Melissa Garfield and her staff were surprised and unaware their home care agency was among the list of providers who received the prestigious 2011 HomeCare Elite designation named in October by OCS and DecisionHealth.
“We actually just stumbled upon our name making this ranking list by accident,” said Garfield, RN, BSN, the clinical supervisor for JerseyCare Home Health, one of the home care divisions for Saint Barnabas Health Care System of West Orange, N.J., which she said ranks as the second-largest private employer in her state.
“This isn’t an honor you apply for or submit documentation about how you’re doing something better than someone else,” Garfield said. “The organization making this distinction already has all of the data and outcome stats from public access, and it’s your successful numbers as a result of your staff’s hard work and dedication that earns the designation.”
HomeCare Elite designation is a compiled listing that has been announced for the past six years naming the top performing home health agencies in the U.S. This year’s winners were announced Oct. 3 at the National Association for Home Care and Hospice annual meeting in Las Vegas.
“The HomeCare Elite program continues to identify excellence and recognize home healthcare agencies that perform at the highest level,” said Amanda Twiss, CEO of OCS-My InnerView. “We congratulate the 2011 HomeCare Elite for their continued success and commitment to high-quality care and strong financial performance.”
The HomeCare Elite annual review identifies the top 25% of agencies nationwide and also further highlights the top 100 and top 500 agencies overall. This year’s winners were ranked by analysis of measures in quality of care, process measure implementation and financial performance.Cristel Finneran, RN
“The 2011 class of the HomeCare Elite have been able to provide quality care to patients while achieving positive financial outcomes, which is significant given the regulatory changes and challenges that home health agencies continue to face,” said Marci Heydt, product manager for the post-acute care business group of DecisionHealth.
The list of honored agencies includes a wide selection of big and small healthcare organizations, some private, others affiliated with hospitals and a mix of for-profit and nonprofit models.
“Of all the criteria, the factor weighted the least has to do with finances and how much money these home care agencies generated during the year,” said Scott Smith, director of marketing and communications for OCSHomeCare. “Really, we just check to make sure each agency is financially solvent.”
Garfield said one of the reasons her facility is so proud of this year’s recognition is because the industry realizes the honor is granted “based on very concrete measurable data.”
“Our agency is a nonprofit, and we’ve been around since 1997,” said Garfield, who has been a nurse for 33 years and with JerseyCare Home Health for four years.
“Everyone in this field realizes that our patient data and the outcome from our client services, which are submitted to Medicare and Medicaid, comprises the public records determining and measuring success,” Garfield said. “There’s nothing subjective about making this list; it’s all about your numbers. So to be among the groups on this published list tells the story about what is, or is not, being accomplished.”
This year, 9,724 Medicare-certified home health agencies in the U.S. had sufficient data to be considered for the 2011 HomeCare Elite, which represents an increase of 349 from 9,375 home care agencies that were eligible last year. Of the 2,434 agencies that were identified as the top 25% for the 2011 HomeCare Elite list, 1,379 are repeat agencies from 2010. There also were 106 agencies in this year’s top 500 which appeared in 2010. Only 22 of this year’s top 100 returned from last year’s top 100.Linda Lomangino, RN
This year, the designation saw 607 first-time winners, such as Garfield’s agency, which made the top 25% list.
Garfield said her agency reports fewer patient falls, increased nurse safety practices and less re-admissions. “We have several other home healthcare agencies that also serve Essex County, but we are the only ones who made this list,” Garfield said.
“I credit our staff and everything from how we use our training and teachable moments to our discharge practices and making sure our patients understand every part of their at-home plan, from medication to follow-up,” Garfield said. “With the area we cover, it ranges from urban lower income addresses to very affluent clients, but to our nurses, it’s all seamless. When you are a field nurse, you’re a lot like MacGyver. You never know exactly what situation might arise.”
Smith said in addition to OCS basing the designation on Centers for Medicare & Medicaid Services Costs information on file, this year, “process of care measures” also was added as a new consideration to the criteria.
As a combined business unit of National Research Corporation, Smith said OCS and My InnerView seeks to “empower clients and partners” throughout the entire post-acute continuum of care, including hospice, home health, skilled nursing, assisted living and others. The company offers market-leading survey solutions, predictive tools, data analytics, quality and outcomes reporting, financial insights and the nation’s largest comparative databases.Cynthia Larson, RN
“Our research teams have been gathering and compiling this type of information and records for 20 years,” Smith said. “But it wasn’t until 2006 it was decided we should be releasing annual lists to recognize the high standards of the top caregivers because they deserve to have their excellence known in the industry.”
This year, there were 338 home health agencies included with the 2011 designation who have appeared on the HomeCare Elite list all six years.
Laurie Biedermann, RN, MA, quality manager for Dominican Sisters Family Health Services CHHA of Ossining, N.Y., is proud her agency is one of the home health services to earn the designation every year since it began in 2006. This year, they are included in the top 25% ranking.
“An important part of our continued success has to do with our research-driven care, which is evidence-based,” said Biedermann, who has been a nurse for 29 years and with Dominican Sisters for 24 years. “We’ve been around for 150 years, and we have three branches and a staff of 300 nurses to cover Westchester and Suffolk counties, in addition to all of Manhattan. We’ve found the best practices that work for our staff, while also working with many factors to consider, from multicultural issues to the quality and safety of our nurses having to travel to such distances to meet patient needs.”
For Family Care Certified Services of Nassau CHHA in Hicksville, N.Y., making this year’s top 25 designation list is a result of many continuing quality measures for success, along with patient “word of mouth” recommendations and endorsements.Ann Fitzpatrick, RN
“Because we are not hospital-based, we pride ourselves for the very personal approach we establish with clients and our accessibility,” said Myrna Sandbrand, RN, BSN, director of the long-term program for Family Care Certified Services of Nassau, who has been a nurse for 30 years and with the independent for-profit agency for 12 years. “We hear from both our patients and families about our care and performance and that’s instrumental in our planning and success. We look at each case individually, rather than using a one-size-fits-all, cookie-cutter plan.”
Cristel Finneran, RN, BSN, director of patient services at Family Care Certified Services of Nassau, said by responding promptly to patient needs, it improves the clinical outcome, while staff also is aware there’s always team support available without the layers of corporate culture.
“We haven’t cut any of our case management support to provide the necessary assistance our staff needs while in the field,” Finneran said. “We have RN case managers in our office to help with whatever is needed, and this yields better results and is just one of the reasons we’ve had this designation now for four years with the HomeCare Elite ranking.”
Linda Lomangino, RN, BSN, manager of clinical services at Saint Francis Hospital Home Health Services Inc. in Poughkeepsie, N.Y., is proud her agency has made the HomeCare Elite designation every year since 2006, with the exception of 2009. This year, they were ranked as one of the top 500 agencies.
“There’s not always very many accolades for nurses in the home health field, which is what makes this listing even more important to all of us who work in this area,” said Lomangino, who has been a nurse since 1986 and has been with the Saint Francis home healthcare division for 11 years. Nonprofit and hospital-based, they have 17 home health nurses on staff.Melissa Garfield, RN
“Not only are we proud of our recruitment and retention efforts, but we also have a very thorough training and orientation process before any of our nurses begin going into clients’ homes,” Lomangino said. “This is a very different type of nursing experience compared to being in the controlled environment of a hospital or doctor’s office.”
Lomangino said as more patients are sent home from hospitals sooner than past practices, there are more chronic conditions for nurses to face in the home.
“From wound care to IVs, it’s much more different than what we faced even a decade ago,” she said. “So before a nurse is ever sent out, we have 12 weeks of orientation and up to six months of shadowing with another nurse, which helps our success with outcomes. It’s more than just taking a blood pressure. These nurses need to know how to manage and organize their time while on a visit, deal with travel conditions and schedules and work as efficiently as possible with working with family members and educating the client.”
Catherine Pignatello, RN, BSN, MPH, MBA, administrator of home care and community services for Nyack Hospital Home Care CHHA in Orangeburg, N.Y., works with 40 home care nurses at her nonprofit agency, which made the top 25% designation for 2011.
“We use this list as a way to benchmark what we’re doing right and compare how other agencies are rating,” said Pignatello, who has been a nurse for 45 years. “We include this in our quality improvement plan, and we make sure our staff and patients recognize this designation as one of the representations of what we are doing to ensure success in our outcomes. We are part of that important transition from a hospital stay for patients to have a continuum of care.”Catherine Pignatello, RN
Ongoing improvements and self-evaluations are one of the ways to ensure success according to Cynthia Larson and Ann Fitzpatrick of Brookdale Hospital Medical Center CHHA in Jamaica, N.Y., which was ranked with a top 25 HomeCare Elite designation.
Larson, RN, HCS-D, compliance auditor, emphasized the importance of communication and the team involvement for patient plan improvement, as nurses work with social workers, physical therapists and occupational therapists for best results. Larson has been a nurse for 30 years and at Brookdale for 11 years.
Fitzpatrick, RN, director of patient services at Brookdale, said staff were excited and honored with the designation, which is the first time the agency has made the list.
“We are a nonprofit, and we’ve been around for 20 years and this honor reinforces all of the hard work and dedication,” said Fitzpatrick, who has been a nurse for 20 years and at Brookdale for four years. “We have four full-time nurses and everyone is included in our process and everyone shares this latest distinction.”
Robert Wood Johnson Visiting Nurses Inc. in North Brunswick, N.J., ranks as the largest VNA in New Jersey and received the HomeCare Elite top 25 designation.Eileen Mazzei, RN
At RWJVN, Eileen Mazzei, RN, BSN, staff nurse, and Ellen Gusick, RN, BSN, executive director, said their organization also received designation honors in 2009 and 2010.
“We cover four counties and are always continuing to improve our care and our technology and training for our staff,” said Mazzei, who has been a nurse for 19 years.Ellen Gusick, RN
Gusick credits the team emphasis and critical thinking measures of Mary Ann Christopher, president and CEO for the Visiting Nurse Association of Central Jersey, as the force that has promoted success for their agency.
“Success starts at the top with the encouragement and belief in our staff who represent us every day,” said Gusick, a nurse for more than 30 years. “We all benefit from recognizing the improvements in our field to help the clients we serve.”