Nursing Home Company Sees Free In-Home Care as Vital to Future Success

Skilled nursing facilities (SNFs) have traditionally strayed away from providing care in the home. But as the popularity of community-based care continues to rise, that’s changing — and the lines between different post-acute service providers are blurring.

Take Lorien Health Services, for example.

Ellicott City, Maryland-based Lorien offers a range of services from skilled nursing to assisted living to dialysis across nine facilities. On top of that, it provides free in-home care services to patients within a short distance of its facilities through Lorien at Home.


The goal of all the services is to make sure patients are able to return to their homes and live there safely, according to CEO Lou Grimmel.

Home continues to grow as the preferred site of care, as a rise in technology has allowed higher acuity patients to be cared for at home. As such, Grimmel sees the Lorien at Home program as a way to prepare the company for the future of post-acute and long-term care, he recently told Home Health Care News sister publication Skilled Nursing News.

You can find Grimmel’s interview below, edited for length and clarity.


How did you develop the Lorien at Home program?

Well, my industry’s been talking about home programs for a long time. I haven’t. I’ve always said, [for] 30 years, if I had the same information on a patient at home that I did in the nursing home, I could take care of a lot more people at home. So the electronic medical record (EMR) gave me that ability to have the same information for that patient at home that I have [in the nursing home].

Now that patient needs oversight, so with all the new technology for home monitoring systems, now I can really watch over that patient at home, be in tune to every physician’s order, all the medication. Everything that I do for that patient in the nursing home, I can do for them at home. And nobody’s paying for the brick and mortar, the building and stuff. They’re in their home.

Now the way that we do it, is that every one of our homes, we do a hub and spoke. So what that means is our Lorien at Home program starts with that nursing home, and then we will only go within a 10-minute radius of that nursing home. Because the important thing is that person needs to know if they need us, we’re coming, no matter what time, if it’s Christmas, New Year’s, Hanukkah, whatever, just like in a nursing home. And we try to send the same staff that they know and feel comfortable with. With the technology, and them being able to talk to us with the technology, and us going to visit them, their comfort is there. I can’t do it for the whole state. I can’t get there within 10 minutes.

So the Lorien nursing homes are where the patients in this program begin?

Right. We offer the service free for people that were discharged to go back home. Technology is opening the doors to caring for seniors, and seniors aren’t just the seniors that they used to be. Our life expectancy is greater now — I say ours because I’m a senior, and whatever we do, I’m doing basically for me. What would I accept, you know? What are my expectations?

My expectation is: I’m going to come because the doc says I need to get intense rehab for the next two weeks. So don’t come up and not give me rehab on Sunday because your therapists don’t work [that day]. If I don’t get rehab on Sunday, I’m leaving. I’m not staying in the nursing home and watching the football game in a nursing home. If I’m there, I’m there for a reason, and you’ve got to be all in on that reason.

You say you provide this for free. This is a blunt way to ask, but how does this program not lose money?

That’s a perfectly valid question. Health care, specifically nursing homes, is probably the only industry I know that has no research and development budget. They just do things the same way, and when somebody drops more money out of the sky, we’ll react to it.

I know what the next customer wants: The next customer wants to be at home. Why aren’t we developing that now, and learning from that now? Because the next customer is more than willing to pay for that. And by the way, it’s a heck of a lot less than assisted living or a nursing home.

So it’s our research and development. We’re in for the long run, we’re going to be there, we’re perfecting our product and we know the users and the families, because every time we get notified, if the family wants to, they can be notified too. They can stay in total control with us. They can hold us accountable, that’s the whole thing. That’s why I can’t do it for all of the state. They don’t want to hear that I got stuck in an accident or traffic jam.

You can read the full interview with Grimmel’s here on HHCN’S sister site, Skilled Nursing News.

Additional reporting by Bailey Bryant

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