This homecare agency provides a wide range of in-home medical, rehabilitation, and support services to help clients remain in their homes. They have a doctor-owned, nurse-managed model with strict safety standards. Services include skilled nursing, physical/occupational/speech therapy, medical social work, and 24/7 nurse support. They aim to improve outcomes through coordinated, compassionate long-term care that improves quality of life.

2. WHO ARE WE?

3. We are NOT your average homecare agency

4. HOME HEALTH & HOME CARE
Our goal is to help individuals
remain in their home AND in their
community for as long as possible,
no matter their diagnosis, by
providing quality, skilled healthcare
and home care services.

5. AREAS WE SERVE
KING COUNTY
SNOHOMISH COUNTY
PIERCE COUNTY

6. PAYING FOR CARE
• Private Pay
• Private Insurance – Premera, Aetna,
etc.…
• Labor & Industries
• Long-Term Care Insurance
We cannot coordinate Medicare OR Medicaid benefits. However,
we can supplement additional hours beyond what is covered under
these programs.

7. WHY ARE WE UNIQUE?

8. A TEAM OF EXPERTS
Dr. Evan Cantini
Medical Director
Julie Clobes, RN, CCM, BSN
Clinical Supervisor
Laura Clark, RN, CSA
Clinical Director
Peter Rigby, PT, MPH
Executive Director
DOCTOR-OWNED, NURSE MANAGED
Dr. Alvin McClean
Chairman of the Board
Jen Fox, PT, DRS
Driver Rehab Specialist

9. NO DIAGNOSIS IS TOO
COMPLICATED.

10. 24/7 NURSE
ON-CALL

11. THE CARE FEEDBACK LOOP

12. WE ARE JOINT COMMISSION ACCREDITED
The Joint Commission
Accreditation is considered the
“Gold Standard” for healthcare
quality control and safety in the
United States.
CHCS is one of the first home care
agencies in the State of Washington
to receive Joint Commission
Accreditation.

13. 1. STRICT SAFETY STANDARDS
We have a “culture of safety” at CHCS.
Everything we do is prioritized by safety for our clients and
safety for our employees.

14. HAND HYGIENE
Annual Unannounced Audits

15. Food Handling Safety

16. Infection Tracking
We keep an infection log with
client name, diagnosis, type of
infection and treatment. The
client and caregivers are
interviewed to see if they can
identify the source of the
infection and then create a plant
to address it.

17. FALL REDUCTION
Our RNs conduct a full risk
assessment and put
together a customized
fall risk plan of care.

18. RN Medication Reconciliation
“ATTEN-TION!”
ACCORDING TO THE FDA THE #1 MISTAKE IN HEALTHCARE IS
MEDICATION ERROR

19. Home OXYGEN Safety

20. Employee Safety and Injury Prevention
According to OSHA
54% of all healthcare
related injuries are sprain/strain related.

21. 2. COMPASSIONATE &
CAPABLE CAREGIVERS

22. “I am doing this job today because it gives me
joy to see the people we care for have a smile
tomorrow.
And to have hope that, despite their condition, they
can still live to do what they aspire to do.”
- Allan N. (CHCS
Caregiver)

23. CONTINUING EDUCATION &
EXTENSIVE ORIENTATION

24. NAR to CNA
We want our caregivers to have more than just the state
requirement for caregiving. We require that all our caregivers go
through the training to become a CNA, within a three month period
after signing on.

25. SKILLS VERIFICATION

26. 3. BETTER
OUTCOMES &
RESULTS

27. EARLY IDENTIFICATION OF
EMERGENCIES
Our RNs and Caregivers are looking for…
PINK FLAGS NOT
JUST
RED FLAGS

28. LOWER READMITTANCE RATE
Expert oversight and increased safety measures lead to a lower re-
admittance rate to hospitals and rehab facilities.

29. RESTORED FUNCTION
CHCS is currently working on a program for trained restorative aids who
will work in conjunction with home health to improve function in our
clients.

30. CLIENT CARE SATISFACTION

31. 4. QUALITY OF LIFE & INDEPENDENCE

32. Teaching our clients to advocate for themselves and go from…
PASSIVE PATIENT ACTIVE PARTICIPANT

33. MATCHING CAREGIVERS TO FAMILIES
Having the right caregiver can make all the

34. TRAVEL Support

35. Encouraging our
clients to continue to
do the activities
they enjoy and to
pursue their passions.

36. WHO DO WE SERVE?

37. WHO WE
SERVE.
a wide range of clients
that require a high level
of care.
An elderly patient with dementia.
A pediatric client with a rare disorder.
A middle aged client with a spinal cord injury.

38. • Rehabilitation
• Post-Op Orthopedic
• TBI – Traumatic Brain Injury
• SCI – Spinal Cord Injury
• Cerebral Vascular Accidents
• Diabetes Management
• Neurological Conditions
• Geriatric Conditions
AREAS OF
SPECIALIZATION

39. SERVICES

40. RN CARE
MANAGEMENT
for the client’s
needs and desires.
ADVOCATING

41. TRANSITIONAL
SUPPORT
HOSPITAL TO HOME TRANSITION (An RN can meet you
at the hospital to discuss care with the client and their
hospital care team.)

42. CONTINUITY OF CARE
• Schedule and Attend Doctors Appointments
• Advocate for Client’s Needs to Care Team
• Keep Detailed Medical Records and Update Plan of Care
• Keep Family Informed of Changes in Health and Care
Plan

43. CLIENT & FAMILY
EDUCATION

44. WITH A NEW DIAGNOSIS COMES A
LOT OF QUESTIONS?

45. How will I pay
for care?
What do I
do now?How will I manage my
pain?
WHAT
RESOURCES ARE
OUT THERE? WILLL I HAVE TO
STOP
WORKING?
Can I keep driving?
Who should I call if
something goes wrong?

46. DISEASE MANAGEMENT
The RN Care Manager can help clients become
empowered to manage their disease well.

47. RESOURCE
COORDINATION
RN Care Managers can connect clients to
a variety of resources, such as:
• Specialized Medical Equipment or Services
• Healthcare Organizations
• Disease Management Programs & Specific Benefits
• Support Groups & Other Support Networks

48. Does having a NURSE as a care manager
really make a difference?

49. One of our care managers arrived at a client’s home and
listened to her heart rate, which was irregular and fast
paced.
She asked the client to stand to monitor postural vital signs
and noticed that her heart rate shot up upon standing.
WHAT
DID THE RN
DO NEXT?

50. THE RN ASKED TO SEE THE
CLIENT’S FEET.
She noticed pitting edema
and recognized it as a
possible sign of atrial
fibrillation.

51. The client was admitted to the
hospital with atrial fibrillation.
And an EMERGENCY situation was avoided.

52. HOME CARE

53. COMPANION
CARE
• Companionship
• Recreation
• Daily Errands – shopping, driving to
appointments, etc.
• Housework – light housework, meal prep, etc.

54. DELEGATED
HOME CARE
As care gets more complex, our caregivers can
be delegated by one of our on-staff nurses to
perform tasks that they otherwise could not.

55. 1. ONLY an RN can delegate.
2. Physicians Orders are
obtained
3. RN obtains consent for
delegation and completes
nursing assessment and plan
of care.
4. RN verifies care specialists (CS)
has completed the delegation
course and is certified.
5. RN determines competency of
care specialist for each
delegated task.
STEPS FOR DELEGATION

56. HOSPICE CARE
• On-staff RN Oversight and Delegation of
Caregivers
• Coordination of Care – CHCS nurses to Hospice
Nurses
• In-House Hospice Training Program for Caregivers
(Prior to caring for anyone on hospice.)
• Emphasis on client comfort and family support
We SUPPORT and work with local hospice
agencies to provide additional care
services, beyond what Medicare allows.

57. HOME HEALTH

58. SKILLED NURSING

59. MEDICATION MANAGEMENT
AND RECONCILIATION

60. PAIN
MANAGEMENT

61. CENTRAL LINE
DRESSING
CHANGES

62. Intramuscular & Subcutaneous
INJECTIONS

63. INTRAVENOUS
TRANSFUSION

64. BLOOD DRAWS

65. WOUND CARE

66. PRIVATE DUTY
HOSPICE NURSE

67. PHYSICAL THERAPY

68. BENEFITS OF PHYSICAL THERAPY
• Shortened recovery time after injury
and surgery
• Prevention of certain complications
after injury, surgery, and illness
• Improved mobility
• Promotion of healing
• Increased range of motion
• Increased strength and endurance
• Reduced risk of falls
• Reduced pain and joint stiffness
• Improved overall health and fitness

69. OCCUPATIONAL
THERAPY
Occupational Therapists and OT Assistants

70. Activities of Daily Living (ADLs)- Activities of daily living (ADLs) are basic
self-care tasks, and include the following
• Feeding
• Toileting
• Dressing
• Grooming
• Bathing/showering
• Walking and transferring (such as moving from bed to wheelchair) (PT
and OT)
• Bed mobility
• Procuring proper DME (durable medical equipment) and instruction on
use (wheelchairs both OT and PT) and splinting (PT lower body and
OT upper body)
• Safety while performing ADLs

71. Instrumental Activities of Daily Living (IADL) – Instrumental activities of
daily living (IADLs) are the complex skills needed to successfully live
independently. These skills include the following
• Managing finances
• Handling transportation (driving or navigating public transit)
• Shopping
• Preparing meals
• Using the telephone and other communication devices
• Managing medications
• Housework and basic home maintenance
• Home safety with IADLs

72. SENSORY
INTEGRATION
Sensory integrative dysfunction is a common disorder for individuals with
neurological and learning disabilities such as autism spectrum disorder.
Clients are usually children and treatment includes “play therapy” but also
used for ADLs like getting a child accustomed to brushing his teeth (both

73. KAYAKING WITH A
CLIENT - A CASE STUDY

74. SPEECH
THERAPY
Speech Language Pathologists

75. COMMUNICATION AND
SWALLOWING
Communication includes
speech production and
fluency, language, cognition,
voice, resonance, and
hearing.
Swallowing includes all
aspects of swallowing,
including related feeding
behaviors.

76. Some of the clients that may need SLP services:
• Cerebral Palsy(CP), Language Delay, Hearing Loss, and Autism
(pediatrics)
• Traumatic Brain Injury (TBI)
• Cerebral Vascular Accident (CVA) also known as Stroke
• Parkinson’s Disease (PD)
• Dementia (Alzheimer’s disease, vascular dementia etc…)
• Cancer (Brain tumors, oral cancers)
• Amyotrophic Lateral Sclerosis (ALS) also known as Lou Gehrig's
disease
• Multiple Sclerosis (MS)

77. • Review of health history & physical and any medications
• Examination of entrances, exits and stairs
• Measurements of doorways, etc…
• Observation of where mobility equipment may be necessary (grab
bars, etc…)
• Write-up with safety observations and/or suggestions for modification
Durable Medical Equipment – Is it safe and does it fit them correctly?
HOME SAFETY EVALUATIONS & HOME
MODIFICATIONS

78. DRIVER
EVALUATION & REHAB
PROGRAM

79. • Conducted By Our Driver Rehab Specialist (DRS)
• Our DRS is 1 of 4 Driver Rehab Specialists in the State of
WA, who is actively accepting out-patient clients.
• Different From a Driving School –the emphasis is on
cognition, physical ability and reflexes VS. understanding
of laws and passing the DMV drive test.
FAST FACTS

80. CHCS DRIVER EVAL & REHABILIATION DRIVE SCHOOL & SAFETY COURSES
• Medical Background – PT, DRS • NO Medical Background
• Evaluates Cognitive Functioning • Does NOT Evaluate Cognitive Functioning
• Emphasis on Cognitive and Physical Ability to Drive • Emphasis on Teaching Rules to Pass the Drive Tes
• Emphasis on Safety as it Relates to Rules of the Ro• Emphasis on Safety as it Relates to Physical
and Cognitive Aptitude
• CAN Recommend Modifications to Vehicle
• Driving Rehab Specialist
• Can NOT Recommend Modifications to Vehicle
• Certified Driving Instructor
Different From a Driving School

81. • One hour – Written Recommendations for
Physician, Individual and Family.
• Two hour - Cognitive Assessment
• One hour - Behind the Wheel
EVALUATIONS INCLUDE

82. SIGNS OF UNSAFE DRIVING
• Increased nervousness when driving
• Difficulty seeing road signs or pedestrians
• Has frequent "fender benders" or "near-misses"
• Experiences delays when changing lanes
• Drives significantly slower than the speed limit

83. CHCS has a modified vehicle with a
variety of hand controls and a
passenger side brake, so that people
with progressive neurological diseases
(such as MS, Parkinson's, ALS), spinal
cord injury, amputations, etc..may learn
to continue driving without the use of
their lower limbs.
Equipment for the car was provided by
NMEDA (National Mobility Equipment
Dealers Association) and installed by
Kersey Mobility in Redmond.

84. • Evaluation for installation of mobility devices.
• Behind the wheel training for hand controls & other assistive devices
• Rehabilitation and training for driving with progressive diseases.
• Cognitive assessments for stroke and TBI clients.
REHABILITATION

85. “To know even one life has breathed
easier because you have lived. This is to
have succeeded.”
Ralph Waldo Emerson

86. Thank you!
www.chcservices.com
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