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Staff training goes a long way

Rehab Regs, June 1, 2004

A training program at your facility can reduce turnover

In addition to adequate compensation and job satisfaction, sufficient training ensures that therapists feel they've received ample information to do their jobs correctly and increases the chance they'll remain at your facility.

The fewer employees, however, the less likely a rehab facility is to have a formal training program in place, says Tessa Chenaille, president and chief executive officer of Chenaille Compliance Consulting, LLC, in Medford, MA. Regardless of size, all rehab facility employees benefit from training.

"Generally, larger organizations will have a formal training department or dedicated staff responsible for overall training programs," says Chenaille. "Training in outpatient facilities-if they aren't part of a larger organization-falls on the shoulders of the owner, director of rehab, or the office manager."

Similar to compliance-plan implementation, facilities also often create a formalized training program as a result of an audit or other type of investigation. Generally, it is during an audit that reviewers identify a lack of adequate training.

"A key component to an effective [compliance plan] is training," says Chenaille. "The standard fine is higher without an effective compliance plan, which includes an adequate training program."

Training is a broad topic that spans multiple subject areas. Tailor your training program to your own facility operations. As a guideline, here's who should attend which types of training, according to Chenaille:

When Chenaille designs training programs for clients, she creates various tiers that meet the different needs of each department within a facility. Some topics apply to all staff members, such as sexual harassment policies, while others apply to individual job roles.

Trainers can cover common topics on the first day, and the staff can break into smaller groups on the second day for individualized training, she says.

Upon hire, a new employee almost always receives some type of training, whether formal or informal. But you should also plan regular training sessions for long-time employees.

"I recommend an initial training program for new hires, and then everyone gets put into a pool for annual training," says Chenaille. The simplest way to monitor training is to hold the training sessions the same time each year, she adds. Administratively, it makes it easier to control if everyone participates in a training session around the same time.

You will need to charge one or more people at your facility with the task of organizing this regular training. These individuals will also need training in how to facilitate the program. Keep the following components in mind:

"People view training as something that takes them away from their jobs, even though it's only once a year," says Chenaille. "Make it as easy to get to as possible and as least invasive on their jobs as you can."

One way to do this is with a training fair that takes place throughout one day, allowing therapists to visit when they have time. This type of training works best when an organization is spread out geographically, or when a facility employs a large group of people. Provide therapists with proof of their attendance.

Consider the other aspects of a training program when you work in a rehab facility. For example, it is essential that you have competent employees submitting your claims.

Joyce Briggs, an accounts-receivable specialist at Merrimack Health Group in Haverhill, MA, has developed a billing guideline manual that includes an accounts-receivable section about one inch thick. Inside, each type of billing is explained. The manual also includes sample forms, graphics of different computer screens, and an error-code listing for Medicaid denials. Merrimack Health Group plans to update the manual to reflect HIPAA compliance requirements.

Training may mean reallocating staff time, but having a more confident and efficient billing team-as well as fewer billing errors-makes the time well spent, Briggs says. Conducting quarterly, full-day training meetings with the billing staff, business office managers, and regional business office coordinators to discuss problems creates ongoing communication and eliminates consistent billing problems.

"If we find different facilities bill things in different ways, we can discuss it. It's a very helpful exchange of information," says Briggs.

Consider attending association meetings in your state, she says. If your billing office rotates staff who attend, encourage the attendee to bring back copies of the information for the rest of the staff.

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