Dayspring promises Behavioral Health care reform.
Well-established in Oklahoma, Dayspring clinicians visit patients in 150 facilities in 58 of 72 Oklahoma counties. Late last year, the 5-year-old company opened offices in Missouri and Arkansas.
Wesley Robbins, executive director of Dayspring in Arkansas, said the potential volume in Arkansas could quickly overshadow Oklahoma's workload.
According to the 2000 Census, Arkansas was home to 374,019 people age 65 and older, and aging baby boomers soon will compound the trend.
The American Association for Geriatric Psychiatry estimated that nearly 10 percent of all Americans over age 65 and as many as half of those over age 85 suffer from Alzheimer's disease or related dementia.
Clinical depression, according to AAGP, affects 15 percent of people over age 65, and more than 50 percent of all nursing home residents become severely depressed.
Already, seven Arkansas nursing homes have signed contracts with Dayspring to treat mentally ill residents. Clinicians now visit nursing home patients in Rogers, Siloam Springs, Springdale, Fayetteville and Fort Smith.
According to Dayspring's annual report, last year the company served 2,150 clients in 117,241 encounters. Also in 2001, the outfit collected $3.2 million, down 7 percent from $3.5 million collected in 2000. Payroll dropped for the year to $2.3 million, down 6 percent from $2.4 million for 2000.
Within five years, Robbins wants to sign half of Arkansas' nursing homes to contracts for geriatric mental health service. Although only three employees work at the Arkansas headquarters in Fayetteville, Bryan Huling, Dayspring's director of clinical services, visits often. Robbins said co-owner Randall Jarman and all of the Oklahoma resources are also available to help the Arkansas branch grow.
Operating the Fayetteville office costs about $15,000 per month, Robbins said, and he expects it to become profitable by the end of this year.
Contracted nursing homes use Dayspring on an as-needed basis, and patients pay for the therapy privately or through Medicare and Medicaid. No cost is assigned to the retirement home.
Nursing center staff or family members refer patients to Dayspring for mental health treatment. Therapists tend to a resident only with the patient's permission and a doctor's orders.
Before Dayspring crossed the Arkansas state line, no mental health provider delivered on-site treatment for geriatric patients in nursing homes. Now, not-for-profit organizations, governmental agencies and private firms all want a piece of Dayspring's plan. Robbins wants to give it to them.
Homes Celebrate On-site Care
Siloam Springs Nursing and Rehabilitation Center was the first to sign up for Dayspring's service. Director and co-owner Jimmy Crone runs the 140-bed home, which employs 100 staff members and houses about 90 residents.
In the next year, Crone expects up to 15 percent of his residents to enroll in Dayspring's care. Under the contract, a licensed Dayspring social worker visits the Siloam Springs home one or two days a week to visit troubled patients.
Because most of Dayspring's revenue comes from Medicare and Medicaid, Robbins was required to hire clinically licensed staff. To serve Arkansas patients, he employs two licensed social workers to cover the area from Fort Smith to Bella Vista.
Crone said he uses Dayspring to keep patients from having to go into an expensive psychiatric unit. Counseling, medication or electroconvulsive therapy can help prevent hospital admission, which saves the family stress and money, he said.
When regular visits from Dayspring don't curb a patient's problems, Crone still uses inpatient psychiatric treatment at Generations, supported by Washington Regional Medical Systems, and Transitions, sponsored by Fayetteville City Hospital.
Robbins knows first-hand the stress that a mentally ill family member can unintentionally bring. Two years ago, lust before he and his wife adopted a baby from India, Robbins ushered his mother through the processes of assisted living, nursing homes and psychiatric-unit visits.
After 15 years of working in psychiatric administration, it was Robbins' first personal experience on the other side of the desk.
UAMS Sparks an Initiative
"Dayspring is successful at what a lot of people have failed to do," Huling said. Part of the company's formula is playing by the rules.
"We have to be squeaky clean," Huling said, and cooperating with other agencies strengthens Dayspring's presence.
The State of Arkansas, in conjunction with the University of Arkansas for Medical Sciences, could be the next entity to partner with Dayspring.
From July 1, 2000, to Jan. 31, 2002, Arkansas Medicaid and UAMS conducted a Medicaid Medication Management Program, a study of the use of psychotropic drugs in nursing homes.
The findings showed many homes were overmedicating or failing to give the most efficient combination of drugs for the patient's case.
Dr. Marisue Cody was principle investigator of the M3 program. This summer, she intends to propose a statewide initiative for nursing homes. Robbins said Cody recruited Dayspring to help implement a multifaceted plan that will train nursing home staff for the initiative.
Other associations also have approved of Dayspring's efforts. In May 2001, Dayspring earned a three-year approval from CARE, an independent, nonprofit accreditation body founded in 1966 as the Commission on Accreditation of Rehabilitation Facilities. A CARP certification sets a health care industry standard for quality.
This year, Dayspring's goals include growing its Arkansas and Missouri stakes and launching a venture in Colorado.