Category Archives: Hospice


Root Cause Analysis with Karolee Alexander

Pathway Health’s Karolee Alexander presents the webinar, titled, “Clinical Online Workshop: Root Cause Analysis,” hosted by Care Providers of Minnesota. The event will provide participants with best practices for thorough root cause analysis and how to prioritize necessary changes.


  • Understand the intent of a root cause analysis
  • Learn several techniques for performing and teaching others to perform a root cause analysis

The webinar will take place on June 12 from 10:00 – 11:00 a.m.

Check out more educational opportunities from Pathway Health »


The Right Connection for the Right Role

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Pathway Health provides quality leadership solutions to skilled nursing, assisted living, home care and hospice providers across the nation.
Healthcare leaders choose Pathway Health Connections for Interim Management and Talent Acquisition services to find the right professional who will be compatible with the culture, value and mission of their organization. Our vetted professionals, whether for a short-term, interim solution or long-term, permanent position, are ready to meet the demands and pressures of the changing health care environment.
InterimInterim Management Services

Having a vacant key leadership position affects clinical quality outcomes and impacts the financial health of your organization. Pathway Health Connections can guide this transition by assisting you in finding an experienced interim staff member. Learn more

TalentTalent Acquisition Services

We find the right professional who will be compatible with the culture, value and mission of your organization. Our candidates are ready to meet the demands and pressures of the changing health care environment. Learn More


Pathway Health provides the insight, expertise and knowledge to keep your organization on the right path.
Visit or call us at 877-777-5463.


A New Career is Waiting for You in St. Paul, MN

Smile, you’ve found your new RN job! Pathway Health has a remarkable direct placement opportunity in the St. Paul area to become an RN at a highly reputable, resident-centered assisted living facility client of ours.  You will be joining a very energetic team of caregivers dedicated to quality service.  The RN will support and assist the Director of Nursing in the daily management of the nursing staff, work with clients, families and outside agencies to provide individualized plans of care.

The qualified candidate will not only possess an unencumbered MN RN license, but also a commitment to outstanding care, excellent communication and critical thinking skills, the ability to be proactive, flexible, and prioritize and have strong leadership skills.

If you are looking to become part of a top-notch team of professionals with competitive pay and outstanding benefits, contact us! We look forward to hearing from you! Contact to learn more.


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w5-PHS-102014-Shop-Icons_WEBINARS-LEADERSHIPWebinars (Live and Recorded)
We have an extensive online catalog of live and recorded webinars, focusing on hot topics, industry updates, clinical systems, health care initiatives and more.


Classroom Training
Designed for healthcare professionals, each of our training sessions w5-PHS-102014-Shop-Icons_CLASSROOM-TRAININGincorporates industry insight and overview, leadership/professional strategies, operational implementation strategies, and quality monitoring processes.


Streamlined tools, focused on one specific topic, serve as a starting point for facility leaders to quickly assess their current practices, policies, procedures and processes.


Resource Manuals and Toolkitsunnamed (1)
Specifically designed to target new healthcare initiatives or a specific clinical or operational system.




Pathway Health Supports the Daily Work of Personal Care

Hospice MonthNovember is National Hospice and Palliative Care Month (often referred to as Home Care & Hospice Month). This year’s theme—Hospice. Helps. Everyone.—perfectly describes the goal of any great palliative program: To provide the best end-of-life support, according to the wishes (and care plan) of a patient and family dealing with a terminal illness.

The benefits of hospice can be seen by the soaring number of people who are selecting this option for comprehensive palliative treatment. According to a 2014 study by the National Hospice and Palliative Care Organization:

  • Hospices range in size from small agencies, with fewer than 50 patients per year, to large corporate chains that care for thousands of patients each day.
  • An estimated 1.5 million patients in the U.S. choose services from hospice, with half of these patients receiving care for 14 days or less.
  • More than 80 percent of hospice and home care patients rely on Medicare.
  • Hospices care for more than half of all Americans who die from cancer, and a growing number of patients with other chronic, life-threatening illnesses, such as end-stage heart or lung disease, as well as HIV/AIDS and Alzheimer’s disease.

Awareness and Appreciation

From in-patient facilities to home care, the number of people served by hospice is quickly growing, which is helping to prove palliative care’s important role. Below are three ways to spread awareness about the hospice movement:

  1. Support the Hospice Action Network, the advocacy arm of NHPCO, which applies pressure in Washington, D.C., to create comprehensive legislation and regulation around end-of-life issues.
  2. Join the National Association for Home Care & Hospice (NAHC) in thanking millions of nurses, home care aides, therapists, and social workers, who are part of the hospice and home care network.
  3. Allow Pathway Health’s insight, expertise and knowledge related to hospice care to have a real impact with you, as a post-acute care provider.

Pathway Health’s hospice consultants assist organizations with assessing, monitoring and improving clinical operations through education, performance improvement assessments, and recommendations on strategies to improve outcomes.

Do you understand the changing hospice regulations? Let Pathway Health be your guide.




Lisa Abicht-Swensen
Pathway Health
Director of Home Care and Hospice Services



Health Care Reform Collaboration: Skilled Nursing Facilities and Hospice

As the average life span in the United States has increased, so has the number of individuals who die of chronic progressive diseases that require longer and more sustained care. An increasing number of these individuals reside in skilled nursing facilities (SNFs) prior to their death. It is projected that by 2030, half of the 3 million persons projected to be in a nursing home will die there.(1)

Hospice programs and SNFs must immediately implement a strategy to develop and market a strong, strategic nursing home/hospice partnership with hospitals, ACOs, MCOs, etc. These entities represent the “new buyers” of our services. So, we need to present an impressive force in terms of our ability to decrease costs, positively impact re-hospitalization rates and increase quality of life for those we serve.

By developing a well-researched, organized approach-utilizing data to support quality and efficiency of care-nursing home/hospice partners can quickly convince these “new buyers” of the necessity for inclusion in their network of providers.


Benefits to Hospitals, ACOs, MCOs

Earlier patient discharges to nursing homes with hospice services lowers mortality rates and shortens LOS in the hospital setting.

The nursing home/hospice partnership prevents hospital re-admissions. Hospice supports the nursing home in providing expert medical care, pain management and additional emotional/spiritual support, thus maintaining the patient’s comfort and eliminating the need for re-admission to the hospital setting.

Anecdotal evidence has long supported the notion that quality of life is enhanced when hospice is involved, resulting in very high levels of patient and family satisfaction.

Terminally ill patients are expensive. Hospice has long demonstrated the cost savings for using hospice, in lieu of curative care.

Hospice/nursing home partnerships working together can effectively influence more utilization of hospice services, thus creating cost savings to the hospital, ACO or MCO.


Leadership Considerations

1. Request and secure a presentation to the hospital, ACO, MCO, etc.

Engage in a dialogue.

Discuss the specific hospital, ACO, MCO setting and their issues.

Strive to make your presentation memorable and different. (Chances are you won’t be the only hospice presenting to them.)

Acknowledge any expressed concerns and their validity.


2. BEFORE your presentation, research and gather data from the hospital you wish to partner with, from sources such as Hospital Compare, State Department of Health and association websites.

Research 30-day, risk-adjusted mortality rates for patients admitted to the hospital with AMI, CHF, COPD, pneumonia.

Research patients dying at rates greater than the norm.

Research LOS longer than the norm.

Calculate the benefit in earlier discharge to hospice in terms of lower mortality rate and shorter LOS.

Calculate the benefit in eliminating re-admissions for this population of patients who typically have high re-admission rates.


3. Utilize the gathered data to advocate for hospice as one of the needed solutions.


In a hospital setting:

Explain how hospice prevents readmissions.

Develop a POA to identify terminally ill CHF and COPD patients in collaboration with the hospital.

Set up policies, procedures and protocols regarding these patients.

Offer to in-service cardiac unit physicians and nurses on terminal criteria.

Commit to being available for an initial hospice consult within a given timeframe.


Within the ACO:

Demonstrate the cost savings for using hospice in lieu of curative care. (There are several evidence-based studies in the literature.)

Request names of specialists and primary care physicians, who are part of the ACO, to determine who is under utilizing hospice. Make joint calls with ACO representatives to educate physicians about hospice.

Request ACO support to work with their network of home health agencies to jointly identify terminally ill Medicare patients.

Request real-time access to ACO patient management databases to monitor for terminally ill patients.


Within a bundled payment strategy:

For post-discharge services focus on the hospice’s value, eliminating costly, unnecessary hospitalizations.

Identify specific patient populations where hospice is being under utilized. Provide literature review for support.


Within MCOs:

Offer to assist the MCO in getting their members to establish health care directives.

Agree to educate health and transition coaches on the benefits of hospice.

Propose a concurrent care pilot with the MCO to allow members to “try” hospice before committing, while still receiving curative care.

Provide articles on the success of concurrent care to make your case.

Determine if the MCO has “complex case management” capability and understands their scope.

Discuss a financially viable concurrent care service package.

Express the goal as a break-even plan for pre-hospice election.


Successful, collaborative partnerships between SNFs and hospice providers represent an important and powerful presence in post-acute care. Together their efforts in service delivery ultimately result in cost savings, decreased re-hospitalizations and, perhaps more importantly in terms of care, more terminally ill people experiencing quality, compassionate care at the end of life.

Lisa-ALisa Abicht-Swensen,M.H.A.
Director of Home Care  and Hospice





(1) Improving palliative care in SNFs. (2008). Center to Advance Palliative Care. Accessed December 6, 2010 from:





Quality and Compliance are within “Cite”

The Top 10 F-Tags Across the U.S.
LeadingAge Wisconsin has published the top 2014 YTD F-Tag citations, not only in Wisconsin, but throughout the U.S.  View and print the full report

The Top 10 Federal Health Citations:

  • F-323: Supervision to Prevent Accidents
  • F-441: Infection Control 
  • F-309: Care Promotes Highest Level of Well-Being
  • F-371: Store, Prepare and Serve Food under Sanitary Conditions
  • F-329: Drug Regimen Is Free of Unnecessary Drugs
  • F-279: Develop Comprehensive Care Plan
  • F-431: Labeling of Drugs and Biological
  • F-514: Documentation
  • F-281: Professional Standards of Practice
  • F-241: Resident Dignity

How is your team ensuring that the correct clinical practice protocols and procedures are in place to avoid costly citations? 

Insight to Keep Quality In View
With Pathway Health’s depth of expertise and resources, we can quickly assess your current operations to assess clinical processes to ensure adherence to new standards of practice, identify operational and clinical area of improvement to meet new regulatory standards, and optimize reimbursement levels.

Pathway Health’s Practical Advice:  

Our expert team is dedicated to providing a clear path to your organization’s strategic vision and goals for long-term viability. Contact us to learn more.

F-Tag Resources at your Finger Tips

Be prepared for survey, maintain regulatory compliance while keeping to potential for an F-Tag within your sight!

  • F323 – Falls and Accidents

View tools & resources>

  • F441 Resources: Infection Control

View tools & resources> 

  • F309 Quality of Care, End of Life

View tools & resources> 

  • F329 –  Unnecessary Medications/ Antipsychotic Meds

View tools & resources> 

F-Tag Grid – Bundle of 10: A concise listing of all

F-Tags, as well as a scope and severity grid. A must have in your survey readiness arsenal! Purchase now> 


Staying Healthy This Influenza Season

It’s that time of year again to pull out the jacket and boots, curl up next to the fireplace, and get your annual flu vaccination.

The CDC recommends that everyone 6 months of age and older receive a yearly flu vaccination as the best preventative measure to avoiding Influenza. Persons 65 years of age and older, those that are immunocompromised, or have a chronic health condition are considered most at-risk for developing complications from the Influenza virus.

According to the CDC, about 90 percent of deaths during a regular flu season occur in people 65 years and older. While flu activity typically peaks in January or February, the season can last from October through May, so early vaccination is a must!

Other Ways You Can Stay Healthy:

• Avoid close contact with people who are sick and stay away from others when you are not feeling well.

•  Stay home when you are sick, including: work, school, and running errands.

•  Cover your mouth and nose with a tissue when you cough or sneeze.

•  Clean your hands often with soap and water or an alcohol-based hand sanitizer.

•  Avoid touching your eyes, nose, or mouth to prevent spreading germs from other surfaces to those areas.

•  Practice other good health habits including: Cleaning and disinfecting frequently touched surfaces, get plenty of sleep, be physically active, manage stress, drink lots of fluids, and eat nutritious food.

To view the CDC’s full guidelines regarding proper hand hygiene, click here.

How Your Facility Can Prepare For and Manage The Flu:

Effective flu management begins with prevention.  Ensure staff members are properly washing hands and that appropriate infection control measures are being utilized facility-wide.  Prepare the staff for what to do in case of an outbreak and what steps can be taken to minimize the number of Influenza cases before the season hits.

Proper surveillance and tracking must be utilized to detect changes in the influenza activity within a facility, so leadership teams can determine what adjustments must be made to current practices to keep influenza at bay or to contain an outbreak.

For more information on preventing seasonal influenza, click here.




Help reduce antipsychotic drugs in your organization in honor of World Alzheimer’s Month

The Centers for Medicare & Medicaid Services (CMS) is constantly introducing and revising parameters of care for skilled nursing facilities. CMS has increased focus on reducing antipsychotic drugs among dementia patients in long-term care facilities.

On March 29, 2012, CMS launched a national partnership with the mission to improve quality of care provided to individuals with dementia living in nursing homes by revising survey guidelines pertaining to the use of antipsychotic medications for dementia patients. The updated version states, “Antipsychotic medications must be prescribed at the lowest possible dosage for the shortest period of time and are subject to gradual dose reduction and re-review,” and only after all other causes [of behaviors] have been identified and addressed.

Learn more ways to improve dementia care through the reduction of unnecessary antipsychotic drugs with Pathway Health’s QuickPath.

In honor of World Alzheimer’s Month take some time this September to familiarize yourself further with the recent changes pertaining to Alzheimer’s and dementia care and join us in the fight to help find a cure


Take a proactive approach to your staffing needs

The healthcare industry has been experiencing increased staffing challenges for the past ten years. With job vacancy rates between 11 and 20 percent, according to the Alzheimer’s Association, the long-term care industry is no exception. Staff shortages within the long-term care industry are predicted to become more desperate when the Affordable Care Act takes effect in 2014; 32 million Americans will become newly insured and the estimated 78 million baby boomers will begin requiring long-term care. With such a drastic rise in the number of patients needing care, staffing will need to grow exponentially.

Unfortunately, there is a disconnect between how healthcare executives see current staffing shortages and how they address them. A study shows that a significant number of executives rank staffing shortages within their facility lower than other issues, such as reimbursement and government regulations. Maintaining compliance needs to remain a top priority, but it’s challenging without a complete staff of knowledgeable and competent employees.

In order for long-term care facilities to provide the best care possible and reduce unnecessary spending on replacing skilled employees, it’s important to get the right employee in the right position. With ever-changing care models and expanding roles as a result of healthcare reform, organizations desperately need to be proactive and create a long-term plan for how to deal with staffing issues. Partnering with organizations that offer extensive interim management, consulting services and succession planning, as well as education and training programs, is one step in making your organization more resourceful and resilient to upcoming changes.

Don’t leave key leaderships positions vacant while you’re searching for a permanent placement; ensure that your organization has the leadership it needs long term and during periods of transition. Pathway Health can assist you in providing an interim staff member or by filling a permanent position. Our interim professionals will also provide you an unbiased assessment of your organization’s strengths and opportunities.  Contact us and find out how we can help you fill vacancies in your skilled nursing, assisted living, home health or hospice organization.