not for reproduction or redistribution...not for reproduction or redistribution the good, the bad,...

Not for reproduction or redistribution


The Good, the Bad, and the Ugly

Dee Kornetti PT, MA, HCS-DCindy Krafft PT, MS, HCS-O

Therapy Utilization in PDGM


• Articulate the key concepts used to calculate payment in PDGM

• Define the role of therapy in the primary diagnosis driven groups

• Identify opportunities for therapists to quantify value in the PDGM environment

Learning Outcomes


• We disagree that the PDGM diminishes or devalues the clinical importance of therapy. The musculoskeletal and neurological rehabilitation groups under the PDGM recognize the unique needs of patients with musculoskeletal or neurological conditions who require therapy as the primary reason for home health services

• For the other clinical groups, we note that the 30-day base payment amount includes therapy services, even if the primary reason for home health is not for the provision of therapy. The functional impairment level adjustment in conjunction with the other case-mix adjusters under the PDGM, aligns payment with the costs of providing services, including therapy

What About Therapy?


• PDGM based on a “regression” analysis– 2017 therapy visit volume included

– CMS reduced price value of therapy in shifting to cost report data

• PDGM is “budget neutral”– Redistribution of case mix weights to other categories– Balanced case mix should result in comparable

aggregate revenues

– Therapy related episodes may still bring profit

National Association for Home Care & Hospice, 2019

Considerations with Changes to Therapy Utilization


Therapy Utilization in PDGM

• “Medicare is no longer paying for therapy”

• “Therapists should no longer treat. Focus on teaching and no more than three visits.”

• “This is the death knell for therapy in home health”

• What do you anticipate the impact will be at your agency?


© 2019 National Association for Home Care & Hospice National Survey

How Do You Anticipate PDGM Will Impact Therapy Utilization in Your Agency?


Pre PPS Initial PPS Revised PPS

Low therapy use overall

Therapy useincreases

Therapy use increases

Less than 10 10 to 13 14+ / 20+

Therapy Track Record


Defining “Best Practice”

• APTA Guide to Practice– Guidelines for the

Provision of Physical Therapy in the Home

• AOTA Occupational Therapy Practice Guidelines– Home Health: A Guide for

Occupational Therapy Practice

• ASHA Scope of Practice in Speech-Language Pathology– ASHA Practice Policy


• ICD-10 coding

• OASIS D collaboration

• One beneficiary = one plan of care

• Reducing re-hospitalization• Maintenance therapy

Preparing for PDGM


Patient Driven Groupings Model

Claims Data

OASIS Data


Claims data

Admission Source/Timing


Claims Data: Clinical Groupings (M1021)

Clinical groups The primary reason for the home health encounter is to provide

Musculoskeletalrehabilitation

Therapy (physical, occupational, or speech) for a musculoskeletal condition

Neuro/stroke rehabilitation

Therapy (physical, occupational, or speech) for a neurological condition or stroke

Wounds: post-op wound aftercare and skin/non-surgical wound care

Assessment, treatment and evaluation of a surgical wound(s); assessment, treatment and evaluation of non-surgical wounds, ulcers, burns, and other lesions

Behavioral health care Assessment, treatment, and evaluation of psychiatric conditions

Complex nursing interventions

Assessment, treatment, and evaluation of complex medical and surgical conditions including IV, TPN, enteral nutrition, ventilator, and ostomies


Claims Data: Clinical Groupings (M1021) (cont.)

Clinical groups The primary reason for the home health encounter is to provide

Medication management, teaching, and assessment (MMTA)

MMTA: surgicalaftercare

Assessment, evaluation, teaching, and medication management for surgical aftercare

MMTA: cardiac/ circulatory

Assessment, evaluation, teaching, and medication management for cardiac or other circulatory related conditions

MMTA: endocrine Assessment, evaluation, teaching, and medication management for endocrine related conditions

MMTA: GI/GU Assessment, evaluation, teaching, and medication management for gastrointestinal or genitourinary related conditions

MMTA: infectious disease/neoplasms/ blood forming diseases

Assessment, evaluation, teaching, and medication management for conditions related to infectious diseases, neoplasms, and blood-forming diseases

MMTA: respiratory Assessment, evaluation, teaching, and medication management for respiratory related conditions

MMTA: otherAssessment, evaluation, teaching, and medication management for a variety of medical and surgical conditions not classified in one of the previously listed groups


Sequencing– List first code (M1021a), or primary code, as the diagnosis,

condition, problem, or other reason for the home health episode

• Most related to the Plan of Care,• Most acute condition, and• Requires the most intensive services (chief reason for care)

– List additional codes (M1023b-f), or secondary codes, that describe any coexisting conditions managed during the episode of care

• Must be relevant to the care delivered, or• Have potential to affect patient’s responsiveness to care

Role of the HH Clinician in Diagnosis Coding


Functional Items

• M1800 Grooming• M1810 Upper Body

Dressing• M1820 Lower Body

Dressing• M1830 Bathing• M1840 Toilet Transferring• M1850 Transferring• M1860 Ambulation• M1032 Risk of

Hospitalization

• “When coding this item, the assessing clinician may consider available input from other agency staff who have had direct patient contact”


• Response 0– Patient is safe and independent completing the task including

gathering the items needed as part of the task• Response 1

– Patient is safe and independent completing the task IF the needed items are laid out or handed to the patient (gathering eliminated)

• Response 2– In order to be safe completing the task someone else should

be involved (includes verbal cues and stand by assistance)• Response 3

– The patient is unable to participate effectively in the task– Could be physical and/or cognitive issue

Grooming and Dressing


GG0130/GG0170: Performance Assessment

Licensed clinicians may assess the patient’s performance based on direct observation (preferred) as well as reports from the patient, clinicians, care staff and/or family

When possible, CMS invites a multidisciplinary approach to patient assessment

If helper assistance is required because patient’s performance is unsafe or of poor quality, score according to amount of assistance provided

Patients with cognitive impairments/limitations may need physical and/or verbal assistance when completing an activity. Code based on the patient’s need for assistance to perform the activity safely.


Reconciling M and GG

M

GG


Reconciling M and GG (cont.)

M

GG


• Discharge goal(s) may be coded the same as SOC/ROC performance, higher than SOC/ROC performance or lower than SOC/ROC performance.

• If the SOC/ROC performance of an activity was coded using one of the activity not attempted codes (07, 09, 10 or 88) a discharge goal may be submitted using the 6-point scale if the patient is expected to be able to perform the activity by discharge.

• Licensed clinicians can establish a patient’s discharge goal(s) at the time of the SOC/ROC based on the patient’s prior medical condition, SOC/ROC assessment, self-care and mobility status, discussions with the patient and family, professional judgment, the profession’s practice standards, expected treatments, patient motivation to improve, anticipated length of stay, and the discharge plan. Goals should be established as part of the patient’s care plan.

GG0130/GG0170: Goals


Reducing re-hospitalization

Improving function

Reducing falls

• M1033: risk for hospitalization

• M1860: ambulation/ locomotion

• M1830: bathing

• M1910• Home safety

assessment

One Beneficiary: One Plan of Care

Managing medications

• M2020: management of oral medications


(M2020) Management of Oral Medications: patient's current ability to prepare and take all oral medications reliably and safely, including administration of the correct dosage at the appropriate times/intervals. Excludes injectable and IV medications. (Note: this refers to ability, not compliance or willingness.)

– 0: Able to independently take the correct oral medication(s) and proper dosage(s) at the correct times

– 1: Able to take medication(s) at the correct times if: (a) individual dosages are prepared in advance by another person or (b) another person develops a drug diary or chart

– 2: Able to take medication(s) at the correct times if given reminders by another person at the appropriate times

– 3: Unable to take medication unless administered by another person– NA: No oral medications prescribed

Oral Medication Management


(M1033) Risk for Hospitalization: which of the following signs or symptoms characterize this patient as at risk for hospitalization?

1. History of falls (2 or more falls, or any fall with an injury, in the past 12 months)

2. Unintentional weight loss of a total of 10 pounds or more in the past 12 months

3. Multiple hospitalizations (2 or more) in the past 6 months4. Multiple emergency department visits (2 or more) in the past 6 months5. Decline in mental, emotional, or behavioral status in the past 3 months6. Reported or observed history of difficulty complying with any medical

instructions (for example, medications, diet, exercise) in the past 3 months7. Currently taking 6 or more medications8. Currently reports exhaustion

Reducing Re-hospitalization


• Hospital readmission rates after acute care discharge are three times higher if physical therapist discharge recommendations are replaced with less intensive interventions

• Older adults who walk less than 4,691 steps per day over the first week post discharge are about six times more likely to be readmitted within 30 days

Falvey, JR, et al. Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community. Phys Ther. 96:8, pp 1125-1134, 2016.

Did You Know?


Fritz S. and Lusardi M. “Gait Velocity: The 6th Vital Sign” Journal of Geriatric Physical Therapy Vol. 32;2:09:2-5.

Focus on Function


• Declines in self-reported ADL ability is strongly linked to poor outcomes following hospitalization

• Older adults who return home with unmet needs for ADL assistance have a 66% increase in the odds of hospital readmission when compared to those whose needs are adequately addressed after discharge

Falvey, JR, et al. Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community. Phys Ther. 96:8, pp 1125-1134, 2016.

Did You Know?


Defining “HAD”

Multi-system decline in function partially avoidable occurrence resulting from prolonged immobility during period(s) of hospitalization

– Decline in ADL performance

– Prolonged periods of bed rest/relative inactivity

• Older adults spend about 83% of hospital stay in bed

• Older adults spend about 12% of hospital stay in chair

Falvey, JR, et al. Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift. Phys Ther. 95:9, pp 1307-1315, 2015.


Underdosing of Exercise in HAD

• Functional reserve: the capacity for older adults to handle additional stressors or illnesses without loss of independence

• Older adults discharged with poor physical function have three times the odds of being re-hospitalized within 30 days as compared to

– Older adults with medically complex conditions

– Older adults with high physical function

• Most common PAC physical therapists choose low-intensity exercises (“safer”)

Falvey, JR, et al. Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift. Phys Ther. 95:9, pp 1307-1315, 2015.


Therapy Coverage Criteria

Skills of a qualified therapist are needed to restore function

Patient’s conditionrequires a qualified therapist to design

or establish a maintenance

program

Skills of a qualified therapist are

required to perform maintenance therapy


Anatomy of a Maintenance Program


Reinforcing Therapy’s Focus on Value/Outcome

• What roles does each clinician play in these identified risks?– SN– PT– OT– HHA

• What are the key elements a patient with HF needs to focus on to prevent re-hospitalization?

Daily weights

Medication management

Dietary restrictions

Vital signs

Monitored activity


Reinforcing Therapy’s Focus on Value/Outcome: CHF

SN PT OT

Education on self management of signs

and symptoms of fluid overload

Able to safely and accurately complete daily weights/getting

on and off scale

Energy conservation during completion of

ADLs

Role of medications on cardiac

pathophysiology

Development and instruction in aerobic

exercise program

Pacing strategies during completion of

IADLs


Example: activity monitoring with cardiopulmonary clients

Reinforcing Therapy’s Focus on Value/Outcome: Care Planning

HHAProvide increased assistance with

bathingMonitor self-perceived exertion during

assisted ADLs

OTIncreased compensatory strategies with

self-care activities Reinforce strengthening program

PTPre-/post-vitals support modification

from aerobic to strengthening exercises Teach how to rate perceived exertion


Reinforcing Therapy’s Focus on Value/Outcome

• Documentation queries– Does documented care

reflect impact of care toward desired outcome(s)?

– Do goal statements reflect anticipated functional impact of improvement in/stabilization of impairments?

– Are risk areas identified on admission remediated/resolved through provision of care?

• Clinical utilization decisions– Are documented

impairments quantified using objective measurement?

– Are frequency/duration decisions supported by data interpretation, clinical judgment, and contextual factors unique to the patient?

– Are expected outcomes of care coordinated between all members of the patient’s care team?


How to Build a Culture of “Value”

Quality =Value


• Patient outcomes: Home Health Compare scores and Star Ratings

• Claims reviews: 2017 vs. 2020 utilization– Over or under utilization?

• Compliance: FCA implications if therapy cut for financial gain

• Value-based purchasing revenue impact– Such as: HHVBP

• Standards of care– Survey and certification– Malpractice lawsuits

© 2019 National Association for Home Care & Hospice

Considerations with Changes to Therapy Utilization


Kornetti and Krafft Healthcare Solutions

• Dee Kornetti: owner/founder

• [email protected]

• Cindy Krafft: owner/founder

• [email protected]

Our mission:Empower home health agencies with

revenue protection strategiesOur core values:

Innovation/trust/integrity

@DKornetti @cindy_krafft

@KornettiKrafft


Question & Answer Session

Therapy Utilization in PDGM: The Good, the Bad and the Ugly

Bibliography

MedBridge Therapy Utilization in PDGM: The Good, the Bad and the Ugly

Cindy Krafft PT, MS, HCS-O Diana (Dee) Kornetti PT, MA, HCS-D

1. Falvey, JR, et al. Rethinking Hospital-Associated Deconditioning: Proposed Paradigm

Shift. Phys Ther. 95:9, pp 1307-1315, 2015. 2. Falvey, JR, et al. Role of Physical Therapists in Reducing Hospital Readmissions:

Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community. Phys Ther. 96:8, pp 1125-1134, 2016.

3. Pierotti, Danielle, PhD, RN, CENP What Is PDGM? Home Healthcare Now: March/April 2019 - Volume 37 - Issue 2 - p 126–127.

4. https://homehealthcarenews.com/2019/02/white-paper-understanding-pdgm-preparing-for-payment-reform/. Accessed 6/6/19.

5. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM11081.pdf

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Dee KornettiPT, MA, HCS-D

Cindy KrafftPT, MS, HCS-O

Tina Marrelli, MSN, MA, RN, FAAN

Wendy Anemaet, PT, DPT, PhD, GCS, CWS, GTC, COS-C

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Stroke Rehabilitation Cases: Community Ambulation and AtaxiaJJ Mowder-Tinney, PT< PhD, NCS, C/NDT, CSRS, CEEASA

Hip Arthroplasty: Improving GaitJohn O’Halloran, PT, DPT, OCS, ATC, CSCS, Cert. MDT

Interventions for Aging Gait: Understanding Cognition and Frailty Julie Ries, PhD, MA, PT, GCS

The Impact of Aging on Functional Mobility and Gait Julie Ries, PhD, MA, PT, GCS

Exercise Prescription in the Home: Mobility, Stability, and Motor Control Wendy Anemaet, PT, DPT, PhD

What’s Up With Falling Down? Rich Briggs, PT, MA

Pharmacology for Geriatric Practice Kenneth Miller, PT, DPT, MA, GCS, CEEAA

Pain Management for Adults Susan Stralka, PT, DPT, MS

Patient-Centered Care: Motivational Interviewing and Health Coaching Tracey Collins, PT, PhD, MBA, GCS

Preventing Readmission Series (2 Courses)Heart Failure and COPD

Ellen Hillegrass, PT, EdD, CCS, FAPTARebecca Crouch, PT, DPT, CCS, FAACVPRKenneth Miller, PT, DPT, GCS, CEEAA

Dementia Types: Differentiation and Appropriate Outcome Measures for Rehabilitation Deborah Kegelmeyer, PT, DPT, MS, GCS

Evidence-Based Rehabilitation to Reduce ReadmissionsJason Falvey, PT, DPT, GCS, PhDKyle J. Ridgeway, PT, DPT

The Aging Brain: Mild Cognitive Impairment and Dementia Jennifer Bottomley, PT, MS, PhD

Functional Cognition Series (3 Courses)Cognitive Impairment, Falls, and Interventions in Rehabilitation Jennifer Bottomley, PT, MS, PhD

Balancing Training and Fall Prevention for the Active Geriatric PopulationJohn O’Halloran, PT, DPT, OCS, ATC, CSCS, Cert. MDT

Hip Stability, Core Stability, and Fall PreventionJohn O’Halloran, PT, DPT, OCS, ATC, CSCS, Cert. MDT

The Adult Learner and Implications for Patient EducationKathryn Brewer, PT, DPT, MEd, GCS, CEEAA

Balance Domains Series (3 Courses)Limits of Stability, Sensory Organization, Biomechanical Issues Andrea E. Ecsedy PT, DPT, NCS

Post Surgical Management Series (3 Courses)Haideh Plock, PT, DPT, OCS, FAAOMPT, ATC

Dysfunctional Breathing Series (2 Courses) Jacqueline Shakar, DPT, MS, PT, OCS, LT


Pediatrics: Nursing + Therapy Instructor

Behavior Management Strategies for Children with Special Needs (MSW) Deborah Boroughs, RN, MSN

Introduction to Pediatric Home Care Nursing: Children and Adolescents (MSW) Deborah Boroughs, RN, MSN

Introduction to Pediatric Home Care Nursing: Infants and Toddlers (MSW) Deborah Boroughs, RN, MSN

Pediatrics: Home Care Nursing of the Complex, Fragile Child (MSW) Deborah Boroughs, RN, MSN

Preventing Accidental Deaths of Ventilator-Dependent Patients (Coming Soon) Deborah Boroughs, RN, MSN

Growth and Development: Infancy Through AdolescenceCyndi Cortes, PhD, MSN, MRE, CPNP-PC, CRRN, COI

Overview of Pediatric Rehabilitation NursingCyndi Cortes, PhD, MSN, MRE, CPNP-PC, CRRN, COI

Rehabilitation Nursing for Common Congenital Pediatric ConditionsCyndi Cortes, PhD, MSN, MRE, CPNP-PC, CRRN, COI

Rehabilitation Nursing for Selected Acquired Pediatric ConditionsCyndi Cortes, PhD, MSN, MRE, CPNP-PC, CRRN, COI

Evaluation and Intervention of Eating and Feeding Jane O’Brien, PhD, OTR/L, FAOTA

Food Selectivity: The Pivotal Role of Parent Education Michelle Suarez, PhD, OTR/L

Orthopedic Management of the Ambulatory Child with Cerebral Palsy Dora Gosselin, PT, DPT, PCS, cNDT

Scientific Basis for Orthosis Prescription to Improve Gait in Children Lisa Selby-Silverstein, PT, PhD, NCS

Pediatric Outcomes Toolbox Series (5 Courses)Participation Measures, Risk Screens, Mobility, Evaluation, Assessment Robin Dole, PT, DPT, EdD, PCS

Clinical Excellence: PT, OT, SLP (continued) Instructor

Practical Strategies for Working with Cognitively Impaired Individuals Robert Winningham, PhD

Nutrition and Dysphagia Denise Dougerty, MA, CCC-SLP

Evaluation of the Stiff Hand Mike Szekeres, PhD, OTR, CHT

Upper Extremity Assessment: Elbow to Hand Mike Szekeres, PhD, OTR, CHT

Training and Understanding Gait in Parkinson’s Disease Series (2 Courses Heather J. Cianci, PT, MS, GCS


Hospice & Palliative Care Instructor

Hospice and Palliative Care: A Primer Rich Briggs, PT, MA

Defining Hospice Nursing: What the Best Hospice Care Looks Like (Coming Soon) Jennifer Kennedy, EdD, MA, BSN, RN, CHC

What to Expect in Hospice: The Four Levels of Care (Coming Soon) Jennifer Kennedy, EdD, MA, BSN, RN, CHC

The Role of the Hospice Team: What Does the Patient/Family Need (Coming Soon) Jennifer Kennedy, EdD, MA, BSN, RN, CHC

Overview of End of Life CarePatty Warring, RN, MSN, ACHPNLuana Krieger-Blake, BA, MSW, LCSW

Palliative Wound Care (Coming Soon)Anne Walsh, RN, MSN, APRN-BC, CWOCN, ACHPN

Palliative Care and Advance Directive After StrokeBarbara Lutz, PhD, RN, CRRN, FAHA, FNAP, FAAN

Symptom Management at End of Life Cathleen Armato, RN, CHPN, CHC, CHPCQuality in Hospice: The QAPI Fundamentals for Quality and Compliance (Coming Soon) Cathleen Armato, RN, CHPN, CHC, CHPC

Advance Directives (Coming Soon) Cathleen Armato, RN, CHPN, CHC, CHPC

Hospice and Palliative Care: Being With Loss Rich Briggs, PT, MA

Family Adjustments at End of Life Luana Krieger-Blake, BA, MSW, LCSW

Late to End Stage Neurodegenerative Disease Karen Mueller, PT, DPT, PhD

Death and Dying: Attitudes, Causes, Process, and Measures Karen Mueller, PT, DPT, PhD

Self Care: Care of the Caregiver and the Health Care Team (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

Understanding the Differences in Inpatient and Home Hospice (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

The Interdisciplinary Team in Hospice (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

Pediatric Hospice and Palliative Care (Coming Soon) Jody Chrastek, RN, DNP, CHPN, FPCN

Pediatric Bereavement (Coming Soon) Jody Chrastek, RN, DNP, CHPN, FPCN

Documenting Findings and Symptoms in Hospice (Coming Soon) TBD

Hospice Assessments and Performance Scales TBD

Patient Family and Caregiver Education and Resources (Coming Soon) TBD

Spiritual and Cultural Considerations for Chaplains Series (Coming Soon) TBD

Recruitment and Retention of Hospice Volunteers (Coming Soon) TBD

Introduction to Hospice Care for Volunteers (Coming Soon) TBD

Hospice Assessment and Admissions (Coming Soon) TBD

Spiritual Counseling and Hospice Bereavement (Coming Soon) Jay Glasgow, BS


Hospice & Palliative Care (continued) Instructor

Hospice and Palliative Care: Being With Loss Rich Briggs, PT, MA

Family Adjustments at End of Life Luana Krieger-Blake, BA, MSW, LCSW

Late to End Stage Neurodegenerative Disease Karen Mueller, PT, DPT, PhD

Death and Dying: Attitudes, Causes, Process, and Measures Karen Mueller, PT, DPT, PhD

Self Care: Care of the Caregiver and the Health Care Team (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

Understanding the Differences in Inpatient and Home Hospice (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

The Interdisciplinary Team in Hospice (Coming Soon) Lores Vlaminck, MA, BSN, RN, CHPN

Pediatric Hospice and Palliative Care (Coming Soon) Jody Chrastek, RN, DNP, CHPN, FPCN

Pediatric Bereavement (Coming Soon) Jody Chrastek, RN, DNP, CHPN, FPCN

Documenting Findings and Symptoms in Hospice (Coming Soon) TBD

Hospice Assessments and Performance Scales TBD

Patient Family and Caregiver Education and Resources (Coming Soon) TBD

Spiritual and Cultural Considerations for Chaplains Series (Coming Soon) TBD

Leadership & Management Instructor

Building Powerful Teams (Coming Soon) Linda Shell, DNP, MA, RN

Coaching and Counseling: Tips for Success (Coming Soon)Cathleen Armato, RN, CHPN, CHC, CHPCTina Marrelli, MSN, MA, RN, FAAN

Customer Centered Home Care: Everyone Has a Role (Coming Soon) Kimberly Bennett, LSW

Developing an Employee First Culture Series (3 Courses) (Coming Soon) Linda Shell, DNP, MA, RN

Enhancing Your Professional Repertoire: Effective Presentations, Writing, and Communication (Coming Soon)

Tina Marrelli, MSN, MA, RN, FAANKim Corral, RN, BSN, MA Ed, COS-C

Fundamentals of Clinical Supervision: Intersection of Management with Best Practices (Coming Soon)


Having a Professional Presence: Creating Professional Boundaries Nathalie Rennell, MSN, RN, CNE

The Impact of Effective Teams (Coming Soon) Linda Shell, DNP, MA, RN

Making a Successful Transition from Clinician to Manager: Role Development and Differentiation (Coming Soon)


Powerful Teams: The Engine that Drives the Organization (Coming Soon) Linda Shell, DNP, MA, RN

SurThriveLeadership Series (5 Courses) Linda Shell, DNP, MA, RN

Thinking Outside of the Box for Retention and Recruitment (Coming Soon) Kimberly Bennett, LSW


Orientation Courses (60 minutes)

The Home Health Aide: Overview of a Very Important Role Supervision in Home Care

Home Care Documentation RequirementsAdministrative Responsibilities of the Home Health and Hospice Aide

Infection Control in Home Health and HospiceThe Team Concept in Home Care and Hospice: Working Together to Help Patients

Aide Safety in Home Health Care and HospiceSafety First: Homemaking and Housekeeping Considerations

Key Components of Home Health Care Practice The Special and Valued Skills Needed in Home Care

Inservice Courses (30 minutes)

Alzheimer’s Disease and Dementia Care Diabetes Care and Management

Amputation Care and Management Emergency Preparedness and Your Role

Arthritis Care and Management End of Life, Hospice and Palliative Care

Bone, Fracture, and Joint Replacement Care Falls in the Home

Cancer Care and Management Hazard of Immobility: Caring for Bedbound Patients

Cardiovascular Care HIPAA, Boundaries, and Ethical Behavior

Care of Children and Adolescents HIV and AIDS Care and ManagementChronic Obstructive Pulmonary Disease (COPD) Management Hoarding and Cleanliness Challenges

Chronic Renal Failure Care Home Care Documentation Requirements

Communication and Team Dynamics Infection Control and Hygiene

Depression and Mental Health Care Key Components of Home Health Care Practice

Maternal Newborn Care Pneumonia Care and Management

Nutrition, Meal Preparation, and Special Diets Pressure Ulcer and Skin Condition Care

Older Adult Care Stress Management and Self-Care for Aides

Ostomy Care Stroke and Neurological Care

Pain Management Surgical Care and Management

Patient Rights in Home Health Wound Care

Home Health Aide Orientation & Inservice ProgramTina Marrelli, MSN, MA, RN, FAAN

Available 2019

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