So, You Think Your ICD 10 Diagnosis Coding Is On Point? You May Need A Back-Up Plan Soon.

Kenyon HomeCare Consulting • March 3, 2021
Right now, you may have a great system in place for ICD 10 coding. Whether in-house or outsourced, it may currently run like a well-oiled machine. Today, we want to talk about about what you do if tomorrow, your system implodes. While awful to think about, it is important to know your back-up plan and have it in place.

Why You Need A Plan In Place Today:
Well, we have all seen when a small office has multiple people out at the same time. You get the call that a nurse just went to surgery unexpectedly and is going to be off for the next 6 weeks. Meanwhile, a billing person is on 3 month family leave after having a child last week. We all know that one missing cog in the well-oiled machine can change everything. It is no different in the world of ICD 10 coding. I am reminded of Dave Ramsey stating everyone needs an emergency fund/rainy day fund. Then, assuring us all that it will rain. It absolutely will! PDGM has forced agencies to be efficient in turnover from the clinical to billing processes. And let’s face it, the no pay RAP hurts. If something happens with coding operations tomorrow, then what do you have planned to do about it today?

Back-Up ICD Coding Options:
If you already use an outsource to complete your coding, then you may not see it as an issue. However, what if your designated coder is not available or something changes with that company’s ability to adequately provide services? Here are some things to consider when looking for a back-up provider:

Turnover Time: Coding companies really need to provide you data within a 24-48 hour window.

Reporting: Does the company provide valuable information to you about individual clinician competencies? Do you require any additional data? You may be paying for Oasis review, so do you receive competency data on the clinicians filling out the assessment tool? If you find that a clinician has 95% accuracy in completion of the tool, then it isn’t necessary to pay for his/her Oasis tools to be reviewed. Conversely, if you have someone who struggles, do you have the proper data to address ongoing coaching with that clinician?

Coder Dedicated To Your Agency: Your  clinicians need a point person. It becomes difficult to establish rapport with clinicians if they never interact with the same coder.
Accuracy: This one is huge. Not all coding companies are created alike. If you are in the market for a back-up coding company, ask them to code 5 of your charts for free. Compare those findings to that of your current provider. You may uncover some issues in your current system or a need to look at a different company for back-up.
Ability To Handle Surge: You know your average range of admissions, recerts, and discharges. What do typical surges look like at your agency? Make sure your coding provider can accommodate it.

Let Us Help You Get A System In Place:
Kenyon Homecare Consulting can assist with every step of the coding process including Oasis review up to review and completion of the 485s. Call us today at 206-721-5091 or contact us online to see how we can help you secure your plan for ICD 10 coding. We will provide 5 free recodes to help determine accuracy of your current system or become part of your back-up plan.a different source.

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Stroke training
By Ginny Kenyon August 12, 2026
When a patient returns home after a stroke, the clinical landscape changes instantly. Survival is just the first hurdle; the real challenge lies in navigating the complex, often unpredictable journey of rehabilitation and long-term care. For home health and home care agencies and senior care facilities, caring for a stroke survivor requires more than help with Activities of Daily Living (ADLs). Stroke can affect a patient’s neurological, physical, and emotional functioning simultaneously. That’s why specialized, stroke-specific clinical training for caregivers is essential to improving patient outcomes, supporting staff retention, and strengthening the agency’s overall performance. The Multidimensional Complexity of Post-Stroke Care A stroke is not a singular event with a linear recovery path. Depending on the location and severity of the brain injury, caregivers may confront a baffling array of concurrent deficits: Physical and Motor Deficits: Hemiparesis (one-sided weakness) or hemiplegia (one-sided paralysis) completely alters transfer techniques. Improperly moving a patient can cause severe shoulder subluxation or skin tears. Cognitive and Communication Barriers: Aphasia (difficulty speaking or understanding speech) and dysphagia (swallowing difficulties) require immense patience and highly specific intervention techniques to prevent profound frustration or life-threatening aspiration pneumonia. Neurobehavioral Changes: Sudden emotional lability, post-stroke depression, or structural personality changes can easily overwhelm an untrained caregiver, leading to burnout or adversarial dynamics in the home. Without structured education, caregivers are left to rely on intuition. In complex neurological care, intuition is rarely enough to prevent adverse events. 4 Strategic Benefits of Specialized Stroke Education Investing in robust stroke-specific training programs transforms an agency's frontline staff from general monitors into clinical assets. 1. Drastic Reduction in Hospital Readmissions The first 30 to 90 days post-discharge are high-risk windows for stroke survivors. Educated caregivers act as the eyes and ears of the clinical team. They are trained to look past basic symptoms and identify subtle warning signs early: Recognizing micro-signs of silent aspiration during meals. Monitoring for deep vein thrombosis (DVT) in affected limbs. Identifying skin breakdown early on the hemiplegic side. Spotting the warning signs of a secondary stroke using the B.E. F.A.S.T. protocol (Balance, Eyes, Face, Arms, Speech, Time). Early identification allows for timely home health or physician interventions, keeping the patient safe at home and protecting the agency's rehospitalization metrics. 2. Safeguarding Staff and Patients (Risk Mitigation) The process of transferring a patient with dense hemiparesis requires precise biomechanical knowledge. Specialized education teaches caregivers how to support the affected side without pulling on weakened joints, how to properly utilize assistive devices (gait belts, sit-to-stand lifts), and how to manage one-sided neglect (where a patient completely forgets one side of their body exists). Proper training mitigates the risk of catastrophic falls and shields caregivers from debilitating musculoskeletal injuries, directly lowering workers' compensation claims and liability exposure. 3. Boosting Staff Retention and Professional Empowerment High turnover in caregiving is often caused by burnout and feeling unprepared for challenging cases. When an agency provides specialized clinical training, helping staff understand stroke-related behaviors and advanced transfer methods, it strengthens the caregiver’s role. Staff members feel empowered, confident, and valued as professionals rather than viewed as standard domestic labor. This professional dignity translates directly into higher job satisfaction and improved staff retention. 4. A Powerful Market Differentiator In a crowded marketplace, families and hospital discharge planners look for specialized expertise. An agency that can explicitly state, "Our caregiving staff undergoes advanced, competency-verified training in post-stroke neurological care, dysphagia management, and transfer safety," holds a massive competitive advantage. It builds immediate trust with families and establishes preferred provider relationships with local health systems and stroke centers. Building a Competency-Based Training Framework Effective stroke education cannot be a passive, check-the-box exercise. To truly impact care quality, an agency's training framework should combine foundational knowledge with hands-on validation: Neurological Fundamentals Core Focus Areas: Types of strokes, one-sided neglect, emotional lability, and aphasia communication strategies. Competency Verification: Written scenario analysis and communication roleplay. Mobility & Safety Core Focus Areas: Safe transfers (bed to chair), handling the flaccid or spastic limb, fall prevention, and skin integrity. Competency Verification: Hands-on return demonstration with a mechanical lift/gait belt. Nutritional Security Core Focus Areas: Dysphagia precautions, recognizing pocketed food, fluid thickening consistency, and aspiration prevention. Competency Verification: Direct observation of meal prep and feeding techniques. Conclusion: An Investment in Excellence The care of a stroke survivor is inherently complex, demanding, and volatile. Expecting caregivers to navigate these intricacies without targeted clinical education places an unfair burden on the employee and exposes the patient and the agency to significant risk. By prioritizing advanced stroke education, agencies and facilities do more than just improve compliance; they foster a culture of clinical excellence. The results are undeniable: safer patients, more confident and loyal caregivers, and a highly respected agency brand that stands out as a leader in complex home-based care. For in-depth education on caring for a person with a stroke, contact Kenyon HomeCare Consulting, which offers an 8-hour DSHS-certified continuing education course . Each chronic disease course includes a certification with a red-and-yellow flag guide that can be laminated for caregiving staff. To learn more, call 206-721-5091 or email gkenyon@kenyonhcc.com .
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