The promising, positive trend of enabling in-home health care for seniors will be dealt a setback at month’s end, when Oahu Home Healthcare permanently closes. That will leave just eight companies, some that operate only on a single island, to provide in-home nurse visits to Hawaii’s population, particularly the steadily increasing number of elderly.
“After months of working diligently to rework our operations to address rising costs, staffing challenges, and adjustments in CMS (Centers for Medicaid & Medicare Services) regulations, we have come to the difficult conclusion to close,” Oahu Home Healthcare CEO Jen Eaton said in a written statement.
On any given day the company’s nurses cared for about 100 patients, mostly seniors on Medicare. There is some short-term relief in that none of those patients will be left in a lurch — they’ll be picked up by other providers or be well enough for discharge by the end of January — but the long-term outlook is far from rosy for this important piece of the senior-care continuum.
Many of these facilities have waiting lists and are “already overflowing,” Kealii Lopez, AARP Hawaii state director told Hawaii News Now. “Now, with this facility shutting down, how are those people going to be placed?”
Oahu Home Healthcare’s struggles underscore the relatively low Medicare reimbursements for nurse home visits, compared with the amounts hospitals and skilled nursing facilities receive; they also highlight the difficulties in hiring and retaining nurses for this type of in-home care during a statewide labor shortage. Hilton Raethel, CEO of the Healthcare Association of Hawaii, pointed out that home health care has a whopping 39% vacancy rate, the highest in the health care industry overall.
That’s distressing to hear, since such house-call visits by registered nurses — which are distinct from long-term nursing care — can certainly boost a patient’s well-being and recovery, outside of a hospital setting. In many cases, these are previously hospitalized patients who can and want to continue healing at home, but need skilled medical help such as for wound care or intravenous antibiotics.
We echo the call by AARP’s Lopez for legislation in the upcoming session to increase reimbursement rates and to incentivize more into this workforce. Aging-in-place has become a promising pathway as more people head into their golden years and deal with infirmities — but that can only happen if there are enough caregivers and medical professionals to make the necessary house calls.
