I sometimes joke that I will buy a coffee shop when I retire and hope my family will not drink or eat the profits. Evidence points to a successful earning potential with the purchase of a coffee shop. For now, I stick with what I love to do-Coordinating care for seniors.
Owning a home healthcare agency has its ups and downs. In social or networking environments I am often asked what I do for a living. The short answer to that question is-I own a home care company. In a networking setting, I read the body language and averted eyes as their “another one” response to my polite introduction.
In a social setting, this is often met with the usual response-
“What is that?”
Me: we care for seniors in their homes through the help of certified home health aides
“Oh! That is a great industry, my goodness, so many seniors need help and there are so many of them”.
My simple response-you are absolutely right.
The truth is, yes, there are millions of seniors and yes, many need help. However, there are also a few misconceptions to work with.
#1 Misconception- All seniors can receive home health care services, if they need it.
The truth is, many seniors are living on fixed incomes and cannot afford to pay for necessary care. Many need care, but cannot afford to pay for it. Many seniors are considered, poor. There are two categories of seniors- those who can afford to pay privately for care (from their own resources including Long term Care Insurance) and those who rely on social services including Veterans benefits for help. Under social services, individuals seeking care must meet eligibility requirements. The resources available are limited and the need is great. Many seniors receiving help through Medicaid, rely on family, and other people to supplement care.
#2 Misconception-All agencies receive equal numbers of referrals and are therefore booming
I wish. Again, the truth is, home healthcare agencies cannot survive without referrals, and the truth is, all agencies do not receive equal numbers of referrals which means, all agencies are not “booming”. Referrals come from word of mouth, advertisements, health care professionals like social workers, case managers, elder law attorneys, and care organizations. There are literally thousands of home care agencies-referring to all of them is impossible. Home care agencies hire sales people to “market” their services and to form lasting relationships with the hope of receiving referrals. Sales and marketing in home healthcare is not a regulated way of doing business; How one decides to refer to a particular company is somewhat puzzling. The truth is-most of the referrals probably go to the top five or so agencies. The other hundreds, are small businesses who work hard to keep going.
#3 Misconception- Caregivers from one agency are better than caregivers from another
No, No, No. Not true says the captain. I know this because I have worked for one of the largest, if not the largest franchise company in both Delaware and Connecticut. I have also seen firsthand that caregivers are transitory. Most caregivers work in a part time or per-Diem capacity. It is not a high paying job so they typically work for several agencies so they make enough to survive. Most agencies hire from the same pool of people. I will say that what can make a difference, are the hiring practices, the supervision, and the amount of additional training, which may elevate one agency over another. I am only including legitimate agencies in this assessment, not staffing agencies or registries.
#4 Misconception- Medicare will pay for all home care
Unfortunately, this isn’t true. To qualify for home health coverage under Medicare and Medicaid Services, a person must meet 4 qualifying criteria:
1. A physician must certify the need for services
2. The patient must remain under the care of a physician
3. The person must be certified by a physician as home-bound
4. The person must need part time or intermittent skilled nursing care (up to and including 28 hours of skilled nursing and home health aide services combined- provided on a less-than-daily basis)
If all 4 qualifying criteria are met, that person may receive care through a Medicare-Certified provider and Medicare will pay for the services if they are deemed “medically reasonable and necessary”. Additionally, “because one must need skilled nursing or therapeutic care to obtain home care services from Medicare, typical coverage averages two or three months. Thus services normally do not address chronic needs or home care”.
I know many people feel that home care agencies are popping up all over the place just like coffee shops. This can sometimes overwhelm the masses. To my colleagues, my response is- does it matter how many agencies there are? Sift through the noise to find an agency whose values coincides with yours. To someone seeking help, choosing the right company can be life changing so, choose wisely.
From my perspective, owning a home healthcare agency means you walk with a constant theme of-Only the strong survive. Caffeine helps a lot- and a song or two.
Community Resource for older adults: Programs and Services in an Era of Change, 4th Ed. Robbyn R. Wacker and Karen A. Roberto.