Former Oxford employees begin Integrity Home Care

When seven former Oxford HealthCare employees formed a new home health care company a few months ago, the integrity of their employees and their patients or clients, as they call them was first in their minds.

Integrity Home Care, owned by Greg Horton, a partner in the CPA firm Whitlock, Selim & Keehn LLP, began providing home health care services in February and now has 70 employees and approximately 130 clients in southwest Missouri.

"The name is as important to us in the way employees are treated as the way clients are treated," Horton said.

Integrity Home Care Administrator Randy Rogers, RN, said six of the former Oxford employees who left Oxford to form Integrity did so because they were dissatisfied with the bureaucracy and were unwilling to sign noncompete agreements. Rogers is also a former Oxford employee, but he worked as a nursing consultant for residential care facilities prior to joining Integrity.

"I saw a lot of things (at Oxford) that I felt could be done better. The overall treatment of employees I felt could be a lot better, as well," Rogers said.

Started as a franchise of Upjohn HealthCare in 1974, Oxford HealthCare is now the largest home health care provider in Missouri, with more than 1,000 employees who care for patients. Oxford merged with Cox Health Systems in 1993, which caused the company to double in size between 1993 and 1998.

Oxford HealthCare Executive Vice President Karen Thomas declined to comment on the statements made by Rogers and Horton, citing pending litigation between the two companies in the circuit courts of Greene and Newton counties.

"Oxford has been in business for more than 25 years. We're very proud of our record. We are a leader in the industry and are known for our quality of care and our high standards," Thomas said. "We work very hard to stay in close contact with our employees and our clients because they are very important to us."

Horton financed Integrity Home Care with a desire to provide quality home care to those in need, after years of involvement in the health care industry as a CPA and business consultant.

"In the last year and a half, I helped a client and friend start a home health care business in Kansas City. My interest in home care came from getting a real bird's eye view of the people side of it," Horton said.

Horton said he and the administrative staff of Integrity want to avoid multiple levels of hierarchy within the company, which he said leads to low employee morale, and in turn, a low quality of care for clients.

"I think in the health care environment, the bureaucracy has almost overcome us. The people get lost ... management, whether it's intentional or not, start to see people as numbers and statistics. It's hard to be motivated as a caregiver when nobody cares about you or what you have to say," Horton said.

Horton said he plans to grow Integrity Home Care without creating the problems he thinks are associated with large home health companies by keeping the focus of the company on people and not numbers.

"The size of the business doesn't have to be a negative issue. It's what your focus and values are," Horton said. He added that home health companies must be either a mom-and-pop operation with few expenditures or a large corporation in order to make it in business.

"The business side of home health is that you need to be large to survive because the reimbursement rates are so close to what you have to spend to support the infrastructure of the business," Horton said.

Rogers said about 95 percent of Integrity's clients are elderly Medicaid recipients who are sick, not ambulatory or both. Integrity also accepts private payment and has provided care to sick or handicapped juveniles whose parents need assistance taking care of them.

Horton said when forming Integrity, he decided the company would have a better chance at succeeding by accepting only Medicaid reimbursement and private payment.

"I really had no interest in considering (accepting Medicare) until the government reimbursement program gets re-evaluated, which they are doing now. And (Medicare acceptance) may still be something that's best left to the hospital-based agencies," Horton said.

Integrity provides 24-hour care and nurse respite services. Varying levels of personal care are also available, from assistance with daily hygienic needs to instilling catheters, drawing blood and giving injections, which require a written order from a physician and authorization from the Division of Aging for elderly patients.

Integrity also provides companion care, which consists primarily of housekeeping services for clients who are not sick but have trouble getting around without help.

"We started this company out based on Christian beliefs and our faith. It's what directed Greg to do this, and I believe that as long as we maintain that focus, we'll see only good things happening here," Rogers said.