presented by Tina Marrelli & Kim Corral
This foundational course offering provides a big picture overview of home care. Home care comprises many models of care delivery systems and types of home care. A brief history of home care, a snapshot of where we are now by the numbers, and the differences between home care and any other health care practice setting are addressed. A holistic and practical definition of home care is also presented. Additionally, this course will also explain why having exemplary clinical, self-motivational, organizational, and people skills is key to success in home care practice and management.
Tina Marrelli is the president of Marrelli and Associates, Inc., a publishing and consulting firm working in home care for more than 30 years. Tina is the author of 13 books, including the Handbook of Home Health Standards: Quality, Documentation, and Reimbursement, (6th edition, 2018). Other books include A Guide for Caregiving: What’s Next? Planning for Safety, Quality, and Compassionate Care for Your Loved One and Yourself (2017), Hospice and Palliative Care Handbook (3rd edition, 2018), The Nurse Manager’s Survival Guide (4th edition, 2018), and the best-selling home health aide educational system, Home Health Aide Guidelines for Care: A Handbook for Care Giving at Home and its accompanying Nurse Instructor Manual. Tina served on the workgroups that defined the first hospice nurse standards as well as serving as a reviewer in 2014 for the revised Home Health Nursing: Scope and Standards of Practice through the American Nurses Association. Tina attended Duke University, where she received her undergraduate degree in nursing. She also has master’s degrees in health administration and in nursing. Tina has worked in hospitals, nursing homes, and public health and has practiced as a visiting nurse or manager in home care and hospice for more than 20 years. Tina also worked at Medicare’s central office (CMS) for four years on Medicare Part A home care and hospice policies and operations qnd served as the interim branch chief for Medicare Part B. Tina loves policy and the nuances that frame care, practice, and delivery. Tina is an international health care consultant, specializing in home care and models of care provided in the community to people at home. Tina and her team of specialized consultants have been in business since 2002 and provide services related to the “design and implementation of challenges to providing home and community-based care.” In that capacity, they have served more than 100 clients throughout the world, clients who represent varying segments of service to home care and/or related products. Services include custom presentations, software development, educational services, serving as Team Leader with a team that served as quality monitors to the OIG, accreditation services, new organizational start-ups, due diligence, feasibility studies, and more. Tina has been the editor of three peer-reviewed publications, most recently for Home Healthcare Nurse (now Home Healthcare Now), on which she served as the editor-in-chief for eight years. She is also an emeritus editor for Home Healthcare Now. In addition, Tina serves on the editorial boards of the Journal of Community Health Nursing and The American Nurse. Tina is the Chief Clinical Officer for e-Caregiving, www.e-Caregiving.com, a web-based support and educational system for family and friend caregivers created to support advocacy and improve care across the health care continuum.
Kim is a registered nurse with a master's degree in Education and over 30 years of home health experience. She is an experienced leader in home health care, having held both clinical and operational positions at regional and national levels for large corporate home health organizations. She brings a passion for providing the clinical voice of quality, while increasing efficiencies. She has extensive experience speaking for state home care associations, national home care organizations, and local home care organizations on regulatory compliance, successful strategies for clinical/operational success, OASIS data collection and strategies, quality outcome improvement, developing successful QAPI programs, documentation standards, and operational processes to support OASIS and ICD-10 accuracy.
This chapter sets the stage for why home care is so different from other practices and business settings. Because the patients and families served are "out there" in the community, this different foundational construct has implications for care delivery, operations, and management, and sometimes home care team members feel "alone" because of this. In fact, this feeling, when reported, can be addressed and supported. This chapter provides a snapshot of some quantifiable data that helps make clinicians and managers know they're part of a large and growing community.
This chapter provides a practical and working definition of holistic home care and health care services provided at home. In this chapter we address the varying models and structures of the kinds of home care programs that provide unique and specialized services.
Generally, we only go into people's homes or get invited in when we know them. The person who lives in the home and their family members are truly the "unit of care" in home care. This chapter addresses some of these differences and nuances that impact practice and operations. From a practical perspective, this means that we function on somebody else's turf and home place. Though we may have been a clinician or manager where we had operational responsibility for a large group of patients in a hospital or nursing home or other facility, it is learned that in home care, this power shifts to the patient.
This summary chapter begins by describing a home visit or a shift in home care by showing an example of a patient, an older woman with chronic conditions that demand skilled care and visits. This chapter delves into the kinds of specialties that are seen in home care, another quality and safety factor when skill-matching patients and clinicians. The topic of how to make a home visit, which, of course, has implications for any type of home care, is presented in its own 60-minute CE course offering. Similarly, there is another course offering entitled Team Member Safety in the Community and Patient Home.