Health System LifeCare Buying Up In-Home Care Agencies

Despite potential policy hurdles on the horizon, LifeCare Health Partners has strengthened its presence along the continuum of care by acquiring two more in-home care agencies. The new deals come after a handful of other acquisitions in the past couple years for the Plano, Texas-based health care services provider, which hopes to continue adding in-home services to diversify its business and take advantage of alternative payment models.

“We are continuously looking for ways to enhance our service offerings and diversify our platform,” LifeCare Health CEO Jim Murray told Home Health Care News (HHCN) via email. “At this time, the home health care sector is particularly ripe for acquisitions nationwide.”

Founded in 1992, LifeCare Health encompasses the LifeCare Family of Hospitals and other post-acute services, including transitional care, inpatient and outpatient behavioral health treatment and, increasingly, home-based care. It has operations in nine states overall, offering in-home services in Nevada, Texas and Florida. LifeCare Health, a subsidiary of privately held LifeCare Holdings, LLC, has about 4,500 employees and a current home health census of about 1,600 patients.

Last week, the company announced it had purchased EverCare Health Services, a provider of personal care and transitional support, as well as Care First Home Health Care, which offers skilled nursing, physical therapy, home health and other services. Both agencies are based in Las Vegas.

Financial terms of the deals were not disclosed.

The deals mark LifeCare Health’s fourth and fifth transactions for agencies that provide home-based care, transactions that have helped fuel the industry’s booming M&A engine. The company purchased Dallas-based Haven Home Health and Boca Raton, Florida-based Complete Home Care in 2016.  Last year, LifeCare Health acquired Beyond Faith Homecare & Rehab, also based in Plano.

There were more than 115 combined deals for private-duty, Medicaid- and Medicare-certified home health businesses in both 2016 and 2017, according to proprietary data from The Braff Group.

“At LifeCare, our strategy is to create world-class, patient-centered, integrated clinical solutions—from the hospital to the home,” Murray said. “To achieve this, we’re working diligently to be competitive across the post-acute care continuum.”

Acquisition strategy

LifeCare Health plans to build upon its expansion into in-home care services moving forward, though there are no current opportunities “baked enough” to mention directly, Kristie Geist, senior vice president of home health operations, told HHCN.

The company will look to add in markets that make strategic sense, specifically targeting five-star agencies that have a track record of growth, Geist said. The recent acquisitions are perfect examples of that strategy, she said.

“We have a [long-term acute care] hospital in Las Vegas,” Geist said. “As we begin to work with the markets and try to establish footprints in certain areas, we’ll want to be able to better connect and improve along the continuum.”

Ultimately, LifeCare Health hopes to add in-home care services to all nine states that it services, she said, adding that the company ramped up its acquisition strategy two years ago in order to better position itself for health care reform and alternative payment models. So far, it has not been slowed down by prospective home health hurdles, such as the potential return of the Pre-Claim Review Demonstration (PCRD) or the Home Health Groupings Model (HHGM).

“Everybody’s pushing into the home,” she said. “ACOs [accountable care organizations] and bundling started gaining some momentum so we decided we should probably diversify more. … Obviously, to survive in the industry right now, we have to be open to being creative, looking at new ways, new payment models.”

Post-acquisition leadership 

In LifeCare’s past acquisitions, home health agency owners have chosen to leave “for various reasons,” according to Geist. As a result, LifeCare has had to take over high-level management duties, promoting from within or picking new local leaders to fill leadership gaps. In the Care First acquisition, the original owners have decided to remain with LifeCare, meaning most operations will remain relatively unchanged.

Industry experts have, in some cases, been skeptical of larger health systems buying up home health agencies and installing their own management teams, arguing that home health operations are best left to the people already familiar with its complex web of rules and regulations.

“Each acquisition has had a different strategy due to the circumstances,” Geist said. “In a perfect world, we believe that instituting corporate guidance for standard processes, procedures and workflows, while maintaining those with specific local knowledge of the market, makes the best combination.”

Written by Robert Holly