The decision to contract for rehabilitation services at Cove’s Edge, effective Jan. 1, will not negatively impact employees or patients, a Lincoln County Healthcare spokesman said.
Lincoln County Healthcare Vice President of Development, Marketing and Community Relations Scott Shott said affected employees will simply become employees of the contractor, Select Rehabilitation Inc., with “like” pay and benefits.
The six full-time and three part-time employees include occupational therapists and occupational therapist assistants, physical therapists and physical therapist assistants, and speech therapists.
Most similar facilities in Maine already “partner with companies” for therapy services, Shott said. “We were one of the last ones who didn’t,” he said.
“We sort of contracted internally with the hospital to have therapists for Cove’s Edge, and it just turns out that having this company, Select Rehab, is more economical for us,” Shott said.
A Nov. 13 memo by Lincoln County Healthcare Vice President of Home Health & Hospice and Senior Living Judy McGuire Sr. explains the change.
“This decision to partner with Select Rehab was made to assist Cove’s Edge in achieving clinical and financial goals in the light of reduced Medicare reimbursements,” McGuire wrote.
“The therapists will have greater resource availability in terms of education and support from a company who is expert at providing rehabilitation services in long-term/skilled care settings,” according to the memo. “The therapy team will utilize new electronic documentation, which will improve efficiency.”
“The decision was NOT due to any performance issues with our current therapy team!” McGuire wrote. “We look forward to the continued exceptional high level of therapy services and care of our residents and team.”
The change for the therapy team follows other, more high-profile changes within the Lincoln County Healthcare system, including, most notably, the move to close the St. Andrews Hospital and Healthcare Center emergency room and the related loss of the facility’s hospital license.
The changes at St. Andrews could result in the elimination of about 50 jobs, according to Lincoln County Healthcare statements at the time.
More recently, the organization cut the pay of personal support specialists at Miles & St. Andrews Home Health & Hospice effective Nov. 12. The cut affects 28 employees.
Cove’s Edge and Miles & St. Andrews Home Health & Hospice are part of the same nonprofit, Cove’s Edge Inc., which, in turn, is a subsidiary of Lincoln County Health Care Inc., part of the MaineHealth network.
According to Miles & St. Andrews Home Health & Hospice Executive Director Kathy Bean, the pay cuts were necessary in order to avoid job cuts.
Before the cuts, Home Health & Hospice paid home health aides and personal support specialists the same hourly rate, as the two types of employees “do essentially the same job in different settings,” Bean wrote in a Nov. 12 letter provided by Shott.
Medicare reimburses Home Health & Hospice for the work of home health aides, while personal support specialists work for clients who pay privately.
The amount private clients pay for personal support specialists is “set by the marketplace,” according to Bean, and is less than what Medicare pays for home health aides.
Despite this disparity, Home Health & Hospice continued to pay the employees the same wage.
As demand for home health aides dropped, demand for personal support specialists grew and the department faced a deficit, “We made the decision to preserve the job and reduce the wage,” Bean wrote.
Despite what Bean refers to as “painful cuts,” the executive director believes wages remain “more than competitive” when one considers the benefits the employees receive.
Shott, the Lincoln County Healthcare spokesman, said home health aides and personal support specialists used to have different pay rates some years ago, and the recent change only reverses what was a relatively recent pay increase.
He said the expense of benefits, which often exceeds the expense of an employee’s salary, “makes it very difficult” to compete with private home health companies that do not offer benefits.
More changes at Lincoln County Healthcare are likely in the future, although Shott said he does not know or cannot talk about what those changes might look like.
Lincoln County Healthcare, like other small health care providers in the state, feels “a great deal of pressure” from multiple sources, he said.
“Reimbursement from our government payers,” primarily MaineCare and Medicare, “is dropping and it’s going to keep dropping,” Shott said, while private health insurance companies pressure providers to be more affordable.
Lincoln County Healthcare will not make changes that “affect the quality of what we do,” Shott said, and if the organization determines it cannot “do something well, we won’t do it,” he said.
“Our goal is to provide accessible, high quality, affordable health care services,” Shott said. “To do that, we have to change. We can’t stay the same.”
