As population ages, home health care grows

Dayton home care companies are growing to meet the demands of an aging population that prefers to stay in their homes as long as possible, said local experts.

Ohio is aging fast, with projections for one in four residents in the local region to be age 60 or over by 2050, according to Miami University’s Scripps Gerontology Center.

People are living with more chronic conditions, living longer and using technological advances to manage their conditions at home, said Paula Thompson, president and chief executive officer of Fidelity Health Care. Fidelity is the home care division of Dayton hospital system Premier Health Partners.

“I think there’s been a real renewed interest in home care,” Thompson said. “I think people are looking for alternatives for care and again to remain in their homes I think [because of] the cost of moving into a facility, and they have to give up a lot to do that. I think independence is important to that population.”

Dayton home care companies have seen their patient volumes grow. Since 2009, for example, the patient volume at Alternate Solutions Healthcare has grown 67 percent, while Kettering Home Care has seen its number of patients increase 43 percent. And new local companies have sprung up in that time, such as Graceworks at Home and Lavender Home Care Solutions.

During the past three years, 300 new home care companies in Ohio have become Medicare certified, said Kathleen Anderson, president of Ohio Council for Home Care and Hospice. Ohio is a non-licensure state, so more companies than that are forming that don’t register for Medicare reimbursement and receive private pay, Anderson said.

Home care companies are also growing as hospitals focus on shorter patient stays. Home health services that educate patients, watch their diets and make sure they take medications right can help avoid a hospitalization, Thompson said. Or home health care can step in after a hospital discharge to keep people from going back to the emergency room.

This becomes more important in October when hospitals will be penalized for high readmission rates of certain conditions under federal health care reform.

It used to be certain wound care, chemotherapy or intravenous injections were administered only in a hospital, said Joan Gravel, director of Kettering Network Home Care, affiliated with the region’s other major hospital system Kettering Health Network. Now those treatments can be done at home with less risk of hospital acquired infections, Gravel said.

“There is a focus on prevention and reducing readmissions to the hospital and promoting better outcomes,” she said. “Patient needs can be met at home in a more cost effective manner.”

Home health aides and personal care aides help their elderly patients with daily tasks, such as going on walks, keeping the fridge stocked and housekeeping. Nurses that work for home care companies can educate patients about their medications. Physical, occupational and speech therapists also provide these patients rehabilitation services.

Personal care and home health aides are projected to be the two fastest growing occupations this decade, growing jobs at a rate of about 70 percent from 2010 to 2020, according to the U.S. Bureau of Labor Statistics. Estimates are for there to be approximately 3.2 million jobs combined by 2020 in these fields, according to labor statistics. A total 3.5 million registered nurse jobs are expected to open up by 2020, the largest overall number of jobs for any occupation.

Local home care companies said they’re hiring. Alternate Solutions, Fidelity, Graceworks at Home, Home Care by Blackstone, Kettering Home Care and Lavender have a combined 2,500 jobs on payroll and growing, said officials with those companies.

Alternate Solutions this year partnered with a technology company to fuel its expansion, mining clinical and medication records to determine the risk of a patient being readmitted to a hospital. By partnering with hospitals in other markets, Alternate is also growing by managing home care services for hospital systems or becoming their preferred provider. The result is 30 to 40 jobs to be added this year at Alternate Solution’s East Dorothy Lane office.

“The trend is going to always be there, the need is not going to go away and the need is going to be greater and greater as we get into the baby boomers,” said Tessie Ganzsarto, president of Alternate.

Horizon Home HealthCare of Vandalia opened an office last year in Middletown to expand its service area south, with plans to open a third office north if business keeps up.

Large local nonprofit group Graceworks Lutheran Services launched Graceworks at Home in 2011 because “we see the growing trend for people preferring to age in place and stay in their homes longer. This is in part due to the advances in medical care. People are living longer lives with multiple chronic medical problems that can be managed in their home better with the help of some additional services,” spokeswoman Karen Kuhn said in an email.

Graceworks provides services to residents of its retirement community Bethany Village, as well as surrounding neighborhoods, according to Kuhn.

Home Care by Blackstone was founded in 1996 in Dayton and moved its headquarters in 2004 to Cincinnati, keeping a main Dayton office on Kettering Boulevard. It has acquired nine other home care companies since 2007, including two at the end of last year that gave it a bigger presence in Cincinnati and Columbus and a foot in Darke and Preble counties, said David Tramontana, chief executive officer.

Blackstone also partners with senior housing communities to serve their residents. Two joint ventures have been formed in Cincinnati, of which one has Dayton operations, and plans are to announce a new partnership next month in Columbus, Tramontana said.

A new satellite office, the 12th, opened in Eaton this summer, the company said.

The biggest challenge facing home health care is paying for it, Tramontana said. Home care companies can be paid by Medicare, Medicaid, senior tax levies, waiver programs, and patients paying out of pocket. But the economy in recent years has hit seniors’ homes and investments, make it more difficult for them to afford health care, he said.

Meanwhile, Medicare and Medicaid funds are being cut.

“We accelerated our growth strategy to offset our shrinking margins. Having scale is important,” Tramontana said. “We’re growing and I think the industry will consolidate, so we’re focused on growth to maintain efficiencies.”

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