Ohio Presbyterian Retirement Services: Nancy King, COO

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Nancy King, COO of the Senior Independence division of Ohio Presbyterian Retirement Services (OPRS), knows evolution first-hand. She began her career with this provider of home- and community-based senior care as a social work graduate student in 1983 and is now responsible for the operation of services from home health care, hospice care to adult day care and meals on wheels, overseeing 600 employees in the process.

Also during her tenure with OPRS, King has seen an evolution in society’s understanding of how long seniors can remain independent and in their homes. With the parents of the country’s growing Baby Boomer population needing some form of assistance, the idea of caring for seniors at home has become more widespread.

“Seniors are more aware of this option today than ever before,” King said. “They are also more aware of and comfortable with these types of programs, where someone comes to their homes to provide them with much-needed assistance. They are more interested in finding programs that will help them remain at home.”

In addition, King points out that increased regulations for senior home care services, as well as the availability of technology that can assist in home care, make this a safe and more viable option. More medical professionals are entering geriatric specialties as well, creating a larger pool of personnel to handle the unique needs of senior citizens who are living longer than ever before.

Founded in 1922, OPRS is a non-profit, faith-based organization located in Columbus, Ohio. Senior Independence one of three subsidiaries that make up the organization, served 75,000 individuals last year, according to King. Another subsidiary, OPRS Communities –– maintains 11 Continuing Care Retirement Communities throughout Ohio, housing 2,600 residents. In addition, the OPRS Foundation raises funds for people served by the organization, to support ongoing projects and to provide services for those who cannot afford to pay.

Remote Operational Expenses

When it comes to expenses on the operational side of the home healthcare business, after people, technology is the number one cost, King said. With care givers going from home to home, it takes a tremendous IT effort to keep everyone connected. The laptop computer can become the most important tool when a home care provider visits a client site, she said. In addition, there is technology directly associated with caring for the elderly, such as Lifeline medical alert systems and automated medicine dispensers.

Make it Happen

In keeping with the organization’s key values of kindness and trust, King described a program called “Make it Happen,” through which OPRS employees provide little extras for seniors to make their lives special. For example, she tells the story of one of their clients, a 90-year-old woman, who wanted to go skiing one last time. The staff organized a trip to make that happen for her. In another case, staff members helped a client reconnect with his daughter, who he had not seen in many years.

“Our employees perform the regular tasks of their jobs on a regular basis,” King said. “This program is about going above and beyond the every day activities and providing something special. The clients and their families are going to remember these special things more so than the baths and meals served.”


Quality assurance is key with an in-home care business, King said. Employee behavior is monitored and clients are surveyed on a regular basis to make sure that there are no breaches of confidence. With 400,000 client visits every year, King said she needs to know that she can trust her staff to not only take proper care of clients, but to follow through on promised pick-up times and other appointments.

“We have to be trusted by our clients,” she said. “We go into their homes unsupervised, providing one-on-one care. It’s a very scary thing for clients to have to open their doors to someone. We need to earn our clients’ trust every day.”

Senior Healthcare Challenges

One of the biggest challenges faced in senior healthcare today involves the decision-making process for the elderly and their families. The decision whether or not to remain in the home and seek in-house care versus finding an appropriate continuing care retirement community requires a great deal of research and faith in the providers of senior healthcare today. Through a program called “Respecting Choices,” Senior Independence provides training for individuals and families to help them understand their options when it comes to advanced care planning and advanced directives.

Oftentimes, King said, the decision-making process can be confused by what she calls today’s “cure philosophy.”

“The healthcare community wants to diagnose and cure and that’s good,” she said. “But sometimes, in the last six months of life, that isn’t what people want. They may want a quality of life at home that doesn’t involve being in the hospital or undergoing a lot of diagnostics. We help people understand what medical care could be like for them in the future and then help them make decisions ahead of time.”

One online resource available to clients and their families is iCaregiver.org, an award-winning Web site maintained by OPRS that provides information on such topics as care-giving issues, senior healthcare terminology, challenges and solutions, and options and resources. King notes that the organization is working on a new program, iPartner,  designed to help organizations similar to OPRS develop their own line of home- and community-based services. To be a leader in the senior healthcare field, she believes that OPRS needs to offer more than just once piece of the continuum.

“We can’t just offer the nursing, the assisted living and the independent living,” she said. “That doesn’t meet the larger need. Our goal is to be the YMCA of senior services.”

Medicare Issues

Another challenge King faces is dealing with insurance companies and managed care. While the privatization of Medicare is different in various parts of the country, the situation has been a tremendous challenge for providers and seniors to deal with, she said. Oftentimes, the process is too complicated to understand and seniors end up joining plans without sufficient knowledge of the plan and what it offers.

“Moving forward, a big challenge is determining how we keep the Medicare benefit intact and have a reasonable reimbursement for all healthcare services,” she said.

-by Kathy Knaub-Hardy

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