Home health care at nonprofit Northwest Colorado Health started in 1964, and today the continuing service predominately assists Medicare patients 65 and older, a growing segment of the population.

But the agency is losing money doing so.

Reimbursement rates for home health care visits are significantly lower than actual operational costs, said Steph Einfeld, CEO at Northwest Colorado Health. That leaves the mission of the health agency, which serves everyone regardless of ability to pay, coming up short approximately $1 million per year for home health and hospice services.

So, the nonprofit leadership is asking partnering agencies and donors for help to keep serving patients in need in their homes across Routt and Moffat counties. On Oct. 1, the nonprofit launched a Home Services Campaign that aims to raise $3 million across 2026-28. The home health program also assists patients who live at The Haven Assisted Living in Hayden, which has no nursing staff, and independent or assisted-living patients at Casey’s Pond senior living, which only has in-house nursing for the skilled nursing unit, Einfeld explained.

The nonprofit launched the three-year fundraising campaign to buy time to host fundraisers and lobby for higher reimbursement rates while still serving some 300 patients per year in their homes. So far, the campaign has raised $701,498 to assist older adults age in place and receive end-of-life care with dignity.

“We need this now to keep going and to create a glide path into a sustainable future,” Einfeld said. “The need for these services will only grow as our aging population increases over the next few decades. We are in this for the long term, meaning we need to be planning that sustainability now.”

Einfeld said the average home care cost per medical episode is $6,000. By comparison, Matt Hansen, executive director of the Home Care and Hospice Association of Colorado, said the standardized home health Medicare “base” 30-day payment amount before case mix, wage index and other adjustments are applied is $2,038.

“That sum is meant to cover all services provided to a patient, including nursing, home health aides and therapy, as applicable, and does not reimburse travel time or mileage,” Hansen explained.

Longtime Steamboat Springs resident Jeff Morehead, standing with his wife, Lura Briscoe, is suffering from ALS and has been a hospice patient since March with Northwest Colorado Health.Northwest Colorado Health/Courtesy photo

“Increases from government sources have been minimal compared to the increases we’ve maintained to keep our staff and provide services,” Einfeld said.

Deborah Lively, CEO at LeadingAge Colorado, agreed.

“For most providers, even modest reimbursement increases have not kept pace with rising costs, particularly the significant increases in labor, insurance and supplies costs over the past five years,” Lively said.

Hansen noted multiple challenges for providing home health and hospice care in rural Colorado.

“These include extended drive time between patients/clients, a limited and often more costly workforce, lower patient density and fewer referral sources, all of which can make it more difficult to maintain operations,” Hansen said. “Colorado has experienced a decrease in nonprofit organizations providing home health and hospice care over the years. Organizations have become more dependent on donations as reimbursement rates have failed to keep up with inflation and minimum wages increases, and any operational margins that had once been used to help provide charitable care to the uninsured are now required to simply stay afloat.”

Each year, Northwest Colorado Health staff travel more than 100,000 miles to deliver care, providing some 10,355 home health visits to patients of all ages. The mission of the nonprofit is to continue to provide that level of care at the same time as other rural health and hospice agencies in Colorado have closed or moved to only accepting private pay or commercial insurance, Einfeld said. She pointed to the example of Eagle Valley Home Health, which closed in 2023.

Einfeld presented to multiple groups last year to ask for financial support. So far, partnering agencies have committed $400,000 for 2026, including $200,000 from UCHealth Yampa Valley Medical Center, $100,000 from Memorial Regional Health in Craig, and $50,000 each from the cities of Craig and Steamboat Springs.

Northwest Colorado Health also requested contributions from Routt and Moffat counties and Steamboat Orthopaedic & Spine Institute, which is a referral partner to home health services. The fundraising campaign is online at NorthwestColoradoHealth.org/homeservicescampaign.

Einfeld said the nonprofit utilized a consultant to make sure the home health services are as efficient as possible, but only limited savings were realized.

One of the locally served patients is longtime Steamboat Springs resident Jeff Morehead, who is suffering from ALS and has been a hospice patient since March, according to patient information released by NWCH. Morehead worked many years driving airport and ski shuttles and volunteered to maintain Jeff’s Garden at the Yampa River Botanic Park next door to his home in Fish Creek Mobile Home Park.

Morehead said one of the biggest frustrations of having ALS is he no longer can use his hands to do the activities he loves.

“It’s weird, because this isn’t painful,” Morehead said of ALS. “The painful part is I can’t do anything well.”

Jeff’s wife, Lura Briscoe, is his caretaker.

“I always associated hospice with death, but it’s really been very helpful for quality of life for Jeff,” Briscoe said. “It’s really nice to know if there’s a problem, like middle of the night, I can call hospice. They’ve provided us with a lot of tools that I never thought I’d have to use … In hospice you have nursing, a social worker, the chaplain, aides and physical therapy to help keep people as mobile as possible.”

Registered nurse Emily Henderson, who works with the couple, said hospice is not about dying but about living the last stage of life “as comfortably and fully as possible.”

“We bring as many resources as we can to the picture and a team that is walking through it with you,” Henderson said. “Whether someone has gotten to an advanced age with a chronic illness that’s progressed, or it’s something unexpected, like Jeff has. But what hospice does is take some of the mystery out of it.”

“Hospice has been so wonderful in this whole process,” Morehead said, “because I never knew we’d talk about death so much. But, you know, it’s not scary like it was.”