HEALTHCARE AT HOME:
THE  ROWAN TECHNOLOGY REPORT

Serving the home health, home care and hospice industry since 1999.

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by Tim Rowan, editor

PT with Patient

Keeping an eye on home health and home care and hospice operations across the country has been one of the joys of this reporter's life. Healthcare's best people run these agencies. That is why the opportunity to walk in and sit down in person with one of these people is an extra treat. Naturally, that doesn't happen these days, but it is still a pleasure to pick up the phone and check in on someone who I used to be able to drop in on and visit at his desk.

Ben van Batum, PT, is the owner of Benefit Health Care in Colorado Springs. It is a small, independent, Medicare agency that recently added personal care, patient-pay services. As were most home health agencies across the country, Benefit was well-prepared for the changes brought about by PDGM and started out 2020 in a decent financial position. Then, it happened. This is the story of how one small agency is coping with the impossible-to-prepare-for uncertainties brought about by the challenges of a global pandemic.

Off to a Good Start

For the second year in a row, Benefit had been named to "Home Care Elite," an annual compilation of the most successful home care providers in the United States. Compiled by ABILITY Network and DecisionHealth, it identifies the top 25 percent of agencies in home health performance measures, including quality outcomes and independent patient satisfaction scores. Benefit is the only agency in its market area to be so recognized, including the national chains with well-known names.

Two years ago, van Batum had also engaged an online marketing team to teach him how to boost his online visibility. By encouraging his in-home staff to request reviews from satisfied patients, Benefit rose from obscurity to be frequently found near the top of Google searches. "We did notice that our phone began to ring a lot more often after we went from about three reviews to more than 60," he said.

Strong Foundation Making Survival More Likely

When the pandemic was declared and Colorado Springs hospitals turned almost all their attention to virus victims, van Batum was grateful he had built a solid foundation. Naturally, Benefit offers skilled nursing services, but had built its business on a physical therapy core, common with agencies owned by therapists, but had also developed a preferred partner relationship with two local hospitals. Nevertheless, some difficult decisions had to be made.

"We hated to do it, but we saw the shutdown coming and reduced all of our office personnel to 30 hours a week," van Batum told us, "so we could reduce expenses but no one lost their employment benefits. Now, all but two people are working from home, including me." The virtual elimination of elective surgeries, which included most joint replacements, hit Benefit hard. Fortunately, these adjustments were working.

Government Programs - All of Them!

With help from attorneys and accountants, van Batum applied for every available federal loan program. He qualified for the emergency loan from the CARES Act, the advance payment from Medicare, and a PPP loan. The next step was to calculate how much of the forgivable PPP loan he could direct to qualifying payments -- wages, rent, and utilities -- within eight weeks. "We should be able to get about $180,000 forgiven," he calculated, "so we put the remainder in a separate account and are trying to forget about it until payments on the loan begin in the fall."

The next step was to create a manageable budget based on anticipated and actual Medicare admissions. "Elective surgeries were 90 percent of our business," he said. "So we made sure our hospital partner and referring physicians knew we could do other skilled services as well. Fortunately, we were not harmed by the high incidence of infections in Skilled Nursing Facilities. We had not been getting many patients from those institutions anyway."

FULL DISCLOSURE

Benefit Health Care is not only one of the best small agencies in Colorado Springs, it is my preferred agency. When I underwent total knee replacement in October, 2017, I got to experience home health from the other side of the desk.

Ben performed a house inspection prior to my surgery. His PT conducted my start-of-care and end-of-care visits and her extremely competent PTA saw me in between. They were both professional, friendly, helpful, and thorough. I walked into my two-week checkup with my surgeon aided by neither walker nor cane.

(See my complete 2017 story here.)

-Tim Rowan

The bottom line is that what works now is similar to what has always worked. "When my wife and I opened this agency, we did what everyone else does," van Batum concluded. "We focused on the revenue stream. Then we tried TV and radio ads; we did giveaways; we created beautiful marketing materials to hand out; we took on a few Assisted Living Facilities. But we gave up on that source of patients after we learned the rules. You can offer excellent care to their residents and the management can love you and call you first every time. Then there is turnover. A new manager comes in and has a buddy with a home health agency and you're out."

Finally, we realized that the only way to compete, to stand out from the other 40 plus Medicare home health agencies in this town, is to focus on quality care. Improving our star ratings led us into the Elite Home Care list of the top 25 percent. It got us our preferred relationship with the hospital. In fact, we were the only small home health agency chosen by UCHealth (statewide University of Colorado health system with two Colorado Springs locations).

"This is the only way for a small company to thrive."

 

©2020 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Home Care Technology: The Rowan Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com