Given the complexity of a home health assessment, where should the therapist start? Although the integration of electronic systems into home health have expanded the options for therapy documentation, the fundamental areas of the SOAP note continue to be the key elements for supporting medical necessity. This course will get “back to the basics” while moving practice forward by providing a structure for the S – subjective and O – objective components.
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.
Value based purchasing and outcome measurements need to be integrated into the therapy assessment and care planning process. Understanding external expectations brings a larger focus to the traditional areas covered by therapy services in the home.
Limited to absent documentation related to subjective information has led some software systems to drop that area from therapy documentation all together. Patient and caregiver provided details are critical to showing individualized care planning and response to interventions.
Choosing a formal test and measure as part of a home health assessment requires a clear understanding of the options available as well as how to administer them correctly.
No one would want to have the person hired to build a dream home arrive with a toolbox only containing a single hammer. Therapists need to have a wide range of tools available in order to be best prepared for the job of the assessment and care planning.