'It's Back to Basics': Home Health Giants Share Staffing Strategies, Growth Goals – Home Health Care News

Basically all of the publicly traded in-home care giants offered internal updates and expectations for the coming year this week during a series of investor presentations. In addition to company-specific plans, the group discussed key policy developments and important macro-level trends such as more high-acuity patients coming to the home health setting.
Home Health Care News tuned into the presentations, recapping some of the most interesting highlights below. The companies featured include Addus HomeCare Corporation (Nasdaq: ADUS), Amedisys Inc. (Nasdaq: AMED), Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH), LHC Group Inc. (Nasdaq: LHCG), ModivCare Inc. (Nasdaq: MODV) and The Pennant Group Inc. (Nasdaq: PNTG).
Addus President and CEO Dirk Allison on personal care: “We’ve never really moved away from personal care. … There aren’t as many large personal care assets out there as there are on the clinical side. Last year, we did one or two personal care [transactions] — small deals, filling in markets. We will continue to look at that and deploy capital in those markets.”
LHC Group Chairman and CEO Keith Myers on refocusing on organic growth: “In many ways, it’s back to basics. What I would put at the top of the list is our focus on organic growth — on getting back to strong organic growth and leveraging our industry-leading quality scores. And [leveraging] our hospital joint venture strategy as a means to getting there.”
Amedisys CFO Scott Ginn on de novos: “If I had anything that I somewhat regret in the past, it’s that we slowed down some of the de novos, which have been very profitable for us when we have pressure on top line. So I’m thinking about that as we move through.”
Ginn on consolidation: “I think we’re going to consolidate this industry. It’s about quality assets, you can get to the finish line, though.”
Aveanna Executive Chairman Rod Windley on M&A success: “We’re an M&A engine. When we built Aveanna, we built it around that concept. And I think we’ve kind of delivered hands down with regard to our M&A activity. There’s no slowdown in M&A activity right now. You know, whether that be the PDN side, or the traditional Medicare piece and the hospice piece, I haven’t seen any meaningful decline whatsoever. I keep waiting to see it, but I don’t see it.”
Myers on personal care: “We’ve talked for a long time about our tri-level of care, meaning home health, hospice, and home- and community-based services. We’re just redoubling our efforts on completing the build out of that. And we have a pathway … to have personal care built out in every home health agency in less than five years.”
Pennant CEO Danny Walker on overall growth strategy: “This is our core of who we are — finding businesses that we can fold into our model that work well, that have a good clinical foundation, and then we can take those and drive significant growth over many, many, many years.”
ModivCare CFO Heath Sampson on acquiring Simplura, Care Finders: “This is a really important, core point in personal care and why we bought them on top of each other: You need density, and you need scale.”
Aveanna CEO Tony Strange on staffing improvement: “We experienced eight weeks of sequential improvement with caregivers paid, and we think that will continue. It took a dip during Thanksgiving. It’ll take another dip during Christmas and New Year’s. But the trend is the same. We’ve seen this slight – but steady – improvement over time.”
Amedisys Chairman and CEO Paul Kusserow on innovative investments: “I’m very excited about the things we’re exploring. We still think there’s a lot of juice left in the orange. We’re using these really interesting techniques of mixing RNs with LPNs, and PTs with PTAs. We’ve made a major investment in Medalogix. That has really helped us with utilization management.”
Myers on LHC Group’s workforce priorities: “We’re going to have to continue improving our recruitment and retention efforts — and recruitment and retention are equally as important. We have to make it easier for nurses to work here. One of the advantages we have that we have to leverage is our ability to give them flexibility.”
Walker on vaccine mandates’ labor impact: “I think an underestimated driver of the labor instability has been the forthcoming mandate process for vaccination. And we saw the reaction to that in the second and the third quarters, largely. What we’re seeing is that people have digested that, and those that have serious concerns about that process and the mandate, and all of those things, they’ve made their decisions.”
Addus COO Brad Bickham on clinical pressures: “Where we are seeing pressure is primarily on the clinical side, on the home health and hospice side, which is a smaller aspect of our business. We are seeing challenges with the retaining and recruiting of nurses in the clinical staff, and seeing some wage pressures that we’re having to make adjustments for.”
Strange on the labor outlook: “I would say, this is just my opinion: I think the [staffing environment] is going to improve. I don’t think we’re going to find ourselves here in the fall of next year with the same labor disruptions that we have this year. Now is it going to improve dramatically in the first quarter or the second quarter? I don’t know the answer to that.”
Ginn on Medicare sequestration: “It’s a unique year for us, because, as we’ll see, sequestration giveth and sequestration taketh away. So certainly, we enjoyed the fact that we got a 2% bump in reimbursement coming out of sequestration. But now, you know, it comes off the table.”
Myers on Choose Home progress: “The support has to be encouraging. Sen. Joe Manchin signed on to Choose Home yesterday. That’s a really big deal.”
Pennant Chief Investment Officer Derek Bunker on increased oversight: “What we’re hearing from the health care community is that senior living needs to improve itself as a health care setting. … And that requires staffing. That requires clinical excellence. That requires being able to comply with increasingly complex regulations. There’s going to be increasing oversight. That’s an environment in which we thrive, both [in senior living and] within our home health hospice [segments]. And from our experience within Ensign, we’ve built robust compliance and clinical programs. So we’re positioning ourselves for that future. And it’s coming. The industry is talking about it.”
Allison on Build Back Better: “It’s anybody’s guess, right now. … That’s one of the areas the Senate seems to have the most problem with, is putting money toward this elderly population. We’ll see if it gets through. We’re hoping it does. And it’ll be a benefit to not only Addus itself, but just the industry — the home health industry in general. So we’re excited and hope that comes through.”
Kusserow on Contessa: “We’re really delivering value-based care with Contessa. It’s very unique, and we’re proud that it is part of our portfolio. We’re very impressed with what [CEO Travis Messina] has done. It has doubled our [total addressable market]. It allows us to go where no one else is going, which is always important from a distinction perspective. The fact that we’re doing hospital at home, SNF at home and palliative care at home puts us into some really interesting parts of the world.”
Myers on high-acuity care: “We have to continue building out our higher-acuity capabilities. We’ve all heard SNF at home, advanced care at home, hospital at home. You know, all of these are terms that are being used to define ‘higher-acuity patients moving to the home.’”
LHC Group President and COO Joshua Proffitt on Imperium business: “We definitely are doubling down our efforts to further grow our ACO-management business, not only in the ACO lives that are served. [We’re also looking at] other ways that vehicle can be part of the overall plan for us to prove out, through evidence-based initiatives, our ability to lower total cost of care.”
Aveanna COO Jeff Shaner on Medicaid opportunities: “The last four or five years, it continues to be a very good business. But we’re as excited about our Medicaid space and have been from the day we started the company. We think, over time investors will really learn to realize the value that is in the Medicaid side of this business as much as Medicare.”
Allison on value-based care: “The reason we’ve been deploying more into the clinical side, even with the prices being somewhat higher, is because strategically we believe that long term, we’re headed toward more of a value-based care approach, where we deal not so much with the states, but more with the managed care providers.”
Greenleaf on building ModivCare’s leadership team: “I do get often asked, ‘What keeps you up at night? At this point in time, it’s really around execution. Do we have the horses in the stable to execute? And I feel very, very strongly that this is, by far, the strongest team that I’ve been part of, collectively.”
Proffitt on LHC Group’s census gains: “For the month of November, we ended at an average daily census at 86,620-something, so about 1,200 [patients] higher in the month of November than we were in October — and about 3% higher than we were in Q3.”
Shaner on vaccination rates: “Our vaccination rates continue to move materially north. There was a day, not that long ago, we were in the [40% range], fully vaccinated. … And today, we’re already approaching 70%, which is really nice.”
Pennant COO John Gochnour on vaccination rates: “As of today, basically 72% of our employees have been vaccinated. We have approximately 15% who are still working through the process. They’ve either gotten one dose of the vaccine or they’re working through the exemption process.”
Allison on Omicron: “We really believe that we, as an industry and as a company, are more prepared. You know, we’ve been through two or three surges, and we’ve been able to get through it.”
Additional reporting by Joyce Famakinwa and Andrew Donlan.
Addus, Amedisys, Aveanna Healthcare, LHC Group, ModivCare, The Pennant Group
When Robert’s not covering the latest in home health care news, you can likely find him rooting for the White Sox or roaming his neighborhood streets playing Pokemon Go. Before joining HHCN, Robert covered everything from big agribusiness to the hottest tech startups. 
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Basically all of the publicly traded in-home care giants offered internal updates and expectations for the coming year this week during a series of investor presentations. In addition to company-specific plans, the group discussed key policy developments and important macro-level trends such as more high-acuity patients coming to the home health setting. Home Health Care…

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