How To Grow Your Home Care/Hospice Business

My parents gave my brother, sister, and me all the love and confidence needed to be successful. We went to church every Sunday. I played guitar and sang at Mass every week. My brother, at the age of sixteen, was killed by a drunk driver. I was just nine years old at the time. Mark’s death was extremely difficult for my family. God helped us all heal, and we were able to move on with all the fond memories in our hearts. When I was thirteen, I started in health care as a volunteer at a local hospital that I could walk to—Parkview Hospital. I worked in the physical therapy department. I helped transport patients from their hospital rooms to therapy. I also had the fun task of cleaning the whirlpool tubs. It was a great experience, and it introduced me to see how a patient can rehabilitate after an acute event. I have been in health care now for more than thirty-three years! As mentioned earlier, I grew up in the Hawkins family nursing home. I had a great-grandmother who had Alzheimer’s, and my mom would have her several days of the week. I would come home from school and go upstairs to the linen closet and take out all the clean towels, unfold them, and place them into a laundry basket. I would then take them to my great-grandma and ask her if she would help me complete my laundry folding chore. Of course, I knew that she wouldn’t offer to help but would say, “Oh, honey, you don’t have to help me. I can do it for you.” Keeping great-grandmom busy would free up my mom to allow her to make dinner for our family. We had my grandmother live with us for a time as well as my grandfather and also my great-aunt. She lived with us for fifteen years. I moved out when I was twenty-two, so I lived with her my entire life. We also had a cousin who lived with us for a while because she was on chemo and radiation for breast cancer, and the cancer treatment hospital was too far from her home. So I was born into being a caretaker. I am so lucky to have been raised in this environment, and I wouldn’t have changed my experience for anyone else’s. These life experiences gave me the tools to understand the customers we service today! My mom died in 2006 after losing her nine-year battle with ovarian cancer. What’s ironic is that my first nursing job when I was twenty-two was working at the first hospital in the nation, a Pennsylvania hospital, on a floor dedicated to GYN Oncology. So I knew what death looked like for a patient with ovarian cancer. I even remember having lost a young woman to ovarian cancer with her young children at her bedside in the hospital. That night I came home from work and told my husband what a terrible death she had. When my mom was diagnosed with ovarian cancer, I was truly aware of what was to come. While my mom was on hospice/palliative care from a local company, she listened to me as I worked on my future hospice company’s policies, and she made many contributions to creating my own hospice company. We branded the company in the color teal, which is the color that represents ovarian cancer. So I have lost a brother, all my grandparents (I was very close to some of them because we lived in the same home), and I had a 24-week fetal demise with my fourth pregnancy. I know grief, and I know caregiving. I have run a homecare and hospice organization since 1995. Deficiency free since inceptions and the receipt of seven gold seals of approval by the Joint Commission on Accreditation. But what does this have to do with being able to have a successful sales program? Well, how we react to stress or pressure is defined by our life experiences. Having worked so hard to build a successful business that I was genuinely passionate about and see it slipping away because of competition and that my organization was making no effort to regain our market share. I was afraid. I had been here once before. In July 1995, the first year we opened our company, it took forever for the first check to come from Medicare. I had a newborn, and my grandfather would go with me every day to work and stay with the baby. Doing this allowed me to bring her to work with me and feed her whenever she was hungry. Grandpa would do the burping, change the diapers, navigate (no GPS back then), and he was also my friend. One day my sister called me on my cell phone (big box phone back then) to tell me that we were not going to make payroll on Friday. We were $7,000 short. We had been running the business for twelve months without being paid a dollar. We used every credit card we had to pay bills, and we had already borrowed from anyone who would lend us money. I had nothing left. I felt so terrible because I had failed. I hung up the phone, and my grandfather asked me what was wrong. I didn’t tell him. I said she called because we had run out of stamps. When we got back to the office after completing my patient visits, my grandfather went to my sister and asked why she called me. He told her that I seemed upset. Well, she told him. The next day I went to pick up my grandfather as usual, and when he got into my car, he asked if we could stop at his bank sometime before noon. We did in between visits, and then after my last visit, my grandfather asked me to stop at another bank. I said sure and asked where. He said whatever bank has your payroll account. He had taken out $7,000 and handed it to me. I was so thankful for his help. The next day I received the first check from Medicare, and we were saved! For now! Chapter 2 A moment of fear! I was afraid again fourteen years later. Yes, pure stare-in-your-face fear! It’s truly astonishing what a man or woman will do when they fear for the lives of their children when they are facing a significant downward spiral. Then you look at the faces of your fifty employees. These are incredible people, some of whom you have worked with for the last fourteen years. You know their families—whose birthday is coming up and who is saving to take their children to Disneyland for the first time. Who is trying to help pay for a child’s college tuition, baptisms, weddings, Bar Mitzvahs, first home, first child, the first car? And you wonder how you will choose which ones to lay off. Once I stopped feeling sorry for myself, (which lasted about ten minutes), I knew I had to act fast. I had to risk it all once again as I had with my start-up fourteen years earlier. I also knew that my husband, Bill, would not want to risk it all again. He was more concerned because this time we had five children to support, and the risk was no longer one we took together as with our start-up. When we started our first business, it was just he and I and two infants. If it failed, we would just have to go back and work full-time in the hospital. Maybe lose our house, but so what? We would rebuild. Now, we had five other mouths to feed. We had tutors to pay, sports, dance, cheerleading, violin, piano lessons, and ice hockey. I had to convince Bill to let me take a big risk once again! Many of you are probably saying, “She doesn’t know my market and how much competition I have in my area.” You’re right, but I will tell you. When my husband and I started the company in 1995, there were about nineteen providers in my territory of five counties, but by 2007, that number had grown to more than a hundred, and it was still on the rise. We had five times more competition than we did when my husband and I started; our marketplace also had a large shift in traditional Medicare. The area went from 100 percent of the seniors in Philadelphia having traditional Medicare to a senior population of 20 percent Medicare and 80 percent Medicare managed care. We were losing not only market share but revenue was a