HME providers shift business models, face challenges

YARMOUTH, Maine - With respiratory equipment back-ordered, PPE in short supply, and employees practicing social distancing from each other and patients, HME providers say it's anything but business as usual as they gear up to backstop hospitals during the coronavirus pandemic.

Provider Irene Magee was readying last week in preparation for an expected surge of non-COVID-19 patients from area hospitals. The Green Island, N.Y.-based Northeast Home Medical Equipment is part of hospital system and serves three acute care facilities, a rehab hospital and 300 medical associates in physicians' offices.

“We're trying to work with the hospitals to help them get out all the patients they can ahead of time,” said Magee, vice president and director of the company, which is about 200 miles from New York City, a hotspot with nearly half the country's coronavirus cases, according to news reports.

Although Northeast was proactive and ordered equipment and supplies ahead of time, it hasn't been enough, Magee said.

“Concentrators are on back order, everything is coming in slower,” she said. “PPE—that's right up there, and the whole health system is concerned. Who would have thought you'd have to tell an employee to use a mask between patients?”

It's much the same in Georgia's rural Dougherty County, which has seen 123 cases, says Tyler Riddle, president of MRS Homecare, which has 11 locations throughout the state. With the supply chain already stressed, he's doing what he can.

“We are going to run out of oxygen concentrators in the next couple of weeks,” he said. “We are making repairs and refurbishing ones in the warehouse. I'm robbing from Peter to pay Paul, pulling from my locations.”

Riddle expects the rest of the state to catch up to the Albany area in two to three weeks in terms of COVID-19 cases.

“What happens when the other dominoes fall?” he said.

One thing Riddle can try and control: spreading the infection. He's closed all of his showrooms, moving to curbside delivery and set ups, and screening employees daily.

“We are taking seriously the slowing of the spread of this, while trying to stay open,” he said.

Curbside services and other distancing methods won't work for Pediatric Home Service, which provides respiratory and nutritional services to medically fragile children in their homes.

“We have very important challenges in how do we ensure the health and safety of kids and families and our employees, following all of the everyday practices of social distancing and washing hands well,” said CEO Cameo Zehnder. “We're working at a very quick clip right now, working with hospitals and planners to get kids that don't need to be in the hospital at home.”

Like other providers, PHS has implemented measures that include having employees work from home where possible and distancing staff from one another, says Zehnder. A task force, initiated in February, helps keep everyone up-to-date in a constantly evolving situation.

“We're re-evaluating on a moment-to-moment basis,” she said.

Daily communication is also key for Bedard Pharmacy and Medical Supply in Lewiston, Maine, says Sean Andrews, director of financial operations.

“There's a fear among front-line staff, especially delivery drivers, that they could be in contact with the virus,” he said. “As far as PPE, we do have some, but not enough, obviously. If our drivers have to go into a home, what we are doing is making them wear masks and gloves, and asking that residents be in a different room.”

Bedard Pharmacy, which serves a rural area, is fielding lots of calls from anxious customers, says Andrews.

“Mostly, people are scared there's going to be shortages on prescriptions and HME so we have patients calling in to get orders early or get more supplies than usual,” he said.