Shay Stevens, a Hurricane Katrina evacuee who reinvented herself as a Little Rock elder care entrepreneur, is selling her home care business in the age of COVID — partly to look after herself.
“I need a break for a minute,” she said, citing the constant pressure of running Millennium Companion Inc. in the tightest labor market she’s ever seen. “I don’t have high blood pressure, but I’m about to have it, you know?”
Compounding her stress is having to compete for high-quality workers on revenue limited by state Medicaid reimbursement caps, she said.
“I can’t pay my employees more than $12 an hour, and it’s wearing me thin, man. And I stand with these workers. We need to treat these home care workers as the paraprofessionals they are, and pay them that way.”
Her 31 home care providers do tasks like bathing, dressing, helping with mobility, and keeping clients on their diets and prescription regimens. “They save a lot of health care money by keeping these folks home, where they want to be, where their families want them, and keeping them healthier.”
The deal for Millennium was pending last week, making Stevens cautious about revealing details. She said she couldn’t name the buyer or the price, and at first was reluctant to confirm a deal was in the works.
But the New Orleans native said the sale would be rewarding, giving her breathing space and time to focus on several other enterprises. One will be Millennium Kids & Family, an after-school care center opening soon on South Battery Street in Little Rock.
Millennium Companion and its sister business, Millennium Adult Day Care, are in the Galleria Shopping Center on Rodney Parham Road. From the same offices, Stevens runs Millennium Cargo Express Inc., which makes deliveries from a warehouse with a cargo van and Stevens’ minivan. “Hey, I’m a girl; I want a pretty van,” she said, vamping.
Then, turning serious, she said the adult day care isn’t for sale, even though its business has been cut in half by COVID-19. “No, no, it’s my baby,” she said.
Started in 2011, Millennium Adult Day Care was her first elder care business after a long career in marketing. Millennium Companion came along in 2014, followed by Millennium Cargo a year ago. The delivery business derived partly from ideas for replacing lost revenue at the adult day care, Stevens said.
“It took a huge hit from the pandemic,” she recalled. On the second Friday in March 2020, it had 19 clients, “one short of being full,” Stevens said. “But the very next Monday, I was down to six.” The average now is about nine a day.
The elder care industry faces an odd conundrum, she said. Just as the baby boom generation ages, fueling an ever-growing demand for home care, companies struggle to find good workers, and COVID complicates matters by scrambling norms in the medical field.
President Joe Biden’s commitment to elder care as part of his extended definition of infrastructure could mean that federal policy will bend toward greater reliance on home care eventually, but that potential is still politically remote. Market forces in health care overall continue to trend toward consolidation.
Charlie Martin, executive director of the Home Care Association of Arkansas, said he wasn’t surprised to hear about the sale of a Little Rock home care agency. His nonprofit trade group represents members providing skilled care and personal care in the home.
“When you talk about potential mergers and acquisitions, it’s not surprising that there are some agencies who might be looking to sell,” Martin said in a telephone interview. “The question [over the course of the pandemic] would be linking up with a buyer.”
LHC Group Inc. of Lafayette, Louisiana, recently bought an Arkansas home health agency in Crossett, announcing the deal July 1.
Publicly traded LHC Group, with 30,000 employees nationwide and a stock price of well over $200 a share last week, purchased Ashley County Medical Center Home Health in a bigger deal that included a Virginia home health company and an Indiana hospice.
No financial details were provided, but the company said in a news release that the three acquisitions would generate $8 million in new annual revenue. It also said it had completed home health and hospice acquisitions in Idaho, Oregon, Arizona and Texas. In all, the company is looking to add $200 million from acquisitions to the $2.06 billion in revenue it generated in 2020. The Crossett home health agency will keep the ACMCH name.
Martin said LHC Group’s moves and others reflect the general health of the home health industry despite continued headwinds from COVID and the job market. “There’s a challenge taking care of the boomer generation already because that population is going to grow, and COVID made that more difficult because people were reluctant to go into people’s homes,” Martin said. “Staffing was hard, and staffing nurses was expensive in other health care settings. If you hired a contract nurse or traveling nurse, you paid more for them.” (See related article on Page 1.)
Agencies don’t necessarily profit in those situations, “because Medicare and Medicaid only pays so much,” Martin said, adding that the industry should be poised to grow because of growing demand for its services. “But we certainly need for Medicaid and Medicare to be as flexible and workable as possible.”
Millennium Companion offers services through ARChoices in Homecare, a Medicaid program of the Arkansas Department of Human Services. It includes home and community-based services for clients 21-64 who have disabilities, and for Arkansans 65 and older.
“We are reimbursed $18.12 an hour for agency attendant care [which help with tasks made difficult by disability or age],” Stevens said. “For personal care, we are reimbursed $20.48 an hour.”
Stevens said the workers deserved the entire $18 as their wage, but business realities allow only so much. “In fairness to the state, I think they’re beginning to agree with us and realize that we desperately need to raise that,” Stevens said, noting that adjustments were made in January to accommodate the new $11 an hour state minimum wage.
“Personal care did rise to $20.48. It has just been confirmed that we’ll get a reimbursement raise in October, we just don’t know what that raise will be. Hopefully attendant care will go up to $20.48.”
Stevens’ “break” from running Millennium Companion will not be a vacation. She is working toward a Sept. 1 opening of Millennium Kids & Family, an after-school care center for ages 5 to 12 at 2705 S. Battery St. in Little Rock.
And she will not be giving up her provider ID, the state credential that allows her to offer home care services. After “hitting the brakes,” she’ll be back in the field, she said. “The provider IDs aren’t transferable.”
Martin, the Arkansas trade association leader, explained.
“You’re limited in Arkansas to a certain number of home health agencies, and it’s all based on need, and I think that over time, that’s been better for Arkansas,” Martin said, noting that the state similarly limits hospital beds, residential-care beds and the like. “There are only about 180 Class A home health licensees in Arkansas. In states without a permit of approval process, you can just go out and open up a home health agency, and there are a whole lot more agencies,” meaning much more competition for patients, and potentially lower standards of care.
For her part, Stevens says she’ll be back eventually. “I will re-enter home care, even though it’s definitely been my point of contention. I just need a break for the moment.”