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Can You Pay Home Care Caregivers $15/hour or More?

There’s been a lot of talk and press about getting home care caregivers to a $15/hour wage, which equates to an annual income of roughly $30,000 per year. There’s even a movement called Fight for $15 that is organizing strikes and lobbying efforts to raise the minimum wage. According to this page on payscalecom, home care caregivers present median hourly wage is $10. The Silicon Valley darling home care company Honor is paying wages in this range and they’re able to do it because they charge more and justify their higher wage with a tech-enabled better experience.

But as long-time home care expert Stephen Tweed points out in this article, a rate increase of this nature would not be affordable to seniors or to Medicaid waiver programs and would likely put home care companies out of business.  I agree that home care caregivers should be able to receive a living wage, but I don’t think that many people will be able to afford Honor, and I agree with Stephen that if we do home care the way that we’ve always done it and raise the wage to $15, that it won’t work.Lunch At Retirement Home

Maybe We Shouldn’t Pay Home Care Caregivers the Way We’ve Always Done It?

As a comparison, let’s look at the movie rental industry…  There was a time not long ago when we went to Blockbuster to rent videos.  We would go there and browse through shelves of VHS tapes, and later DVDs to see what movie we might want to watch.  There were Blockbusters pretty much everywhere and I’d imagine that the leadership in Blockbuster thought that their business model would live forever. It didn’t work out that way and Blockbuster is now gone, replaced by Redbox, Netflix and other on-demand services.  We didn’t stop renting videos, we just do it in a different way.

Can We Do Home Care a Different Way?

First of all I believe that home care is a fantastic industry that needs to grow and not die, and I would go as far as to say that there is no way that the home care industry can fail.  But by the same token, the movie rental industry didn’t fail either – only the video rental store model failed. Skeptics at this point might argue that the failure of Blockbuster and video stores occurred because technology was able to replace people, and that in home care there is no technology that is going to sufficiently help grandma with her bath and toileting.  You’d be right, there is not a way to care for fragile people in their mid-80s and above without people, but I do believe that there’s a different way.

How Can We Pay Home Care Caregivers $15/Hour?

One way to be able to pay caregivers $15/hour is to change the model of home care from a 1-on-1 experience to shared caregiver experience.  As I’ve shared a few times, I had knee surgery last summer and was in the hospital for two days.  Over that period of time I had 24-hour care, but the care providers were not in my room for 24 hours. I would hazard a guess that my 24-hour care required less than 2-hours of 1-on-1 care time.  The rest of the time, the care team was helping other patients.

To make this work in home care the concept would be different that it is today.  Instead of sending a caregiver to an individual client’s home, what if you sent them to a suburban neighborhood where they could care for numerous clients in a one-mile radius, or in a city to care for multiple elderly clients in the same building.  With a model like this, clients could pay less for their care because other neighbors are paying too, and caregivers can be paid more because there’s more money coming in to pay them.  Making this model work would involve a lot of technology because you’d have to look at proximity for emergency support, making sure that caregivers have sufficient breaks, clients are charged fairly based on their acuity and other factors.

Tying back to the Blockbuster saga, the movies are still the main attraction and what we’re paying for.  In this new home care model, the caregivers are still the star of the show and they’ll need to do more work during their shift, but ultimately they’ll be able to get paid more and have a life outside of work, and we can have an affordable and sustainable care model.

Will Your Home Care Software Take you into the Next Generation?

Is your home care software company thinking about and talking about how you can compete in an age with more clients but fewer caregivers? If they’re thinking that the new models of payment for post-acute care won’t affect you, it might be time for new software.  Please contact us if you’re ready for next generation home care software or want to learn about our Care Transitions solutions.

If you’re interested in learning more ways to improve revenue, check out our free white paper, Why Care Transitions Is The Next Big Thing for the Home Care Industry.

Today’s guest post is by Ken Accardi, who is sometimes referred to as the “Home Care Software Geek.”  Ken founded Ankota LLC to improve the efficiency and coordination of care outside of the hospital.  Ankota provides software to improve the delivery of care, focusing on efficiency and care coordination. Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care.

This article first appeared as “The Right Path to Paying Home Care Caregivers $15/hour or More” on July 21, 2016 via the Ankota blog.

Bundled Payments are NOW! Time for Home Care to Act!

Today’s guest post is by Ken Accardi. Ken, who is sometimes referred to as the “Home Care Software Geek,” founded Ankota LLC to improve the efficiency and coordination of care outside of the hospital. Enjoy his post and feel free to comment below.

We’ve done several very popular articles about bundled payments.  If you’d like to get caught up, please read this article How Will Bundled Payments Effect Home Care?” and this articleWhat’s A Bundled Payment? Will It Influence Home Care?”  The difference between those articles and today’s offering are that the prior articles were written in future tense.  This one is talking about NOW.

Bundled Payments for Join Replacements went into effect 4/1/16

The Wall Street Journal published an article on April 1st entitled Hospitals Brace for new Medicare Payment Rules.  The article mostly focuses on payment reform at a high level with the joint replacement bundle as an example.  Note that the joint replacement bundle is now in effect for 800 US hospitals. This picture (below) from the article is a great representation of what’s going on.

Bundled_Payments_WSJ_4-1-16.jpg

How Do I Interpret These Bundled Payments?

Here’s how to understand it.  Until very recently, hospitals billed for knee and hip replacements and then discharged patients mostly to skilled nursing facilities (SNFs) and home healthcare agencies (HHAs). The SNF or HHA would then bill Medicare separately for their services.  If there was a readmission, the hospital would bill Medicare for the readmission (but might pay a penalty of around $250).bundled payments

With the bundle, the hospital gets a fixed fee of around $28,000 and needs to pay for everything.  So, referring to the diagram above, if they send the patient to a SNF they’ll lose money and if the send the patient to home health they’re likely to be profitable.  You might be thinking that since you’re home health, you’re all set and in fact you’re likely to get even more referrals. But wait, if the hospital discharges a patient who used to go to a nursing home to home health, it’s very likely that the patient is going to need help with meals, toileting, and more. Sending a nurse for 30 minutes a week and a PT for 2 hours a week won’t get it done.  Plus, the hospital doesn’t need to pay the OASIS rate, they’re going to shop for the best provider at the lowest cost, and since they’re losing money on SNF discharges, they’re going to be looking to make it up on their discharges to home.

This Post-Acute Care Picture Paints 1,000 Words

The diagram below, courtesy of Dr. Josh Luke, sums it up.  The hospital (meaning a readmission) is the last resort because the hospital won’t be reimbursed for the readmission and will likely lose $8,000.  SNFs are the second to last resort because they’re a guaranteed loss for the hospital.  Home Health is viable but CMS is trying to reduce the number of home health agencies (read our ebook on Home Health Value Based Payments).

Post-Acute-Care-Preference-Josh-Luke.png

 What Do Bundled Payments Mean for Home Care?

Seeing the glass half-full, this represents a great opportunity for non-medical home care providers to participate in the reimbursed continuum of care.  Our expectation at Ankota is that the historical divide between home health and non-medical home care will break down and that organizations will merge.  The real leaders will also use call centers to drive patient adherence and behavior change and will use automation like our product Foresight Care to get early warnings to prevent hospitalizations.

Here’s Your Homework:

If you read this article and smiled because this is the direction your agency is moving in, then I applaud you.  For the rest of you, here’s what to do:

One of Ankota’s recent whitepapers, entitled “Selling Care Transition Services to Hospitals” is available for download and we think you’ll find it useful.

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care.

This article first appeared as “Bundled Payments are NOW – Time for Home Care to Act” on May 26, 2016 via the Ankota blog.

A Physician’s View On Preventable Readmissions

A recent New York Times article, entitled Most Dangerous Time at the Hospital? It Might Be When You Leave gives a doctor’s perspective on the causes for readmissions.  I’d encourage you to read the full article, but here are some high points.

They first walk us through the case of a patient who came to the hospital with blood in their stool.  The doctors recognized the patient as having low blood pressure, so they stopped his Lasix (a diuretic he took for congestive heart failure) and proceeded to perform an endoscopy where they were able to find and clip the source of the bleeding.  So far so good.  They sent the patient home with instructions to see primary care so that the Lasix could be restarted and the dose reviewed.  The patient didn’t see primary care and ended up being readmitted for congestive heart failure.readmissions

The Committee for Medicare and Medicaid Services (CMS) has estimated it’s annual cost for preventable readmissions to be approximately $17 B (out of a total cost of $26 B).  In other words, CMS believes that 2/3rds of readmissions can be prevented.

A Physician’s View Of Preventable Readmissions

Dr. Eric Coleman has been a pioneer at preventing readmissions.  His evidence based methodology, the Care Transitions Intervention, is based around four pillars of transitional care, as follows:

  • Managing Medications,
  • Use of a Personal Health Record that engages the patient in understanding and documenting their care and sharing that knowledge with all care providers,
  • Making sure that there’s a follow-up appointment with primary care, and
  • Understanding and managing red flags.

Note: The Care Transitions Intervention® and all of its materials are the property of the Care Transitions Program®. All content on this website is © to Eric A. Coleman, MD, MPH.

Had the Coleman method been followed, the patient in the NYT article would notDr_Eric_Coleman_Care_Transitions.png likely have been readmitted.  Let’s review:

  • Medication Management: FAIL – should have gotten back onto Lasix
  • Personal Health Record: FAIL – clearly not in place
  • Primary Care Visit – FAIL – it was prescribed but not attended
  • Red Flags: FAIL – patient should have recognized increased congestion as a red flag

The doctor who inspired the article, had numerous other valuable observations, as follows:

  • Doctors prepare daily plans for all admitted patients.  The plans are often developed by a resident, reviewed with a more senior resident and approved by the attending physician.  For discharge, however, no such rigorous plan is put in place.
  • Often discharges are rushed because either the patient feels better and wants to leave or a bed becomes available in a post acute facility and they rush to take advantage of it.
  • In the hospital, vital signs are constantly monitored, whereas at home they are not
  • Sometimes a patient’s urgency to be discharged, or the hospital’s desire to clear the bed result in a premature discharge
  • There’s a practice whereby hospitals should notify the patient’s primary care physician about the patient’s hospitalization, but often it’s not done.
  • 30 percent of patients are discharged with orders for more tests, but a third of these never happen
  • As many as 40% of patients are discharged with open orders for required lab tests but often the physicians are unaware of these and they are inadvertently cancelled when the patient is discharged
  • There are numerous effective techniques for avoiding preventable readmissions, including the Coleman method, automated follow-up phone calls, pharmacist led interventions and more.

Why Does Preventing Readmissions Matter?

CMS is driving a major shift in the way that home care agencies are compensated.  They are aggressively moving away from the fee-for-service episodes of care and moving instead to bundled payments, value-based payments, and more.  All of these new payment methodologies favor post acute care with a strong track record for preventing avoidable readmissions.

How Home Care Wins In The Bundled Payment Era 

In a recent webinar, Ken Accardi explained how to be a successful post acute care provider in the era of bundled payments.  Hospitals will look for organizations with the best outcomes at the lowest cost.  Successful organizations think differently about how to organize and staff their offerings using a combination of professional care, paraprofessional care and technology. The winners will be highly profitable and win a disproportional share of referrals.

Ankota was co-founded by Ken Accardi and provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. 

This article was posted by Ken Accardi and first appeared as “Preventable Readmissions – A Doctor’s View” on Apr 3, 2016 via the Ankota blog.

What’s A Bundled Payment? Will It Influence Home Care?

“If I were in charge of a bundled payment, I’d look for the lowest cost partner with the best chance of avoiding a readmission…”

I was reading a website’s FAQ recently and thought to myself how helpful FAQ’s can be at getting to the core of my questions and answers regarding a complicated topic.

With that in mind, here is something similar to an FAQ, a series of questions and some suggested answers regarding the topic of bundled payments and how they may play a part in home care.

bundled payment

What’s a Bundled Payment?

Great Question!  Bundled payments are a new way that certain procedures will be reimbursed.  Ultimately, CMS (the Medicare and Medicaid people) will make one fixed-price payment for a procedure (like a knee replacement) that covers the whole procedure and associated recovery.  This differs from the historical fee-for-service model of reimbursement where, for example, the knee surgery would have one payment, the post-acute recovery in a nursing home or with home care would have a second payment, and a readmission would have a third payment.  (Read more about bundled payments).

Who Will Divvy Up the Bundled Payment?

Following up on the knee replacement example, the surgeon and the hospital are the big players and they’ll get the bundled payment and decide how to divvy it up.

Won’t They Want to Keep Most of the Money for Themselves?

Of course they will!

Today My Home Health Agency Gets Up to $3,000 for nursing and PT. Is That at Risk?

Yes, very much so!

Who Will They choose?

Another great question!  I opened this blog by saying that if I were in charge of bundled payments, I’d look for the lowest cost partner with the best chance of avoiding a readmission…

This is just logical…  I definitely won’t want a readmission because it will come out of my pocket, so I’ll do everything in my power to avoid a readmission at the lowest price possible.

Imagine that you are personally paying out of pocket for the post-acute care for people with knee replacements.  What would you do?  Let’s say that you had a very healthy young patient not on blood thinners who took personal responsibility for their recovery?  Perhaps you’d send them home with no post-acute care except for a YouTube video of exercises that they should do and you’d have an automated phone call check in with them every 5 days to make sure nothing’s going wrong.  Then you’d have them visit your NP a couple of times to make sure they’re on track.

Hmmm…  My Home Health Agency Might be Cut Out of the Loop!  Any advice?

Yes – I’m glad you asked…  What if you set targets for the number of visits per episode (like 6 instead of 15), personally approved any episodes with more visits and gave the nurse in charge a bonus if they do it with fewer visits?  Then, since you’re doing fewer visits, what if you added automated phone calls (available for a quarter per call) to check in on them and let the nurse case manager if they’re off track.  Then I’d keep detailed records of my costs, visits and success rate and I’d use this to market my services.

How Can I Learn More?

A few resources that can help you are as follows:

Ankota was co-founded by Ken Accardi and provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. 

This article first appeared as “What’s a Bundled Payment and How Does It Effect My Home Care Agency?” on the Jan. 22, 2016 Ankota blog.

How Will Bundled Payments Effect Home Care?

Everyone has heard about how Obamacare is driving a change in healthcare reimbursement from a pay per service model (where each service is reimbursed against a price sheet) to a pay per outcome model, and ultimately to an accountable care model (where health systems that combine payer and provider will receive a fixed amount per patient and will need to manage the health of that population).bundled payments

One of the ways that the Centers for Medicare and Medicaid Services (CMS) will implement the  “pay per outcome” model is called bundled payments.  CMS explains the model here, as follows:

Traditionally, Medicare makes separate payments to providers for each of the individual services they furnish to beneficiaries for a single illness or course of treatment. This approach can result in fragmented care with minimal coordination across providers and health care settings. Payment rewards the quantity of services offered by providers rather than the quality of care furnished. Research has shown that bundled payments can align incentives for providers – hospitals, post-acute care providers, physicians, and other practitioners – allowing them to work closely together across all specialties and settings.

How Do Bundles Work?

There are various flavors of the bundled payment programs, but essentially the idea as described above is that there will be a fixed price payment made to the hospital to cover the procedure and its post-acute care.  The subtleties between the various “flavors” relate to the time period covered by the bundle and whether the reimbursement is via fee-for-service and then “reconciled” or whether a single payment is made (and the providers submit “no cost” claims”).  Again, more details is provided by CMS at this site.

What is the Impact on Home Health?

It is possible that home health will be profoundly impacted by bundles in the following ways:

  1. You’ll need to negotiate and be paid by hospitals for the bundles
  2. You’ll need a different way of thinking.  Today your perfect world is to get a high agreed reimbursement and do enough visits to avoid a LUPA.  With bundles, you will be competing with other agencies who are able to provide the best outcome at the lowest cost.
  3. With bundles, the hospital won’t be reimbursed extra for readmissions, so part of your competitive strategy will need to be to prove that your agency avoids preventable readmissions

Where Do Bundles Stand Presently?

As of July 1, 2015, there were 101 home health agencies enrolled in the bundled payment model.  There’s a strong feeling among some home health experts that the successful bundle participants will be the agencies who thrive in the future and that others are in danger of extinction.  This was a major theme at Tim Rowan’s Healthcare in Transition conference.  If this posting makes you nervous, perhaps you should book yourself at Tim’s next conference.

What About Non-Medical Home Care?

The editorial position of this blog is that non-medical home care agencies can play a key role not only in helping their clients stay out of assisted living and nursing homes, but also in avoiding hospitalizations.  When individuals are discharged who don’t have the physical, cognitive, or mental capacity to engage in their care, they will be at higher risk of non-reimbursed readmissions than others.  Further, non-medical home care can likely fill that void to help them avoid the readmission at an affordable cost (and will likely transition these referrals to long-term clients).

Home care agencies who will benefit from this will be the ones who do the following:

1) partner with home health agencies for referrals,

2) provide care transition services in addition to standard care, and

3) will start to build practices that help their clients with ongoing chronic and recurring health conditions to avoid hospitalizations.  If you aren’t doing items 2 or 3, Ankota can help.

Ankota’s latest whitepaper offering, entitled How Homecare Can Win Under the New Care Model” is now available.

Ken Accardi founded the software company Ankota. Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota’s primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. 

This article first appeared as Bundles of Joy? How Bundled Payments will Effect Home Care on the Ankota blog on Oct 4, 2015.

Employee Engagement Equals Higher Home Care Agency Profitability

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It’s pretty clear that the quantity and quality of caregivers you have will determine your ability to grow your home care or hospice business.  Research at Leading Home Care and Caregiver Quality Assurance show that in 2015, the biggest barrier to growing your agency will be your ability to attract and retain high quality caregivers.

Gallup Employee EngagementA new report with ongoing research by the Gallup Organization shows a direct connection between employee engagement and company performance.  Between January 2013 and December 2014, Gallup interviewed 166,409 employed adults.  The results are quite startling, but not surprising for those of us in the home care industry who have faced low levels of employee engagement for years.

US Employee Engagement

% of Employees                            2013       2014

Engaged                                       29.6%     31.5%

Not Engaged                                 51.5%      51.0%

Actively Disengaged                       18.8%      17.5%

Gallup defines …

Engaged – Employees who are involved in, enthusiastic about, and committed to their work and workplace.

Not Engaged – Employees who have essentially “checked out.”

Actively Disengaged – Employees who are not just unhappy at work; these employees undermine the accomplishments of their engaged co-workers.

Engagement Varies by Geography

The study was able to determine that the level of employee engagement varies by geography.  The states with the highest employee engagement were:

  • Montana – 39%
  • Mississippi – 37%
  • Louisiana – 36%

The states with the lowest level of engagement:

  • Connecticut – 21%
  • New York – 21%
  • Michigan – 21%

According to a report on the study in USA Today, the data show that businesses with engaged employees have a 22% higher profitability than other companies.

Caregiver Quality Assurance Measures Employee Engagement

The data from this study reinforces what we know about engagement in home care.  When employees are engaged with the company and with the job, they stay longer.Employee Engagement  Employee turnover goes down, client satisfaction goes up, client referrals and word of mouth marketing go up, and costs go down.  The result is a faster growing, more profitable home care company.

According to the 2015 Private Duty Benchmarking Study from Home Care Pulse, caregiver turnover took a huge leap this year from 53.2% in 2013 to 61.6% in 2014.  According to Gallup, work units in the top quartile for employee engagement have from 25% to 65% lower turnover than work units in the bottom quartile for employee engagement.  For all practical purposes, companies with high employee engagement have lower employee turnover.

The CQA pre-employment assessment shows graphically the extent to which a prospective caregiver believes they are engaged with the company and the job.  It’s important to explore this in your behavioral interview as we see some candidates exaggerating their level of engagement.  However, the assessment report gives you a sound basis for organizing your interview and getting at the real issues.  We encourage you to look more closely at this issue of employee engagement as you look for ways to improve caregiver retention in the coming year.  For a FREE 30 Day Trial of the Caregiver Quality Assurance pre-employment assessment, click the link or call Diane West at 502-339-2132.

 

StephenTweedphotoStephen Tweed is an internationally known health care and business strategist, award winning professional speaker, and published author. He is the CEO of Leading Home Care … a Tweed Jeffries company.  He can be reached at www.leadinghomecare.com.

This article first appeared as Businesses with Engaged Employees have 22% Higher Profitability at Leading Home Care blog on April 28, 2015.

 

Benefits of Private Insurance Contracting: Non-Medicare vs Medicare Home Health

Question MarkAs a home health agency, one of your most important jobs is helping clients figure out the right payment options. While you want to provide the best care possible, you also need to be properly reimbursed for your services. This article will discuss three reimbursement options: private health insurance, Medicare, and long-term care insurance.

Private Health Insurance

Many of your clients may assume that the health insurance plans they’re currently enrolled in through their employers will cover any services required if they were to become homebound. However, that’s not necessarily the case. Private health insurance will pay for some home health services, but not all – and only for a limited period of time. Here’s what your clients can expect from their private insurance plans:

  • Coverage for skilled nursing services
  • Available coverage only for short-term, medically necessary services
  • Limited or no coverage for personal care services
  • Varying premium costs based on individual policies
  • Possible deductible, coinsurance, or copay responsibility.

If you have clients who require home care due to illness or a temporary condition, and they don’t meet Medicare’s requirements, then need to research what their private health insurance will cover. Clients need to consider their total out-of-pocket costs, and you should discuss with them all the services you’ll provide in order to avoid any surprise expenses.

Medicare

Anyone 65 or older is eligible for Original Medicare. Like private health insurance, Medicare will only cover certain home health services. Medicare will pay for qualified skilled services when the client is homebound and services are ordered by a physician. A multitude of personal or homemaker services are not covered by Medicare. Here’s what your clients need to know about Medicare and home health:

  • Services NOT covered include:
    • 24/7 in-home care
    • Meal delivery
    • Personal care
    • Homemaker activities
  • Only part-time, intermittent care is allowed
  • Skilled nursing, physical therapy, speech-language pathology, and continued occupational therapy are covered if ordered by a physician
  • Services must be deemed medically necessary
  • Home care agency providing services must be Medicare-certified
  • No copays for Medicare-approved services

Medicare is a good option for older adults who only need temporary care, like following a hospitalization and who are able to manage most daily activities independently.

If more care is needed and a client has Medicare, he or she can choose to purchase a supplemental health insurance plan – called Medigap – to help fill in the coverage gaps. This is something that, unlike Medicare, the client will need to pay for, both through a monthly premium and through copays or coinsurance. They should also keep in mind that Medigap plans are designed to allow for superior temporary care; they still won’t allow for long-term care.

Long-term Care Insurance

For those clients who suffer from chronic illnesses, can no longer function on their own, or simply need more help than either of the above options provide, long-term care insurance is the way to go. Through this type of policy, your client can feel confident they will receive the care they need without worrying about cost, and you can rest assured that you’ll be reimbursed appropriately.

Long-term care insurance is designed to pay for in-home medical services, as well as personal care (such as bathing) and homemaker activities (like meal preparation). While clients are required to purchase these plans, there are a variety of options that can be catered to meet individual needs.

No matter how you’re reimbursed for the care you provide, Kenyon Homecare Consulting can help you manage it. We offer ICD-9 coding and other services to help you increase your reimbursement percentages. Contact us today for more information!

4 Things Your Home Care Agency Needs to Review For 2015

Business Strategy on BlackboardThe home care industry saw many changes in 2014, and we can count on many more to come in 2015. To prepare for the changes ahead, home care agencies need to take a look back at last year to learn from what they’ve experienced and plan for a more productive and profitable 2015.

(more…)

Is Your Home Care Agency Bleeding Money? How to Improve Cash Flow

home care consultantHome care agencies have traditionally billed in arrears—billing after shifts or assignments are complete. While this may be more convenient for tracking and invoicing, home care agencies often find that they lack sufficient cash flow with this method. This is because an agency ends up having to pay vendors and employees before they get paid from insurance agencies or clients.

There are ways to stop your home care agency from bleeding cash—and prevent you from dipping into reserves or, worse, taking out a line of credit just to pay the bills. But before you can stop the bleeding, you need to identify why you’re losing cash. (more…)

Top 5 Reasons Your Home Care Agency Could Be Going Out of Business

home care consultantHome care agencies fail for numerous reasons. From poor planning to lack of funding to inadequate staff, the success rate in an already competitive environment isn’t very high. But the mark of a successful small business owner is the ability to quickly overcome those challenges.

How healthy is your home care agency? If the future doesn’t look as bright as you think it should, the following pitfalls may be holding you back. Here’s how to avoid becoming another statistic of well intentioned but failed home care agencies. (more…)