Sooner Hospice and Hometown Home Health find the correct protocols between staff and physicians to better manage patient care, says Cheryl Medawattage, RN, director of business development.

Managed care and peace of mind – Hometown Holdings purchases hospice and home health companies

by James Coburn, Staff Writer

Sooner Hospice and Platinum Home Health were recently purchased by Trey Bippen, a local businessman and the successful owner of Hometown Home Health.
Sooner Hospice retains its name and the company and Platinum Home Health is now Hometown Home Health. They are under the umbrella of Hometown Holdings.
“We roughly serve 400-500 patients under the home health side,” said Cheryl Medawattage, RN, director of business development for Sooner Hospice.
There are five to six home health offices scattered across Oklahoma. Sooner Hospice is the first hospice.
“I think the benefit to us was to be strategic and to look into the future of health care,” Medawattage said. “There are so many changes coming down the pipe with home health, hospice and health care in general.”
So the opportunity for the company is to continue to partner with hospitals and other health care agencies to improve patient outcomes and decrease hospitalization rates, she continued. The plus factor is to hopefully decrease health care costs in general. Ninety percent of all Medicare recipients is spent during the final year of their lives. So hospice and home health can be a huge money saver when it comes to Medicare.
“Something I’m very big on is ensuring that our patients — No. 1 that they do not die alone unless that is something they have requested, or the family has requested that they just want some privacy,” Medawattage said. “Nobody should have to die alone. Our goal is to always have somebody there to hold somebody’s hand at the end of life. Most of the time we can predict that.”
A Duke University study from 2007 revealed that hospice saved Medicare an average of $2,700 per patient that goes on hospice vs. those who do not, Medawattage explained. More than 1.1 million patients were on hospice last year in the United States, so the cost savings is evident.
Congestive heart failure is the primary reason why patients go back and forth to the hospital, she said. There are also chronic pain issues bringing people to emergency rooms multiple times.
“Pneumonia and heart attacks are areas where we are trying to develop protocols with home health specialists and consultants where we can provide high level, state-of-the-art services for those CHF patients,” she said.
They will develop protocols for those patients to minimize their symptoms in order to avoid the need for hospitalization.
Patients who go on hospice typically will not go to a hospital. But patients with congestive heart failure tend to panic due to difficulty breathing and fluid retention.
“But there are innovative ways we can partner together with physicians to keep them out of hospitals,” Medawattage said.
Medawatage also serves as the transitional care manager for Sooner Hospice. The transitional care team includes three registered nurses, a social worker and a chaplain. They are in the process of adding a nurse practitioner to the team.
The goal is to have the right patient at the right place during the right time, she added. It is important to recognize patients and bring them into the process earlier than later, she said. Nurses are educated to look for signs and symptoms early in their patients for better care. A lot of the problems that happen with end-of-life care is that patients and family members have not made arrangements for end-of-life transitions. They have not considered advanced directives as far as resuscitation and how their goals will be managed.
“With the transitional care they hopefully will not be ready for hospice, but we can start having that dialogue as to their goals as their illness progresses.” she said.
Discussing one’s goals with loved ones prevents families to have to scramble at the end to make hasty decisions when they are already experiencing profound stress.
“I’ve heard a lot of families say, ‘I wish I didn’t do this’ because things were not put in writing,” Medawattage said.
Advanced care planning helps people with their right for self determination by empowering them to make decisions ahead of time, she said.
“Not everyone needs a DNR to come on hospice,” she said. “Again, our goal is just to what is the need of the patient. Is the need hospice? Is the need resources in the community. Is it just not just education and palliative consultation? Or is it just psycho-social and spiritual support”.