The Greene County Health Department is ending its Home Health program after more than five decades of serving residents in their homes.
Health Department Administrator Molly Peters says the decision is due to several factors: “Over the past multiple years, really, home health reimbursement and ability to sustain a balanced budget has been difficult and challenging. And recently we’ve had staff that had to leave basically because our health insurance for families went up to extreme levels and that staff member could no longer manage that cost. Another staff member left or is planning to leave because of being paid higher rates at another agency. We had another retirement of a long-term staff member that’s at 28 years of service at the community level. We wanted to continue and maintain the service. We searched out trying to find nursing staff to come in and maintain. But upon doing that, home health in general is kind of a segmented organization. Not all nurses want to do home health in general. We had few apply, but as we had them apply, nursing rates over the last five to six years I’d say has staggeringly increased for rates that small organizations such as our rural home health can’t afford to pay and maintain service.
“Nursing staff deserve to be paid well as they contribute to our home care and healthcare agencies, but at the same time, our rural communities don’t have enough revenue coming in from generally people participating in the service. And just generally the reimbursement for Medicare and from insurance companies is low in comparison to the cost that it takes to drive to homes and to serve the clients that we serve. We had lots of discussion about this. We didn’t want to lose the service, but at the same time, we know that if we can’t find a nurse, we can’t see patients.”
The Home Health program began in Greene County in 1969, providing services that were not otherwise available locally.
The department says it will no longer accept new Home Health referrals, but current patients are expected to continue receiving care through their planned discharge.
Peters says that the department hopes to pivot and provide some semblance of the service in a different way down the line: “We are seeking a homemaker’s license which would sustain our current home health aid. We do think that would be a good structure and a good need for the community where they will assist with baths or other home health aid type situations within the home as well. And then, we are [also] seeking and planning at this time to look for home nursing, which is not the same as home health, but it’s not a skilled need, but it is assistance that we hopefully will be able to secure a license for and continue offering services. Unfortunately, we won’t be able to take insurances at this time, but we would have a self-pay system that if this plan comes to fruition, then we’ll have processes [for] doing that.”
The department says the closure highlights broader challenges facing rural health care, including reimbursement, workforce shortages and the rising cost of health insurance. The announcement tagged federal and state lawmakers. Peters says she hopes it a call to action to change reimbursement rates and regulations for small, rural health centers that have a lot more burdens and differing services compared to the state’s larger metro areas.
Peters says it should be a call to action for federal and state lawmakers to do something about the disparity: “We’re calling to action because rural communities aren’t always a focus and our reimbursement rates and things can’t be the same as an urban community and sustained services. Our hospitals are needed, our EMS is needed. And if we don’t have those supports in place, people don’t have access to care and it’s going to go quick. What we think is it’s a small ripple, it does affect everyone and we know that this will effect others in our community as well. It definitely effects five jobs that we could have had in the community that we now don’t in several ways. So there has to be something done in rural communities to assist us in reimbursement rates as well as just considerations that we’re all struggling and it could be very simply a situation where we’re kind of devastated all at once.”