rehabilitation hospitals. Services may be provided in lieu of, or to delay the need
for, hospitalization. Our home health services are provided on an intermittent basis to patients who are unable to leave their homes without considerable effort, including the homebound elderly and adult infirm.
Our home health services are provided by nurses, physical, occupational
and speech therapists, medical social workers and home health aides. Specifically, our registered and licensed practical and vocational nurses provide a variety of medically necessary services to homebound patients who are suffering from acute or
chronic illness, recovering from injury or surgery, or who otherwise require care or monitoring. These services include patient education, pain management, wound care and dressing changes, cardiac rehabilitation, infusion therapy, pharmaceutical
administration, and skilled observation and assessment. We also have designed best practices to treat chronic diseases and conditions, including diabetes, hypertension, arthritis, Alzheimer’s disease, low vision, spinal stenosis, Parkinson’s
disease, osteoporosis, complex wound care and chronic pain, along with disease-specific plans for patients with diabetes, congestive heart failure, post-orthopedic surgery or injury and respiratory diseases. Through our medical social workers, we
counsel patients and their families with regard to financial, personal, and social concerns that arise from a patient’s health-related problems.
Our physical, occupational and speech therapists provide therapy
services to patients in their homes. Our therapists coordinate multi -disciplinary treatment plans with physicians, nurses and social workers to restore patients’ basic mobility skills, such as getting out of bed, walking safely with crutches or
a walker, and restoring range of motion to specific joints; our therapists also assist patients and their families with improving and maintaining functional activities of daily living, such as dressing, cooking, cleaning, and managing other
activities safely in the home environment. Our speech and language therapists provide corrective and rehabilitative treatment to patients who suffer from physical or cognitive deficits or disorders that create difficulty with verbal communication
or swallowing.
Hospice
Our hospice business is one of the nation’s largest providers of
Medicare-certified hospice services in terms of Medicare revenues. For the twelve months ended December 31, 2021, our hospice services had an average daily census of 3,762 hospice patients. As of March 31, 2022, we operate 99 hospice agencies in
22 states, with a concentration in the Southern United States.
We primarily provide hospice services in a patient’s home but may also
provide them in a nursing home, assisted living facility, or other patient care facility. In 2021, approximately 88% of our hospice patient admissions were from a community residential setting, approximately 3% were from an acute care hospital,
and approximately 9% were from a long-term care facility, skilled nursing facility, or other institutional setting.
Individuals with a terminal illness, such as cancer, heart disease,
pulmonary disease or Alzheimer’s, may be eligible for hospice care if they have a life expectancy of six months or less. Our Medicare-certified hospice operations provide a full range of hospice services, including pain and symptom management,
palliative and dietary counseling, social worker visits, spiritual counseling, and bereavement counseling for up to 13 months after a patient’s death, all of which are designed to meet the individual physical, emotional, spiritual, and
psychosocial needs of terminally ill patients and their families.
Operations
We operate our business in two segments—home health and hospice. Each
of our home health and hospice agencies are staffed with clinical and administrative professionals who are experienced in providing a wide range of patient care services. Each of our home health agencies and hospice agencies are licensed and
certified by the state and federal governments. Our operations consist of three core areas—field- and branch-level operations, sales team operations, and corporate support operations. We believe separating responsibilities among these categories
allows our clinical and administrative professionals to focus on patient care, while enabling our sales team to focus on referral development.
Our branches are managed locally by branch directors who oversee branch
clinical and office teams. Branch directors report to an administrator or regional director who oversees one or more branches. Our field-level operations use branch operating metrics provided by Homecare Homebase to monitor performance and
quality, monitoring, among other things, volumes, clinician productivity and efficiency and cost per visit.
Our sales team operations are staffed and managed as a standalone
group, discussed in “—Sales and Marketing” below.