Home Nursing Firms Tackle AIDS Challenges

Four years ago, David Kessler, a registered nurse, tried to interest the home health-care companies for which he was working to establish a special group of nurses devoted to helping patients with AIDS.

When his supervisors scoffed at the idea, he founded his own company, Progressive Nursing Services in West Hollywood.

“I created this company from a nurse’s viewpoint,” said Kessler, who treated his first AIDS patient in 1983.

Progressive Nursing is one of a handful of Southern California small businesses dedicated to treating AIDS patients at home. Together, the companies are providing care for many of the 7,993 AIDS patients in Los Angeles County and hundreds more in adjacent areas.

Company executives say their greatest challenges are finding competent, compassionate nurses to meet the demand and pressing the state and private insurance companies to reimburse them in a timely manner.

Their businesses are thriving for two reasons. The primary one is that most AIDS patients prefer to remain at home with friends and relatives if at all possible. Staying home also makes financial sense. A week in the hospital for a seriously ill AIDS patient can cost up to $15,000, compared to $700 to $800 a week if visiting nurses can provide the same care at home.

The growth of home nursing firms has been fueled by new technologies and portable medical equipment. Treatments once limited to hospital settings, such as intravenous antibiotics and liquid nutrition, can now be administered safely at home.

Companies providing home care for AIDS patients and those considering a move into the field recently received an incentive from the state of California. Starting this month, California’s medical insurance program, Medi-Cal, will pay for certain home health-care services for AIDS patients.

“The state will pay for attendants, nurses and some housing renovation costs for things such as wheelchair ramps and grab bars,” said Rob Peterson, program manager for the AIDS Project L.A.’s community health pilot project.

He said there are limits on the coverage, but it is an important first step toward better home care for Medi-Cal patients with AIDS.

Peterson is familiar with local health-care companies because he is supervising a three-year, state-sponsored study comparing the cost of home care to hospital care for AIDS patients.

“There is always room for more companies to treat AIDS patients,” said Peterson. “I wish there were more nurses, too. The ones who are doing it are very dedicated and thorough, but the burnout rate is quite high.”

Founders of the companies treating AIDS patients at home said they started their own businesses because they were unhappy with the way their employers were doing the job.

“Our founders were nurses who worked for another company,” said Renee Ryan-Johnson, director of nursing for Comprehensive Nursing Services in Los Angeles. “They were quite dissatisfied and unhappy with the service given to AIDS patients.”

Ryan-Johnson said companies providing AIDS care are different than most nursing registries because they must be very involved in managing insurance benefits and acting as a patient advocate. She said most insurance policies are “just not suited to the kind of care AIDS patients need.” By working closely with insurance providers, Ryan-Johnson said comprehensive has “conserved a lot of insurance dollars for patients wanting to be treated at home.”

Integrated Care Systems opened in March, 1988, and has seven offices around the state. About half of its patients have AIDS, according to Bruce Borggreve, president.

“We look at ourselves as a complete care company,” said Borggreve. “We provide a composite of services surrounding the IV (intravenous) patient.”

Integrated Care Systems, with its 175 employees around the state, is a subsidiary of a publicly held health-care company in Boston. Borggreve, who formerly worked for American Hospital Supply Co. and Caremark, said his greatest challenges are recruiting good staff members and dealing with Medi-Cal.

“An inexperienced company should approach it cautiously if they are trying to build a new business around AIDS,” said Borggreve. “You’ve got to be here tomorrow to continue the service.”

David Kessler, the former actor now considered a pioneer in AIDS care, said he thought AIDS would be a short-lived malady like Legionnaire’s disease.

Instead, the need for the specialized care Progressive Nursing provides has soared and Kessler finds himself at the helm of a company that has doubled in size in the past four years.

“It’s been hard for me to deal with the business side,” admits Kessler, who hired a business manager early on to help him with the nuts and bolts of running a company.

In recent years, he has learned to delegate more and more responsibility to his 22 staff members. And he has joined a group of top executives who meet regularly to discuss common problems.

This year, he expects sales to exceed $3 million. He said he is talking with hospital executives who are interested in setting up a joint venture with Progressive to treat patients.

“I never set out to start a business,” he said. “It really kind of happened out of the blue.”

Caltech/MIT Forum Seeks Tech Firms

The Caltech/MIT Enterprise Forum is seeking technology companies interested in presenting their business plans to a panel of experts and an audience of entrepreneurs. The Forum, beginning its sixth year, attracted more than 300 people to a recent session at Caltech. Participants are being sought for two programs. One program is for growing companies with sales between $1 million and $20 million. The other program is designed for technology start-ups of any size. For more information, or to submit a business plan, contact: Ken Deemer, General Partner, InterVen Partners, 333 S. Grand Ave., suite 4050, Los Angeles, Calif. 90071, 213-622-1922.

Deadline Is Today for Ride-Sharing Talk

After Jan. 1, companies with more than 100 employees will have to set up a ride-sharing program. Are you ready? If you are interested in learning more about ride-sharing, air-quality officials and others will meet at 8:30 a.m. Nov. 7 at the Regency Club, 10900 Wilshire Blvd., in Westwood. The discussion will focus on the state regulation requiring ride-sharing and how to start a program. The cost is $25 and includes breakfast and parking. Today is the deadline for reservations. For information call the DeVinny Group: 213-306-8584.

Seminar to Focus on ‘Stress of Success’

“The Stress of Success” is the subject of a Nov. 7 seminar sponsored by the Los Angeles County chapter of the National Assn. of Women Business Owners. Patty DeDominic, president of PDQ Personnel Services, will lead the discussion. The session is scheduled from 6 p.m. to 9 a.m. at the GTE office, 2001 Broadway St., Santa Monica. The fee is $35 for non-members and $25 for NAWBO members. For reservations, send a check to NAWBO, 900 Wilshire Blvd., suite 1434, Los Angeles, Calif. 90017. Or call: 213-623-9977.

GUIDES FOR HOME CARE COMPANIES David Kessler, founder of Progressive Nursing Services in West Hollywood, offers the following suggestions for those interested in starting a home nursing business:

Concentrate on providing the highest-quality service.

Hire for tomorrow’s needs, not for yesterday’s.

Surround yourself with the best people possible.

Learn how to talk to bankers.

Don’t be afraid to ask people for their opinions.