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Impact of Staffing Shortages on Home Health Agencies
July 2023
Overview
The biggest issue for homecare providers moving into the new year is the need for more staff. The National Association for Healthcare Quality predicts that 500,000 nurses will leave their careers in 2023, creating a one-million-nurse shortage nationwide. Employment for personal care assistants is expected to expand by 33% between 2020 and 2030, which is substantially faster than the average for all occupations.
Why is there a shortage?
Staffing shortages in the healthcare industry are the most severe challenge to the modern global healthcare system and one of the most significant healthcare hurdles. This problem is caused by several factors, including the retirement and aging of medical professionals and their move to higher-paying positions. It results in the remaining positions being vacant for an extended period. Furthermore, most young people need more motivation to devote their lives to medicine. The nursing industry still struggles with a dearth of skilled teachers, high employee turnover, and uneven workforce distribution.
As a result of medical advancements and the management of chronic conditions, individuals are now living longer. Consequently, those who reach retirement age will require healthcare for an extended period compared to previous generations. This increased demand for healthcare services, particularly from gerontologists and other specialists, highlights the need for an expanded number of general practitioners to cater to the remaining population.
What is the impact of staffing shortages on Home Health agencies?
The majority of home health operations have been adversely affected by understaffing. Despite the increasing number of patients, healthcare providers are either scarce or declining.
Compromise in Care Quality: A lack of caregivers can strain those already on the job, increasing stress and exhaustion, and lowering the standard of care. It is difficult for caregivers to give each patient individualized care and attend to their unique needs when swamped with patient caseloads. Overall, patient satisfaction and patient outcomes may suffer as a result.
Limited Availability: Staffing shortages frequently make it difficult for home health services to meet customer expectations. Patients and their families may become impatient with longer service wait times or a lack of availability. Patients may also seek alternative forms of care or experience needless hospital readmissions as a result of these delays.
Burnout and High Turnover Rates:The ongoing stress from staffing shortages can result in caregiver discontent and burnout. Heavy workloads combined with the emotional and physical stresses of the job might cause significant turnover rates among healthcare professionals. This turnover worsens the lack of staffing, which feeds the loop of inadequate staffing and subpar care.
What can Home Health agencies do to address staffing shortages?
Home Health agencies can use several ways to address staffing issues. These include stepping up recruitment efforts through various channels, providing rewarding remuneration packages, implementing employee recommendation programs, and concentrating on retention efforts. Offering flexible work alternatives, such as part-time or remote possibilities, can help employers attract and retain employees. Staff productivity can be increased by investing in training programs, working with educational institutions, and utilizing telehealth and electronic health records technologies. Creating cooperative relationships with community organizations and staffing companies can offer extra assistance. Lastly, promoting helpful policies and interacting with policymakers can address structural workforce issues. A thorough and flexible approach is essential for Home Health agencies to overcome staffing shortages.
Additionally, outsourcing some tasks is an option that Home Health providers may want to consider as they search for staffing shortage solutions. By utilizing the skills and resources of outside service providers, agencies can lessen some of the pressures related to staffing concerns while still focusing on providing patients with great care. Outsourcing can provide cost savings, operational enhancements, and improved electronic capabilities, thereby enhancing the long-term viability and sustainability of Home Health organizations.
What is Outsourcing?
Employing a third party to carry out operations typically done in-house is known as outsourcing. Businesses, including Home Health agencies, are increasingly turning to outsourcing to cut expenses, increase efficiency in administrative duties, improve coding and documentation, and expand their electronic capabilities.
How does outsourcing help the Home Health industry?
Time Management: Numerous steps can be implemented to directly address staffing shortages in Home Health businesses. Agencies can focus on time management by ensuring that additional staff successfully handle administrative activities, freeing up more time for clinicians to provide direct patient care. This strategy enables clinicians to maintain a happier workplace, lower burnout, and increase job satisfaction. By efficiently allocating resources and streamlining administrative procedures, Home Health organizations can distribute workloads more evenly among their personnel, ultimately improving patient outcomes and care quality.
Information Technology: Home Health agencies can leverage information technology to address staffing shortages effectively. With the increasing prevalence of electronic health data and billing systems, it is essential to employ outside experts who possess expertise in these technologies. By collaborating with such professionals, both internal personnel and clients can troubleshoot any technical challenges they encounter. Enlisting external help allows Home Health agencies to maintain efficient operations, reduce disruptions caused by technology issues, and free up their staff to focus on providing high-quality care to patients.
Medical Billing: Outsourcing medical billing services is a practical solution for Home Health organizations facing workforce issues. The volume and complexity of medical bills can overwhelm internal personnel, leading to mistakes and financial losses for the agency. By working with a trained team of sector experts, Home Health organizations can ensure accurate and timely processing of medical invoices and statements. Outsourcing this time-consuming operation to professionals familiar with coding and invoicing processes reduces the workload on internal staff and minimizes the possibility of billing errors. Ultimately, this improves the agency's financial management and operational effectiveness.
Clinical Services: Home Health organizations can address staffing shortages by identifying opportunities to outsource specific clinical services. Recognizing that some healthcare tasks can be assigned to outsourcing companies allows agencies to save time, money, and labor. For example, outsourcing coding and clinical documentation review can free up clinicians to focus on their core strength—patient care. By strategically outsourcing clinical services, Home Health organizations can improve resource allocation, streamline processes, and deliver effective patient care.
Scheduling Systems: The scheduling, rescheduling, and cancellation of appointments can consume a significant portion of your employees' time. Most routine appointment scheduling can be handled outside the company. By outsourcing scheduling activities, the appointment-making process can be made more efficient, resulting in lower costs for your business. Customers appreciate having someone available at all times to schedule an appointment.
How can Cliniqon help Home Health agencies?
Cliniqon is a third-party solution that provides qualified and experienced healthcare professionals to Home Health agencies. Here's how we can assist you:
Cost-efficiency: We offer competitive pricing, scalability, flexibility, cost reductions, and value-added services. We strive to provide reasonable outsourcing choices that fit within your budget and support the overall success of your business.
Security and Compliance: We prioritize data protection and address concerns related to security breaches to maintain HIPAA compliance. We employ data encryption, maintain a secure infrastructure, implement access restrictions, educate employees about confidentiality, conduct frequent audits and assessments, have incident response procedures, and engage in risk management. By working with Cliniqon, clients can trust that their sensitive data is protected by strong security measures.
Consistent Quality and Accuracy: Cliniqon ensures that all healthcare professionals in our network undergo rigorous screening and credentialing processes. This commitment to quality helps maintain a high standard of care and provides peace of mind to Home Health agencies, knowing they are working with qualified and competent professionals with up-to-date certifications. Our coders are fully certified by the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).
Transparency: We provide detailed records and performance reports, giving you visibility into your coding and billing processes. This allows you to gain a complete picture of your practice's operation. Additionally, we facilitate effective communication with your team members, ensuring seamless collaboration, cultural awareness, open lines of communication, regular updates, and dedicated client managers.
On-Demand Access to Qualified Staff: Cliniqon maintains a network of pre-screened, licensed healthcare professionals, including registered nurses, doctors, and other allied health professionals. Home Health agencies can leverage Cliniqon's platform to quickly and efficiently find and hire qualified staff as needed. This enables agencies to overcome immediate staffing gaps and ensure uninterrupted patient care.
Flexibility and Scalability: Cliniqon offers Home Health agencies the flexibility to scale their workforce up or down based on fluctuating demand. Whether due to seasonal variations or unexpected circumstances, agencies can easily access additional staff or reduce their workforce without the burden of recruitment, onboarding, and training processes.
Reduced Administrative Burden: By partnering with Cliniqon, Home Health agencies can streamline their administrative tasks related to staffing. Cliniqon can take care of payroll, compliance, scheduling, and other administrative functions, allowing agency staff to focus on delivering quality care to patients.
OASIS-E Changes and its Impact on Home Health Agencies
May 2023
Overview
Since introducing OASIS in 1999, OASIS-E constituted the most significant changes to meet the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) requirements by refining interoperability among the post-acute providers using Standardized Patient Assessment Data Elements (SPADEs).
Below are the critical areas of OASIS-E changes :
1. Restructuring of OASISOASIS sections have been reorganized and named from A to Q. Moreover, new elements have been added and grouped together with the previous OASIS-D1 elements under these OASIS sections.
- A - Administrative Section
- B - Hearing, Speech, and Vision
- C - Cognitive Patterns
- D - Mood
- E - Behavior
- F - Preferences for Customary Routine Activities
- G - Functional Status
- GG - Functional Abilities
- H - Bladder and Bowel
- I - Active Diagnoses
- J - Health Conditions
- K - Swallowing/nutritional status
- M - Skin Conditions
- N - Medications
- O - Special treatment, Procedures, Programs
- Q - Participation in Assessment and Goal Setting
OASIS-E now includes new and modified elements, while certain previous elements have been eliminated. Some of the OASIS guidance for existing elements have also been changed in lieu of these changes. Furthermore, the OASIS guidance for existing elements has been adjusted to accommodate these changes. Moreover, the newly added elements adhere to the naming convention and structure used in other post-acute care (PAC) assessment instruments. This facilitates the collection of patient assessment elements across various post-acute settings, enabling data comparison, outcome evaluation, data exchange, and quality assessment within and across PAC settings.
| Type | Elements in OASIS-D1 | Elements Added in OASIS-E | Elements Removed in OASIS-E | Change | Elements in OASIS-E |
|---|---|---|---|---|---|
| Start of Care | 158 | 59 | 14 | 45 | 203 |
| Resumption of Care | 131 | 49 | 8 | 41 | 172 |
| Recertification | 36 | 8 | 0 | 8 | 44 |
| Transfer | 22 | 1 | 1 | 0 | 22 |
| Death at Home | 9 | 0 | 0 | 0 | 9 |
| Discharge | 97 | 51 | 2 | 49 | 146 |
OASIS-E has implemented additional assessments to assess the mental status, mood, behavior, and related factors of patients, in accordance with the requirements of the IMPACT Act. These new assessments include:
1. Reconciled Medication List and Transfer (Section A): This assessment focuses on reconciling the patient's medication list during the transfer process.
2. Cognitive Patterns (Section C): This assessment aims to evaluate the patient's cognitive patterns, including their memory, attention, and decision-making abilities.
3. Signs and Symptoms of Delirium from CAM (Section C):This assessment focuses on identifying any signs and symptoms of delirium using the Confusion Assessment Method (CAM), which is a validated tool for diagnosing delirium.
4. Mood - Expansion of PHQ-2 to PHQ-9: The Patient Health Questionnaire (PHQ) is expanded from a 2-item questionnaire (PHQ-2) to a 9-item questionnaire
(PHQ-9) to comprehensively assess the patient's mood and screen for depression.
These additional assessments have been introduced to fulfill the requirements of the IMPACT Act and enhance the evaluation of mental health-related aspects in patient care.
What is the impact of OASIS-E changes on Home Health agencies?
Home Health Agency operations, quality of care, and patient outcomes were directly impacted by the OASIS-E changes. Although it improves interoperability and the transfer of health information within and across PAC settings, the estimated additional 2.5 minutes to complete the OASIS became an undeniable concern for clinicians for the past months since the introduction of OASIS-E.
What can Home Health agencies do?
Ensure Continuous Education and Training: Continuous education and training initiatives are crucial for Home Health Agencies to enhance their service quality in light of the OASIS-E changes. By providing ongoing education and training to clinicians and staff, agencies can equip them with the necessary knowledge and skills to navigate the updated requirements effectively.
Develop and Update Policies and Procedures: It is essential to review and update existing policies and procedures to align with the changes introduced by OASIS-E. Developing a streamlined process that meets the OASIS-E requirements will enable agencies to better adapt to the Home Health Value-Based Purchasing Model (HHVBP) and ensure compliance.
Establish a Reliable Coding and Quality Assurance (QA) Partnership: Collaborating with a dependable coding and QA partner will play a critical role in helping Home Health Agencies address the challenges associated with the OASIS-E changes. This partnership can assist in effectively addressing clinician pain points, such as OASIS-E documentation and other clinical aspects, allowing agencies to concentrate on delivering high-quality patient care.
By implementing these strategies, Home Health Agencies can proactively respond to the OASIS-E changes, enhance their operational efficiency, and maintain a focus on providing excellent patient care.
About Cliniqon
Cliniqon is committed to delivering Guaranteed Quality, Ensured Compliance, and Unparalleled Outcomes in Home Health agencies.
Cliniqon is a rising outsourcing business process management company with an outstanding reputation for delivering unparalleled outcomes to its clients. Cliniqon’s focus is for our partners to have peace of mind knowing that they are assured of guaranteed quality and ensured compliance throughout their journey with us.
Our thorough review process will further improve the quality of your clinical documentation, leading to accurate claims, and ensuring you receive the reimbursement you earn.
Cliniqon offers a complete and systematic approach, focused on improving the agency's quality measures and patient outcomes as we code and review OASIS. (SOC, ROC, Recertification, Transfer, and Discharge), Plan of Care, and Concurrent Documents for Star Rating Management and Survey Preparation so the agency can focus on providing high-quality care.
For more information, please visit Cliniqon or call us at 1800-826-2477 .