Along a family’s care journey, circumstances can change, and clients and families may need to reassess their needs and consider whether it’s time for additional caregiver support, either on a short-term or long-term basis.

At Family & Nursing Care, Client Services Managers are here to engage with clients and families. They are with you every step of the way and can provide insight and assistance around all care decisions.

Kelly Salb, Vice President, Client Services, Kelly Ann Sharp and Natalie Blickman, Directors of Client Services, and Celina Quismorio, Director of Nursing, Family & Nursing Care Select, recently sat down to discuss their experiences in guiding clients and families through the process of arranging additional caregiver support.

Additional Support for Short-Term Needs
“It’s important for our clients and families to understand that we are flexible and able to provide support beyond what is originally scheduled when short-term needs arise,” says Salb. The team readily identified various situations which could trigger a need for additional short-term Caregiver support:

• Vacation/travel – Caregivers can travel with families to care for clients so that everyone can relax and enjoy their time together.
• Events – (weddings, reunions, graduations, etc.) – Caregivers can help clients get ready and assist them while at the event.
• Hospital/Rehab Stay – Many family caregivers dread leaving their loved ones alone in a hospital or rehab setting, even for a little while. A Caregiver can offer respite to the family members by staying with their loved one in the hospital, even overnight. Caregivers can also learn about and help clients digest information about continuing exercises, diet, and other changes needed to help the client successfully recuperate at home after discharge.
• Discharge/Recovery Support – Caregivers can accompany clients home from the hospital or rehab and/or continue to provide additional support while they recuperate at home. Caregivers can watch clients who may be a fall risk in a weakened state, remind them to take medications, and much more.
• Respite care – Caregivers can provide fill-in support while a family caregiver is away/on vacation or when they just need a break.
• Emergency/back-up care – Caregivers can provide fill-in support when a family caregiver has an emergency.
• Moving support – Moving can be a difficult adjustment for anyone. A Caregiver can offer support and assist a client in acclimating to their new home environment (especially when the move is to an assisted living community or memory care).

“I often ask family members, what would you do with your Mom or Dad if you could be here?” says Quismorio. “I explain that Caregivers can fill in for those needs – help to go up the stairs, keep them company, take them out to lunch or to the doctor. Really anything the family caregiver would like to do for their loved one but can’t because they are not available.”

Consistent Additional Support
Client Services Managers form strong relationships with their clients and keep close tabs on their changing needs. Even more importantly, they pay close attention to feedback from Caregivers on how their clients are progressing. If a Caregiver observes noticeable changes in a client’s condition, they are encouraged to share their concerns with Family & Nursing Care so that Client Services Managers can have a conversation with the client and/or family about the possibility of needing more Caregiver support. Some changes Caregivers have observed include:

• balance issues
• confusion
• depression
• poor sleep
• risk for wandering
• hygiene issues (soiled linens, household tasks not completed)
• worsening medical conditions
• forgetting to take medications

“We definitely rely on feedback from Caregivers to alert us to changes with a client’s condition. However, family members should know that if they observe changes or have concerns, we are here for them and can help talk through options for additional care,” says Sharp.

Couple Care
Salb says that clients who are already actively using Family & Nursing Care services have found a lot of value in adding couple care services. “Many clients don’t know that we offer couple care services at a much lower rate than we would charge for two individual clients,” she says. “For example, if a Caregiver is providing services for a client, and along the way the client’s spouse feels that they could use a Caregiver too – either for a short time while they recover from an illness or injury, or on a regular basis. In that case, we can set up a couple care plan.”

It should be noted that couple care is not only for spouses. Couple care plans and rates can be applied to care for any two individuals living in the same household – parent and child, siblings, friends, etc.

Family & Nursing Care in Action
A client named Pam is the primary caregiver for her husband Ron who suffers from dementia. She came to Family & Nursing Care to set up care for Ron that included a Caregiver coming to their home for four hours a day to give her some respite and time for self-care. Then one weekend, Pam fell and was admitted to the hospital. “This unexpected emergency left us panicked. Without someone reinforcing his usual routine, Ron would become confused and forget things like taking his medications, eating, and letting out the dogs,” she recalled. “Our Client Services Manager was able to quickly refer additional Caregivers to give Ron 24-hour support until I could resume my responsibilities.”

When Pam was discharged from the hospital several days later, she was still weak and tired, so the Caregivers began providing care for both Pam and her husband. When Pam regained her strength and health, they changed their schedule back to what it had been before the crisis hit.

“I was very impressed with how Family & Nursing Care’s client services helped us seamlessly change our care situation as our needs shifted. The unparalleled hands-on and emotional support from Family & Nursing Care and the exceptional care from the Caregivers made a world of difference,” said Pam.

Communication is Key
Blickman says that when it comes to working with your Client Services Manager, communication is key to a successful relationship. “We are in this together to try to provide the best outcomes for clients,” she says. “Whatever you might be thinking about, whatever questions you have, just reach out and ask. If we can’t provide the service or solution, we will offer suggestions for resources that can.” Family & Nursing Care maintains great relationships with area senior living communities, aging life care professionals, rehabilitation facilities and hospitals, and can help with guidance and resources for clients and families looking to take a next step.

From the responsiveness and flexibility of the Client Services team to the high-quality, sincere, and enthusiastic Caregivers, we offer the support, empathy and respect every family needs to navigate their care journey, through every twist and turn along the way.

CEO Neal Kursban, attended the Home Care Innovation Forum from June 4-6, 2023 in San Diego, CA, where he joined with other home care executives to connect and learn from each other, and explore new ideas, solutions, and technologies in the industry. Neal was a featured speaker at the conference where he presented on the topic of “How to Retain Your Culture While You Scale.”

At Family & Nursing Care, we don’t just talk about culture – we live it. Our staff abides by a set of 15 Guiding Values that emphasize respect, integrity, excellence, compassion, collaboration, and personalization. The Guiding Values serve as a compass for our staff, providing clear guidance on how to approach work and every interaction.

 

Re-emerging Gaps in Care
The first 48 hours after discharge from a hospital or rehab are critical to the safety and health of patients. This small window of time is when they are at their weakest, and at greatest risk for a fall or other adverse event, which can result in a return trip to the hospital. Preventing hospital readmissions following discharge greatly improves the quality of life for patients and saves our partner hospitals (and the healthcare system as a whole) a tremendous amount of money. Yet, there is often a gap in care from the time that a patient is released from the hospital until their rehabilitation or Medicare services begin.

This gap in care is at risk of being exacerbated by the May 2023 expiration of the Public Health Emergency (PHE) spurred by the COVID-19 pandemic. With the end of the PHE, the Centers for Medicare & Medicaid Services (CMS) has in turn expired their waiver of the “3-midnight rule” requiring Medicare beneficiaries to have a three-day hospitalization to be eligible for Medicare-covered skilled nursing facility (SNF) services without incurring high out-of-pocket costs.

A Changed Healthcare Landscape
During the PHE, hospitals came to rely on the “3-midnight rule” waiver to free up hospital beds and relieve overwhelmed acute care facilities during the pandemic.

Now, the Medicare rule has returned despite facing a changed healthcare landscape. Some hospitals continue to experience surges due to respiratory viruses, leading to a shortage of inpatient beds and cancellation of elective procedures. Additionally, the pandemic has led to critical shortages of healthcare workers including nursing staff and physical and occupational therapists. These workforce shortages often result in delays in starting Medicare services after hospital discharge.

One regional hospital reviewed its records for December 2022 and found that 160 patients were discharged to a SNF under Medicare who would have been sent home without the 3-midnight rule waiver in place. While advocates continue to push for the permanent establishment of the 3-midnight rule waiver, upon its expiration, hospitals will need to make sure they are complying with the reinstated rule to avoid any penalties or reimbursement issues from Medicare.

On the patient side, the reinstatement of the Medicare “3-midnight rule” impacts those who may have previously qualified for SNF coverage but may no longer meet the 3-midnight requirement. These patients may need to seek alternative care options or pay out-of-pocket for SNF care. This could be a financial burden for some patients and families, and hospitals will need to work closely with patients and their families to ensure they understand their options and can make informed decisions about their care post-discharge.

Enter Family & Nursing Care
Family & Nursing Care helps patients receive the crucial care they need as they transition home from the hospital. During the first 48 hours post discharge, when there is the most confusion and misunderstanding of needs and instructions and there are often delays in the start of Medicare or Medicaid services, there is a dramatic difference in successful transitioning between patients who utilize home care services and those who do not.

As a regional leader in providing access to compassionate and reliable home care services since 1968, Family & Nursing Care’s Hospital to Home program existed long before the COVID-19 pandemic, and continues to help ease the transition home for patients after a hospital stay.

• We can help provide a safe and comfortable environment for recovery at home with easy and quick access to home care provided by experienced and compassionate Caregivers.
• Family & Nursing Care liaisons are available to visit with patients and their families while the patient is still in the hospital or rehab facility to help them understand their options for coverage and care at home.
• Support can be on a short-term basis to help with the transition home or on a longer-term basis as needed.
• Family & Nursing Care requires no up-front deposits or long-term commitments from clients.

For instance, we partnered with Medstar Montgomery Hospital to identify patients in most need of care at home and to discuss options and set up a plan for receiving home care services upon their discharge.

In addition, a few years ago, we conducted a “Skilled Nursing Facility to Home” pilot program in conjunction with Nexus Montgomery, where we learned that even after a SNF stay, patients often experienced delays in getting home health care started following discharge due to the bureaucracy for home health agencies, including Medicare and Medicaid, in helping a new patient or client.

The Family & Nursing Care Difference
Getting a dedicated Caregiver on board to help with the transition home from the hospital or rehab can make a world of difference for patient outcomes. Caregivers not only help manage tasks of daily living such as errands, medication pick-up and reminders, groceries, meal preparation, bathing, dressing and support for those who may be at risk for a fall, but they can also help clients digest all the information given to them upon discharge.

Caregivers can also help effectively manage the patient’s specific needs by ensuring they adhere to a special diet, practice breathing techniques and required exercises, and more.

Many Caregivers have used their extensive background knowledge and training to recognize “red flag” symptoms for a client, so that post-discharge issues that can commonly lead to readmission can be treated at a lower level of care.

When hospital readmission statistics are lowered, everyone wins.

Home care company leaders are increasingly being challenged to find creative ways to solve some of the sector’s most persistent issues, while looking to thrive in a space that has more eyes on it than ever.

We are thrilled that our CEO, Neal Kursban has been included in MissionCare Collective‘s 2023 Future of Care Guidebook.

As an industry leader for 27+ years, Neal has dedicated his career to improving the lives of older adults and their families through exceptional home care services. He also recognizes the vital importance of home care companies like Family & Nursing Care making every effort to treat Caregivers with the deep appreciation and respect they deserve.

We’re proud to see Neal recognized amongst fellow senior care industry thought leaders.

If you’re interested in learning more about the future of care and the leaders who are shaping it, be sure to check out MissionCare Collective’s 2023 Future of Care Guidebook.