The Hillsboro County Home Health Agency (HCHHA), previously known as the Middleboro Home Health Agency, is a non-profit organization aimed at addressing the home health needs of Hillsboro Country. It operates under the patronage of the Joint Commission of Accreditation of Healthcare organization and seeks to serve individuals in their familiar environments by providing home-based assistance, information, instructions, and guidelines for patients and their families. The company was founded in CY-68, and has since been expanded from Middleboro to accommodate the needs of the larger community. It has a generally good professional reputation among employees, works with Medicare and Medicaid programs, and receives various grants to support itself. The purpose of this consultation report is to review the company’s community relations and perceptions, board composition and ownership, service expansion or reduction prospects, and facility locations. Short-term and long-term recommendations for sustainable growth and development will be provided at the end of the paper.
Community Relations and Perceptions
The perception of the HCHHA has generally been positive in the community, with some programs being particularly popular and well-received by society. At the same time, there are several issues associated with the expansion of services and coverage from Middleboro to Hillsboro. The organization started off as a Middleboro agency and has been perceived as such by the local communities. When it expanded to cover a larger area, this came with the perception of reducing attention and efforts in Middleboro proper. There have been complaints about the organization caring less for the Middleboro residents to accommodate other areas, which hurt local relations. Middleboro aims to provide a high-quality care for elderly, and it is related to Affordable Care Act that support general public health (Green et al., 2018). Finally, the organization is very known and successful for its private fund-raising activities, to the point that it is being viewed by United Appeal as self-sufficient, thus not needing extra grants and funds.
Board Composition and Ownership
As it stands, the company’s board is comprised of 21 members. The members are elected by the board for three years and have the possibility to be re-elected. Despite the fact that short terms have been introduced to facilitate a healthy rotation of the board of directors, the majority of key board members have been in the position for 1-2 decades, if not more. This system might not be beneficial for both workers and managers as the risk of nepotism increases and gossips appear in the workplace (Kaushal et al., 2021). Other approaches may be necessary to improve the situation and give fresh blood to the organization. Some of the positions occupied by certain board members are also suspect. For example, it is unclear why certain members of the board are running a healthcare organization while their experiences and private businesses are related to different areas. The lack of proper education and familiarity with healthcare may cause issues in governance at the highest level.
Service Expansion/Reduction
Two primary issues associated with service expansion and reduction relate to the fact that HCHHA is overly reliant on Medicaid reimbursement as well as experiencing critical staff shortages. Services that are not imbursed by Medicaid force the organization to demand out-of-pocket payments, which are not viable for many individuals that need them. At the same time, staff shortages result in the reduction of quality, long wait times, and greater strain on nurses and patients alike. The company is showing a downward financial performance as well as below-state ratings in several healthcare indicators. Namely, HCHHA has a higher hospital admission rate and increased pain scores in moving patients, which indicates a lack of care. When it comes to demand, personal health services, in particular, are wanted by the population. They are affected by the lack of Medicaid/Medicare coverage, low performance, and a lack of nurses to cover 24/7 care.
Facility Locations
Facilities belonging to the HCHHA are located all around Hillsboro country, with a focus on Middleboro as their home region. The expansion to encompass the other areas did not come without its costs for logistics and transportation. Many workers from the Middleboro are provided with specific YouTube videos that show geographical location of the country where they can work (Green et al., 2018). This method makes the personnel more interested working in diverse places with diverse patients. Employees do not have to spend many hours driving to their workplace, which takes away from sleep, leisure, and work/life balance activities. Finally, it decreases inconvenience for patients to travel to Middleboro for specific services when HCHHA is supposed to cover the entirety of Hillsboro.
Short-Term and Long-Term Recommendations
- Merge with hospitals/hospices eligible for Medicare/Medicaid and increase of teaching in distant location of the country (Green et al., 2018). Creating video to make workers more integrated with their responsibilities and encourage them to increase their knowledge.
- Increase hiring/retention. The bulk of the issues with quality is, in one way or another, associated with poor hiring and retention practices (Mahoney et al., 2020). HCHHA should increase benefits and hire people closer to medical care centers to reduce driving times, save time, and improve staffing rates;
- Downsize (Alternative Strategy). As it stands, the HCHHA appears to be handling the entirety of the Hillsboro County while remaining largely in the position and managing staff from back when they had to work with Middleboro alone. Using more digital technologies might help to concentrate on specific workers and increase efficiency by avoiding human contribution in the activities that might be done by technologies (Demir, 2019).
References
Demir, O. (2019). Digital skills, organizational behavior and transformation of human resources: A review. Ecoforum, 8(1).
Green, J. C., Aziz, T., and Joseph, J. (2018). YouTube enhanced case teaching in health management and policy.Health Professions Education, 4(1), 48-58. Web.
Kaushal, N., Ghalawat, S., Kaurav, R. P. S. (2021). Nepotism concept evaluation: A systematic review and bibliometric analysis.Library Philosophy and Practice (e-journal). Web.
Mahoney, C. B., Lea, J. D. N. P. M. B. A. C., Schumann, P. L., & Jillson, I. A. (2020).
Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: Role of job characteristics and personality. AANA journal, 88(1), 39-48.