Home Hellth III


This is my third article about the state of the home health care industry, based on personal experience. If you couldn’t tell, this topic has been front of mind in recent months. The first article dealt with the reality of living with home health versus the perception you see in the ads. The ads depict attractive, caring employees virtually doting on the every need of their charges. Caregiver and patient are shown laughing and engaging in easy conversation. The intimation is that if you hire this firm, you will be served by stable, long-lasting caregivers with warm personalities. The reality is they will likely not become a member of your extended family, lasting on average about five weeks.


The second article looked at customer service practices of home health agencies. I cited a recent example of a home healthcare worker who had given me covid. I remarked that when I began isolation and let the home care company know I was positive, I heard crickets. Nothing at all. Out of sight, out of mind. That individuals affiliated with the healthcare industry are coming into the homes of elderly and vulnerable people who are not vaccinated is beyond senseless. To be informed however that your employees are the cause of covid spread among this segment of the population and then not even respond, borders on callous irresponsibility.


The focus of this article looks more at business practices of the home health care industry. Typical of the service industry of which it is a part, this field relies on the billable hour for its very existence. Like a hotel room that goes unoccupied for a night, or a meal that goes uneaten at a restaurant, a lost billable hour for a home healthcare agency can never be recovered. That means overhead expenses aren’t recovered, and wages are not paid. That also means of course, that care isn’t provided. If the billable hour were key to the success of your business, you might want to have KPIs in place to look at total hours billed versus total hours available, billable hours lost due to shifts not able to be covered, etc. A properly designed set of KPIs for this type of business would have direct correlation with the amount of care you are providing for your clients. Similarly, a properly designed set of KPIs around customer service would have direct correlation with the type of care you are providing.


Recently, my wife had major surgery, and during the month prior we planned both the level and amount of care needed with our home healthcare agency. On the day after my wife’s surgery, the LVN showed up for her shift as scheduled, albeit 30 minutes late. On day two, we weren’t concerned when the appointed hour came, as we thought she was merely running late again. When we called however, we were told she was ill that morning and would not be coming – at all, anymore that week. “Who will be coming instead,” we asked. “We’re working on it,” was the reply. As it turned out, no one came for the rest of the week. The evening shifts were different. Someone came at the appointed time every night that first week. It wasn’t until the second week that the no-shows began. It was a good thing that my sister had come to stay with us for a month, otherwise we would have been in quite a bind. At the end of a similar second week, we canceled all morning shifts thereafter. When we inquired as to how the scheduling process worked, we were told that a day or two before a shift was to be filled, the scheduler would put out a notice to all their caregivers asking if anyone wanted the shift. If no one responded, the shift went unfilled, and the client was left in the lurch. The agency probably prided itself on their ability to have hired a scheduler for minimum wage, not even knowing the thousands of dollars in lost revenue this critical position was costing them. Not exactly how I would run a railroad, but who’s asking? I’m just the guy stranded back in the caboose.


Noticeably absent when we all left rehab was the instruction manual for dealing with the myriad of situations we would find ourselves in.Ask This Old Quad articles serve to fill in that vacuum, because we have all developed tricks of the trade that we believe would be valuable for others.Share your ideas and experience with us atinfo@northtexasusa.org

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