Blog Takeover: My Family Hosted a Legislative Home Visit ─ You Should Too.

My name is Lisa Letterman and my son John was in a severe car accident in 2020, which left him paralyzed from the neck down, unable to walk, talk, or breathe on his own. As he was preparing to be discharged from the hospital, I unfortunately was not aware of any other long-term care option other than a nursing facility, so I made the difficult decision to send him to a facility in Virginia. But after a short time, it was clear that John’s health and quality of life were deteriorating, so I started researching other care options until I found home care.

After a long and stressful separation, John was finally able to return home to receive in-home care under North Carolina’s Private Duty Nursing (PDN) services. Since returning home with one-on-one nursing care, his condition has improved immensely. He no longer requires a feeding tube, he is now able to talk on his own and is even slowly making progress in regaining movement. However, there is a new hurdle that we face: trying to find enough nursing coverage for John. There is a critical nursing shortage that leaves families like mine struggling to care for our loved ones on our own, putting us in a constant state of exhaustion and concern when we can’t get coverage. I knew that something must be done to fix this shortage, so I started to advocate.

Our experience with a legislative home visit:

Recently, John and I invited our North Carolina Representative, Dudley Greene into our home (virtually), to show the importance of in-home nursing services and to advocate for better access-to-care. At first, I wasn’t sure what to expect from the virtual visit, but I can tell you it was an incredible experience that I believe other home care families should consider when wanting to advocate and make a difference.

Before the visit, BAYADA client services manager, Rachel Miller, handled the logistics. Once we agreed to opening our home, she handled everything from scheduling, practicing our call, and keeping us updated. When the 30-minute meeting began, it was like Rep. Greene was sitting in our home having a conversation with us. He could see all of John’s machines, medical routine, and he listened to the challenges we face. It was clear by the look on Rep. Greene’s face that he was truly understanding our situation in a way that no letter, email, or phone call could describe. We had his undivided attention for 30 minutes and in that time, we showed him the power of home care. After the visit was over, both John and I were impressed with how easy and rewarding the process was.

Top Left to Right: BAYADA CSM, Rachel Miller; BAYADA Government Affairs Manager, Cai Yoke; BAYADA Director, Kristen Church
Bottom Left to Right: North Carolina State Rep. Dudley Greene, BAYADA client & NC resident, John Letterman during the virtual home visit.

Why I advocate:

I advocate for home care because I can’t image what it would feel like to go through what John, and others like him, have had to experience and not have anyone around to speak up on your behalf.  I have seen John in every stage of his recovery: in the hospital, nursing home and then at home. It is because of PDN that John is thriving and living the quality of life he deserves. I want other families to have access to this same high quality, in-home care, but without better state-funding, that won’t be possible.

John Letterman with BAYADA nurse.

Why YOU should participate in a home visit:

Legislators like Rep. Greene determine the budget and funding for these types of programs, so we must do our part to educate them as best we can. I believe that legislators want to make a difference in their communities and help their constituents, but most are not aware these issues even exist. The more that decision-makers understand of the benefits of in-home care, the more advocates we have supporting our cause. Whether it’s a virtual or in-person home visit, these types of interactions with legislators give them a glimpse inside our challenging environment and help them understand the importance of in-home care ─ something that an email, letter, or phone call could never convey.

Advocacy Matters!

Despite the fact that many people in government and regulatory positions agree that home health care is a cost-effective, patient-preferred solution, it continues to be prioritized below institutional care. Not investing in home care will decrease the supply of qualified workers, increase turnover, and compromise the quality of home care services. At Hearts for Home Care, we help those that care about home care by enabling YOU to get involved at the capacity in which you’re able to do so.

Email us at advocacy@bayada.com or visit our website  in order to learn more about the home care advocacy community and find opportunities to get involved.

Patient Recognition Week: Celebrating Patients Who Live Their Life to the Fullest Thanks to Home Care

For thousands of Americans across the country, home care allows them to be contributing members of society, giving them the freedom and independence to live life to the very fullest despite their diagnoses. During National Patient Recognition Week, Hearts for Home Care celebrates some of these unique and inspiring patients who are foraging their own path and letting nothing slow them down. These individuals are proof that quality, in-home care, can truly change someone’s life for the better.

La Mondre Torohn Pough

La Mondre Torohn Pough, South Carolina.

LaMondre Torohn Pough not only lives his life in his community, independently, but is also contributing member of society. Thanks to the support of home health aides who care for him and keep him safe at home, LaMondre has become a highly successful businessman, owning his own podcast, 5P with LaMondre, and company that focuses on inspirational speaking, entrepreneurship, and consulting. If it weren’t for his in-home caregivers, LaMondre would need to be cared for in a long-term care facility instead of thriving at home.

In return, LaMondre is a passionate advocate for the healthcare heroes who care for him along with other people with disabilities. He says: “Caregivers contribute so much to the community of people with disabilities and society as a whole. Effective advocacy is essential to ensure that we create an equitable and sustainable future. We are in this together.”

John Letterman

John Letterman with his home care nurse, North Carolina.

After a severe car accident in 2020, North Carolina resident, John Letterman was left paralyzed from the neck down, unable to walk, talk, or breathe on his own. Unfortunately, as he was preparing to be discharged from the hospital, John’s family were not told they had the option of bringing John home under Private Duty Nursing (PDN) care. Knowing no other option, they placed him in a nursing facility where his health deteriorated.

After a long and stressful separation from his family, John was finally able to return home to receive PDN services in his home. Since returning home with one-on-one nursing care, his condition has improved immensely, no longer requiring a feeding tube, able to talk on his own, and slowly making progress in regaining movement. Thanks to this quality, in-home care, John recently invited Representative Greene into his home (virtually), to show the importance of the care he receives and advocate for better access to care. John said that it’s important that decision-makers understand the impact of home care, espeically if they are the ones passing the budget and determining funding. “We need more people educated about home care so they can be advocates for us too,” he said.

Erin Hamby

Erin is 20 years old and relies on highly skilled nurses to care for her complex medical needs in the comfort of her home. If it weren’t for access to home care, Erin would unfortunately be in a skilled nursing facility, separated from her family and friends and without the personalized care she receives at home. However, thanks to in-home care, she has not let her diagnosis slow her down! With the support and care from her in-home nursing team, Erin has been attending college at Caldwell Early College and most recently, she was accepted at N.C. State, which she will be attending virtually in the fall!

Erin Hamby, North Carolina.

Erin’s father says that home nursing is crucial to Erin’s quality of life: “It allows her to be home and not in a facility. Her nurses have become her friends and they are invaluable to us as a family in managing her medical needs, equipment, and prescriptions. I don’t know how we would manage without these nurses, to be perfectly honest.”

Advocacy Matters!

Despite the fact that many people in government and regulatory positions agree that home health care is a cost-effective, patient-preferred solution, it continues to be prioritized below institutional care. Not investing in home care will decrease the supply of qualified workers, increase turnover, and compromise the quality of home care services. At Hearts for Home Care, we help those that care about home care by enabling YOU to get involved at the capacity in which you’re able to do so.

Email us at advocacy@bayada.com or visit our website  in order to learn more about the home care advocacy community and find opportunities to get involved.

North Carolina State Representative Zack Hawkins Experiences a Day in the Life of a Durham Veteran Receiving Support at Home

NC state representative Zack Hawkins (left) meets home care client Mr. Mendenhall (seated) and his wife

State Representative Zack Hawkins, an active supporter of home health care, recently visited with a Durham family who rely on services to stay safe at home.

Representative Hawkins visited with a constituent, Mr. Aubrey Mendenhall, an armed service Veteran with a wonderful sense of humor. As a young US Sargent in Germany, he saw the prettiest lady working at the base general PX store…and spent the next thirty days asking her out. Margarete finally agreed and they’ve been together for more than 65 years.

Some five years ago, Mr. Mendenhall was diagnosed with Dementia – a condition characterized by a decline in memory, language, problem-solving and other thinking skills that affect a person’s ability to perform everyday activities. His dementia makes it difficult for him to manage without constant supervision and puts him at a high risk of falling. A certified nursing assistant (CNA) comes to help him bathe, toilet, and dress. “The aide’s goal is to help Mr. Mendenhall stay as independent as possible. Make sure he doesn’t fall or get an infection that can put him in the hospital,” said BAYADA Home Health Care Clinical Manager Megan Russell, RN.  

The Department of Veterans Affairs covers 11 hours of aide services per week. Outside those 11 hours, Margarete is his constant companion and support. She uses the 1 ½ – 2 hour breaks she receives each day to perform other necessary tasks such as running to the grocery store, to a doctor’s appointment, or to simply have an uninterrupted cup of tea. It is her only break from caregiving. At 90 years old, dealing with her own health issues, and after five years of serving as Mr. Mendenhall’s primary caregiver, Margarete finds herself exhausted!

With tears in her eyes, their only daughter, Kathy, commented that she is considering quitting her job as a nurse and move in with her parents so that she can better manage their care. While carrying for a loved one with a chronic illness can be profoundly meaningful, it can also be overwhelming as the physical, emotional, financial tolls compound on the family caregivers.  

“Having personally been touched with seeing my mother and aunt provide care to my grandmother, I understand how important it is to be able to take care of one’s family,” said Representative Hawkins. “And as a lawmaker, we need to support seniors and their families. To ensure they can live a full life at home. Care at home is an important option, less expensive, and where people want to be.” 

According to AARP’s online article, Caregiver Burnout, “over time, that physical and psychological wear and tear can lead to caregiver burnout – a condition of feeling exhausted, listless and unable to cope.”  Russell has reached out to the VA case manager to explore respite care which would allow for the family some much needed breaks. The Mendenhalls want to stay together, however, they need some additional support to effectively care for themselves while maintaining their responsibility to their loved one.

“In-home care programs provide one-on-one care by licensed nurses or certified nursing assistants under the care of a physician,” said BAYADA Area Director Lee Dobson.  “They allow families to stay together and be safe at home. It really gives the state more for less and is clearly part of the health care budget solution.”

Client Spotlight: BAYADA NJ Client Jim Davies Turns Home Visit into an Opportunity to Fight for Nursing Coverage

BAYADA client Jim Davies (center, seated) hosted a home visit with Assemblyman Benson (upper left)

When BAYADA Home Health Care client Jim Davies received a notice in the mail last year that his insurance would be transitioning to another agency, he tried not to panic. After all, the letter stated there would be no change, he would still receive coverage for his home health care nursing and personal care home health aide services.

However, Jim was not convinced. The 66-year-old, who suffered a spinal cord injury as a result of a diving accident 20 years ago, is nearly paralyzed from the neck down. He relies on his nurses for his complex medical needs, which include wound care, range of motion exercises, mechanical transfers to and from bed, medication administration, catheter care, and care to prevent a serious complication called autonomic dysreflexia, which can lead to seizures, stroke, or even death.   

As a former sheriff and local fire commissioner, Jim is used to working collaboratively with others to make things happen. That’s why he immediately called a case manager at the insurance company, who reiterated what was explained in the letter, his home health care coverage would not change.

Coverage denied

Fast forward to the end of the year when Jim received another letter, this time from the new insurance company. Despite written and verbal assurance that his coverage would not change, the new company denied his home health care services, insisting Jim was stable enough and no longer needed nursing care.

Jim reached out to his BAYADA Mercer County Adults (MCA) office Director Meghan Hansen and Clinical Manager Sharon Wheelock who appealed the decision on his behalf, to no avail. That’s when they turned to BAYADA Government Affairs Area Director Louise Lindenmeier, who suggested Jim reach out to New Jersey Assemblyman Daniel Benson, a member of the state Health and Senior Services Committee.

Legislative home visit leads to positive change

“When I called Assemblyman Benson’s office, I wasn’t sure what the response was going to be, but I was pleasantly surprised,” says Jim. “The assemblyman made me feel that as his constituent, my problem was a major concern, and he owned it.”

Assemblyman Benson visited Jim and his wife of 40 years Rosemary at their home to witness, first-hand, the critical role home care nurses play in Jim’s health and well-being. During the visit, Assemblyman Benson also learned about the catastrophic medical consequences of stopping Jim’s nursing care and BAYADA’s unsuccessful efforts to appeal the denial from the insurance company.

Following the visit with Jim, Assemblyman Benson jumped into action. He joined BAYADA Managed Care (MCO) Director Pamela Soni, BAYADA Area Director for Pediatrics Managed Care (MCP) Stephanie Perna, and Louise for a meeting with the NJ Department of Banking and Insurance to discuss Jim’s case. In addition, he personally contacted the insurance company to negotiate the contract, resulting in a reversal of the denial. Thanks to his efforts, the issue was resolved within two weeks.

“It is really important to educate politicians on how insurance changes can impact their constituents,” says Jim, who encourages others in similar situations to reach out to legislators who may be more than willing to help. “Assemblyman Benson should be recognized for his prompt and professional response to my needs.”

Assemblyman Benson considered it a privilege to play a role in helping Jim. “It was my honor to work with Mr. Davies to ensure that he received the care he needs and deserves,” he says. “As legislators, it is our sworn duty to represent our constituents, and that means lending our assistance whenever possible, whether by simply cutting through red tape or elevating a situation to a higher level so that it is promptly addressed. I would encourage those in need to reach out to their elected representatives to learn what they can do for them.”

Want to Help Make a Difference: Register for Hearts for Home Care

Whether you can give a minute, an hour, or a day, there are many ways to get involved in advocacy. It can be as simple as sending a pre-written email to your local legislators, hosting a legislator in your home, or attending an event at a legislator’s office or your state capitol.To learn more, consider becoming a “Heart for Home Care” advocate. It only takes five minutes to register at heartsforhomecare.com. You’ll receive email updates about current issues and opportunities to make your voice heart.

GAO Federal: Advocacy Spares BAYADA’s Home Health Practice $11 million Annually

GAO’s 2019 Federal Affairs Team with Senator Tom Carper (D-DE)
  • BAYADA GAO’s federal affairs team supported both the Partnership for Quality Home Healthcare (PQHH) and the National Association for Home Care and Hospice (NAHC) in lobbying both Congress and the Centers for Medicare and Medicaid Services (CMS) to reduce the reimbursement cut mandated by the Patient Driven Groupings Model (PDGM) from 8.36% to 4.06%.  This reduction in the rate cut, effective January 1, 2020, saves BAYADA more than $11 million in annual gross revenues.  While the industry was successful in having the reimbursement cut reduced by more than 50%, it still faces further cuts based on behavioral assumptions.  This partnership of BAYADA and national associations will continue into 2020 with the goal to eliminate any further cuts made based on assumed behaviors and limiting future reimbursement cuts and increases to 2%.  
  • BAYADA led the Partnership for Quality Home Health’s (PQHH) first annual Home Visit Program by providing specific guidelines so that the industry continues to be consistent in its efforts to educate legislators on the value of home health.  Each quarter BAYADA was represented in several tactics (office visits locally or in Washington D.C., action alerts, town halls, comment submissions) that essentially led to the reduced reimbursement cut, and led a federal home visit in Florida with Congressman Vern Buchanan (R-FL). BAYADA continues to be recognized for our grassroots efforts on a national level within the industry.
  • GAO, along with the Hospice Action Network (HAN), lobbied MedPAC and successfully reversed MedPAC’s recommendation to cut hospice reimbursement in 2020 by 2%, saving BAYADA a potential revenue loss of nearly $1.5 million in 2020.

NC: SHE, GAS, and RAN Offices Demonstrate Advocacy by Building Relationships and Sharing Clients’ Stories


Sen. Alexander (back left) visits BAYADA client Rusty (front left) and his nurse, Vikki (front right) with BAYADA staff Cheryl, Jillian, and Rusty’s mother (back right).

GAO can’t do it alone, and in North Carolina we are proud to have so many employees that understand the impact of sharing their voice on behalf of all our staff and clients!

SHE and GAS Host Impactful Home Visit

Last month two offices, SHE and GAS, teamed up to host a home visit with newly elected Senator Ted Alexander. Our BAYADA team of advocates, including MIM Division Director Joe Seidel, GAS Clinical Associate Cheryl Reading and GAS Client Services Manager Jillian Fernald, as well as the client’s long-time nurse Vikki, spoke passionately about our services and the challenges we face in care delivery.

The visit was a grand success! The importance of home care and the work you do every day was certainly not lost on Sen. Alexander, whose wife and daughter are both nurses: “Our goal,” he explained, “is to keep families where they belong, together and at home.” These types of interactions lay the foundation for support of our legislative asks because the decision-makers see first-hand the impact home care has on families.

RAN Builds Relationships in a Different Way


BAYADA Ribbon Cutting Ceremony with Senator Wiley Nickel

Last month, the RAN office hosted a ribbon cutting ceremony to commemorate the grand opening of our new state-of-the-art simulation lab and training center. This was no regular ribbon cutting ceremony where the office invited current and prospective nurses to tour and see-in-action the simulation lab. We took the opportunity to educate lawmakers on the scope and breadth of what is possible in the home by inviting Senator Wiley Nickel to welcome the group. We also included Ed Troha, Vice President for the NC Chamber, who has four nurses in his family, to speak about the importance of the training center in job creation.

Additionally, former Senior Chairman for House Appropriations Nelson Dollar issued a proclamation to show his strong and constant support for home care. This center allows BAYADA to train nurses using real life scenarios that helps develop confidence, competence, and builds career-building skills to home health care nurse. Increasing awareness among legislators and other community leaders on the benefits of home care helps garner support as we work toward our legislative goals. 

Thank you to the many North Carolina staff and families that regularly share their voices in advocacy! To find out how you can get more involved, contact GAO Director Lee Dobson today!

South Carolina Representative Garry Smith Visits Local Family to Learn How Home Care Impacts his Constituents

Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).
Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).

 

South Carolina State Representative Garry Smith (R, District 27) visited a local family in his district to learn how his constituents and many South Carolinian families rely on home care to keep their loved ones together at home and out of more expensive settings. Rep. Smith is one of the many legislators that Hearts for Home Care advocates bring into home care clients’ homes to show them how federal, state, and local policies affect home care recipients and their families.

During his visit, Rep. Smith met 21-month old BAYADA Home Health Care client Emma Ferguson, Emma’s mother Gina, and Emma’s in-home BAYADA Nurse Danielle Rian. Emma was born with a Chronic Lung Disease of Prematurity, which causes Emma to experience severe breathing problems, pain, and other symptoms. At her young age, Emma has already had several surgeries and currently still requires use of a Gastrostomy-Jejunostomy (G-J) Tube to assist with her feedings and medication management throughout the day. At birth, state Medicaid authorized Emma to receive private duty nursing (PDN) services in her home so that Emma can remain safely and comfortably at home with her mother.

In March, Emma’s PDN services were terminated when Medicaid determined that her skill level no longer qualified her to receive care in her home. From March until May, Emma attended a local day care facility for children with complex needs so that her mother could continue to work. During this time, Emma was hospitalized on several occasions and required ventilator support due to respiratory illness. In May 2018, Emma’s mother Gina reapplied for PDN services, and Emma was able to start receiving care at home again. Emma currently receives 32 hours of PDN services in her home, and since the reauthorization, she has not been readmitted to the hospital.

Emma’s mother Gina stated, “I’m grateful Rep. Smith was able to visit our home to see how Emma and other medically-complex children can grow up and thrive with in-home nursing. These kids deserve some normalcy in their lives, and I have seen first-hand how much better she does when she can be with me at home rather than in an institution. She only receives 32 hours a week, and this allows her to receive the care she needs in the best place–her home–and allows me to be able to work to support my family.”

After the home visit, Rep. Smith said, “visiting sweet Emma and her family has opened my eyes to what home care means to my constituents and to the many South Carolinians who depend on Medicaid home care to stay with their families and out of higher-cost settings. I look forward to exploring ways we can help keep families together while at the same time effectively managing the state’s budget.”

“One-on-one nursing services have allowed Emma to remain safely at home under the Medically Fragile Children’s Medicaid Nursing Waiver. This program is an alternative to nursing home placement at a lower cost to the state,” said Melissa Allman, Hearts for Home Care advocate and Director of Government Affairs for BAYADA. “In-home nursing care helps minimize deterioration and can prevent costly hospitalizations as staff can address subtle changes in the medical condition before it becomes serious. I hope that more legislators continue to learn about how cost-effective these services are to the state, and how valuable they are in keeping South Carolinian families together.”

Home visits like this one really give elected officials a better understanding of how their decisions on key issues like Medicaid impact real people who are seeking to remain safely at home with their families. To find out ways in which you can participate in a home visit with a local legislator, or other ways you can advocate, email advocacy@bayada.com.

Assemblywoman Speight Meets ESS Client on Home Visit

Assemblywoman Shanique Speight is new to the state legislature, which makes it all the more important to introduce her to home care right away.

Essex County State Assistive Care (ESS) Director Lisa Minnella and her Clinical Manager Bonnie Caterson arranged for the assemblywoman to meet one of their special clients, 92-year-old Ms. Tisdale. Ms. Tisdale lives in Assemblywoman Speight’s district and has no family in the area. She needs certified home health aide (CHHA) services to assist her with the tasks she cannot do and help her be as independent as she can be in her own home.

The assemblywoman was very happy to meet Ms. Tisdale and spend time learning more about how home care services benefit her constituents and keep so many seniors in their homes.

Picture: ESS Director Lisa Minnella and Assemblywoman Speight with Ms. Tisdale

PA Client Visit to Discuss BAYADA’s Advocacy Program

Submitted by Rick Hynick, Director, Client and Family Advocacy (GAO)

 On Friday, October 20, Chief Government Affairs Officer Dave Totaro and I met with adult Home Health Aide client, William Bezdziecki at his home near Wilkes Barre to discuss the BAYADA Hearts for Home Care program and different client advocacy opportunities.  Also, present at the meeting were William’s parents, Jack and Mary Lou Bezdziecki, Wilkes-Barre/Scranton (WBS) Clinical Manager Susan Youells, WBS CSM Kristie Spinello and Certified Nursing Assistant Gerald Stevenson.

NJ Client & Family Advocacy Manager Shares Her Own Client Experience During Recent Home Visit

Submitted by Tara Montague, Manager, Client and Family Advocacy, NJ (GAO)

I had the pleasure of hosting Carol Murphy, Assembly candidate in Legislative District 7, for a home visit to meet my daughter Mary.  As a 20 year long client of Mt. Laurel Pediatrics (MLP), Mary is the epitome of what home care can help families to achieve and we wanted Ms. Murphy to experience that first-hand.  Clinical Manager Chantel Denny and Administrative Coordinator Brooke Fitzpatrick discussed some of the challenging staffing issues that occur due to low reimbursement rates and difficulty attracting qualified nurses.  Registered Nurse Stacey Sutton shared some of the varied tasks that she performs in order to keep Mary healthy and safe at home and at school.  Ms. Murphy made a commitment, if elected to work with us to make home health care nursing a more attractive career option in the state.

Photo: Tara Montague, Client Mary, Carol Murphy