TYLER - Home care has been described as the missing link of health care, the cost-effective personalized, patient-centered alternative to lengthy hospitalization or nursing home care.
There are roughly 10,000 home care facilities in the country, according to the National Association for Home Care and Hospice. Three facilities in Lincoln, Lyon and Yellow Medicine counties are rated by the Home Care Elite organization among the top 25 percent, top 500, and top 100 most successful home care providers in the nation.
The facilities are ranked according to a number of measures that include patient satisfaction and medical outcomes.
Photo by Steve Browne
Staff of Tyler Home Care and Ridgeview Hospice, from left: Director Elise Williams, Scott Lawrence, RN, Jessica Guida, RN, Carrie Timm, RN, and secretary Marcia Miller.
"It's a distinction that's given to agencies that rank according to a number of health care measures," said Elise Williams, director of the Tyler Home Care and Ridgeview Hospice.
Tyler Home Care was rated among the top 25 percent last year and among the top 500 facilities for 2012.
"It's not easy to show success," Williams said, "because a lot of our patients are elderly, some on the bridge between treatment and end-of-life care."
Home care facilities usually operate in association with a hospital or clinic, the difference being that the staff goes to the clients in their own home, offering services that offer an alternative to in-patient care. Typically home care personnel operate within a 30-mile radius of the facility.
"Nurses go to the home and offer services patients need," Williams said. "It could be post-surgery, medical assessments, physical therapy, medical set-ups, or help for someone home from the hospital."
Scott Lawrence is a Registered Nurse with Tyler Home Care.
"We have IV therapies," Lawrence said. "If someone has an infected knee we can help them at home instead of a facility."
Though home care clients are mostly elderly, they also include infants with health issues, and teenagers who are accident victims or have chronic health care issues.
Asking home care personnel what makes an excellent facility, a few factors come up in all cases.
One is technology.
The Internet allows rural home care personnel to keep on top of new developments in medicine. Remote monitoring equipment helps providers monitor patients conditions without having to be physically present. Once bulky and expensive medical equipment is more portable and less expensive these days.
Jody Hempel is director of Granite Falls Home Care, which Elite has rated among the top 100 in the nation three years in a row.
"We can provide Telehealth, a piece of equipment set up in the home to monitor special health issues," Hempel said. "It monitors blood sugar and pressure, heart rates, oxygen levels, weight, questions specific to a patient."
Another factor is longevity of the staff. All three facilities have very low turnover rates for nurses, LPNs, and nursing aids.
Marianne Boerboom is director of Shetek Home Care, which is affiliated with the Sanford system and has facilities in Tracy, Slayton and Westbrook. Elite rated Shetek among the top 25 percent of home care providers in 2007, 2011 and 2012.
"I have an excellent staff that has been with me for a very long time," Boerboom said. "They're seasoned, and most have been in home care for at least 10 years. I think they truly have a knack for caring for the elderly."
For many medical professionals, the slower pace and personal nature of the service is quite rewarding.
Helen Gunderson, RN, joined the Granite Falls Hospital staff in 1971 and switched to home care 15 years ago.
"I just felt I wanted a change," Gunderson said. "It was a nice change from the acuteness over there. Home care is a little slower paced. We still have acute things, but not as much as the hospital."
Home care personnel also cite the personal relationships with their clients.
"I love it," said Jenna Hempel, a nursing assistant with Granite Falls Home Care. "Just being in their homes, working one-on-one with them, I work in the Manor Home also, and it's a whole different atmosphere."
And though there are many first-ranked facilities in the major metropolitan areas, there is something about the rural environment that gives rural home care agencies an advantage.
"It's the small-town atmosphere," Lawrence said. "We know the patients and we know their needs."
Carrie Timm, an RN with Tyler, agrees.
"We have open communication with their families," Timm said.
According to Hempel, people in the community feel comfortable calling up and asking what they can do for themselves or a relative, helping the agency educate people to become proactive in their own health care and provide services prior to a crisis.
"The most cost effective way of health care is home care," Hempel said. "Maintaining people at home is where they're happiest and healthiest."