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Home Health move slated

May 6, 2011

AHN Executive Director Marvin L. Baird

    What originally started as a single-person department by former Washington Township trustee Bob Gay in Adams County over 35 years ago — with registered nurse Vickie Gagle in charge —  will soon be assumed by a new agency.
    The Adams Health Network Board (AHN) of Trustees recently revealed that Adams County Home Health, which currently has a staff of 17 employee and has been operated by the hospital for the past several decades, soon will be assumed by Family Hospice of Northeastern Indiana with plans to expand into Jay and Wells counties
    AHN Executive Director Marvin  L. Baird strongly stressed the point that "we're (Home Health) still open for business at full steam. We'll still be taking patients and providing the quality in-home care our patients have grown accustomed to."
    It is hoped the change can be accomplished by June 30.
    Baird said the change in program direction was necessary due to cuts in reimbursement from Medicare. He said the hospital was over $500,000 in the red in 2010 from Home Health services, a deficit that could not be allowed to continue.
    What hurts Home Health in terms of Medicare reimbursements is that the agency requires Home Health, as a department of the hospital, to share in the cost of expenses of the entire hospital even though Home Health may have limited or no involvement with certain departments, such as dietary or laundry. That brings the reimbursement for services in at a reduced rate.
    In looking at the makeup of hospital patients, Baird said over a decade ago the hospital had about 40 percent of its patients with private insurance such as Blue Cross-Blue Shield, Aetna, Sagamore, and others. Reimbursements from those companies allowed the hospital to run programs such as Home Health and to be able to cover deficits, although the deficits weren't anywhere as high as what they have been in recent years.
    Fewer and fewer patients in the hospital setting now are covered with the private insurance companies making cuts necessary in needed programs such as Home Health and others.
    For example, Baird said Medicare has become "a big part of our hospital financial picture," and the rules have tightened greatly in recent years concerning the eligibility of Home  Health. "Fewer and fewer of the patients needing Home Health are eligible today because of goverment cutbacks and regulations," Baird lamented.
    Baird estimated that on any given day, Home Health has approximately 65 patients being cared for by the hospital HH staff.
    "Back in the heyday, that figure used to be between 90-100 patients a day," he said, adding that despite the goal of government being to keep patients at home and out of hospitals (also the goal of Home Health), Medicare rules just aren't allowing the needed care to be reimbursed.
    Baird said Family Hospice is a non-for-profit agency just like Home Health, but reimbursements may be higher with Hospice than with Home Health under Medicare.
    Home Health will be a separate division of Family Hospice with the opportunity to grow as a new program. Several new programs are perhaps in the works for Home Health as a Hospice program, including being a pediatric care provider, especially for children at home who had been treated at Riley's Hospital in Indianapolis or the Shriner's Hospital in Cincinnati or Chicago.
    Other possibilities: doing infusion therapy at home and broadening services to Wells and Jay County, and perhaps to some degree in southern Allen County.
    Baird said the increased volume of programs and counties should be able to make Hospice break even with the Home Health division.
    "Sue Ann (Reynolds, president of Family Hospice of Northeast Indiana), has met with the Hospice directors and they're on board with this decision. If they didn't think it would be possible to do I don't think they would have agreed to it," Baird said.
    Baird said the hospital trustees were adamant about finding a solution to the problem that would still provide a full range of services to the community and the agreement with Hospice appears to be the best one available.
    In addition, all of the current Home Health employees will be retained by Hospice so no jobs will be lost in the move. Baird said Home Health Director Ginny Terveer will continue to supervise the Home Health activities as a division of Hospice and will report to Reynolds instead of the hospital.

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