Covenant Care
Home health and hospice services provider.
PE-OWNED
Acquired by Bain Capital2017-06-30
What Made It Great
Home-based healthcare services with focus on end-of-life care
What PE Will Likely Do
Reduction in skilled nursing staff (RNs) and replacement with lower-cost LPNs or nursing aides, leading to lower-quality in-home care and less time spent with each patient
Aggressive coding and billing practices to maximize reimbursements, potentially leading to upcoding and patients receiving more intensive services than necessary
Closure or scaling back of less profitable service lines like psychiatric care, rural home health, or end-of-life/hospice services
Sale-leaseback of Covenant Care's owned real estate to extract equity, which could lead to higher rents and reduced investment in facilities and equipment
Expected Timeline
“0 to 6 months months”
Announcements of 'optimization' and 'efficiency' programs, potential leadership changes
“6 to 12 months months”
Initial staffing cuts under the guise of 'right-sizing', service line reviews begin
“12 to 24 months months”
Noticeable decline in quality of care as nursing staff is reduced, wait times for in-home visits increase, and essential services start to be scaled back
“24 to 36 months months”
Major issues emerge, such as facility closures, quality of care scandals, and difficulties for patients accessing necessary services
“36+ months months”
Potential bankruptcy, fire sale to another operator, or continued decline in quality and access to Covenant Care's services
Similar Cases
Other companies that followed a similar path after PE acquisition
What You Can Do
Actions
Closely monitor any changes in the quality of care, staffing levels, and availability of services at Covenant Care facilities and in-home care
Advocate for maintaining essential services, such as end-of-life care, psychiatric care, and rural home health, to ensure vulnerable patients continue to have access
Be vigilant about potential billing issues and seek clarification on any changes to the services being provided or covered by insurance
Alternatives
Community-focused healthcare
Integrated managed care consortium