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Kindred Healthcare

Kindred Healthcare. Opportunities Career Growth Nursing/Case Management. Objectives. Be able to verbalize Kindred Healthcare’s mission; what kind of patients are served in the continuum of care, and where facilities are located Learn about Kindred’s Case Management roles

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Kindred Healthcare

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  1. Kindred Healthcare Opportunities Career Growth Nursing/Case Management

  2. Objectives • Be able to verbalize Kindred Healthcare’s mission; what kind of patients are served in the continuum of care, and where facilities are located • Learn about Kindred’s Case Management roles • Learn about Kindred’s annual MSN Mentorship Program structure and the 2012 opportunities for new graduates • Learn about Kindred’s investment in nursing case management growth, development, and career ladder • Discuss actual 2011 Mentorship MSNs’ weekly feedback and guided educational experiences • Take away “pearl points” from CMSA President’s MSN and Dr. Abbott’s talk with new grad hires • Answer questions

  3. Who is Kindred Healthcare?“Dedicated to Hope, Healing, and Recovery”” • Leading Provider of Post Acute Care Services specializing in critically-ill and complex patients • Publically traded healthcare organization with Corporate headquarters in Louisville, Ky. • 121 Acute Care Hospitals throughout the U.S. in 40 states • Also has Skilled Nursing, Rehab-based contracts, and Home Hospice divisions • Ranked one of Fortune magazine’s Most Admired Healthcare Companies 2009, 2010, and 2011

  4. Three Market Leading Post-Acute Service Lines HOSPITALS Long-term Acute Care Hospitals Inpatient Rehabilitation Hospitals NURSING CENTERS Nursing & Rehabilitation Centers REHABILITATION SERVICES RehabCare $1.2 billion revenues(1) $2.7 billion revenues(1) $2.2 billion revenues(1) • Largest contract therapy company in U.S.(2) • 1,563 external locations served through 16,100 therapists (3) • 113 hospital-based acute rehabilitation units (3) • Largest operator in U.S. (2) • 121 LTAC hospitals 8,585 licensed beds (3) • 5 IRFs 183 licensed beds (3) • Third largest nursing center operator in U.S. (2) • 224 nursing centers 27,252 licensed beds (3) • 6 assisted living facilities413 licensed beds (3) • (1) Revenues for the twelve months ended March 31, 2011 (divisional revenues before intercompany eliminations). • Ranking based on revenues. • As of June 1, 2011. 4

  5. LTACHs (121) Inpatient Rehab Hospitals (5) Nursing and Rehabilitation Centers (224) Acute Rehabilitation Units (113) RehabCare External Customers (1,563) Home Care and Hospice (19) Existing Cluster Market Potential New Cluster Market (as of June 1, 2011) Market Specific Integrated and Coordinated Care Delivery Models With Focus On Developing Cluster Market Service Offerings

  6. Uniquely Positioned to Take Advantage ofChanging Healthcare Landscape “Continue TheCare” ACUTE CAREHOSPITALS TRANS CARE LTACs FREESTANDING/ HIH ICU IN-PATIENT REHAB SAU SKILLED NURSING FACILITIES TCC &TCU Patient Service Intensity OUTPATIENT REHAB ASSISTED LIVING HOSPICE HOME HEALTH CARE ADULT DAY CARE HOME Patient Illness Severity

  7. Coordinating Clinical Services & Programs Across Service Lines to Improve Outcomes and Prevent Readmissions Inpatient Rehabilitation Facilities Long-Term Acute Care Hospitals Hospital Based Sub-Acute Units Skilled Nursing & Rehabilitation Centers Rehabilitative Therapy Kindred Long-Term Acute Care Hospitals: 28,766 (64%) patients went home or to a lower level of care in 2010 after an average length of stay of 30 days Kindred Inpatient Rehabilitation Facilities 34,960 (76%) patients returned home after an average length of stay of 12 days in 2010 Kindred Nursing and Rehabilitation: 39,836 (50%) patients returned home after an average length of stay of 32days in 2010. Kindred Rehabilitative Therapy Patient functional improvement from evaluation to discharge was 76.4% in 2010

  8. Kindred Healthcare’s Mission… …is to promote healing, provide hope, preserve dignity and produce value for each patient, resident, family member, customer, employee, and shareholder we serve

  9. Roles and Functions- Complex skills promoted in: Resource Management Complex Discharge planning Interdisciplinary care facilitation and coordination Clinical Documentation Improvement (CDI) Patient Advocacy Kindred has 4 Regions (West, Central, Southwest, and East) in U.S. Over 400 case managers (District Directors, Area Directors, Directors of Case Management, Case Managers and Social Worker Case Managers Typical caseload 1:15 -1:18 Kindred Case Management

  10. Kindred/Samuel Merritt Partnership: MSN in Case Management Mentorship Program • From 2010 - 2011, Kindred hired 7 MSNs and provided them with an intensive “onboarding” 4-week orientation to Kindred complex case management practice and • A 6- month guided educational experience and mentorship through local Preceptors following orientation period • Weekly Preceptor and MSN meetings occur to provide resources and guidance for growth • CMSA Membership support for leadership and practice growth • Post-Mentorship: Entry into a guided CM Career Ladder: 1, 3, 5 year plan for CM Certification and administrative growth (if desired)

  11. Evaluation of the MSN-Prepared CM New Graduates’ 2010 Orientation and Mentorship Program Fusae Abbott, RN, DNSc., Wendy De Vreugd, RN, BSN, FNP, CCDS, MBA, Janet Rowland, RN, MSN Samuel Merritt University & Kindred Healthcare, Inc. Recommendations To the SMU-CM program: Five-minute case presentation exercises in clinical seminars. Reviewing standard treatment options for five common disease conditions seen during a student’s preceptorship. Communication simulation exercises involving difficult patients, family members, and physicians. Speaking up in inter-disciplinary meetings during the clinical practicum. To KH: Strengthen the 4-week orientation to bring new graduates onboard to KH. Provide opportunities for new graduates to work at least a week with bedside RNs and priority LTAC ancillary services. Teach LTAC-specific equipment and treatments. Develop critical pathways for five common disease conditions at LTAC. Teach about site-specific issues, such as resources in the community, insurance companies and kinds of insurance that patients may carry, physician practice patterns, and types of patients. • “What worked and what didn’t” • Factors related to the success of the program • Work environment • Support provided from senior administrators to staff CMs • Having some experienced CMs to whom the graduates could go for advice and suggestions • Stable staffing • Welcoming atmosphere • Graduates’ characters and skills • Positive and “Can Do” attitudes • “Self-starters” and flexibility • People skills • Organizational skills • Time management • Ability to ask for help Purpose The purpose of the study was to evaluate the effectiveness of the CM orientation and mentorship program for MSN-prepared new graduates with no RN work experience. Research Questions •Can an MSN-prepared new CM graduate from SMU, with no RN work experience, perform competently as a case manager after completing a 6-month new graduate orientation and mentorship program? • What parts of the orientation and mentorship program helped the graduate to function as a case manager? To what degree? What didn’t work? • Findings • “Subjects” • “Can new CM graduates perform competently as case managers after orientation/mentorship?” • All three SMU new graduates met all the standards for the 90-day evaluations, as assessed by their supervisors at KH. • At the end of the 6-month program the three graduates were rated on a 5-point scale as functioning at “independent”or higher levels for all the CM functions, as assessed by their trainers. • CM Functions and Skills • Conclusion • The data indicated that MSN-prepared new graduates could perform satisfactorily at entry-level CM work. • It became clear that the educational needs of the new graduates differed from experienced RNs entering the CM field. • It is necessary to define what RN work experience is critical to CM practice. • The challenge to MSN education is to find how academia can prepare graduates on those critical tasks, and so prepare the next generation of case managers. • Implications • The SMU-Kindred orientation and mentorship program provides an innovative approach to bridging the gap between hospital employment requirements and graduating case managers’ levels of experience. • Based on the successful outcome of this trial in 2010, the partnership between SMU and KH continues and KH has hired four SMU graduates in 2011. • KH has created a Career Ladder to promote professional development of case managers. Methods • A case study method • Subjects: Three SMU new graduates and their four trainers. Data Collected: • Demographics and characteristics of the subjects • Thoughts and feelings of the new graduates and their trainers in regard to the program • Confidence and competency levels of the graduates • Various on-going assessments at KH as part of their standard practice for new hires • Weekly SWOTT reports by the new graduates • Learning process: • Challenges and what helped Background Case Management Program In 2010, Kindred Healthcare, Inc. formed a partnership with the SMU CM Program and hired three SMU-CM graduates who had no RN work experience. KH Hospital Division, West Region provided a 6-month new graduates’ orientation and mentorship program (6/14/10 – 12/31/10). Aging case managers and the potential shortage of qualified case managers are critical issues in the case management field. The CMSA data for 24,000 certified case managers (CCMs) revealed that the average age of the CCMs was 55.1 and only 4.0% of them were younger than 40 years of age (Park & Huber, 2009). Although the healthcare industry recognizes the shortage issue, SMU ELMSN-CM graduates still face difficulties in obtaining CM positions. Hospitals traditionally require 1 to 3 years of RN work experience for CM entry positions, but ELMSN-CM students can have no more than one year of RN work experience by the time they graduate.

  12. Kindred Educational Partnerships • Educational University Partnerships developed to provide opportunities for continued growth to working Kindred RN Case Managers (RN to BSN to MSN to DNP) • West Region: 4 CM Scholarships awarded annually • Additional Tuition Reimbursement Policy: $2500/year • Four-level Case Management Career Ladder for opportunities for engagement, advancement, growth, and recognition • Kindred Foundation: in 2011 awarded 3 Scholarships to Samuel Merritt University MSN in Case Management students

  13. Questions? Wendy De Vreugd, RN, BSN, PHN, FNP, CCDS, MBA, Regional Senior Director Case Management Kindred Healthcare, Hospital Division, West Region Office (714) 899-5020 Bruce Mattos, West Regional Director Talent Acquisition, Hospital Division Office ( 916) 351-8774

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