The closure was cited as due to economic reasons, according to a notice filed with the state Department of Labor on Oct. 10.

The workforce reductions occur as the Louisville, Kentucky-based firm plans to discontinue all its home care services in order to concentrate on its senior living business. The company established its Nassau County home care agency to support the 30 assisted living facilities it operates across the state.

The home care business’s closure is reportedly unrelated to the industry consolidation of the Medicaid-funded Consumer Directed Personal Assistance Program (CDPAP) participants in New York next year. Atria does not accept Medicaid.

“After careful consideration, we have made the decision to discontinue operations at Atria Home Care in an effort to focus on our core business of social model senior living communities,” an Atria Senior Living spokesperson told Home Health Care News. “We are working with all home care customers and employees on a transition to other home care providers and are committed to supporting our employees and clients through these changes over the next several weeks.”

Founded in 1996, Atria Senior Living provides independent and assisted living and memory care facilities for adults with dementia or Alzheimer’s disease in more than 300 communities across 43 states and seven Canadian provinces, according to its website.

Atria’s portfolio of brands includes Coterie Luxury Senior Living, Atria Signature Collection, Atria Senior Living, Atria Park, Holiday by Atria and Atria Retirement Canada. The privately held management company employs more than 13,000 caregivers and has approximately 36,000 residents.

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“Health literacy is a state of knowledge and comfort that allows you to navigate the world and achieve wellbeing,” Danielle Brooks, director of quality health equity at AmeriHealth Caritas, told Home Health Care News. “It is critical to navigating, supporting and advocating for yourself when experiencing a medical or health-related need.”

AmeriHealth Caritas, based in Newtown Square, Pennsylvania, is a national managed care solution provider.

Limited health literacy significantly impacts Medicaid members, with 60% having basic or below-basic literacy, compared to only 24% of those with employer-sponsored coverage, according to the Center for Health Care Strategies. This demographic includes people aged 65 and older, individuals with lower incomes, those with lower education levels, people with limited English proficiency and minorities.

Furthermore, low health literacy rates lead to higher hospital use, higher mortality rates and higher health care costs. Improving rates could prevent one million hospital visits and save over $25 billion annually, according to the Centers for Disease Control and Prevention (CDC). Health literacy is essential in home care because it can affect a patient’s ability to understand and follow their treatment plan.

Oftentimes, patients also don’t realize that home health care or home care are options available to them.

“The complexity of the health care system and health concerns like COVID-19 require strong literacy skills to find, understand, evaluate and use health information to make informed decisions,” Sabrina Kurtz-Rossi, assistant professor at Boston’s Tufts University School of Medicine, told HHCN. “Compelling sources of health information, including inaccurate information on social media and the internet, intensify the need for improved health literacy for all.”

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) have listed improved health literacy as organizational priorities. Specifically, HHS has included it in its Healthy People 2030 initiative.

Organizations and professionals can enhance their health literacy by implementing proven strategies. These include addressing questions in simple, non-medical language and creating and testing written materials for the intended audience, as per the HHS.

It’s important to consider that any patient may face challenges in understanding health information. Adults with limited literacy often feel ashamed of their abilities and may conceal their difficulties. Conducting informal client assessments can help identify individuals with limited literacy skills.

“Organizations should start by asking themselves this question,” Brooks said. “What do we need to do to reach our clients in a way they understand and that speaks to them? Materials and messaging need to be presented in a way that is most easily understood by clients and resonates with them. Employees must learn how to incorporate health literacy into their work every day.”

State contracts often require insurers serving Medicaid enrollees to have materials available in multiple languages, written at a sixth-grade reading level or lower, and have member-facing staff who can speak languages other than English.

“It is important to have data on how your current and potential clients understand and process information,” Brooks said. “This includes not only what languages they speak but also factors like age, education level, gender identity, sexual orientation and family structure. This information provides important insights into their needs. It is about communicating to members in a way that is most easily understood and actionable.”

The CDC recommends asking patients how often they need help reading written material from their doctors or pharmacies and asking them to explain instructions in their own words to show that they understand. Use videos, models and pictures to help clients learn. Listen to concerns without interrupting and consider clients’ cultural and linguistic norms when developing messages. Use certified translators and interpreters to adapt to language preferences.

“There are validated tools for analyzing written health information for reading ease and accessibility,” Kurtz-Rossi said. “These include the Patient Education Materials Assessment Tool, the CDC Clear Communication Index, and the Readability, Understanding and Actionability of Key Information on Informed Consent Forms (RUAKI) Indicator. Readability formulas can tell you the reading grade level at which a material is written but do not assess layout and design, cultural relevance or other features that help make information accessible.”

Active engagement is also vital to improving clients’ health literacy and ensuring they receive the best care. Engaged clients are more likely to follow treatment plans and work with their caregivers to make informed decisions.

Caregivers should encourage questions, ask clients to express concerns, and readily offer information during visits. Open communication helps build relationships between clients and caregivers and may make clients feel more comfortable asking questions about their conditions.

“The ten attributes of literate health care organizations provide a framework for how organizations can ensure clear communication and understanding,” Kurtz-Rossi explained. “Health-literate organizations strive to provide equitable and understandable information and services using evidence-based health literacy interventions, including plain language in written and oral communication and teach back to confirm understanding. Other health literacy tools and resources can help organizations engage leadership, prepare the workforce, create a shame-free environment and use plain language print materials and websites.”

Caregiver literacy is also a concern

It is important to note that caregivers also have a range of health literacy skills.

“Health literacy is a multifaceted concept which reflects not only individual-level skills but also the unnecessary burden placed on clients and caregivers by an overly complex health system,” Rachel O’Conor, assistant professor at the Center for Applied Health Research on Aging at Chicago’s Northwestern University, told HHCN. “Thinking about health literacy as both an individual skill, but also an organizational trait, can be helpful for agencies to consider as they seek to promote health literacy among their caregivers.”

A recent study showed that 44% of caregivers demonstrated adequate knowledge, 36% demonstrated marginal knowledge and 20% had low health literacy skills. In adjusted analyses, caregivers with marginal and low health literacy demonstrated worse overall performance on health tasks and poorer interpretation of health information presented on print documents and recall of spoken communication. As a result, these caregivers demonstrated poor performance on everyday health tasks with which they commonly assist older adults. The application of health literacy best practices to support better training and capacity-building for caregivers was found to be warranted.

Researchers suggested online training modules to promote caregiver communication with health care clinicians. Following health literacy best practices, these modules should be developed using plain language and cultural inclusion.

“To ensure caregivers are equipped to provide a high level of care, agencies should provide skills-based training on how to assist with health-related tasks,” O’Conor said. “The training could incorporate health literacy best practices in order to promote comprehension and application of the information.”

O’Conor said that she has found that the inclusion of both spoken and print information can promote recall, as well as breaking the information into manageable pieces for better comprehension.

“All corresponding information needs to be easy to understand,” she said. “Passing a simple test demonstrating competency may be reasonable to ensure proficiency in these skills. This act of demonstrating proficiency is in essence the application of teach-to-goal procedures, which is a common health literacy best practice to promote comprehension of health information.”

Home-based care agencies that prioritize personal and organizational health literacy can benefit from multiple positive outcomes. Expanded literacy can improve client health outcomes, decrease emergency department visits by ensuring clients seek preventative care, reduce the number of dosing errors, help clients manage chronic conditions and increase satisfaction.

“Caregivers have a unique role to play when it comes to tailoring and communicating treatment plans to meet the unique needs of individual clients,” Kurtz-Rossi said. “Doctors are one important point of content, but it takes a health care team – including family members – and each member of the team needs to listen to client concerns and communicate plans and services clearly. Clear communication builds trust. When a client is engaged with and trusts their caregivers, they are more likely to follow recommendations.”

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According to court documents, Zakia Khan and Ahsan Ijaz owned two Brooklyn-based social adult day care organizations, Happy Family Social Adult Day Care Center Inc. and Family Social Adult Day Care Center Inc., and a financial intermediary called Responsible Care Staffing Inc.

These organizations were involved in the New York Medicaid Consumer Directed Personal Assistance Services Program (CDPAP), which allows family members of Medicaid recipients to receive payment for helping the recipients with daily activities.

Starting around October 2017, marketers Elaine Antao, Omneah Hamdi and Manal Wasef reportedly directed Medicaid recipients to Happy Family, Family Social or Responsible Care in exchange for kickbacks and bribes. In return, the marketers allegedly paid kickbacks and bribes to Medicaid recipients for social adult day care and CDPAP services that the organizations billed to Medicaid – services they either did not provide or services that were influenced by those kickbacks and bribes.

Ansir Abassi, Ansir Zaib and Amran Hashmi purportedly managed Happy Family and Family Social along with the marketers. To carry out the kickback scheme, Khan, Antao, Ijaz, Abassi and Hamdi allegedly used business entities to launder the fraud proceeds and generate cash to pay kickbacks and bribes. Seema Memon, an employee of Happy Family who was previously charged by complaint on July 1, was also indicted.

“As alleged in the indictment, these defendants orchestrated a years-long scheme to defraud Medicaid of tens of millions of dollars for social adult day care and home care services that they did not provide,” Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division, said in a statement. “The defendants allegedly paid cash bribes and kickbacks to recruiters and Medicaid recipients as part of a scheme to enrich themselves at the expense of vital programs for senior citizens. The charges make clear that the Criminal Division will not tolerate schemes that brazenly steal from federal health care programs.”

Khan has been charged with several offenses, including conspiracy to commit health care fraud, three counts of health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, paying health care kickbacks, conspiracy to commit money laundering, and money laundering. If found guilty, she could face a maximum penalty of 20 years in prison for each count of conspiracy to commit money laundering and money laundering, ten years in prison for each count of conspiracy to commit health care fraud, health care fraud, and paying health care kickbacks, and five years in prison for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Abassi, Antao, Hamdi and Ijaz face charges of conspiracy to commit health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, conspiracy to commit money laundering and money laundering. If found guilty, they could be sentenced to a maximum of 20 years for each count of conspiracy to commit money laundering and money laundering, ten years for conspiracy to commit health care fraud, and five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Hashmi is facing charges of conspiracy to commit health care fraud, three counts of health care fraud, conspiracy to defraud the United States, and paying and receiving health care kickbacks. If found guilty, he could be sentenced to a maximum of ten years for each count of conspiracy to commit health care fraud, health care fraud, and paying health care kickbacks, as well as five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Memon is charged with conspiracy to commit health care fraud, conspiracy to defraud the United States, and paying and receiving health care kickbacks. If convicted, she faces a maximum penalty of ten years for each count of conspiracy to commit health care fraud and paying health care kickbacks and five years for conspiracy to defraud the United States and pay and receive health care kickbacks.

Wasef faces charges of conspiracy to commit health care fraud, conspiracy to defraud the United States, and conspiracy to pay and receive health care kickbacks. If found guilty, she could face a maximum penalty of ten years for conspiracy to commit health care fraud and five years for conspiracy to defraud the United States and to pay and receive health care kickbacks.

Since March 2007, the Health Care Fraud Strike program, consisting of nine strike forces operating in 27 federal districts, has prosecuted over 5,400 defendants who have overbilled federal health care programs and private insurers by over $27 billion.

“The crimes outlined in this indictment took advantage of a network that offers essential health care and other services to those in need,” Interim Commissioner Thomas G. Donlon of the New York City Police Department (NYPD) said in a statement. “Let it be clear: anyone who attempts to profit by defrauding the system will face consequences, as these schemes drain already limited resources and deprive beneficiaries of crucial funds. I commend our NYPD investigators and federal law enforcement partners for their continued collaboration.”

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Mental and physical health are vital components of overall wellbeing and can influence each other in many ways. Yet, individuals with mental health conditions may encounter challenges in accessing adequate health care, which can impede their ability to manage their physical health. Home health care providers, however, are increasingly stepping in to bridge this gap.

In-home behavioral health care provides specialized support to promote mental wellness for individuals with a wide range of behavioral or psychiatric disorders. Those who qualify may be experiencing depression, anxiety, agoraphobia, difficulties associated with aging in place, struggles with substance use or problems coping with trauma. Mental health at-home support aims to improve these patients’ access to quality care.

“Untreated mental illness or behavioral health issues can significantly increase the risk of worsening mental conditions, the progression of chronic medical conditions, and the development of heart disease, stroke, dementia and a weakened immune response,” Barbara Andazola, vice president of clinical practice, strategy and programs at Amedisys (Nasdaq: AMED), told Home Health Care News.

Amedisys, headquartered in Baton Rouge, Louisiana, provides home health care, hospice, palliative and high-acuity care in 38 states.

“Most adult patients receiving home health services have a chronic or life-altering illness that can affect their mental wellness, which is crucial for how they think, feel, cope, make health-related decisions and determine how they will participate in their care,” Andazola continued. “Providing person-centered care and achieving quality clinical outcomes is impossible without addressing patients’ mental wellness needs, especially in home health, where clinicians directly observe the impact of mental and physical health on a patient.”

Many home health providers see behavioral health as a natural extension of their mission to help seniors successfully age in place.

At the same time, as value-based care measures become more prominent, making sure seniors are as mentally fit as possible also becomes more important from a business perspective.

“Behavioral health care is a crucial offering for home health providers because it allows for continuity of care across lifespan and settings, especially for individuals with dual diagnoses or developmental disabilities,” Dallas Star, regional director for Bayada Home Health Care, told HHCN. “Home health providers can leverage their expertise in home-based care to deliver specialized behavioral health therapies such as applied behavioral analysis (ABA) in the comfort of the client’s home. This personalized approach can help clients generalize skills and improve the overall quality of life.”

Bayada provides home health, home care and hospice services in 23 states, as well as in Canada, Germany, India, Ireland, New Zealand, South Korea and the U.K.

Psychiatric registered nurses (RNs) usually provide services for this patient population, sometimes with the aid of a licensed clinical social worker.

Those with Medicaid or a limited income may qualify for in-home behavioral health care at no cost. Most providers will work with clients to seek approval and evaluate needs to determine coverage available through insurance providers.

To initiate services, clients must speak with their physician or mental health professional who can provide a referral and work with the home health care provider to develop a personalized care plan. The duration of care depends on individual needs and goals.

Psychiatric nurses conduct an initial assessment and collaborate with the physician to develop an individualized care plan. The nursing services outlined in the care plan typically include evaluating, teaching and administering medications; managing situational crises; conducting self-harm assessments; teaching self-care and promoting mental and physical wellbeing; providing supportive counseling and delivering psychotherapeutic interventions such as education on disease processes, symptom management, safety, coping skills and problem-solving.

If a patient needs additional services or a different level of care, home health clinicians, with the approval of the patient’s physician, will coordinate with local community resources to ensure the patient receives the necessary services to remain safely at home. If this is not feasible, they will arrange to transfer care to an appropriate outpatient or inpatient facility.

“Similar to patients receiving other types of in-home services, those receiving behavioral health care are satisfied with their outcomes and appreciate the ability to receive care in the comfort and safety of their own homes,” Andazola said.

States mobilize crisis intervention teams to further address access to care

The Centers for Medicare & Medicaid Services (CMS) recently approved New Hampshire’s Medicaid State Plan Amendment for community-based mobile crisis intervention teams to provide services for people experiencing a mental health or substance use disorder crisis.

New Hampshire can now connect Medicaid-eligible individuals in crisis to a behavioral health provider 24 hours a day, 365 days a year. This approval marks 20 states and the District of Columbia that have expanded access to community-based mental health and substance use services under a new Medicaid option created by the Biden-Harris American Rescue Plan.

Mobile crisis intervention teams provides screening and evaluation; stabilization and de-escalation; and coordination with and referrals to health, social and other services, as needed. This helps states better integrate behavioral health services into their Medicaid programs.

Providing fast, appropriate care to someone in crisis may reduce the need for costly inpatient services, and this new option will help states expand access to behavioral health professionals as the initial contact for someone in crisis. New Hampshire can now receive Medicaid funding for mobile crisis response crisis planning, directly connecting people to specialized services, referring ongoing supports, and follow-up check-ins for individuals experiencing a mental health or substance use disorder crisis.

Though home health providers often have behavioral health capabilities – and sometimes even specific service lines for that care – there are still barriers to implementation.

“There is a clear need for ongoing behavioral health services as a standard offering for home health patients,” Andazola said. “However, the shortage of psychiatric-trained RNs and the specific experience requirements set by Medicare for reimbursement limit the expansion of these services. The Medicare home health benefit excludes occupational therapy (OT) as a qualifying clinician discipline. Despite OTs being highly skilled and capable of addressing functional limitations often experienced by behavioral health patients due to mental illness or cognitive deficits, they can only provide these services if the patient’s condition also requires skilled nursing physical or speech therapy. Until CMS addresses these and other requirements, expanding behavioral health services for home health patients will remain limited.”

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Broadly, the company captures detailed observations from caregivers in real time to identify client needs and predict unforeseen events.

The care coordination program depends on caregivers submitting weekly observations and reporting any changes in client conditions.

Community health workers (CHWs) also conduct a self-reported health assessment using the Centers for Medicare & Medicaid Services (CMS) Accountable Health Communities Health-Related Social Needs screening tool. This tool includes 24 questions about the home environment and access to eligible benefits and services. These questions help identify issues such as housing instability, food insecurity, transportation challenges, financial strain, safety concerns and lifestyle factors that can affect a client’s ability to achieve long-term health goals.

“We’re uniquely positioned, using the millions of hours we spend with our clients, to connect home care to health care through our innovative care coordination management programs and services supported by our value-based care philosophy,” Julie McCarter, president of care coordination at Help at Home, told Home Health Care News. “Through the launch of our health care coordination strategies that build on our longitudinal caregiver-client relationships, we’re addressing access to care, health-related social needs and unmet client health needs, advancing care as we improve quality and cost outcomes.”

The Chicago-based Help at Home is one of the largest home care providers in the country. It provides home- and community-based services (HCBS) via over 200 locations across 11 states.

In its first year, the program made one million observations and carried out 4,000 proactive interventions that had an impact on the health care system. These interventions included scheduling pulmonology appointments when there was a decline in breathing and mobility, activating mental health resources when there were signs of agitation or mood changes and connecting individuals with food resources when food insecurities were identified. The results of these interventions included a 31% decrease in emergency room visits, a 37% decrease in inpatient admissions compared to the previous year, and a 51% improvement in depression, among other positive outcomes, according to McCarter.

“Our caregivers serve as an extra set of eyes and ears in the home, and through the program, they can digitally capture physical, behavioral and environmental observations,” McCarter said. “Clinical teams can assess, act and prevent avoidable health events in real time to avoid unnecessary hospitalization or institutionalization.”

McCarter mentioned that the clinical care team supporting caregivers includes CHWs. These CHWs typically reside within the community they serve and share the same ethnicity, language, socioeconomic status and life experiences as the client population, allowing for the formation of trusting, organic relationships.

“The results of caregiver tools and care teams engaging populations with high-tech, high-touch wraparound clinical efforts are proving to reduce emergency room visits, inpatient utilization, close preventative gaps in care, increase primary care and optimize health care benefits and services,” McCarter explained.

Furthermore, Help at Home reports that caregivers involved in the care coordination program have higher net promoter scores, demonstrating the program’s ability to improve caregiver satisfaction and retention, making them feel valued and motivated.

“Caregiving can be a difficult job, so we are attentive to the caregiver and work to elevate the caregiver role by providing a village of support through care coordination clinical care teams,” McCarter said. “We’ve seen this lead to greater caregiver satisfaction scores and tenure. Not only does the program support client health and wellbeing, but it also focuses on identifying and supporting the caregivers’ needs. Through the program and that understanding, we’ve found that nearly 50% of caregivers expressed that having a better understanding of their clients’ conditions or needs and how they can be a part of the solution helps them to alleviate their worry and stress.”

Building on the strength of the company’s foundation, core service offerings and long-term relationships, McCarter said that the company is expanding its efforts. Caregivers now have a deeper understanding of a client’s overall health journey and how they can improve the quality of life for underserved populations who wish to age in place.

“We’re energized by the program’s results thus far and are continuing our journey to build on learnings and successes,” she said. “As we move to 2025, we’re excited about embarking on a broader clinical care delivery journey that furthers the value we can provide to our partners, clients and caregivers with value-based care and wraparound support programs to drive quality outcomes and total cost of care opportunities – further connecting health care to home care.”

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Before joining Vivo Infusion, Rodgers was CEO at AccentCare for over a decade. He was also formerly CEO of OptumHealth Collaborative Care, a division of UnitedHealth Group (NYSE: UNH) that owns, manages, and provides administrative and technology services to health care delivery systems.

Earlier in his career, he was a health care executive at General Electric, responsible for purchasing health care benefits.

Vivo Infusion provides cost-effective infusion care to patients in partnership with their physicians.

Accra names Frette as chief solutions officer, Chad Derner CFO

Accra has named LeAnn Frette as chief solutions officer. Frette transitions to her new role after serving as chief financial officer (CFO) for over a decade. The company has also appointed Chad Derner to succeed Frette as CFO.

“Over 18 years of service at Accra, LeAnne has guided our organization through tremendous growth and helped us maintain financial success despite constant disruption in the home care industry,” said Accra President and CEO John Dahm said in a statement. “Her expertise will be critical in clearing the future hurdles we face to best serve the thousands of Minnesotans who need care at home.”

Accra is a nonprofit organization providing individualized home care services to people with disabilities and older adults. Headquartered in Minnetonka and operating in all counties throughout Minnesota, Accra helps people who need care get self-directed assistance with activities of daily living.

As chief solutions officer, Frette will partner with leadership on all operational and strategic issues and provide recommendations based on financial analysis and projections, cost identification and allocation, and revenue/expense analysis.

“I am excited to dive into my new role as chief solutions officer and look forward to collaborating with Accra’s executive leadership team on strategies to build an ecosystem that better meets the needs of Minnesotans who require personalized care at home,” Frette said.

Frette started with Accra as a system analyst in 2006 and supported the company’s growth by building out its financial operating systems and practices. She was named CFO in 2014.

Taking on Frette’s former role as CFO, Chad Derner will manage Accra’s accounting and billing departments, oversee all financial activities and operations and provide strategic guidance to leadership. Derner joins Accra with 25 years of experience in finance and accounting, the last 16 of which have been in leadership.

“I am thrilled to welcome Chad Derner as Accra’s new CFO,” Frette said. “Having dedicated many years to this role, I understand the importance of having a leader with Chad’s extensive experience and strategic vision. I am confident that Chad’s broad health care experience will help Accra grow and thrive in our ever-changing industry.”

Derner will focus on identifying opportunities to optimize financial strategies across all of Accra’s business ventures. He will be critical in ensuring Accra fosters financial excellence and strategic growth.

“I am excited to join this dedicated team and contribute to Accra’s mission by ensuring financial excellence and strategic growth,” Derner said. “I look forward to leveraging my experience in financial management and technology-focused health care to support Accra and significantly impact our community.”

CaringBridge announces new board members

CaringBridge, a Bloomington, Minnesota-based health care platform supporting family caregivers, recently announced new members to its board of directors: Sandy Chung, American Academy of Pediatrics immediate past president, CEO of Trusted Doctors, Medical Director of the Virginia Mental Health Access Program; Kristy Lindquist, co-founder and partner at Chasm Partners and Steve Margolis, retired health plan executive, independent board member and current president of the Vitality Group.

The company also announced that retired health care executive Sarah Krevens was the board chair, and Linda Ireland, an independent board director, was the board vice chair.

Calvin Allen, executive vice president and chief human resources officer at Children’s Hospital of Philadelphia has joined as Treasurer, Finance & Development Committee chair.

Cris Ross, chief information officer at Mayo Clinic, is the new Impact Committee chair.

Adrian Slobin, chief growth officer at Huron Consulting, has joined as the Governance Committee chair.

Scott Spiker, board director and chairman at First Command Financial Services, is board chair Emeritus.

“I am thrilled to welcome our new members to the CaringBridge board,” CEO Tia Newcomer said in a statement. “Our board comprises seasoned professionals in health care with deeply personal connections to caregiving. I am truly excited about the future and what we will accomplish together. The board is essential in continuing our path of meaningful and transformational work to surround family caregivers with emotional, social and functional support as they care for a loved one on a health journey.”

nVoq welcomes Iddings as chief revenue officer

nVoq announced Dawn Iddings as its chief revenue officer. Iddings brings over 20 years of experience in health care, technology and electronic health records. Most recently, she served as senior vice president and managing director of post-acute care at Netsmart Technologies. 

“Dawn is an incredible addition to our executive team,” President and Chief Operating Officer Debbi Gillotti said in a statement. “Her deep expertise in the in-home health care market, combined with her career-long commitment to creating technology solutions for our industry, will elevate our ability to service our agency customers and industry partners.”

nVoq Inc., headquartered in Boulder, Colorado, provides HIPAA-compliant, SaaS-based technology for the in-home health care industry.

“The in-home health care market is on the brink of a significant transformation, and AI is at the heart of it,” Iddings said in a statement. “nVoq has been developing and evolving this technology to meet the unique needs of clinicians for over a decade. Our solutions continue to redefine efficiency, quality and accuracy in clinical documentation, and I’m thrilled to be a part of this journey.”

One Senior Care expands executive leadership team

Erie, Pennsylvania-based One Senior Care announced the expansion of its leadership team.

As chief medical officer, Dr. Jerry Wilborn, a 25-year veteran in post-acute care, will work alongside the organization’s medical directors to drive clinical strategy and positive health outcomes.

“Over the last few years, it’s become increasingly clear that seniors want to age in their homes. One Senior Care is making this a reality for the older adults we serve in Pennsylvania, Virginia, Kentucky, and soon, Ohio,” Wilborn said in a press release.

The newly appointed chief operating officer, Craig Worland, brings a professional background in leading growing health organizations, having previously served in Southeast Primary Care Partners and Tanner Health System.

“I’m honored to join One Senior Care, which has great potential to expand this truly integrated and participant-centered program to serve more older adults and communities across the country,” Worland said in a press release.

As chief quality and compliance officer, Laura Lyons will enhance the company’s quality and compliance programs, according to the release.

“As we look toward the future, we look forward to building upon our reputation in quality care and continuing to ensure that older adults can live healthy, happy and independent lives in their own homes and communities,” Lyons said.

Element Care appoints Thompson new CEO

Element Care announced the appointment of Douglas Thompson as chief executive officer (CEO). Doug brings experience in health care leadership, financial management and community engagement to the company.

“In seeking a new CEO, it was essential to the board of directors to select a candidate that not only has the leadership and technical skills necessary to manage such a complex organization but also someone committed to providing high-quality health care to low-income seniors,” President of the Board of Directors, John Feehan said in a statement. “We are extremely excited to have Doug join the Element Care team and look forward to working with him to bring high-quality, wrap-around medical services to many more seniors in need.”

Element Care, based in Lynn, Massachusetts, provides managed care for senior care options (SCO) under a contract with Commonwealth Care Alliance. The company serves over 1,000 Program for All-Inclusive Care for the Elderly (PACE) participants and 2,000 SCO members across 60 North Shore, Merrimack Valley and Greater Boston communities.

“I’ve worked with diverse populations throughout my career and am passionate about developing innovative programs to serve patients with complex health needs,” Thompson said. “I am excited about the mission and high quality of health care that is the foundation of Element Care. I look forward to building on the success of this organization and leading its next chapter as the population of aging seniors continues to grow.”

Thompson was previously the CEO and founder of Perfect Health Inc., where he developed a comprehensive primary care clinical model as a risk-bearing provider organization focused on serving seniors with complex health care needs at home. He was also the former chief financial officer of the Massachusetts state Medicaid program and three Medicaid managed care organizations.

Avenues Home Care welcomes Hendrix as senior care coordinator

Avenues Home Care announced Grant Hendrix as senior care coordinator for northwest Georgia and southeast Tennessee. Hendrix will help families and veterans living in Dalton, Chattanooga and surrounding areas engage with home care services to meet their needs.

“At Avenues Home Care, we are committed to offering those we serve professional, compassionate and flexible home care solutions,” CEO Doug Markham said in a press release. “With our years of experience and industry knowledge, we empower our local teams to foster meaningful connections within the community. Grant’s extensive experience, education, and the Avenues’ vision and support give him the essential insights and resources to ensure we meet our clients’ distinct needs.”

Dalton, Georgia-based Avenues Home Care is the parent company of community-centric home care agencies spanning multiple communities across the South. The company provides in-home senior care, activities of daily living, medication assistance, meal preparation, companionship, transportation, light housekeeping and more.

“Avenues’ motto, ‘your journey, our care,’ is something I will strive to remember every time I visit families and their loved ones,” Hendrix said. “My passion is to connect people to exceptional home care services that will help improve their quality of life. With their excellent reputation and resources, Avenues Home Care has given me a great opportunity to help families in the areas we serve.”

In his new role, Hendrix will analyze the market, visit communities and meet with clients in their homes.

Integrated Home Care Services Inc. welcomes Ajani Nimmagadda as CMO

Integrated Home Care Services Inc. (IHCS) announced that Dr. Ajani Nimmagadda has been named the organization’s new chief medical officer. Nimmagadda will assume clinical and medical management leadership across the organization.

“Dr. Nimmagadda’s leadership in driving clinical outcomes, quality of care and health care affordability will be instrumental in helping us continue to fulfill our mission and support our continued growth,” CEO Christopher Bradbury said in a statement. “Her proven track record of achieving better outcomes for patients, providers, and health plans and her expertise across the health care ecosystem will further accelerate our innovation and value-based care solutions.”

Integrated Home Care Services is a home care benefit manager that enables and accelerates value-based home care for health plans and risk-based provider organizations. Headquartered in Miramar, Florida, the company services millions of patients across many states and Puerto Rico.

“I am honored to join IHCS as chief medical officer,” Dr. Nimmagadda said. “I look forward to leveraging my experience in successful health care operations and improved operational efficiency while optimizing clinical outcomes. IHCS’s approach is reinventing home care benefit management, replacing fragmented approaches with an integrated, insights-based, coordinated model that improves clinical outcomes and patient experience and reduces health care costs. Improving care in the home has always been a passion of mine, and I look forward to unlocking the full potential of care in the home with our team members, providers, caregivers and health plan partners.”

Dr. Nimmagadda has nearly three decades of experience in health care, both as a practicing internal medicine and infectious diseases physician and as a health care executive.

Most recently, she served in various leadership roles at Cigna Healthcare, overseeing comprehensive medical and pharmacy utilization management programs and specialty drug clinical programs, including gene therapies.

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Based in Dallas, VitalCaring provides home health and hospice care to patients in the Southern U.S., covering Texas, Oklahoma, Louisiana, Mississippi, Alabama and Florida.

Constant Therapy is a digital health company. Its technology enhances the effectiveness of cognitive, speech and language therapy while also increasing access to and reducing the cost of these therapies, according to the company.

The Constant Therapy app uses AI technology to offer personalized exercises that aid in rebuilding cognitive and speech function for individuals recovering from stroke or traumatic brain injury, as well as those living with aphasia, dementia or other neurological conditions. A team of neuroscientists at Boston University developed the app.

“The pilot program was launched to harness the power of technology to elevate the quality of in-home therapy and alleviate the burden on families and caregivers of patients with cognitive disorders,” Janice Riggins, VitalCaring’s chief clinical officer, told Home Health Care News. “The initiative was driven by several key objectives, including enhancing cognitive abilities to improve physical functioning, enabling patients to age in place more effectively, collecting data to support medical necessity and tailor interventions more precisely, and expediting the patient’s journey toward regaining independence safely within their homes.”

The pilot took place from October 2023 to May 2024 and involved 52 patients aged 54 to 92. The patients had various primary diagnoses, including cerebral infarction, brain tumors, dementia (including Alzheimer’s disease), Parkinson’s disease, encephalitis, encephalopathy and mild cognitive impairment (MCI). Patient performance was assessed using the Montreal Cognitive Assessment/MoCA and the Saint Louis University Mental Status/SLUMS cognitive screening.

The program included various exercises to improve auditory and visual memory, reading comprehension, speech, attention, problem-solving and visuospatial processing.

“While the primary goal for patients with chronic diseases is often to maintain cognitive function or slow its decline, we observed more gains in functional cognition, and caregivers reported more social and physical activity gains than anticipated,” Riggins said.

Patients in the program showed statistically significant cognitive improvements, including improvement by at least one cognitive level and achievement of normal cognitive function by discharge, according to Riggins.

“Success in the program required both the patient and caregiver to demonstrate a willingness and ability to comply with the recommended regimen,” she said. “Ideally, patients had access to a device compatible with the app to maximize results during and beyond therapy visits, ensuring continued progress post-discharge.”

Patients’ ability to independently access Constant Therapy’s therapeutic exercises at home has proven valuable to clinician-supervised therapy, Riggins noted. The VitalCaring Cognitive Care pilot program aimed to determine how additional therapy tools could speed up recovery and maximize cognitive functioning for VitalCaring patients with dementia-related diseases and those recovering from stroke or other brain injuries. On average, each patient in the pilot could access an additional 11 hours of digital therapy independently.

“This program equips our clinicians with an additional resource to complement their skilled interventions, maximizing patient success,” Riggins said. “It enables us to support our patients longer in their goal to age in place.”

Following the pilot, VitalCaring plans to explore more opportunities to expand this initiative across its network.

“We’ve already begun training clinicians throughout our organization and are committed to providing this valuable resource to all patients who can benefit from it,” she said.

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The need for a new ICD-10 code for sepsis survivors was spurred by findings from a VNS Health study showing that sepsis was noted in admission assessments only 7% of the time. This caused researchers to question whether home health providers were aware that a patient had been diagnosed with sepsis. The study also identified the risk factors associated with early readmission of sepsis survivors.

“Having an ICD-10 code for sepsis aftercare lets providers know when a patient discharged to them is a sepsis survivor,” Dr. Kathryn H. Bowles, director of the VNS Health Center for Home Care Policy & Research, told Home Health Care News. “When people are hospitalized for sepsis, they are not discharged until the illness is resolved. When sepsis is resolved, it falls to the patient’s history and may not be included in the current problem list communicated during the transition to post-acute care.”

VNS Health provides home, hospice, and personal and private care services in New York. The Center for Home Care Policy & Research conducts research to support home- and community-based services and inform decision-making providers, policymakers and consumers.

“Because sepsis has a high readmission rate mainly due to recurrence, any patient who has had sepsis is at risk, and many suffer a long recovery dealing with the after-effects of sepsis,” Bowles continued. “Research showed timely attention the first week after sepsis discharge effectively decreases 30-day readmissions. If the next level of care doesn’t know the patient is a sepsis survivor, providers cannot activate effective protocols for prevention. The new code will alert the next level of care.”

An ongoing study by the same research team revealed the lack of a diagnostic code to identify sepsis survivors after discharge. Home health personnel explained that because sepsis is an acute care condition treated and resolved in the hospital, they cannot place it on the home care record. The study provided evidence that because of this communication gap, home care providers and clinicians may not be prompted to give the attention and close monitoring that sepsis recovery warrants.

“As our team discovered, there was a serious communication gap between hospitals and post-acute care providers when it came to caring for sepsis survivors,” Bowles said. “Without knowing an incoming patient had recently survived sepsis, home care providers were missing an important piece of the puzzle in determining a plan of care. Because there was no aftercare code, sepsis survivors were being coded as having pneumonia or urinary tract infection, or ‘other aftercare.’ However, as we know, knowledge is power, and with this code, home care teams and patients are empowered. They can provide the necessary care to avoid a recurrence of sepsis and preventable hospitalizations or death.”

Following the publication of these findings, the research team led an advocacy effort to persuade the CDC to adopt a diagnostic code defining sepsis aftercare as a separate condition. The new code was accepted and announced in July and took effect Oct. 1.

“Knowing the patient is a sepsis survivor alerts the team to activate evidence-based protocols for timely start of care and outpatient follow-up, close surveillance, antibiotic stewardship and patient teaching,” Bowels explained. “Sepsis strikes fast, so patients and caregivers must be educated to monitor their temperature, take their medications as prescribed and call their home care providers immediately if they feel worse.”

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Electronic Visit Verification (EVV) was established as law in 2016 under the 21st Century Cures Act to address fraud and abuse in home-based care delivery. The law provides federal guidelines, but individual states can determine which service codes are included. However, years after nationwide implementation, EVV still remains a burden for home care providers.

Simply put, EVV confirms the details of in-home visits. It holds caregivers accountable for their schedules, ensuring that their work is completed on time and in its entirety. Typically, caregivers work within a mobile app to conduct the EVV process. The app sends the necessary information from their devices to their agency’s home care software.

Six data points are captured at the point of care to verify the facts of a home care visit in real time.

Collecting this basic information in home care settings helps providers and states ensure that authorized care is provided and that caregivers deliver the proper care at the right time. When this verified visit data is collected and analyzed, states can use it to help identify and reduce Medicaid fraud, which drains resources from the system and hinders care delivery to those in need.

There was initial confusion because the act required states to implement EVV for at-home visits conducted by Medicaid personal care providers and home health agencies. However, each group had different go-live dates. Medicaid-funded personal care services were required to comply with EVV statutes by Jan. 1, 2020, and home health agencies by Jan. 1, 2023. However, delays and exemptions made compliance anything but simple.

Further, the federal government has passed legislation regarding EVV, but its implementation varies at the state level. States are categorized as “open” or “closed” models. Home health agencies have the freedom to choose their EVV provider in open states, while in closed states, they must work with a vendor selected by the state.

According to Matt Kroll, practice president of Assistive Care & Assistive Care State Programs at Bayada Home Health Care, despite challenges, Bayada has found that EVV helps prevent false claims.

“It allows us to monitor caregivers in real-time, verify service delivery, and allow for faster issue resolution,” he told Home Health Care News. “For example, if a check-in is late or a caregiver indicates that the client is showing signs of a larger issue, we can see that in real time and detect and prevent adverse events before they lead to a larger medical issue or hospitalization.”

Headquartered in Moorestown, New Jersey, Bayada provides in-home clinical care and support services in 21 states and five countries.

“We believe that we will be able to leverage some care documentation data points to help improve the quality of care we provide our clients and, over time, industry-wide data points may improve the industry as a whole,” Kroll said.

Kroll explained that Bayada supports efforts to prevent fraud, waste and abuse, with the caveat that overregulation can actually hurt the industry in some instances.

“We do feel that overburdensome requirements and unfunded mandates can deter agencies from providing Medicaid-based services, which is detrimental to those populations who already struggle to access the care they need to stay safely at home,” he said.

EVV still a pain point for providers

Because EVV varies by state, its challenges differ by market.

“EVV is still a pain point for providers for various reasons – and they vary by state,” Tim Nyberg, senior vice president of strategy at Sandata, told HHCN. “These can include variance in education from states to providers, the provider’s experience in onboarding and implementing EVV systems, how caregivers are educated on EVV, and whether they understand its purpose and benefits.”

Sandata, based in Port Washington, New York, provides agency management software, systems, and services to optimize billing and claims processing and streamline administrative processes.

“Additionally, some caregivers cite privacy issues in using their personal cell phones to clock in and out of shifts and having their location tracked,” Nyberg said. “Some clients and family members share those same concerns.”

Although all states have worked to implement effective EVV programs, some have needed help with clear and open communication regarding their policies, transparent enforcement timelines and timely responses to questions and concerns from the provider community.

“EVV continues to present challenges for providers primarily due to its complex integration into existing workflows,” John Atkinson, chief technology officer at AxisCare, told HHCN. “The additional effort required is not just about submitting claims, but also ensuring that EVV data is accurately collected and transmitted to the aggregator. This process requires meticulous attention to detail, often adding layers of administrative tasks to an already burdened system. Providers must balance maintaining the quality of care and adapting to new technological requirements, often leading to frustrations. While EVV aims to streamline and enhance transparency, the transition and implementation phase continues to be arduous.”

Founded in 2013, AxisCare is a full-service home care software company based in Waco, Texas.

“Bayada has made every effort to ensure that the transition to EVV compliance is as easy as possible for our caregivers and as least disruptive to client care as possible,” Kroll said. “However, pain points persist. Most notably, cost, lack of standardization across states, technology issues for caregivers and lack of cell service in rural areas.”

Providers who fail to comply with Medicaid rules risk not being paid for their work. Non-compliance with Medicaid rules and policies may also result in the provider’s inability to do business under the Medicaid program.

Apart from the stricter compliance issues, there are also significant downstream impacts. When caregivers fail to clock in at a client’s home, the home care agency cannot verify the services provided, especially in the case of a fall or hospitalization during or after a shift.

There is a continued lack of clarity regarding the consequences of non-compliance, according to Kroll.

States and payers each have a compliance threshold that needs to be met, and most – but not all – states have published this information. Non-compliance could result in payment penalties, loss of referrals, audits, and additional penalties and corrective action plans.

The future of EVV

States that have a burdensome EVV system run the risk of losing providers that may be otherwise interested in conducting business there.

“Looking ahead, the future of EVV will be marked by increasingly stringent standards and tighter tolerances,” Atkinson said. “We anticipate a future where the manual entry of EVV data will become largely unacceptable as states demand greater accuracy and efficiency.”

He emphasized the importance of proactively creating a culture of compliance and ensuring that staff are well-prepared to meet changing standards. This includes adopting technology and simplifying processes to enable smooth data transfer to aggregators.

“By staying ahead of these developments, providers can enhance operational efficiency and continue to meet regulatory requirements effectively,” Atkinson said. “Above all, EVV will enhance the accurate delivery of care to seniors, ensuring they receive the attention and services they need when needed.”

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The report found that patients receiving care through the program differed demographically from those at traditional inpatient facilities. Generally, hospital-at-home (HaH) patients were more likely to be white, live in urban areas, and less likely to receive Medicaid or low-income subsidies. These differences may be due to the criteria established by participating hospitals to identify suitable patients for this type of care.

Patients receiving care at home generally experienced fewer catheter-associated urinary tract infections. Mortality rates were also lower. Those with less complex respiratory and infectious conditions had lower 30-day readmission rates than those in traditional inpatient settings. However, readmission rates for patients with more complex respiratory infections were higher for those receiving care at home.

The study found that patients receiving care at home through the initiative resulted in lower Medicare spending during the 30-day post-discharge period. Furthermore, even though at-home patients received the same services as those in traditional hospital settings, they used fewer of the same services. This suggests that hospitals experience lower costs over time when providing care to patients in their homes.

The study also revealed that at-home patients required care slightly longer than those in traditional settings, but the difference was negligible (less than a day).

Feedback collected from patients, caregivers and family members about at-home care was overwhelmingly positive. Patients reported feeling more relaxed, less anxious and less depressed at home, which seemed to facilitate their recovery. Caregivers and family members believed better health outcomes were one of the main benefits of receiving care in a familiar and comfortable environment.

“People who have been in a brick-and-mortar hospital and also cared for in their home report that they sleep better in their beds and that it is less noisy and confusing,” Nancy Foster, vice president for quality and patient safety at the American Hospital Association (AHA), recently told Home Health Care News. “For older folks who sometimes get confused when they’re away from home, this is a way for them not to experience those challenging effects of being hospitalized but still receive hospital-level care.”

Lessons learned

While the feedback received was primarily positive, it also revealed some limitations and opportunities.

One concern was the potential need for additional care, especially for patients with limited mobility. While approved hospitals are expected to provide all nursing care, including help with daily activities, CMS received feedback that, at times, family members took time off to be with their loved ones or hired extra nursing aides.

Another common concern was the program’s effective implementation. Specifically, there was potential for confusion among clinicians and hospital staff regarding the services provided and among patients about what services are covered by Medicare.

Overall, feedback from patients and caregivers aligned with existing evidence on HaH programs; they generally viewed the care provided as safe, effective and a positive experience.

“Clinicians, doctors and nurses who have been involved in the HaH program are enthusiastic about it,” Foster said. “It allows them to have a deeper relationship with their patients, to see more of what their home life is like, and to be able to advise them on how to recover well and then how to stay well from whatever condition brought them into the hospital, even if that hospital was their home.”

The waivers and flexibilities associated with the AHCAH initiative expire Dec. 31, and its future remains unclear.

“By the end of the year, Congress will need to act to extend the Medicare waiver,” Foster said. “We’ve heard considerations of a bill that would extend it for five years, but we don’t know whether that will be passed.”

Foster added that if the bill is not passed, no fee-for-service Medicare or Medicaid patient could be cared for at home.

“Congress is concerned that we can demonstrate high-quality care being delivered, that we are not putting a tremendous burden on family members or other loved ones in the home, and they have expressed concern about whether this would be equitable,” Foster said. “However, we see a dominance of people with more limited means benefiting enormously from the hospital-at-home program.”

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