Health department to sell home health branch

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Lincoln Trail to phase program out as costs soar

By Marty Finley

Lincoln Trail District Health Department is looking to relinquish its home health services to an outside entity.

Director Linda Sims said the health department’s board has approved a request for proposals to find a buyer for the department’s service branch, which has become unsustainable as reimbursements shrink and costs surge.

“It’s a decision we felt we had to make,” she said.

Sims said the department noticed diminishing returns last year as costs significantly increased. The department believed it could stabilize its budget this year and attempted to do so by making staffing changes through attrition, but Sims said the effort has not proved effective and the shortfall is significant enough to warrant the sale. Because regulations require certain fixed costs, it was not possible to raise rates to generate new revenue, she said.

“We were looking at a financial loss,” she said.

Sims declined to release exact financial data because this year’s numbers have not been finalized. She said only a dozen or more health departments still manage home health branches in Kentucky.

“It’s not a mandatory service for us,” she said.

Request for a proposal has been posted for a few weeks and bids are due by April 19. Sims said proposals received will be reviewed and scored by the

department to determine the best offer. Sims said there has been a wellspring of interest from potential buyers.

Typically, she said, a change in home health ownership has little effect on patients’ care. She expects little to no impact on those enrolled across the spectrum of home health services offered by Lincoln Trail because of regulations placed on home health by the Centers for Medicare & Medicaid Services.

Sims said around 198 unduplicated patients are enrolled in the program on a monthly basis, many of whom receive multiple visits each month. The service is offered in Breckinridge, Grayson, Hardin, LaRue, Marion, Meade and Washington counties.

Once the purchase is complete, patients will be offered a choice of staying with the buyer or transferring to another home health service in the area, she said.

“We’ll continue to stay in business until that transfer is done,” she said.

Sims said the department would prefer to finalize the purchase and phase the service out by July.

“Hopefully the sale will get us back above water,” she said.

The sale could affect the jobs of the roughly 25 employees assigned to the program. Sims said the buyer will need employees with the specific range of skill sets offered by those on staff at Lincoln Trail and they should be considered for employment. Sims said those services particularly will be sought after if the company that makes the purchase has no presence in some of the counties where home health is offered.

“But it’s not a given,” she said.

As the costs to manage the service continued to rise, reimbursements declined as regulations and health care requirements morphed, Sims said. This led to a gradual downsizing of staff during the last two decades. Sims estimated the program employed 110 workers 20 years ago.

But she believes there is a future in the home health industry through health care reform if the company has the size and proper resources to manage the service.

The health department’s home health program was established in 1981 and uses a multidisciplinary approach to patient care through patients, families, caregivers, physicians and home health teams working together to execute a plan of care, according to its official website. The home health team consists of registered nurses, licensed physical therapists, speech therapists, occupational therapists, home health aides and physical therapy assistants who help patients regain their strength, improve their quality of life and maintain their independence in their own homes.

Sims said the loss of home health is bittersweet because of the program’s longevity.

“We still feel like it’s the right (option) for us, but we’re really saddened by the fact we’re having to do this because we’ve been doing it for 20-plus years,” she said.

Marty Finley can be reached at (270) 505-1762 or mfinley@thenewsenterprise.com.