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At Home with The Joint Commission

A discussion highlighting developments in home health, DMEPOS, hospice, pharmacy and personal care.

Home Care Organizations Speak Out on Changes that will Endure Post-COVID


By Gary Bachrach, Executive Director, Business Development, Home Care Accreditation

As the COVID-19 emergency stretches into a second year, it’s interesting to look back on the impact the pandemic had on different health care sectors.

Last fall, The Joint Commission contracted with C + R Research to survey 735 respondents representing a variety of health care settings, including hospitals, home care, behavioral health and human services, and ambulatory care. 

For home health, respondents fell in the following categories:

  • home durable medical equipment
  • personal care and support
  • hospice 
  • pharmacy
  • home-based primary care

Organizational Challenges
Our accredited home care organizations reported their fair share of challenges.

Staffing and supply issues dominated home care responses. The lack of personal protective equipment (PPE) at the beginning of the pandemic accounted for the supply issues. Vendors were backordered on critical supplies for most of spring 2020, especially N95 masks. PPE availability eventually strengthened but this happened later for home care organizations, as hospitals were understandably prioritized for distribution.

Staffing issues were more complicated. The main concerns were:

  • retention
  • working from home
  • staff emotional response

While working from home shifts were easier for some home care organizations to address, other staffing issues were considerably more difficult, including:

  • changed plans due to staffing shortages
  • hiring difficulties
  • impact of infection/quarantine on staffing
  • uncertain and changing child care needs of staff
  • furloughs
  • pay reductions

Longer Term Changes
It’s become quite clear that some changes are here to stay. Initial challenges impacting staff like mandatory PTO or furloughs may be a more short-term impact. Other changes, like working from home, may become more permanent.

Additional changes home care organizations should expect to endure include:

  • revisions to infection prevention plans
  • monitoring guidelines to keep protocols up to date
  • stockpiling PPE, equipment and supplies
  • pre-visit COVID-19 screenings

Future of Telehealth
Interestingly, respondents had mixed views on whether  telehealth would be a long lasting change that would come out of the pandemic.

Reasons cited include:

  • in person interactions cited as better for providing care
  • patient discomfort in using technology
  • lower reimbursement rates
  • provider discomfort in using technology
  • HIPPA concerns
  • unreliable technology
  • challenges of training staff in a new platform
  • cost of maintaining technology

Areas of Need and Support 
Home care organizations reported lower levels of access to resources such as:

  • information on adequate testing capacity for COVID
  • environment of care and life safety code guidelines
  • tools/communications to reduce anxiety/fear among staff/patients
  • personal/staff mental health, counseling and/or self-care services

Home care staff in particular reported seeking additional support in:

  • outbreak monitoring and local resources
  • information/guidance on choosing the best supplies
  • database of PPE suppliers/supplies
  • performance/process improvement tools and training
  • information on proper PPE use and/or compliance

As more vaccines roll out, we’re encouraged at moving into the recovery stage of the pandemic. The Joint Commission can provide resources in emergency management, environment of care, process improvement and much more. Accredited organizations are encouraged to contact their designated account representatives. More information on home care accreditation and certification options is available here  and our COVID-19 resources here.

Gary Bachrach is Director, Business Development, Home Care Accreditation at The Joint Commission.