Noble County Home Health Agency - Suspending Operations
After almost 53 years of service, the Noble County Home Health Agency (NCHHA) will be suspending all operations. At the Noble County Board of Health meeting on the evening of January 10, 2019, the Board voted to suspend the operation of the Home Health Agency. “This decision, while necessary, is about as painful to reach for all of us here at the Health Department as anything we could decide. For 53 years, the department was the first in the field, willing to care for all, and a provider of top-notch loving care to our patients. The patients and their families we became involved with, the extensive long-term care we provided them, the happiness and grief we shared with them, defined us as people and as an agency,” states Health Commissioner Shawn Ray.
Ultimately the burden of the regulatory environment, as lead by Medicare, Medicaid, and insurance companies, has been the primary driver to the suspension of services. The NCHHA is an independent, small provider - in essence a “small business”. The increasing complexity of the regulations and the large cost to comply with those regulations are coupled with lower or even denied reimbursement. These do not allow for our continued operations. The home health field was once about providing good skilled care which allows patients to remain in their homes. Sadly, it has evolved into being primarily about continual justification of why care is needed and how care is delivered. This justification process is through very extensive documentation of medical records that nurses spend much more time completing than they do providing quality care. The care is now secondary to the paperwork.
Since the Balanced budget Act of 1997 that drove 30% of the Home Health Agencies in the nation out of business, the NCHHA adapted and overcame many regulatory and financial challenges. We still provided great care to the patients. In that time, patients became sicker and in more acute need. We mastered home IV Therapy, wound care, pediatric care and more. With an extremely long relationship with Renee Nelson and her agency, Southeastern Rehabilitation Services, we were also able to offer physical therapy, occupational and speech therapy in the home.
Despite our great care and service, we kept facing declining reimbursement. The last five years has seen significant general fund (tax dollars) subsidy of the home health agency. Board of Health member, Dr. Spencer stated, “While this has been long coming and very hard for us, ultimately the patients will be able to get the care they need elsewhere and the Noble County Health Department can use the public dollar better to address the many other public health needs of our community”.
It has also been a loving but heavy burden on our nursing staff. They chose to provide quality care first. This meant late and extended hours in the office completing documentation, coordinating care with physicians and arguing with the payment source to allow the care and then hopefully get reimbursed. Every Health Department nurse was once employed in home health and continued to cover our 24/7 “on call” as needed. Ultimately, we struggle to find and keep skilled nurses employed in home health as we cannot provide competitive salaries.
The Board of Health reached its decision on January 10th and has delayed the public announcement to give the staff ample time to individually, in person, share the decision with their patients and work with them to transition to another agency if continued care is still need. The patient is always first.
It is projected that the suspension of operations will be complete by March 31, 2019. Our last nurse has accepted a position at another agency, and her last day will be February 6th. Our longtime biller has been waiting to retire and is staying with us until we can complete the books. Finally, we have two very long-term, part-time home health aides who unfortunately will be laid off at different stages of the process. We are hoping to assist them in finding a new employer.
To all the patients and their families we have served in the last 53 years, thank you for allowing us to be a part of your family.
Noble County Home Health Agency provides a wide range of health care services that are given in your home for an illness or injury. Our staff is skilled to care for children and adults.
Skilled home health services we provide include:
- Wound care for pressure sores or a surgical wound
- Patient and caregiver education
- Intravenous or nutrition therapy
- Monitoring serious illness and unstable health status
- Physical, Occupational and Speech Therapy
Our caring home health staff can:
- Check what you’re eating and drinking.
- Check your blood pressure, temperature, heart rate, and breathing.
- Check that you’re taking your prescription and other drugs and any treatments correctly.
- Ask if you’re having pain.
- Check your safety in the home.
- Teach you about your care so you can take care of yourself.
- Coordinate your care. This means they must communicate regularly with you, your doctor, and anyone else who gives you care.
Our goal is to help you get better, regain your independence, become as self-sufficient as possible and maintain your current condition or level of function.
We accept Medicare, Medicaid and most private insurances.