presented by Cindy Krafft & Diana 'Dee' Kornetti
What makes therapy care planning different in a home-based model? At face value it may seem that the delivery of therapy is fundamentally the same across all settings but being in a person’s home presents unique challenges and opportunities to maximize impact of functional ability. This course will set the stage for home based care by comparing and contrasting regulatory, care coordination and documentation expectations to facility based care.
Cindy Krafft brings more than 20 years of home health expertise that ranges from direct patient care to operational and management issues. Years spent in the homes of patients confirmed that she was in the best setting to focus on functionality and the specific challenges faced by each patient. Cindy recognizes that providing care in the home environment is different than any other setting, which is clearly evident in both her training and consultation activities. For the past 10 years, Cindy has been a nationally recognized educator in the areas of documentation, regulation, therapy utilization, and OASIS. She has served in several national projects and been an expert resource for OASIS updates. Her focus is on providing the knowledge and tools to operationalize external requirements while keeping the driver of care where it needs to be – the needs of each patient being cared for in the home setting. Cindy has been involved at the senior leadership level of the Home Health Section of the American Physical Therapy Association for more than 10 years and is the immediate past President of that organization. She has been working with APTA and CMS to clarify regulatory expectations and address proposed payment methodologies to ensure the long-term participation of therapy services in home health. She has written two books – The How-to Guide to Therapy Documentation and An Interdisciplinary Approach to Home Care – and co-authored her third, The Post-Acute Care Guide to Maintenance Therapy.
Dee Kornetti, a physical therapist for 30 years, is a past administrator and co-owner of a Medicare-certified home health agency. Dee now provides training and education to home health industry providers through a consulting business, Kornetti & Krafft Health Care Solutions. She serves as Chief Operations Officer with her business partners Cindy Krafft and Sherry Teague. Dee is nationally recognized as a speaker in the areas of home care and standardized tests and measures in the field of physical therapy, therapy training, and staff development in the home health arena. Dee is the immediate past Editor of the Quarterly Report, a publication of the American Physical Therapy Association’s (APTA) Home Health Section, as well as a member of the Home Health Section’s Practice and Education Committees. She currently serves as the President of the Home Health Section of the APTA and has been an active member in good standing since 1986. Dee currently serves as the President of the Association of Homecare Coding and Compliance, and is a member of the Association of Home Care Coders Advisory Board and Panel of Experts. Dee is a published researcher on the Berg Balance Scale, and has co-authored APTA’s Home Health Section resources related to OASIS, goal writing, and defensible documentation for the practicing therapist. Dee has contributed chapter updates to the Handbook of Home Health Care Administration 6th edition, and co-authored a book, The Post-Acute Care Guide to Maintenance Therapy. Dee received her B.S. in Physical Therapy from Boston University’s Sargent College of Allied Health Professions, and her M.A. from Rider University in Lawrenceville, NJ. Her clinical focus has been in the area of gerontology and neurological disease rehabilitation.
Home-based care is impacted by the patient-specific physical and psychosocial environment. Regulations regarding homebound status and treatment implementation impact the Medicare Part A population. The increasing focus on quality over quantity will shape the provision of both Part A and B moving forward.
Not being in the location of care provision at the same time means that coordination of care between disciplines must be an intentional activity as opposed to a product of the environment. The “one patient = one care plan” model improves the effectiveness and efficiency of the interdisciplinary team. Strategic documentation ensures all payers see clear evidence of medical necessity.
The International Classification of Function model is gaining traction in the larger healthcare community as a construct for clarity around the intertwining nature of impairments and functional ability. It provides a mechanism for acknowledging the role of the environment, which makes it particularly relevant to the provision of care in the home.
Translation of a theoretical model into real life practice takes more than an understanding of concepts. Operationalizing the International Classification of Function model in the home setting requires knowledge application to specific patient populations being served in this setting.