A special case: Cichon keys on ventilation

WASHINGTON, Mich. - At a time when many providers want to reduce their service costs, Carlia Cichon “is getting back to basics” with a respiratory company that seeks out high-needs ventilator patients. “We specialize in the high-tech patient, the trach patient, the patient nobody wants,” said Cichon. Cichon started her new company, Specialized HomeCare, in June. She has locations in Washington and Eastpoint, Mich., and employs four respiratory therapists. It's no surprise the HME veteran is back with a company that focuses on patients who have suffered catastrophic injuries from car accidents, drowning and various other head and neck injuries. - patients many providers consider too labor intensive to care for adequately. It's her forte. Over the past 20 years, Cichon has started a respiratory company that Abbey Healthcare acquired in 1990; ran branches for Abbey; served as a respiratory consultant; and developed a pediatric high-tech respiratory program for a hospital. “My staff loves to service these types of patients,” she said. “You may have a patient go home, and you are told they have 30, 60, 90 days to live. Then they'll be on our service for years. That is a challenge, a success story.” With her new venture, Cichon believes she can weather the storm of pending Medicare reimbursement cuts. That's because 85% of her reimbursement comes from commercial insurers. Cichon markets mostly to case managers at insurance companies rather than to physicians. Being one of the few local companies to service ventilator patients nets her a lot of business. “If you can get the referral while the patient is still in the hospital directly from the case manager, that is a plus,” she said. “And if you've got the resources and documentation, and are keeping the patient home and out of a facility, you have an edge.” It also helps that she and her RTs have good reputations and relationships with local referral sources. Additionally, Specialized works closely with several case management nursing agencies, training them on ventilators. The companies refer business back and forth, Cichon said. While her new business may be, as she says, “outside the box,” solid business fundamentals will determine its success. Effective education, teaching caregivers how to properly operate ventilator equipment, reduces on-call visits and controls costs with this group of patients, Cichon said. “The big thing is keeping inventory control, not keeping a lot of stock on shelf and keeping equipment serviced properly and knowing your patients needs,” she said.