It’s taken two years, but in mid-April Washington’s nearly century-old Caroline Kline Galland Home opened its new home health care agency to all eligible clients in the Jewish community and to all who qualify in King County.
After complying with hundreds of federal Medicare regulations and working in close partnership with the Jewish Federation of Greater Seattle, which granted $45,000 in operating funds for the new service while it proved its competence to the state, Kline Galland earned Washington’s Department of Health certification and now offers a full continuum of healthcare services.
“This is an important program for us and a great gift that the Jewish community can give to the greater community,” Kline Galland CEO Jeff Cohen told JTNews. “Kline Galland is a five-star rated facility. If we can take that Kline Galland quality and follow it into people’s homes, we can continue to be the preferred partner of hospitals who are referring patients to us.”
To help fund the program’s transition to viability, the Jewish Federation marshaled its resources in 2011 by contacting its nearly 2,000-member Washington State Jewish Action Center mailing list, asking them to support Kline Galland’s new venture.
Hundreds of letters poured in, blowing away the competition.
“Several applicants applied to become a home-health provider,” said Cohen. “We generated over 200 letters of support from the Jewish community. Our competitor generated three.”
Currently, the Kline Galland’s rehabilitation unit is caring for 10 patients. But with the expansion of services into private homes, independent and assisted living communities, and adult family homes, Cohen said he hopes to serve hundreds, if not thousands more each year.
“The Jewish Federation sees serving the needs of our community’s elderly as a critical obligation, especially as this population grows here in Seattle,” said Nancy Greer, the Federation’s interim president and CEO. “Thanks to support raised specifically for the needs of older adults under our philanthropic model, Federation donors were vital partners in this important accomplishment for Seattle’s Jewish community.”
The Kline Galland’s newly expanded division couldn’t be more well timed. Under the new Hospital Readmissions Reduction Program added to the Social Security Act and implemented in 2012 under the Affordable Care Act, Medicare will reduce its payments to hospitals that have “excess readmissions” within 30 days of a discharge from a facility. The incentive, said Cohen, is to get people well, if possible, outside of the hospital setting.
“Hospitals are laser-beam focused on preventing these readmissions,” said Cohen. “Under Obamacare [the Affordable Care Act], hospitals are looking for partners that can help prevent these readmissions.”
In order to qualify, Medicare and most insurance companies require patients to be under the care of and referred by their doctors. Patients must also be “homebound.”
Diane Tepfer, 68, flew to Seattle for knee replacement surgery at Virginia Mason Hospital in April from her home in Washington, D.C. Tepfer spent time in Kline Galland’s rehabilitation wing before she was discharged to a temporary apartment in South Seattle, where she has been using the new home health services.
Tepfer told JTNews that as of her current nine visits from their in-home caregivers, she has been progressing, getting stronger and better every day, and learning how to take care of herself once she gets back home.
“I had physical therapy, I had occupational therapy, I had a shower aide, and I had a nurse,” Tepfer said. “They came into where I live and found ways to make it safer for ‘ADLs,’” or activities of daily living, she said.
Tepfer’s Medicare coverage and her supplemental insurance plan covered the procedure and all additional expenses, leaving her with no out-of-pocket co-pays. She said she has been impressed by the overall experience.
“I feel very fortunate to have their services,” Tepfer said. “They’re all very experienced. Sometime by the end of the month I’ll go home.”
Pam Swanborn, the program’s clinical director since May 2012, has been working as a physical therapist for 18 years, 13 of them previously in Swedish Medical Center’s home health program.
According to Swanborn, in order to qualify for in-home care, it must take “a considerable or taxing effort to leave the home, or require assistance, or it could be that there is a condition that prevents them from leaving home for safety reasons.
“Let’s say someone is at a high risk for infection, or there can be cognitive issues,” said Swanborn. “If someone has severe dementia or has memory issues, it wouldn’t be safe to leave the home without assistance. If someone is wheelchair-bound but has systems in place to allow them to get out of the home on a regular basis, then they wouldn’t qualify.”
To determine whether someone qualifies for home care, home health sends a clinician to the home to make an initial assessment.
“We try to gather all of that information over the phone before we go,” Swanborn said. “The first visit typically takes about an hour and a half. It’s a comprehensive assessment — cardiac, respiratory, musculoskeletal, full vitals testing, a comprehensive medication review, a fall-risk assessment, that looks at whether they have any incontinence issues or balance issues, do they have any vision impairments, hearing impairments, and any mobility issues, like whether or not they can get in and out of bed.”
Kline Galland’s home health services include nursing, physical, speech and occupational therapy. Other staff includes medical social workers and certified nursing assistants who also function as home health aides. They can provide assistance with light chores, errands, bathing, and meals, but Medicare will only reimburse for the cost of a home health aide if one of the other skilled therapies is also being provided.