(Fort Worth, TX)…The most vulnerable Texas adults, those who have IDD diagnoses plus high medical needs and living in State Supported Living Centers (SSLC) or those in nursing home settings now have additional, alternative Medicaid-funded long term care settings available.

Caregiver, Inc., a Fort Worth-based company that provides intermediate, home and community care services to thousands of Texans who qualify as developmentally or intellectually disabled or are impacted by related conditions, has new options for Texans with both IDD and high medical needs who meet the criteria for leaving SSLCs, according to Amanda Corrigan, Caregiver’s President for Texas Operations.

Caregiver opened the first of two newly state-licensed group home Intermediate Care Facilities (ICFs) just south of Austin
in the San Marcos/New Braunfels area, with space for six individuals each.

A second, only five minutes away, will open soon.

“We have spent the last 18 months investing in and preparing two homes under the first two of only three new Texas licenses granted to operate ICF group homes,” explained Corrigan. “There is a great need for ways to serve individuals who meet criteria to move from SSLCs or nursing homes to a community setting. Working hand-in-hand with our SSLC partners, we developed community homes with the highest site and service standards and are thrilled to be able now to accept those referrals.”

During the last legislative session, funding was made available for up to 100 applicants. Only three licenses were released last year by the state. Caregiver received two, to provide care for up to 12 people.

It takes about a year to become approved as an ICF due to various renovations and inspections.

“There is an extensive leadup to readiness. Caregiver invested over $150,000 in the first home, with additional dollars committed to the second in final preparation now,” added Kathy Griffith, Caregiver’s Regional Director for South Texas.

Before opening, Caregiver extensively remodels each open-concept home, purchases specialized equipment, designs and structures wheelchair accessibility, and identifies and assigns ideal 24-hour Direct Service Providers (DSPs) and nursing staff, among other activities to prepare for new residents.

While formerly living in SSLC facilities, these first six individuals reached a level of ability for referral to transfer to a community group home, Griffith explains. There are hundreds of individuals in Texas with high medical needs who could be considered for a group home setting, but limited spaces are available.

“Caregiver’s new homes make it possible for careful attention to individuals’ medical needs while providing a measurable increase in quality of life,” explains Griffith. “Patients may have tracheostomies and require gastric tube feeding. They are at risk for extensive wound issues and pressure ulcers and at a high risk for aspiration. The Caregiver group home setting supports these needs and provides great peace of mind for an individual’s family or guardian.”

Caregiver’s group home open floor plan benefits the individuals, caregivers, and family members. Each home has a shower trolley, modified bathrooms, fully accessible lifts, and a weight scale for wheelchairs. Every employee in the group homes has been trained by SSLC staff, including former staff nurses, physical therapists, dieticians, and DSPs.

Underpinned by a staffing ratio of two professionals caring for each six individuals 24/7, care includes attention from a registered nurse who will float between two homes and an on-call physician who visits the home for routine services on a regular basis. Other health care professionals see group home residents via telemedicine or in their offices.

As well, group homes are often closer to families than are SSLC facilities.

“We must remember that these individuals have been in care of SSLC for a long time, many since before age five,” stresses Griffith. “Now, most are middle-aged and non-verbal. They require supports for bathing, repositioning, hygiene and all activities of daily living (ADLs). Experienced staff members can understand their likes and dislikes with no verbal cues.”

Caregiver’s team also plans community outings like shopping, going to the park, or perhaps a field trip to Morgan’s Wonderland in San Antonio, the world’s first ultra-accessible theme park. Since none of the individuals can propel their own wheelchairs, additional staff are required for outings, and a nurse may go along to do the G-tube feedings. Caregiver has backpacks to carry formula and continuous feeding pump equipment to hang the unit on the back of wheelchairs, allowing each individual mobility and continuity of care while enjoying activities outside of the home.

“It is a happy situation,” stresses Griffith. “Individuals blossom and open up.”

Concurrently, Caregiver also offers alternatives for non-high medical need individuals with IDD diagnoses living in nursing homes who want to come back into a community group home. For example, an individual with IDD formerly living in his family home may have had to move to a nursing home after losing one or both parents.

“An individual may use a wheelchair and need a hospital bed but may not need a nursing home level of care,” Griffith explains. “Without a small group setting available, a nursing facility might have been the only option. Now Caregiver’s nursing home diversion program can offer these individuals group home community living.”

Following evaluation by federally regulated Preadmission Screening and Resident Review (PASRR), the process is facilitated by a local intellectual and developmental disability authority (LIDDA). The State of Texas carefully monitors all Caregiver, Inc., group homes throughout the state.

“These are two shining examples of how Caregiver is developing and providing group home settings ideally suited to individuals’ unique needs,” Griffith stated. “Our Texas group homes offer environments that are closer to what these people enjoyed when living at home with their families.”

For more information about Caregiver’s group homes and other services, please call (800) 299-5161 or visit www.cg-idd.com.

ABOUT CAREGIVER, INC.

Caregiver, Inc., is a privately held company with over 3500 employees within the headquarters support group in Fort Worth and branded affiliate organizations in four states. The affiliates provide intermediate, home and community care services to nearly 2800 individuals who qualify as developmentally or intellectually disabled or are impacted by related conditions. Caregiver, Inc. was formed in 2015 and now includes these affiliates: Unified Care Group,  Southern Concepts, River Gardens, Daybreak Community Services Inc., St. Giles Living Centers, DSA of Indiana, CG-HHC, All Care Services, T/R Residential, and Omni Support Services of Tennessee, and S&K in Ohio. All have similar service offerings and strong reputations in their local communities. Caregiver services include supported home living, family protective services, case coordination, nursing services, respite services, day habilitation, psychology services, dental treatment, specialized therapies, adaptive aids, minor home modifications, and supported employment. Caregiver president and CEO is Mark Lashley. Company headquarters are at 4800 Overton Plaza, Suite 440 in Fort Worth, Texas 76109. Phone is (800) 299-5161. They are on the web at cg-idd.com.

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(Fort Worth, TX…) Mark Lashley, President and CEO of Caregiver, Inc., a leading provider of services to adults with intellectual and developmental disabilities (IDD), has announced that Amanda Corrigan has been promoted to President of Texas Operations for the company.

Corrigan will support Caregiver’s Regional Directors throughout the state of Texas and report directly to Lashley.

“Since joining Caregiver, Amanda has quickly made an impact improving the quality of our service delivery and placing strategic focus on core business processes and the financial performance of our Texas business,” said Lashley. “In just a short time, Amanda has proven herself to be a critical member of our team; she is a great leader, and in her new position, she will play a pivotal role as we continue to differentiate through strategies such as of employing technology for advanced and personalized care, partnering with state government as well as managed care organizations, and developing our leadership teams as we grow as an employer and provider of choice.”

Corrigan joined the company in February 2019 as Vice President of Operational Excellence and jointly led the internal Project Management Group. In her new role, she will provide operational oversight while supporting Texas leadership on Caregiver’s largest segment of the business.

Prior to joining Caregiver, Corrigan led teams in the skilled nursing industry. She previously served as the Senior Vice President of Operations for Paramount Healthcare, where she helped grow the company, improve quality and successfully develop her teams. Before Paramount, Corrigan held executive positions with several companies, including America’s Medical Home Team, Diversicare Healthcare Services and Cantex Continuing Care Network.

Corrigan is currently working toward a Master of Business Administration degree from Texas A&M Corpus Christi. She received a Bachelor of Science in Marketing from Louisiana Tech University and holds a Nursing Facility Administrator license from the Nursing Home Administration Program at Tarrant County College.

About Caregiver

Caregiver, Inc., is a privately held company with over 3500 employees within the headquarters support group and branded affiliates in four states. They provide a wide range of intermediate, home and community care services to nearly 2800 individuals who qualify as developmentally or intellectually disabled or are impacted by related conditions. Formed in 2015, Caregiver headquarters are at 4800 Overton Plaza, Suite 440, Fort Worth, Texas 76109; (800) 299-5161. Visit cg-idd.com.

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(June 5, 2019 | Fort Worth, TX) … When Caregiver, Inc.’s Director of Nursing, Randi Morgan, RN, BSN, launched a single-market RN On Call pilot in 2012, she had three priorities in mind: sustain excellence in continuity of care, assure immediately available support after hours for direct service professionals (DSPs) caring for individuals with intellectual and developmental disabilities (IDD), and provide weekend and evening relief for staff nurses with full caseloads.

Today, the Caregiver RN on Call program’s dedicated team of full-time, after-hours telephone triage nurses are hitting those targets as they help manage health issues that arise among the nearly 2300 individuals with IDD issues whom Caregiver serves throughout the State of Texas.

“The pilot was an epic success,” Morgan (pictured left) noted. “We saw the positive effects immediately and began expansion statewide.”

No other service provider for IDD care in the state has such a supplementary, full-time, professionally staffed on-call program in place, according to Morgan. Texas cities served include Dallas, Fort Worth, Houston, Baytown, Beaumont, San Antonio, Lancaster, Temple, New Braunfels, Amarillo, Abilene, Lufkin, Mexia, Benbrook, Brownwood, Wichita Falls, Granbury, College Station, Lubbock, San Angelo and Victoria.

According to Morgan, through the RN On Call program individuals Caregiver supports have reduced hospitalizations, decreased emergency room visits, and greater quality of life. Caregiver’s coterie of highly-skilled after hours triage nurses helps drive greater accountability, lessen fatigue and burnout for the daily nursing staff and assure a better flow and continuity of reporting. And importantly, front line DSPs report reduced stress and peace of mind knowing after-hours help is one phone call away.

“Daytime nurses are more satisfied with their jobs, with reduced downtime and enhanced retention,” said Morgan. “Caregiver’s Direct Support Professionals, families and guardians receive quick after-hours access and support 24 hours a day, seven days a week, 365 days a year.”

Such responsiveness and access is important, as telephone triage can be more complicated when serving the IDD community. Frequent issues include illnesses, medications, injuries, and maladaptive behavior, among others.

Each quarter, Caregiver on-call RNs receive thousands of calls, often averaging 30,000 calls annually. In the last quarter of 2017, of 5,056 calls answered by RN On Call nurses, only 137 resulted in transfer to emergency departments and less than a quarter of the calls required a follow-up conversation.

Among the goals of the program are facilitation of after-hours access, reduction of delays in response time, sustaining excellent continuity of care, and preserving ER and doctors’ visit appropriateness.

“The program has exacting protocols and guidelines,” said Diane Rickman, RN, (left) Caregiver Lead On Call RN nurse in West Texas. “This assures that good judgment underpinned by years of experience and strong educational backgrounds prevails.”

Randi Morgan explains that such judgment capability also reflects metacognition, thinking about thinking. Nurses have scientific skills, empathy (generally defined as an effort to appreciate the patient’s experience from his or her perspective) and situational consciousness that can guide the interviews with Direct Support Professionals so that each DSP supplies the best information about the individual they support to the RN On Call nurse.

“Our nurses draw upon finely-honed intuition informed by experience and decision-making over many, many years,” said Morgan.

Experience also contributes to clear communication. Information shared via electronic health records helps on-call nurses appropriately manage or escalate any situation. Healthcare data and full histories are available at their fingertips; Caregiver will have fully implemented its Taskmaster Pro electronic health records protocol by the fourth quarter of 2019. As communication capabilities continue to evolve, accessible records, voice and now video conferencing inspire even better assessments.

“With video conferencing, we can see the injury, look at the skin condition, essentially get a full picture of each patient,” Rickman states. “In many cases individuals are nonverbal, so visual interaction assures that nurses see facial expressions and observe behavior.”

IDD individuals’ complex situations are often exacerbated by multiple diagnoses. According to the National Council on Disability, “…adults with developmental disabilities are at risk for hearing and vision difficulties, cardiovascular disease, obesity, seizures, mental health and behavioral problems, poor oral health, and poor general fitness.”

Considering those complexities, Morgan reiterates that thorough information-gathering by the nurse is critical.

“Direct support professionals, while skilled at working with the individuals they serve, are not licensed medical professionals,” she noted. “Licensed nurses can help guide each DSP so that the nurse gets the best information.”

A residual benefit is the value of educating the Caregiver Direct Support Professional staff. Each registered nurse shares knowledge and understanding during every conversation.

Five years ago, Caregiver staff nurses had to take call in addition to their daily activities. Even when tired, professionals still had to be the eyes and ears to everything. When fatigued, nurses could miss less transparent behaviors in this complex population, Morgan explained.

“Now, there is less fatigue and more transparency,” she said. “Transparency and visibility of daily reports assures everyone understands what is going on, at all times.”

Morgan stresses again that Caregiver is the only company that works with IDD individuals in Texas to have an on-call nurse triage department. Before the RN On Call program began, Caregiver used contract nurses exclusively. While adequate, continuity was lacking. There was less familiarity among the teams, and peace of mind suffered. Having full-time, on call triage nurses was the solution.

“I believe the RN On Call formula is people + passion = improvement,” said Diane. “We integrate technology and relationships. Each personal touch builds trust and connection. Every team member at Caregiver understands his or her common reason for being here. In short, good staff means good care.”

For 2019, managing ratios of nurses on staff is at the forefront. Morgan has developed the proprietary Caregiver RN On Call training program that includes an 1100-page nursing guidebook, a five-hour education course and Caregiver’s electronic health records training for both waiver and non-waiver reimbursement programs. She is ready to add RN On Call team members who have patient experience, excellent communication skills, depth of pathophysiology knowledge, and a thorough understanding of pharmacology.

During the third and fourth quarters of 2019, Randi Morgan anticipates expanding the RN On Call program just as soon as practicable to additional Caregiver service areas in Tennessee, Indiana and Ohio

ABOUT CAREGIVER, INC.

Caregiver, Inc., is a privately held company with over 3500 employees within the headquarters support group in Fort Worth and branded affiliate organizations in four states. The affiliates provide intermediate, home and community care services to nearly 2800 individuals who qualify as developmentally or intellectually disabled or are impacted by related conditions. Caregiver, Inc. was formed in 2015 and now includes these affiliates: Unified Care Group, Southern Concepts, River Gardens, Daybreak Community Services Inc., St. Giles Living Centers, DSA of Indiana, CG-HHC, All Care Services, T/R Residential and S&K in Ohio, and Omni Support Services of Tennessee. All have similar service offerings and strong reputations in their local communities. Caregiver services include supported home living, family protective services, case coordination, nursing services, respite services, day habilitation, psychology services, dental treatment, specialized therapies, adaptive aids, minor home modifications, and supported employment. Caregiver president and CEO is Mark Lashley. Company headquarters are at 4800 Overton Plaza, Suite 440, Fort Worth, Texas 76109. Phone is (800) 299-5161. They are on the web at cg-idd.com.

“With the RN On Call program, individuals Caregiver supports have reduced hospitalizations, decreased emergency room visits, and greater quality of life. Caregiver’s coterie of highly skilled after-hours triage nurses help drive greater accountability, lessen fatigue and burnout for the daily nursing staff and assure a better flow and continuity of reporting. And importantly, front line DSPs report reduced stress and peace of mind knowing after-hours help is one phone call away.” Randi Morgan, RN, BSN – Caregiver, Inc.’s Director of Nursing

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