Interim HealthCare of the Eastern Carolinas: Happy at Home
Home Care
Written by Amanda Gaines   
Thursday, 01 November 2007
Interim HealthCare of the Eastern Carolinas: Happy at Home - Health Executive - RedCoat Publishing
Stephen Smith describes how this homecare agency strives to keep up with industry and customer demands.

While the future of healthcare in the US appears to be on shaky ground, one thing is certain: the baby boomers stand to influence this industry more than any other generation. As that population ages and the word “senior” slips into its vocabulary, those in the homecare industry are realizing their services may become more of a focus.

“Based on a number of national studies, an overwhelming number of Americans have declared they would rather age in place at home,” said Stephen Smith, president of Interim HealthCare of the Eastern Carolinas. “We’re here to prevent or delay institutionalization, providing people their freedom and dignity.”

Interim HealthCare of the Eastern Carolinas: Happy at Home - Health Executive - RedCoat Publishing
Stephen Smith, President
For the past two years, the administration at Interim HealthCare has looked at expanding its in-home aide, private duty nursing, and healthcare staffing services while separating from other services not in alignment with its primary focus—long-term homecare. In 2006, the company divested its Medicare-certified home-health agency to take a step in that direction. “The Medicare home-health benefit really focused on the short-term rehabilitation aspect of homecare, and we made a policy decision to focus solely on the long-term aspect,” Smith said.

Streamlining and centralizing
A franchise of national provider Interim HealthCare, Inc., Smith’s company came into existence in January 1984. At its peak geographical expanse, the company was spread throughout South and North Carolina with 22 operating units. The company has since streamlined its focus to avoid, in Smith’s words, “being a jack of all trades and a master of none.” It now operates eight homecare offices in 15 counties, solely in Southeastern North Carolina.

Two urban markets, Fayetteville and Wilmington, have low unemployment and tough recruitment, and its coastal plains offices are in some of the largest counties in the state. To accommodate the travel distance, as well as enhance its attractiveness to potential caregivers, Smith and his team looked at how to create efficiencies in all aspects of their business.

A significant task in homecare is the scheduling of caregivers to patients, with scheduling traditionally done at the branch level. Instead, the company developed a centralized scheduling department with 15 staff members who handle those tasks. Purchasing, payroll billing services, and all other administrative support tasks are also centralized.

“It’s all about focus,” Smith said. “We want our branches to focus on what we call the three big things: high-quality patient care, retention and recruitment of the best caregivers we can get, and maintaining a positive image in our communities. Centralizing the ancillary services allows us to do that.”

Smith’s company is also looking into investing in telephony to increase efficiencies with its caregivers. If a particular caregiver is running even 15 minutes late, the technology will alert the central office, which can alert the patient not to be distressed. “The technology would eliminate all paper time and attendance slips, as well as payor charting,” explained Smith. “We’re not there yet, but we’re definitely moving in that direction and will be there in a matter of months.”

Being the purple cow
The company’s 16-person management team recently challenged itself to be the purple cow in a world of black-and-white cattle with the help of Seth Godin’s Purple Cow, a book focused on differentiating your business to stand out from the herd. The inspiration came from Smith’s concern that the growing popularity of homecare and increasing number of agencies could eventually commoditize the industry.

“Homecare truly needs to be a personal service,” said Smith. “Although our 24-year history in the communities we serve is part of the reason we’re considered a market leader, our loyalty to integrity, compliance, and vertical expansion is another major factor.” To stay in alignment with industry standards, Smith’s team developed a compliance audit tool that measures nearly 900 items. The company also has affiliations with providers from other industry sectors across North Carolina to diversify its services without veering too far from its core. At an industry conference, Smith was impressed when the CEO of the National Association for Homecare cited his vision for the future. “He predicted self-pay homecare services may eventually be the biggest payor of homecare, even outstripping Medicare,” Smith said.


Along with a higher level of education and more disposable income, Smith believes the baby boomer generation will be a population with fewer chronic illnesses but a multitude of frailties. “We’re positioning the company to be immersed in those in-home aide and private-duty nursing sectors in preparation for where we see the industry demand heading.”

One service line that has always separated Smith’s franchise from others in the industry is its healthcare staffing. Through its healthcare staffing divisions, it provides contingent staff to hospitals, clinics, and even colleges, such as St. Andrew’s Presbyterian College.

“St. Andrews is one of three colleges in the nation with a program for severely physically disabled students,” Smith explained. “Those students excel academically but are physically or developmentally disabled. The college handpicked us for this project after being contacted by a group of parents that heard of our long-standing reputation of service and commitment to quality. The freedom and dignity these young people have gained is what it’s all about for us.”

 
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