Medicare Advantage Stock Prices After Trump Elected

by Kristin Rowan, Editor

Will the Change in Leadership Usher in a Change in Reimbursement Rates?

As in any election year, we have been bombarded with promises, predictions, and pandering from senate and house hopefuls as well as presidential candidates from every party. Each of them found platform issues that resonated with their followers. In turn, they have accused their opponents of all manner of sin. 

Now that the election has passed and the lame duck session of congress has begun, analysts have started looking to January and how election results may impact different industries. Analysts believe Trump, along with congressional Republicans, will aggressively push Medicare Advantage. One researcher predicts that traditional Medicare will “wither on the vine.” 

Privatization

Opposition to our current health care and insurance system often advocate for a single-payer system that is seen in places like England and Canada. Naysayers refer to this as the “socialization” of medicine, referring to socialist and communist governments. Privatization, on the other hand, moves healthcare out of the hands of the government and into the hands of privately held, usually for-profit, health insurance companies. Medicare Advantage has quietly moved more than 50% of all Medicare eligible patients to a privatized system. Senior policy analyst at Paragon Health Institute, Joe Alabanese believes that the Trump administration and a republican Congress would be “more friendly” to the idea of privatized health care. 

Insurer Stock Prices

Whether the stock prices just before and after election day are predictive of things to come remains to be seen. For now, the information before us is this:

    • Between Nov 1 and Nov 7, Humana Inc. had the largest increase in stock prices at 10.7%
    • UnitedHealth Group Inc. rose 5.1% in the same time period
    • Both companies had greater stock increases than the average across S&P
    • Elevance Health was in keeping with the rest of the S&P with an increase of 3.6%
    • Molina Healthcare, Inc. and The Cigna Group dropped 0.2% and 0.4%, respectively
Medicare Advantage Stock Trump

Analysts say the jumps are in keeping with expectations that Republican control in Congress and in the White House will be beneficial for Medicare Advantage

Medicare Advantage Stock Trump<br />

Final Thoughts

It’s no secret that The Rowan Report is not a fan of Medicare Advantage. Specifically, the sales tactics used on the elderly and infirmed are predatory and the denial rate is criminal. The more eligible patients sign up for Medicare Advantage the less they will receive the care they need. Further, the more Medicaid has to supplement the cost of Medicare Advantage, the more home care agencies will suffer. Nationally, the more CMS regulates payment rates, pre-authorizations, and denial rates by privatizing Medicaid, the worse off our entire healthcare system will be.

With the state and national associations, we will continue to advocate on behalf of care at home agencies and their patients. And we hope you will too, regardless of who is in office. We have support at the federal level and we will continue to fight the good fight.

# # #

Kristin Rowan, Editor
Kristin Rowan, Editor

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Safeguarding Home Care Heroes Part 2

by Marcylle Combs, BS, MS, RN, CHCE

This article is part 2 of 2-part series. Read part 1 here

Protecting our Care at Home Heroes

Preventive Measures and Safety Protocols

To deal with these dangers, several preventive steps have been recommended.

Personal Protection

Personal Protective Equipment (PPE) and hand hygiene are basic but important ways to prevent disease spread. Making sure workers are up to date on vaccinations, following cleaning protocols, and safely handling sharp objects and hazardous materials can also significantly reduce risks.

Beyond PPE

Safety policies personal protective equipment

But safety isn’t just about using PPE. There’s also a need for ergonomic tools to prevent injuries, regular safety checks of patient homes, and ensuring safe driving practices for workers who spend a lot of time on the road. Just as important are communication and conflict de-escalation strategies to help healthcare workers manage tense situations with patients or their families.

Safety policies de-escalation

Training

Training home health workers to spot signs of potential violence or aggression, whether from patients or their families, is vital. They should also have strategies to defuse conflicts and a clear plan to exit safely if a situation turns dangerous. Since hazardous chemicals in the home can be a real threat, agencies should train workers to recognize unsafe conditions and take the necessary steps, like reporting the problem or moving the patient to a safer environment.

Emotional Resilience

A Must-Have for Care at Home Workers

Physical safety is important, but emotional well-being is just as crucial. Feeling emotionally secure—valued, supported, and heard at work—is key to keeping employees engaged and satisfied with their jobs. It helps reduce burnout, absenteeism, and turnover.

Creating a culture of psychological safety starts with good leadership. Managers need to actively listen to their employees’ concerns and encourage open communication. When workers feel that their voices are heard and their opinions matter, they’re more likely to stay proactive and engaged.

Real-Life Examples and the Importance of Strong Policies

The dangers faced by home health workers aren’t just theoretical—they’re very real. I’ve seen this firsthand. As both an owner, administrator, and nurse, there were times we felt unsafe.

One instance that sticks out happened a few years ago

A nurse on a routine visit encountered the patient’s grandson breaking into the house, clearly high on some kind of drug. She and the patient managed to block the bedroom door while she called 911, and thankfully, the police arrived before the grandson could get to them. He was carrying a gun, though she didn’t know that at the time.

Safety policies awareness

Putting Comprehensive Policies in Place

A solid safety program that meets the unique needs of home health workers is a must. This includes having zero-tolerance policies for workplace violence, infection control measures, and clear guidelines for handling dangerous materials. Ongoing education and training are essential to make sure staff follow these protocols.

In addition, there should be regular assessments to gauge how effective safety policies are. Gathering feedback from workers on the ground is crucial to making sure these policies address real-world challenges.

Final Thoughts: Safety is a Mindset

Workplace safety isn’t just about following rules or checking boxes. It’s something that should be part of the culture of every organization. By putting in place measures that protect both the physical and emotional well-being of home health workers, we can ensure that these “home care heroes” continue to provide the critical care that so many people rely on. As Eleanor Everet wisely said, “Safety is not a gadget, but a state of mind.”

# # #

Marcylle Combs Care at Home Worker Safety
Marcylle Combs Care at Home Worker Safety

Marcylle has faithfully served and advocated on behalf of home health and hospice patients for over 30 years. She started her career as a nurse, worked diligently to strengthen her leadership skills and ultimately became the owner/president of a successful home health and hospice company. She has served the home care industry in Texas and nationally throughout her years on multiple committees, boards, associations and dedicated lobbying efforts. Currently, Marcylle serves on the board of directors for The National Association for Home Care & Hospice (NAHC), the Home Care and Hospice Financial Managers Association (HHFMA) and the Industry Advisory Board. Additionally, she serves on NAHC’s Governance and Nominating Committee, the HHFMA workgroup, Innovations Committee and chairs the Women in Leadership Committee for HHFMA.

As a wife, mother of 5 adult children and as a female in the workplace she aspires to grow and lead others until her last breath on this earth. She continues this quest through three new business ventures she has founded: MAC Legacy, MAC Legacy Investments and The Marcylle Combs Company.     

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

The Great Hospital/Home Health Divorce Movement

by Tim Rowan, Editor Emeritus

Hospitals Divesting Home Health Departments

Is this an early omen of two related trends? A number of hospitals are divesting their home health departments, while large health insurance companies are swallowing up large home health companies.

Beckers reported on October 23 that Providence Health plans to spin off its home-health services along with hospice and palliative care into a new joint venture that will be managed by Compassus, a for-profit, Tennessee-based provider of home care services in 30 states. The move will affect about 700 patients receiving care every day in Spokane County.

The Catholic not-for-profit health system’s agreement with Compassus will be known as “Providence at Home with Compassus.”

After a regulatory review, the deal is expected to close in early 2025. Providence and Compassus will each own a 50% stake. The new venture is part of a strategy to expand and improve home-based services, but also to cut costs. Providence, which operates Sacred Heart Medical Center and Holy Family Hospital in Spokane, declined to disclose the financial details of the joint venture.

LHC Group Was Not Enough

A news release that surfaced on October 25 said that UnitedHealth Group representatives are set to meet with Justice Department officials to make the case for the insurance giant’s acquisition of Amedisys to be approved. The meeting is often the last step before the Justice Department decides whether to file a lawsuit challenging an acquisition, according to the news outlet

Amedisys operates more than 500 facilities in 37 states. Shareholders approved the acquisition in September 2023, but the deal has been held up by regulatory scrutiny. Justice Department officials are concerned the deal could increase prices for home health, according to Bloomberg. 

Hospitals Divesting Home Health

If approved, this would be phase two of UnitedHealth’s historic foray into our sector. United acquired LHC Group, a home health provider with more than 900 locations, in February 2023. If UnitedHealth’s acquisition of Amedisys is approved, the company would own 10% of the entire home health market, with significant overlap between Amedisys and LHC acquisitions in some Southern states, according to Bloomberg. 

Regulators could approve the deal with some changes to address competition concerns, Bloomberg reported. In August, Amedisys and UnitedHealth agreed to sell a reported 100 home health and hospice care centers to VitalCaring Group if the merger is approved.

Three or More is a Trend

UnitedHealth is not the only insurance company interested in owning home health agencies and hospices:

  1. Humana acquired Kindred, one of the nation’s largest HHAs, and rebranded it CenterWell Home Health. Today it operates more than 360 home health locations in 38 states. In 2023, the company said it would expand into in-home primary care in several states.
  2. In 2023, CVS Health acquired home health provider Signify Health for $8 billion. The company won a bidding war for Signify over UnitedHealth Group, Amazon and Option Care Health. Signify Health has more than 10,000 clinicians.
  3. Evernorth, Cigna’s health services arm, offers home health services with a staff of more than 430. In January, Cigna CEO David Cordani said home health was one area where it would focus on future acquisitions.
  4. In 2021, Centene sold its majority stake in home-based primary care provider U.S. Medical Management. Centene retained a minority stake in the company.

Our healthcare sector is changing as the entire U.S. healthcare scene changes. Next week we will delve further into the ramifications of the CMS 2025 final rule and of course the political events of this week.

# # #

Tim Rowan, Editor Emeritus
Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com
Tim@RowanResources.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Fraud Soup

by Elizabeth E. Hogue, Esq.

Everyone in the "Fraud Soup" Together

Fraud Soup

Perhaps you remember the CEO of a hospice in the Dallas area, Novus Health Care Services, who texted staff members urging them to administer drugs to patients to avoid exceeding per patient spending caps. He then sent texts praising them when patients passed away from the drugs he had urged them to administer: “Good job!” There were also accusations of recruiting ineligible patients and falsifying documentation. Ever wonder what happened to him and other staff members?

Well...Here's the Scoop!

  • Sixteen individuals from the hospice were indicted and at least eleven of them pled guilty.
  • Thirteen individuals involved in these activities were sentenced to a combined eighty-four years in prison.
  • The most recent sentence of four years in prison was imposed on the hospice’s marketing director.
  • The CEO of the Hospice was sentenced to thirteen years in prison.
  • Two Medical Directors decided to go to trial instead of pleading guilty. They were sentenced to thirteen years and ten years in prison.
  • A nurse involved in these activities was sentenced to eight and a half years in prison.
  • An LVN who received a text from the CEO saying “good job” after she administered drugs to a patient who then passed away was sentenced to eight years in prison.
Fraud Soup Elizabeth Hogue
Fraud Soup Elizabeth Hogue
  • A triage nurse was sentenced to seven years in prison.
  • The Director of Operations was sentenced to five and a half years in prison.
  • A Medical Director who pleaded guilty received a sentence of four years and nine months.
  • The VP of Patient Services was sentenced to three years in prison.
  • The VP of Marketing was sentenced to two years and nine months in jail.
  • A nurse was also sentenced to two years and nine months in prison.
  • An owner of a lab and home health agency was also sent to jail for eighteen months because she allowed the CEO to access potential patients’ confidential medical information in exchange for using services provided by her companies.

Far-Reaching Effects

Can you imagine the effect on professionals who surely also lost their licenses and their families?  Not to mention patients and their families!

The lesson in this heartbreaking story is that fraud enforcement is not limited to owners and upper management. Enforcers will dump everyone who engaged in inappropriate conduct into the “fraud soup.” Therefore, when providers refuse to engage in fraudulent conduct, they are not only protecting themselves, but everyone else involved.

# # #

Elizabeth E. Hogue, Esq.
Elizabeth E. Hogue, Esq.

Elizabeth Hogue is an attorney in private practice with extensive experience in health care. She represents clients across the U.S., including professional associations, managed care providers, hospitals, long-term care facilities, home health agencies, durable medical equipment companies, and hospices.

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

©2024 Elizabeth E. Hogue, Esq. All rights reserved.

No portion of this material may be reproduced in any form without the advance written permission of the author.

New EVP for Talent Acquisition

Axxess

FOR IMMEDIATE RELEASE

Contact:                 Johnathan Eaves
(903) 445-6969
jeaves@axxess.com

Axxess Names Tim Ingram Executive Vice President for Talent Acquisition

His Appointment Will Ensure New Hires Reinforce Its Award-Winning Culture As Company Grows Worldwide

DALLAS, October 21, 2024 – Longtime Axxess leader Tim Ingram has been named Executive Vice President for Talent Acquisition to work closely with company leaders around the world to ensure new hires continue to reinforce the award-winning culture known as The Axxess Way.

A Message from Axxess CEO

“Beyond our industry-leading solutions, our foundational strength has always been and will always continue to be our unique culture,” said John Olajide, founder and CEO of Axxess, the industry leader in care at home technology solutions. “Tim’s demonstrated commitment to excellence and his collaborative and cooperative nature make him the perfect choice to represent our unique culture and work with our team to ensure new hires also embody The Axxess Way as we continue to grow around the world.”

Tim Ingram, in His Own Words

“Axxess is easily the most dynamic and collaborative culture I have ever been part of, and it’s an honor to be responsible for ensuring we find only the smartest, highest-quality team players who can help take Axxess to the next level,” said Ingram, who joined Axxess in 2016 and will continue to serve as Executive Vice President for Interoperability, partnering with industry-changing technology companies to enhance Axxess’ solutions. “Our vision is to be the global home healthcare technology leader, and most admired for our people, partnerships and solutions. Ensuring we achieve our vision starts at the interview.”

Tim's Background

Ingram has more than 20 years of experience in healthcare, including working in software, as well as regulatory and mergers and acquisitions environments. He serves as an ambassador for the National Hospice and Palliative Care Organization’s My Hospice Ambassador program; a member of several committees and councils for both NHPCO and National Association for Home Care and Hospice and is a past board member for the California Hospice and Palliative Care Association. He was named one of DirectTrust’s Interoperability Heroes in 2022.

Tim Ingram Talent Acquisition

# # #

About Axxess

Axxess is the leading global technology platform for healthcare at home. The company offers a robust ecosystem that empowers healthcare organizations and professionals to deliver the highest quality care. By integrating with partners and payers from across the healthcare continuum, more than 9,000 organizations trust the Axxess network to care for more than 5 million patients worldwide. Multiple independent certifications have confirmed that Axxess has the most secure and industry-compliant software solutions. The company’s collaborative culture focused on innovation and excellence is recognized nationally as a “Best Place to Work.”

This press release was originally published by Axxess and is reprinted with permission. For more information or for permission to use this material, please use the media contact above.

Safeguarding Home Care Heroes

by Marcylle Combs, BS, MS, RN, CHCE

This article is part 1 of a 2-part series. Check back for part 2 on November 7th.

Protecting our Care at Home Heroes

Building Emotional Strength & Ensuring Workplace Safety

In the fast-paced, ever-changing world of home health and hospice care, paying attention to care at home worker safety—both physically and emotionally—is critical. These “care at home heroes” offer life-saving care to people in need. The environments they work in, including patients’ homes and their surrounding neighborhoods, can be unpredictable and uniquely risky.

Agencies must put more focus on their caregivers’s emotional well-being and physical safety to help them provide the best care possible. Developing strong safety policies and creating a supportive work atmosphere are key strategies to ensure they can focus on what matters most: caring for their patients.

Care at Home Worker Safety Hidden Dangers

Understanding the Risks

Care at home workers face a wide range of hazards, many of which are heightened by the fact that they’re working in spaces they can’t fully control. These dangers range from exposure to bloodborne pathogens and other biological risks to dealing with physical strains, like lifting patients in cramped spaces. There’s also the issue of unclean home conditions, aggressive pets, crime-ridden neighborhoods, and the risks involved in driving between homes.

By the Numbers

Statistics show that care at home workers are five times more likely to experience nonfatal workplace violence compared to people in other industries. More than 60% of these workers have reported experiencing at least one incident of violence in the past year. Registered nurses (RNs) specifically have reported high levels of verbal abuse (up to 65%), physical assault (44%), and sexual harassment (41%) on the job. In addition, these caregivers often deal with musculoskeletal injuries, with injury rates being 50% higher than those in hospitals due to patient handling tasks.

Common Incidents and the Problem of Underreporting

Many of these incidents go unreported, which only adds to the dangers care at home workers face. Since they’re constantly on the move, it’s tough to track these events. Still, reports clearly show that violence, harassment, and injuries occur more frequently and are more severe in care at home than in many other fields.

Care at Home Safety

Threats Aren't Always From the Patient

On top of dealing with violent patients, care at home workers may also face threats from family members. Tensions and emotional stress in the home—often tied to a patient’s declining health—can sometimes escalate into verbal or physical threats toward caregivers. These situations can make workers feel unsafe, even if no direct threat is made.

Real-World Relevance

For example, I once had a patient’s family member follow me to my car while talking about his pet venomous snakes. He didn’t threaten me directly. I definitely felt uneasy, though, but I didn’t report it. As I look back on this encounter, I believe I truly should have reported this and recorded it for future review.  It just highlights what we should teach our employees on how and when to report incidents.

Hidden Threats

Chemical exposure is another issue. Care at home workers often encounter dangerous cleaning or other chemicals that aren’t stored or used properly. Sadly, there was a tragic case where a home health nurse in Los Angeles died after being exposed to hazardous chemicals stored incorrectly in a patient’s home. Other in-home hazards include fall risks, aggressive animals, weapons hidden in the home, and illegal substances. These hidden risks make it crucial for workers to follow safety protocols when entering patient homes.

Care at Home Safety

# # #

Marcylle Combs Care at Home Worker Safety
Marcylle Combs Care at Home Worker Safety

Marcylle has faithfully served and advocated on behalf of home health and hospice patients for over 30 years. She started her career as a nurse, worked diligently to strengthen her leadership skills and ultimately became the owner/president of a successful home health and hospice company. She has served the home care industry in Texas and nationally throughout her years on multiple committees, boards, associations and dedicated lobbying efforts. Currently, Marcylle serves on the board of directors for The National Association for Home Care & Hospice (NAHC), the Home Care and Hospice Financial Managers Association (HHFMA) and the Industry Advisory Board. Additionally, she serves on NAHC’s Governance and Nominating Committee, the HHFMA workgroup, Innovations Committee and chairs the Women in Leadership Committee for HHFMA.

As a wife, mother of 5 adult children and as a female in the workplace she aspires to grow and lead others until her last breath on this earth. She continues this quest through three new business ventures she has founded: MAC Legacy, MAC Legacy Investments and The Marcylle Combs Company.     

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

National Alliance for Care at Home: An Interview with Dr. Steve Landers Part 1

by Kristin Rowan, Editor

Alliance CEO Landers

For more than a year now, The Rowan Report has been providing updates on the merger between the National Hospice and Palliative Care Organization (NHPCO) and the National Association for Home Care & Hospice (NAHC). This week, we attended the first National Alliance for Care at Home (The Alliance) Annual Home Care and Hospice Conference and Expo. We had the opportunity to sit down with Dr. Steve Landers, inaugural Chief Executive Officer of The Alliance.

Dr. Steven "Steve" Landers

Dr. Steven Landers brings his almost 20 years of experience to The Alliance as its first CEO. Dr. Landers is a board-certified physician in family medicine, geriatric medicine, and hospice and palliative medicine. He has dedicated his career to seeking home- and community-based solution to traditional healthcare. His focus is on providing compassionate, dignified, and cost-effective care to patients.

Dr. Landers graduated from Case Western Reserve University School of Medicine, where he completed a geriatric medicine fellowship at the Cleveland Clinic.

Dr. Landers is no stranger to NAHC and NHPCO, having previously served on the board of directors for NAHC.  He has met with Congress, state legislatures, CMS, and PAC officials, providing testimonies, discussing home care policy and regulation, and advocating for care at home.

Steve lives in Little Silver, New Jersey, with his wife, Allison, and their three sons. His hobbies include golfing, fishing, hiking, traveling, enjoying good food and watching horse racing. When he is not taking part in these activities, you can find him cheering on his sports teams — the Browns, Cavaliers, Guardians and Indiana Hoosiers.

The Alliance Landers
The Alliance Landers

Dr. Steven Landers: On the Record

The Alliance Landers
The Rowan Report:

What do you know about the status of the ongoing lawsuits, going back to the 2024 final rule?

Dr. Steven Landers:

One, we should probably bring Bill [Dombi] into it because he’s truly a technical expert on it and I’m still getting up to speed on it. My understanding is there is no active lawsuit at the moment. We were asked to go back and take some additional administrative steps, which we’re doing. Then we’ll be able to evaluate what further legal paths are possible.

RR: 

That leads me to, not a question, but an observation I’d like you to comment on, Steve. For 45 years, the organization has been run by attorneys and the emphasis in lobbying and advocacy has been ‘you need to stop this cut because it’s hurting businesses and also it’s hurting patients.’ The way you’re talking, you emphasize as you begin with how it’s hurting patients. And so I’m wondering if the organization being run by a physician and not an attorney indicates that different emphasis going forward.

Steve: 

I certainly am going to do everything I can to tell the story of how policies impact patients and families. That will be part of what I try to do every single day using my experiences as a physician to do that.

RR:

Would it be exaggerating to say “new day, new emphasis” at The Alliance?

Steve:

Well, The Alliance is new in and of itself, so The Alliance is a new day for the industry, a hundred percent. We brought together two legacy organizations. The opportunity to have a stronger voice is very real and certainly I am going to bring a clinical perspective. I’m also a family caregiver. I have my own personal experiences with home care and hospice that have instructed how I think about these things.

And there is every opportunity here to get stronger, to try to make a bigger impact. I would not diminish the truly heroic work that’s been done by advocates within our associations in the past. There’s a lot of love and care that’s happening out in our country because of the leadership that’s been in place. But as you can see by some of the things that we’re talking about, we need to do better. We need to find another way to tell these stories to somehow get somebody to listen.

The Alliance
RR:

You recently released a statement about your position as CEO of The Alliance and your vision going forward. There was a commitment attached to that. Can you speak to that?

 

Steve: 

Yeah, so that’s one of the things that I’m really happy we’re doing very early in our work with the Alliance. For membership, whether to join or to renew membership, we are requiring an attestation from our members around their commitment to quality and to compliance. We’re requiring any provider member to attest to having a program in place for quality and compliance. And we’re requiring that they attest that they monitor the OIG exclusion list and don’t take referrals for employees that are people that are on that list. Also for home health and hospice providers, we’re asking that they attest that they do their level best to participate in the Medicare Home Health and the Medicare Hospice Quality Reporting program.

In order to make a difference on behalf of our members and make a difference on behalf of the people that need care at home, we have to have as credible and high integrity of a voice as possible. And so this is just one simple step of additional things that we’ll consider going forward. We want to make sure that our alliance, our coalition is high integrity and has a deep commitment to quality and compliance.

RR:

It’s one thing to ask people to sign an attestation. It’s another to find the bad players and help CMS to get rid of them.

Steve:

And we’re right there as a partner in that. I think you’ll see more announcements from us in the future about what we’re doing to help with that. I mean, on one hand, we’ve made many proposals around fighting fraud and hospice in particular. If you followed the hospice policymaking, both Legacy NAHC and Legacy NHPCO over the last year have made many policy recommendations. And you’ll definitely see us both advocating for anti-fraud measures as well as having resources within our association to focus on those topics.

The Alliance Landers
Interviewer 1:

Just to clarify, did either of the legacy organizations have this same kind of attestation?

Steve:

No, this is new. The impact of the legacy organizations cannot be questioned. It’s been amazing. But, it’s a new day and we are looking at ways to increase our impact. So, this is a new part of our membership process that we feel strongly about to just take another step to ensure that our coalition, our membership, is of the highest integrity possible. We are walking the walk and talking the talk with respect to quality and compliance.

RR:

Thank you, Dr. Landers

This article is part 1 of 2 interviewing Dr. Steven Landers. Read the rest of the interview here.

# # #

Kristin Rowan, Editor
Kristin Rowan, Editor

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Home Care Patient Dies in Care: Aide Arrested

by Kristin Rowan, Editor

Elderly Patient Needs 24-hour Care

In Polk County, FL, an 86-year old man, identified only as Mr. Anderson, was hopsitalized and diagnosed with congestive heart failure. In addition to receiving care from Good Shepherd Hospice, his family hired round-the-clock care through Assisting Hands. The home health aides were caring for Mr. Anderson in 12-hour shifts. 

Night Shift

Beatrice Taylor arrived for her night shift at 9 p.m. She noted that Mr. Anderson and his wife were already in bed, but not sleeping. Shortly after the day aide left, Taylor fell asleep on the couch in the living room of the patient’s home. Company policy states she was responsible for the patient’s care and should not have been sleeping.

An Avoidable Tragedy

Taylor was awakened by a “thump” coming from the bedroom. She entered the bedroom to investigate and found Mr. Anderson lying on his side, on the floor, with his head wedged between the nightstand and the bed. Taylor told investigators that she tried to help him back into the bed. He told her not to touch him, so she left him there and went back to sleep on the couch. She did not call 911, as was the policy of Assisting Hands in the event of an emergency. Nor did she call her agency or anyone else to assist. 

Four Hours Later

Taylor woke up somewhere between 3:45 a.m. and 4:53 a.m. that morning. At some point, she called her parents and had a 36 minute conversation. During that conversation, she decided to check on the patient and found him still on the floor, but now unresponsive. It was her parents who suggested she call 911.

Contrary to both her parents’ urging and her employer’s policy, Taylor still did not call 911. Instead, she called Assisting Hands and left a message through the company portal. Taylor finally called 911 at 5:37 a.m., more than four and a half hours after Mr. Anderson fell.

The implanted pacemaker found during autopsy showed that Mr. Anderson was still allive at 1:oo a.m. when Taylor initially found him. The autopsy also concluded that he would have survived if Taylor had called 911 right away. His official cause of death was positional asphyxia with pre-existing health conditions listed as contributory causes.

Home Health Aide Arrested

Not actual image from story

Company Policies Broken

During the course of their investigation, detectives reviewed the Assisting Hands employee policies. That investigation uncovered several policies that Taylor violated:

  • If a patient falls, home aides are required to seek help which may entail calling 9-1-1. Home aides must notify the company as soon as the patient is safe
  • Home aides are not permitted to sleep during their assigned shift unless it is a “live in” shift
  • Home aides are required to submit care notes using the company portal throughout their shift to ensure assigned services are being followed appropriately.

The 911 call that Taylor placed at 5:37 a.m. should have been placed at 1:00 a.m.
Assisting Hands confirmed to detectives that this was not a “live in” shift
No information was provided as to whether Taylor submitted care notes during the shift.

Arrested Development

Taylor worked for Assisting Hands for eight months, but did not show up for her shift following the incident with Mr. Anderson. Assisting Hands has since terminated her employment. She was a licensed home health aide, but does not have a medical license, nor is she a nurse. 

Taylor was arrested by detectives and made several statements about her innocence. She insisted she had done nothing wrong saying she, “didn’t kill that man.” A paramedic who responded to her 911 call overheard Taylor on the phone say, “he was old anyway so what does it matter.” Taylor remains in custody at the Polk County Jail and is being held without bond.

Polk County Sheriff

The complete disregard for Mr. Anderson’s life by the person who was employed by his family is completely outrageous, and egregious. I believe someone who was not even being paid to look after this elderly man would have immediately dialed 9-1-1 under these circumstances. Her behavior and attitude are simply deplorable. Mr. Anderson’s family members are in our prayers.”

Grady Judd

Sheriff, Polk County Sheriff's Office

Risk Fall

In 2021, more than 38,000 older adults died from falls. This is the leading cause of injury death for adults aged 65 and older. The death rate increased 41% between 2012 and 2021. You can read more about the risk of falling and what one company is doing to help prevent falls in our accompanying article this week, an interview with Dr. Ann Wells of InnovAge.

# # #

Kristin Rowan, Editor
Kristin Rowan, Editor

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Creating a Culture that Retains Employees

This article is part two of a two-part series. You can read part one here.

by Todd Austin and Sasha Erickson

3 Steps Towards Creating a Culture of Love that Retains Employees

In a study done on the “Culture of Companionate Love and Employee and Client Outcomes in a Long-Term Care Setting,” researchers found displaying warmth, affection, and connection had a tangible impact on employee turnover, resident outcomes, and family satisfaction.

Employees who felt they worked in a loving, caring work environment reported higher levels of satisfaction, increased teamwork, and showed up to work more regularly. But the effects of a companionate culture aren’t just felt by your employees.

Research shows that employees who work in a culture of love companionate culture directly related to client outcomes such as improved patient mood, quality of life, satisfaction, and fewer trips to the ER.

A culture like this is only made possible through a conscious effort from leadership to make their employees feel cared for and appreciated. To see similar results in your own business, start creating a culture of love.

Be an advocate for your employees' mental health

Contrary to popular opinion, an employee doesn’t leave their emotions at the door when they come into work. Especially if they work in a service-based industry like long-term and post-acute care.

The emotions an employee feels while caring on the job affects performance, customer and employee satisfaction, and care outcomes.

For example, if an employee is feeling stressed, frustrated, or disgruntled, they will either appear so as they’re caring for their residents and patients or be forced to put up a positive front on the outside while bottling up negative emotions on the inside. Whether these types of negative emotions are revealed in the open or held within, either outcome leads to low satisfaction and high employee turnover.

Instead, be an advocate for your employees’ wellbeing and mental health. Provide resources for mental health support and regularly check-in with your staff at important milestones. Offering competitive benefits, flexible hours, and paid time off encourages employees to tend to their own needs as well as others.

Broaden your company’s definition of culture

Culture is more than a staff break room with a foosball table. Your company’s culture will create itself, whether you’re in control of it or not.

Creating a healthy company culture requires deliberate and consistent actions from your leadership team. It is your goal to ensure that when your employees think about work on a Sunday night, they feel positive about coming to work every Monday morning. At Activated Insights, our approach centers on understanding and enhancing the employee experience through several key strategies:

    • Culture and Engagement Assessments
      • We regularly administer assessments to identify strengths and areas needing improvement to help us stay attuned to the evolving needs and perceptions of our employees.
    • Employee Focus Groups and Culture Audits
      • We have started administering focus groups and culture audits to gain real insights and solutions directly from our employees. These sessions create open lines of communication where employees can express their thoughts and ideas.
    • Prioritizing Employee Wellness
      • We offer unlimited PTO with mandatory minimums, including one mental health day off each quarter and a minimum of two weeks off per year with at least one period of five consecutive days off. This policy underscores our commitment to employee well-being, ensuring that they can balance work with personal life effectively.
    • Effective Communication and Leadership
      • Continuously communicating, modeling, and reinforcing the company’s vision, values, mission, and guiding principles is crucial. Leaders play a significant role in setting the tone and maintaining a positive culture by leading with transparency, empathy, and consistency.
    • Team Building and Collaboration
      • At Activated Insights our teams are often comprised of both in-office and remote employees. We encourage teams to get together at least annually. It’s imperative that companies are deliberate in providing opportunities for their teams to collaborate, build trust, and break down silos. We find that this improves overall job satisfaction and productivity.
    • Building Trust and Accountability
      • Trusting employees and treating them like adults to manage their work and personal demands is essential. By creating an environment of trust and accountability, we encourage employees to take ownership of their roles and contribute meaningfully to the organization’s success.

By focusing on these strategies, we ensure that our employees look forward to coming to work, feel valued and supported, and are motivated to contribute to a positive company culture.

Learn to speak your employees’ professional “love language”

If you don’t speak two languages, you won’t connect with your employees to make them want to stay.

While everyone communicates in their own way, if you don’t know the language your caregivers will listen to, your recognition efforts are going to waste.

But this isn’t the type of language Duolingo can teach you. Rather, every provider in the long-term and post-acute care industry should become fluent in appreciating their employees.

The Value of Communication

In 1992, Dr. Gary Chapman noticed a pattern of miscommunication after practicing couples’ counselling for years. He discovered that individuals often misunderstand one another’s needs by communicating how they would personally like to receive recognition, without taking the others’ needs into consideration. He concluded that how we respond to appreciation boils down to one of the following categories.

Learn how to speak your caregivers’ language of appreciation to increase caregiver retention, refine your leadership skills, and foster a culture of recognition:

Professional Love Languages

  • Words of Affirmation
    • Care employees ranked verbal recognition by a supervisor as their number one preferred form of recognition—and lack of communication from their employer as their top complaint. Actively seek out reasons you can praise your caregivers to boost company morale and foster a culture of gratitude:
      • Send handwritten thank you cards
      • Give your caregivers a shoutout in company newsletters or on social media
      • Recognize top performers using an employee of the month program to give everyone a chance to be in the spotlight
  • Receiving Gifts
    • While a raise may be outside of the company budget, 20.4% of caregivers mentioned smaller forms of monetary recognition as their chosen form of acknowledgement. Small bonuses for top performers, extra vacation time, or gift cards are simple forms of appreciation:
      • Give gift cards or free movie tickets
      • Give company branded clothing
      • Offer paid vacation time
  • Acts of Service
    • A care employee’s occupation is to literally provide service to those in need—but have you ever thought of ways to serve your care staff? Although it may seem counterintuitive to serve in a workplace where employees are paid, you can offer your staff the relief that they need by helping to shoulder some of their responsibilities:
      • Gather feedback and listen to how you can make their daily tasks or commute a little easier
      • Go the extra mile to make them smile by hosting random appreciation events where you can offer the company donuts, coffee, or even turkeys on Thanksgiving
  • Quality Time: Caregiving can be a very isolating job where they receive little social interaction with people other than their clients. Consciously create opportunities to spend quality time with your caregivers:
      • Hold group training events to create an environment where caregivers can ask questions and learn from fellow coworkers.
      • Schedule one-on-one meetings or lunches to build individual relationships with your caregivers and check in on how they are doing.
      • Support their learning and professional development by discussing your caregivers’ goals and needs

So, What Does Love Have to Do With It?

In short: everything.

Your ability to create a companionate culture of recognition for your care staff will be the difference that pulls you out of the revolving doors of recruitment and retention.

The quality of your leadership within your company directly impacts your quality of care for the long-term and post-acute care industry.

In 2024, spend more time consciously creating a companionate culture and start to see your employee retention and client satisfaction skyrocket.

# # #

Kristin Rowan, Editor
Kristin Rowan, Editor

As a highly accomplished executive, Todd Austin, COO & President of Activated Insights, is recognized as a leading voice in the rapidly-growing care industry. With over a decade of experience in executive leadership roles, Todd brings a wealth of knowledge and expertise to his current position as a key member of the Activated Insights team.

With a background in sales, marketing, management, operations, and finance, Todd is a true Renaissance executive with a rare combination of strategic and tactical skills. His expertise in developing and implementing growth strategies, optimizing operations, and driving profitability has made him a sought-after advisor to many organizations.

Sasha Erickson is the Director of Talent at Activated Insights, formerly HCP. With over 10 years of experience in human resources across a variety of industries, Sasha has worked with organizations ranging from small businesses to Fortune 500 companies. She graduated Summa Cum Laude from Utah State University with a degree in Business Administration and minors in Human Resource Management, Marketing, and Finance.

Sasha’s career history includes roles at Avant Guard Monitoring Centers, Goldman Sachs, Schreiber Foods, JBS and Pilgrim’s Pride Corporation, RR Donnelley, and Denver Public Schools. Her expertise spans talent acquisition, employee engagement, culture development, HCM software implementation, and strategic HR management.

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

What’s Love Got to Do with It?

This article is part one of a two-part series from Activated Insights, formerly Home Care Pulse. Come back next week for the continuing story. Read more about Caring for the Caregiver here

by Todd Austin and Sasha Erickson

How to Create a Culture that Keeps Your Employees from Breaking Up with You

Healthcare employees admit that the 3 main factors contributing to the most stress at work are:

    • Concerns about being trainied for the required workload
    • Worries about job security
    • Finding the time to balance work and personal life

As a result, almost 60% of those working in the healthcare space reported their self-assessed level of burnout to be between moderate and very high—which can be attributed to the high-level emotional investment required for the job.

Post-Acute Turnover

While the long-term and post-acute care is one of the fastest growing industries in the nation, it also ranks in the top 5 workforces with the highest turnover.

Fortunately, the care employee burnout crisis is fixable.

The cure?

Treating our staff, and ourselves, with a little more conscious compassion.

It's Not You, It's Me

The Long-Term Effects of Unappreciation

For most other industries, employee turnover peaks at one year.

But for the long-term and post-acute care industry, 40% of turnover occurs within an employee’s first 100 days.

Which isn’t leaving much room for providers to retain their staff. According to the 2024 Activated Insights Benchmarking Report, annual care staff turnover increased by 14% within the last two years, averaging a total of 79.2%.

But there is hope in the data.

What if we told you that simply thanking your care staff more could get them to stay longer than 3 months?

According to the Benchmarking Report, recognition received the lowest satisfaction score from employees. Care staff are most dissatisfied with the appreciation they’re receiving after a job well done, followed by feeling inadequately prepared for the field.

Activated Insights Culture

Not only are feelings of unappreciation causing turnover rates to skyrocket, it’s also having a detrimental impact on the state of the industry.

As a result of not feeling appreciated or recognized for the work they do, your employees may be showing warning signs of impaired grief processing:  

    • Irritability or anger
      • oddly negative behaviors or attitudes that are uncharacteristic for the employee
    • Obsessive thoughts
      • rumination over certain patients or issues that is constantly brought up and seems to never be resolves
    • Hyper alertness or overreactive behaviors
      • intense, erratic behaviors or excessive attention to work that is unwarranted or outside of the normal response
    • Self-harming behaviors
      • gravitation to overworked, exhaustive behaviors e.g. refusing to take breaks, taking on added tasks unnecessarily
    • Apathy or numbness
      • lack of reaction to items that would normally cause a response, decrease in emotions, or refusal to address difficult emotions

Contrary to popular opinion, an employee doesn’t leave their emotions at the door when they come into work. Especially if they work in a service-based industry like long-term and post-acute care.

The emotions an employee feels while caring on the job affects performance, customer and employee satisfaction, and care outcomes.

For example, if an employee is feeling stressed, frustrated, or disgruntled, they will either appear as they’re caring for their residents and patients or be forced to put up a positive front on the outside while bottling up negative emotions on the inside. Whether these types of negative emotions are revealed in the open or held within, either outcome leads to low satisfaction and high employee turnover.

Instead, be an advocate for your employees’ wellbeing and mental health. Provide resources for mental health support and regularly check-in with your staff at important milestones. Offering competitive benefits, flexible hours, and paid time off encourages employees to tend to their own needs as well as others.

# # #

Todd Austin Culture

As a highly accomplished executive, Todd Austin, COO & President of Activated Insights, is recognized as a leading voice in the rapidly-growing care industry. With over a decade of experience in executive leadership roles, Todd brings a wealth of knowledge and expertise to his current position as a key member of the Activated Insights team.

With a background in sales, marketing, management, operations, and finance, Todd is a true Renaissance executive with a rare combination of strategic and tactical skills. His expertise in developing and implementing growth strategies, optimizing operations, and driving profitability has made him a sought-after advisor to many organizations.

Sasha Erickson is the Director of Talent at Activated Insights, formerly HCP. With over 10 years of experience in human resources across a variety of industries, Sasha has worked with organizations ranging from small businesses to Fortune 500 companies. She graduated Summa Cum Laude from Utah State University with a degree in Business Administration and minors in Human Resource Management, Marketing, and Finance.

Sasha’s career history includes roles at Avant Guard Monitoring Centers, Goldman Sachs, Schreiber Foods, JBS and Pilgrim’s Pride Corporation, RR Donnelley, and Denver Public Schools. Her expertise spans talent acquisition, employee engagement, culture development, HCM software implementation, and strategic HR management.

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Sasha erickson Culture