Home Health Care Explodes

Home Health Care Explodes

An increase in demand coupled with technology, cost containment has sparked a mini-industry in Traverse City.

By Becky Kalajian

Ten years ago, those needing a little more care had little to choose from: rely on family, or move to an assisted care or nursing facility.

Now, increased demand, technological advances, and a changing Medicare reimbursement model have caused a local mini-industry to erupt: home health care.

Used by seniors and their families as a way to keep a loved one in their own home as long as and as safely as possible, home health care companies offer services as diverse as home cleaning, foot care, skilled nursing, and even rides to the casino.

Rates vary, but local companies charge anywhere from $17 to $22 an hour for certain services, with skilled nursing starting at $30 an hour. Compared with nursing homes, whose median annual costs run from $83,950 to $93,075 in Michigan, home health care has become a hot industry.

When Russ and Leslie Knopp decided to leave their careers as management consultants to nonprofits in 2005 and sign on with Comfort Keepers, a national home health care franchise, their biggest hurdle at the time was educating people on exactly what it was they did.

"At first, it was our biggest growing pain: letting people know that home health care was an alternative for them," said Leslie Knopp, who along with her husband recently bought and moved into a new facility on the corner of 8th Street and Garfield Avenue. "Now that the word is out, our biggest problem is finding enough people to hire."

To help fill the demand for workers, the Knopps are using their new building as a training facility. Along with training prospective employees, it will also be used for continuing education for their 200-plus current employees.

Along with their high-touch approach, which includes a variety of human-delivered services, the Knopps say that technology will play a bigger role as the Boomers age.

"I see technology playing a greater role because we are all looking for ways to deal with the caregiver shortage," Leslie Knopp said. "Things like door and window sensors for dementia patients; an automated medication system, which securely releases medication on schedule; and personal emergency response systems that allow seniors to easily summon emergency help at home are all things we offer now. I fully expect the range of products to grow."

Tammy Tarsa, a registered nurse who is the co-owner of Integrity Skilled Care and Integrity Home Health Care, attributes the increased demand to greater awareness, a greater need, and Traverse City's national reputation as a desirable place to retire.

Since she purchased Integrity Home Health Care in 2008, Tarsa echoed Leslie Knopp, saying the biggest problem right now is staffing.

"Employee retention is the hardest part. It's not a high-paying job, it's a lot of emotional stress, and it's a lot of physical labor," said Tarsa, whose company received the 2011 Traverse City Area Chamber of Commerce Small Business of the Year Award. "It's not just our problem locally; it's a national problem."

The uncertainties of the Affordable Care Act have prompted questions on how care will be paid for in the future, especially for the elderly.

"I don't know how that will look, but we can't continue to put people in nursing homes," Tarsa said. "There's just not enough room."

Other issues plaguing the relatively young industry are Michigan's lack of licensing and a non-unionized workforce. Amy Northway, owner of Monarch Home Health Service, said that she is in favor of licensing but opposes worker unionization.

"Right now, in the state of Michigan, anyone can open up a home health care company," she said. "I'm definitely in favor of licensing regulations. As far as unionizing the home health care labor force, the federal reimbursement is such that a union would put many companies out of business."

Regardless of the problems they face, Northway and her competitors say there is an ever-growing need for what they do.

"Right now there is a six to nine month wait to get into the county-funded [Grand Traverse] Pavilions," Northway said. "It's only going to get worse."