Specialty service equals success at Advent Home

MADISON HEIGHTS, Mich. - The numbers don't lie. Carlia Cichon has carved out a niche for herself, providing care to patients with catastrophic injuries. In 2006, Advent Home Medical grew 161%. "There's a push to get patients into the home environment," said Cichon, president and owner of the three-year-old company, which specializes in ventilator dependent patients ranging from infant to adult. "Anything associated with the vent, we'll maintain and cover," said Cichon. "The suctioning, the tracheostomy, the respirators." Advent's patients need "everything" from hospital beds to wheelchairs and walkers, for which the company works with local HMEs. "We can't do everything," said Cichon, "or we could no longer be specialized." That specialization extends to Advent's 12 employees. Cichon takes great care in hiring her employees. Not everybody can do the job, she said. "They are all respiratory therapists," she said. "From the person who answers the phone to the one delivering the equipment." The RTs work closely with family members, teaching them to care for patients, dealing with anything from the ventilator to the tracheostomy. "Even though the patient may have 24/7 care, there is always something the family member needs to know," said Cichon. Cichon's staffers rotate through all the patient's homes, so that on-call staff knows all the patients. A team leader coordinates care. Advent's referrals include insurance adjusters and attorneys, as well as nursing agencies. It's all word-of-mouth, said Cichon, who does no advertising. The company offers a weekly class for nursing agencies that want staff trained in ventilator therapy techniques, including patient care, infection control and safety goals. "We have the agencies calling every week and giving us a list of nurses coming to class," said Cichon. Advent has about 65 patients, and commercial insurance represents 90% of her payer mix. Understanding how to bill for specialized ventilator services is crucial to the bottom line, said Cichon. "You cannot put a dollar amount on your billers," she said. "I have a biller who knows how to bill, how to write letters, how to talk to insurance companies and how to get paid."