What 30 years of Home Care, Medicare, and the Joint Commission taught this RN about quality outcomes

In Christine Bunch's experience - all 30 years of it - setting a high standard is a measure that serves both patients and professionals. Exceeding Medicare standards is not only a great way to guarantee reimbursement; it goes a long way toward explaining why Health First Home Care has a Five-Star Quality Rating with the federal program

Bunch recently celebrated her 30-year anniversary and a promotion to Health First Home Care Compliance Supervisor. Her job is to make sure the department follows the Medicare Conditions of Participation (CoPs) and adheres to the Joint Commissions Standards of Excellence for Home Care. In Bunch's telling, she's building on a legacy left by her role model and first supervisor, Marge Roebuck, founder of Roebuck and Associates out of her home in Satellite Beach.

A registered nurse, Bunch had done orthopedic rotations at Wuesthoff Hospital (now Stewart Medical Center) and ophthalmology at Florida Eye Care, an ambulatory surgery center. Seeking a broader experience in care, she contacted Roebuck, asking for a chance to sign on with her small agency. She got it.

"You're helping the patient with clinical decisions, interfacing with the physician, letting them know the holistic story about the patient, what was going on in their home environment that was impacting their health. And we were actually able to do one-on-one teaching with the patient about their medications, their disease process, with the goal of improving outcomes. It's very rewarding."

Under Roebuck, Bunch stepped into a unique role within the small agency - quality assurance. She became the agency lead on Medicare regulations and successfully directed it through a Community Health Accreditation Program survey. Quality outcomes became "a deep passion."

"I actually love reading about Medicare regulations," she says, without a hint of irony.

Roebuck and Associates was purchased by Cape Canaveral Hospital in 1993, which itself became a key partner in the formation of Health First Health System later in the decade. Bunch has been an educator, a supervisor, and an assistant nurse manager.

Today, her supervisor, Michelle Rogers, calls her "an investigator," and she herself has said she's something like "a data miner." This is what they mean: The key patient reporting tool for home care is OASIS, or the Outcome and Assessment Information Set. It's the Medicare standard, and Bunch is not only the keeper of the data but a chief "scrubber" - she can trim and highlight data sets for analysis and key metrics for improvement.

"Every day that I come to work it's something different. I know what I have to accomplish each day, but I could be doing 10 different things to get there, and I love that!"

The system has set high standards during COVID-19. From acquiring personal protective equipment (PPE) to training on it (donning and doffing), the leadership has supported the frontline providers and been transparent about efforts and direction.

"Even from the system out to the county, that communication was extremely open."

When she's not raising the bar for Health First, she's at home with her husband and her dog, Rael, named for the Peter Gabriel-era Genesis concept album The Lamb Lies Down on Broadway. She likes experimenting in the kitchen - recently, it's been sushi. When the pandemic lifts, she'll look forward to getting back to concerts. She particularly loves Classic Albums Live at the King Center for the Performing Arts.

Bunch hopes to work a few more years, to get her supervisor Michelle Rogers "through a few more Joint Commission surveys." And she hopes that younger Home Care nurses and staff take from her what she gleaned from her mentor, Roebuck - keep high standards, reap job satisfaction.

"I'm still friends with that core group of nurses Marge brought up," she says, and "when I meet with new nurses, I tell them, 'I'm probably going to send every report back to you. It's not that you're doing everything wrong, but we have a high standard here.'"

Visit Health First Home Care online to discover why patients choose Home Care and how we can help.