At one point during the spring COVID-19 surge, Bayada Home Health Care and its in-home care workers burned through a year’s worth of personal protective equipment (PPE) in a single week.
Since then, the Moorestown, New Jersey-based home health, hospice and personal care services provider has largely mastered the PPE problem. Now, its biggest challenge is battling through COVID-19 fatigue — a daunting task as new infection numbers continue to climb.
To get an update on Bayada’s current operations, Home Health Care News recently caught up with CEO David Baiada. In addition to the coronavirus, Baiada also touched on a few highlights of 2020 while looking ahead at strategic priorities for next year.
One of the largest in-home care providers in the U.S., Bayada employs more than 26,000 nurses, home health aides, therapists, medical social workers and other professionals. Its global footprint spans 345 locations, with international locations in Canada, Germany, India, Ireland and three other countries.
You can read HHCN’s conversation with Baiada below, edited for length and clarity.
HHCN: How is your team at Bayada doing as we speak here toward the end of November?
Baiada: I’d say we’re doing as well as we can, given the circumstances. There’s clearly a lot happening in the community, a lot happening in organizations like ours. But more than ever, we feel a sense of purpose and commitment to playing our part in keeping people safe, healthy and independent at home. The current environment only shines a brighter spotlight on that opportunity and responsibility.
Everyone has seen the headlines about daily new infection numbers across the U.S. Are you seeing that impact on the ground within your operations?
Oh, yeah. We see all the same formal data, of course, that is available to everyone. But we also have lots of informal indicators that we keep an eye on, whether it’s activity with our referral sources or volume through our COVID command center. We look at the volume going into our call center teams, people with questions about exposure and protocols, etc. We’ve seen increases in these informal indicators that are consistent with what you’re seeing in the news and in the formal data.
How does what you’re seeing now compared to what you saw in March and April?
Well, I think the data feels similar. The surge is real — and it’s happening to us. I think, though, there are a lot of things that are very different. Clearly, we feel more prepared for what to do about that surge. We feel like we’re in a much better position around our understanding of protocol, around PPE availability, sourcing and distribution. We now know how to adapt our business and communication processes to navigate periods of surge. So, I’d say on the one hand, we’re seeing all the same indicators. But we do feel better prepared.
The only thing that advantage of preparation and experience might be offset by is just a sense of fatigue. In society at large and in an organization on the front lines like ours, I think there’s a sense of fatigue. You know, “Wow! We got to go through this again? It was hard enough the first time.” That’s something we spend a lot of time thinking about.
The No. 1 challenge early on seemed like getting enough personal protective equipment. I think you guys pointed out that you had gone through a year’s worth of PPE in a week. How’s that situation now?
We feel quite good about our supply levels and distribution, in addition to access to future supplies through our vendors. Clearly, we’re still concerned about the cost burden. We’re also not a supply-chain organization. Real-time fulfillment and distribution to our clinicians in the home is a constant learning experience. But relative to the spring, we feel much more prepared and well-supplied than we were then.
What would you say the No. 1 challenge is then? Is it staffing and making sure that those folks who are feeling the fatigue are supported?
Yes. Again, I think it’s the, very broadly stated, sense of fatigue. That fatigue is rooted not just in the constant unpredictability of the care situation we face with our clients, partners and our staff, but also the situations that our team members are facing in their personal lives. I’m talking about, for example, having kids and the unpredictability of school situations. People may have friends and loved ones facing COVID-19 in one form or another. There’s unpredictability around whether it’s okay to go to a restaurant or not outside of work. I mean, these sorts of things create a lot of energy-drain on people.
As a nonprofit, Bayada is a very mission-focused organization. I know the financial impact of COVID-19 isn’t your top concern. Still, can you talk a little more about the financial challenges?
Financially or otherwise, this has been anything but what we expected 2020 to be. Like most organizations that provide home- and community-based services of any type, we faced a lot of financial ambiguity and stress early on, particularly as we saw volumes drop precipitously over the course of just a few weeks. But I do think the bigger story here is a long-term view on how the spotlight is being shined on the importance of staying safe and healthy at home. That’s everything we represent and stand for.
So in the long run, we’re seeing more opportunities to be a meaningful part of the future health care delivery system. That’s real and important. Being the driving force in health care’s future, to me, is huge. It’s a beneficial long-term financial story, but more importantly a beneficial long-term societal health and wellness story.
What have been the most helpful federal or state-level measures enacted for Bayada? The Provider Relief Fund? Certain Medicare waivers?
We operate in 23 states and eight countries. We’ve experienced all the interesting flavors of federal and local support. I think the thing that has been most important but least consistent is the recognition that our front-line workers are our most important resource in the fight against COVID-19. I’m talking about thinking creatively about how to ensure organizations have the funding to be able to adequately pay front-line workers and recognize them for rising above, for answering the call of duty to help people at home in a period of uncertainty.
Bigger picture, a lot of attention is being paid to how you virtualize health care. Everyone is trying to figure out how to, you know, improve outcomes and experiences at a lower cost through use of virtual care and telemedicine. I think the spotlight that COVID-19 is placing on the opportunity to be more creative around virtual care — and the ways in which the government is creating regulatory relaxation or reimbursement structures to support that — is super, super important.
Can you talk a little bit more about that international presence? I can’t really imagine how difficult it must be to manage U.S. operations across multiple states, then have to think about what’s going on in India, for example.
It clearly adds a level of complexity. Every town, city, state, country is different, whether it’s domestic or international. But at Bayada, we really think about running our various locations at the local level. We have a lot of great social entrepreneurs. Whether they’re in Indiana or India, it’s all about having a team that’s committed and aligned with a common purpose. All of our locations have had to be creative, flexible and determined to figure out how to adapt to a crazy environment.
Let’s press pause on COVID-19 for a second. And I want to talk about some of the bright spots for Bayada in 2020. What are your highlights of this year? For example, I know Bayada recently announced a big JV partnership with Baptist Health in Florida.
Yeah, we’re proud of the Baptist relationship. I think it’s an amazing organization and a part of Florida where Bayada doesn’t currently have a presence. We’re also excited by how that relationship is a positive indication of something that we’ve been helping foster for many years — really strategic thinking by health systems. Systems are more often thinking about the ways in which we can align with them, strategically. They want to bring best-in-class home- and community-based capabilities into their networks.
It’s hard to predict the future right now, but what’s in store for Bayada in 2021, in terms of priorities, growth plans and other strategic initiatives?
I will try to set COVID aside, though, it is an undercurrent that runs through everything that we’re doing and thinking about.
Our first and most important priority is people. How do we continue to attract, engage, develop and support amazing people and teams committed to delivering amazing services? We’re hugely focused on talent — all things talent.
The second is that we’re thinking a lot about digital transformation. In addition to what’s instigated by COVID, how do we begin to accelerate how we invest in things like automation and artificial intelligence? How do we invest in the clinical virtual health tools and technology to really transform the way our services are delivered over the next 10 years?
Then third, how do both of those first two things — talent and digital transformation — support our continued growth as a mission-driven social entrepreneurial growth company.