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Ankota: Ushering in the Next Generation of Homecare Blog

The Real Nurse Jackie Shares Life Lessons With Our Home Care Readers

Posted by Ken Accardi on Dec 29, 2014 4:03:00 PM

Ginny_Kenyon_Home_Care_Consultant

As anyone working in the various areas of the health care field probably knows, it tends to be a personal business.  That is, many of us get involved in health care because of our personal experiences with healthcare or the experiences we observed with that of a loved one.

To illustrate this point, we are reposting an article from the blog, Real Nurse Jackie, which is written by Jacqueline Vance, RNC, CDONA/LTC.

We have reposted the article below, but be sure to click the title link to follow The Real Nurse Jackie and her future posts.

With age comes wisdom ... and a sense of humor

Anyone who knows me well knows I idolize my dad. He's taught me so much that there is no way I could quantify it all.

I learned in first grade how to pronounce anesthesiologist (my dad's profession.) I learned from watching him that family is a priority. Dad waited until he finished school, finished his residency and established his specialty before having children because he wanted to spend time with us.

I learned almost every single fairy tale because Dad would act them out with my sisters and me. I learned that you never alter who you are to please people; and if they don't like you that's OK — you'll find someone who likes you just the way you are.

I learned that you are never allowed not to like someone because of their race, creed, religion, etc. After you meet someone and you don't like them, then that's OK. Dad taught use to respect all and that everyone deserves dignity.

Dad taught us things like its important to enunciate because it doesn't matter how smart you are, people won't listen if you don't speak well. Through Dad's eyes, I learned to be amazed at how the human body works and heals. And I learned that he has a heck of a sense of humor, albeit sometimes inappropriate.

My dad recently turned 90 and we had this surprise party. He was surrounded by family and friends who roasted and toasted him. It was heartwarming and validating to hear so many people say what they, too, have learned from my dad.

Then my dad stood up and gave an impromptu speech. He spoke about how much he has learned in this life. He began by declaring that a man is a measure of his friends and family and as you age, that becomes more important. He added that it is a wonderful thing to look back at your life and realize it is a gift — to recognize how delightful it is to be surrounded by family and friends. He continued in that vein until just about everyone had a tear in their eye (or a look of shock because my dad is not really “the sentimental guy”). 

And THEN he said the stuff I would expect from my dad, like, “I've learned that at the age of 90, you pee in Morse code. You just forget what the message is by the time you are done.” And, “When you're younger man, you need an adrenaline rush to feel alive. At this age, a good BM is a life validating experience!”

Yeah, that's my dad. So I keep learning from him, and now I learned that with age not only comes wisdom, but there also comes a wonderful sense of humor.

My dad was my hero and teacher when I was growing up and now he's my role model for growing older. In his unique way he teaches me how to deal with aging with grace and humor. I wish I could have 90 more years of him. I still have so much to learn.

Just keeping it real,

Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

If you're interested in another personal story, this one from one of Ankota's founders, you can read this article from a few years ago, Founder's Passion for Health Care uncovered in Daughter's Essay.

If you're interested in recieving Ankota's paper on Home Care Best Practices, 7 Habits of Highly Effective Private Duty Home Care Agencies,  just click the link. 

Increasing_Profitability_via_Care_Transitions

 

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 Ankota.

 

Topics: Home Care Blog, Home Care Best Practices, Aging in Place Technology, Health Care Stories, the real nurse jackie

6 Ways To Prep Your Home Care Agency for 2015 from Ginny Kenyon

Posted by Ken Accardi on Dec 22, 2014 2:17:00 PM

Ginny_Kenyon_Home_Care_Consultant2015 is almost here, and with the new year, some changes in the home care space that agencies should be ready to adadpt to.  Ginny Kenyon from Kenyon HomeCare Consulting, has written a forward-thinking article called 6 Ways Your Home Care Agency Startup Will Survive in 2015, that I highly reccommend that you read.

Here's a quick summary of her 6 points, but please read the full article for in-depth insight.

  1. Be Aggressive About Education
  1. Use Comprehensive Software Programs
  1. Establish a Learning Organization
  1. Utilize the “Lean” Theory of Operations
  1. Use Transformational Leadership
  1. Create Niche Services to Respond to Customer Needs

education_and_trainingAs I'm sure you noticed, Ginny suggests staying current, both through education and training of your team and with the software that you use to manage your business, as a way to survive and thrive.

If you're interested in recieving Ankota's paper on Home Care Best Practices, 7 Habits of Highly Effective Private Duty Home Care Agencies,  just click the link. 

Increasing_Profitability_via_Care_Transitions

 

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 Ankota.

 

Topics: Home Care Entrepreneurship, Home Care Blog, Home Care Best Practices, Care Coordination, Aging in Place Technology, Care Transitions, Ginny Kenyon, home care marketing

Happy Holidays from Ankota!

Posted by Ken Accardi on Dec 19, 2014 2:47:00 PM

Ankota_Team_Christmas_Photo

 

This holiday season, as we gather with loved ones, we are reminded that every day an individual is at home surrounded by the people and things that they love, their quality of life is better, and their health care costs are lower.  This time of year reinforces Ankota's top goal - To make the delivery of care more efficient and easier to coordinate.

The Ankota Team would like to wish you, our readers and clients, Happy & Healthy Holidays!  We hope you had a wonderful 2014 and we wish you the very best in 2015! 

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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 Ankota.

Topics: Private Duty Home Care Blogs, Private Duty Agency Software, Care Transitions, happy holidays

Kaiser Shares That 2,610 Hospitals Will Be Penalized $428MM for Readmissions

Posted by Ken Accardi on Dec 17, 2014 12:53:00 PM

Kaiser Health News has graciously allowed us to republish their article disclosing CMS Readmision Penalties for 2015.  Without further adieu, here's the article: 

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

By Jordan Rau, Kaiser Health News

 Kaiser Health News (KHN) is a nonprofit national health policy news service. 

Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show. Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

The federal government’s penalties, which begin their third year this month, are intended to jolt hospitals to pay attention to what happens to their patients after theyReadmission_Vicious_Circle leave. Around the country, many hospitals are replacing perfunctory discharge plans—such as giving patients paper instructions—with more active efforts, such as ensuring that outside doctors monitor their recoveries and giving supplies of medication to patients who may not be able to afford them. Others are still struggling to meet the new expectations. Before the program, some hospitals resisted such efforts because they weren’t paid for the services, and, in fact, benefited financially when a patient returned.

Last year, nearly 18 percent of Medicare patients who had been hospitalized were readmitted within a month. While that is lower than past years, roughly 2 million patients return a year, costing Medicare $26 billion. Officials estimate $17 billion of that comes from potentially avoidable readmissions.

Under the new fines, three-quarters of hospitals that are subject to the Hospital Readmissions Reduction Program are being penalized. That means that from Oct. 1 through next Sept. 30, they will receive lower payments for every Medicare patient stay —  not just for those patients who are readmitted. Over the course of the year, the fines will total about $428 million, Medicare estimates.

More than 1,400 hospitals are exempted from the penalties, including certain cancer hospitals and critical access hospitals, as well as facilities dedicated to specific services such as psychiatry or rehabilitation. Maryland hospitals are also excluded because the state has a unique payment arrangement with Medicare. The fines are based on readmissions from July 2010 through June 2013.

In New Jersey, every hospital but one will lose money this year. So will a majority of hospitals in 28 other states, including California, Florida, Georgia, Illinois, Massachusetts, New York, Ohio, Pennsylvania, Tennessee and Texas, as well as the District of Columbia, according to a Kaiser Health News analysis of the penalties.

Pay_fines

While some penalties are as small as a hundredth of a percent, hospitals with the highest readmission rates are losing 3 percent of each payment, an increase from a maximum punishment of 2 percent last year. The increase brings the top penalties to the full force authorized by the federal health law.

The 39 hospitals where payments will be lowered by 3 percent include a number of specialty surgical hospitals, small community hospitals and the Pennsylvania Hospital, a major teaching facility. The hospital, founded in 1751 by Benjamin Franklin and Dr. Thomas Bond, is part of Penn Medicine. Hospital officials did not immediately respond to a request for comment.

Another 496 hospitals will lose 1 percent or more of their Medicare payments. Those include Northwestern Memorial Hospital and Rush University Medical Center in Chicago, Beth Israel Medical Center in Manhattan, Tufts Medical Center in Boston, and a few satellite hospitals owned by well-respected systems, including the Mayo Clinic and Geisinger Health System.

Medicare levied penalties against 433 more hospitals than it did last year. The average penalty this year is 0.63 percent, up from 0.38 percent last year, according to the KHN analysis.

Two More Conditions Added

One reason for the higher and more widespread fines is that this year Medicare began evaluating readmissions of two new categories of patients—those initially admitted for elective knee or hip replacements, and those suffering lung ailments such as chronic bronchitis. Those patients were assessed along with the heart failure, heart attack and pneumonia patients Medicare has examined since the penalties began in October, 2012

Heart

A hospital was fined if it had higher than expected readmission rates in any category. Thus, a number of specialty hospitals that focus on hip and knee replacements received fines for theq first time because readmissions of those patients are now being assessed, the KHN analysis found. Fines increased for each condition where rates were above Medicare’s expectations. “Every time they add conditions, the penalties go up,” said Nancy Foster, a quality expert at the American Hospital Association.

Dr. Stephen Jencks, a consultant who was one of the first researchers to document the nation’s high readmission rates, said he was impressed overall by how much the fines have prompted hospitals to concentrate on their patients’ health after discharge. “This really fairly modest step” of penalties has “persuaded a lot of hospitals to talk in ways they simply were not talking 10 years ago,” he said.

Dr. Don Goldmann, chief medical and science officer at the Institute for Healthcare Improvement, a Massachusetts nonprofit, cautioned against attributing the drop in readmissions only to the penalties, since the government also has other, less punitive programs underway. “There’s so much at play,” Goldmann said. “I’d be careful about imputing the reduction to any one intervention.”

As the penalties have played out, an increasing number of prominent experts are voicing concerns that the punishments are too harsh and doled out unfairly. For one thing, Readmission_Arm_BandsMedicare lowers payments to hospitals even if they have reduced their readmission rates from the previous year—so long as their rate is still higher than what the government believes is appropriate for that hospital. Medicare uses the national readmission rate to help decide what appropriate rates for each hospital, so to reduce their fines from previous years or avoid them altogether, hospitals must not only reduce their readmission rates but do so better than the industry did overall.

“You have to run as fast as everyone else to just stay even,” Foster said. Only 129 hospitals that were fined last year avoided a fine in this new round, the KHN analysis found.

Medicare officials, however, consider the competition good motivation for hospitals to keep on tackling readmissions and not to become complacent with their improvements.

Another concern about the program is that safety-net hospitals that treat large numbers of low-income patients have been more likely to receive penalties, in part because poor patients face financial and logistical challenges that make them more likely to get sicker after discharge than others, even if the hospital is trying to oversee their recuperations.

Much of the formula that calculates the fines was written into the health law, and Medicare has maintained it cannot unilaterally change it. The Medicare Payment Advisory Commission, which makes recommendations to Congress, has urged that the government compare hospitals to similar ones—academic medical centers to each other, for instance—when assessing penalties.

bill

Experts convened by the National Quality Forum, a nonprofit that evaluates measures the government uses, also endorsed the idea of taking socio-economic status into account in creating many different health care metrics. The forum said it will test the approach. Meanwhile, bills are pending in both houses of Congress that would make Medicare consider socio-economic status of a hospital’s patients when calculating fines.

The Obama administration has raised concerns that assuming safety-net hospitals will do poorer in avoiding readmissions might encourage lower expectations for the quality of care for low-income patients. Some experts fear that hospitals with many readmissions are providing substandard care and should not be let off the hook.

“Low [socio-economic status] patients do often—but not always—have worse outcomes, and yet we know they are often exposed to lower quality of care, whether that’s the places that they go or the access to care that have,” said Dr. Susannah May Bernheim, director of quality measurement at the Yale School of Medicine’s Center for Outcomes Research and Evaluation, which created the method Medicare uses to count readmissions. However, she said, “it is important to understand that safety net providers both may be more vulnerable to payment penalties and may in fact need more than average resources to achieve good outcomes for their patients.”

‘It’s A Quagmire’

study published this month in The Joint Commission Journal on Quality and Patient Safety examined eight safety-net hospitals to see how they were handling readmissions. The researchers found that most of the hospitals’ leaders were concerned about the penalties, with one telling interviewers that they expected “the penalty will get bigger and bigger and then other payers [such as private insurance companies] are going to pick up on it.”

The program was popular among nurses and doctors, with one saying “we understand, we know the importance of it,” that “in order to get a response from administration, you have to penalize.”

The researchers, led by Dr. Karen Joynt and other current and former academics at Harvard’s school of public health and the medical school, discovered that one of the eight hospitals was not trying to cut readmissions because its financial stability would be undermined by fewer patients.  “It’s a quagmire,” an anonymous hospital official was quoted in the study as saying. “If you affect the population correctly, you will reduce both readmissions and overall admissions, which is good for the patient but financially bad for the hospital.”

Gina Kaurich, director of client-care services at the Cincinnati-based FirstLight HomeCare, one of many companies offering to help hospitals prevent readmissions, said she has seen hospitals take various approaches in light of the penalties. Some have tried to care for returning patients without readmitting them overnight so Medicare does not count their cases, she said. Others have assigned their own nurses to visit patients at home shortly after discharge to ensure the patients are properly taking care of themselves. Still others hire private companies like hers, which sends nurse assistants to homes.

“Before the penalties and the focus, I believe the hospitals were quite well aware of this, and a readmission almost was something that was expected,” Kaurich said. “It was [considered] part of the disease process.”

jrau@kff.org

Read more about this story’s methodology, view the average impact on each state, and download hospital data as a printable PDF or CSV spreadsheet.

This article was produced by Kaiser Health News with support from The SCAN Foundation. 

Increasing_Profitability_via_Care_Transitions

If you're interested in learning more about how your agency can benefit from a Care Transitions initiative, you can download our free White Paper, Increasing Profitability via CareTransitions. 

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 Ankota.

Topics: Care Coordination Payments, Care Coordination, transitional care, Care Transitions, kaiser, medicare, readmission penalties

Many Seniors Report Disabilities: What Can We Learn From This?

Posted by Ken Accardi on Dec 15, 2014 10:30:00 AM

This short news article in HealthDay gives us the insight that 40 percent of seniors have reported a disability.  The study behind the article focuses on disabilities including hearing, sight, thinking and memory, walking, self-care and independent living.  It draws from data via the census bureau.

Ted_talk

Reading this article has made me think about a few different things:

  • There's an organization called TED (www.ted.org) whose mission is to share good ideas around the world.  The cornerstone of their content is in the form of TED Talks, which are 15 minute lectures by experts on topics where they have expertise.  One such TED talk, given by British researcher Aubrey de Grey, outlines a plan to overcome aging.  Putting aside whether or not it's a good idea, it's certainly interesting.  You can watch it here.
  • The second thought that this conjures is a discussion with the person who sold Long Term Care Insurance to me and my wife. We arranged for coverage for both of us but that transfers to the surviving spouse after one passes away.  One piece of advice that she gave was to start using your benefits when you're eligible (when you need help with at least two activities of daily living (ADLs).  In her experience, people are inclined to save their benefits for later, but indicated that once an individual needs help with two or more ADLs, that life expectancy is generally 4 years or less, so she encourages us to use them when the time comes.
  • Last is the most simple and possibly the most compelling thought.  There's a quote on a poster in my gym with a quote attributed to Dr. Kenneth Cooper that says "We do not stop exercising because we grow old - we grow old because we stop exercising."  That's pretty compelling.

Exercise

So far, no human has figured out how to live forever, but there is compelling evidence that part of the aging process and associated disabilities comes from lack of exercise.  This could be exercising the body or exercising the mind.  So the take away for home care is to encourage your care givers to help their clients exercise their body and mind.  Take them for a walk and play some Scrabble.  It will likely pass the time faster and more enjoyably and you may just be increasing their life.

If you're interested in recieving our 7 Habits of Highly Effective Private Duty Home Care Agencies, just click the link.  If you're interested in learning more about how your agency can benefit from a Care Transitions initiative, you can download our free White Paper, Increasing Profitability via CareTransitions. 

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 Ankota.

Increasing_Profitability_via_Care_Transitions

 

Topics: Home Care Blog, Care Coordination, Care Transitions, HealthDay, Long term care insurance, TED talk

Walgreens Positioning to Be a Major Health Care Information Hub

Posted by Ken Accardi on Dec 8, 2014 5:05:00 PM

A few months ago, we shared that Walgreens pharmacy had entered the Care Transitions business with a program to help avoid readmissions.  You can read the article here.  In a nutshell, they saw some opportunities in the Care Transition space.

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To start, Walgreen's understands that a couple of the key reasons patients are readmitted is that they don't fill their meds or they have the wrong meds.  Guess what?  Walgreens can provide the meds that they need and make some money at it (note that the program doesn't require that the patient get their meds from Walgreens).  

It also seems that Walgreens pictures the future of health care and knows the critical role that they can play in helping avoid hospitalizations.  I admire their vision and their resolve, and remain optimistic that the home care industry will borrow from their playbook.

Future_Sign_ExitCare Transitions is only the beginning for Walgreens.  According to this article in Forbes,  They recognize that healthcare is undergoing a transformation that will include new players and new ways of doing business.  They are determined to being one of those key players and they are putting technology at the core of their strategy.

"Walgreens is looking to improve its whole operating model from end to end" - Walgreens CIO Tim Theriault

Among the elements in Walgreens' strategy are the following items:

  • A cloud-based Electronic Medical Record
  • Mobile-enabled retail outlets and clinics
  • Managing immunizations and secure immunization records for Veterans
  • Expanded customer rewards programs
  • Prescription updates on cell phones
  • Use of Big Data analytics in determining consumer behavior

What Can Home Care Learn from Walgrens?

Unlike Walgreens, the home care industry isn't one company, so movement in the industry needs to come from individual agencies.  Some recommended actions for your agency are as follows:

  • Look for new roles for your agency to play in the future of healthcare.  My recommendation is to look for opportunities in managing care transitions and ongoing chronic care.
  • Think beyond the traditional boundaries of your agency and look for opportunities to collaborate and coordinate care with others (perhaps Walgreens)
  • Take a hard look at your technology and whether it will take you to where you need to go.  Specifically, can your systems share patient information, scheduling and notes with others?

It's an exciting future and the visionary leaders among you will play a key role in it.

If you're interested in learning more about how your agency can benefit from a Care Transitions initiative, you can download our free White Paper, Increasing Profitability via CareTransitions.

Increasing Profitability via Care Transitions

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 Ankota.  

 

Topics: Home Care Blog, Private Duty Agency Software, Care Coordination, Home Care, Care Transitions, Walgreens, Future of Health Care

Home Care Social Media Really Matters - Here are the Numbers

Posted by Ken Accardi on Dec 3, 2014 10:55:00 PM

How important do you consider Social Media to be in the success of your home care agency?  If your answer is something along the lines of "not so much", consider taking this opportunity to rethink it a bit.

MOZ_info_graphic

MOZ is a company that helps other companies succeed on the web and they have a useful page called, The Beginner's Guide To Social Media. 

I feel it's worthwhile for any businessperson to review.  Among the gems on the page is an infographic (shown to the left) that shares some key statistics on the subject.  

I suggest clicking through the MOZ page to view the source of each statistic.

If you're interested in finding more ways to improve your home care agency, you can download our free white paper, The Seven Habits of Highly Effective Private-Duty Home Care Agencies.  It offers folks a look at some Best Practices of what we've found successful private duty home care agencies possess. 


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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 Ankota.  

 

Topics: Home Care Blog, Private Duty Agency Software, Home Care Best Practices, Home Care, social media

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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 Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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