Little Growth in Number of Home Health Agencies

As the population of American seniors continues to grow, so does the need for long-term care services, but the number of home health increased only slightly between 2012 and 2014.

About 12,400 agencies were operational as of 2014, up from 12,200 two years prior, according to a newly released report from the Centers for Disease Control and Prevention (CDC). Southern states accounted for the largest share of home health agencies in both 2014 (46.6%) and 2012 (48.3%).

The report—Long-Term Care Providers and Services Users in the United States: Data from the National Study of Long-Term Care Providers—draws from multiple sources, including administrative records on home health obtained from the Centers for Medicare & Medicaid Services (CMS). The data covers the years 2013 and 2014. The report provides information about long-term care service providers and users, including staffing information, most common services provided, and health characteristics of residents and patients.

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Home health agencies were the third largest provider of long-term care services, representing 18.5% of the 67,000 providers measured in the study. Residential care communities were the biggest providers in 2014 (45.1%), followed by nursing homes (23.3%).

Compared to 2012, the proportion of long-term care services provided by home health agencies actually declined from 20.5% of the overall share. While the report does not draw this connection, CMS has been enforcing an ongoing moratorium on certifying new agencies in several key markets, including Miami and Chicago. These areas have been flagged for high prevalence of fraud.

About 80% of home health agencies were for-profit as of 2014, with 15% being nonprofit, and 5% being run by the government or some other entity. Nearly all were Medicare certified, and 78% were Medicaid certified.

Nearly 42% of all HHAs served between one and 100 people per day, while 27% served between 101 and 300, and 31% served 301 or more.

About one-tenth of the of all nursing full-time workers in the long-term care sector were employed by home health agencies in 2014. Registered nurse was the most common type of full-time employee among HHAs.

About 70% of agencies employed a full-time licensed practical or vocational nurse, while about 45% employed a full-time social worker.

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In terms of services offered by agencies in 2014, stats included:

  • 82% offered social work services
  • 4.8% provided pharmacy or pharmacist services
  • 93% conducted depression screening

The most common chronic disease home health agencies were found to be treating was diabetes, according to the study. Compared to adult day participants and residential are residents, home health patients also had more overnight hospital stays and emergency department visits.

Bathing, walking/locomotion, and dressing were the three daily living activities with which home health patients most commonly needed assistance.

Written by Tim Mullaney and Amy Baxter