Do's and Don'ts: Documenting for Success

This session will outline strategies and tools to utilize with the interdisciplinary team to achieve accurate, objective documentation that supports the care and services provided. In a day and age of social media and increased access and scrutiny of all communication, it is important now more than ever, that healthcare providers understand the Do's and Don'ts of reporting the residents' status in the medical record. Participants will learn about the current industry standards and approved wording and acronyms, as well as ways to identify the good - vs the bad and the ugly when it comes to progress notes and assessments. This course will also provide resources and training items to use for community teams to assist with education on accurate, thorough, and objective documentation practices.

Objectives:

• Define appropriate documentation guidelines for the interdisciplinary team.
• Outline industry approved language and terms for the healthcare setting.
• Identify "good" vs "not good" documentation

Faculty:

Karen Welsh | Functional Pathways | Vice President of Clinical & Reimbursement Excellence

Karen Welsh has over 35 years of SNF and post-acute care experience with an extensive background in 5-Star and Quality Measure improvement and outcome management. Her areas of expertise include: PDPM, clinical program development, documentation audit and improvement processes, reimbursement, and EMR development and implementation. Karen holds a master’s degree in Speech Language Pathology, RAC-CT, and RAC-CTA certification through AAPACN. She is an active member of Advion (formally NASL), NARA, The Alzheimer’s Association, and LeadingAge in multiple states. In her current role as VP of Clinical & Reimbursement Excellence with Functional Pathways, Karen oversees the development and implementation of clinical programs and policies for over 190 facilities across 26 states, directs analysis of clinical outcomes to guide patient care and reimbursement process improvement, and develops clinical protocols and pathways to ensure functional patient outcomes. Karen is passionate about guiding quality patient care and improving clinical and reimbursement outcomes, a passion she enjoys sharing with therapy teams and client staff by providing education regarding PDPM, Medicare and Medicaid regulations, and clinical standards of practice.

Jen Callahan | Functional Pathways | Director of Clinical & Reimbursement Services

Jen Callahan is the Director of Clinical & reimbursement Services with Functional Pathways and an SLP by background. She received her masters degree in Speech-Language Pathology from the University of South Carolina in 2000 and has over 23 years of experience in providing care and therapeutic services, as well as developing programs, education, and training materials around providing care for the aging population. She has held various operational and clinical positions, is RAC certified, has been a speaker at several state and national level conferences and has extensive experience along the post-acute care continuum.