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

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by Tim Rowan, Editor

The state of Home Health staffing, 2023:

  • HHAs struggle to hire enough nurses to meet patient needs.

  • Competing with hospital sign-on bonuses is out of the question.

  • COVID burnout and fatalities have significantly reduced the available pool of RNs.

  • Some RNs say they would be willing to continue working in nursing if they could work from home, but how would that work?

  • Many HHAs report that they occasionally turn down referrals because they do not have the staff to take on one more patient. 

In our post-COVID environment, which some reports warn may linger for years before subsiding, Medicare beneficiaries often receive fewer in-home RN visits than their care plan calls for. Many cannot reach a nurse by phone for an otherwise routine concern and wind up resorting to a hospital or independent Emergency Department, which often leads to an avoidable hospital admission.

Looking at this crisis, a trio of healthcare innovators and software developers, Jenna Morgenstern-Gaines, Ryan Saunders, and Sam Thomas set out to find a way to at least mitigate the problem. The result is a communications application for Home Health, Home Care, and Assisted Living Facilities that they have dubbed "PocketRN." We were given a chance to watch the product in action last week. Overall, we found it extremely easy to use; and we can see its potential to avoid many of those hospital admissions.


Simply described, PocketRN puts frail elderly persons in touch with a nurse at the touch of a button, but the details go well beyond that summary. 

In addition to elderly patients or clients themselves, non-nurse in-home caregivers, both paid and family, have access to the service. Any with written HIPAA releases can inquire about their loved one's status or talk over a concern about a change in condition. If they become comfortable with one individual and prefer to speak with that nurse most of the time, the app tells them when that nurse is on duty. Meetings can be via video or voice.

On the other side of the equation, nurses work from home and choose their own hours. "Like an Uber driver," Saunders told us, "they log on when they want to work, and simply log off when it is time to put the kids to bed." Incentives are in place to encourage working nights and weekends. As an example of how accepting nurses are about the idea of working from home, it came up during our demo that PocketRN advertised recently for open RN positions and was inundated with applicants. "We had to take down the ad," Chief Growth Officer Nancy Gillette laughed.





The initial PocketRN pilot was conducted with the Advanced Wound Care Center at Stanford Healthcare. Following the pilot, PocketRN launched partnerships with Home Care agencies, RPM companies, and Federally Qualified Health Centers. Each provider type reported that PocketRN supported their efforts to comply with the Quadruple Aim: reduced costs, improved provider experiences, improved patient experiences, improved outcomes.

Providers have found that their hiring burden has eased while their ability to know how patients are doing grows. Early adopters have also seen their Workers' Comp premiums lowered. When one of their own nurses suffers an injury that keeps him or her from working in the home, but does not cause a serious disability, that nurse can sign up with PocketRN and continue working from home.

PocketRN nurses stay in close touch with an HHA's nursing staff and with a Home Care provider's caregivers, offering updates and insights that neither would ordinarily have, improving patient care with a larger team, some of whom are available at odd hours.



PocketRN told us that the company assumes all liability for care and services delivered on its platform by its Registered Nurses. Liability insurance covers the company and its clinicians. MDs and NPs supervise and provide oversight for all RNs, and there are escalation protocols so that nurses can elevate issues on-demand to specialists or other clinicians as needed. PocketRN vets and trains nurses to ensure fluency in virtual care, key specialty areas, and nursing scope of practice.

"We also have robust quality assurance processes to uphold compliance and the highest quality of care and safety on an ongoing basis," added company spokesperson David Won. "In short, our liability processes function almost identically to how it works in a hospital and for other telemedicine providers."


©2023 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Home Care Technology: The Rowan Report. One copy may be printed for personal use; further reproduction by permission only.