The bill serves to address the workforce shortage and concerns over necessary training palliative care roles.
Legislation reintroduced this week by U.S. Sens. Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) would assist efforts to bolster the healthcare workforce, specifically those providing care to the elderly and more vulnerable patients.
Both Baldwin and Capito have served as caregivers for loved ones which, according to a statement released by Baldwin's Senate office, has shown them how valuable such services are.
"Our bipartisan Palliative Care and Hospice Education and Training Act (PCHETA) will make an overdue investment in education and research," Baldwin said, "to ensure doctors, nurses, and healthcare professionals have the tools they need as they work tirelessly to keep patients with serious or life-threatening illnesses comfortable and safe."
The bill focuses on three areas:
Workforce training: Supporting the training of interdisciplinary health professionals in palliative care, along with the training and retraining of faculty and providing students with clinical training
Education and awareness: Sharing research and information with patients, families, and health professionals about the benefits of palliative care and the services that are available
Enhanced research: Directing the Department of Health and Human Services (HHS) to use existing authorities and funds to expand palliative care research to advance clinical practice and improve care delivery.
The bill has been co-sponsored by 12 other senators and is supported by more than 90 national and state organizations, including the American Academy of Hospice and Palliative Medicine (AAHPM).
"We urge Congress to recognize the importance of a well-trained, interprofessional healthcare team to providing coordinated, person-centered serious illness care and to act now to build a healthcare workforce more closely aligned with America's evolving healthcare needs—including future pandemics," Holly Yang, MD, MSHPEd, HMDC, FACP, FAAHPM, president of the AAHPM, said in a statement."
"Advancing PCHETA will go a long way toward improving quality of care and quality of life for our nation's sickest and most vulnerable patients, along with their families and caregivers."
The facility is now referred to as the Center for Rehabilitation and Nursing at Washington Township.
Jefferson Health Care Center has joined Allaire Health Services' family of skilled nursing and rehabilitation facilities.
For the past year, the New Jersey-based provider of short- and long-term care has been working with Jefferson Health's leadership team to transition operations to Allaire's management and ownership. The facility is the largest provider in the Philadelphia area and has served patients for more than 35 years.
Going forward, Jefferson Health will be known as the Center for Rehabilitation and Nursing at Washington Township.
"We are very excited about adding the Jefferson Health Care Center to the Allaire family," Ben Kurland, LNHA, CDP, RACT-CT, president and CEO of Allaire Health Services, said in a statement.
"In this building, we see tremendous opportunity to impact the health and wellness of the region in collaborating with Jefferson Health. Jefferson Health is a tremendous organization, providing a comprehensive array of advanced specialty services.”
Kurland is also confident that Allaire's model of care and collaboration with hospitals and physicians will extend the value that both entities aspire to deliver to the market. The provider now owns and operates 13 facilities spread throughout New Jersey, Vermont, and Pennsylvania.
"Quality of care has always been our top priority for Jefferson Health and we believe that Allaire shares this passion for excellence," Brian Sweeney, RN, MBA, FACHE, regional president of Jefferson Health, said in a statement.
"Their extensive experience and commitment to fostering strong relationships with residents, their families, and staff members will ensure that patients will continue to receive the high-quality care they have come to expect.”
The franchise's partnership with Connected Home Living has been well received by franchisees and clients alike.
The use of remote patient monitoring technology in the post-acute space is expanding from the skilled nursing and home health setting to the home care setting.
ComForCare, a home health provider that also offers caregiving services , initiated their partnership with Connected Home Living, Connected Care, nine months ago, implementing the technology into their in-home care protocol. Connected Home Living is a remote patient monitoring and telehealth services provider.
In addition to monitoring vital signs, the technology will monitor alerts, medication, and the mental and physical state of a client daily.
HealthLeaders spoke with J.J. Sorrenti, CEO of Best Life Brands, the parent company of ComForCare/At Your Side Home Care, on how the partnership came to be and the process of introducing the technology into operations.
The following transcript has been edited for brevity and clarity.
HealthLeaders: What was the background going into this partnership?
J.J. Sorrenti: We had been looking at it for a full year prior to rolling it out about nine months ago. We see it as a transformative step forward in our commitment to helping deliver compassionate care to our clients.
Technology, for us, is proactive care and it allows us to bridge the gap during times that we're not in the home and that therefore provides greater stability. It provides greater insights to our caregiver people and as a result helps with improved outcomes.
HL: Who or what entity monitors the data that comes in?
Sorrenti: Connected Home Living is helping us. They're all certified caregivers and they're certified to provide remote patient monitoring assistance on the phone.
We also monitor a change in the activity of a home. If there's no movement by a certain time or in a certain room that might be inconsistent, for example, we have people that are keeping an eye on these things and will then contact the caregiver, the franchisee, and the client's family.
HL: How have franchisees responded to it? Have there been any troubleshooting issues?
Sorrenti: No issues. I think, as they see it, they like the engagement.
We want to be in the home 24/7 if we could find enough caregivers for that or if the family could afford that, because that would provide the best care, but the technology allows us to be there and so it gives us wellness monitoring and fall detection when we can't be in the home all the time. There's daily face-to-face telehealth calls with a real person and there's a comfort in connection that aids well-being to the client. This helps us with frequency and better care.
HL: What technological components are involved? Is there a phone application, a modem?
Sorrenti: It's very simple technology. There are some Bluetooth-enabled devices that can be connected, so there could be a pulse oximeter, a blood pressure monitoring system, and then there are some monitors that go on the walls.
These are not cameras, so we're not actually looking in the home. These are detection devices so they can monitor movement in the room.
One of our primary concerns was how easy it would be to install and how easy it would be for the senior to use it, but we've had no issues with that.
There's a little bit of training that's involved, both for our franchisee and our caregiver and then, of course, for the client, but that's all been dealt with very well and much easier than we thought.
HL: Has it helped alleviate the strain of the caregiver shortage?
Sorrenti: It's helped a lot, but we're very careful to make sure that our franchisees understand that this is no replacement for in-home care with a real live human being.
This is a supplement to make sure that we're always there, with our technology that protects the client, but we don't think this is the replacement for it completely.
We still like to make sure that we have some interactions, so it's a hybrid combination of both, but it does give the family much more comfort. It's hard to know what's going on in the home, but not with this system. We're able to keep the family members comforted, knowing that the information is flowing.
HL: Do you see the potential for other franchises or smaller agencies to use similar innovations?
Sorrenti: It think technology of different scales will be available to the smallest agencies, to the largest chains. More agencies will continue to engage with this as they start to understand how easy it is to implement and it's not scary for the senior to use.
See which post-acute providers and agencies have introduced new faces and promoted familiar ones.
As the third quarter begins, there have been a number of appointments and promotions within different home healthcare agencies. Here are a few that HealthLeaders has previously reported on.
Rinn's appointment was announced in late June, with him set to succeed current president and CEO, Dr. Stephen Landers, MPH, in August. He was selected after a search by the VNAHG board.
Having experience in public health, policy, and community health, Landers believes Rinn is an "excellent fit" for the association’s future.
"As a longtime member of the VNA family, I heartily welcome this opportunity to help move healthcare forward for all our communities," Rinn said.
The home health provider announced Nabb's appointment in early June, replacing current CEO Stacie Bratcher.
Prior to joining Jet Health, Nabb served as CEO and board member for Providence Care, LLC where he led the provider's acquisition strategy, bolstered its executive team, and expanded its reach from single- to multi-state.
"My background and experience, coupled with the company's solid footing in both the space as well as geographic areas it reaches, will serve as a springboard for taking Jet Health to the next level," Nabb said.
In late May, BayCare appointed William Walders as its new chief information officer and promoted James Haislip to vice president of system finance.
Walders has more than 20 years of leadership experience in healthcare and information systems, and Haislip previously served as the system's director of financial planning and analysis.
Blacker's appointment was announced in May, with Best Life Brands, the parent company of Boost Home Healthcare CEO, J.J. Sorrenti, saying his two decades of experience will play a "key role" in scaling the business.
Previously, Blacker served as home care administrator for Seabrook Village in Tinton Falls, New Jersey, where he oversaw the integration of two standalone home care agencies into one department.
In his new role, he will oversee Boost Home Health's business operations, procedures, and the organization's continued expansion efforts.
In addition to private duty caregiving services, Tennessee Quality Care, owned by American Health Partners, also provides home health and hospice services to an average of 1,800 each day, spanning 50 counties.
"This acquisition fits squarely into our growth strategy to leverage our strong personal care presence and add clinical services in key markets," Dirk Allison, Addus chairman and CEO, said in a statement.
Acquiring Tennessee Quality Care's operations will allow Addus to provide all three levels of care—private duty caregiving, home health, and hospice—which previously would have been difficult, with Tennessee being a Certificate of Need (CON) state.
CON states require a health planning agency or similar entity to approve the creation of new healthcare facilities or the expansion of an existing facility's services in a specified area, according to the National Conference of State Legislatures.
"This combination will benefit everyone associated with Tennessee Quality Care, especially the patients, families, and employees," Michael Bailey, CEO of American Health Partners, said in a statement.
"We believe this acquisition will be an ideal addition for Addus with an established market presence and reputation for quality, compassionate care," Allison said. "We have a shared commitment to provide safe and cost-effective home care services, and we look forward to the opportunity to offer patient-centric care, home health, and hospice services to more patients and families in Tennessee."
The transaction is expected to close in the third quarter of 2023.
The bill would protect access to home health care by preventing CMS from making cuts to the Medicaid Home Health Program.
U.S. Sens. Debbie Stabenow (D-MI) and Susan Collins (R-ME) recently introduced the Preserving Access to Home Health Act, preventing the Centers for Medicare and Medicaid Services (CMS) from implementing dire cuts of 7.85% to the Medicare Home Health Program, safeguarding access to essential, clinical home-based healthcare services.
The bill has bipartisan support.
"We strongly support this essential legislation as current policy positions of CMS put access to home health services for the over three million beneficiaries that utilize this care in jeopardy," William A. Dombi, president of the National Association for Home Care and Hospice, said in a statement.
"The Medicare home health benefit has shrunk over the last decade due to various payment cuts, the most recent of which is the subject of the legislation."
The bill addresses CMS cuts specifically with two policy changes: repealing permanent and temporary payment adjustments and instructing the Medicare Payment Advisory Commission (MedPAC) to analyze the Medicare Home Health Program to consider the impact of all payers on access to care for beneficiaries.
The Preserving Access to Home Health Act is needed to protect the future viability of the Medicare home health program, according to the Partnership for Quality Home Healthcare and National Association for Home Care and Hospice.
Going forward, the home health leaders want lawmakers to consider the following:
Medicare home health spending is projected to drop to $18 billion to $16 billion this year, and $15 billion in 2024 onward, according to the Congressional Budget Office (CBO).
Most Medicare beneficiaries prefer to receive post-hospital, short-term care at home.
Home health saves the Medicare Trust Fund $1.38 billion over six years due to avoided hospitalizations and skilled nursing placements.
Without home health, hospital lengths of stay are increasing, and patients are unable to transition easily from hospital to home.
"We applaud Senators Stabenow and Collins for their leadership in introducing this bill and their ongoing efforts to protect the Medicare home health benefit," Joanne Cunningham, CEO of the Partnership for Quality Home Healthcare, said in a statement. "This legislation offers the stability the Medicare home health community so urgently needs."
"We are thrilled to welcome Rob to the Fortis team at this important point in the company's evolution," said Buddy Gumina, founder and managing partner of Grant Avenue Capital, a lower middle market healthcare-focused private equity firm.
"His extensive home-based care background, commitment to clinical excellence, and proven leadership will help advance Fortis' mission of building a leading home-based care company that is renowned for its outstanding patient care and dedicated workforce."
With Radics as Fortis CEO, the company hopes to expand through investing in its clinical and leadership teams, as well as strategic acquisitions, partnerships, and "de novo launches," according to Gumina.
Before working Aveanna Healthcare, Radics served as CEO of Five Points Healthcare, which he founded in 2011 and later sold to the former organization in 2020. While serving as president of Aveanna Healthcare, he managed a $250 million annual budget for 92 locations across 15 states, along with overseeing the completion of five acquisitions.
"Grant Avenue has strategically cemented Fortis' position as a high-integrity, experienced provider of choice for patients and families, and as partner of choice for our talented Fortis team," Radics said in a statement. "I am incredibly proud to join the company as it embarks on its next phase of growth and advancement."
The franchise's operations manual compiles 25 years of information from successful partners and serves as a guide to new partners.
As the demand for aging services like caregivers continues to grow, agencies and franchises alike are taking the opportunity to expand and grow their businesses.
After considerable growth in 2022, Seniors Helping Seniors, a home care franchise, finished the first quarter of this year opening six new locations and completing eight new agreements for a total of 14 new territories, enabling their expansion in Illinois, Texas, Colorado, California, Florida, New Jersey, and Virginia.
Over the rest of this year, they plan on adding 25 franchise partners and are currently developing a website franchise owners can use as a resource for additional business support and to streamline internal processes.
The franchise currently has 125 locations serving 260 territories nationwide.
HealthLeaders spoke to Seniors Helping Seniors franchise consultant, Dave Wagner, to learn more about the franchise's growth strategies and best practices when looking for partners.
HealthLeaders: What has been the franchise's growth strategy during this current boom in demand for home care services?
Dave Wagner: The key is finding potential franchise owners who have a passion and energy to deliver high-quality care to seniors with our unique model.
The caregiver shortage is certainly a challenge. Many home care brands are plagued due to recruiting from a vast demographic pool of potential caregivers. However, our model of recruiting mature adults uniquely positions us to navigate this challenge. The goals of our target demographic have different motivations. As is always the case, no gimmick replaces the hard work of building a team of passionate caregivers, whatever the challenge of professional outreach.
HL: What is the importance of brand recognition when it comes to attracting clients and recruiting caregivers?
Wagner: It is essential in both of these areas. Awareness brings a level of belief and confidence. For families that are working through the angst of providing care, safety, and security for their loved one, a nationally recognized brand provides a lot of comfort, confidence, and credibility that they're aligning themselves with a supportive partner.
Our unique matching process invests effort into providing caregivers with similar life experiences, communication, and care scope that allows our client to flourish.
Regarding caregivers, brand recognition brings along with it the credibility and security in knowing that you're working for a provider of choice. In our case, the uniqueness of our business model is a lure for caregivers.
HL: What are some best practices for managing relationships with franchise partners to ensure they provide the quality of service the franchise upholds?
Wagner: Standardization of our branding in all facets of our marketing and advertising across the franchise population. To effectively take advantage of the power of the brand, we provide our franchise offices tools to assist in preparing their messaging. It makes the creative phase simpler and allows franchise offices to take advantage of the compounding duplication of Seniors Helping Seniors.
We have an operations manual which assists in establishing every facet of the agency. This is a collection of 25 years of information that we have gleaned from successful franchise owners to provide a road map for new franchise owners. There's no need to reinvent the wheel.
There is a consistent communication cadence with all our franchise owners. From the multi-weekly communications necessary to assist a new owner in getting launched to the less-frequent communications with our more mature owners, continuing to maintain this line of communication guarantees that the Seniors Helping Seniors brand and methods are duplicatable across the United States.
Facilities should be wary of relaxing infection prevention efforts.
Though current conversations around infection prevention and control relate back to the COVID-19 pandemic, there are between one to three million healthcare associated infections (HAI) in long-term care facilities in any given year, with an estimated 380,000 deaths annually, said Devin Jopp, CEO of the Association for Professionals in Infection Control and Epidemiology (APIC).
"There's a much broader sense of issues regarding these healthcare-associated infections that are critically important, and they too require us to have diligence and policies and procedures and staffing in place in order to make sure that we're keeping residents safe from them," Jopp told HealthLeaders.
Part of the solution to these issues will require improving the infrastructure around infection prevention and control practices—starting with more healthcare professionals exploring that particular career pathway.
With 40% of the workforce reaching retirement age in the next 10 years, in addition to the workforce shortage, there aren't enough professionals working toward becoming infection preventionists to accommodate the need, Jopp explained.
Historically, he said, infection preventionists have come from nursing backgrounds and public health, but they can also come from the biotechnology field.
"We have to make sure that we make it easier for them to enter the career, and I don't mean lowering standards," he said. "I mean having undergraduate degree programs and certificate programs in place."
It's ideal for a facility to have an infection prevention specialist on staff; however, those that don't should identify individuals who can be trained to assume some of the responsibilities of the role. According to Jopp, all staff should be trained on infection prevention basics.
Policymakers could also help with these efforts, he added, if Congress would help fund them and make it a national priority. Healso suggests expanding the National Health Surveillance Network to enable nursing homes to report HAIs in the same way acute care facilities do, to keep track of infections.
"Infection prevention isn't just about a pandemic, it's around all of the different infections that could impact the residents of these nursing homes," he said. "Part of that is around what controls we put in place."
"It's making sure we're doing hand hygiene programs, making sure that we're masking at the height of respiratory virus season. It's ensuring that we have vaccinations for personnel that are coming in and our healthcare workers, making sure things are cleaned properly."
APIC is working with the U.S. Department of Labor to encourage the adoption of a national registered apprenticeship program for infection preventionists. In doing so, they would be able to streamline professionals into those roles and ensure facilities have access to the staff they need.
Much of this will depend on the effectiveness of the programs and creating a culture of learning and competitive pay, Jopp added.
"I think it's also going to come into that issue of ensuring that they're investing in their people and they're paying them what they’re worth in order to hold on to them," he said.
Silver is the second of three quality distinctions for the honor awarded by the organization, recognizing long-term care facilities that meet the "rigorous" performance standards to improve the lives of their residents and staff.
"I am incredibly proud of our remarkable members for this achievement," Mark Parkinson, president and CEO of AHCA/NCAL, said in a statement.
"This recognition is a testament to their unwavering dedication, passion, and tireless efforts to deliver exceptional services, innovative solutions, and transformative care for their residents and staff,” he said. “Their impact is undeniable.”Silver is one of three distinctions for the organization's quality awards, with the others being bronze and gold. To earn the Silver Award, a facility must have previously received the Bronze Commitment to Quality Award.
Bronze honorees were announced at the beginning of June.
"We are delighted to honor these incredible providers for being recognized at the Silver level," Cathy Bergland, AHCA/NCAL National Quality Award board chair, said in a statement. "I applaud their resiliency and dedication to the quality journey and for this outstanding achievement."
Gold Quality Award recipients will be announced in August, and awards for all three distinctions will be presented during Delivering Solutions 23, the AHCA/NCAL Convention and Expo, October 1-4, 2023, in Denver, Colorado.
