Home-Based Care Operators Expect to Use Screening Tools ‘Far into the Future’

For Bayada Home Health Care, the idea of implementing a sensible COVID-19 screening process began with pieces of paper. After some brainstorming, the company began exploring more technology-savvy processes and, ultimately, landed on text messages.

Originally thought to be an above-and-beyond type measure, the screening concepts Bayada ended up with may become not only the norm for home-based care providers moving forward — but a requirement.

“Eventually, I think it’s something that everyone in our industry is going to have to think about,” Matt Kroll, Bayada’s president of assistive care services, told Home Health Care News.

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As one of the biggest home health providers in the country, Bayada searched for a tool to seamlessly implement, one that could be accessible to all of its caregivers to help them avoid spreading the coronavirus during patient visits.

Moorestown, New Jersey-based Bayada turned to its health-tech partner, Dina, for screening support. Dina — formerly known as Prepared Health — responded with its text messaging screening process, which coaches, guides and collects information from Bayada’s caregivers.

At the outset of the public health emergency, when Bayada was being pressed by some of its clients inquiring what the company was doing to mitigate risks, it responded with its personal protective equipment (PPE) protocols and call-in requirements for caregivers.

But as time went on, that began to feel inadequate, Kroll said.

“We had a conversation with Dina about the idea of daily text messages as a way to support our caregivers while also monitoring their health and making sure we weren’t spreading the virus to any of our clients,” Kroll said. “We were getting so many calls from our clients saying, ‘What are you doing?’ We’d talk to them about PPE, we would talk to them about educating our caregivers to call in. But as we were having those conversations, it just didn’t feel like it was enough.”

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The text messages ask a handful of “yes” or “no” questions. Those questions range from symptom-related ones to environment-related ones, including asking caregivers whether they’ve been exposed to someone with COVID-19.

If any of the answers indicate risk, all of Bayada’s home office team members are notified.

Bayada’s network covers 23 states and includes about 30,000 caregivers. Originally, the screening was only done for employees tied to a few locations in New Jersey.

Now, 6,000 caregivers in the agency’s network receive the text messages.

“We’re still in the process of expanding it,” Kroll said. “We started with … our home health aides and rolled it out to our Medicare division. We’re in the process of rolling it out to our [other divisions], such as private-duty nursing.”

Some of the other divisions within Bayada are using different technology to better fit their day-to-day work.

“When it’s fully rolled out, we should be in the tens of thousands for employees receiving the text messages,” Kroll said.

Bayada’s caregivers have been welcoming of the screening set-up thus far, Kroll said. And while it’s impossible to calculate the number of COVID-19-positive cases Bayada has prevented with Dina’s tool, the anecdotal examples have done a lot for peace of mind.

“We haven’t had a time where there has been an overwhelming number of troublesome answers on a particular day,” Kroll said. “But there are stories. We had a caregiver call into the office [after screening] to say, ‘I have a sibling living in my home who is having symptoms and has gone out for a test, should I still go to work?’ We were able to prevent that person from going to work because when they read the screening instructions that mentioned [living situations], it reminded them to double check.”

The data has also been valuable to examine as cases spike around the country. Bayada is able to isolate those hot spots and see which — if any — caregivers in that area are experiencing symptoms.

Current national hotspots include areas in Florida and Texas, which are well into their reopening plans.

Bayada, a nonprofit organization, is happy that it began a more extensive screening process when it did, Kroll said. Two of the states it operates in — Delaware and New York — now require at least some sort of screening for front-line health care workers.

“I think it’s likely — especially if we experience a second wave — that many more states are going to require these types of screenings on a daily basis,” Kroll said.

Screening, just like PPE, is becoming a cost of doing business in home-based care — an industry that already generally operates on tighter margins.

No one knows when the COVID-19 crisis will be gone, or what that even looks like. Until then, operators will have to consider risk-mitigation efforts as a new part of the work day and a factor of the bottom line.

“We haven’t really considered what it is that would mean we could stop [screening],” Kroll said. “We’re more so doubling down — how do we add in more elements to support caregivers? [For instance], we actually started sprinkling in with return text messages. But in terms of what point will we stop that? That’s a great question. I think we see ourselves using it into the future as far as we can see right now.”

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