Thankfully 2020 has come to an end, but the pain from the last year has lingered on. I wanted to share a look at how one agency owner, who owns a home health, hospice, and private duty organization, survived the year.  The owner I am speaking about is me, Cheryl Peltekis, RN “The Solutionist”.  

Covid came into my awareness I believe in December 2019, but I did not see it having much of an impact. Boy was I wrong! 

In March, all hell broke loose. 

It all started at my corporate headquarters when 50% of my operational team all came down with Covid at the same time! We had to operate the organization with 50% of our team. It was insane. I became intake for home health, hospice, and private duty as well as the initial authorization nurse, and nursing supervisor taking all the reports on all new admissions. It was 18 hours days for 2 weeks straight. Insane does not come close to describing these 2 weeks.

Next, my consulting business, Home Care Sales, had to completely change the way we do business. We had to deal with all our clients reaching out to say hey what do I do now that my reps cannot get in to do sales calls or pick-up referrals?  

We quickly pivoted and in March launched our Inside Sales Course, which rocked the industry. Our clients were gaining more referrals than ever before! My personal sales representatives that work for my agencies were all placed on the inside sales training program.

Hospital referrals were significantly cut. We had on average about 178 admits from hospitals a month, and that was cut down to under 40. 

Trying to keep my businesses above water, we reached out to all our physicians that have referred in the past and told them we can help with telehealth visits. We would go into their patients’ home and complete an assessment, review their meds, and help get the patient with face to face virtual visits with our iPad.  

If problems were identified that would meet the requirements for admission for home health to monitor how the patient is responding to changes in the patient’s plan of care, we would do the admission that day. With the sales reps using the inside sales training, our home health census boomed! We made up for all of the referrals that didn’t come from the hospitals and more!

Now we had a new problem… 

We needed more nurses and at the same time, 3 full-time nurses quit, saying they do not want to care for Covid patients. Now what! Okay, brush off the dirt, and get recruiting. God must have a plan for all of us because I had just been working on an amazing recruiting and retention program, so I quickly used what I created and got busy hiring.  

First, we put in place a new retention program to prevent losing any other staff. Success! Now, during this time of onboarding new staff, we had a shortened length of stay on services. We were discharging patients sooner than necessary to make room for new admissions.  

This is why one of the things I say all the time during webinars or workshops to owners is: 

“Grow your census, not just your admissions.”  

If you want to grow your census by 25 more patients on census you will need another full-time nurse.  You cannot grow without hiring more staff.

Of course, private duty began booming. After all, adult daycare centers were closed and now those patients were at home and left alone. 

We were already a waiver/options provider so we could provide the additional patients with private duty services paid for by the waiver program. Soon, AAA was referring more than ever before to our organization. We needed to hire more aids. By the time we got that done, private duty hours had grown (by over 2500 hours a month by end of June).

In hospice, we experienced no growth. In fact, fewer and fewer referrals. As if that wasn’t enough, our hospice Medical Director gets Covid and ends up in ICU on a vent for 28 days.  Skilled Nursing Facilities were preventing access to buildings and keeping patients on their version of palliative care to capture higher reimbursement.  

This led to fewer patients going to ER or urgent care centers for fear of contacting Covid. So we hired some new sales representatives for hospice, only to find out they had a non-complete and they can’t work for 18 months selling hospice services.   

So here we are back to the drawing board. Does anybody else relate to this 2020 story? Well, don’t worry. You can’t keep a Philly Girl down for long!

Our hospice Medical Director released from the hospital and admitted to home health services. OT and PT work with him and get him back on his feet within 6 weeks. During those weeks, I worked with my current team to leverage the inside sales process with the message of the Roadmap to Referrals Hospice. Calling about specific diagnoses was the key. 

After closing out the year, we conducted a review of the year of stats for 2020, and would you believe it?

We shattered every goal we set for growth in 2020!  

What a year of ups and downs. I do not think I worked this hard for quite a few years! My agency, family, and Home Care Sales learned so much from 2020! We saw what worked at my agency as well as the many agencies that we consulted for. The good news is this: Vaccines are going out! We will conquer this.  

We have all learned so much from this tough year. The beautiful thing about facing adversity is it gives you a chance to push through and battle on! Once you accept your situation and decide that you will conquer the challenge, you can push through and win your battles!  

It gives you the ability to tap into strengths that you may not even know that you possess. Look back over your 2020. It was so hard, right?  Well…you made it through it.  If you can do that, what can’t you do? 2020 taught us all that we are stronger than we realize.

Cheryl Peltekis, RN “The Solutionist”

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