I am the director of a small Medicare certified Home Health agency. We have just hired a full-time Physical Therapist with no experience in homecare. Though I am familiar with the role of rehab in our care, as a nurse I feel unable to help guide her in areas of clinical direction. Are there resources that can help orient physical therapists new to Home Health? 

            You have posed a question that we actually hear quite often. This is an area in which both agencies and therapists regularly encounter problems. When considering the shortage of licensed clinicians at all care levels, an agency is fortunate to have the opportunity to hire a full-time therapist, even if they have no homecare experience. Employers that provide adequate orientation for new employees often find therapists frustrated with the obstacles of the homecare environment. Multiple layers of Home Health specific nuances confront the therapist trying to achieve a comfort level with the new care setting. In all cases, the in-home aspect of the care delivery model is new to the rehab clinician; even the most seasoned homecare veteran occasionally wrestles with the task of traveling to individual homes. Weather, traffic, construction, and inconvenient schedule requirements are part of the daily routine that must be managed prior to delivering care. In addition, therapists new to homecare who find themselves struggling with either their daily routine or clinical care often find themselves opting for another type of job opportunity that appears less challenging. Others return to previous employers, some find new employers with lucrative reimbursement packages. In any case, it is in the agency’s best interest to help this therapist achieve a level of comfort in the Home Health world as soon as possible.

          To answer your question, success lies in connecting the new homecare therapist to the care dynamic they learned in school and refined in their last employment position. The specifics of the PPS mechanism currently used by Medicare Part A Home Health are the first order of the day. The introduction to how PPS simultaneously defines the care mandate and provides a progressive programming guide is crucial for therapists initially entering the field. But resources for a) agencies wishing to help therapists learn the in and outs of homecare, or b) therapists who may be seeking new clinical or professional opportunities, are scarce and often fail to identify the keys to a successful practice.

Specific publishing companies play major roles in this area. Decision Health has an entire line of Home Health related products including Home Health Line, Home Care Outcomes, and many others. Advance News Magazines, publishers of the Home Health Forum, also provide regular features that touch on therapy practices in a number of different environments. Many agencies (and therapists) have informed us that archived articles from Advance’s Home Health forum offer insight on specific topics relevant to homecare.

Other steps to educate therapists new to homecare are found from professional organizations that are specifically centered on the industry. Both the National Association for Homecare (NAHC) and the American Physical Therapy Association (APTA) have multiple products and on-going publications that can help to immerse rehab professionals in the Home Health environment. PTs that have APTA membership should consider joining the Home Health Section of the American Physical Therapy Association for quarterly journals and annual conferences that address the role of rehab in homecare.

          Also very beneficial are the annual conferences presented by state Home Health professional organizations where agencies and clinicians gather to discuss the latest level of contemporary homecare delivery. The networking opportunities provided for all clinicians who may be interested in exploring Home Health are invaluable. Exhibit halls are often filled with Home Health agency representatives eager to recruit licensed therapy personnel while educational sessions expose the homecare novice to best practice based care techniques that could help make homecare a positive and successful experience.