Editorial: Homecare disaster

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The promising, positive trend of bringing seniors home healthcare will suffer a setback at the end of the month when Oahu Home Healthcare closes for good. That will leave just eight companies, some operating on just a single island, to provide home nursing care to Hawaii’s population, particularly its ever-growing elderly population.

“After months of diligent work to overhaul our operations to address rising costs, staffing challenges and adjustments to CMS (Centers for Medicaid & Medicare Services) regulations, we have come to the difficult conclusion to close,” said Jen Eaton, CEO of Oahu Home Healthcare in a written statement.

On any given day, the company’s nurses tended to about 100 patients, mostly seniors who were on Medicare. There’s some short-term relief, as none of these patients will be let down — they’ll be picked up by other providers or be healthy enough to be discharged by the end of January — but the long-term outlook is far from rosy for this important piece of the elder care continuum.

Many of these facilities have waiting lists and are “already overcrowded,” Kealii Lopez, AARP Hawaii state director, told Hawaii News Now. “Now that this facility is closing, how will these people be housed?”

Oahu Home Healthcare’s struggles underscore the relatively low Medicare reimbursements for home visits by nurses compared to the amounts hospitals and skilled nursing facilities receive. They also highlight the difficulties in hiring and retaining nurses for this type of home care during a nationwide labor shortage. Healthcare Association of Hawaii CEO Hilton Raethel pointed out that at 39%, the rate of home care services is the highest in the entire healthcare industry.

This is unfortunate to hear, because such home visits by registered nurses – which are to be distinguished from long-term care – can certainly promote a patient’s well-being and recovery outside of a hospital. In many cases, these are previously hospitalized patients who can and want to continue to heal at home, but who need qualified medical help, for example for wound care or intravenous antibiotics.

We join AARP’s call for Lopez to introduce legislation in the upcoming session to increase reimbursement rates and provide more incentives for this workforce. Aging in place has become a promising avenue as more people reach their golden years and struggle with infirmities – but this can only happen if there are enough nurses and medical professionals to make the necessary home visits .

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