A Reflection of 2020… Giving Thanks

Giving Thanks

As I reflect back on this year, I am overwhelmed with profound gratitude for our partners and healthcare heroes that have shown devotion, bravery, and solidarity during the most challenging times in our industry. There is no doubt that this crisis has brought us all together.

HTS has remained strong as we continue to adapt and deliver the services and quality of care that our patients deserve. From utilizing telehealth technology services to providing new clinical programs focused on COVID and respiratory interventions, we are committed to providing the best patient-centered care. Together, this compliments our combined mission as we improve the lives of those entrusted to our care.

On behalf of the entire HTS Family, we express our most heartfelt thank you for choosing HTS as your partner in therapy. It is an honor to serve your organization and we are blessed to continue to provide a “hope and future” (Jeremiah 29:11) for those in our care.

 

Sincerely,

Cassie Murray, OTR, MBA, QCP

Chief Operating Officer | Chief Clinical Officer

Healthcare Therapy Services, Inc.

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New Wellness Event Toolkit

Presenting:  Staying Healthy During COVID

During this presentation, we discuss the impact COVID has had on our daily lives and overall wellness. A closer look at our emotional, social and physical wellness is discussed with strategies and tips to stay in good physical and mental shape.

Toolkit Includes:

  • VIDEO – Staying Healthy During COVID Presentation Recording
  • MARKETING FLYER – Use this flyer to advertise the presentation video airing on your community TV channel or a specialviewing in the lounge area.
  • HANDOUT – Tips to Stay in Good Physical & Mental Shape

HTS Partners can conveniently access this toolkit along with many other wellness resources under the Wellness Dashboard on HTS PartnerHQ web portal.

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Stories from the Field

Meet Denise Johnson, PT

Denise brings with her several years of field experience and a somewhat new accolade: Teletechnology Delivery Service Mode Expert. It all started back in September with a SNF COVID-19 outbreak. Implementation of telehealth as a service delivery mode became imperative after the outbreak and Denise led the charge! Denise, like many other HTS therapists, provides therapy at a few buildings. As we know all too well, due to the PHE, many facilities have implemented policies prohibiting therapists to work at mulsites in order to mitigate exposure of contagion. These types of (necessary) policies and the need for therapeutic services in a building with a COVID-19 outbreak furthermore illustrated the need for Telehealth.

So, how did Telehealth implementation begin? After the administrator of the building was made aware and approved Telehealth as a service delivery mode, the therapy team went to work on logistics. Per Denise, this is the biggest challenge with Telehealth Services. Consent forms must be received prior to treatment. Brian Kemp, PTA at Southfield Village suggests use of a binder so that all of the consent forms can be tracked and kept in one place. Once the consent form is signed and received, the person at the other end of the camera with the patient must then play their part in order to effectively provide a Telehealth session. Most often this person is a PTA/COTA. However, depending on your facility’s staffing and policy, other facility staff members are also able to fill-in. “Things like getting the camera angle right and assuring the patient is able to hear you is imperative and contributes to the effectiveness of your skilled therapeutic session” says Denise. As a seasoned PT working with Telehealth, Denise’s main concern with the newly available platform being used (Zoom) is those patients suffering from dementia. Patients with poor or limited participation poses its own set of challenges. However, for the most part, telehealth has worked and bottom line, although most therapists prefer visits to be face-to-face and hand- on, Telehealth provides an acceptable alternative to provide coverage to a population who needs it.

When specifically asked about the benefit of Telehealth as a service delivery mode, Denise emphasized and thanked the PTAs and COTAs she has worked with. For example, a therapist providing Telehealth is unable to look to quantify edema in the legs, accurately observe when a patient goes sit-to-stand, or if there is a retro bias when the patient is standing. The therapist on the other side of the Zoom video call may be missing firsthand on these clinical components and are heavily reliant on the person on the other camera who is with the patient to pick-up on these types of observations. What’s the silver lining? Well, according to Denise, the nice thing is that the therapy assistants she has worked with are even more in-tune with the global picture of what is trying to be achieved during evaluations and supervisory visits. This results in more accurate documentation and effective treatment sessions.

 

Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

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Winter Risk for Slips and Trips

Along with colder temperatures, winter brings us fresh crisp air, crackling fires, and glistening snow. Winter temperatures also pose many health risks, especially for older adults. While falls can happen year-round, winter can be increasingly hazardous for seniors with icy sidewalks and snow-covered roads. Falls can lead to hip fractures and other serious injuries. In fact, each year falls account for more than 2.8 million emergency room visits and 800,000 hospitalizations due to a fall injury.

Here are a few safety tips that everyone, especially older adults, should take this winter…

Outdoor Fall Prevention Tips:
• Wear rubber-soled shoes that provide traction on snow or ice
• Avoid walking on snow and ice by staying on designated walkways
• Try attaching an ice gripper to your cane tip
• Test potentially icy areas by tapping your foot on them
• Carry a small bag of rock salt to sprinkle on slick surfaces

Tips to Fall Safely & Prevent Injury:
Avoiding a fall all together is the best method of prevention. However, learning how to fall safely can help reduce your risk of getting injured when a fall does occur.
• Keep your body relaxed and loose
• Protect your head
• Don’t use your arms to catch yourself
• Keep your legs and arms bent to protect yourself
• Let your bottom take the hit

If you have fallen recently or are having trouble with your balance, talk with your doctor about Physical and Occupational Therapy. Our goal is to identify and address any factors that lead to falls to keep you moving safely and help prevent future falls.

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Indiana National Guard Assistance for Nursing Facilities

On October 21, 2020, Governor Holcomb and the Indiana Department of Health (IDH) announced the Indiana National Guard would be utilized for administrative and other similar tasks at nursing facilities in Indiana, in order for nursing facility staff to be able to focus their time on providing resident care.

The Indiana National Guard will be sent to nursing facilities in three phases—on November 2, November 9, and November 16—based on the need / outbreak status of the facility. Those nursing facilities in Phase 1 and Phase 2 will be assigned three guard members each, and those nursing facilities in Phase 3 will be assigned two guard members each.

Click here for all the details.
Click here to download a list of phases and locate your facility in the applicable phase.

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Stories from the Field

Meet HTS SHEro Jessica Duffy

You may be asking yourself, what exactly is a SHEro? A SHEro is a woman admired for her courage, outstanding achievements or noble qualities; a heroine. The pandemic has made it clear that HTS has been blessed with many heros and sheros but for this story from the field’s purposes we will focus on Jessica.

“Great leaders don’t set out to be a leader, they set out to make a difference. It’s never about the role…always about the goal.” Author Unknown

Jessica is an OTR and Regional Director who has been with HTS for 13 years. Like many HTS facilities, staffing became cumbersome due to a COVID-19 outbreak resulting in therapists being unable to provide therapy at multiple buildings. This has become common practice and is done in order to mitigate risk of exposure. Jessica knew there was a need and immediately jumped in to help navigate this all too familiar situation. Census soon began increasing a couple months after the pandemic began. Jessica took swift action to assist with the staffing issue which ensued. She began by facilitating and setting-up PT with telehealth treatment sessions. Jessica herself also served as the primary therapist and OTR for the facility. As she juggled her primary responsibilities to provide support and management for her region, she also provided patient care to ensure each patient received the vital therapy services needed.

“Ultimately, it is our responsibility to the patients we serve to figure out a way to make it work” said Jessica. And make it work she did! According to Jessica and the therapy team, the most challenging aspect of an outbreak within a SNF is logistics. Scheduling of patients becomes tricky at times as does assuring all precautions are appropriately taken to keep the staff and the families they return home to safe. Jessica does have a tip for other facilities going through a similar situation… over-communicate. Educating nursing staff on patient needs observed during therapy (which are constantly changing and evolving) is of utmost importance. Communication of isolation, environmental stimulation techniques, and activity engagement to combat contagion and depression risks are some examples of the training Jessica has provided facility staff members.

Jessica is encouraging fellow therapists to assure they are taking time for themselves and engaging in activities that are fulfilling. Jessica herself likes to spend time with her family outdoors which has helped her refocus during stressful, overwhelming times. Just as many of our star therapists in the field, Jessica has gone above and beyond and for that we thank her (and you)!

 

Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

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Healthy Habits to Benefit Your Brain and Body

Although research is still developing, there is strong evidence that people leading a healthy lifestyle can lower their risk of developing Alzheimer’s disease and other types of dementia. By following these tips, you can take the steps to reduce your risk of cognitive decline.

1. Cardiovascular Exercise
Incorporate physical activity that raises your heart rate and increases blood flow to your brain and body such as walking, swimming, and aerobics.

2. Brain Challenge
Stimulate your brain by playing bridge, chess, and crossword puzzles. Challenge your brain by trying something new like learning a new language or playing an instrument.

3. Healthy Diet
The Alzheimer’s Association suggests a diet that is rich in vegetables and fruits and low in fat may help to protect brain cells.

4. Laughter
Most people agree that laughing can cheer you up, but did you know laughing can lower stress hormones, stimulate your brain, and reduce stress. Tell a funny story to a friend or watch a comedy movie.

5. Sleep
During sleep, the brain is able to repair and regenerate. Quality sleep is essential for healthy brain function.

If you or someone you know is having problems with completing daily tasks, comprehension and/or expressing thoughts, please talk with a doctor. Ask your doctor if you could benefit from physical, occupational, or speech therapy.

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Stories from the Field

Featuring HTS Healthcare Hero, Kristen Stedman

Meet Kristen Stedman, a 9-year HTS veteran and a PTA at Ketcham Memorial Center.

Kristen’s healthcare hero status was further solidified by Ketcham’s Administrator, Kathy Wittmer who stated, “We wouldn’t have been able to make it through navigating the PHE without the infection control nurse and Kristen.”

Kristen displayed her commitment to the residents during the PHE in many different capacities. For example, she showed up at Ketcham everyday – regardless if she had therapy patients on her schedule or not. Specifically, Kristen was involved in helping transition patients to ambulances, checking temperatures, and answering call lights to help prioritize patient needs.

Kristen stated the most challenging part of the PHE is knowing residents who became sick and some who even passed away. Oden, Indiana (where Ketcham is located) is a small town. “Since the community is so small, we are like family,” said Kristen. As like many facilities across the nation, Ketcham’s staff pivoted to meet the needs of residents. They adapted and they did so as often as necessary. The therapy team at Ketcham was praised for many reasons with the primary being their ability to change in order to navigate these new COVID-ridden waters.

Now that the initial shock and “pivot” is over, Kristen described some other COVID-related challenges. Restorative is now working in the therapy gym side by “distanced” side. This has required some shift in scheduling. The activities department is now requiring split groups. This also presents a call to action for better communication and organization when scheduling patients attending therapy sessions. All in all, everyone at Ketcham has worked together nicely. As Kristen put it, “For other facilities that are going through this now, it is most important to stick together (with the IDT). Everyone has to work together and you have to be there for each other.”

Thank you Kristen and Ketcham Memorial Center for sharing your Story from the Field!

Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

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Common Citations During Infection Focused Surveys

Blog by:  Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

Now that routine surveys are beginning to take place in most states, it is important that vigilant infection prevention and control practices do not take a backseat to other survey-ready quality assurance activities. Notably, HHS announced a $2.0 billion payment incentive program (VBP) with $500 million per month for four months Sept. -December 2020 paid based on SNF performance in managing the rate of COVID-19 infections each month and the COVID-19 mortality rate for the month as compared to other facilities with similar community infection rates. Details are forthcoming on the specific formula to be used for distribution of funds, but it is anticipated that a facility may be excluded from receiving a portion of these funds if performing significantly worse than peers on these measures.

Click here to continue reading this blog.

 

About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

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Avoid the Survey Tag (F-866) with Five Simple Steps

By: Sheena Mattingly, Director of Clinical Outcomes

On August 26, 2020 CMS released a memo detailing COVID-19 testing requirements. In order for nursing homes to participate in Medicare and Medicaid, staff and residents need to adhere to new testing requirements. A revised survey tool for surveyors to assess nursing home compliance in this matter is also available.

See below for a list of steps that need to be taken to remain in compliance.

1. Remember, only antigen tests and PCR tests are permitted to be used to meet the testing requirement – antibody tests are not acceptable forms of testing.

2. Testing is based on three different triggers:

Symptomatic Individual Identified

  • Staff with signs/symptoms must be tested
  • Residents with signs/symptoms must be tested

Outbreak

  • Test all staff with previous negative results until no new cases identified
  • Test all residents that previously tested negative until no new cases identified

Routine Testing

  • Test staff according to County Positivity Rate in the past week
  • Resident testing not recommended unless resident leaves the facility routinely

3. Routine testing must be completed of staff according to the table below and is based on the facility’s county positivity rate in the prior week. These county-level positive rates are available here (last modified Sept. 8, 2020). The below table identifies minimum testing frequency related to the county positivity rate within the past week.

*Source: https://www.cms.gov/files/document/qso-20-38-nh.pdf

4. There is a 48-hour time requirement for results of COVID-19 testing. If for any reason, this is unable to be met, the facility should have documentation of efforts to obtain results as quickly as possible. Also, document the lab the facility is using and any contact the facility has had with local and state health departments. Criteria for the inability to meet testing result time requirements may include supply shortages, limited access, or labs failing to process tests within 48 hrs.

5. The newest F-Tag (F-866) is related to noncompliance with new testing requirements. However, if the facility has documentation supporting their attempts to adhere to new testing parameters such as timely contacting state officials and inquiries with labs that can provide results within 48 hours, then surveyors should not tag the facility. Instead, they are to inform state and/or local health departments of the facility’s lack of resources.

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