As skilled nursing facilities see occupancy slowly tick upward from the lows of the COVID-19 pandemic, the topic of shifting post-acute residents into the home health space was kicked into a higher gear with members of Congress and President Biden himself weighing in on the conversation.
And while the push to home care may be of concern to some, a few of the industry’s chief executives consider it a complement as nursing homes continue to take on more medically complex patients.
“I think it’s a complement, it’s not a competitor,” Ignite Medical Resorts CEO and Co-Founder Tim Fields said during a panel discussion at the Skilled Nursing News RETHINK conference held this week.
“I think that for the most part home health is needing to step their game up just like we’ve had to do. If you look at the continuum and the shift from patients who used to go to our setting was once the orthopedics and kind of easy breezy rehab, that’s kind of continued to go to the home setting, and we continue to get more patients that again are coming out of hospitals quicker… and so we’re taking more high acuity,” he added.
Fields also said it varies greatly depending on where an operator is geographically.
“I think that another huge piece of this is not everybody’s on the same wavelength. If you operate in New York or Florida or Texas or California or Chicago or somewhere else in between, it’s different,” he added.
Ignite operates a portfolio of 10 short-term rehab facilities in Wisconsin, Illinois, Missouri, Kansas and Oklahoma.
As part of the Biden administration’s $2 trillion infrastructure package, announced back in March, the president proposed a $400 billion plan designed to beef up Medicaid coverage of long-term care outside of skilled nursing facilities.
Most recently in late July, members of Congress introduced the Choose Home Care Act of 2021 — which seeks to create a new pathway for providers using both medical and non-medical services in order to keep Medicare beneficiaries out of skilled nursing facilities.
“You know I’ve joked with somebody where I said, ‘Come in and you find anybody you can take home right now go ahead and have them,’ but I mean most of the people we’re getting are pretty, pretty sick,” Fields said.
And Carespring Health Care Management CEO Chris Chirumbolo agreed with Fields, noting that he is an advocate for people going home.
“I wish every person, especially our long-term care residents, could be home, but they can’t,” Chirumbolo said. “And if you walk down the hall and look at the assessment of each person’s issues, from ADLs, to medication needs, to comorbidity management, a lot of these patients either they don’t have the family resources, they don’t have the family to do it and they don’t have the clinical backup, I just don’t see that person being at home.”
Chirumbolo said 10 years ago the average long-term care resident stayed for almost one year or a year and a half. Now residents are spending closer to three to six months because they are nearing the end of their life, which means “the system’s working.”
American Health Partners CEO Mike Bailey, who operates across the health care continuum, said the conversations surrounding home based care can help not only the home health industry, but those working in skilled nursing as well.
The Franklin, Tenn.-based firm operates 29 SNFs through its American Health Care arm, but it also provides services including home health, hospice, psychiatric care and a nurse practitioner program.
“It’s really an opportunity for us then to take that more acute patient … It’s a much more fragile individual that comes to our facilities today, thus the whole transitional care approach for us, and then we take the other patients and they go to the home setting,” Bailey said.
Companies featured in this article:
American Health Partners, Carespring Health Care Management, Ignite Medical Resorts
