Home Health Care Industry Adjusts to Pandemic

YOUNGSTOWN, Ohio – At a time when business owners can only guess at what the pandemic will bring next, the home health care industry – both skilled and companion-based – remains stable and growing.

Before the pandemic, demand for home health care was on a steady rise, say local providers. And now, growth is even stronger as the industry adapts to changing conditions.

Greg Davis, founding member of Girard-based Patriot at Home, says the field has become more “connected.”

“Adversity breeds camaraderie,” he says. “We’re much stronger than we were before the pandemic.”

“You have to be nimble” in accommodating new guidelines, adds Kevin Root, Patriot vice president of business development.

Denise Ayers, vice president of sales and executive director of hospice for MVI HomeCare, Youngstown, says her staff has been working through the “lack of access to hospitals, physician offices and facilities.”

This has changed how the sales and marketing team communicates with doctors, case managers and social workers, Ayers says.

Also building a stronger team dynamic at work is Mirkin and Associates, which operates Comfort Keepers and Comfort Care-A-Van in Youngstown.

Since 2002, Comfort Keepers has provided nonmedical home care to seniors and those with disabilities.

Dave Mirkin, president and CEO, attributes his company’s resilience to a dip in employees since the start of the pandemic, despite demand for services.

The trend of fewer employees started before the pandemic, but became a common topic last year when many home health care workers – mostly women – stayed home with their children when schools shut down.

Mirkin says the Ohio Department of Aging and the Ohio Department of Medicaid have not kept pace with reimbursement rates.

As of today, the two state programs reimburse private companies about $19 per hour for home health care service. Private-pay programs cost about $23 an hour and veteran’s programs are around $26 an hour.

Within two years, Comfort Keepers in Youngstown dropped 60% in Medicaid work, doing about $2 million in 2019.

There are instances where family members are paid through the state to care for a loved one.

“If we can provide that service, then we’ll do it,” Mirkin says.

His company’s roster of employees went from 300 to about 130, despite greater demand for services.

In addition to staying home with their children, many of Mirkin’s employees are leaving to go into the service industry, where they can make more than the average of $10 an hour in the home health care industry.

One aspect of the pandemic workplace that MVI experienced is where office administration tasks are completed. Ayers says the scenery changed for some departments within MVI, including “converting staff in our billing, financial and administrative areas to work from home.”

Home health care services have added new services over the last several years.

Comfort Keepers introduced Comfort Care-A-Van in 2016, a nonemergency transportation service to doctor appointments, shopping or visiting friends and family. The service spans Trumbull, Mahoning and Columbiana counties, but is primarily in Mahoning, Mirkin says, and it’s growing.

In Trumbull County, Patriot at Home has grown, largely from referrals. Davis says there is a “very healthy” growth rate of home care and physician home care.

Patriot at Home offers skilled care – registered nurses, therapists and physicians – in the home. Now, the company is offering hospice care. And it recently evolved along with the pandemic, adding RegenCov, a monoclonal antibody therapy for COVID patients.

“We’re all over the board,” Davis says. “The demand is growing.”

Throughout the pandemic, Windsor House has seen demand ebb and flow, which was a trend before COVID-19. The pandemic forced the industry, as well as all health care-related fields, to deal with sick patients and employees. Teams had to think outside the box, says Jeena Anness, manager of Windsor Home Health.

“We had to be creative with our efforts of making sure we continued to take care of our patients with the same vigor and compassion as when we were fully staffed versus some of the staffing challenges with the pandemic quarantines and testing results lagging [at the beginning of the pandemic],” Anness says.

Windsor Home Health has suited employees with personal protective equipment, not only for their safety but for that of clients.

Caregivers must wear masks at Comfort Keepers, Mirkin says, and clients are asked to do the same.

At MVI, continued usage of personal protective equipment is standard protocol. The company purchased masks and other necessary items for employees and patients, Ayers says.

When COVID-19 arrived, Patriot at Home was ready. Workers suited up with PPE and kept an open dialog with employees about what to expect, and how to keep patients comfortable.

“There was a lot of buzz around COVID,” Davis says. “This is what we do. We know how to mitigate infection.”

Windsor House also provided PPE to staff and patients. The challenge was entering homes, Anness says.

“Will they be there, will they be okay, will there be a family member there, will they let us in, what are the conditions of the home?” she says, citing questions employees typically ask even outside the pandemic. “As home health care providers, this is just another hiccup we have had to work through,” she said.

Meanwhile, the future of the home health care industry looks different depending on the services.

For example, Mirkin is ready to start having a conversation about downsizing its caseload if state agencies don’t start paying better, competitive wages.

Patriot at Home is preparing for growth as the aging population requests in-home care rather than at health care facilities.

Ayers from MVI says while the pandemic has been a continual strain with staffing, the vaccines have “improved our ability to gain access.” Both Ayers and Mirkin say they are watching possible mandatory vaccination measures from the federal government.

“The pending mandate of the vaccine for health care providers creates an additional concern. We may lose professional staff that choose not to get vaccinated,” Ayers says.

Looking forward with optimism, Windsor’s Anness is excited about what 2022 will bring, regardless of the constant changes.

“I am hopeful the pandemic will continue to show reduced outbreaks and we can get out again in full capacity to really show the passion we have for our home-bound patients,” she says.

The goal is for patients to be able to perform their daily routines safely.

“We will be with them every step of the way,” Anness says.

At the end of the day, local home health care companies agree that employees get into the industry because they want to provide compassion and assistance to patients and their families.

“This is a calling. Thank God there are people who want to do this,” Mirkin says.