By Stephen Smoot
As American youth grew more mobile and parents had fewer children between World War II and the end of the 20th century, the support systems for many aging individuals dwindled. Fewer family members and friends could help when their loved ones faced the challenges of old age.
Additionally starting in the 1920s, increased attention to personal hygiene, lifelong good nutritional practices, and improved health care meant that many lived longer lives. This meant that dramatic end of life events took fewer people, but those who lived longer sometimes experienced chronic conditions that slowly sapped at their vitality and quality of life.
The Greatest Generation, those who grew up in the privation of the Great Depression, then fought National Socialism in Europe, militarism in the Pacific, and Communism in Korea, needed more help as they reached their senior years. In 1978, Pendleton Manor launched its Home Health program to meet the needs of seniors who needed extra help and regular attention to keep living as they wished, independently.
A single registered nurse, Ruth Hott, took up the duty of helping Pendleton County seniors, joined shortly after by Eleanor Rexrode, RN.
“In the end home care was included in the Medicare, Medicaid, and the Older Americans Act initiated in the 1960s,” shared an article on the University of Pennsylvania’s nursing school website. It added that “it was home care’s presumed ability to empty hospital beds that resulted in its inclusion in the Medicare program.”
At the start, “care covered by Medicare was limited to medically necessary, intermittent skilled care for the homebound acutely ill following hospitalization. It was not designed to reduce the growing burden of chronic disabling illness.” As Americans continued to live longer, however, the mission of home health in some cases expanded to providing assistance to those battling such conditions.
Assistance to seniors still living at home came from the start in the form of skilled nursing and rehabilitation services. For many years, Dr. H. Luke Eye, a graduate of Franklin High School, West Virginia University, and the University of Maryland, and “beloved country doc” served as medical director of both the residential facility and home health.
The Navy veteran also served as president of the Pendleton Manor building fund, helped to found the Potomac Highlands Recreation Center, led the rebuilding of Thorn Spring Park in addition to a number of other endeavors that earned him a Pendleton County Farm Bureau Lifetime Community Service Award.
One can be sure that the standards of care and compassion established from the start and nurtured by Eye remain in place as Pendleton Manor Home Health tackles the work of helping seniors remain home as long as they can.
During the past three decades, Vickie Bennett and her dedicated colleagues have upheld that standard through changes ranging from the needs of patients through differences in society over time, to the always difficult and shifting requirements from the state and federal governments.
“We travel all over Pendleton County,” noted Bennett. She shared that they work with clients who are recovering from joint replacements, patients who need IVs, and other problems. “Medication education is a big need,” she shared, adding that “we do some wound care” but specialty clinics handle more of those cases now.
Bennett explained that practices in the insurance industry bring challenges to providing home health services, saying, “These companies are always trying new things.”
One of the innovations that has caused home health care establishments independent of hospital ownership headaches lies in how they bill. Bennett shared that insurance companies formerly reimbursed per visit. Now they estimate out a lump sum to pay out and expect home health services to work within the previously established amount.
It operates in some ways similar to the school aid funding formula that pays Pendleton County Schools a lump sum per year for different categories of personnel. It funds what the state thinks is needed, but PCS has the flexibility to employ under that amount. Likewise, home health can earn more in this system by keeping costs under.
Additionally, the sum does not go directly to home health but to the hospital that contracted them. Bennett explained that good outcomes usually allowed home health to get compensated. Bad outcomes, however, incur additional costs and could put home health in a situation where it has to pay the hospital. That happens when costs go above the preapproved lump sum.
Additionally, “a big obstacle for us,” says Bennett, is that hospital service expansions have included providing home health. She speculates that “they want to keep that money in house.”
Challenges pale in comparison to the wages of joy paid by compassionate care.
“I’ve been here for 30 years and I’ve always had really great people,” said Bennett. One of those long tenured “really great people” is Diana Botkin.
“They have a lot of stories to tell,” shared Botkin, who added that “you learn a lot of valuable information.” She talked of clients who had lived in Pendleton County for many decades. Stories of times past, Botkin stated she always enjoys.
“Some aren’t from around here,” said Botkin, who told of a military veteran who shared tales of serving at bases as far away as Alaska.
“They give a lot of wisdom if people listen,” she added.
