The Speech-Language Pathologist in Home Health Care

by Betros, Cecil G.

• ISBN13: 9780834209190
• ISBN10: 0834209195
• Format: Paperback
• Copyright: 1999-01-01
• Publisher: Pro Ed

Summary

Communication Concepts and Consulting, Inc., Birmingham, AL. Presents a comprehensive descrip- tion of the nature of providing clinical speech, language, cognitive, and swallowing services to homebound individuals. Specific procedures are outlined and case studies are included to illus- trate the speech-pathologist's role. For clinicians. Softcover.

Table of Contents

Preface	ix	(2)
Acknowledgments	xi
PART I--THE HOME HEALTH MODEL	1	(40)
Chapter 1--Introduction and an Overview of Home Health Care	3	(18)
Home Care Development	3	(1)
Recent History	4	(1)
Financial Concerns	4	(1)
Scope of Home Care	5	(1)
Range of Home Health Agencies	5	(4)
Other Home Health Care Providers	9	(1)
Description of Home Health Care	10	(1)
Initiation of Home Health Care Services	11	(2)
Reasons for the Growth in Home Health Care	13	(3)
Current Trends and Definitions	16	(3)
Conclusion	19	(2)
Chapter 2--Scope of Home Health Speech-Language Pathology Practice	21	(20)
The Principles of Rehabilitation and Home Health Care	21	(4)
Distinguishing Characteristics of the Profession	25	(4)
Traditional Service Settings	29	(2)
Typical Home Care Case Types	31	(1)
Assessment and Development of Intervention Strategies	32	(2)
Special Skills Needed by the Speech-Language Pathologist	34	(3)
Rural Home Health	37	(1)
Conclusion	38	(3)
PART II--STEPS IN THE ASSESSMENT PROCESS	41	(88)
Chapter 3--The Referral and Home Visit Process	43	(14)
Introduction	43	(1)
The Referral Process	43	(7)
Conducting a Home Visit	50	(5)
Conclusion	55	(2)
Chapter 4--Assessment Considerations in Home Health Care	57	(38)
Introduction	57	(1)
General Considerations	57	(1)
Assessment Considerations	58	(13)
Vital Parts of the Assessment	71	(2)
Case Studies	73	(10)
Conclusion	83	(2)
Appendix 4-A: Summary of the Principles of Universal Precautions and Body Substance Isolation of OSHA's Bloodborne Pathogen Standards	85	(6)
Appendix 4-B: Independent Skills Checklist: Speech-Language Pathology	91	(4)
Chapter 5--Special Concerns in Home Care	95	(34)
Hospice	95	(4)
Patient and Family Interaction	99	(1)
Discharge Planning	99	(2)
The Patient Management Model for Development of the Patient Plan of Care	101	(6)
Dysphagia Management in Home Health Care	107	(5)
Conclusion	112	(2)
Appendix 5-A: Home Health Examinations and Treatment	114	(15)
PART III--DOCUMENTATION, REIMBURSEMENT, AND ACCOUNTABILITY	129	(128)
Chapter 6--Business Aspects of Home Care for the Speech-Language Pathologist	131	(34)
Employee versus Independent Contractor Status	131	(1)
Program Administration	132	(4)
Reimbursement	136	(16)
Marketing	152	(6)
Conclusion	158	(2)
Appendix 6-A: Sample Fee-for-Service Rehabilitation Services Agreement	160	(5)
Chapter 7--Program Integrity: Documentation and the Written Plan of Care	165	(52)
Introduction	165	(1)
The Principles of Documentation: An Overview	165	(1)
The Increased Emphasis on Documentation	166	(2)
Documentation Guidelines	168	(3)
Documenting the Plan of Care	171	(5)
Conclusion	176	(2)
Appendix 7-A: Interpretive Guidelines for Speech-Language Pathology	178	(18)
Appendix 7-B: Speech-Language Pathology Services	196	(4)
Appendix 7-C: Speech-Language Pathology Adult Home Health Functional Outcome Measure	200	(17)
Chapter 8--Professional Accountability through Continuous Quality Improvement	217	(40)
Introduction	217	(2)
Quality Assessment/Improvement: An Overview	219	(1)
Continuous Quality Improvement	220	(3)
Quality Definitions	223	(1)
Methodology	224	(7)
Outcome-Based Quality Improvement	231	(3)
Critical Pathways	234	(9)
Competency Assessment	243	(3)
Appendix 8-A: Clinical Competency Appraisal: Speech-Language Pathology	246	(11)
PART IV--THE FUTURE	257	(36)
Chapter 9--Implications of the Interim Payment System on the Practice of Speech-Language Pathology in Home Health	259	(20)
Background	259	(2)
The Medicare Home Health Benefit	261	(1)
Balanced Budget Act of 1997	262	(1)
Impact of Key Provisions on Beneficiaries	263	(3)
Impact of Key Provisions on Home Health Agencies	266	(4)
Quality of Care	270	(1)
Budgetary Impact Estimates	271	(2)
Administrative Issues	273	(2)
Conclusion	275	(4)
Chapter 10--Future Trends in Home Health Care	279	(14)
Introduction	279	(1)
Changing Goals	280	(1)
Preparing for Changes under Managed Care	281	(2)
The Changing Role of the Speech-Language Pathologist	283	(1)
Computerized or Automated Clinical Documentation	284	(2)
Proposed Changes in the Conditions of Participation	286	(1)
Fraud and Abuse Initiatives	287	(2)
Other Federal Reimbursement Changes	289	(1)
Anticipated Effects	290	(1)
Conclusion	290	(3)
Appendix A--Physician Certification and Plan of Treatment Requirements	293	(12)
Appendix B--Generic Referral Form	305	(2)
Appendix C--Service Codes for HCFA Forms 485 and 486	307	(4)
Appendix D--Glossary	311	(12)
Appendix E--General Abbreviations	323	(4)
Index	327