Fulton County home health agency reports drop in visits

PHOTOGRAPHER: Jason Subik

A change requiring co-pays for skilled nursing visits for patients with Medicare HMOs contributed to a year-over-year drop of 252 visits from Fulton County’s Certified Home Health Agency, according to an annual report released Tuesday.

Karen Hogan, director of patient services for Fulton County’s CHHA, said the nursing service made 4,379 visits to Fulton County residents’ homes in 2009, down from 4,631 in 2008.

“Medicare changed to a managed Medicare system where people became responsible for co-pays, so that had a lot to do with people refusing home care because they didn’t want to be responsible for the co-pays,” Hogan said.

According to the annual report, 54.2 percent of the nursing services clients paid using traditional fee for service Medicare, 23 percent used a Medicare HMO, 8 percent used a private insurance HMO, 7.1 percent used fee-for-service Medicaid, 5 percent used a Medicaid HMO and 2.7 percent used private insurance. The CHHA reports 5 percent of its customers, 74 people, paid through an “unknown method,” while the rest used workers’ compensation, title programs and other government programs.

The CHHA reports having 1,477 customers in 2009, with an average daily patient census of 99 people, 99 percent of whom were white and 53.6 percent of whom were women. The average age was 72 years old.

Hogan presented the CHHA’s 2009 annual report to the Fulton County Board of Supervisors Health Services Committee on Tuesday. The board is considering privatizing the CHHA and the county’s nursing home.

The annual report included six pages of patient comments from 2009 praising the nursing staff’s efforts. The comments did not include the patients’ names but sometimes mentioned nursing staff by name. All of the comments were positive.

Hogan said 2009 is the last year CHHAs will be able to survey their own patients for comments; later this year a new regulation will require CHHAs to contract with an independent company to survey patient results.

It remains to be seen whether 2009 is the last full year Fulton County’s CHHA will remain a publicly run agency. Bleecker Supervisor David Howard, chairman of the county’s Health Services Committee, said the county is still posing questions to the four entities that have expressed interest in acquiring the nursing home: Bronx-based Centers for Specialty Care; Herkimer-based Leatherstocking Healthcare LLC; Nathan Littauer Hospital in Gloversville; and Tarrytown-based Pharney Group LLC. Only one organization submitted a proposal for the CHHA: Mountain Valley Hospice in Gloversville.

“We’re waiting for [our consultants] to get more information from the people who responded. We haven’t set a rigid timetable, we want to make sure we are as thorough as possible,” Howard said.