COVID-19 is changing the landscape for health care delivery

With the materialization of the virus causing the disease COVID-19, there is a need to expand the use of technology to help people who need routine care, and keep vulnerable beneficiaries and beneficiaries with any symptoms in their homes while still providing access to the care they need.

The Centers for Medicare & Medicaid Services (CMS) has expanded access to Medicare telehealth services so that Medicare patients can receive a wider range of services from their doctors without having to travel to a healthcare facility.

Medicare patients will be able to receive a specific set of services through telehealth including evaluation and management visits (common office visits), mental health counseling, and preventive health screenings. I have not seen how this will be done with Medicare Advantage plans. The reason for this welcoming change in the law is to safeguard Medicare beneficiaries who are at a higher risk for COVID-19. This way they are able to visit with their doctor from their home, without having to go to a doctor’s office or hospital (which puts themselves and others at risk). 

One of the challenges that quickly comes into my mind is the concern of how many seniors have access to a smartphone. Additionally, how many will know how to download apps (if the physician’s office uses an app to conduct the visits) and how can home health agencies use this technology to conduct face to face visits as well? 


There are three main types of virtual services physicians and other professionals can provide to Medicare beneficiaries:  Medicare telehealth visits, virtual check-ins, and e-visits.

MEDICARE TELEHEALTH VISITS:  Currently, Medicare patients may use telecommunication technology for office, hospital visits and other services that generally occur in-person. 

  • The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. Distant site practitioners who can furnish and get payment for covered telehealth services (subject to state law) can include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals. 
  • It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness. Accordingly, the Department of Health and Human Services (HHS) is announcing a policy of enforcement discretion for Medicare telehealth services furnished pursuant to the waiver under section 1135(b)(8) of the Act. To the extent the waiver (section 1135(g)(3)) requires that the patient have a prior established relationship with a particular practitioner, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.


  • Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.
  • These visits are considered the same as in-person visits and are paid at the same rate as regular, in-person visits.
  • Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.
  • While they must generally travel to or be located in certain types of originating sites such as a physician’s office, skilled nursing facility or hospital for the visit, effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any healthcare facility and in their home.
  • The Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.
  • To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.

Information for this blog, provided by:

What does all of this mean for home care, home health, and hospice organizations? I have had conversations over the last 24 hours and so many new ideas and thoughts are being discussed.

  • Hospice agency/home health providers now using their nurse practitioner to perform home visits, and billing part B for the services.
  • This allows every home health agency to visit a patient and assist in helping in the use of an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. 
  • Use RPM equipment. Private duty companies, that are short on staff, have increased their charges by $2 a day and placed these devices in every patient’s house. With devices like Electronic Caregiver, the patient has an emergency button that they can press, plus a fall detection device that will alert anyone who is listed on the notification that the patient fell or activated the emergency response system. When home care is involved with those notifications it allows us an opportunity to immediately reach out and identify that more hours may be needed for a patient plan of care.

It has become apparent that new strategies are needed to continue providing care the those who have the highest risk of contracting the COVID-19 Virus. Telehealth is an obvious solution that needs truly evaluated to reduce the spread of this disease.

If you would more information about digital health or to become a master care partner with Electronic Caregiver at no cost to you, go to www.homecaresales/caregiver and you can help your patients be monitored by your agency. 

4 Ways to Winning Weekly Referrals

As an agency owner, I used to feel like all I looked at was the numbers. I watched with triumph when they were up, and I panicked when they were down. I felt like I was on a never-ending roller coaster of referrals and revenue. 

Once I found what worked for me, I made a commitment to making sure I would use what works every week. Today, I share with you one of my favorite ways to win more referrals every week.

Starts with a Weekly Win Call!

Every week I pull my teams together for a chance to review progress toward hitting our monthly census and admit/hours goals as well as give them what they so long for to win more referrals. Accountability! Yes, I did say accountability! 

You see accountability breeds response-ability. We all want sales representatives to be responsible for their results, so let’s set them up to WIN each week. Invite each sales representative, Clinical Leaders from each service line (if you have more than one), the CEO, Intake and anyone else that you need to help motivate the agency to be in a growth conscious mode. Have the call every week on the same day and at the same time for ease and consistency.

WIN Calls give you the opportunity to help your sales reps be prepared for next week. Each win call we start by reviewing numbers. We look at admissions/hours MTD and how close in percentage are we to hitting or exceeding the goal for the month per location or per sales representative. After we review the numbers we move into covering the following 4 W’s:


Why         Where          What          When


These four simple questions can transform your regular sales meeting from a jumbled mess into a solid track to success. The best part? It’s extremely easy. Check it out:

Why are you going out into the field to sell this week?

What do you believe about the services your company can provide? How does the sales representative transform their mindset into wearing a superhero costume? Have each representative connect to their “why” each and every week. If they can’t articulate how they are going to get themselves in the right mindset then the clinical manager can help by sharing a recent patient success story.

Your sales representatives will hear no over and over again when out in the field asking for the business. They need to control their mindset, so they never feel like an interruption but understand on a very deep level that when they go out and ask for referrals, they are asking to help get someone identified that needs our services delivered into their homes!  They are changing lives, and we must help get them in that mind space every week! 

Where are you going this week?

What are the new accounts that you will go to qualify? Melanie and I ask each one of the sales representatives that we work with to qualify every week at least 10% of the time. Where also has us focusing in on if there are any new people at accounts that you must meet? New social workers, or discharge planners, or new building administrators. If they don’t know, like and trust you they aren’t going to refer, so you must stay on top of getting to know the new people.   I ask each sales associate if they are “3 Deep” in relationships with each account. If not, they know that is their goal and they will share with me where they are going to get 3 deep with an account.

What are you going to say to trigger a hospice referral?

What are you going to say to trigger a home health referral or private duty? What is the purpose of your sales calls this week. I don’t want any sales representative aimlessly running out to “visit” an account without a purpose. We love to give them a specific patient type, or trigger question to use each month to help their accounts quickly form an image of an exact patient that they should refer on the spot! Strategy, revel, qualify, or maintenance sales call. Role Play with your sales representatives to help them form what they are going to say to each account type they are going to visit. I almost laugh at loud when I hear an owner tell me, “Well my team isn’t good with role-play so I don’t force it.”  Well folks, if they can’t roleplay it with you, how in the world do you think they are doing when they are out selling? 

If a rep can’t role play they may need to get in a different line of work.

and of course… When?

Are you performing sales calls to the accounts the right day and time? Can you find out if an account is better served if you visit on days of discharge rounds? If you’re a private duty organization and you want to work with a hospice agency, are you conducting sales calls during the schedule Interdisciplinary Team meetings, that happen at least every 15 days? Make sure that you are keenly aware of when an account is best served by the rep to get the most benefit. If you want referrals from physician offices, you need to make sure that you are visiting on days that the doctors are in the office! 

After a few weeks of running this “4 W’s to Win” sales call, your team will develop incredible pre-call planning behaviors that lead the top-performing reps to sales success. This win call should last less than an hour and should always start and end on time. Sales Representatives love structure and this give enough structure and it is holding them accountable to how they are working each of their accounts. It makes them stop and review their account list, to really own where they are in the sales process. 

This is accountability without the manager or owner assuming all the workload. Hope this helps!  If you need help with formulating your trigger questions, we got you. Check out our Roadmap to Referrals and gain 52 reasons a year to visit your accounts with a purpose. 

Our roadmap has been known to 5x the referrals you currently are getting from an account. Learn more at    

Private Duty, Home Health, and Hospice Sales Representatives: I learned a secret that increases referrals!

I remember back in Middle School, I had to read the book “The Death of a Salesman” and at the time I thought the book was just total crap. But recently, as I cleaned my office, I came across the book and looked through it with different eyes. 

This time, I found one hidden gem inside. In fact, it is such a gem that I can’t believe I previously hadn’t identified it as a key skill or competency that each sales representative must develop before going out in the field to sell our much needed in-home care services. 

I have encountered thousands of patient care liaisons that have the same problem as the main character in the book. Today, I want to share that gem with you.  (Continue to Blog Post to learn about the hidden gem)

Hidden Gem

Use fewer words! That’s it folks! Speak less ask more! If the account that you are visiting is doing more of the talking (at least over 70% of the sales call) than you, my friend, may be doing a great job!

Now I know you have so much to say. Let’s face it. Salespeople talk too much. When salespeople talk too much, they generate too few referrals. So why do those of us trying to grow our numbers constantly find ourselves in this position? Perhaps because we do not understand why we talk too much.

Our prospective accounts NEED to know so much about your company’s services. 

  • Service Area
  • Insurances you accept
  • Caregiver packages
  • How to refer
  • Who to refer
  • Star rating
  • Why they should refer to your company

But, here is the truth: “No one cares how much you know until they know how much you care. 

Research suggests, that in order for someone to feel that you care about them or their patients that they could refer to you, is that they feel heard and understood. In order for someone to refer to you, they need to feel that you heard them and understood their patients’ needs. The only way to do that is by listening. To hear what they have to say, you have to ask them open-ended questions.

What questions are you going to ask them?

If you struggle with this, you need to get the 52 Week Road Map to Referrals!  Each month Melanie and I will role play with you the correct way to ask questions and demonstrate listening to make them feel understood.

Competency Evaluation Is A Must. 

The only way to ensure that a representative is helping you grow and not stopping you from growing is with ROLE PLAY!

According to an article by the Rain Group, reps report the following reasons for why they talk so much:

  • I get nervous, so I talk: If this is the case, explore why you are nervous. Are you uncomfortable starting new conversations? Are you uncomfortable talking to senior-level managers? Do you not know your products and services very well and the value they provide?  Maybe you need to go back and watch your orientation training program from Home Care Sales once again?


  • I have no plan or objective: There is a saying in sales, “if you don’t have a plan, stay in the car.” When you enter a sales conversation and you are not sure where you want to go or what you want to accomplish, the conversation meanders every which way and ends with neither clarity of purpose nor asking for the business in a productive way. 


  • I easily get distracted: Much related to the previous point, if you don’t have a plan, you can’t be sure what you are trying to communicate. Thus, any new topic that gets introduced in the sales conversation can lead you on time-consuming and fruitless paths.


  • I don’t talk too much, I am lively: You may have a dynamic, effervescent personality that springs forth in every conversation. That’s fine. You don’t have to hide your personality; just learn to share it in easy to swallow doses. Your prospects will appreciate your liveliness even more.

There is good news.

You see… as a fellow business owner, I need results. It is expensive to have sales representatives working for us. We need to make sure that they are making valuable sales calls each week. We have the solution for you. Just check out our products at 

You will want to find the one called, Road Map to Referrals. This is the product that gives your reps the exact words to say each week that they walk into see one of their accounts.

Remember, speak less, learn more. 

Yeah! You got your first private duty referral from a doctor’s office, now what?

You have done the hard work. You got your first referral from a large doctor’s office and now you set up your meet and greet at the patient’s home. 

It goes well, and you get a patient signed on for 24 hours of care a week. This is great news. Now, you have an opportunity to get more from this same account.

You have to go back to the doctor’s office, in-person if possible, and thank them for the referral. Personally, I like to write a handwritten thank-you note to each person I have meant or want to meet.

I usually write something like:

Dr. Jones,

I wanted to thank you for the opportunity to provide care to Mrs. Female Patient.  We were thrilled to receive her referral for services on Monday 1/3 and we were able to meet with the patient and family the next day. She will be receiving services starting Monday the 10th by one of our dementia trained caregivers. I

would love to discuss any other patients that look just like Mrs. Black to evaluate them to receive help in the home. Don’t worry about knowing if they can pay for the services. We have so many options to help get the care paid for. My cell is ###-###-####, and if you have any other patient that may need help feel free to call me anytime. My email address is Looking forward to helping you help others.


I make sure that every nurse practitioner and physician that practices at the account has a thank-you note. You never know who in the practice has influence over referrals and you don’t want to miss an opportunity.

Now, when I leave my note, it is in an envelope with the doctors’ name on it, and the word “confidential.”  This piques their curiosity and they will most likely read it.

Understand this: I bought a watch recently and had the watch for a day. I was already thinking about another watch. I bought a Cadillac XT6 and by the time it got delivered I told my assistant if they follow-up, to ask them what it would cost to get a black one. 

As a consumer, I’m literally thinking to reinforce the first purchase with a second purchase. Have you ever been to a furniture store? I recently went in, bought some furniture, and on the ride home thought, “Why didn’t I buy that side table? I wish we had grabbed that lamp… Why didn’t we get the matching bedding?” This happens to everybody.

People who make the decision to refer will say to themselves, I” should have given them Mr. Jones too.”  If you follow up, you will get Mr. Jones if you are asking for him to be identified and you are sharing how easy it is for them to give you the next referral. It’s that simple.

What if the account that gave you a referral is outside your selling area? 

I get that question all the time. I would call and leave a message for the physician updating him/her on the situation. I would also write a note that same day with an update and deliver it right away, so I could get them to quickly see if they have another patient that I could service. 

If you think you need to help your sales representative to develop better sales skills or you yourself are being tasked with selling you need to check out how we can help.  We have a product that can help you get to the next level.  Just go to and check out our products or email and set up a product demo today. 


Go change lives and be a solution to someone’s problem, TODAY.

Cheryl Peltekis, RN “The Solutionist”



Mistakes Sales Rep’s make that drive me crazy!

I have been working now for 26 years in post-acute care, specifically home care, home health, and private duty and over 10 years using my operational experience to support business development. 

I have done so many sales calls with reps, and coached or managed thousands of reps around the country and I have made the list of the things that sales executives do that just drive me crazy.

#1.  Just Don’t Go. 

They identify an account that could be a leader and they just don’t make a sales call to the account. They’re too busy organizing, searching the CRM, looking for a script, thinking about what you’re going to say, trying to find what Cheryl or Melanie said…

MAKE THE CALL! 48% of all salespeople don’t make the call. ALL you have to do is make the call! And then you’re at least better off than the 48% of people who don’t. They put it on their call log, and yet at the end of the week, they didn’t get there. 

When I ask reps why this is the reason I hear over and over again. “I didn’t know what I exactly wanted to say”  Well folks, if you show up at an account you have a chance to at least get a referral if it’s top of mind. If you never go, you will never get a referral. JUST SHOW UP! If you don’t know what to say, just buy of Roadmap to Referrals and you will gain a valuable reason to walk into an account every single week of the year!

#2.  Not Enough Sales Calls to an Account!  

Not enough contacts with an account OR frequency OR not often enough volume… You get the idea. All of these describe the second most commonly made mistake in sales: not enough calls. 80% of all sales are made between the 5th and the 12th contact. The average salesperson doesn’t make enough sales calls to the same account. The data is ridiculous.

You see I have spent time researching through tons of sales reps call logs, and I see it all the time. Not enough visits to get them the referrals. You see sales reps need to make at least 5 sales calls all that include requests to make the sale. If you think it’s going to be one, two, three or even four calls you aren’t going to make it. Trust the data! Know that you are going to have to do the 12, to really know if you have potential.  Follow the High-Performance Sales Process, and you will get the referrals you long for! 

#3.  Calls not on a regular basis. 

Your calls need to be on a regular basis. Randomness, one call now another call in 30 days, 3 months now, another one-you need volume and you need frequency.

It’s like dieting. You can stick to your diet once a week, different days every week, skip weeks-who cares? You aren’t getting results you’re just getting fatter. Just stop saying you are on a diet and eat cookies.

The way for the diet to work is to do it every single day. You’re going to feel better about yourself, create a discipline, it’s going to create a different self-esteem. The same goes for follow up, the calls the emails and the contacts must be regular. Be consistent and regular, there all the time. When you call people back with regularity, you will start to build your persona in the marketplace and take you out of obscurity. You become dependable, trust­worthy and become the contact to give a referral too.  In order to do this, your reps need to focus on a smaller number of targets and really give them that week to week visibility to put them through the 5 step selling system. Remember folks, this system has been tried over the last 10 years, and over and over again has proven to work! All you have to do is follow the program.

#4.  Run out of reasons to call.

Lacking variety in reason to follow up is a major mistake. In a transaction, you can’t just keep repeating the same thing over and over to get a deal.  You need variety or you’ll get bored or worse the contact your calling on will start to dodge you when they see your car pull into the parking lot. 

You can’t be dependent upon one mechanism. It doesn’t matter if you like handwritten notes. It doesn’t matter whether you like phone calls. It doesn’t even matter if you like leaving a message! This is for them, not for you. Use all that is in your arsenal, but don’t use it all at once. 

I have seen reps, do a qualifying sales call, and they provide the account this amazing branded folder filled with every flyer they have about all their different programs. Folks, you just gave away the reason for you to walk in there for the next 11 weeks. 

Now I know some accounts you need to do what I call a personal visit. Rapport building visits are a must with some of our accounts for sure. I hate personal visits. I hate getting into the car, driving across town,  and walking into chit-chat. However, I do them because personal visits are so powerful. You have to make that investment.

You have to be willing to do the things you don’t want to do and use the full variety of sales call types. That is what will show your client that you are there for the long run. You’re creative, you have solutions, and you’re willing to do whatever it takes – whenever it takes – however it takes – to get the job done.

Use variety. Don’t get too comfortable and too reasonable with the same old mechanisms. Add variety to your reasons to follow up.  If you are struggling you need to get the 52 week Road Map to Referrals! It schedules out a variety of sales calls for you! It can also 5 x the volume of referrals from accounts that are already referring to you! Email and ask him to share with you a free webinar on our incredible Roadmap to Referrals!

#5.  No purpose sales call. 

I have been on so many ride-along sales calls to observe patient care liaisons (fancy name for sales representatives in the private duty, home health, and hospice sales space) in the field visiting accounts and I see this all the time. They use this phrase, “I just was stopping in to check on you.” 

What!? I don’t want someone just stopping by to check on me! Instead, I want to feel that someone comes to see me with a purpose.  So folks please announce, in the first 30 seconds, why you are there.  

“Hi Donna, you look amazing today. The purpose for my call today is to discuss patients that are at risk for making a mistake with taking their medications.” 

Now that is a reason to call on any one of your accounts. My intention wasn’t to be there to ask about the kids and how everyone is doing. Some people like that. Maybe that’s good for your client. If it is, do that but make sure you are there with a clear intention and purpose. Was your clear purpose or reason to find out about the kids? If it was, don’t present your services…

Do you see what I’m saying? If your purpose was to make contact and teach them something about how you can help their patients in hopes to get a referral then why don’t you make your attention clear up front?  Just be honest and forthcoming on what your intentions are.

If you make a call about their kids, you are a visitor and not a salesperson. If you make it about a benefit a patient can receive when they are getting cared for by your agency, it is a sales call. This is why we teach the TADA sales call!  Because it works. If you need to learn how to do it, then go to and purchase the High Performance Sales Academy. It costs less than $500, and it will teach you this plus a repeatable sales process that is used by the best in the business!



Go change lives and be a solution to someone’s problem, TODAY.

Cheryl Peltekis, RN “The Solutionist”




A private duty, home health, and hospice owner’s story of transforming her life from FAILURE to FORTUNATE!

It’s me Cheryl Peltekis, RN “The Solutionist”.  Yes, I know what a weird nickname, but it truly fits my quirkiness! I am super grateful for the success that I have been able to accomplish.

It feels beyond great to know that I’m set for my retirement and that I have the home of my dreams and the career that I love.

It wasn’t always like this…

My childhood wasn’t a Disney princess story. One of the worst days happened when I was only 8 years old. My brother Mark was killed crossing the street by a drunk driver. I can’t even express in words how this rocked our family’s world for the next few years. Just writing this makes me relive this tragic time.

A few years later it was time for high school. I really, really hated high school. You see, I had gone to public school up until the final four years. I attended special classes for the gifted kids and I never felt that I fit in. My parents decided to let me go to Catholic School for high school. Even though it was with my neighborhood friends, I felt removed from the kids I grew up with. I felt like someone made a mistake…and that mistake was me!

It was hard going to a school where everyone had their childhood friends from their elementary years. I didn’t get involved with many activities and immersed myself in working and schoolwork, as well as reading. To this day, I still read about a book a week. All nonfiction.

I did well in school without working very hard and I decided that I wanted to be a physician. Imagine my shock when I failed in my first year of college! Too much freedom made for some bad choices and boy was I good at making some really bad decisions. The thing that changed my life was this embarrassing college failure. It was a low time in my life. I felt so stupid and so disappointed in myself.

I was smart, but not smart enough to realize that I was wasting a scholarship that I received to pursue my biology degree. Somehow, I survived and I decided to go after my next career choice that would allow me to help patients. I decided to pursue nursing. While applying to nursing school, I realized very quickly that wouldn’t be an option for me because I really couldn’t afford school and my parents weren’t in the position to help me.

Thankfully, the nursing school shared with me that Pennsylvania Hospital gave a scholarship to a student each year to go to nursing school in exchange for 3 years of work once you completed the program. I applied, went for the interview and got the scholarship. I really believe that my failure, is what got me the scholarship.

I remember telling the HR Manager (her name was Terry) that I screwed up and didn’t apply myself in college and insisted that I was never going to make that mistake again. I took 100% responsibility for my situation and I remember her telling me that is why she selected me.

Over the next few years, I gave up any social life I may have had and I converted to nerdism. Full nerd submission. I became a bookworm without the glasses….

I attended 3 different colleges at the same time

  1. Penn State for Nursing
  2. Philadephia Community College to get pre-requisites out of the way
  3. Holy Family University for business classes

I was on a mission to get done as fast as I could and completed all three in 2 ½ years! I finally felt like I was starting to like “me” and was proud of my success. I was (and am) content with this accomplishment, but I still was carrying around a small source of continuous pain like I wasn’t producing enough value in the world. It was a nagging feeling that wouldn’t go away, even with my accomplishments. So, over the next 3 years, while I was working full time at the hospital in oncology nursing, I really started my transformation.

It was like I was a worm turning into a butterfly. I loved helping people, and I was ready to take another step towards becoming more than just a pair of hands helping others. At the age of 26, I took a leap of faith and opened my first business.

Today, I own a home health, hospice, and private duty organization besides being the co-owner of Home Care Sales.

I know how hard it is to get a business to be lucrative. The pains of growing a business are as bad as birthing a child (And I would know… I have 5 children).

In these industries, we faced (and still face) so much competition. Everyone has built their SEO optimizations, allowing them to capture more online business and as for services, we were all offering basically the same with some minor differentiators. I struggled to just get a foot in the door of many accounts, and growing seemed like a pipe dream.

Many days, I felt nauseous, had sweating hands, and felt like I was walking around in a fog trying to figure out what the heck is going on. “Why wasn’t my organization growing?” I would repeat over and over.

We had suffered 3 years in a row of financial losses and once again failure was looking at me right in the face. I couldn’t even stand to look at myself in the mirror. I had to save this business. I couldn’t handle another failure.  Understandably, this caused me to be depressed and (if I wanted to drive business) I needed to snap out of this sad state.

Finally, I looked at the top 5 companies that were my competitors and I conducted a SWAT analysis. Quickly I found what I was missing. There was one thing that I didn’t have that was giving my competitors free rein to steal my business. I was missing a Sales Team!  A professional liaison, relationship builder, customer service guru, and post-acute care expert.

Now, I know so many of you out there don’t have sales representatives, but this one thing made the difference between failure and success. Once I made the leap to hire, I was again afraid because I had no clue on how to manage them. I found help by going to 5 different boot camps and attending a sales manager’s class. I mentioned I read books right? I don’t want to share how many books I read, but I’m pretty sure I set a Guiness World Record.

I saved my business that year and now I want to help save yours!  I went from failure, to “The Solutionist”.  I was able to regain my self-worth and prove that I was a winner! I want you to have the same experience. I want you to come out a winner!

If you want to grow your organization and you don’t have sales reps or you have reps that aren’t bringing in the business, Home Care Sales can help.  We create superhero sales representatives that are high performers!

I know it is hard, but if you follow our High Performance Sales process, you and your team can gain new accounts and grow existing accounts. This sales process has been proven to work in any market when it is followed and supported with exceptional services. I almost lost my business, but because I lived by the success principle of taking 100% responsibility for my life –  I acted. I went out and built my self a sales team of superheroes that turned my company around using the high performance selling process.

If you want to read my story about how I saved my organizations you can get my book “Five Steps to Sales Success”  on Amazon, or download the free eBook version at

While you are online, check out this brief video about our products:

If you want to grow, just email and he will unlock the vault of products to make it happen!

Successful Selling,

Cheryl Peltekis, RN

“The Solutionist”


The 3 behaviors that you can adopt to help grow your private duty, home health or hospice agency

What makes someone a growth leader?

When working with private duty, home health, and hospice organizations around the country, I have found that business leaders that work in the post-acute care space have several traits in common.

First, they put growth at the top of every agenda.

From board room meetings, to clinical care meetings and performance reviews, growth is the number one priority.

Growth leaders demonstrate this kind of commitment by constantly scouring for funds to invest in more growth. They have a clear vision on what they will do, say, or buy that will help their organizations continually grow year after year. They also keep raising the bar. No matter how ambitious growth targets are, growth leaders do this by setting targets that seem almost impossible to reach – forcing teams to strive for greater impact. These leaders see stagnation as death of the company.

Second, they unite the business around a culture of growth.

Growth leaders make growth the principal emphasis of everyone in the business by creating a common belief and language.

For example, they co-create growth goals and metrics with their leadership teams and then help translate them into metrics for every individual at every level.  For example, sharing that the company has a friend and family referral bonus plan.

Establishing this kind of shared and co-created language binds employees together to think about how they can contribute to top-line growth.   This can be done with just a weekly call with all department heads and sales representatives to ensure that everyone knows what the goals are, how close they are to hitting them, and identify if there are any barriers that are restricting growth.

Third, they take customer service very seriously.

By making it personal, they own customer satisfaction…and it always shows.

Many of the best companies have strong customer-insights organizations. Customer insights and analytics are crucial to supporting growth. However, growth leaders go the extra mile by embracing complaints, building committees to work on performance improvement, and taking the time to focus on building empathy with the customer.

As an owner of a home health, hospice, and a private duty, I have had the opportunity to experience the flow of receiving care from my agency with my own family members. I experienced the level of customer service touch points that I want my family to receive and identified areas for improvement as well. I have been blessed to see incredible care from my team that surprised my family (in a good way).

Spend time at your intake desk with the mindset that every referral that arrives is your own mother. If you like your mom, it will give you so much insight into what your patients need, what are your patients fears, and what we could do as a company.”

Follow the leader

Creating a growth culture begins with your leader. You need to have a growth-minded leader and the rest will fall into place.  Remember, we have a mastermind group that will help you grow as a leader.

If your interested check out this brief video:

You can also learn more and complete the application at

The Solutionist, Cheryl Peltekis, RN.

I just hired the wrong sales representative to grow my Home Care, Home Health, and Hospice Agencies

Have any of my fellow owners felt the pain of hiring the wrong sales representative to grow your agency? This morning the pain hit me. I hired the wrong sales representative. I should have seen the signs from the first 2 weeks…

  • Not replying to my emails timely
  • NO initiative in building her potential account list
  • Waiting for direction from leadership
  • The way she walked, breathed, or just existed

I mean come on now, I’m an expert at hiring. Well folks, it happens to the best of us. I got duped into hiring someone who showed up with her prestigious sales awards in her briefcase. Sharing how she made millions in sales the previous year and demanding a high salary to join my team with her amazing skills.

I wanted the easy way out. I wanted someone who didn’t need much hand holding and so I grabbed this Presidential Award Winner, and offered her the sun, moon, and the stars, and what did I get over the next 2 months? NOTHING! Just another box of business cards to add to my trash can!

…Or did I gain something from this?

What did this opportunity give me a chance to learn?

Was the lesson, don’t be so easily impressed by previous sales successes? Don’t let an employee join your team without making part of their salary in commissions? Was it, always hire 2 reps at the same time so even if one quits you still have one that works out? Maybe all the above. It’s been a while since I just picked wrong and I was really feeling quite sorry for myself. Jason, my colleague and friend, said, “Hey, God is just making way for the next best thing to walk through the door.” I was thankful for his kindness.

This experience made me think about all the reps that I had hired for all the companies around the United States. I slowly went through at least the last 25 hires, and all but 4 are still working at the companies they were placed with and still producing excellent results. Not a bad track record at all.

Next, I looked at the 4 that didn’t work. Interesting again. All 4 had previous sales experience in either pharma or health related sales. I went through 5 of my favorite hires. I found that all five of them were not in sales before they became full time sales representatives.

  • Competition Cheerleader Coach at a College
  • One waitress for 12 years
  • One Bartender for 7 years
  • One a Home Health Aide for 5 years
  • One a hostess at my Flyers Suite Box

What made all these non-salespeople so great at there job?   What did they have in common that made me love helping them grow into the incredible salespeople they are today? Then it hit me like a ton of bricks. They all had a deep passion for getting people help at home. Each of them had a personal connection to the services we provide. Each was eager to go make a difference in the world by helping patients obtain the needed services we long to provide. That is where I went wrong with this hiring mistake that I will call Sales Representative L.  (L = Lazy).

Morale of my story: Don’t get duped…

Don’t get duped by a fancy appearance and a bag of awards. Don’t think years of selling Pharma will make them a great rep. Sometimes it may, but in my case it didn’t. Look for the passion connection to the industry. Look for someone who has had a personal connection to what services you provide in the home. They are the ones who will go knock down doors.  They have a bigger mission than their paycheck. Those are the ones that we should seek out.

So, my friends remember we have the orientation training, high performance sales training, and the master’s in high performance selling program, and coaching to support your reps. If you are like me, looking to hire to get more revenue in the door than hopefully my failure will help you also find the next hire.


Happy Hiring!

The Solutionist, Cheryl Peltekis, RN.

Fellow Private Duty, Hospice, and Home Health Owners: This one’s for any owner who has had to deal with a complainer!

Some of us have employees who go around complaining about someone else. Some of them tell us they are just venting and blowing off some stream. But I want to share some information with you on what they are really doing.

One of my mentors, is  the legendary executive coach Marshall Goldsmith, who interviewed more than 200 of his clients and what he discovered matched previous research he read, but found hard to believe: “A majority of employees spend 10 or more hours per month complaining — or listening to others complain about their boss or upper management. Even more amazing, almost a third spend 20 hours or more per month doing so.”

And that doesn’t even include the complaining they do about their peers and employees! Which would be hard to believe if not for the fact that, if you pay attention to what you experience during your day, you’d find it’s pretty accurate.

Imagine the productivity gain of reducing all those complaining hours.

Why do we complain about other people?

Because it feels (really) good, requires minimal risk, and it’s easy.

Here’s what happens: Someone annoys us. We’re dissatisfied with how they’re behaving. Maybe we’re angry, frustrated, or threatened. Those feelings build up as energy in our bodies, literally creating physical discomfort (that’s why we call them feelings — because we actually, physically, feel them).

When we complain about someone else, the uncomfortable feelings begin to dissipate because complaining releases the pent up energy. That’s why we say things like “I’m venting” or “I’m blowing off steam” (But, as we’ll see in a moment, that dissipation doesn’t just release the energy, it spreads it, which actually makes it grow).

Additionally, when we complain to people who seem to agree with us — and we almost always complain to people who seem to agree with us — we solicit comfort, camaraderie, connection, support, and justification, which counteracts the bad feelings with some fresh, new good ones.

Complaining changes the balance of negative/positive energy and, for a brief moment at least, we feel better. It’s actually a pretty reliable process. Addictive even.

Which is the problem (beyond even the wasted time): Like just about all addictions, we’re feeding the spin of a destructive, never-ending cycle. The release of pressure — the good feeling — is temporary. In fact, the more we complain, the more likely the frustration, over time, will increase.

Here’s why: when we release the pent up energy by complaining, we’re releasing it sideways. We almost never complain directly to the person who is catalyzing our complaints. We generally complain to our friends and family. We’re not having direct conversations to solve a problem. We’re seeking allies. We’re not identifying actions that could help. We’re, almost literally, blowing off steam.

Why is complaining such a bad move?

Complaining creates a number of dysfunctional side effects (again, beyond the time wasted): It creates factions, prevents or delays — because it replaces — productive engagement, reinforces and strengthens dissatisfaction, riles up others, breaks trust, and, potentially, makes the complainer appear negative. We become the cancer we’re complaining about; the negative influence that seeps into the culture.

Worse, our complaining amplifies the destructiveness and annoyance of the initial frustration about which we’re complaining.

Think about it: someone yells in a meeting. Then you go to the next meeting (where no one is yelling) and you complain about the person who just yelled. Now other people, who weren’t at the initial meeting, feel the impact of the yelling and get upset about it too. Encouraged by their support, your brief, momentary release transforms into righteous indignation and, becoming even more incensed, you experience the initial uncomfortable feelings all over again.

In other words, while the energy dissipates, it expands. The amount of time you spend thinking about it extends for hours, sometimes days and weeks. And you’ve multiplied the people who are also thinking and talking about it. Meanwhile, our complaining improves, precisely, nothing.

In fact, that might be the biggest problem: Complaining is a violent move to inaction. It replaces the need to act. If instead of complaining, we allowed ourselves to feel the energy without needing to dissipate it immediately — which requires what I call emotional courage — then we could put that energy to good use. We could channel it so it doesn’t leak out sideways.

In other words, let the uncomfortable feeling you have — the one that would otherwise lead you to complain — lead you to take a productive action.

What’s a better move when we feel like complaining?


Go ahead and complain. Just do it directly — and thoughtfully — to the person who is the cause of your complaints.

Talk to the person who yelled in the meeting. If that person doesn’t listen, talk to their boss. If you don’t like that idea, then, when it actually happens, say “Hold on. Let’s respect each other in this conversation.” If you missed the opportunity in the moment, then meet with them afterwards and say, “Please let’s respect each other in our conversations.”

That, of course, also takes emotional courage. It’s a scary, more risky thing to do, but it’s why it’s worth developing your emotional courage. While scary, it’s far more likely to be highly productive. It holds the potential for changing the thing that is the problem in the first place. Rather than become the negative influence, you become the leader.

If you want to brave this route, let your urge to complain be the trigger that drives you to take action in the moment (or, if you missed the moment, then shortly after).

The following advice can help:

  • Notice the adrenaline spike or the can-you-believe-that-just-happened feeling (e.g., someone yelling in a meeting).
  • Breathe and feel your feelings about the situation so that they don’t overwhelm you or shut you down. Notice that you can stay grounded even in difficult situations (e.g., feel, without reacting).
  • Understand the part about what’s actually happening that is complain-worthy (e.g., it’s not okay to yell and disrespect others in a meeting).
  • Decide what you can do to draw a boundary. Ask someone to shift their behavior or otherwise improve the situation (e.g., “Please let’s respect each other in our conversations.”)
  • Follow through on your idea (e.g., actually say: “Please let’s respect each other in our conversations.”)

It’s not nearly as easy as complaining. But it will be far more productive and valuable.

“But wait,” you might protest, “the whole reason I’m complaining is that I’m powerless in this situation. I can’t tell the person to be respectful because they’re my boss.”

You may be right. It’s true that most people complain because they feel powerless.

It’s also true that most people have more power in a situation than they believe they have, even with their boss. And, just maybe, it could be worth the risk to say something. You could say “I see that you’re very angry and I can feel how it’s shutting me down. Can we go a little more gently here?”

It’s a risk because the person may blow up even more…

…Or it may gain you their respect and, in one sentence, change the direction of the leader and the organization. That one moment could transform what could have become weeks of complaining into a moment of productive engagement.

More than once I have seen someone gain the respect of everyone in the room because they were courageous enough to be direct — caringly, compassionately, and truthfully. Almost always, everyone is surprised by the offending person’s response. Most times, the offender was more open to the feedback then they thought. Not always. But almost always.

Let complaining — and the feeling that leads to complaining — be the red flag that it should be: something wrong is happening and you are probably not powerless to do something about it.

I know we usually always blog about sales and business development, but I wanted to share this, because I know someone reading this, right now, needed this!  Now go have a great day.


The Solutionist, Cheryl Peltekis, RN.


For most of 2019, we have been hearing about all the fears that PDGM will bring our home health agencies. We have heard issues with cash flow, 1/3 of the companies going out of business, and rumors of agencies that won’t survive with Rap Payments decreased to 20%.

I really felt like we were in the Chicken Little Movie, with the chicken running around screaming, “The sky is falling!” Now, the first week is here and the sky is still in place.

Let’s review what is going to help support our agencies operationally

First, we need to make sure that (with every referral) we get a list of all the possible diagnosis codes. This is going to help with getting the correct clinical group and capture the additional reimbursement for co-morbidities.

Next, we need to make sure that we have everything needed to support the face-to-face documentation. We don’t want anything to slow down the billing process or admission process. It is critical that every referral can become an admission and we don’t want to have the face-to-face encounter making our intake offices have a delay in accepting patients.

Now, what if they are for heavy therapy? Hopefully you already have a plan in place but if not you want to keep reading…

You must look at the referral sources and decide on how to service the patients without losing your shirts. You must know that you have the right therapist who will treat the patient according to what they need to keep out of the hospital and recover safely at home. You want to make sure you have therapy assistants working with your therapist to keep the cost of servicing the patient down.

You may need to add home health aide services to support patients more on days that the therapist isn’t seeing the patient. There may be opportunity to land some of the accounts from competitors that are fearful of taking therapy cases as well. If you can figure out how to do it without losing money, you may quickly become a preferred agency from your referral sources.

Another vital step to prepare for

We need to make sure that our staff is scoring the functional assessments correctly. That each nurse is reading the OASIS answers from the bottom up when completing the assessment. Too many times the nurse reads the possible OASIS answers from the top down and they underscore the patient’s functional status.

If your nurse still has questions about how to score functional assessment you can have one of the physical or occupational therapist and the nurse collaborate on possible answers. The OASIS Guidance Manual is the best resource out there. I am always shocked when I ask clients how they train their staff on OASIS and many clients never mention one of the best resources available to agencies and it is free!

You can find it here:

The OASIS Guidance manual shows the items intent, and response-specific instructions. It also provides data sources and resources for answering the functional assessments. I always make sure each new nurse knows how to answer the functional assessment questions.

Final tip for PDGM

If you are a salesperson, you may be pressured more than ever to bring in new business. You may be pressured to bring in facility referrals because they reimburse the agency at a higher level. You will not be successful out selling without a repeatable sales process that is proven to give you results.

If you haven’t gone through our High-Performance Sales Academy this is the time to do it! If you are an owner and finally realized that you must have a salesperson help your organization grow, know we have the products that can help support you!

Go check out our website at and find the solution to grown challenges! Happy, healthy, and prosperous New Year to all!


By Cheryl Peltekis, RN “The Solutionist”


PS: For those that need results FASTER – Our live coaching program starts Tuesday, January 14th and goes for 6 weeks with supplemental virtual training and weekly calls with the Home Care Sales team to launch your team to faster results. The best part? Coaching attendees all get a years access to the High Performance Sales Academy virtual suite!

You can sign up today and launch your team to new levels of success. The link is HERE: