At our Home Health Sales Meeting this week, one of my Sales Reps reported a Resident Life Care Director said to her, “I heard you are not going to accept ANY residents for generalized weakness or because they had a recent fall. What am I supposed to do with these residents? They need help!”

This is another case of almost right. How would your rep respond?

We have been educating on PDGM with our Home Health Marketers since the 2nd quarter. They are well versed in the changes and complexity of the statement shared by the Resident Life Care Director.

The dreaded “R” codes.

They are not acceptable for our operations team in 2020.

I would submit to you – they never were.

These are simply symptom codes and symptoms are just a manifestation of the underlying cause.

“WHY does the resident have weakness?”

Perhaps they had a stroke (Non-traumatic intracranial hemorrhage)  and they are limited in their function, which then manifests itself in weakness. In the past, we didn’t ask the why.

?WHY did they fall??

The stroke diagnosis for that resident increased their fall risk due to decreased balance and strength.

THAT is the REASON for the need for skilled care! Stroke (which is one of the 12 clinical groups for PDGM).

Are your Home Health Marketers “skilled” in having the conversation about how to ask the right questions and get the clinical documentation to support a “good” referral?

If you are from In-Home Care and you are reading this article – GOOD FOR YOU! It means you care enough to be a solid care partner for your referral sources.

I would also share that these residents may benefit from in-home care support too!

Together home health and in-home care will create better outcomes.

2020 brings many changes for Home Health. It starts with the referral. Marketing is the key to success. Identifying clinical information to support the billing team and the plan of care is critical to the success of the agency.

This MUST happen at the point of the referral with MARKETING! Time to empower your Home Health Marketers.

In-Home Care Marketers: this is your time too! If you know what PDGM means for your Home Health Marketing friends you can help augment their care to their patients.

If you are looking to gain a competitive advantage, starting with the referral!

Join us for our PDGM for Marketers.

Last week I was training ten owners and Directors of Ops for a large Home Care Company that I have been training and consulting with for the past nine years. Every year we evolve their training, and this year has had payment changes woven into the fabric of the materials.

They are smart and passionate, and I love working with them.

I have been impressed by their quick comprehension of the payment changes for their colleagues in Skilled Nursing Facilities and the upcoming changes for Home Health.

I heard a story of one of their offices who finally got an audience with a Home Health. This Home Health previously didn?t ?get in-home care,? but the owner and the representative got an audience at a case conference and shared the message of how in-home caregivers could help. They positioned their agency as the answer to outcomes! The Director of Nursing requested the nurses and therapists to put this Home Care agency’s phone number in their cell phones right in the meeting so that when there was a patient who could benefit from in-home care, they could immediately call.

The result:

5 referrals in the first week!

This is a great example of business communication. When you speak the language of your referral sources, you are heard. You are patient/client-centered. I know this because you care enough to read our blogs and listen to our trainings ? you want to care for more people with your extraordinary service.

Today, it is not enough to be client-centered. You do NOT want to be the ?best-kept secret? in your area. You don?t want to be a secret AT ALL!

You have a desire to impact more lives. Do you know the best way to do that? Help your referral sources get what they want ? to thrive in this new landscape.

We need each other. At our Growth Summit in Vegas, we unveiled the Total Patient Care Delivery Model?. This model will deeply serve your referrals sources, your agency, and your patients/clients.

Just like the agency who was struggling to ?be heard? by the Home Health Agency at the beginning of this blog made the connection and received referrals…you can too!

How? Become knowledgeable about the payment changes. Understand how they will impact you (home health) or your referral sources if you are in-home care.

Home Health marketers: You MUST understand who are the high-value patients for referrals.

In-Home Care providers: You want to know this too ? because the same patients will become the clients you can support. When you know how to best support these 12 high-value patient types, you will be a great care partner. You will become a preferred provider.

There is an easy way to do this. Join us for an exclusive webinar ? PDGM for Marketers

Learn the language of PDGM. Discover the high-value patient types, understand how you will interact with your doctors to get the information you need to make a ?good? referral.

In-Home Care ? those of you who choose to upgrade your language and support your referral sources will elevate your position.

This is your time! We can help. Join us on our PDGM webinar for Marketers

Melanie Stover, OT

Co-Owner of Home Care Sales


Owners and Managers want to learn more about the Total Patient Care Delivery Model??? Join us for our Virtual Growth Summit


Sales vs Operations

I have written about this so many times that it really starts to exhaust me. However, the message still hasn’t completely permeated our industry. We still find ourselves at a standoff between your sales people and your clinical or operational staff. Note, this is not a problem that just exists in the senior care industry, but is commonly found throughout companies who manage both a sales team and a product delivery team.

I like to imagine a movie-esque stare down between rival gangs. Not unlike the 80’s movie “The Outsiders.”

The idea that – A) We will never get along – and – B) We are always ready to fight – is what I see just under the surface. Personality types that succeed in these various positions are often to blame, but this idea that there will never be harmony is totally false. Especially throughout our industry.

If you are in sales or operations, you share one key aspect. You are providing much needed care to exactly the demographic that needs it most. Operations has an important role to play and NO PATIENTS or CLIENTS WOULD GET CARE without them. That is a fact. However, sales has an important role too. Without them educating your referral sources, you have to hope that your agency’s name will come up in the “rotation” or that you’ve done a good enough job to drive referrals in the past (even though your competitors are talking to your referral sources every week).

So, why the division? I eluded to it previously. Personalities.

Generally, sales people are more outgoing, talkative, and motivated for success. These are all good qualities and many are shared with operations. Operations, on the other hand, is often focused on the details, preparation, and completion of tasks to ensure smooth…well…operation. While both parties can share some of the same qualities, they often have different levels of priority for each.

They will often find themselves at odds with one another and even feel like enemies, but that doesn’t have to be the case. It shouldn’t be the case. You know why? Your patients. There is a need for harmony for the simple fact that what you do actually impacts lives and patients can go without care due to this strife.

Somebody’s mother, grandma, spouse, or best friend needs help and you have an opportunity to do exactly that. There is no doubt that sometimes, sales and/or operations will get on your very last nerve. You’ll find yourself just trying to complete the job, but not finding the support you need. That’s where communication becomes paramount.

If you are an agency that does not have “managers” or “directors” due to your size, then you’ll have to step up and start having these conversations with your team. Care comes first, but sales needs to drive patients for care.

Here is my challenge to you.

Sales or Operations: Invite your “difficult” or “problem” counterpart to a cup of coffee or a bagel. Make conversation light and try to get yourself fixed in their shoes. Ask the question: “How can I help you more when we work together?” Listen to the answer and try to do that. Then, wait a week (while doing their suggestion) and present issues you need their help with over another cup of coffee. You might find that the issues go away when you fix the issues they have with you…

Let’s work together to get more patients the care they need!

On a related note: You’ve no doubt had your operations team slogging through training on PDGM for the past 8 months in preparation, but is your sales team ready and confident that they will be driving the “right” patients from their referral sources? With just 90 Minutes, we can help! Check it out here:

– Jason


About the Author:

Jason Lewallen is Vice President of Marketing

for Home Care Sales

He can be reached at:


Phone: 615.815.7907


PS: Might want to consider…

If you are a home health, hospice, or private duty agency who struggles with:

  • educating your referral sources
  • not having professional handouts with the correct clinical/treatment info
  • not knowing what to say to drive referrals
  • not having time to train your sales team about diagnosis specific info

…then the 52 Wk Roadmap to Referrals program is the answer you have been looking for. Agencies are using this methodology to gain more referrals and position their entire sales team as experts.

It’s a plan for every week of the year and can lead to double and triple the referrals you are currently getting. The investment is a mere $500 per month. That’s less than a fraction of a referral!

As a leader and Coach of private duty, home health, and hospice services, I am on a mission of getting patients post-acute care in their home. Some of you know that we had our Growth Summit a few weeks ago, and so many people have asked us to have another one, so we are!? This time, we are doing a Virtual Growth Summit.? You can learn more here.

You can also check out what people said about the growth summit below! Jason does a great job on capturing attendees’ stories at these events.

Today, in my blog post I wanted to share with you a question that I get asked from CEO?s all the time about what a sales rep should and shouldn?t do when out selling hospice, private duty services, and skilled home health. Recently, I was asked by an owner, “Should my sales associate be spending time calling bingo at senior centers, Skilled Nursing Facilities, and Assisted Living Facilities?”

My answer isn?t an easy yes or no. You see, every sales representative that I have been blessed to coach or work with each approach these accounts differently. Some reps use this account to fill up their schedule and call this community outreach. If your rep has that mind set, then you have the wrong rep or you must impact their mind set to get it to evolve to one that produces referrals. If the rep just goes in, calls bingo, gives out the prizes, and says “see you next month,” there is no real value of your sales representative?s time.

However, if the rep goes to call bingo at the senior center and asks the coordinator “who didn?t show up for lunch this week?” You can actually see an impact. If the rep gets their names and phone numbers – now you have a rep that uses the bingo to get referrals!

The rep may also ask who missed coming over the last few weeks because of a hospitalization or ask the coordination, ?has any one of the seniors had a change in their health?? This again will allow you to see if the rep is using this opportunity to get referrals or if they are using this to do some non-selling activities.

Ask your rep the following question:

Today when you go to call bingo at the ALF how will you walk out the door with a referral in your hand?

Listen to their response. They may have a plan. If they don?t have one, help them make one. Help them to provide direct consumer Marketing to those seniors in attendance. You can ask them directly if they need your services. I?ll give you an example.

Imagine I’m selling private duty services, or hospice services:

I have this cute missing person?s poster that says “Missing, Mrs. Jones, she is a 75-year-old patient who can?t get to bingo!”? She is my friend and I wish someone would help her get up and dressed and bring her to the senior center. I miss her. I read the poster and I ask them, “do you have anyone that is just like Mrs. Jones?”

Who known?s someone that probably needs help at home and yet for one reason or another no one is helping them? As they put up their hands, make your way toward them with one of your brochures. Ask them to write the persons name and room number if they live in the ALF building.? After the event your sales representative can go check in on them.

Here is a home health example:

Before I begin calling bingo, I would ask the audience the following questions. “Who, by a showing of hands has gone to the doctor?s this month?” Make note of who raised their hands. Ask the audience another question: “Did any of you here today have a change in any of the medications that you were taking this last month?” Again, make note of who raised their hands.

Ask one last question before we call bingo. “Did anyone have a fall, or near fall since I was last here calling bingo?” Make a note of who raised their hand. Now, you have a reason to have a conversation with these folks to see if home health is needed.? Remember, you need to know why Medicare pays for home health services.? That information can be found here.

Always ask your sales associate, “what is your plan on how to get referrals from doing an activity” and if they need help to figure it out you have Home Care Sales to help you. We have amazing group coaching programs, High Performance Sales Training and Fast Track Orientation programs to help your organization grow.


Cheryl “The Solutionist” Peltekis, RN




This week I spent the day with 16 fantastic Home Care reps and Directors of Operations discussing the current landscape and changes in COPs and payments for some of our favorite friends and referral sources.

Home Care Sales in the time of:

  • PDPM – October 1, 2019
  • New COPs for the Hospitals and Discharge Planning
  • PDGM – January 1, 2020

The 4th Quarter is a perfect storm!

The theme:

In the chaos, there is an opportunity!

We already see “chaos.”

This week on coaching calls, I heard reps report out some of the misinformation that is being shared to and by referral sources.

One representative reported a CM at the hospital told her? “Another rep told me that starting January 1 you will no longer be taking joint patients in Medicare Certified Home Health. Is that true?” – NOT TRUE

Another representative reported, “Over 50 therapists were laid off from a Skilled Nursing Facility chain” in her territory. And she asked? “How is that going to impact patient care? And what can we do as an agency to help?” ? WE CAN HELP!

Another rep reported a client who was also being served by a Medicare PT told their client services director, “I have to get in all my PT because they said in January Medicare will no longer pay for PT in the home.” -NOT TRUE!

These are just three examples of the changes happening in our client’s lives? and they are happening in yours too.


How are you responding?


Do you know how to position your agency to help our referral sources and, most importantly, serve the patients who will be impacted by these changes?

In the workshop, we covered the basics of PDPM, PDGM, and the new COPs for Discharge Planning. Knowledge is POWER.

We have to combat misinformation with the truth!

Be the lighthouse in the swirling seas of confusion.

I seek to arm the reps I am responsible for as thought leaders in their territories, which is why we spend so much time on industry “happenings and changes.” I believe those reps to present a clear way forward for our referral sources are more trusted and gain more referrals.

This has been proven time and time again.

When your rep faces questions about how we are going to care for a patient during these changes ? this is your time to SHINE!

I believe there is a HUGE opportunity in these changes


It will change the way you market.

When you become the preferred partner, you will serve your referral sources more deeply? and impact more families, all while helping your agency grow!

If you are looking to gain tools and tactics on PDGM and growth, we have two opportunities for you

The wildly popular Growth Summit that we just did in Las Vegas was AMAZING! And so many people asked did we have a recording? Others shared they wished their partner would have come to the event too. Now it is your chance!! We are doing the best sessions from the event via Video Conference that you can experience via the comfort of your own office.

Upcoming PDGM for Marketers & Liaisons Webinar:

Join us for 90 mins of proven strategy and tactics for your marketers and liaisons to lead the charge in the field and gain the right referrals for PDGM!

During these 90 minutes you will receive:

  1. Overview of the payment changes, so your team is knowledgeable on how the specific referrals impact payments
  2. Identification of the 12 clinical groups to impact high-value patient types
  3. Referral checklist to make sure every referral brought into the agency has the right clinical information to maximize your reimbursement
  4. 4th Quarter game plan to ramp up to 2020. Maximize your pipeline to weather the cash flow crunch created by the reduction in the RAP starting January 1, 2020.

Sign up for the PDGM for Marketers & Liaisons Webinar Here