Founder, Doug Mehling's Family Story
In my last semester as a senior in college, I was undecided as to where my career was going to go. The school offered a new elective course in nursing home administration. This was the first course offered in Texas that met the requirements that all new nursing home administrators have a college degree. I decided to take the course, which was taught by a professor who was an officer in a fairly large chain of nursing homes. I made an A in the course, and the instructor asked if I had yet decided what I wanted to do with my life. I told him I had not. He offered me a job as a nursing home administrator intern. With the degree program, a 6 month internship under a licensed administrator was required to obtain a license. I thought about it for about a minute, and then told him I would take the job.
Interns were supposed to rotate through every department and gain knowledge of how all of the systems worked. When I arrived at the facility, the administrator told me that they had a big problem in finding staff to work the night shift, and that was where I would start. That night, I went to work at 11pm, and the charge nurse assigned me to work with another nursing home aide to cover a 60 bed wing of very sick Medicare patients. My job, with the help of the other aide, was to turn all patients every two hours to avoid bedsores, and to also clean up patients that were incontinent, and change bed linens if required. I spent my 6 month internship on that 11-7 shift. I have no idea how many incontinent episodes I cleaned up, or how many beds I had to remake. It was hard work, and I will always have the greatest respect for care givers who do this work for a living.
The patients really made me take a different look at life. Each one had a personality, many problems, no independence, and they were literally dependent on others for everything. I got to know many of them, not as patients, but as people. We would visit about their families, their kids and careers. I also saw many of them die.
I left the nursing home industry after 4 years. But during that time, I saw poor service, bad management, and staff with high hopes but few chances. The challenges of providing great service, superior care, and having competent staff provided me with purpose. Health care was where I wanted to be.
At a nursing home continuing education conference, I met a hospital administrator in Dallas. He took me on a tour of his hospital, and then challenged me by offering me a job if I completed a Master’s degree in Health Care Administration. Six months later, I had quit my nursing home job, sold all of my stuff, moved to San Antonio and enrolled in the program at Trinity University. Eighteen months later, I was back at that same hospital, now as an administrative resident and completed a year of residency to complete my degree.
I lived for 8 years at this 1,000 bed, county tax supported, acute care teaching hospital physically attached to a medical school. The hospital was directed by the county commissioner’s court, and was a constant political football. Most of the time, I felt like I was trying to direct a runaway train going 100 miles per hour, with very little that could be done to change direction or slow it down.
The hospital always had a shortage of beds and the patient population was largely indigent. As a result, we constantly looked at solutions that might free up beds, and reduce the cost of operation for the taxpayers. I was fortunate enough to spend considerable time on a project considering the option of providing earlier discharges for patients to their homes. The end result of the project was to contract with the Visiting Nurses Association to provide home care services. It also became evident to me fairly early on in the project that home care would play a much larger part in the continuum of patient care in the future.
I had set a goal to be at that hospital 6 to 7 years. I had exceeded that goal and was looking for a change in my career that would provide a more rewarding sense of purpose and also fill a need for accomplishment. My thoughts quickly turned toward home care as a result of the research that we had done. Within a year (1986), I had left the hospital, moved to Tyler and entered the very different world of home care.
Major changes were already taking place in the industry. Governmental agencies were looking for ways to stretch budget dollars and lower the cost of health care. Studies had been performed in many states that showed that patients recover more quickly when in their own homes, and they prefer to be at home rather than in a hospital. Studies also showed that the longer a patient was in the hospital, the more likely that they would contract some type of infection. Many of these infections were fatal. Sending patients home more quickly or avoiding a hospital stay completely made a lot of sense.
When we started the company in 1986, we decided that we would base all operating decisions on the premise that if we took good care of the patient, their family, and our staff, the money would take care of itself. This principal has stood the test of 25 years of successful operation, and continues to be the guiding premise for how we do our work. As a result we continue to grow. Many companies are reducing services or leaving the industry completely. The majority of home care companies look to short term profits as their measure of success. We do not.
The cost effectiveness of home care is now becoming much more obvious to hospitals and physicians. The majority of functions we perform now in the home were provided in a hospital setting ten to fifteen years ago. Yearly, more and more functions are shifted to the increasingly skilled staff in home care companies. Today, in-home electronic monitoring of diseases, with the physician’s oversight, help to respond to the needs of the patient without the need for hospitalization. I expect to see this type of service greatly expanded in the next few years.
At Home Healthcare has an extremely competent and knowledgeable administrative staff. As a result, we are able to make decisions regarding future activities based on years of experience. We also count our relationships with Medicare and Medicaid to be great assets as well as our relationships with other payer groups.
About Our Family
Written by Patti Mehling
Doug and I are a Brady Bunch; he had 2 boys and I had 3 girls. My girls’ dad was deceased. We were committed to re-marriage only if we could be a “real family”, so “we have 5 kids”!
Claire, 29, is a 1st grade teacher at Jones Elementary in Tyler. She is a graduate of All Saints in Tyler, received a Bachelor of Business Administration from TCU with a Marketing major and did some work on her master’s at University of Texas at Tyler. After working in two family businesses she returned to LeTourneau University and received her teaching certificate. She loves teaching. She is also a new mom to our 1st grandbaby, Miss Lucy Grace Cozad. Claire is married to Jeremy Cozad, who works in the insurance industry. They live in Tyler.
Douglas II, 28, is working on his master’s of theology and lives in Cleburne. He graduated from Grand Prairie High School, then Southwestern Adventist University. We have to brag a bit and note that while at SWAU, he was Senior Class President and graduated with a 4.0 GPA. During college he worked as an associate pastor and still preaches near his home from time to time. His desire today is to complete both his master’s and PhD degrees then write as a recognized authority on the Old Testament. These accomplishments are certainly ones in which we are proud, knowing that Douglas also lives with so many physical handicaps accompanied by Dyschennes Muscular Dystrophy. He has been in a wheelchair since the age of 9 and now requires around the clock care. His limitations have not deterred his desire for accomplishment. His studies are now done online and he reads and writes through the use of special computer programs. Douglas is currently writing a new book chronicling some of the trials and tribulations of life with Muscular Dystrophy.
Alex, 23, is a happy resident of Breckenridge Village of Tyler, a Baptist home for adults with a disability. Alex has experienced a wide range of education: she was home-schooled by two of our wonderful Christian friends, ETCA, Robert E Lee, Brush Ranch in Santa Fe, New Mexico and in Delaware. She now helps her older sister Claire with the first graders giving one-on-one attention in listening to them read. At BVT she is also a helper. She calls herself a “caregiver in training” and takes much pride in this position in part because it is her connection to At Home Healthcare. She assists some of the other residents in chores and also is teaching some to read and spell.
Carlyle, 21, has studied at Baylor University for the last 1 1/2 yrs and has decided to complete her education at University of Texas at Tyler. She has heard Doug praise the education available at both University of Texas and Tyler Junior College. She would like to enter some area of healthcare within the At Home Healthcare organization.
Dan, 16, is a junior at Brook Hill School in Bullard. Dan plays football for the Guard, enjoys his youth group at First Baptist Church where he has done Royal Kids Camp for foster kids and mission trips. Dan has grown up in and around At Home Healthcare and worked this summer in the IT Department. He is considering the military as part of his education and career. Dan has the heart of a great caregiver if we are blessed to one day include him in the At Home Healthcare family.