JOHNSON CITY — UHS Home Care has settled into its new home, allowing it to centralize its operations and set the stage for future growth.

The home-health-care provider is now headquartered at 601 Riverside Drive in Johnson City, just off the Route 201 traffic circle. The parent organization, UHS, owns the building. UHS Home Care occupies 28,000 square feet of the 35,000 square feet available and moved to the new location in May.

“The move enabled us to centralize our operations,” says Greg Rittenhouse, vice president and COO of UHS Home Care. “[Prior to the move] … we had multiple locations in Endicott and Vestal, which made it difficult to deliver our services to patients scattered throughout a four-county region (Broome, Chenango, Delaware, and Tioga). This site features a spacious retail showroom, as well as offices for the health-care staff and plenty of parking.”

Rittenhouse is not thinking just of the advantages of consolidation. He is anticipating a radical change in the way America delivers its health care and expects an increased demand for home-health-care services.

“A person’s home is one of many settings in which he or she may receive care today, and it’s growing in importance,” observes the company COO. “Care can be provided safely and effectively in the familiar, comfortable surroundings of home, where it’s a bit easier for family and friends to visit. Traditional hospital and nursing-home settings are still the right options for many patients and situations, but home care can be both a low-cost and beneficial option. There is a shift toward community-based organizations like ours, which are growing and redeploying our home-health services.”

A continuum of care
UHS, has long focused on developing a continuum of care. “This home-health-care division was formed in 1986 to respond to the demand for DME (durable medical equipment),” notes Rittenhouse. “Today, [under the UHS Home Care/Professional Home Care name], we sell [and rent] wheelchairs and walkers, hospital beds, bathroom items, patient lifts, support hosiery, cushions and pillows, canes, oxygen, infusion meds, blood-pressure units, incontinence supplies, and aids to daily living.

“Everything you need to recover, stay safe, and independent at home is here, including a retail pharmacy. UHS Home Care/Professional Home Care conducts 17,000 patient transactions a year and generates $9.5 million in annual, net revenue … In addition to our Riverside Drive location, we lease 5,000 square feet in Ithaca and another 2,000 feet in Norwich … [from which] we sell and rent DMEs,” Rittenhouse says.      

The original focus on DMEs has been expanded to include a certified home-health agency (CHHA) called UHS Home Care/Twin Tier Home Health. CHHAs provide part-time, intermittent health care and support services to individuals who need intermediate and skilled health care. “Twin Tier serves patients requiring a short-term stay (fewer than 60 days): for example, people recovering from illness, surgery, a recent hospitalization or those living with a chronic condition,” Rittenhouse continues. “The special-care services we offer include nursing, physical and occupational therapy, home-health aides, speech and sleep therapy, nutritional advice, and even Home Emergency Alarm Response (HEAR), which operates 24/7 with 650 subscribers. Our annual budget includes $9.5 million of net revenue to support 20,000 patient-visits annually.”

UHS Home Care also offers long-term services through a program called Ideal Long-Term Home Health Care. “Think of this as a nursing home without walls,” continues Rittenhouse. “This home-care program provides a coordinated plan of care and services for those over the age of 21, who do not qualify under a CHHA or who need additional services to stay in their homes.”

He adds: “The legislation was created by State Sen. Tarky Lombardi (of the Syracuse area) to provide comprehensive, coordinated care for the Medicaid-eligible, chronically ill and disabled who are qualified to enter a nursing home but would rather remain in their homes. These patients require more than 120 days of continuous care, receiving assistance from home health aides and are often provided with social day-care, home-delivered or congregate meals, house improvements and moving assistance, respite care, and transportation to and from medical appointments. UHS Home Care has budgeted $1.5 million in net revenue to support 83 patients.” (The normal case load is 105).

UHS Home Care’s growth has expanded the organization beyond its original mission.

“What began as a small ‘downstream provider’ of durable medical equipment has blossomed into a full-service agency consisting of UHS Home Care’s Professional Home Care, Twin Tier Home Health, and Ideal LTC,” asserts Rittenhouse. “Our consolidated annual budget is more than $20 million, and we employ 242 people (230 operate from headquarters in Johnson City).”

Pressure to expand community-based health care in New York is driven by the cost of the program. In 2013, the Empire State included more than 5.3 million people enrolled in the Medicaid program from a population of about 19.5 million. The state spends $53 billion annually on Medicaid, or approximately 40 percent of the $133 billion budget. New York, with 6.3 percent of the nation’s population, consumes nearly 13 percent of the total cost of the U.S. program.

The DSRIP program
On April 14, Gov. Andrew Cuomo announced final terms of a ground-breaking waiver with the federal government that allows New York to reinvest $8 billion in federal savings generated by Medicaid Redesign Team reforms. The dollars invested for comprehensive reform are known as the Delivery System Reform Incentive Payment (DSRIP) program.

“The purpose of DSRIP is to promote community-level collaborations and focus on system reforms,” posits Rittenhouse. “The goal is to achieve a 25 percent reduction in avoidable hospital use over a five-year period.”

Performance will play a big role in funding decisions.

“The funds will be based on performance linked to achievement of the projected milestones. Of the $8 billion [invested over 5 years], $500 million is designed to ensure that the Medicaid safety-net providers can fully participate [without disruption]; $6.2 billion covers planning grants, provider-incentive payments, and administrative costs; and a little over $1 billion will support home-health development, investments in long-term care, and workforce and enhanced behavioral health services.”

UHS Home Care is required to ascertain the community’s health-care needs.

“As a provider, we are required to conduct a community-needs assessment to determine a description of the population served, an assessment of its health status and clinical needs, and an assessment of the health care and community-wide systems currently available to address these needs,” Rittenhouse says.

Reimbursement systems are changing. “In long-term care, we are moving away from a cost-based reimbursement system with a two-year lag and no trend factor,” states Rittenhouse. “Reimbursements for this program will now go to managed long-term care (insurance) companies (MLTC), which are responsible for managing the payments. UHS Home Care has already negotiated contracts for Broome County with Fidelis and United Health Care, and we expect to operate in Chenango, Delaware, and Tioga Counties in the coming years. We also expect to sign contracts with two other MLTC companies this year. The MLTCs operate on a capitation system. This is still a work-in-progress, so it’s not entirely clear how our agencies will coordinate with the MLTCs.”

UHS Home Care’s leadership
Rittenhouse grew up in Endicott and graduated from Binghamton University with a major in applied social sciences and an MPA from Marywood University in Scranton. He began working at age 16 washing dishes in the kitchen of Ideal Hospital. His career path led to the manager of food services at the hospital. When UHS was formed, Rittenhouse became the manager of registration (admissions) and later took on the title of administrative director of medical services at UHS Hospitals. His next position was as the vice president of operations at Professional Home Care before assuming his current position as vice president and COO of UHS Home Care in 2011. Rittenhouse reports to the CEO and the UHS Home Care board of directors.

In addition to Rittenhouse, UHS Home Care’s leadership team includes Joseph Cerra as senior vice president, physician practice management and president and CEO of UHS Home Care; Karla Dotts as vice president of clinical services; and Cynthia Wine as CFO.

The locally owned, locally governed UHS health-care system was formed in 1981. It has grown to include four hospitals and a senior-living campus in addition to UHS Home Care and is affiliated with the UHS Medical Group and the UHS Foundation. From 60 locations around the Southern Tier, it employs 5,557 people and has a medical staff of more than 500 physicians and other providers. UHS posted 2013 annual revenue of $647.7 million, with a surplus of $9.6 million.

“Home health care is on a path to move to the forefront,” opines Rittenhouse. “As care becomes more community based, home care will be in increasing demand. UHS Home Care is anticipating the changes in how we deliver health care, and focused on getting ahead of the curve.”

Contact Poltenson at npoltenson@cnybj.com