Kindred at Home Exec: Senior Living Operators Should Leave ‘Heavy Lifting’ to Home Health Partners

Senior living providers should embrace home health partnerships as a way to care for complex patients. Those who don’t may not only be hurting patients, but also employee retention and morale.

That’s according to Carrie Coumbs, vice president of national care collaboration for Kindred at Home.

“If you utilize your home health benefit proactively in your [senior living] community, you’re not burning through your nurses, and you’re not burning through your care team because you’re giving that home health provider that heavy lifting,” Coumbs said. “When you give them the heavy lifting, your team can do the day-to-day, and you’re not having to replace people left and right.”


That was just one piece of advice Coumbs shared earlier this month at BUILD, a Chicago event hosted by HHCN sister publication Senior Housing News.

“I’m having some very deep conversations with some of the largest organizations around the country who are realizing now is the time and place to have proactive utilization of home health benefits in a community setting in a narrow network format, just like the acute care setting,” Coumbs said. “I thank you for that, but some of you waited far too long.”

Kindred at Home is the nation’s largest provider of home health and hospice services. The provider is partly owned by Humana — along with private equity groups TPG Capital and Welsh, Carson, Anderson & Stowe. The three acquired the Louisville-based home health provider last year for about $4.1 billion.


In her role at Kindred at Home, Coumbs has seen the benefits of senior living and home health partnerships firsthand.

“We have a community right now that’s … adding on memory care because, obviously, their community needs it,” she said. “In the meantime, they’re burning through their care team fast and furious because they’re taking care of people who are memory care and people who [have independent-living and assisted-living] care needs.”

To fix that, Kindred at Home worked with the community to identify 27 high-risk patients who could appropriately be put on home health care services. As a result of the extra help, the number of call-in days by the care team reduced by 40%, Coumbs said.

“That was just by alleviating this overwhelming push on their resources so people could get their rest at home, they could have a day off and all these good things were happening,” she said. “It was just a matter of recognizing you can’t be [everything] to your residents. You have to reach out to your community.”

PDGM and senior living partnerships

While senior living communities are a relatively popular partnership target for home health agencies today, that could change come Jan. 1, when the Patient-Driven Groupings Model (PDGM) is set to take effect.

“I believe Jan. 1 you’re going to see a lot of people who have been stalking and chasing you stop,” Coumbs told senior living operators at BUILD. “I will not. I’m not stopping.”

Coumbs pointed to one of PDGM’s many reimbursement changes as the catalyst.

Under the new model, home health agencies will receive higher reimbursement for patients referred from institutional settings — such as hospitals — as opposed to those who come from community settings. In other words: senior living communities.

“[Senior living residents’] home health will be reimbursed by Medicare at a 20% reduction than that from the acute setting, so we are driving seniors to hospitals and skilled nursing [facilities],” she said.

While Coumbs is hopeful the Centers for Medicare & Medicaid Services (CMS) will eventually see the error of their ways, she’s doubtful that will happen by Jan. 1.

“Quite frankly, senior housing is going to be the victim of the change of reimbursement when it comes to home health,” Coumbs said. “You will not see the proactive utilization of home health, and seniors will suffer.”

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