How to Start a Nursing Home Wound Care Service

The nursing home is often the final destination for patients with chronic, stable conditions that no longer require hospitalization. These patients, however, cannot take care of themselves. Nursing homes have an overabundance of bed-bound patients, whose sedentary existence is a primary cause for wounds --- bed sores, deep-vein thrombosis --- that can lead to severe infections like sepsis and complications that can weaken the immune systems of patients who are already debilitated. It is imperative for nursing homes to hire conscientious and highly skilled personnel who can provide effective and efficient wound care. Following some important steps will help you to start a successful and proficient nursing home wound care service.

Instructions

• 1

  Develop outcome-driven wound care plans. It is necessary to understand every stage of a wound and provide the necessary care at each stage. Nursing homes can set themselves apart from other nursing facilities when they provide precisely written wound care plans that direct the nursing staff regarding how to treat wounds, and they document the time lines for each procedure. Discharge planners and the patient's family will know when to expect definitive results including decrease in wound size and the progression of scabbing.

• 2

  Recruit certified wound care nurses. A couple of organizations provide wound care certification to nurses seeking this kind of expertise. The Wound, Ostomy and Continence Nursing Certification Board offers certification in wound care. The American Academy of Wound Management also offers various levels of wound care certification, including Certified Wound Care Associate and Certified Wound Specialist. Both organizations have a reputable track record; so, nursing homes should hire nurses who are already certified by either of these certification boards.

• 3

  Poll wound care patients in hospitals. Often, wound care patients have a previous history of wounds and they know the pitfalls of recurring wounds. Find out what makes them uncomfortable with the wound care process or what they like about the process. Use patient feedback to find out how to develop definitive outcomes and at the same time reduce the level of discomfort for the patient.

• 4

  Market the nursing home to doctors and hospitals with patients who are prone to wounds --- for instance, patients with diabetes, hip replacements and obesity are just some of the patients who could potentially require wound care. A nursing home seeking to start and develop a wound care service should associate with facilities and practitioners who manage patients who will eventually need this type of care.

• 5

  Determine payer coverage for wound care. Medicaid covers patients based on income level, whereas insurance companies like Blue Cross and Blue Shield require deductibles and have a coverage limit within a benefit period. HMOs offer standard rates for patient care. The cost of wound care is bundled into the primary diagnoses of the patient. Nursing home accountants must analyze the rates offered by various HMO plans and they must determine on a case-by-case basis whether or not wound care can be administered safely to the patient and at the same time cover the cost of care. Nurses' salaries, supplies and administrative costs must weigh into this decision.

  Starting a successful wound care service in a nursing home means deciding which payers the service will use and understanding the coverage guidelines of the payers. The decision to accept charity or indigent patients should be based on the resources available to the individual nursing home. If the nursing home can remain viable and at the same time provide care that will not be reimbursed, it will definitely be a benefit to the patient. Nursing homes must provide counselors as case managers to work with patients if they plan to use Social Security benefits as payments for care. Obtaining these benefits may involve researching a power of attorney ruling as well as working with a spouse who still lives independently.

• 6

  Follow state and federal guidelines. To remain viable as a business, the nursing home must adhere to federal and state guidelines for owning and operating a nursing home. The federal guidelines are the same, but state guidelines will vary from state to state.