While the COVID-19 crisis’ primary effect on the home care industry may have been temporary, its secondary effects could be more long-lasting. The same idea holds true for other aging services providers as well.
A recent report from the American Health Care Association (AHCA) highlighted the economic headwinds that providers are facing even as the pandemic subsides, with the top three costs being increased pay for staff, hiring additional staff and personal protective equipment (PPE).
Expenses that weren’t much of a consideration to providers before the virus took hold — like PPE — will likely become commonplace moving forward.
“I think it’ll be a part of doing business moving forward,” Peter Ross, the CEO of Senior Helpers, told Home Health Care News. “I think your home care companies will start to build in the cost of masks and gloves, for instance, into their overall operating cost. So maybe, in general, they might aggregate 25 cents more per hour across the board for people.”
PPE prices have lessened substantially since the height of the public health emergency, but certain supplies remain relatively costly.
“We always had latex gloves or something for caregivers. That was a given, but what was new to us was the face masks, facial shields and gowns obviously,” Ross said. “Now, it’s not as drastic with the gowns and face shields over the mask, but the rest — I think — is here to stay.”
Based in Maryland, Senior Helpers is a home care services provider with more than 320 franchised and corporate-owned locations in 44 states, Australia and Canada. The company provides meal planning, personal hygiene, transportation and companionship services, among others.
Earlier this year, the company was acquired by Advocate Aurora Enterprises, a subsidiary of the Midwest-based Advocate Aurora Health, one of the largest nonprofit health systems in the country.
“More importantly, though, is that the clients and caregivers are getting vaccinated — and that’s making things a bit easier,” Ross said. “But I saw a survey today that 40% of the country still wears a mask, even if they’re vaccinated. So I just think you’re going to see the masks here to stay.”
Ross jokingly said in May of 2020 that he had been in “PPE anonymous for two months” when the pandemic began. A concept mostly foreign to home care providers was now one of their largest — and most vital — focus points.
“You were competing with every person on the planet,” Ross said. “We had to repurpose marketing fund monies and things like that just to go find PPE because, you know, we never even knew we had to use it until the pandemic. So that demand was tough. It drove up some of the costs for sure.”
The cost environment is different now, however.
Where a mask may cost anywhere from 10 to 15 cents now, back in the spring and summer of last year, costs were much higher per unit. Plus, the face shields and gowns were added costs, almost as if you were “prepping caregivers for surgery,” Ross said.
“You’re definitely going to have some costs that were not a part of the process before, but I think we were able to weather that bigger storm, and now I think it’s becoming more routine to do the things we’re doing,” he said. “But I don’t think masks, let’s say, are going to drive a ton of costs in the long run.”
But a lot of it depends on geography and the size of the provider. Senior Helpers, for instance, was able to divert marketing money to take care of PPE procurement when it needed to. Smaller agencies may not be able to do that if the situation gets dicey again.The delta variant of the COVID-19 virus is now the most prevalent strain in the U.S. and cases have increased by nearly 40% over the past two weeks.
The added costs of staffing woes
PPE is not the only added cost that may be here to stay, however.
While home care demand may offset some of the added-on costs tied to PPE usage, it won’t with staffing issues.
Staffing a caregiver workforce was a challenge before the pandemic, but for some providers, it’s changed for the worse — and maybe for the long haul.
“The thing I feel has changed the most is the lack of aides willing to work,” John Bradshaw, the CEO of Georgetown Home Care (GHC), told HHCN. “We never really had any trouble finding aides to take jobs prior to the pandemic, but it’s near impossible now, which is dramatically driving up the cost as we pay more to get aides to come back.”
GHC is a home care agency that provides personal care, respite care, senior companionship services and senior transportation services. Based in Washington, D.C, it also services Montgomery County, Prince George’s County and northern Virginia through around 460 employees.
Demand has been high for the company, but that only matters if its able to staff the jobs that are requested. Growth without adequate recruitment and retention is a pipe dream.
“I think we will get aides back as the unemployment benefits go away, but I’m not sure about that,” Bradshaw said.
Since irregular unemployment benefits have popped up, Bradshaw has added additional benefits, like more paid vacation, to try to woo workers. He’s also increased wages by $2 to $3 per hour in some cases to compete with benefits, which has added on to the cost of care for clients.
While Bradshaw has always tried to find ways to reward the company’s workers — and actually sided with many of them when they opted out of work amid surges — the recent hikes in wages have landed him in a dilemma.
“I also am not sure if we can bring pay rates back down now,” Bradshaw said. “And that is significantly raising the cost of care to both our company and our clients. My biggest fear is that we don’t return to [how it was before].”