Senior Living Facilities Enlist Home-Based Care Providers Amid COVID-19 Staffing Battle

Many senior living and skilled nursing facilities (SNFs) continue to struggle with the COVID-19 virus, as their residents are often vulnerable older adults who live in fairly close proximity.

In some cases, coronavirus concerns have prompted such congregate living facilities to turn away outside caregivers and home health aides; in others, the struggle has led to new, sometimes unorthodox partnership opportunities for home-based care providers.

That’s especially true for agencies with staffing divisions, as well as those who have flexed their focus to meet the newfound needs of SNFs and senior living communities. Such providers are bolstering their business by backfilling staffing shortages at those facilities — something most agencies have not typically done.


Such opportunities are especially valuable as the COVID-19 virus continues to disrupt the economics of home care, with widespread declines in visit volume plaguing home-based care providers nationwide.

Agencies with already established staffing arms — such as Sunrise, Florida-based Interim HealthCare Inc. — are well positioned to capitalize on those opportunities.

While the national in-home care franchiser has seen portions of its business decline — namely therapy-led home health and non-clinical home care — its staffing service has thrived in recent weeks.


The division places qualified health care professionals with organizations who need them. That includes hospitals and post-acute care settings, especially as of late.

“We’ve seen a large increase in our staffing side of the business,” Interim CEO Jennifer Sheets recently told Home Health Care News. “We will send supplemental staff into a hospital system that is resource-strained or into a nursing home.”

That boost has helped Interim maintain some normalcy amid all the coronavirus craziness. Thanks to increases in demand for its staffing service, as well as its hospice and nurse-led home health service lines, Interim’s business is on par with last year and up slightly month-over-month, despite declines in other areas, Sheets told HHCN in early April.

Interim’s dedicated staffing arm gives it a leg up; but even home-based care providers without staffing divisions can capitalize on senior living providers’ workforce needs.

Home Healthcare Solutions, a Medicare-certified home health agency based in the Chicago area, is one such agency.

“Some of the communities are calling me up and asking if I have nurses that can go literally to their facilities and work — almost like an agency nurse — because it’s starting to get crazy in these communities,” Kevin Colman, president of Home Healthcare Solutions, recently told HHCN.

In the 14 years since Colman started the company, he says this is the first time he’s received such requests.

Steven East, CEO and president of Caring People, has had a similar experience, but on a larger scale.

New York City-based Caring People is a home care agency that operates in five states: New York, New Jersey, Connecticut, Texas and Florida. It also has a Medicare home health offering.

However, what it doesn’t have is a dedicated staffing division; still, East and his team are negotiating contracts and agreements with senior living communities across its geographies to supplement their workforces.

“Some of them are large systems, and some of them are just one-off standard ones,” East told HHCN, noting that his organization is now engaged with 40 to 50 communities. “They were experiencing significant call outs, and so we’ve been able to support them.”

While Caring People has worked with congregate living facilities in the past, those relationships were historically one-offs, with the agency sending caregivers into communities to support the one-on-one needs of specific residents.

Essentially, communities acted as referral partners. But amid the coronavirus, that dynamic has changed.

“Now it’s like, ‘Caring People, we have 10 open shifts across our entire portfolio where we service various locations. Can you please help us?’” East said. “So we have negotiated rates with the community system that allows us to go out there and just do what we have to do.”

Communities have asked Caring People to supply home health aides, certified nursing assistants, LPNs and RNS, as well as universal workers, who “don’t have certification, but can help them do things like help them in the kitchen or things like that,” East said.

Despite reaching dozens of agreements to help, sometimes senior living communities’ needs are greater than what Caring People can provide.

“We had one community who needed 72 full-time employees,” East said. “Obviously, there’s no way we were able to do that, … but we just hired as many people as we could for that scenario.”

FirstLight Home Care is another agency that’s taking advantage of the newfound senior living staffing opportunities, CEO and co-founder Jeff Bevis told HHCN.

While the Cincinnati-based in-home care franchiser does not have a formal medical staffing arm, it has worked with senior living facilities to augment staffing for years. But recently, the COVID-19 virus “took that up a couple notches,” Bevis said.

In other words, senior living facilities are now turning to FirstLight to not only supplement staffing, but also to replace existing employees who aren’t able to work their shifts.

“We are probably running a 18% to 20% increase in hours per week purely from staffing requests from facilities,” Bevis said.

FirstLight has also seen a rapid increase in requests to care for seniors who have been pulled from senior living facilities, as well as to provide additional one-on-one assistance to those still in congregate care communities.

In addition to drafting a staffing template agreement, Bevis’s advice to agencies interested in pursuing similar opportunities is to be open-minded, both in terms of what they can offer and who they could partner with.

“We get a little bit myopic in the home care industry, and we think it’s got to fit into this exact hole,” Bevis said. “Usually, facilities want some variation, some flex to it. … Second, definitely continue to build relationships with facilities in your area, and it doesn’t have to be just the non-majors. The major, largest networks out there still have very much a local decision making process.”

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