Our COVID-19 Response: A Letter from Our CEO Mike McMaude

To the Abode Healthcare Community,

I hope this note finds you and your loved ones safe and healthy. The COVID-19 pandemic is affecting each of us in different ways. As we navigate the current situation together, I want to provide an update on the steps we have taken to be there for our community, our employees, and our patients.

All of us at Abode Healthcare are focused on providing the highest quality of care to our patients. I provided an update at the end of March outlining the changes we implemented to prioritize safe patient care in this new environment. Every decision we have made, and continue to make, has been based on the priority of the health and wellbeing of our patients and employees.

I am deeply grateful for our employees who display incredible dedication by continuing to fulfill their commitment to our patients during this especially challenging time. These individuals, and everyone working on the frontlines of care, deserve to feel protected, confident, and taken care of.

In recent weeks we have made informed decisions and taken actions that ultimately support and benefit our entire community:

  • PPE: At the first sign of COVID-19, we prioritized spending where it’s needed most and to date, have purchased $1 million of Personal Protection Equipment (PPE) so no one reported to work without protection. I’m proud to say that we’ve not had to turn down any patients due to lack of PPE. We’ve even been able to assist other homecare and hospice organizations, and hospitals serving the Navajo nation as well as other underserved populations, in providing supplies for their employees by donating thousands of PPE items. In addition to our company’s commitment, several executives on our team have made personal PPE donations for local health organizations so they can work safely.
  • Paid Leave: To support employees who risk their own health and safety to care for patients, we instituted a special paid-time-off policy modeled after the Families First Coronavirus Response Act designated for companies with fewer than 500 employees. In Abode’s plan, employees receive unlimited leave for issues relating to COVID-19, including a newly instituted emergency paid time off (EPTO) benefit that is in addition to the PTO employees accrue with regular benefits. These additional benefits allow employees to potentially recover from COVID-19, care for a family member who is ill with the virus, or care for children whose schools and daycares have closed.
  • Business Investment: Rather than cut back, we’ve leaned into the business to make sure that we are even better prepared to care for patients. Some of these actions include:
    • Building out our telehealth and remote care solutions
    • Retaining a dedicated, talented workforce
    • Hiring new employees and growing our team locally and nationally
    • Expanding our team’s knowledge with the addition of an infectious disease physician, Dr. Shannon Thorn
  • Charitable Donations: As we have every year, we continue to support charitable organizations in our communities. That will not stop just because of COVID-19. Support for neighbors, near and far, is needed now more than ever.

I am extremely proud of how everyone at Abode has reacted and handled the unique situation that the COVID-19 pandemic has presented. It’s difficult to adequately express my appreciation for our community—patients, employees, and partners. I have been reminded, once again, what an incredible organization we have—one that is driven by a common purpose of caring for, and serving, vulnerable patients. Every member of our team has come together to do what’s right, and I thank you. We look forward to continuing to work together and supporting each other through this challenging time.

Stay safe and healthy,

Mike

Celebrating Nurses | Shirley Vitela

Abode Hospice & Home Health is celebrating nurses during the month of May! Meet Shirley and learn about her passion when it comes to nursing as she shares her “why.”

Why nursing? I firmly believe it is my calling. I went back to school as an adult who was working in finance, a Registered Investment Advisor with a Series 7 commodities license. Once I started working in healthcare, I no longer felt like a square peg in a round hole and truly felt I had found what I was hardwired to do. Having worked in multiple areas of Nursing, I am so grateful to have made my way to the very special service of Hospice. It is remarkably fulfilling to assist patients and families during a very sacred time. I feel so blessed to love my work.

Happy Nurses Day!

Today, we recognize our nurses for their hard work, support, and compassion. Because of you, we live in a happier, healthier world. Happy Nurses Day!

Your hard work and dedication does not go unnoticed. Now, more than ever, we appreciate you!

COVID-19 & Hospice

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Waive non-core services (physical, occupational, and speech pathology) *hospice only
  • Waive on-site visits for hospice aide supervision

Telehealth and Telephonic Visits

  • CMS permits hospices to provide telehealth to a Medicare patient receiving routine home care during the emergency period, if it is feasible and appropriate to do so.
  • Face-to-face encounters for purposed of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (must be 2-way audio-visual)
  • Must be physician-ordered and on the plan of care

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

COVID-19 & Home Health

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Face to Face encounters to establish HH services
  • Non-physician practitioners (NNP) certification authority accelerated

Telehealth and Telephonic Visits

  • CMS permits HHAs to provide all necessary telehealth during the emergency period
  • Must be physician-ordered and on the plan of care
  • Does not replace in-person visits (telehealth or telephonic visits are not billable visits)
  • Allows for HHA to supplement in person visits for patients who might refuse more frequent visits or senior living or other congregate living facilities that might be restricting access to HHA personnel.
  • The Home Health Face to Face visit may also be provided by telehealth but must be performed utilizing 2-way audio and visual programs.

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

CMS clarification on homebound status for COVID-19 patients and those at high risk of contracting:

Non-Physician Home Health Certification Authority

  • Allows patient to be under the care of an NPP to the extent permitted under state law
  • NPP= Nurse Practitioner (NP, ARNP), Physician Assistant (PA) and Clinical Nurse Specialist (CNS)
  • Authorities
  • Order Home Health Services
  • Establish and review POC (Plan of Care)
  • Certify and recertify eligibility
  • CMS utilizing discretionary authority not to enforce rules
  • Must also check state HHA licensure for any barriers to implement
  • CARES Act makes this relief permanent, but CMS needs to implement

For more information, contact Jon Wilder.

Our “Why” During COVID-19

Times of uncertainty often bring about reflection on our individual mission and purpose – our “why” in life. We all have a different “why” that has been formed through our passions and life experiences. Maybe your mission and purpose in life is teaching and mentoring the youth in your community, or maybe it is working in law enforcement to keep your community safe. Across the company, we are fortunate to have some of the healthcare industry’s most talented professionals whose “why” also aligns with our mission to provide first-class care to our patients and their families.

While we all adjust to changes in our daily lives, our employees are continuing to fulfill their commitment to our patients. From conducting music therapy in outdoor nursing home courtyards to providing meals for hospital staff and first responders, the current pandemic has even given us the opportunity to be creative in carrying out our mission.

As stated by Rosie Avila, Community Liaison at our Nurses in Touch location, “our purpose here is not for ourselves; it’s for others and in turn their purpose was for us.” This rings true throughout the company, and our employees are living out their mission and purpose every day.

What is your mission and purpose – your “why” in life? Perhaps it will be uncovered during these times. Perhaps it will align with ours. Perhaps it will provide an opportunity for us to partner in carrying out our missions to support our communities. We are all in this together!

Making the Hospice Decision

Before a baby is born, planning around the baby’s life begins. The parents prepare for the baby by creating a registry. Friends plan and host a baby shower. Family helps decorate the nursery. As the baby grows, the parents teach the baby, now a child, how to read. They prepare the child for kindergarten, then elementary school, then middle school, and then high school. The child, now a young adult, decides on a trade school versus entering the work force directly after high school versus college, and if college is selected, the young adults selects a major, and prepares to earn a degree. Then the young adult applies for and accepts a job, decides to get married, and chooses when to start a family. He or she then decides how many children to have and how to raise those children.

We spend so much of our life preparing and planning—so why should it be any different when making a hospice decision? Ideally, from the start of a diagnosis of a life-limiting illness, people should begin planning their goals and priorities with their physician. By having these conversations early, the person with a life-limiting illness can be fully involved in planning and making decisions regarding their wishes before the stress of a medical crisis.

Hospice is a continuation of care that shifts the goals of the patient from curative to comfort. When you or a loved one has a life-limiting illness and medical treatment is no longer effective, the doctor may refer you to hospice care. It should not be seen as a last resort but rather as an opportunity to focus on managing pain and other symptoms to find relief. This approach lets you dedicate your attention to what truly matters: living the rest of your life to the fullest.

A study by the National Palliative Care Organization found that patients who spent their final days on hospice reported having a better life experience than those who spent the end of their lives in intensive care. The researchers found that the patient’s choices often influenced the end-of-life care they got, which is why it is so important for people to plan for hospice, long before the need arises.

So, when should you make the hospice decision? Talk to your physician about signs and symptoms to consider prior to electing hospice care. Frequent hospitalizations, frequent infections, a decline in functional status, and an increase in uncontrollable symptoms or pain can all be indicators. Decide what you wish to do when treatment is no longer effective. Consider the benefits of managing symptoms from home rather than frequent visits to the physician or hospital. Consider the benefit of having a team of specialists available to you in your home—from a registered nurse to an aide, your doctor, a medical director, a social worker, and a chaplain. Consider access to your hospice team by phone 24 hours a day, 7 days a week, 365 days a year, where you could call your team if you had a question or a medical need. Consider the benefits of having medications related to your diagnosis and medical equipment made available to you in your home. These are all resources included in the Medicare hospice benefit, at no cost to the patient or their family.

If you have questions about the hospice benefit or when to elect your benefit, please contact us at info@abodehospice.com.

Hospice Care That Focuses On Quality of Life

The hospice benefit is a multi-disciplinary approach to end of life care. When hospice patients are able to utilize the benefit, in its full capacity, self-fulfillment needs, psychological needs, and basic needs are met. At Abode Hospice, we seek to meet all levels of needs for each hospice patient in order to maximize their end of life journey and hospice benefit utilization. 180 days on hospice not only allows for better end of life transitions for patients, but allows family members to be family members and our team to become caregivers. Thank you for allowing us to be a part of your journey.

Is COVID-19 the source of your grief?

Sad young woman sitting on the window

That nagging feeling in the pit of your stomach. The worry that you just can’t shake. The anxiety that you’re feeling. It’s easy to recognize stress, fear, and worry. But at its core, these feelings of stress, fear, or worry could really be expressions of an even deeper emotion—grief.

During this time of uncertainty with COVID-19, we are grieving a loss of normalcy; a loss of safety; a loss of finances; a loss of health for people we love and care about deeply; a loss of milestone moments for our kids—graduations, proms, sports; a loss of connectivity to our family and friends; and a loss of events and regular activities that bring us together, allow us time to destress, or provide us with an escape from the daily grind. The list goes on and on with the challenges and changes that our new social distancing practices have put in place.

It’s okay to feel these emotions and to recognize your grief. Recognizing your grief does not diminish all that you are thankful for. For example, you can grieve a loss of work but still be thankful for your time with your family—time that you might never would have taken, otherwise. Or you can grieve the expectation that you are now an employee, parent, and teacher all in the same moment while still being thankful that your children are home safe and that you have a job. Grieving one does not lessen your joy of the other.

Seasons of life, even the really difficult ones, are not strictly one-sided or black and white. These moments are Bittersweet and point to the fact that something can be both bitter and sweet at the same time. Much like this, joy can exist, intertwine, and mingle right alongside our grief. We can feel the hurt and the loss, yet look around and find moments of joy, happiness and hope.

This bittersweet feeling is one that our patients and families often describe. A loss of independence, health, and ability to perform tasks that bring joy can cause grief, but periods of togetherness, closure, acceptance, and comfort can provide sweetness and enrichment to the lives of our patients and their families. Our staff feels this complex grief too – grief upon our patients’ passing but also a comfort and peace that our patients and their families found moments of joy during a difficult time.

In an article in the Harvard Business Review, grief expert David Kessler discussed these feelings of grief and how to combat those feelings. To summarize, he said:

  1. “Find balance in the things you’re thinking.” – Don’t just dwell in the worst-case scenarios. As it relates to the Coronavirus—think not just of the people who will be sick but also of all the people who will not because of our efforts to flatten the curve. As it relates to hospice – think not only of the passing of a loved one but also of the joy that your time with that person has added to your life.
  2. “Come into the present.” – In this present moment, your anticipatory thoughts are just that—thoughts, which may or may not come to fruition.
  3. “Let go of what you can’t control.”—Focus on what you can control. As it relates to the Coronavirus – practice social distancing, wash your hands, and don’t touch your face. As it relates to end of life– focus on what you can do, what you can enjoy, and what makes you happy.
  4. “Stock up on compassion.”—Fear and emotion manifest at pivotal times, such as a pandemic or at end of life. Recognize that a behavior may seem magnified out of fear. Give grace to those who behave out of character due to fear or emotion. Recognize them for who they typically are.

For the complete article from the Harvard Business Review, visit the link: https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief?fbclid=IwAR35_lZ8_xajIcqad-GfMTT6_Hcp_ytepXFah30uvVNMHnbri4RB6GmVPC4

Safe Activities to Enjoy While Social Distancing

Due to COVID-19, more and more Americans are practicing social distancing. While working at home, schooling from home, and sheltering in place, it’s understandable to wish for a simpler time when you could leave the house or interact with others outside of your household without worry. With new recommendations from the White House to continue social distancing through at least April 30, it’s more important than ever add a variety of entertainment to your life to keep yourself from feeling stir crazy. Here is a list of activities to help pass the time at a socially responsible distance:

  1. Utilize social media and video apps to stay connected to friends and family. Skype, FaceTime, Google Hangouts and Zoom are all video options you can use to connect with your long-distance friends.
  2. Walk, jog, hike or bike outdoors (while practicing social distancing from others).
  3. Read your neighborhood forums to see what types of social-distancing activities they have in place. For example, many neighborhoods are participating in bear hunts, where community members place teddy bears in windows so that kids can look for and count bears during their walks.
  4. Take a virtual tour of the Yellowstone National Park: https://www.nps.gov/yell/learn/photosmultimedia/virtualtours.htm. Many parks, aquariums, and zoos are offering free online tours or virtual experiences at this time.
  5. Write letters to your friends, family, nursing homes, and first responders.
  6. Do some spring cleaning.
  7. Play cards, board games or do a puzzle with your immediate family.
  8. Cook dinner – make a pizza from scratch or try a recipe that you’ve never made before because it was time-consuming.
  9. Join an online book club or meet with your friends virtually to discuss a book.
  10. Take a nap.
  11. Watch a movie or your favorite TV series on Netflix.
  12. Dig out your old coloring books. Coloring isn’t just for kids!
  13. Call the elderly people in your life and check on them. This would be a great time to interview your grandparents to learn more about their lives.
  14. Make a photobook online by uploading your favorite pictures from this past year.
  15. Buy gift cards from your favorite local businesses to use after social-distancing ends.

Let’s make the best out of this current situation by staying positive and being responsible. Spread the love, not COVID-19!