When an agency administrator at a SunCrest location in Clearwater was asked why the agency missed five patient visits in one week, the administrator said the office simply had no helpers: “We’re doing our best to staff the cases. but sometimes we just don’t have enough staff, ”the administrator told the health department. At another LHC-owned agency in Sarasota, an associate responsible for scheduling care visits made a similar statement when asked why records showed the agency missed three or more visits for multiple patients: Loud According to an inspection summary, the agency’s case coordinator said “she” had staffing issues and did not offer visits as ordered. “

In some cases, these disturbances in care can prove fatal. In late 2014, nursing assistants at a near-family-run agency in Jacksonville, Florida missed six visits to a single patient over a two-week period that resulted in that patient’s death.

The patient was a man in his eighties with a variety of health problems, including burns. After experiencing health problems in mid-December, he was treated in a hospital, then released back into the agency’s care and received a health assessment from an agency nurse.

However, as of December 29, the agency missed six consecutive visits to the patient’s home. On January 9, the patient was found dead for unknown reasons.

In assessing the agency’s role in death, the government evaluator found agency records listing “various issues in managing the case exposure”. For example, one employee wrote that the agency received “100 referrals a week with no identified person taking ownership – anyone who picks up the phone or checks the fax is working [sic] the transfer. Several service errors due to this. ”

A few years later, LHC merged with Almost Family and took over the agency.

In early November 2020, as the number of daily coronavirus cases rose to new levels, LHC CEO Keith Myers received a call for earnings to deliver some good news.

“We continue to see a new normal in referral patterns,” he said, “one in which patients, families, doctors, discharge planners and other referral sources increasingly choose … home health services” over nursing homes and other care facilities. The coronavirus pandemic offered “unique opportunities to demonstrate our range of skills and potential,” and this was reflected in investor dividends: In the summer of 2020, the company’s shares rose to an all after years of constant profits – time high. (Myers had already received total compensation of more than $ 4.5 million in 2018.)

Myers also touched on the company’s ongoing merger and acquisition trend: in the past six months alone, the company had acquired home health agencies in Georgia and South Carolina, and hospice locations in Texas and Colorado. In the previous quarter, LHC also took over a number of home health offices from a nonprofit in Florida.

“Our organic growth is accelerating,” added Company President Joshua Proffitt. “Our inorganic growth has only scratched the surface” – in other words, both the company’s patient roles and acquisition opportunities have increased. “This historic consolidation opportunity that we anticipated for home health is now showing as government incentives for some smaller agencies are waning,” added Proffitt, signaling a focus on engulfing smaller and struggling agencies.

Over the next decade, aging demographics and the aftermath of the pandemic are likely to further accelerate the growth of LHC and, in general, to consolidate the industry as a whole. The federal revenue streams funding the Medicare program will only keep the program liquid until 2026, which means Congress will either have to raise new funds or reduce the level of payments for companies like LHC.

LHC and its key colleagues have built their business model on one bet: By cutting labor costs whenever possible, they can turn stagnant Medicare revenues into big profits. However, if the experiences of LHC employees and customers indicate it, then this strategy is detrimental not only to the employees who run the company, but also to the patients who the company is designed to care for.

For Donna, the North Florida nurse, the company’s increased demands eventually got too high. She and her co-sisters complained to their superiors, who sent their complaints up the career ladder. Nothing has ever changed.

Donna herself later fell ill with a chronic illness and soon found she could no longer keep up with the company’s workload. Her bosses understood her illness, but she has since withdrawn.

“Some of us nurses resisted the leadership changes because we felt [patient] Care and consistency were affected, ”she told me. “I know every agency is a ‘business’, but … it’s about people.”