Written by The Business Journal Staff
Devin S. Nugent, Chief Executive Officer
What we do: Medicare certified home health agency providing skilled nursing and therapy services to homebound patients
Education: B.S., Business Administration
Family: Wife, Nikki
Children; Kinsley (2), Presley (1) and Ryker (1)
How did you come to position with HealthCare California, Devin?
After graduating from Fresno State, I took a job with the U.S. Small Business Administration in Sacramento as a loan officer in its disaster loan program. From there, I landed a job at Oracle Corporation in the Bay Area managing all of the company’s real estate lease compliance for 100-plus offices throughout the United States. After two years, I was offered a similar position with Longs Drug Stores at its corporate headquarters just across the Bay in Walnut Creek. I was with Longs for 10 years where my responsibilities grew to directing the group that managed over 500 Longs stores and other properties. My group was responsible for all real estate lease compliance and financial payments totaling over $100 million a year.
How many home care professionals work with the company, Devin?
We employ approximately 65 people with roughly three-fourths of those being clinicians who work in the field providing care to patients in their homes. Our services include nursing, physical/occupational/speech therapy, certified home health aides and medical social workers. We are unique in that we cover an expansive geography from Porterville north to Atwater and west from Los Banos through Mendota/Firebaugh and Kerman east to Coarsegold.
HealthCare California has often been recognized for low hospital readmission rates. What do you attribute that to, Devin?
We have been specifically recognized and awarded by Medicare for our outstanding results in keeping patients from returning to the hospitals. This is a major focus of hospitals, which are increasingly facing penalties for readmissions. In 2015, skilled nursing facilities will be facing more of these penalties. I attribute our success to programs in place that focus our attention on higher risk patients. This includes rigorous oversight and action in response to any early indicators our clinicians observe that may increase the chance of a return trip to the hospital. They work hard to ensure medication education and regime compliance, the thorough training of the patient’s regular caregivers (family members, friends) and the ability to quickly modify a care plan in response to changing conditions.
Medicare reimbursement is expected to drop for home health providers in the coming years. How will this affect you, Devin?
Medicare has continued to cut home health reimbursement rates each year I have been with the company. This remains a challenge in our industry. On the one hand, Medicare recognizes the benefits of home health and the cost savings we achieve over other types of care, especially hospitalizations. On the other hand, Medicare is trying to save money anywhere it can in response the increasing costs of covering more people, especially as our baby boomers age. We must adapt to these cuts by becoming as efficient as possible and finding ways to cut costs where we can without sacrificing our outstanding level of care.
How do home health providers like HealthCare California help to keep overall health care costs and insurance rates down, Devin?
With an average daily cost that is less than 10% of a hospital stay, the financial benefits of home health are very apparent. Further, studies show patients thrive within their home environment. Fortunately, Medicare, although continuing a pattern of reimbursement cuts, still understands this and reimburses home health providers an amount adequate to enable home health providers to sustain operations. We remain challenged on the commercial payer side where it is not uncommon to receive reimbursement at a level that does not even cover our operating costs. It is our hope that commercial payers will come to realize the valuable role home health care plays in curbing the ever increasing costs our seniors face towards the end of their lives.
How quickly are electronic medical records catching on and when did HealthCare California begin the transition, Devin?
Electronic health records [EHR] are becoming the rule, rather than the exception, in our industry. Fortunately, HealthCare California was quick to respond to this change having implemented an EHR system over five years ago. In fact, we were the first home health agency in the Central Valley to integrate on a web-based platform. We are now able to see in real-time the care being provided in the home enabling us to be more responsive to our patients changing conditions and, ultimately, enable us to provide the best care possible.
What was your first job and what did you learn from it, Devin?
My first job was irrigating my grandparents’ 20-acre almond farm in Winton at the age of 15. I would get up at 5 a.m. and manually drain and transfer the irrigation pipes to each new row of almond trees. It was hard, but rewarding work. I remember recording my hours in a time sheet and the excitement of receiving each paycheck for an honest day’s work.
What are your roots in the San Joaquin Valley, Devin?
I was born and raised in Atwater. My parents were both teachers and instilled in me a love of learning and the values of working hard, taking my education seriously and always setting my goals high with an end towards achieving them.
What do you like to do in your spare time, Devin?
With three children two and under, spare time is a commodity. I enjoy spending time with them and being there for each new stage they reach. My wife and I try to enjoy a date night every now and again; whenever we can find a babysitter!