LHC Group, Inc. provides post-acute health care services to its patients.
As of December 31, 2022, the company had 920 service providers in 37 states within the continental United States and the District of Columbia. The company’s services are classified into five segments: home health services, hospice services, home and community-based services, facility-based services, primarily offered through its long-term acute care hospitals (LTACHs), and (5) healthcare innovations (HCI).
The company’s...
LHC Group, Inc. provides post-acute health care services to its patients.
As of December 31, 2022, the company had 920 service providers in 37 states within the continental United States and the District of Columbia. The company’s services are classified into five segments: home health services, hospice services, home and community-based services, facility-based services, primarily offered through its long-term acute care hospitals (LTACHs), and (5) healthcare innovations (HCI).
The company’s home health service locations offer a wide range of services, including skilled nursing, medically-oriented social services and physical, occupational, and speech therapy. The nurses, home health aides, and therapists in its home health agencies work closely with patients and their families to design and implement individualized treatment plans in accordance with a physician-prescribed plan of care. As of December 31, 2022, the company operated 527 home health service locations, of which 320 are wholly-owned by it, 203 are majority-owned by the company through equity joint ventures, two are under license lease arrangements, and the operations of the remaining two locations are managed by it.
The company’s hospices provide end-of-life care to patients with terminal illnesses through interdisciplinary teams of physicians, nurses, home health aides, counselors, and volunteers. The company offers a wide range of services, including pain and symptom management, emotional and spiritual support, inpatient and respite care, homemaker services, and counseling. As of December 31, 2022, the company operated 159 hospice locations, of which 96 are wholly-owned by it, 61 are majority-owned by the company through equity joint ventures, and two are under license lease arrangements.
The company’s home and community-based locations offer assistance with activities of daily living to elderly, chronically ill, and disabled patients, performed by skilled nursing and paraprofessional personnel. As of December 31, 2022, the company operated 128 locations, of which 119 are wholly-owned by it and 9 are majority-owned by it through equity joint ventures.
The company’s LTACH locations provide services primarily to patients with complex medical conditions who have transitioned out of a hospital intensive care unit but whose conditions remain too severe for treatment in a non-acute setting. As of December 31, 2022, its LTACHs had 367 licensed beds. The company operated 11 LTACHs with 12 locations, of which all but two are located within host hospitals. As part of its facility-based services segment, the company also owns and operates two skilled nursing facilities, two rural health clinics, one physician practice, one family health center, and 81 physical therapy clinics. Of these 99 facility-based services locations, 88 are wholly-owned by it and 11 are majority-owned by it through equity joint ventures.
The company’s HCI segment reports on its developmental activities outside its other business segments. The HCI segment includes Imperium Health Management, LLC, an Accountable Care Organization (ACO) enablement and management company; Long Term Solutions, Inc., an in-home assessment company serving the long-term care insurance industry; and Advance Care House Calls, which provides primary medical care for patients with chronic and acute illnesses who have difficulty traveling to a doctor's office. These activities are intended ultimately, whether directly or indirectly, to benefit its patients and/or payors through the enhanced provision of services in its other segments. The activities all share a common goal of improving patient experiences and quality outcomes, while lowering costs. The company has seven HCI locations, of which all are wholly-owned by the company.
Services
The company provides post-acute care services in the United States by providing health care services to patients within the comfort and privacy of their home, place of residence, or long-term acute care hospital facility. The company’s services can be broadly classified into five principal segments, such as home health services, hospice services; home and community-based; facility-based services offered through its LTACHs; and HCI.
Home Health Services
The company’s registered nurses and licensed practical 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, teaching or monitoring. These services include, but are not limited to wound care and dressing changes; cardiac rehabilitation; infusion therapy; pain management; pharmaceutical administration; skilled observation and assessment; and patient education.
The company has also designed proprietary clinical pathways to treat chronic diseases and conditions, including diabetes, hypertension, arthritis, Alzheimer’s disease, low vision, spinal stenosis, Parkinson’s disease, osteoporosis, complex wounds, and chronic pain. Through its medical social workers, the company counsel patients and their families with regard to financial, personal, and social concerns that arise from a patient’s health-related problems. The company provides skilled nursing, ventilator and tracheotomy services, extended care specialties, medication administration and management, and patient and family assistance and education. The company also provides management services to third-party home nursing agencies, often as an interim solution until proper state and regulatory approvals for an acquisition can be obtained.
The company’s physical, occupational, and speech therapists provide therapy services to patients in their home. The company’s therapists coordinate multi-disciplinary treatment plans with physicians, nurses, and social workers to restore basic mobility skills, such as getting out of bed and walking safely with crutches or a walker. As part of the treatment and rehabilitation process, a therapist will stretch and strengthen muscles, test balance and coordination abilities, and teach home exercise programs. The company’s therapists assist patients and their families with improving and maintaining a patient’s ability to perform functional activities of daily living, such as the ability to dress, cook, clean, and manage other activities safely in the home environment. The company’s 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 Services
The company’s Medicare-certified hospice operations provide a full range of hospice services designed to meet the individual physical, spiritual, and psychosocial needs of terminally ill patients and their families. The company’s hospice services are primarily provided in a patient’s home, but can also be provided in a nursing home, assisted living facility, or hospital. The key services provided through its hospice agencies include pain and symptom management accompanied by palliative medication, emotional and spiritual support, inpatient and respite care, homemaker services, dietary counseling, and family bereavement counseling and social worker visits for up to 13 months after a patient’s death.
Home and Community-Based Services
The company’s home and community-based operations offer a wide range of services to patients in their home or in a medical facility. The services range from assistance with grooming, medication reminders, meal preparation, assistance with feeding, light housekeeping, respite care, transportation, and errand services.
Facility-Based Services
LTACHs is a reporting unit within its Facility-Based services segment. The company’s LTACHs treat patients with severe medical conditions who require a high-level of care and frequent monitoring by physicians and other clinical personnel. Patients who receive its services in an LTACH have been diagnosed as being too medically unstable for treatment in a non-acute setting. For example, its LTACHs typically serve patients suffering from respiratory failure, neuromuscular disorders, cardiac disorders, non-healing wounds, renal disorders, cancer, head and neck injuries, and mental disorders. The company also treats patients diagnosed with musculoskeletal impairments that restrict their ability to perform normal activities of daily living. The company also operates two skilled nursing facilities, family health center, rural health clinics, a physician practice, and physical therapy providers that staff both facilities and outpatient clinics.
Healthcare Innovations Services
The company’s HCI segment reports on its developmental activities outside its other business segments. The HCI segment includes Imperium Health Management, LLC, an ACO enablement and management company; Long Term Solutions, Inc., an in-home assessment company serving the long-term care insurance industry; and Advanced Care House Calls, which provides primary medical care for patients with chronic and acute illnesses who have difficulty traveling to a doctor’s office. These activities are intended ultimately, whether directly or indirectly, to benefit its patients and/or payors through the enhanced provision of services in its other segments. They include, but are not limited to, items, such as technology, information, population health management, risk-sharing, care-coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments.
Operations
The company’s home health agencies are operated in one segment that is separated into multiple geographical regions and further separated into individual operating markets or clusters. The company’s hospice agencies are operated in one segment that is separated into multiple geographical regions. The company’s home and community-based agencies are operated in one segment separated into multiple geographic regions. Each of its home health and hospice agencies are staffed with experienced clinical home health and administrative professionals who provide a wide range of patient care services. Each of its home health agencies, hospice agencies, and home and community-based agencies are licensed and certified by the state and federal governments.
The company’s facility-based service locations are operated in one segment separated into multiple geographic regions. The company’s facility-based services, through its LTACHs, follow a clinical approach under which each patient is discussed in weekly, multidisciplinary team meetings. In these meetings, patient progress is assessed and compared to goals and future goals are set.
The company’s home health service locations use its Service Value Point system, a proprietary clinical resource allocation model and cost management system. The system is a quantitative tool that assigns a target level of resource units to a group of patients based upon their initial assessment and estimated skilled nursing and therapy needs.
Patient care is coordinated on-site at the agency level of each home health service, hospice service, and home and community-based location. All coding, medical records, case management, utilization review, and medical staff credentialing are provided on-site at the hospital level of each facility-based service location. Centralized functions, such as payroll, accounting, financial reporting, billing, collections, regulatory and legal compliance, risk management, information technology, and general clinical oversight accomplished by periodic on-site surveys are provided from the company’s home offices.
The company’s HCI business lines primarily provide assessments and related services to the long-term care insurance industry and management services to ACOs with over 400,000 Medicare lives under management.
Strategy
The key elements of the company’s strategy are to drive internal growth in existing markets; expand into new markets; and pursue strategic acquisitions and develop joint ventures.
Equity Joint Ventures
As of December 31, 2022, the company had 82 equity joint ventures including 75 with hospital and health systems, which are consisted of over 350 hospitals, four with physicians, and three with other parties.
Intellectual Property
The company was issued a patent for its Service Value Point system during 2009 by the U.S. Patent and Trademark Office.
Regulation
The company’s compliance and ethics program focuses on regulations related to the federal False Claims Act, the Stark Law, the federal Anti-Kickback Law, billing and overall adherence to health care regulation
To participate in the Medicare program and receive Medicare payments, the company’s agencies and facilities must comply with regulations promulgated by the Centers for Medicare and Medicaid Services (CMS). The company endeavors to conduct its operations in compliance with federal and state health care fraud and abuse laws, including the Anti-Kickback Statute and similar state laws.
The company operates its business to avoid exposure under the federal False Claims Act and similar state laws. The company has modified its existing Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security policies and procedures to comply with the HIPAA regulations.
DHHS, the Centers for Medicare & Medicaid Services (CMS), DOJ, and other federal and state agencies continue to impose intensive enforcement policies and conduct random and directed audits, reviews, and investigations designed to insure compliance with applicable healthcare program participation and payment laws and regulations. As a result, the company is routinely the subject of such audits, reviews, and investigations.
The institutional pharmacy operations within the company’s Facility-Based Services segment are also subject to regulation by the various states in which the company conducts the pharmacy business, as well as by the federal government. The pharmacies are regulated under the Food, Drug and Cosmetic Act and the Prescription Drug Marketing Act, which are administered by the United States Food and Drug Administration. Under the Comprehensive Drug Abuse Prevention and Control Act of 1970, administered by the United States Drug Enforcement Administration, as a dispenser of controlled substances, the company’s pharmacy operations must register with the Drug Enforcement Administration, file reports of inventories and transactions, and provide adequate security measures.
History
LHC Group, Inc. was founded in 1994. The company was incorporated in the state of Delaware in 2005.
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