Home health care agencies are rated for quality

By Bill Heltzel

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Indira Gaviola was unaware of “star ratings” when she directed patient services for United Hebrew of New Rochelle last year.

She applied her skills as a registered nurse and her ethic of patients first as she helped manage United Hebrew’s new home health care agency. And after its first full year of operation, a government scorecard awarded the agency 4.5 out of a possible 5 stars for quality of patient care.

United Hebrew scored higher than any other Westchester-based home health agency and placed in the top 6 percent statewide.

Frank Conway, head of United Hebrew of New Rochelle home health division. Frank Conway, head of United Hebrew of New Rochelle home health division.

Lighthouse Home Health Care, in Old Saybrook, also scored 4.5 stars among agencies that operate in Fairfield County. What’s more, Lighthouse scored four stars for feedback on patient surveys. That gave it a combined score of 8.5 stars and put it in the top three in both categories in Connecticut.

United Hebrew, as a new home health agency, was not graded on patient surveys.

The Centers for Medicare & Medicaid Services calculated the star ratings to guide patients and their families in selecting a home health care service.

Home health care encompasses a broad range of services that are customized in plans that address each individual’s conditions. Patients are treated for short-term health conditions, chronic illnesses, post-surgical care and even terminal illnesses.

The health care teams include doctors, nurses, aides, therapists and social workers. Patients are bathed and fed, given assistance with medications and injections, and get physical, occupational and speech therapy. The services enable patients to stay in their homes, avoid hospitalizations and delay long-term nursing home care.

Two numbers – 12.1 and 6.5 – stand out in the underlying data that comprise the star ratings. United Hebrew treated 174 patients at home last year. Just over 12 percent had to be admitted to a hospital. That’s 27 percent lower than the national average.

And 6.5 percent of United Hebrew’s home patients needed urgent, unplanned care without being admitted to a hospital. That’s nearly 39 percent lower than the national average.

Gaviola and Frank Conway, who heads United Hebrew’s home health division, attributed last year’s success to thorough patient assessments, training, communication, constant monitoring and multi-disciplinary teamwork.

They hire seasoned professionals, people with more than 10 years of home care experience, and give them extensive training, they said. United Hebrew’s 260 home health aides on the front lines make sure patients are eating properly. They count pills in vials rather than rely on patients’ memories of medications taken.

specialreportchart

If a patient is not getting out of bed to exercise, that information is entered in a laptop computer. Skin is checked after baths, and if redness is seen the office is called right away. Injuries are photographed weekly to track progress of healing.

Each patient’s status is monitored daily. The entire staff is involved. They make sure eating patterns match the diet plan. If a patient is at risk for falling in the shower, a shower bench is delivered. If a patient’s skin redness is significant, someone intervenes.

“We overcommunicate,” Conway said. “Our whole team knows everything about our patients. It’s discussed at our morning meetings and we go forward from there.”

If a patient’s health deteriorates, the team looks for answers on the New Rochelle campus, where United Hebrew oerates a long-term skilled nursing center, a rehabilitation unit, an assisted living facility, a memory care program, geriatric care services and assisted living units. “We can get immediate answers on how to follow the continuum of care,” Conway said.

“It’s all about the patients,” Gaviola said.

The quality-of-care star ratings are based on Medicare claims and extensive data submitted by the agencies. Star ratings are calculated from nine of the 24 collected measurements. They include processes, such as how quickly patient care is initiated and whether the patient gets a flu vaccine.

A big emphasis is put on outcomes. Is the patient able to walk or move around better? Are they getting better at bathing themselves?

Medicare needs at least 20 patient reports a year to rate a home health agency.

The average quality of care star score nationally, and in New York and Connecticut, is 3.

Star ratings for patient surveys are based on questions about the patient’s experience. At least 40 surveys must be submitted for an agency to be rated. National and state averages are not calculated.

WESTCHESTER

Thirty-five agencies that operate in Westchester County received quality of care ratings. Most are based outside of the county and as far away as Vermont.

Americare Certified Special Services, Brooklyn, also scored a 4.5 quality of care score in Westchester.

Wartburg Home Care in Mount Vernon was the only other Westchester-based agency among the seven that scored at 4 or above.

Nineteen agencies, or 54 percent, got average scores. Nine agencies scored below average.

Manchester Health Services from Vermont scored a perfect 5 stars for patient surveys. It had a combined score of 9 on quality of care and patient surveys.

Westchester Medical Center’s MidHudson Regional Hospital in Poughkeepsie also scored high on both categories, with a combined score of 8.

Five agencies did not receive patient survey scores.

The Centers for Medicare & Medicaid Services says patients and families should discuss star ratings with doctors, health care providers and the home health agency they are considering.

The government agency has created an online Home Health Compare tool that enables people to see all of the measurements. The tool can be found at medicare.gov/homehealthcompare/search.html.

FAIRFIELD

Forty-nine agencies that operate in Fairfield County received quality of care ratings. Most are based in Connecticut.

Four agencies rated just below Lighthouse Home Health Care, at 4 stars. They include Amedisys Home Health in Stamford; Atrinity Home Health in Chesire; Home Care Plus in Milford; and VNA of Rhode Island in Warwick, Rhode Island

Thirty-one agencies in Fairfield, nearly two-thirds, got average scores. Thirteen agencies, or 27 percent, scored below average.

Three agencies got perfect 5-star scores on patient surveys. They include Bethel VNA, Orange Visiting Nurse Association and Stratford VNA.

Six agencies did not qualify for patient survey scores.

The Centers for Medicare & Medicaid Services says patients and families should discuss star ratings with doctors, health care providers and the home health agency they are considering.

The government agency has created an online Home Health Compare tool that enables people to see all of the measurements. The tool can be found at medicare.gov/homehealthcompare/search.html.

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About the author

Bill Heltzel
Bill Heltzel has covered criminal justice, courts, government and sports – as a beat reporter and investigative reporter – for daily newspapers in Florida, Indiana, Ohio, and Pennsylvania. He worked for Bloomberg LP in training and sales. He joined The Business Journal in 2016.

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