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Home Care News Digest for November 21

Home Care News Digest for November 21

Medicare Medicaid Private Duty

The following is a roundup of recent home care industry news and views from across the country.

The First 90 Days: What Amedisys, BAYADA Have Changed to Retain New Hires

Home Health Care News (November 17, 2023)

The first 90 days of a caregiver's tenure at a home-based care company are critical, and recent data tracking highlights the importance of this period for both long-term employee retention and minimizing quick turnovers. A study by MissionCare Collective and the National Association for Home Care & Hospice found that 57% of caregivers in the industry quit within the first 90 days.

Amedisys and BAYADA Home Health Care, two major home health providers, emphasize the need for efficient hiring processes, streamlined onboarding, and personalized approaches to improve retention, particularly within the crucial first-year retention period for nurses. Both companies have implemented changes to enhance the caregiver experience and increase retention rates. Amedisys reduced new caregivers' responsibilities by 75%, allowing more time for interaction with managers and peer mentors, while BAYADA Home Health Care focuses on a faster, more engaging hiring process.

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Federal Officials Back a Ruling on Kids in Florida Nursing Homes

News Service of Florida (November 14, 2023)

The Biden administration is urging a federal appeals court to uphold a ruling aimed at preventing Florida children with complex medical conditions from being placed in nursing homes. The U.S. Department of Justice (DOJ) filed a 79-page brief at the 11th U.S. Circuit Court of Appeals, supporting a ruling by U.S. District Judge Donald Middlebrooks, which requires the state to provide more private duty nursing (PDN) to help children live with their families or in their communities. The case involves Medicaid program children requiring round-the-clock care, and the injunction calls for the program to provide 90% of authorized PDN hours for these children. The state challenges this requirement, citing a nursing shortage, while the DOJ argues that the lower court properly exercised its discretion, and the 90% benchmark is achievable. The appeals court is expected to hear arguments in January 2024.

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Medicare Advantage Patients Attempting to Utilize Home Health Care Are Hitting More Roadblocks

Home Health Care News (November 10, 2023)

The 2023 Home Care Chartbook from the Research Institute for Home Care (RIHC) reveals disparities in access to home health care between traditional Medicare and Medicare Advantage (MA) beneficiaries. While traditional Medicare users report solid access, one in 10 MA patients faces challenges. Notably, 47.7% of MA patients with access issues attribute them to coverage barriers, compared to 23.7% of all Medicare beneficiaries. Racial disparities also emerge, with 81% of traditional Medicare home health users being white, contrasting with 72.4% of MA users. Home health patients, generally older and sicker, are well-managed by providers, handling diverse cases including sepsis and heart failure. The report emphasizes the need to address coverage issues for MA patients.

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Florida Department of Elder Affairs Seeks $10 Million to Keep Elderly in Their Homes

The Florida Phoenix (November 9, 2023)

The Florida Department of Elder Affairs (DOEA) has requested $10 million from state lawmakers for an existing program offering services like home-delivered meals, personal care, and transportation. Another $5 million is sought for the Home Care for the Elderly Program, benefiting family caregivers with a monthly stipend and subsidies for medical equipment, potentially reaching over 1,300 additional individuals. The DOEA plans to collaborate with municipalities and non-profits to inform the public about these programs.

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Discharge to Skilled Nursing Facility Led to Higher Readmission Rates vs. Home Health Care

Healio (November 6, 2023)

The American Association of Hip and Knee Surgeons Annual Meeting featured data revealing notable differences in readmission rates based on discharge location after total hip arthroplasty (THA). The study, presented by Dr. Matthew E. Deren and colleagues, analyzed 13,000 THA patients discharged either to a skilled nursing facility or home health care between January 2017 and August 2022. Results demonstrated that patients sent to a skilled nursing facility, often older women with higher comorbidity indices and area deprivation index (ADI) scores, had significantly higher 30-day and 90-day readmission rates compared to those discharged to home health care. The overall 90-day readmission rate was 5.9%, with a notable discrepancy of 12.6% for skilled nursing facility discharges versus 4.9% for home health care discharges, indicating the potential impact of postoperative care settings on readmission outcomes after THA. Adjustments for various factors reinforced the association between skilled nursing facility discharge and increased readmission risk.

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Visiting Nurse Found Dead in Basement of Patient's Home in 'Deeply Troubling' Case: Police

ABC News (October 31, 2023)

The murder of home care nurse Joyce Grayson in Willimantic has sparked a call for stronger home care protections in Connecticut. Legislators and health care workers gathered at the state capitol to advocate for increased safety measures in health care workplaces, especially in home settings where workers are vulnerable to dangerous conditions. Grayson's tragic death highlighted the risks health care workers face, particularly in unregulated home care environments. The lack of specific protections for home settings, coupled with the industry's rapid growth, has raised concerns about the safety of the predominantly female workforce. Advocates are pushing for legislative action to ensure the safety of workers providing care in homes, emphasizing the need for comprehensive regulations and reporting mechanisms to address incidents.

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These Are the Fastest-Growing Health Care Jobs and How Much They Pay

Incredible Health (October 24, 2023)

The health care sector, projected to make significant contributions to employment gains from 2022 to 2032, is experiencing substantial growth driven by an aging population and increased health care spending. A notable trend is the increasing demand for health care professionals engaged in the care of older patients, particularly in home settings. Among the noteworthy professions is home health and personal care aides, ranking as the sixth fastest-growing with an expected 21.7% increase in jobs. The median annual wage for these workers is $30,180.

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New Report Examines Workforce Challenges in Medicaid Home- and Community-Based Services

Kaiser Family Foundation (October 24, 2023)

The Kaiser Family Foundation recently published an issue brief focusing on the persistent workforce challenges in Medicaid home- and community-based services (HCBS) and states' responses to these challenges. The report outlines ongoing efforts by states, emphasizing that all responding states have taken actions to address workforce shortages, such as raising payment rates and developing training programs. All states, except Florida, participated in the survey.

Key takeaways include:

  • All responding states (including the District of Columbia) reported taking action to address workforce shortages, primarily through raising payment rates.
  • All states reported shortages of HCBS workers, with the most common shortages among direct support professionals, personal care attendants, nursing staff, and home health aides.
  • Most (43) states reported permanent closures of HCBS providers within the last year.
  • Among the 34 states reporting time-based payment rates for personal care providers, the majority pay less than $20 per hour.

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