Do you find yourself being pulled in many directions as you juggle the needs of multiple family members? The demands of caring for a family member who has issues with memory, mobility, or other health concerns can easily become overwhelming.
Nationally approximately 20 percent of pneumonia patients and 25 percent of Congestive Heart Failure patients are readmitted to the hospital within 30 days of being discharged.
Here to discuss ways that Meritus Home Health is helping prevent unnecessary hospital readmissions is Darlene Herrod, BSN, RN. She is the Clinical Manager, Meritus Home Health.
Selected Podcast
Preventing Hospital Readmissions with Home Health Care
Featured Speaker:
Darlene Herrod, BSN, RN
Darlene Herrod, Clinical Manager at Meritus Home Health. Darlene obtained her Associate of Science in Nursing at Hagerstown Community College in 2006. She obtained her Bachelor of Science in Nursing from Notre Dame of Maryland University in 2014. Her clinical background is as a staff nurse and a nurse manager of the Comprehensive Care Unit at Western Maryland Hospital. Since 2011 Darlene has worked for Meritus Home Health as a Home Health Liaison, a Clinical Coordinator and a Clinical Manager. Transcription:
Preventing Hospital Readmissions with Home Health Care
Melanie Cole (Host): The demands of caring for a family member who has issues with memory, mobility or other health concerns can be overwhelming for any of us. My guest today, is Darlene Herrod. She’s the Clinical Manager of Meritus Home Health. Welcome to the show Darlene. So, what makes a patient eligible to receive home healthcare, because so many people need help with their loved ones when they are at home, it can be very overwhelming?
Darlene Herrod, BSN, RN (Guest): Well most of the time, home health patients are home bound. And what that means is that even though the patient can leave their home for periods of time, to go on outings such as doctors’ appointments and pharmacy, to church and those types of things; but the majority of the time is spent in their home. And the patient must be under the continuing care of a physician who is willing to work with home health to develop a treatment plan. The patient also has to have medical needs that require skilled nursing services or therapy services. The patient would have to live within our service area and if the patient has Medicare or Medicaid; they would have to have a physician perform an assessment of the patient and this is known as a face to face encounter and as a result of that face to face encounter; the physician would then order home health services.
Melanie: So, how is receiving home health care? How can it help keep a patient from being readmitted to the hospital because that’s been a problem and people get readmitted pretty quickly but how does home health help to avoid that a little bit?
Darlene: Home health looks at things in a different way and they provide a holistic approach that can help the patient improve their quality of life and improve their outcomes. Our home health nurses and therapists strive to improve communication among all the disciplines that are involved in the care and also with the patient’s physicians. When we go in to see a patient, we develop a treatment plan that’s designed to accomplish patient- centered goals and sometimes we use technology in the home to provide closer monitoring of the patient. Telehealth is frequently used for patient with congestive heart failure, COPD exacerbation and pneumonia because it has been shown to reduce readmission for these patients. Telehealth allows the case manager to have daily monitoring of the patient’s vital signs. The patient sits down and does a health check once a day and once the patient does that, that data is transmitted to a team of nurses who are trained to identify problems with the patient’s health status. When they do identify a problem, they would either contact the patient or the home health case manager or they may contact the physician to let them know what the symptoms are that the patient is having and then they come up a strategy for managing those symptoms. This type of monitoring has been proven very effective at preventing unnecessary hospitalizations and emergency room visits.
We, at home health, we work to establish strong clinical oversight. One of the things that we do to make sure that the patient is receiving all the care that they need; is we have weekly team meetings where we meet with our nurses and our therapists. They meet and they talk about the plan of care and make sure that everything is being done to ensure that the patient has a good outcome. We work closely with the patient to provide education and we work with family members and people who have been identified as caregivers. One of the biggest things that we do in home health is try to teach the patient and the family how to administer medications safely. Studies have shown that 30% of hospital admissions in the elderly are due to an adverse drug event. So, one of the things that our staff does is we work very closely with the physicians to ensure that the medications that our patients use are correct and used appropriately in the home.
Melanie: So, Darlene, as nurses learn and understand which patient populations are at greatest risk of readmissions and the things the red flags that you look for to prevent some of those; what other types of services can be provided in the home?
Darlene: We offer a wide variety of services. We offer skilled nursing care, physical therapy, and occupational therapy, speech therapy, medical social services, home health aides and registered dieticians.
Melanie: And what can that do? Do they visit in the home and work with both the caregiver and the patient?
Darlene: Yes. All of those disciplines would schedule visits with the patient in the home and they would come in and do an initial assessment and once they have assessed the patient, they would develop a plan of care, notify the physician about what the plan of care is going to be and then they will schedule with the patient for ongoing visits throughout the episode.
Melanie: And Darlene, for a caregiver, it can be difficult to know how to use oxygen machines or to know how to administer medications or IV infusion or any of these other things, a colostomy if some one has that, and the caregiver needs to know how to care for that ostomy. Is that part of home health is teaching that stuff and how to help keep things clean, keep all of that stuff working well and the oxygen machines?
Darlene: That’s one of the biggest things that our staff at home health do is really promote education. Education on disease process, education if we have a wound patient we are going to go in and educate on wound care and healing. We are going to teach the patient and the family signs and symptoms of infection and what to do if they see those signs or symptoms. We are able to care for many invasive devices in the home. We take care of central catheters, Foley catheters, PleurX catheters, wound drains, tracheostomy patients, colostomy and urostomy patients. We can care for patients who need tube feeding in the home and hydration in the home. We can administer IV antibiotics and TPN in the home. And we really believe that being cared for in the home, provides the patient with the best of both worlds. They have the comfort of their home. They feel better when they are in their home environment and they have the best skilled healthcare right at their door.
Melanie: Absolutely, now how about cost to the patient to receive home health services? Is insurance on board with that?
Darlene: Most of the services that Meritus Home Health provides are covered by Medicare and Medicaid and we also work with private insurance companies. Meritus Home Health has an insurance case manager who works with insurance companies to determine if the patient might need preauthorization and if they will have any financial responsibility for the visits that we provide. The patient will be informed of their financial responsibility usually during the first visit to the home.
Melanie: At the beginning of the segment Darlene, you mentioned Meritus Home Health service area. What is that?
Darlene: Generally, we see patients who live 30 minutes or 30 miles from our office which is located in Hagerstown Maryland. Our license allows us to see patients who live in Washington County Maryland and if the patient discharges from Meritus Medical Center; we can provide services to a small portion of Fredrick County Maryland.
Melanie: Wrap it up for us Darlene, with your best information and advice about Home Health Care and patient’s eligibility and why it so important for patients to receive home health care and why should they choose Meritus Home Health?
Darlene: Meritus Home Health makes the following pledge to all of our patients. We want to ensure that you have an excellent experience. To help you do that, it is our commitment to keep you informed and address your needs during each visit to your home by communicating important information to you regarding your plan of care, the management of your pain, and all medications and keeping your physician updated on your plan of care. This is a pledge that we take seriously, and all of our staff are steadfast in their determination in keeping this commitment to our patients.
Melanie: Thank you so much Darlene. What great work you are doing. You’re listening to Your Health Matters with Meritus Health. For more information please visit www.meritushealth.com that’s www.meritushealth.com . I’m Melanie Cole. Thanks for tuning in.
Preventing Hospital Readmissions with Home Health Care
Melanie Cole (Host): The demands of caring for a family member who has issues with memory, mobility or other health concerns can be overwhelming for any of us. My guest today, is Darlene Herrod. She’s the Clinical Manager of Meritus Home Health. Welcome to the show Darlene. So, what makes a patient eligible to receive home healthcare, because so many people need help with their loved ones when they are at home, it can be very overwhelming?
Darlene Herrod, BSN, RN (Guest): Well most of the time, home health patients are home bound. And what that means is that even though the patient can leave their home for periods of time, to go on outings such as doctors’ appointments and pharmacy, to church and those types of things; but the majority of the time is spent in their home. And the patient must be under the continuing care of a physician who is willing to work with home health to develop a treatment plan. The patient also has to have medical needs that require skilled nursing services or therapy services. The patient would have to live within our service area and if the patient has Medicare or Medicaid; they would have to have a physician perform an assessment of the patient and this is known as a face to face encounter and as a result of that face to face encounter; the physician would then order home health services.
Melanie: So, how is receiving home health care? How can it help keep a patient from being readmitted to the hospital because that’s been a problem and people get readmitted pretty quickly but how does home health help to avoid that a little bit?
Darlene: Home health looks at things in a different way and they provide a holistic approach that can help the patient improve their quality of life and improve their outcomes. Our home health nurses and therapists strive to improve communication among all the disciplines that are involved in the care and also with the patient’s physicians. When we go in to see a patient, we develop a treatment plan that’s designed to accomplish patient- centered goals and sometimes we use technology in the home to provide closer monitoring of the patient. Telehealth is frequently used for patient with congestive heart failure, COPD exacerbation and pneumonia because it has been shown to reduce readmission for these patients. Telehealth allows the case manager to have daily monitoring of the patient’s vital signs. The patient sits down and does a health check once a day and once the patient does that, that data is transmitted to a team of nurses who are trained to identify problems with the patient’s health status. When they do identify a problem, they would either contact the patient or the home health case manager or they may contact the physician to let them know what the symptoms are that the patient is having and then they come up a strategy for managing those symptoms. This type of monitoring has been proven very effective at preventing unnecessary hospitalizations and emergency room visits.
We, at home health, we work to establish strong clinical oversight. One of the things that we do to make sure that the patient is receiving all the care that they need; is we have weekly team meetings where we meet with our nurses and our therapists. They meet and they talk about the plan of care and make sure that everything is being done to ensure that the patient has a good outcome. We work closely with the patient to provide education and we work with family members and people who have been identified as caregivers. One of the biggest things that we do in home health is try to teach the patient and the family how to administer medications safely. Studies have shown that 30% of hospital admissions in the elderly are due to an adverse drug event. So, one of the things that our staff does is we work very closely with the physicians to ensure that the medications that our patients use are correct and used appropriately in the home.
Melanie: So, Darlene, as nurses learn and understand which patient populations are at greatest risk of readmissions and the things the red flags that you look for to prevent some of those; what other types of services can be provided in the home?
Darlene: We offer a wide variety of services. We offer skilled nursing care, physical therapy, and occupational therapy, speech therapy, medical social services, home health aides and registered dieticians.
Melanie: And what can that do? Do they visit in the home and work with both the caregiver and the patient?
Darlene: Yes. All of those disciplines would schedule visits with the patient in the home and they would come in and do an initial assessment and once they have assessed the patient, they would develop a plan of care, notify the physician about what the plan of care is going to be and then they will schedule with the patient for ongoing visits throughout the episode.
Melanie: And Darlene, for a caregiver, it can be difficult to know how to use oxygen machines or to know how to administer medications or IV infusion or any of these other things, a colostomy if some one has that, and the caregiver needs to know how to care for that ostomy. Is that part of home health is teaching that stuff and how to help keep things clean, keep all of that stuff working well and the oxygen machines?
Darlene: That’s one of the biggest things that our staff at home health do is really promote education. Education on disease process, education if we have a wound patient we are going to go in and educate on wound care and healing. We are going to teach the patient and the family signs and symptoms of infection and what to do if they see those signs or symptoms. We are able to care for many invasive devices in the home. We take care of central catheters, Foley catheters, PleurX catheters, wound drains, tracheostomy patients, colostomy and urostomy patients. We can care for patients who need tube feeding in the home and hydration in the home. We can administer IV antibiotics and TPN in the home. And we really believe that being cared for in the home, provides the patient with the best of both worlds. They have the comfort of their home. They feel better when they are in their home environment and they have the best skilled healthcare right at their door.
Melanie: Absolutely, now how about cost to the patient to receive home health services? Is insurance on board with that?
Darlene: Most of the services that Meritus Home Health provides are covered by Medicare and Medicaid and we also work with private insurance companies. Meritus Home Health has an insurance case manager who works with insurance companies to determine if the patient might need preauthorization and if they will have any financial responsibility for the visits that we provide. The patient will be informed of their financial responsibility usually during the first visit to the home.
Melanie: At the beginning of the segment Darlene, you mentioned Meritus Home Health service area. What is that?
Darlene: Generally, we see patients who live 30 minutes or 30 miles from our office which is located in Hagerstown Maryland. Our license allows us to see patients who live in Washington County Maryland and if the patient discharges from Meritus Medical Center; we can provide services to a small portion of Fredrick County Maryland.
Melanie: Wrap it up for us Darlene, with your best information and advice about Home Health Care and patient’s eligibility and why it so important for patients to receive home health care and why should they choose Meritus Home Health?
Darlene: Meritus Home Health makes the following pledge to all of our patients. We want to ensure that you have an excellent experience. To help you do that, it is our commitment to keep you informed and address your needs during each visit to your home by communicating important information to you regarding your plan of care, the management of your pain, and all medications and keeping your physician updated on your plan of care. This is a pledge that we take seriously, and all of our staff are steadfast in their determination in keeping this commitment to our patients.
Melanie: Thank you so much Darlene. What great work you are doing. You’re listening to Your Health Matters with Meritus Health. For more information please visit www.meritushealth.com that’s www.meritushealth.com . I’m Melanie Cole. Thanks for tuning in.