Why Do The Best Health Care Companies Still Struggle With Updating Policies?

Hello again,

I used to play video games as a kid. And I had a group of neighbor kids and friends who did as well.

If you happened to have grown up in the '80s undoutedly your life as a kid was impacted by Nintendo. The Nintendo gaming system is the undisputed champ of all-time video game systems, in my opinion. There have been many imitators since that time, but nothing like the original NES.

I still remember the Christmas we got our very own Nintendo in the mid '80s!

It was a totally new concept to be able to play video games at home and there were a variety of types of games to play. The games were challening and time consuming.

If I had to guess, probably greater than 15% of my awake time between 1986 to 1994 was spent playing Nintendo games. Not sure if that is a badge of honor or a better explanation for my poor social skills!

CONTRA. Top 10 video games of all time.

If you played Nintendo during this time, you probably recognize the image above. It is the main screen for the game CONTRA. It was one of my favorite games to play. 2 guys running around with guns and shooting up everything in sight. What's not to love. 

And chances are if you remember CONTRA, you remember this:

CHEAT CODE: up, up, down, down, left, right, left, right, B, A, start

This was a CHEAT CODE that when entered to start the game, would give you an extra 30 lives!

I mean 30 lives was an eternity on that game. After you found out about the CHEAT CODE, everything changed. The levels on the game became easier. The enemies that needed to be defeated were suddenly less scary. The thought that it was possible to win the whole game was all of a sudden within reach.

But, here's what you might not know about the origin of the CHEAT CODE. Kazuhisa Hashimoto worked at Konami in the 1980s, the company who created CONTRA. Before CONTRA, he was tasked with moving a spaceship game, Gradius, from the arcade version to be able to operate on the Nintendo home system in 1986.

He created his own code to be able to beat the Gradius game, because it was so difficult to beat he said. He made up the code pattern so he could easily remember it. Boy did that work!! Countless kids from that era have this code seared into their brains for eternity. Try it. Ask someone from that era what the Contra cheat code is!

He later used that same code on hundreds of games after that, including Contra, Castlevania and Mortal Kombat.

Here's the point of this story: Hashimoto created the code to make life easier for others based on his expertise.

Countless people benefited from the knowledge he shared. 


            Ok, but how does this relate to home care? 

Great question and thank you for letting me go on that quick journey of my youth.

Some big things have happend for home care agencies in Colorado just in the last few months. COVID regulations and reporting have been forced upon us. Plus, a total reorganization and update of the main regulations for home care, Chapter 26.

You may be trying to determine what changed. And then, what your company needs to do to be in compliance.

Today, I'm going to provide an overview of what has changed and initial steps to take to stay in compliance.

What has happened? 

The original Chapter 26 regulations for Class A & B home care agencies in Colorado have official been retired. On December 15, 2021 the Board of Health finalized changes to Chapter 2. Then, on February 14, 2022, the final version of Chapter 26 became effective and enforceable by surveyors. 

Originally, home care agencies in Colorado fell under state regulation for the first time back in 2009. This was the establishment of licensure for Class A & B agencies. As part of the regulation, there was included a sunset provision that the regulations needed a comprehensive review every 10 years.

Initially delayed by the pandemic, it took until 2022 to get everything finalized. But, now we're here.

What has changed?

There were numerous changes to Chapter 26 throughout all sections. Company policies and procedures will need to be changed to accomodate the updated regulations. Which is great news because we all have time to do a comprehensive review of policies. No we don't.

So, here are 5 of the top changes for Chapter 26. Stay tuned for another email providing tools to get all policies in compliance. 

Top 5 changes for Chapter 26 & 2: 

* Chapter 26 was shortened from 8 sections (called parts) to 7 parts, deleting Part 2 which discussed what happened to new and existing agencies at the time of licensure back in 2009/2010.

Part 7 (previously Part 8) for Non-Medical (Class B) agencies was reorganized and updated, including: more flexibility for Governing Body/Administration/HCA Manager, PCW training requirements were restructured to create a stacked "homemaker" based qualification and then a "personal care worker" needing additional requirements, and telehealth visits for supervision being possible in certain circumstances.

* Requirements around developing an Emergency Preparedness Plan in Part 5 were beefed up to include: adding a risk assessment component, modernizing outdated language, bolsters existing requirements to ensure consumer and staff safety.

Chapter 2 added Part 12 for COVID-19 Vaccinations. This section includes regulations around: requirements for staff COVID-19 vaccinations, medical or religious exemptions, requirements for unvaccianted staff members and requirements for agencies to report COVID vaccination status to CDPHE.

Part 7 for Skilled Home Health agencies was moved to Part 6 and this section had some large changes, including: deleting the requirement for a Professional Advisory Committee, written summary report for Plan of Care was reduced from every 60 days to only with a 'change in status', added telehealth visits are ok for nurse aide supervision in certain circumstances, and a new section about standards for clinical records.

Great, can you give me anything to help me? 

While there are many changes that need to be made, perhaps one of the most pressing is related to COVID-19. With the addition of Part 12 in Chapter 2, each agency needs a clear policy on how they are handling vaccination, exemptions, testing and reporting.

Here's an acutaly policy that you can use for COVID-19 to comply with Chapter 2, Part 12. 

Be sure to review and make sure it fits your agency and then customize with your logo.

Stay tuned for a comprehensive program to successfuly transition to the new regs at your agency!