feb 2022 18:15:00 GMT

Clinical employee retention is such a loaded subject. There are so many facets to what makes a clinical employee stay or leave an agency. You have to consider everything important to the employee while realizing generational issues greatly changes the focus for each individual. So, in considering wage, benefits, vacation, family leave, onboarding and the generation of employee involved, have you thought about what robust educational programming brings to the table? Have you ever considered it as a retention measure?

It’s Not Just About The Onboarding:

We used to see so many agencies with high turnover rates related to the onboarding process. Employees consistently wrote in exit interviews that the orientation was inadequate and employees felt thrown out on their own before ready to safely provide care. While there are still agencies out there with poor education and training in the onboarding process, Kenyon Homecare Consulting would like to focus on what you do to keep the employees challenged and engaged through ongoing education. Let’s consider each clinical background for purposes of this article:

Home Health Aides: Aides are often our most underutilized resource with the highest turnover rate. Maybe this prevents you from investing training dollars because the overall lack of long term employment is a hindrance. So, look at things like pay increases attached to additional education. Our biggest cost in healthcare is related to chronic illness. Invest in chronic disease education programs for your aides. This way, the knowledge base is elevated as is the clinical capability of your staff. If you can reward staff with chronic disease certification with pay increases and a different level of engagement in the care plan, then you have potential for cost savings with other disciplines involved. Pull random care plans where chronic illness is the primary diagnosis. When reviewing documentation, are there visits made by a therapist or RN that could have potentially been made by the less costly home health aide? It isn’t about decreasing the nursing or therapist, but about maximizing the potential of the employees and determining service frequencies accordingly. If the home health aide is rewarded for advanced engagement and accountability in patient care, you greatly decrease the desire of the aide to jump ship.

Rehab Services: Regardless the therapy discipline, advancing clinical education is a win-win for the agencies. However, since so many agencies utilize contracted services, they don’t invest here. That is a mistake. How many agencies still have therapy providers unwilling to address any medication issues in the home? How many do not provide simple wound care? Do you miss out on vital communication? How many extra visits does nursing make into the home because of it? Providing training to the therapists allows them to improve competence in areas where they may not feel comfortable. Reality is that just because something is within scope of practice doesn’t mean the clinician has competence in the area. My nursing degree says treating pediatric patients in a NICU is within my scope of practice. However, spending the majority of my clinical career in home health and hospice tells me I am clearly not currently competent to do so. We can’t throw our clinicians into the deep end. How many therapists have refused or left your agency because they were uncomfortable or unwilling to complete something within scope of practice? How many would stay if you provided education and training that allowed them to become really good (and comfortable) at managing what you need them to address in patient homes?

Nursing: Now, let’s talk about education from the standpoint of mixing things up for your case managers here. Since all nurses provide case management for the patients, we don’t often evaluate how empowering those in the role can help retention. You may have the nurse that does an absolutely fantastic job in the home, but haven't trained these nurses on the meaning and scope of case management. Did you just assume they are really good at the process? You need to also consider your client population in your education to nurses. What is missing that really improves patient care while getting the nurses excited about their mission in the homes? Have you asked them?

Ok, What’s Next?

If you would like to think differently about education and training as a retention measure, then figure out what your employees are missing. Whether it is chronic disease, specialty services, or improving competence in certain tasks, you need to invest in the right programming. And, you can’t determine what your agency needs here without talking to clinicians. So, include them in the strategic plan. At Kenyon Homecare Consulting, we assist agencies with education to include on-site and virtual training platforms, strategic planning with seasoned clinical consultants, and operational assessments to determine what your educational program needs. Call us at 206-721-5091 or contact us online today!

Not Sure About Buying A Policy And Procedure Manual Online? What's Holding You Back Today?

Wed, 09 Feb 2022 18:49:00 GMT

If you are getting ready for survey, then you realize having an up-to-date policy and procedure manual is key to avoiding citations. This means having all the necessary policies present to represent current regulations and to have your operations noted to show how you comply. Many times, agencies have one or the other, but not both. If you are considering buying a manual online instead of updating yours, then here is what you should know. Then, there is no reason to hold back.

The Process To Buying An Online Policy and Procedure Manual:

The first question to ask is how long it has been since yours has been updated? It’s not uncommon for us to see agencies with policies that have not changed over 20 years and now they have big issues at survey time. Here is what to do when looking to purchase a manual online:

1. Research your manual: Talk to the vendor looking to sell you a policy and procedure manual before you put anything in your online shopping cart. Many providers offer a multiple different manuals for different service lines. You need to make sure you purchase one that is accreditation ready if you need it. The accrediting bodies will review vendor’s manuals for accuracy. Before you buy, ask if the particular policy and procedure manual has been approved by the accrediting body.

2. Do you want your state rules incorporated? If so, then you need to find a vendor that provides it. If not, you will need to add them in yourself or pay a consulting service to make sure it is up-to-date.

3. Once it is purchased: You will have instructions from your provider. For instance, the template should allow you to type in your agency’s name one time and it populate throughout the manual. These things are important from the standpoint of ease to customize your manual.

4. Making the manual specific to your agency: Operations still need added to your policy. The manuals will have all the regulations incorporated into it. The one thing it will not contain is how your agency complies with the regulation. Anything policy that requires a process measure or needs to designate the person responsible for maintaining compliance will have to be added. This is the step agencies can’t forget when purchasing the manual.

5. Pull out what doesn’t apply and add what does: Don’t keep policies in your hard copy that don’t apply to your agency. You will also need to add things like your agency’s line of authority. You may see there is a line of authority policy in your purchased manual, but you need to alter it to fit the job titles in your agency.

Let Kenyon Homecare Consulting Be Your Online Manual Vendor:

At Kenyon Homecare Consulting , we have a comprehensive line of fully customizable online manuals for homecare/ private duty, home health, and hospice. We have accreditation and non-accreditation ready versions. We have several manuals with the state rules incorporated. If you want assistance to incorporate your state rules, then we have senior level consultants to assist. You can see our full of manual on our website here . Before purchasing, please call us at 206-721-5091 or contact us online to make sure you choose the right one to meet your agency’s needs.

Are You Basically A Medicaid Home Health Provider And Want To Dip Your Toe Into The Medicare Pool? What Do You Need To Consider First?

Sun, 06 Feb 2022 21:13:00 GMT

Have you wanted to start up a new program or diversify services in your agency? Many home health agencies see patients with private payers as well as Medicaid, but have stayed clear of the Medicare world. If that is you, then let’s talk about some things to consider when making your decision to become Medicare certified.

Top 5 Things To Consider When Becoming Medicare Certified:

Many owners consider the larger profit margin potential with Medicare, but don’t go into the process with eyes wide open. Here are the things to research prior to submitting an 855 form to Medicare:

2. Know your regulations and steps to certification: This is a must. Agency owners and administrators must know the Medicare certification process and what regulatory compliance will mean in terms of staffing and operations.

3. Complete a competitive analysis: You need to know if you have a shot a market share in your area. Do a deep dive into the competition to know if you can break into the Medicare market in the communities you wish to serve.

4. Know the patient market: As part of the competitive analysis, you will find out who your potential competition serves. This will also guide you to know if there are gaps you can fill. Maybe your communities have specific needs your other Medicare competitors don’t adequately serve. We see this often in diverse communities where language is a barrier. Cultural sensitivities may unlock an underserved client base in your area. You can be the agency these underserved populations want to have in their homes because you have taken the time and effort to educate yourself on different cultural needs.

5. Consulting: If you are new to Medicare certification, having a seasoned consultant on board makes the process much easier. You can eliminate the question marks you have with the steps of the process. Yes, this will be an additional cost, but if you can avoid errors in your 855, decrease time in the process of getting started, and get through surveys successfully the first time, the money is beyond worth it. We hear from agencies trying to do it themselves for extended periods of time unsuccessfully who now want the help. Whether it has been issues with policies, survey failures, hiring the right staff, operations, education, or software implementation, it is a lot to handle. The mistakes and lost time costs agencies a lot more.

Kenyon Homecare Consulting Can Help!

At Kenyon Homecare Consulting , we can help brand new start-ups or those looking to diversify into new service lines. We have seasoned consulting staff with decades of experience doing it themselves. If you would like to look further into the Medicare certification process, give us a call at 206-721-5091 or contact us online to see how we can help you succeed.

COVID 19 Vaccine Mandates And Tools To Determine When And Where Your Obligations Lie

Thu, 03 Feb 2022 16:08:00 GMT

The COVID-19 vaccine mandates have been a hot topic for most health care providers. On January 27, 2022, CMS’s MLN Connects posted tools regarding vaccine mandates. Let’s look at the guidance and accessing the tools. The following is a direct excerpt from COVID-19: Tools to Determine if Vaccine Requirements Apply :

Ultimately, CMS has made data available for agencies to assist with compliance to the mandate and knowing what responsibilities you have and don’t have. In order to not be penalized, know your agencies requirement and educate staff averse to the vaccination mandate. There is concern from some parts of the US that there will not be enough clinical staff to manage patient care with vaccination mandates. This is the hot button topic for our industry, but ultimately, clinicians will have to choose whether to remain working in environments serving Medicare and Medicaid patients. Should you have any questions, please use CMS’s guidance provided here.

Kenyon Homecare Consulting is a comprehensive home care, home health, and hospice consulting service. We have consults with decades of high level experience working in clinical, operational, and financial departments within our industry. Call us today at 206-721-5091 or contact us online to see how we can help you achieve your clinical and financial goals today.

Sometimes Updating Policy And Procedure Manuals Can Lead You Into What Seems Like An Abyss Of Regulations. Time To Make It Easier!

Sat, 29 Jan 2022 20:23:00 GMT

When your policy and procedure manual is out-of-date, it really can seem like a never-ending abyss to clean it up. If it has been a long time since you thoroughly went through you manual, then consider whether to update a current one or buy a new one. Let’s look at some pros and cons of both.

Update Your Policy And Procedure Manual Versus Buying A New One:

Obviously, if you keep up on your policy and procedure manual, buying a new one is a moot point. As changes occur in regulations, you have updated policies accordingly. As operations change, you make the updates in your manual to match. Unfortunately, based upon our experience with agencies around survey time, this is not normally the case. We saw agencies who never updated manuals to reflect the COP changes in 2018. So, if agencies didn’t keep up with regulations to comply with the biggest changes to the Medicare program in 20 years, it is not shocking that the rest of the manual was outdated. It is not uncommon for us to be in agencies and see manuals that have some of the exact same policies in place from over 30 years ago. It is unrealistic to think that a large chunk of policies would remain the same if you are actively using your manual to assist in running your business. Too many things change in this industry. The result is many agencies got condition level deficiencies during that process. Some still aren’t truly in compliance.

If you are in that boat, then the process of getting a very out-of-date manual up to par is time consuming and cumbersome. You really should consider purchasing a manual online that is complete with federal and potentially all your state regulations. If you have never ordered an online manual, then let’s look at the process and how it is the solution for so many agencies with non-compliant policy and procedures.

Purchasing An Online Manual:

First, always contact the vendor to ensure you are choosing the right manual for your business. Many vendors sell multiple service lines with and without state specific rules. Do not make the mistake and choose the wrong one by accident. You do not want to have to purchase a second manual if you bought the wrong one by mistake. These manuals come as a download to you normally in an email. You want one that is completely customizable online so you have the ability to tweak things along the way.

Now that you have your manual, you need to begin the customization process. Agencies that purchase online manuals and do not edit them are just as much as risk for citations as those that are out-of-date. You need to go through the manuals which are completely up-to-date with regulations and add the specifics of how your agency complies with that policy. You need to add if a specific job title is responsible to carry out something in that policy. Some policies will not need anything changed, but you need to go through it and make sure. It is also a very good way to familiarize with regulations if you have become out of touch with them. If you bought a manual that only includes the federal regulations, then you will need to add anything state specific in order to comply as well.

Kenyon Homecare Consulting Has Your New Online Manual Available Today!

At Kenyon Homecare Consultin g, we have a comprehensive offering of manuals for homecare, home health and hospice. We offer accreditation ready and some with the state regulations included. Call us today at 206-721-5091 on contact us online to get your easy to customize manual today! Don’t waste a ton of time trying to resurrect and old manual because it will cost you a lot more than you think to get it ready for survey.

What's Your Check And Balance For ICD-10 Coding? Do You Even Have One Today?

Wed, 26 Jan 2022 17:28:00 GMT

In today’s complex world of ICD 10 coding, you need to make sure you receive all the dollars you deserve to care for the patients you see. And although this is something directly related to compliance and reimbursement, we rarely check competency on our ICD 10 coders. Let’s consider what a coding check-and-balance system looks like for your agency.

How Do You Do An ICD 10 Check-and Balance?

In our industry, we have competencies and supervision on everything and everyone. So, why don’t we check the accuracy of our own coding departments? If you haven’t put a check-and-balance in place, then now is the time. You need to start with a sample of previously coded charts in your agency. We would suggest 5-15 charts depending on the size of your organization and the number of certified coders you have on staff.

Contact an outsourced company and ask them to evaluate the charts and code them accordingly. Then evaluate your results. You should see only slight differences. For example: Your agency has 4 diagnoses on the 485. The outsourced company agrees with the diagnoses, but the order in which they are on the 485 if different. If this does not impact the dollars paid to your agency, then it is not a big difference. However, it could mean something different if the second diagnosis is weighted. If the diagnoses are very different, you have a problem. This is a process that should be completed yearly.

So, What Comes Next:

If you have a problem, then you need to decide what the issue is. Is it a lack of knowledge? Maybe your coding department isn’t requiring the amount of documentation to justify the codes being used. Maybe you still have someone who isn’t coding certified doing Oasis and coding review? Ultimately, Kenyon Homecare Consulting has a comprehensive ICD 10 coding department and can help be your complete solution, your back-up plan, or your ongoing check-and-balance. We will offer your first 5 recodes for free on your check and balance. Call us today at 206-721-5091 or contact us online .

How Are You Doing With Chronic Disease Education Today? Do Your Outcomes Say Otherwise?

Tue, 18 Jan 2022 19:53:00 GMT

Chronic disease management is something that is so vital to patient outcomes and efficient patient care, but it is often put on the back burner of day-to-day operations. So ask yourself why you haven’t invested in keeping chronic disease education on the forefront of your plan. Is it financial? Is it because you don’t have the staff to pull from the field? If it hasn’t been something you have thought about in a long time, then it’s time to revisit your plan.

Why Chronic Disease Education?

It is a well-known concept that when you put the clinical emphasis on something, it improve for a period of time. For instance, have you taken a routine approach to Oasis education at some point in the past? Did you notice an improvement in accurate Oasis scoring? When our staff is engaged with routine education, the topic becomes forefront in routine practice. So, it only makes sense to make chronic disease education an important investment in your agency. Now, let’s take a look at things to consider when choosing your chronic disease education platform.

1. Online or In-person: For those agencies large enough with decent-sized education budgets, you may have your own education department. This makes in-person lecture style teaching work for your agency. If you don’t have your own in-house education department, then online is the more affordable and easily accessible option. Either way, you have to find the best fit for your agency.

2. Comprehensive Teaching: Chronic disease education is a huge topic. You have to consider the disease process, care-planning, care coordination, and discipline specific care.

3. Discipline Specific Education: Chronic disease education isn’t a nurse only thing. It needs to include therapy disciplines and home health aide staff. Our aides are so often underutilized and they can be such an integral part of chronic disease management.

4. Ongoing Process: This can’t be a one-and-done kind of teaching. You have to make it consistent to stick just like anything else you want to implement in your agency. Hone in on certain disease processes one at a time. Then, what changes in the care plan depending upon how long the patient has had the diagnosis? Work with staff on realistic care plans. Are you going to suddenly make the 45 year smoker quit? If not, then maybe you need to work in other areas that you can improve quality of life for the patient. The care plans need to be patient specific and not cookie cutter for a particular diagnosis.

5. Operational Changes: Once you have completed the education to staff, then you need to move to how it will change the way the clinician practices in regards to work flow. You need to have a plan in place to change the way staff execute the care plan. You should see an increase in care coordination that is meaningful and patient specific. If you just provide the education and no way for the clinical staff to put it into practice, the dollars you have invested will be lost.

Kenyon Homecare Consulting Can Help:

At Kenyon Homecare Consulting , we have comprehensive educational platforms to help your homecare staff make a difference in chronic disease management. Give us a call today at 206-721-5091 or contact us online to see how we can help you become the experts in chronic disease care.

Are Your Nurses Still Doing Your Coding? Get Your Nurses Back In Their Swim Lane Now. Avoid Mistakes and Loss Of Reimbursement.

Sat, 15 Jan 2022 19:41:00 GMT

Remember when we nurses did our own coding in the times of ICD-9? It was pretty basic. Then, along comes ICD 10 coding. It was a whole different ball game. Now, we have a much more complicated Oasis and codes that are no longer 3 digits of specificity. How can your nurses do a complete Oasis assessment and patient specific care planning and be expected to be expert ICD 10 coders at the same time. They can’t.

4 Reasons Nurses Need To Give Up ICD 10 Coding:

In many agencies, the nurse still does his or her own coding. If you are one of those agencies, then it is time to make a change. Here are 4 big reasons to have your nurses give up coding:

1. Accuracy: The bottom line is that you can’t have individuals who are not coding and Oasis certified doing the job. It is too complicated a job. The professional nurse needs to be just that: a professional nurse. There are too many things related to outcomes, Oasis, and proper care planning to then expect the nurse to spend the adequate time it takes for accurate coding.

2. Time: So, let’s say you have a nurse that will take the time to really dig deep and get the right code and understand how it interacts with the Oasis data. What did that cost you? Is it really cheaper than outsourcing ICD 10 coding and getting your code done correctly right out of the gate. Most likely, it isn’t.

3. Dollars: Those certified in ICD-10 and Oasis will make sure the code is correct for the documentation that is present. They will make sure you get the correct amount of reimbursement to take care of the patient. On the other hand, our experience is that agencies with nurses doing their own coding have significantly less of an HHRG and reimbursement per episode. Again, we cannot expect our nurses to be experts at everything.

4. Auditing: When it comes time for ADR or if you are a state doing the Review Choice Demonstration, you can’t afford to have claims kicked back for improper coding and you could set yourself up for full blown audit. Make sure you have the right code the first time.

Kenyon Homecare Consulting Can Be Your Coding HQ:

At Kenyon Homecare Consulting , we have certified coders who are also Oasis certified. Regardless of the level of coding you want, we can provide it. We can do the basic code, coding and oasis review, discharge oasis, employee tracking for oasis accuracy and more. Call us today at 206-721-5091 or contact us online to see how we can help you reach your ICD goals.

It's A New Year: What Are The 5 Things You Will Do Differently In Your Homecare Agency?

Wed, 12 Jan 2022 16:03:00 GMT

Agencies face issues every year and 2022 will be no different. The question is, how do you narrow down what to change and cultivate? When you really take a deep dive into how your agency operates, what stands out as your biggest concerns? Let’s look at taking your top 5 as a priority for 2022.

What Are My Top 5?

It starts with an honest SWOT analysis. Take off the rose colored glasses about yourself and the rest of staff. Look at the things that work really well and what doesn’t in operations. It means considering those things tangible as well as those that aren’t. Now, when you think of those things, how many have you changed over the last 5 years? Have the issues been ongoing long-term? If so, then it is time to change. Ultimately, we say pick your top 5 because you need to focus on them enough to make the change successful. If this is something you do as part of your yearly strategic plan, then that is fantastic. That means pulling out previous strategic plans to see how well you actually cultivated growth and successfully implemented change.

When you analyze your agency, don’t look only at the individual departments, but how they work together as part of the larger agency. Sometimes, the department appears to be a well-oiled machine until it has to function outside itself. Individual staff efficiencies are a big deal. When we are asked to dig into financial issues with agencies, we often find efficiencies play a huge part. Now, we aren’t always talking clinical here. You need to look into finance efficiency. So often we agencies that utilize work-arounds within finance or other departments. For instance, we all know that new software can be frustrating when it doesn’t seem to jive with our current work flow. In these cases, we find finance departments that take twice the time to complete tasks because they do not want to alter work flow. This means they do a lot more things by hand by using old systems. Then, they have to re-input data into software. Do you know if all departments work efficiently?

Let Us Help You!

Considering things in a deep dive format, you may not choose to pick 5 this year. Maybe you really need to focus on a realistic goal of 3 big changes. Ultimately, the goal is making any change successful or cultivating a new program so it doesn’t fail. At Kenyon Homecare Consulting , we help agencies work through strategic changes. Should you need help to evaluate your program and set up solutions for organizational change, please call us today at 206-721-5091 or contact us online to see how we can help you meet your goals!

Make Your Strategic Planning Fun Instead Of An Obligation Every Year! You'll Get A Lot More Accomplished!

Sat, 08 Jan 2022 18:41:00 GMT

When you think of strategic planning, it is often in a conference room and ends up being a long day of meetings. When it is over, do you have a workable plan you enjoyed putting together or paper that gathers dust? Let’s look at ways to update your strategic planning process while making it more fun to improve your agency.

5 Ways To Improve Strategic Planning:

So, how do you change it up? The process requires the same results and analysis, but how you come to your conclusions is your call. Let’s look 5 ways to make your process better:

1. Change the players: Do you normally just do planning with your administrative team? You need to include other members of your team. For example, when is the last time you pulled a few of your home health aides into the mix discussing operations or work flow that affects your agency?

2. Change the location: Before budget cuts and the pandemic, agencies often went off site for strategic planning. If you haven’t considered what a change of scenery can do, then you miss an easy way to potentially have a better process. Host it at your house. Decide on a TV show or movie you all watch during the lunch breaks. Go to a restaurant meeting room. Never underestimate the benefit of the staff being comfortable and laid back. It doesn’t have to cost a lot of money.

3. Change the dress code: It is a good thing for staff to have a break from uniforms and suits. It is not a bad thing for them to see you that way as well. If you want different ideas from people, then ditch the formal or required attire and let people be comfortable. Consider team dress during football season or high school spirit wear for rivalry games. Again, it may sound little, but it changes the vibe for your planning process.

4. Change up the usual agenda: When you look at your strategic plan over the last 10 years, how many times have you really changed what you are analyzing? When we look at agency’s plans, we often see the same data over time. Although some things always need to be a part of the plan, have you considered what might be missing? How often do you do a deep dive into your ICD 10 coding solution? How often do you analyze maintenance costs? When was the last time you really looked at your EMR to potentially change operational issues?

5. Change the time: Is your strategic planning always done in a few hours with you and the admin team? Is it always one day? Whatever your timing is, consider it potentially being longer. Ask the admin team and departments if there is anything they would like the team to consider.

Your Process Needs To Make A Difference:

Regardless of how you do things, the document needs to make a difference in your agency during the next calendar year. We have seen agencies that do great strategic plans and visit those consistently to complete goals. We also see those who do nothing with it. When you leave strategic planning, your team should be excited about its potential. Should you need assistance with your strategic planning or feel stuck in the rut of day-to-day operations, Kenyon Homecare Consulting can help. Call us today at 206-721-5091 or contact us online to see how we can help you.

Keep Your ICD 10 Coding In-House Or Is It The Right Time To Outsource? What Do You Have To Lose Other Than Money?

Wed, 05 Jan 2022 15:56:00 GMT

The decision on your ICD 10 coding solution is a big one. If you have in-house coding, then you may not think about outsourcing. It may not have crossed your mind. We don't often think about coding as a part of an agency's strategic plan, but it should be. Ultimately, there are positives and negatives to in-house or outsourcing, but you need to evaluate both to make the best decision for your agency. So, let's give you some ideas on grading your agency's ICD 10 report card.

Do You Know If Your ICD 10 Coding Does You Justice?

There are so many things to worry about as agency owners and administrators. Coding if often something that is done in the background that often isn't evaluated. The reality is that most agencies do not know if their ICD 10 coding solution is a help or a hindrance. In order to adequately evaluate your program, here are some of the bullet items to consider:

1. Certification: This is not optional. Your ICD 10 coders must be Oasis and ICD 10 certified. It is necessary for compliance to coding rules and to make sure you receive proper reimbursement.

2. Competency: Our industry has a competency requirement for everything, but not coding. Regardless of whether you are outsourced or in-house, you need a check-and-balance system in place. Have a yearly random sample sent to another coding provider and have them recode the charts to see if the results are the same.

3. Job Roles: Does your coder have a dual role? Ultimately, employees who hold multiple positions migrate to the job role they like the most. You can’t afford for coding to take a back seat.

4. Cost: Have you compared the cost of having an ICD 10 coding department in-house versus the cost to have it outsourced? When it comes to cost, you need to look at the all-in cost and not just direct wage.

5. Data: If you are outsourced here, then look at what data you get from your provider. Is your provider tracking Oasis accuracy? Is there an educational component available to clinical staff to help improve Oasis accuracy? Utilize the expertise of your coding provider to make staff better.

6. Reimbursement: How do you compare to others in your state and nationally? Is your HHRG very low? Then you need to evaluate if it is an ICD 10 coding issue, documentation/ Oasis issue, or whether you are not receiving referrals that provide decent reimbursement. It may mean a pivot in your marketing strategy.

8. Turnover Time: How long does it take for your agency to get ICD 10 coding completed from your in-house or current outsourced provider?

9. Back-Up Planning: This is crucial. Most agencies, unless they have a large coding department, are not prepared for decent surge or loss of staff. So, make sure you have an outsourced company to cover you. You may have long term coding staff with lots of vacation and personal time accumulated. You have to make sure it doesn’t hurt you.

Let Us Help!

At Kenyon Homecare Consultin g, we have a comprehensive ICD 10 coding solution that fits your agency’s needs. Whether you need just coding, coding and Oasis, or a back-up plan, we can help. Call us today at 206-721-5091 or contact us online . We will offer 5 free recodes today to see if your current solution is on the right track!

Distracted By Changes? Keep Your Eye On ICD 10 Coding And You Won't Miss Out On Dollars You Deserve.

Thu, 23 Dec 2021 19:17:00 GMT

When we are asked to look at agencies dealing with financial concerns, we consistently see ICD 10 coding issues contributing to it. Look, things keep getting thrown at us as an industry and that is not going to stop. Therefore, we can't minimize the power of proper coding. Let's look at some of the things that we see in agencies.

5 Common ICD 10 Coding Mistakes:

So, agencies often look at cutting costs by way of staffing before they consider coding as a potential issue. So, before you make drastic changes, consider these 5 things:

Ultimately, in spite of everything going on, you can't be distracted from the importance of proper Oasis scoring and ICD 10 Coding. At Kenyon Homecare Consulting , we provide both services. We can be your coding and oasis outsource solution or your back-up plan during vacations or absences. Our agency will complete 5 free recode of current ICD 10 charts to see if you are on the right coding track! Call us today at 206-721-5091 or contact us online today!

The Key To Home Health Care Survival: Diversification

Sat, 18 Dec 2021 17:34:00 GMT

About thirty years ago, most home health agencies were non-profit Medicare agencies. Many had private pay home care as part of the organization's services. Back then, most of the Medicare agencies were VNAs or attached to a hospital system. We had our Medicare caseload and then there was the private pay which also included the DSHS Chore Services personal care program. There were few free standing private pay agencies. Approximately twenty years ago many of the Medicare agencies began to drop their private pay programs. It was about that time that that HCFA, now CMS began to allow for-profit organizations to participate in the Medicare Home Health benefit. The Medicare rules began to be enforced and those agencies which ran the private pay home care with the Medicare began to close the private pay sections because they were losing money. Most of that had to do with running the agencies under the Medicare license thus costing considerably more with less income to balance the P&L.

We are now coming full circle with Medicare Home Health and Private Pay services. We are beginning to see articles in the industry media about the need for diversification and alluding to the inclusion of home care private pay services as another revenue stream for the Medicare Certified agencies. For those Medicare Home Health agencies considering this move, there is one word of caution, run the new private pay company under a separate license. In looking back at why Medicare Home Health and Hospice agencies divested themselves of the private pay, it is clear that applying the Medicare rules to private pay made the private pay business a loser. In addition, the home care private pay business is a very different type of business and must be run differently. While Medicare is highly regulated, private pay is either moderately regulated or not regulated at all depending on the state. The managers of the home care private pay agency must be open minded and able to respond to the environment without regard to the constraints of Medicare. We have found that Medicare Home Health or Hospice staff has difficulty moving out of the regulated box they live in. It is for that reason we recommend that if you are considering this addition, you should run the home care private pay under a separate license with different home care staff.

Diversification to include a private pay program may still not be enough. As the competition becomes more intense for the private pay line of business, we are now seeing the need for home care private pay agencies to differentiate themselves from others as well. No longer will the tried and true personal care services only guarantee success. Private pay home health must add additional streams of revenue in order to survive and grow. There is no single set of services that will fit all agencies. Just as all politics are local, so are services.

Diversification takes two different forms in the private pay industry, additional lines of services (e.g. Cruise Companions, Day Surgery Support, Mom and Babe, pharmacy drug reviews with recommendations and counseling, home modifications and Holiday Helpers) and value added products that are part of service packages. Value added products include such things as Life Alerts, pharmacy discount and delivery, and financial management support. When addressing value added services, the services are included in the hourly or daily rate. The clients do not pay extra for these services or products, but receive them as part of agency package. As long as the client is a customer of the agency, they automatically receive the product or service. The cost of the value added is embedded in the hourly or daily rate by calculating the cost of the value added feature and dividing that cost by the hours of days of services currently provided by the agency. Sometimes the extra charge is as little as $.25/hour more.

Whatever services or value added elements you select, they must be services or products that your particular customers view as something they are willing to pay for or see as an added value. With this in mind it is critical that you survey your customers to make sure they see what you have to offer is something they want.

If you need help with determining what other services or value added elements would be appropriate for your agency, call Kenyon Homecare Consultin g at 206-721-5091 or contact us online today!

Time To Rethink Our Stance On Home Care Aides And Medications

Wed, 15 Dec 2021 16:37:00 GMT

I have been working in the home health arena since 1975. In those early days, home care aides were pretty much used as glorified maids who did primarily home making chores and some personal assistance services. They were assigned to two hour shifts per client and did a maximum of 5 clients a day. Home health was not required to do any special training and in some cases, none was provided. Over the years the role of the aide has evolved. In the early 90’s it was recognized that the home care aides needed special training to care for the Medicare home health populations and, HCFA (now CMS), issued a rule that all aides caring for Medicare clients, whether in the hospital, nursing home or home health had to be Certified Nursing Assistants with the requisite 80 hours of class room and hands on experience and be licensed as a CNA by the state in which they resided and provided services. The training was and continues to be focused on the fundamentals of care, such as bathing, ambulation, turning, dressing, eating, etc. and is primarily acute care focused. Not much has changed since the initial curriculum development. In the home, the home care aide provides all the acute type of care plus meal preparation, light housekeeping, companionship and can remind a client/patient of the time to take their medications.

The biggest departure from the acute arena of care is in the area of “medication reminding”. Home care aides may remind, “tell a client when it is time to take their medications”. In the last decade or so, both Oregon and Washington state passed legislation allowing for “Nurse Delegation” of the drawing up and giving of insulin by home care aides to selected insulin dependent diabetics. Other states are beginning to explore the expanded use of these very valuable members of the home care team. I believe it is time we did a serious reassessment of all the members of the home health team and look at how best to use all of the team members including the home care aides. I believe it is time all home care aides were required to have course work on medications, common uses, side effect and medication interactions.

I do not know if it is ego or clinical arrogance that has prevented the full use of our “aide colleagues”, but we can no longer afford to keep them in the dark and our clients/patients at risk. I have been told by surveyors in the past that they did not even want a medication list left for the aide to follow as they were not allowed to know anything about the medications other than to remind when it was time. I have never followed that rule because I wanted my home care aides to know what pills were to be given. It was not uncommon for me to make a list and tape one of the pills with the name of the drug and the times of day each of them was to be taken. I wanted them at the very least to know for example that the blue pill was taken at breakfast and bedtime and if it was not in the cup, they should report it to me.

Since that time in the field as a practicing home care nurse, I have become even more of an advocate for the aides and the patients we serve by wanting both the aides and the clients to fully understand the medications that they are dealing with. No longer does a typical home care patient have two to three drugs but more commonly now 9 to 12 on average. The statistical chances of the client/patient having an interaction of some sort or a side effect is almost a certainty. Most interactions or side effects are mild and not something to be worried about, but some of them are very serious and lead to bad

outcomes. Why would we not want the home care aides to be able to recognize and inform us immediately when one of the bad events occurs?

Over the last 10 years I have had several occasions to act as an expert witness for home care aides who have been accused of wrongful deaths as a result of drug interactions. In the last two cases, the charges were eventually dropped against the aides because the states they worked in did not allow them to know or understand the medications. The laws were followed, but the clients died. I think it is time to rethink our use of home care aides and what they have to bring to the table in terms of comprehensive care for our patient/client. Think of how valuable it would be to the patients/clients and their families if they knew that the person who spends the most time with them or their loved one was specially trained to recognize drug side effects and interactions and report them so that early interventions could prevent problems associated with drugs, side effects and interactions. I wonder how many repeat hospitalizations could be prevented and how better the quality of life would be if we fully used the eyes, ears, and noses of those very valuable members of our team, the home care aides?

I welcome any thoughts on this subject. We are in the middle of a paradigm shift in health care in this country. Why not go all the way and make it quality for all, patients, clinical staff and our home care aides?

If you have questions or are in need of assistance with you home health, hospice or home care private pay agency, please call Kenyon Home Care Consulting at 206-721-5091 or contact us online . We can help!

The Cost Benefit of Interim Management in Home Care

Tue, 07 Dec 2021 14:33:00 GMT

Over the years we have provided numerous home care interim managers for home care executive level positions. On a few occasions we have been told that the cost of using one of our senior home care executives is more than they can afford. This has always intrigued me, because when we do a cost of service comparison, we frequently find that by the time we add in all the benefits and overhead burden, the interim home care executive costs about the same and in a couple of situations less. What we have found is that some home care organizations only look at the monthly salary of the previous executive and measure against that number alone. We find that if the employee burden of an organization is 20% or more, the cost of using one of our interim managers is about the same or depending on the salary of the previous executive, a little less. So there always needs to be a comparison of apples to apples when calculating the cost of an interim home care manager for a senior level position. But cost is only one area that a home care organization needs to think about in using an interim home care executive. The benefits sometimes prove to be so beneficial that in retrospect we have been told that the vacated executive position gave the organization an opportunity to really look at themselves, their weakness and strengths, and develop a meaningful and effective strategic plan to carry the agency forward.

When we fill an interim manager position, we do require that an organizational assessment be accomplished in order to make sure that the services are meeting the needs of the home care agency and that the interim home care executive is focused on the issues and goals that need attention. Not uncommon is the discovery of issues and problems that were not apparent to the higher level managers of the home care agency. Sometimes we find that the staff filling certain positions is either not competent for the position or their personality and style are disruptive to the team which makes it difficult to build a cohesive and effective management or staff team. In other situations we have found that the home care organization has very dedicated and competent staff, but the systems of the organization has not kept up with the changes in the environment and the implementation of required processes or software. In these cases we see time consuming “ work arounds” developed by the staff to accomplish what they know needs to be done. All of this is costly to a home care agency and frequently are not identified because the work is getting done. The benefit of an outside consulting firm with interim mangers doing the organizational assessment is that these types of issues get identified with recommended solutions for the owner or corporate officers so they have directions on how these can be addressed and resolved to the benefit of the agency.

Finally, the benefit of using an interim manager is that the agency does not lose momentum on previous projects and initiatives. It allows the agency to continue to function effectively and maintain their progress toward organizational goals and objectives. It also gives stability to the organization in a time of stress and flux. Using a seasoned executive assists the staff to move forward with confidence that they will be okay. One of the biggest mistakes that an organization makes is to allow a key position such as the Director, Administrator or CEO to go unfilled for 4 to 6 months. The company becomes distressed that the business is down, referrals are not coming in, and collections have fallen off the radar. Without a leader at the helm, critical things fall by the way side because there is no one at the top with the view of the “world” of the agency. It is a critical mistake to leave an executive level position empty. An agency without a leader is an agency afloat on the sea with no one at the rudder.

If you are in a position with an executive level position open and need help during this time of change, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help you through your agency transition.

Have A Small Medicare Footprint? Think You Don't Need To Worry About ICD 10 Coding? Think Again!

Thu, 02 Dec 2021 17:38:00 GMT

After years of being in the business of homecare consulting, we have seen importance of accurate ICD 10 coding increase. However, those who primarily focus on Medicaid services in their area tend to dismiss the importance of the ICD 10 code. We consistently see these agencies doing coding internally by non-certified coders. Sometimes it's nurses who did the admission or better yet, another staff member such as an office manager who does the codes when needed. Let's talk about why this hurts your from a compliance level and big time when it comes to your financials.

But We Only Do A Small Amount Of Medicare:

Here's the thing: The method of your ICD 10 coding should not be determined by the size of your Medicare footprint. That's right. Whether you do in-house or outsourced ICD 10 coding is a matter of clinical accuracy, compliance and proper reimbursement. Let's look at each one of those items and why have the proper ICD 10 code is so important.

Ultimately, ICD 10 coding is so important and not to be dismissed regardless the size of your Medicare footprint. What do you potentially lose both on the clinical and financial side with bad coding? If you have a small Medicare footprint, just make the call and outsource your Medicare coding. It isn't worth the loss of money or risk of non-compliance. If you aren't sure about your agency's coding grade card, call Kenyon Homecare Consulting at 206-721-5091 or contact us online . We will complete 5 free recodes to see if your ICD 10 coding is on point or if it misses the mark!

Succession Planning And Interim Home Care Management

Tue, 30 Nov 2021 19:05:00 GMT

Nothing is more unsettling to a home care organization than the loss, or impending loss of an essential leader. Home care agencies that fail to plan for this event experience major disruptions in their business; initiatives lose momentum or are completely lost, uncertainty increases, staff resignations, and business drops off causing a decline to the bottom line. To avoid this problem, a home health or hospice organization must have both an emergency succession plan as well as an established succession plan.

What is a Succession Plan?

A sound home care succession plan is an ongoing process that contains the following:

1. Identification of critical positions needed for your home care agency.

2. Determination of the requisite skills needed for those positions.

3. Identification and assessment of potential successors or sources capable of providing individuals with the requisite skills.

4. Management and leadership involvement at all levels throughout your home care agency in developing the plan.

5. Ongoing commitment to developing internal talent and monitoring progress.

A successful home care agency leadership succession plan identifies the environment, prepares for contingencies, and minimizes disruptions. Therefore, effective succession planning must be an ongoing process of regularly identifying, assessing, and developing talent to ensure leadership continuity for all key positions in a home care agency. The process must be in keeping with your home care or hospice agency’s ongoing strategic goals and objectives. This may mean that the kind of leadership style, skills, and behaviors that need to be developed and promoted might be different in the future from those in the existing culture. Therefore, the plan must be visited yearly and updated to match what your home health or hospice agency needs moving forward.

It must be understood that "succession planning is not a "replacement" strategy. A properly prepared succession plan is a proactive, systematic effort designed to ensure the continued effective performance of an organization, division, department or work group.”

Christopher Simoneau, The Business Review

With an up-to date succession plan, a situation creating one or more vacant leadership positions is less of an emergency for your home care agency. If individuals within your home care agency are not capable of taking the helm and leading your organization, then an alternative will need to be implemented as soon as possible to prevent damaging disruptions to your business. This replacement is frequently an interim home care manager with the requisite skills to fill the position.

With both an emergency and a succession plan in place, the selection of an appropriate interim home care manager is considerably easier. The requisite skill sets have been identified and updated and the essential work elements are in place with all staff on board with their identified responsibilities during the interim home care manager’s time with your agency

As with all things in our lives, planning makes a big difference. We never want to think of disasters occurring, but we all know that they do. People experience fires at their homes and businesses, hurricanes occur, earthquakes happen, and people become ill or die. How we plan for these times dictates the outcomes. As interim home care managers, we too often see the failure to plan.

Kenyon HomeCare Consulting can assist agencies with succession plans that help them through leadership transitions and lay the groundwork for when an interim manager is needed. The interim manager then helps to fill the gap until a permanent leader can take the helm. It you need assistance with either developing succession plans or interim management, call Kenyon HomeCare Consulting at 206-721-5091 or contact us online today. We are here to help.

A Paradigm Shift for Home Health A New Dream

Mon, 22 Nov 2021 14:36:00 GMT

For years I have dreamed of a day when home health nurses and therapists would be in charge of their own services and doctors would be part of the team, but not the “directors” of the plan. It has never made sense to me that a physician who knows little about home health services would be required to sign off on our orders. I agree that the physicians or Nurse Practitioners should confirm the working diagnosis and the medications. From there on, it is the professional clinician in home health that does assessments, defines problems in terms of their discipline and sets the plan of action, not the physician. Having a physician sign our orders and “direct the care” of the home health period makes as much sense as asking the plumbers building a house to sign off on and be in charge of the electrician, the sheet rockers, the framers and the roofer’s work. Physicians have repeatedly objected to the requirement that they sign orders and now with face to face documentation, the objections are even more stringent.

So, how did we get here? When and why has there been a paradigm that the physician directs the care of other providers? Certainly the therapists have been able to have individual practices that do not require a physician oversight, but not nurses. The origins of physician control over nursing practice started in the early part of the last century when it was determined that the independent practice of nurses was the single biggest threat to future physician financial growth. Nurses were considered a financial threat to the physician financial futures. As a result, the American Medical Association set out to get congress to pass legislation requiring that nurses work under the direction of a physician. The current state of affairs is testimony to the success of that plan. Unfortunately for nurses, consumers and those who pay, it has not always been the best practice.

Many physicians who sign the plans of care developed by the nurses and therapists will be the first to tell us that the plans make little sense to them but they sign them so their patients can get the care they need. Is it any wonder the plans make no sense to them? They are not medical plans of care, they are nursing and therapy plans written in the language of each discipline. It is time that home health plans are recognized for what they are, discipline specific plans that should be signed by the individual disciplines. The physician needs to continue to sign the medical components, diagnosis and medications lists, but the rest belongs to the individual disciplines.

Think of the money that is spent trying to support this false paradigm. Think of all the hours and time spent by home health staff gathering a physician signature on the 485. Think of the patients who were denied services because their physician did not want to be deal with the added burden of the paperwork required to gain their patients the care through the home health agency. Frankly I do not blame physicians for not wanting the added burden of paperwork imposed on them by this requirement.

So, what could the future look like? I dream of a future for home health where the physician is part of the team and works with the other disciplines to achieve the desired

goals that our patients have identified. Each discipline is responsible for their part and nursing is responsible for coordinating the overall plan. Medicare recognized long ago that nurses should be the coordinator or case manager of patient care in home health. In that respect, there would be no change to the current practice.

The physician would confirm the working diagnosis and medications electronically and each discipline would sign and date their plans. Compliance with the home health conditions of participation would continue to be the responsibility of the clinical staff at the agency and the requirement that the physician certify the patient is homebound should go away.

If the intent of the physician certifying the patient is homebound was intended to prevent fraud, then it is evident that it has not been successful and should be dropped. The best person to determine homebound status is the clinician in the home doing the assessment. However there is another serious issue with the homebound rule. It interferes with the home health staff’s ability to provide the care needed to really return an individual to full capacity and independence. Much of what home health does is to assist the patient make life style changes in order to stabilize their condition and prevent further exacerbations and subsequent need for emergent services. To achieve these goals, particularly for those with chronic diseases and co-morbidities time is needed beyond a 60-day 485. But, because of the homebound requirement, home health barely gets the patient to begin the changes to their life and they are discharged because they can not leave their homes. Experience provides evidence that it may take as long as 6 months to successfully integrate a change in lifestyle. There seems to be a beginning glimmer of hope with CMS beginning to recognize that particularly those with chronic diseases need longer times of care and support beyond the current homebound phase.

The focus of the system would change from rules enforcement to one of outcomes focused. What is the patient achieving in terms of their desired goals and outcomes and then what are the costs. I believe that with these few changes, cost would decrease and outcomes would improve as well as physician, home health staff and patient satisfaction.

Finally the 485 needs to be revised and made to reflect these new changes. I have had numerous physicians complain over the years that the 485 makes no sense to them and provides them with little useful information other than the diagnosis and the medications. Physicians are asking for information about their patient’s progress and responses to services as well as any identified medical issues that they would need to address. That is not an unreasonable request and as a member of the team something we would want to provide them. This will require a paradigm shift for home health clinicians however.

I believe a return to individualized plans of care provided in a structured format would not only help others on the team do better planning, it would help staff new to the home health practice understand the care planning process. The current system does not support critical thinking of the clinical staff and the whole process has become an exercise in checking items in a list.

It’s time to dream a new dream. These are just a few of the things I see as needed for the home health industry to achieve the goals of true patient centered care that allows each team member to fully use their particular set of skills and expertise to assist the patients in their goal achievement. Time to dream. What are your dreams for the future of home health? Let me know. Together we make a difference. At Kenyon Homecare Consulting , we can help you achieve your clinical, operational, and financial goals. Call us today at 206-721-5091 or contact us online to see how we can help you today!

Where Are All The Home Care Staff?? Recruitment And Beyond

Mon, 15 Nov 2021 16:15:00 GMT

As we work with home care agencies all around the country, we hear this cry for caregivers all too often. With the increased aging of the population, this cry is getting louder. While different areas of the country have shortages of nurses and therapists, the largest challenge is hiring home care aide. This class of caregiver is called different names depending on the state and the type of care the employee is providing. Since every state has their own set of rules, the caregiver designation will vary with the state except for CNA which is a federal designation and is required for certain federally funded programs.

There is evidence of a growing need for home care aides, but the biggest challenge is getting the right fit. The CNA schools are turning out multiple graduation classes a year, but many do not read or speak English enough to work in an unsupervised situation, lack the basic skills to provide care for the patient population and do not always have sufficient knowledge to recognize when the client is having issues. Therefore, health related issues are not brought to the attention of the home care agency management staff.

So where do we start? First, you need to assess the clients your home care agency serves and identify the skills and personal attributes that the home care aides will need in order to properly care for them. This includes not only skills and knowledge, but personality traits as well. Once you have identified what is needed to care for your clients, develop a profile of the ideal aide. To establish the presence of the desired traits, require all applicants to take a knowledge test of caregiving (a 50 question test is available through Kenyon Home Care Consulting) and a hands on skills test (recommended to be administered on-site or through a local nursing home). Once it is determined the applicant has the basic knowledge and skills, require that the applicant take an online personality test to determine the presence of desired personality qualities. (One such test is offered online through Steven Tweed Leading Edge called Caregiver Quality Assurance test).

If you approach hiring using the above process, the home care aides you hire will be superior and provide your clients with the quality of care that you need to protect the clients but your reputation, which helps your business grow. You will also find that 60% to 80% of home care aides that apply will not meet your requirements. If you have had a very lenient process for hiring this may come as a shock to you and a lament from your schedulers that there are not enough aides to meet your demand. In the short term that will be true. However we have found that over time, the stringent process produces a workforce of quality, dedicated and loyal employees that help with your scheduling headaches.

Building a workforce of knowledgeable, skilled, dedicated, loyal and dependable home care aides is the way to the future for home care agencies. Failure to screen and hire for excellence in the home care leads to customer complaints and in some cases litigation. We have provided expert witness services in some cases and when we did an analysis of the root cause of why the agency was sued, it was because of the agency’s failure to hire individuals with the knowledge and understanding needed to adequately care for such a frail population. Additionally, the language barrier present in almost all cases added to complexity of the situation with bad outcomes for the agency, the client, and the home care aide.

We realize that in some situations this will prove to be a difficult process to follow because the demand for services exceeds availability of home care aides. When this is the situation, we moved to plan B, developing our own training school to meet our customer needs.

If you need help with recruitment and retention or building a quality in-house educational program, Kenyon Homecare Consulting is available to help. Call us at 206-721-5091 or contact us online to see how we can help!

Strategic Planning in Home Care: Setting the Path to the Future

Mon, 15 Nov 2021 15:46:00 GMT

Planning is a critical process that every home care organization must participate in if it is to thrive. Yet so many home care agencies do not have the discipline of developing a strategic plan for their organization. We find it interesting when a home care agency does not have a strategic plan but they dismayed when they arrive at a place they did not want to go. It is at that point we are engaged to assist with problems the home care agency is now confronting. Wouldn’t it be more cost effective and less stressful to engage us in helping you develop your strategic plan BEFORE problems occur?

" Strategic planning determines where an organization is going over the next year or more, how it's going to get there and how it'll know if it got there or not." (Carter McNamara MBA, PhD)

As noted earlier, strategic planning is a process that is part of yearly activities. Many think this is a complicated and involved process. In reality, it is a simple process used to visualize your dreams for the future of your home care organization and implement the actions to make those dreams a reality. Simply put, strategic planning looks at three key points:

· The present

· The future

· The plan (how to get from the present to your future)

The Present

"As you think about where your organization is now, you want to look at your foundational elements (mission and value) to make sure there has not been a change." (My strategic plan) While missions and values do not usually change, you want to re-visit them at least yearly to determine if they need to be modified or changed. The mission and values ultimately assist the management team in selecting those opportunities that match your home care agency and rejecting those that do not fit.

In conjunction with the review of the mission and values, an assessment analysis needs to be conducted to determine the agency's current position, the strengths and weaknesses, including current threats and opportunities. This ensures that the strategic plan has a solid foundation.

The Future

This is the creative and exciting part of the process. The questions that determine the future of your home care agency are:

· Where is the home care agency going?

· What is the future that the home care agency wants to create?

The basics of sustainable competitive advantage and your vision statement help define the future for your home care business:

Sustainable competitive advantage: "Sustainable competitive advantage explains what the home care agency is best at compared to the competitors. Each home care agency strives to create an advantage that continues to be competitive over the time. What can the agency be best at? What is its uniqueness? What can the home care organization potentially do better than any other organization?" (My strategic plan)

Vision statement: "T he home care vision is formulating a picture of what the home care organization’s future makeup will be and where the organization is headed. What will the home care agency look like in 5 to 10 years from now? "(My strategic plan)

The Plan

Building the roadmap to the future is the most time consuming element of the process, yet much like the home care plan of care for our clients/patients, it is the difference between failure or success. The process begins with developing long term and short term goals, and adds assigned responsibilities and time lines for achievement to each goal.

Effectively stated goals clearly tell what your home care agency wants to accomplish, when it is to accomplish it, how the home care agency is going to do it, and who’s going to be responsible. Each goal must be specific and measurable and include realistic targets for the plan.

Achieving your goals will require an honest look at what your home care agency will need to strengthen in terms of people, operations, and resources. Keeping employees, software, or operational systems that do not support your goals is a hard process to go through, but essential if the plan is to be successful.

Building the roadmap to the future of the home care agency is more vital now in this time of great change. Once built, it must be clearly disseminated throughout the organization, operationalized, and revised frequently to assure that your home care agency is on track...and stays on track.

Assistance with strategic planning is a core service of Kenyon HomeCare Consulting . If your home care agency needs support with this process, then call Ginny Kenyon at 206-721-5091 or contact us online today!

Ten Things to Consider When Hiring A Consultant

Sat, 13 Nov 2021 16:03:00 GMT

From time to time, we all have an occasion to need some “outside” help with problems that arise in our day to day business activities. Many of us turn to a consultant or coach to assist with the issues. Hiring a consultant is much like hiring a senior level employee and should be treated with the same due diligence.

Choosing The Right Consultant For You:

How do you assure that your experience is just what was needed? What the consultant does or recommends frequently has more impact than an employee and can have long lasting effects. The interview and background review should include the following;

1. Experience: How many years has the consultant been in the home health business and at what level of responsibility? How many years was the consultant in that previous position? What does the consultant do to maintain their knowledge of the industry? Do they regularly speak at conferences or write articles? Ask for an updated resume.

2. Years as a Consultant: How many years has the consultant been in the industry consulting and can they give you references that support their ability to assist you? You will want to have a consultant that has not only experience, but also someone who understands the role of the consultant. Ask about their style and how they function in the consulting role.

3. Depth of Resources: Does the consultant work alone or do they have associates that are experts in different areas e.g. accreditation, OASIS training etc., ICD-9 coding, sales and marketing etc. With the complexity of the home care industry, it is imperative that the consultant is either an expert themselves in the area you need assistance or have associates who are expert in the area. Ask for their background as it relates to the area of practice you need assistance with or who of their associates will be providing this service.

4. Culture Sensitivity: Interview the consultant for their ability to be sensitive to culture. If you have a culture based in religious beliefs or one of bottom line practice, it is important that the consultant be able to modify the approach to your organization allowing them to effectively interface with staff. Construct interview questions that will elicit this information.

5. Assessment Skills: The consultant must be able to fully understand your issues and problems as you perceive them and effectively determine how much of it is perception and what is predicated on data and facts. The ability to quickly assess an organization and develop effective approaches is critical to the success of your investment. Ask how the consultant will do this assessment.

6. Personalized plans: Does the consultant use a basic plan for all contracts and modify it to meet your needs or is it a plan developed only for you and your organization? Because of culture, area of the country, structure of the organization and staff, no two agencies are alike. What works in one agency may have elements that work in yours but the plan must be personalized to your needs. Ask how the consultant prepares the recommendations for your agency.

7. Reference Checks: Can the consultant provide you with references for the type of services you provide and for the kind of assistance you need? Do they primarily specialize in Medicare services or do they offer a wide range of experience in community based services? Does their reference list reflect this?

8. Cost or Fees: Cost is of course a factor in the decision to hire one consultant over another, but should not necessarily be the deciding factor. A consultant with limited experience may take longer to provide the recommendations and then may not be what you need. This will cost more than a tenured experienced consultant may charge. In the proposal, is there evidence that the consultant is attempting to control the costs? Is there language that says for example, costs not to exceed a certain amount for specific sections of the proposal? Discuss how they can help limit the cost with the same deliverables.

9. Reporting structure: Whether you are hiring a consultant to do an interim management contract or an organizational assessment with recommendations, there needs to be an understanding in the proposal or verbally as to when the report(s) will be provided and to whom those report(s) will go. An organizational assessment with findings and recommendations is not helpful if it is delivered to the organization three or four months after the assessment. Two to three weeks is the normal expected time for such a report. If the contract is for interim management, then a monthly written or verbal report of the status of the organization and issues with a dashboard report would normally be expected. Ask the consultant how they provide reports of their findings and their time lines for such reports.

10. Follow-up : What is the follow-up plan after the initial consulting? Is it part of the fee or is there an additional cost? Follow-up to assist with the implementation of the recommendations is often critical. At this phase the most important question is are you willing to make the changes in practice and possibly staff to achieve the goals that the consultant has helped you develop? Ask how the consultant can help with that and what the additional costs may be.

Now, if you have hired the right consultant, received a great report with recommendations but never follow through, you have wasted the money and potentially some credibility with staff. You will have a couple different potential reactions from staff. Some will want to enact changes recommended by the consultant to fix problems that exist. Others will have a vested interest in not seeing any changes and may overtly or covertly try to sabotage the

changes recommended by the consultant. A good consultant can assist you not only with the implementation of the recommendations, but with strategies to achieve buy in by your staff as a whole. If you need to consider a consultant for your agency, then call kenyonhcc.com at 206-721-5091 or contact us online to see how we can help you achieve your goals.

CMS Home Health 2022 Final Rule: What Does It Mean For You Next Year?

Wed, 10 Nov 2021 18:25:00 GMT

On November 2nd 2021, the Centers for Medicare and Medicaid Services (CMS) released the final rule for home health PPS in calendar year 2022. Let's take a look at some of the bullet points included in these changes.

Final Rule for 2022:

As always, agencies are advised to review the full CMS final rule for specifics, but here are some of main items to consider:

At Kenyon Homecare Consulting , we help agencies to provide high-quality, patient-centered care that is in compliance with state and federal regulations. Should you need assistance with your agency start-up, operations, or compliance, please call us at 206-721-5091 or contact us online to see how we can help you today!

What Is The Backbone Of Your Clinical Documentation? We Lost The Meat And Potatoes Of The Visit We Used To See In Clinical Notes.

Tue, 02 Nov 2021 18:43:00 GMT

Documentation has become very cumbersome. There are certain items that must be contained in your documentation whether you provide home health or hospice services. However, with the initiation of the electronic medical record, something seems to get lost. It's the patient. We have beautiful care plans and comprehensive assessment tools available to us in our EMR, but so often the nuts and bolts of patient care isn't clear in what we document. What are we missing? It's the clinical note.

Remember When?

Many of you may not remember the days before the EMR was standard. Those of you who do will note that documentation was much simpler then. One thing was clear though, a clinical note communicated what the focus or skill of the visit was, what teaching was completed, whether the patient or caregiver verbalized understanding/ was able to return demonstrate task, and what the plan for the next visit was. It was that simple. Sure, there were notations if a physician was called or an order was taken, but it was normally easy to know what was happening with the patient over the course of many visits.

How Do We Fix It?

Well, it begins with streamlining the EMR. When we go into agencies, we see an EMR with everything activated in a patient assessment. Now, we are not suggesting you inactivate body systems but you need to look at what your staff is required to document each visit. Staff should go into depth on certain body systems where it makes sense for the patient. But, if your assessments are excessively comprehensive, do you miss the focus of the visit altogether? If you are an agency that has eliminated a clinical note, then how does staff know what happened in previous visits without taking an inordinate amount of time to review? Do they actually do it? In a perfect world, the same nurse or therapist would see the patient every time a visit was made, but this isn't realistic especially in rural agencies. The same concept applies in hospice. Do you need a ton more data or clinically specific documentation that leads to better care that flows from visit to visit? What have you gained by eliminating a good clinical note? We would argue you have not gained anything.

At Kenyon Homecare Consulting , we help agencies to provide high quality efficient care that promotes patient satisfaction and positive profit margins. We can help with strategies to streamline your EMR and clinical operations to achieve it. Call us today at 206-721-5091 or contact us online to speak to a senior consultant for free today!

Have You Complied With Quality Reporting For Hospice? Uh Oh. It's About To Hit You Hard In The Bank Account.

Sat, 30 Oct 2021 17:48:00 GMT

Quality Reporting to CMS

Kenyon Homecare Consulting

Start Your Home Care Company Off On The Right Foot: Systematize Internal Operations Today

Tue, 26 Oct 2021 15:46:00 GMT

What Makes You Different Than The Rest Of Your Home Care and Hospice Competition? Stop And Decide What to Add Today To Secure Your Tomorrow!

Sat, 23 Oct 2021 18:25:00 GMT

An ICD 10 Code By Any Other Name Is Not The Same. Make Sure You Are Maximizing The Use Of Yours!

Tue, 19 Oct 2021 17:31:00 GMT

Kenyon Homecare Consulting

Is Your Turnover Rate Stopping You From Being Profitable? You Need To Be The Best Employer In Homecare And Fix The Problem.

Fri, 15 Oct 2021 16:18:00 GMT

Do You Need Help Now? When Is It Time To Say Yes To Interim Management?

Sat, 09 Oct 2021 19:22:00 GMT

Kenyon Homecare Consulting

Want To Sell? Is Your Agency Ready For The Store Window Or Is It Only Ready For The Clearance Rack?

Tue, 05 Oct 2021 18:02:00 GMT

Expanding Value Based Purchasing In 2022: What Does Over $300 Million More Dollars To Our Industry Look Like?

Thu, 30 Sep 2021 13:46:00 GMT

several goals

4.6 percent to quality scores and an an average annual saving to Medicare of $141 million

certification

main ones in the proposed rule

How Well Do You Engage Your Millennials? Does Keeping Them Feel Like Combat And You Are Always On The Losing End? Now, Let’s Find The Solution

Thu, 23 Sep 2021 12:26:00 GMT

21% of millennials changed jobs in the last year.

$30.5 billion each year

Gallup reports only 29% of millennials report engagement in their jobs

Bringing Gen Z To The Recruitment And Retention Table: Their Voice Can Be A Huge Part Of Your Success!

Wed, 22 Sep 2021 18:41:00 GMT

For quite some time, recruitment and retention has focused around the millennial employee. In doing so, the Gen Z employees have kind of been lost in the mix. These individuals born after 1996 are in your workforce now or getting ready to enter it. So, how do you see these post millennial employees? Do you distinguish between the millennial and post millennial in recruitment and retention? Let’s consider at what the Generation Z employees look like today.

What Do You See With Generation Z?

Today in society it is common to hear that someone has spoken their truth. This kind of defines the Gen Z individual. Whereas a Boomer or a Gen X often defines themselves attached to a larger group or mission, the Gen Z is more about the individual truth which is often defined in a more complex way. The use of social media connects people in a way that was not possible in the Boomer or Gen X world. It allows a level of inclusiveness with the Gen Z that our culture has never before been able to experience. Because of this, the Gen Z is able to communicate with different people in a way that is not confrontational when beliefs differ. The amount of information at the fingertips of these individuals is unbelievable and they have had it pretty much all their lives. So, they tend to be curious about finding out these different “truths” about different things. So, what does this mean as an employer?

Seeing Your Gen Z’s As The New Vantage Point For Success:

Reality is that the Gen Z employees are genuinely curious and capable. Gallup reports 61% of Americans think it is likely today’s youth will live better than their parents. This up is up from 44% in 2011. Consider what this means as the Gen Zs are in the workforce or getting ready to enter it. Our society is more optimistic about our Gen Z or post millennial generation than what came directly before it. So, what does this mean for you?

Utilize the strengths of these individuals to find a way to do things potentially quicker, faster, and better. They are likely to utilize social media marketing in a way you never have and can help your Gen X and Boomers with the technological aspect of the times. They are problem solvers, but may go about solving things a little differently. These employees want to understand why things are being done a certain way. It is not because they are being oppositional, but more about how their brains work. Remember, these guys are an all-inclusive group looking for answers behinds everyone’s individual truths. Keeping them from understanding why something is being done will not help with recruitment or retention in your agency. Instead work to help them understand your agency culture and operations. These employees will look elsewhere if the employment doesn’t allow them to see themselves as a valuable piece of the puzzle. They don’t want to just put in the time. The meaning behind the time is huge. They will value diversity and cultural differences. It may be challenging to merge all these different types of brain chemistry together, but exciting to see what it can do when you hone into the strengths multiple generations bring to the table.

At Kenyon Homecare Consulting , we can help you with recruitment and retention strategies within your agency. Call us today at 206-721-5091 or contact us online about how recruitment and retention can be an ongoing part of your strategic plan. We can help you put the pieces

Recruitment and Retention In Your Agency: Banging Your Head Trying To Figure Out Why It Doesn't Work?

Tue, 14 Sep 2021 15:42:00 GMT

Let's Talk Policy And Procedure Manuals: Do You Know What's In Yours Or Is It Just A Big Book You Stare At Everyday?

Sat, 04 Sep 2021 16:40:00 GMT

What Does The Choose Home Care Act of 2021 Mean For Your Agency? It Gives Home Care A Bigger Portion Of The Entire Body Of Patient Care.

Wed, 01 Sep 2021 20:53:00 GMT

analysis by Dobson, Devanzo, and Associates

Kenyon Homecare Consulting

Do You Need To Hire A Consultant For Your Agency Start-Up? Don't Try To Save A Few Dollars Now And End Up Pulling Your Hair Out Later Because Your Mistakes Keep You From Starting!

Fri, 27 Aug 2021 14:57:00 GMT

Is Nursing Butting Heads With Your ICD 10 Coders? Clinical And Nursing Practice Implications That Impact Coding.

Sat, 21 Aug 2021 18:58:00 GMT

Getting Ready For Hospice Survey In 2021 or 2022? Keep Your Eye On The Top 10 Accreditation Citations And Avoid Them!

Mon, 16 Aug 2021 17:19:00 GMT

From Time The Nursing Visit Begins To The Sync At The End, What Is Costing You More Money In Nursing Operations?

Sat, 14 Aug 2021 15:13:00 GMT

What's Your Orientation Process Like Today? When It's Over, Do People Want To Stay Or Have They Already Left?

Mon, 09 Aug 2021 16:21:00 GMT

What Are The Top 5 Things That Come To Mind When You Consider Agency Operations?

Sat, 07 Aug 2021 20:41:00 GMT

Headed For Survey in 2021 Or 2022? Avoid The Top 10 Citations And Keep Your Eye On Success!

Tue, 03 Aug 2021 19:51:00 GMT

Do You Promote Your Chronic Disease Program? Why Not? If You Can't Say It Brings You New Clients, Then It Is Time To Make A Change Today!

Sat, 24 Jul 2021 17:10:00 GMT

Kenyon Homecare Consulting

Are Your ICD 10 Coders Staying Up To Date? How Do You Know? When Is The Last Time You Asked About Changes?

Wed, 21 Jul 2021 18:24:00 GMT

ICD 10 coders need to be up-to date for compliance, accuracy, and financial reasons. Do you know how your coders keep current? Maybe you need a good check and balance to be sure.

Are Your Marketing Dollars Well-Spent Or Do You Not See A Light At The End Of The Tunnel?

Fri, 16 Jul 2021 16:18:00 GMT

We often spend money and time on ineffective marketing strategies when we should be looking closely at the dollars we spend. Consider the mistakes made in the past so you don't miss opportunity for the future.

If Are you Ready To Start You Own Agency, Then You Must Be The Head Of It. You Can't Take A Back Seat In The Process!

Tue, 13 Jul 2021 14:43:00 GMT

Kenyon Homecare Consulting

Is Home Health Aide Education Getting Too Expensive? Time To Consider Alternatives To Traditionally Having A Nurse As A Full Time Employee For Training.

Thu, 08 Jul 2021 16:37:00 GMT

Kenyon Homecare Consulting

Your ICD 10 Coder Comes Into Your Office Today And Resigns Or Has To Be Out For The Next 3 Months. What's Your Back-Up Plan?

Tue, 06 Jul 2021 16:53:00 GMT

Kenyon Homecare Consulting

Hiring The Right Clinical Manager: Its Much More Than Just Promoting Your Best Staff Nurse.

Sat, 03 Jul 2021 17:15:00 GMT

Sometimes our best clinicians are not the best managers. We need to provide these staff with the tools for them to become as good a manager as a clinician. If not, then we should keep these individuals where they thrive. Use these items to help determine if you are hiring the right person.

An ICD Code By Any Other Name Is Not The Same

Tue, 29 Jun 2021 16:52:00 GMT

This is a subtitle for your new post

The basis of an ICD 10 diagnosis code is disease tracking. Categorizing a diagnosis by a numbered system used universally allows numbers of a particular diagnosis to be tracked. This makes a lot of sense in terms of studying prevalence and potential environmental factors that may be linked to a diagnosis. Now, our system of ICD 10 involves payment and this is where our world of healthcare has had to be more particular than ever regarding the proper diagnosis code. Now comes the reason getting it right is more important than ever.

What's In An ICD 10 Code?

You may think this is a silly question, but it's not. The majority of people, even clinicians see the code only as a reimbursement tool. It certainly is, but it is more. If you polled all of your professional clinical staff as to why a diagnosis code exists, how many of them would say if is just there for reimbursement? I bet it is more than you think. The reality is that your diagnosis code should be firmly a part of the care plan used by the staff. Often the specificity of the code can lead to different interventions by clinical staff if generalities are taken off the plate. For example, when your clinical staff sees heart failure, do they look for the symptoms normally associated with left-sided failure like dyspnea on exertion, crackles in the lungs, and fatigue? What about those with right-sided failure that would experience different symptoms such as weakness, ascites, and weight gain? Left-sided failure is more common and it is often automatically what is treated in the nursing care plan. Now, while we acknowledge that there will be some overlap in intervention regardless which side is affected, being able to assess and recognize the differences are extremely important for teaching the patient and recognizing an exacerbation early.
Yes, now we will talk about the money. Having the wrong code can hurt you monetarily. It is critical to capture the code that best represents the level of specificity you are able to prove. ICD 10 coding has to be completed by certified coders who understand the intricacy of the code. They must be well-versed and keep themselves up-to-date on changes to coding rules. Nurses completing clinical care should not be responsible for coding as well. There is no way for the nurse to be a professional nurse and also be a GOOD full time clinical coder at the same time. Often we see those nurses who get certified either go full time into coding or they end up doing so much hands on care that it becomes too difficult to effectively and efficiently code. If nurses are not properly trained, then ICD 10 codes are just put in and nurses tend to pick non-specific codes. Nurses have enough to do in the homes today and the time on coding is not cost-effective.
ICD 10 coding requires clinical accuracy. This is so important for compliance. You do not want variations of a diagnosis code used because it give more reimbursement. If you are audited, then you are at risk of money being pulled back as well as a full blown audit of your organization which could put your agency at real risk if there is a pattern in the practice of upcoding. The most important thing is to have the proper documentation and find the corroboration from the MD to support what you have listed on the 485.

Let Kenyon Homecare Consulting Help Be Your Coding Experts:

At Kenyon Homecare Consulting , we have different levels of coding, documentation support, and education to help your agency maximize accuracy, reimbursement, and compliance. We can review Oasis, complete remote or in-person education, care plan review, and ICD 10 coding from our certified coding experts. Call us today at 206-721-5091 or contact us online to see how we can help you reach your coding and documentation goals.

Need Better Profit Margins In PDGM? What Did You Do To Make Your Agency Pivot During The Change?

Sat, 26 Jun 2021 18:51:00 GMT

Manage Chronic Disease From Head To Toe Within Your Agency To Maximize Use Of Your Clinical Staff

Sun, 21 Mar 2021 17:35:00 GMT

Manage Chronic Disease Effectively

There is something missing in chronic disease management today. We educate staff and push chronic disease care during staff meetings. However, the overall improvement in the patient's outcomes aren't what it should be. The problem isn't the clinician staff, but it lies in operations. Let's take a look at what we mean.

What Do You Mean It's Operations?

Let's say you are an agency that focuses a decent chunk of money into your educational programs and quality improvement. That's great, but here is what is often seen:

1. Clinicians have individual trainings (normally just the nursing staff)

2. Clinicians return to seeing patients

3. Back to the same old way of doing things

Here is what it should look like:

1. Clinical Administration has done a SWOT analysis of chronic disease management in your organization.

2. A multidisciplinary approach has been taken to education which includes all clinical disciplines including the home health aides and therapy providers.

3. Once the clinical groups are trained, then the entire clinical staff is educated on the operational flow within your organization related chronic disease management. It is Chronic Disease Management for Agencies training and this is different from the individual clinicians learning about the disease itself.

4. All clinicians will understand the change in their individual roles in chronic disease management. It will be clear to the clinicians that nursing is not wholly responsible for chronic disease management within the care plan.

5. Evaluating the process and making adjustments to improve clinical outcomes will be an ongoing part of the CQI process.

Make the Change To Better Chronic Disease Management

At Kenyon Homecare Consulting , we strive to help agencies manage chronic disease more effectively. Ultimately, this decreases overall costs made in unnecessary visits and emergent care/hospitalizations. We provide both online and onsite educational services that focus on the individual clinician as well as the agency in operations. Call us today at 206-721-5091 or contact us online to see how we can help you! And, join us for our free webinar on March 31st entitled, Don't Miss The Forest For the Trees In Your Educational Program Or You Will Lose Time And Money! Register here today!

Attention: Homecare Agencies, Don’t Educate Until You Read This!

Tue, 16 Mar 2021 17:56:00 GMT

How To Use Chronic Disease Education To Build An Elite Staff

Tue, 16 Mar 2021 17:56:00 GMT

Are You Tricking or Treating Clients With Inadequate Aide Training?

Tue, 16 Mar 2021 17:52:00 GMT

Educating Homecare Aides: What You Need to Know!

Tue, 16 Mar 2021 17:52:00 GMT

Chronic Disease Education Makes Aides Better Caregivers

Tue, 16 Mar 2021 17:52:00 GMT

Chronic Disease Management: Bridging The Gap Between Physician Care And Homecare For Improved Patient Involvement In Self-Care.

Tue, 16 Mar 2021 17:52:00 GMT

Home Care Education in 2019: Growing Clinical Knowledge And Technical Skill Is The Secret Sauce To Outcomes And Success In The Face Of Challenge!

Tue, 16 Mar 2021 17:35:00 GMT

It’s often difficult determining whether your home health agency succeeds in specific areas. In Managing Chronic Disease, weakness can be challenging from inside the organization. Evaluating Chronic

Tue, 16 Mar 2021 17:34:00 GMT

Alcohol And Chronic Disease – Safe Or Sorry?

Tue, 16 Mar 2021 17:34:00 GMT

Transitioning Your Clinical Manager Into PDGM Case Management. It’s A Whole New Ballgame And We Are In The Bottom Of The 9th!

Tue, 16 Mar 2021 17:34:00 GMT

5 Ways to Keep Documentation Training Fun

Tue, 16 Mar 2021 17:34:00 GMT

Does Your Agency REALLY Manage Chronic Diseases?

Tue, 16 Mar 2021 17:34:00 GMT

Do You Utilize Clinical Staff To Full Potential? Home Health Aides Can’t Be In The Shadow In PDGM. Position Yourself For Your Future Success!

Tue, 16 Mar 2021 17:34:00 GMT

Reasons To Not Provide Aide Advanced Disease Training

Mon, 15 Mar 2021 17:00:00 GMT

Chronic Disease Education: What Are the Game Changing Benefits?

Mon, 15 Mar 2021 17:00:00 GMT

Importance Of Chronic Disease Education To The Homecare World

Mon, 15 Mar 2021 17:00:00 GMT

Rehospitalization Outcomes: Are They Improved With Advanced Education?

Mon, 15 Mar 2021 17:00:00 GMT

What is Chronic Disease? Improve Patient Care With Knowledge!

Mon, 15 Mar 2021 17:00:00 GMT

Don’t Be A Turkey: Empower With Advanced Disease Education!

Mon, 15 Mar 2021 17:00:00 GMT

Is Staff Still Struggling With Oasis? Time To Focus On Getting It Right. PDGM Doesn’t Allow You To Error On What Should Be Second Nature To You. Decrease Your Risk For Denials And Auditing Now.

Mon, 15 Mar 2021 16:59:00 GMT

Homecare Education: Hire A Consultant That Meets Your Educational Needs. Make The Investment And Save Yourself A Whole Lot Of Headache!

Mon, 15 Mar 2021 16:59:00 GMT

Elders and Depression: Mealtime Tips to Improve Emotional Health

Mon, 15 Mar 2021 16:59:00 GMT

Quality of Home Health Care: Luxury or Essential?

Fri, 05 Mar 2021 17:38:00 GMT

9 Homecare Hacks: An Informative Cheat Sheet For Startups

Fri, 05 Mar 2021 17:38:00 GMT

Who, What, When, Where, Why & How Of An Excellent Homecare Startup

Fri, 05 Mar 2021 17:09:00 GMT

Understanding Risk In Your Homecare Population: Remember To Protect Your Patients At Risk Of Dying, Not Just From The COVID 19 Virus, But From The Effects Of The Pandemic

Wed, 03 Mar 2021 19:05:00 GMT

Branding Your Agency: What Does Your Tag Line Say About You? Is It Enough To Set You Above And Beyond The Rest?

Wed, 03 Mar 2021 19:05:00 GMT

Are You A Gambler? Are You Willing To Take Vegas Risk With Clinical Documentation Or Realize Less Can Be A Whole Lot More!

Wed, 03 Mar 2021 19:01:00 GMT

Are You Utilizing CMS COVID 19 Flexibility Or Is It Business As Usual And Tough To Maintain?

Wed, 03 Mar 2021 16:43:00 GMT

Did You Jump On Board With Medicare COP Changes Or Just Cross You Fingers And Hope For The Best? Time To Tackle Them Like A Lion And Be Prepared For Survey!

Wed, 03 Mar 2021 16:43:00 GMT

If You Were A Nurse Expert Witness, Would You Be Able To Defend Your Agency? Make Sure You Don’t Have Sweaty Palms And A Pounding Heart If You Get Called To The Witness Stand.

Wed, 03 Mar 2021 16:38:00 GMT

Do You Ever Feel Like A Dog At The Track Who Can’t Catch The Rabbit? Does It Feel Like A Never Ending Struggle In Your Home Care Agency?

Wed, 03 Mar 2021 16:38:00 GMT

Why Interim Management For Home Health Or Hospice? It May Be The Answer You Have Been Waiting For!

Wed, 03 Mar 2021 16:28:00 GMT

Succession Planning And Interim Home Care Management: Is Your Agency Ready For What Is Planned And What Isn’t?

Wed, 03 Mar 2021 16:28:00 GMT

So, You Think Your ICD 10 Diagnosis Coding Is On Point? You May Need A Back-Up Plan Soon.

Wed, 03 Mar 2021 16:24:00 GMT

As ICD Coding Becomes More Complicated, It Is Time To Outsouce So You Don’t Get Squashed Like A Bug On A Windshield

Wed, 03 Mar 2021 16:23:00 GMT

Make Sure Your Staff Wants To Be At The Party! Are You Afraid Your Recognition Strategies Still Have People Considering Leaving?

Wed, 03 Mar 2021 16:19:00 GMT

In The Game Of Recruitment And Retention, Do You Know Why You Are Losing In The 7th Inning Stretch? Want To Hold The Pennant At The End Of The 9th?

Wed, 03 Mar 2021 16:19:00 GMT

It’s Still A Problem, Right? Fixing The Policy And Procedure Manuals That Get You Every Time!

Wed, 03 Mar 2021 16:13:00 GMT

Not Excited About Policies And Procedures? When Your Business Road Map Works, It Makes For A Much Smoother Ride.

Wed, 03 Mar 2021 16:13:00 GMT

Understanding Risk In Your Homecare Population: Remember To Protect Your Patients At Risk Of Dying, Not Just From The COVID 19 Virus, But From The Effects Of The Pandemic

Wed, 03 Mar 2021 16:07:00 GMT

All The Education in The World Doesn’t Matter Without Processes In Place That Keep It From Failing

Wed, 03 Mar 2021 16:04:00 GMT

Keeping Up With Chronic Disease Care: Are You Making A Difference Or Going To End Up Last To Cross The Finish Line?

Wed, 03 Mar 2021 16:01:00 GMT

Thinking about Private Duty? Not Sure If You Want To? Check These Items Off Before You Start The Process To Make Sure You Finish Successfully!

Sun, 28 Feb 2021 23:43:00 GMT

Are You Considering Starting An Agency? How About A Technology Niche’ To Put Yourself Ahead Of Other New Guys?

Sun, 28 Feb 2021 23:39:00 GMT

Considering Starting A Homecare? Know Your Market And Your Potential Landmines

Sun, 28 Feb 2021 23:31:00 GMT

The beginning of a successful homecare, home health, or hospice agency begins with a drive towards its mission. It is often here an owner decides to jump in with both feet. If this is where you are right now, then you need to take a step back and do your homework. Whether an existing agency looking to diversify with new service lines or someone starting from scratch, knowing about the business climate around you is crucial in making sure you can succeed.

Homework Isn’t Just The Steps To Get A License:

As a long time consulting agency that has helped hundreds of agencies get their start, we have seen every level of owner engagement, preparation, and drive to making the business succeed. If you have done your research on the steps to licensure, then that is great. However, many potential owners have not even considered the competition, the market, or where to really maximize on potential referrals. This is really where you can run into a big snag. Here are some items to consider before you take the plunge:

Patient Population: In the geographic area you serve, what is the estimated number of people that are potentially in the patient demographic? You may be very rural and think that because there aren’t a lot of agencies around, you would be the main provider. If the costs to get the care to the patient means you can’t sustain the business, then there is no point to opening doors in that area.
Competition: How many agencies are providing the services you want to provide? Knowing this helps you determine what type of community-based services to provide. Maybe you start a niche market in your particular area such as Peds, Hi-tech services such as blood products and immunoglobulin infusions, or a mental health focus. What can you do to set yourself above the rest? Consider the reputation of the agencies currently serving the area. Do they have a foothold on market share?
Marketing: This has become quite the challenge in recent years. Considering many hospitals and medical facilities do not allow direct outside marketing anymore, agencies have to be creative to gain market share. New and existing business owners must consider non-traditional marketing efforts and educating local businesses and first responders on exactly what we do in this industry. There is still a large knowledge deficit out there as to what the actual potential of home and community based services can do.

Need Help Starting Or Diversifying Your Agency?

At Kenyon Homecare Consulting, we focus on high-quality, patient-focused, outcome based care. If you have questions and need help to start or diversify, we have start up packages or strictly consulting based services to get you to your goal. Call us today at 206-721-5091 or contact us online for your free 30-minute consultation. We can help you succeed

Weeding Through The Cost Of A Homecare/ Home Health Start-Up.

Sun, 28 Feb 2021 23:08:00 GMT

Kenyon Home Care Consulting

Kenyon Home Care Consulting has assisted with a number of start-up home health agencies across the country over the years. There are many questions that are asked, but we have noticed that only about 10% or less of those individuals calling have projected out the assumed cost of starting up or ask if the assumption is correct. The remaining individuals or about 90% have no idea what the cost of starting up a Home Health agency are and if they have thought about it, tend to grossly underestimate what it will take in the first year of operations. Costs of a start up home care agency vary by state as well as by the type of Home Care agency that an individual may wish to start. The least expensive is the non-skilled Home Care agency followed by the licensed skilled home care non-Medicare and finally the most expensive Medicare/Medicaid Home Health and Hospice.

We understand that one of the major reasons new businesses fail is because of lack of working capital for the start up phase of the business. The estimated cost to start up a non-skilled Private Pay Home Care agency runs about $40,000 to $80,000, Licensed Home Health non-Medicare $60,000 to $100,000 and Medicare Certified agencies $150,000 to $350,000, all depending on the state the home health agency start up is in. Much of the cost is incurred around licensing issues and regulations requiring licensed personnel, computer software and hardware, patient care non-recoverable costs paid out of the owners pocket, commercial office space. and length of time the state is out until initial review or survey. Additionally many states now require that all Medicare start up agencies go through an Accreditation organization which also adds cost and time to the start up phase.

It is recommended that anyone thinking about starting up a home care/health agency first develop a working budget for the first year. There are some basic costs that all home care start-ups share; name and logo development, policy and procedure development if in a licensed state or going for Medicare, computer software and hardware, marketing and sales, recruitment and retention, office furniture and equipment, in some states office space rental, plus telephones, office supplies and personnel costs depending on the type of agency and the state and federal rules. For the Medicare agency, the requirement of paid clinical staff to care for a minimum of ten patients has to be added in the budget as start up cost. Those monies are not recoverable from Medicare and are considered part of the startup costs. Additionally Medicare and the states will require a specified amount of money be in a bank account to prove the financial viability of the new organization. All of these elements must be in the startup budget.

There is one last budget element that must be added. The most common missed budget line is payment to the new owner. The time and energy put into starting up an agency is considerable and requires a line item for reimbursement. Starting a business is a full time job! Some of the estimated start-up costs stated above is the reimbursement that the owner will need to survive financially while the agency is getting started. Failure to include this expenditure leads many aspiring home care agency owners to work outside the start-up to generate income while they simultaneously try to start the business. This is a sure recipe for failure.

If you are considering starting up a home care/health agency and need some assistance in developing the budget, contact Kenyon Home Care Consulting for a sample budget. Or call 206-721-5091 for consulting assistance.

6 Useful Homecare Start-up Lessons: Dancing With The Stars

Mon, 20 Jul 2020 22:42:00 GMT

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“Dancing with the Stars” has been blowing viewers away for 21 seasons. What’s their secret? It’s hard to nail down one single factor that contributes to the show’s success – there are numerous things that go on behind the scenes, things we as viewers can’t even comprehend. Just as with all the great shows on television, embarking on a homecare start-up takes time, dedication, and a whole lot of work. But the return is well worth the investment.

Comparing “Dancing with the Stars” and a Homecare Start-up

To get you headed in the right direction, here are six lessons from “Dancing with the Stars” that can be applied to your homecare start-up efforts.

Lesson 1: Production Begins With a Plan

Behind every amazing production – whether it’s a million-viewer show or a homecare start-up – is loads of planning. For a show like “Dancing with the Stars,” that planning includes finding the right cast, staging, practicing and much more.

When launching your homecare agency, planning means determining the services you’ll offer, finding a place to hang your hat, meeting licensing requirements and hiring staff. But before you do any of that, it’s crucial to perform adequate market research. This research will help you make the rest of those important decisions.

Lesson 2: Promotion Creates Buzz

A show – and a homecare agency – can’t succeed without the proper promotion. With a major show, promotion is TV ads and social media. But how do you promote your homecare start-up before it’s even launched?

Creating a buzz around your agency before it opens is one of the best ways to ensure success. Here are a few ideas:

Network with medical professionals in your community and let them know about your plans

Place ads with your launch date in local publications

Speak with an industry expert for more ideas

Lesson 3: Community Is Key

Ever heard the expression, “it takes a village”? That’s not only true about raising a child; it’s also relevant to putting on a TV show and starting a homecare organization. TV shows require camera crews, actors (or contestants, in the case of “Dancing with the Stars”), directors, producers, and musicians.

For the best chance of success with your homecare start-up, surround yourself with plenty of behind-the-scenes support. What does this look like? Basically, it’s your staff. Managers, office assistants, aides, and others supporting roles all have a huge impact on the way your organization is run.

Lesson 4: Practice and Perseverance Make Perfect

We’ve all been told practice makes perfect, but that’s only partly true. Any successful producer or business owner will tell you it’s not just the practice that gets results – it’s the perseverance.

Whether it’s a big-time TV dance competition or a homecare start-up you’re pursuing, there will be times you want to give up. But the only way to attain your goals is to keep pushing. Even when that means working on your business plan past midnight!

Lesson 5: Everybody Needs a Coach

If you’ve watched “Dancing with the Stars,” you know each star gets paired with a pro dancer – a coach. These coaches not only teach their partners dance steps and correct form, but they also serve as a foundation of encouragement. Coaches push the beginners and celebrate when goals are obtained.

Engaging a coach or expert in the homecare industry to guide you through all phases of a start-up is a very powerful tool. Their knowledge and experience will pave your way toward success.

Lesson 6: The Show Must Go On

In show business, there’s a popular saying: “the show must go on.” No matter what happens offstage, the audience is waiting for a performance.

In homecare, focus on your clients – the frail and elderly – that depend on your services. No matter the effort or delays, focus on your goals. With planning, promotion, perseverance and an experienced coach your homecare start-up can be a reality!

Achieving Homecare Start-up Success

At Kenyon Home Care Consulting, we’ve got the experience and the know-how to guide you on the path toward homecare startup success. From customized forms, to recruitment strategies and aide education, we’ve got you covered. Contact us to get started now!