“A sense of calm came over them,” said Ken Hudson, newly appointed vice president of business development for Houston Hospice, about the first family he met with as part of a hospice team. Nearly 11 years on, Hudson is stepping into an executive role charged with building and maintaining referral partner relationships and engaging consumers, while contending with limited access brought on by the pandemic.

Hospice News caught up with Hudson to discuss the strategies for growth Houston Hospice will pursue in a rapidly changing environment.

What are your top priorities as you come into this new role?

I’m very excited about this new role because I’ve been competing against Houston Hospice for years, and now I get to join this amazing organization.

My top priority is first to just really showcase this amazing program to the community that’s out there at a higher level. We have been taking care of some of the highest acuity patients, and we’ve done such an outstanding job taking care of these patients. I really want us to be able to get the message out to those home-based patients that we think we do a great job with these difficult patients in the facility. We can do the same thing with patients at home.

We’re really excited to open that avenue and bring that up to a higher level. We have an outstanding pediatric program. That’s very difficult to do in hospice, and a lot of hospice companies won’t take that on. We have a hospice pediatric physician that is also on board with us. We have a lot of really neat things that we want to showcase and just bring them into the light in a bigger, more robust way.

Could you add some color around the term “high acuity patients”?

We’re located right here in the Texas Medical Center. We’re in the backyard of almost every large hospital in the area: St. Luke’s Methodist, Memorial Hermann, all of those really big hospitals. Basically we could throw a rock out my window and hit them. Anytime they had a very complex patient that is reaching the end of life, they send them over here to Houston Hospice. We have our three-story, 32-bed, inpatient unit (IPU). We take care of those patients at an outstanding rate, but we don’t do as much of the home patient business. That’s where we really want to differentiate ourselves — that we can do both. 

Let me just add that the types of home patients we take care of sometimes are not that dissimilar to the ones we’re taking care of in our inpatient unit. It’s more difficult to care for those patients that have these types of needs and live for just a short period. Often, they want to be in their own home, and so we try to make that happen for them.

How would you characterize the growth trajectory that Houston Hospice has been on for the past couple of years, and how do you plan to build on that in 2022?

Year over year, we’ve been doing well. We’ve always been very strong. The community knows we’re here. We’ve been in Houston for 42 years. We’re the oldest, largest independent, not-for-profit hospice here in the greater Houston area.

Our growth has been consistent. As far as how we’re going to build on that, it kind of really goes back to that first question of what we’re going to do to continue that growth.

Can you talk about how Houston Hospice, or even perhaps providers in general, have had to adapt their sales and marketing strategies as a result of COVID?

COVID has been hard on all hospice companies. I’ve worked for a number of different hospice companies, and they’re all very much suffering with all the things that are going on with COVID.

What’s been amazing with Houston Hospice is they have done an outstanding job with an outstanding infectious control program. We’ve had no workforce infections due to COVID. We have been able to continue to serve the patients in the IPU. (We don’t serve as any COVID patients here in the IPU, but we do take care of them at home.)

We still let families come and visit their patients here in the IPU. We’ve had no interruption to patient care.

COVID has just made it harder for all hospice companies to find the people that need our services. That’s one of the things that hospice companies have worked our way through, figuring out that little puzzle of getting to see the people that need us, because even during COVID, people still aged and people still needed hospice services.

Can you talk about some of the non-pandemic market forces that impact your sales and marketing strategy for the coming year?

Access will always be a problem, and now it’s even more of a problem— being able to get in to find those people to see the people. Also there’s just awareness of hospice in general. You’re not talking about just this company. There’s a study out there that says 98.5% of people that come on hospice wish they would have done it sooner.

A patient that comes on hospices lives 29 days longer than a patient with similar comorbidities that did not come on hospice. If you think those two things alone, that is our job. That’s the message we need to get out, to show people that this is an amazing program.

You said that, “Access is always a problem.” Can you talk about some of the specific access issues you’ve seen?

Pre-COVID, I could go into a nursing home and walk right to the director of nursing’s office and talk to her about some of her patients. Then I could walk down the hall and talk to the activities committee person and ask them how their patients are doing. I can walk to the cafeteria and talk to the cafeteria staff about who’s possibly not able to eat anymore. I could walk into that building to talk to all the people I need to speak with, and then go into the administrator.

Now, we’re lucky if we can get into the lobby. We can get an email or have them come out to the parking lot to talk to us. Same with hospitals, so I used to go from floor to floor, talk to all the social workers. We would talk with the nurses. You’d actually be able to talk to some of the hospitalist if you bumped into in the hallway. You’d be able to talk to doctors, but now all those access channels are shut down. Those are still all the people we need to talk to. So you have to kind of get creative with your access. That’s not just one hospital company; that’s all hospice, that’s pharmaceuticals too.

Physicians’ offices have still been open. If you have a mask on, you can usually get in and talk to the people you need to. That’s another area where we’re really going to focus on more is the physician’s office, because it gives you more access.

Have you seen a shift in your referral mix towards more physician offices as opposed to hospitals and nursing homes?

The hospice companies that did really well are the ones that really had great relationships with these physicians, because you can call them and ask which patients they are worried about and whether we should evaluate them. You could just call up and say, “Hey, how are Mr. Smith and Ms. Jones doing?”

You did see a lot of that coming from the physician’s office, because they were not set up to do house calls. Some of these older people that require our services are not really telehealth savvy, so we still need to lay eyes on them. It makes a big difference on who you’re seeing and how you’re seeing them and what messaging you’re giving. You’ve got to get very creative to maintain access with COVID.

What do you see as the biggest opportunities for Houston Hospice in 2022?

The biggest opportunities are raising that awareness of what we’re doing, and then really operating well in that physician offices type environment, where we can build relationships with the office and the staff. We point out the benefits of referring patients to hospice earlier.

Oftentimes we get these patients on service so late that they’re unable to get to know their nurses or be able to just really build that relationship, because they come in the last week or a few days of life. Those relationships are what made this job so amazing.

We follow the family for 13 months after the patient passes. We want to be able to build that relationship, by getting those longer length-of-stay patients, seeing them out of the physician’s office, bring them on our service and help make sure they never have to go into the hospital. Those are things that we’re going to really try to do this year, to just cut the hospital right out of this right out of the system and move more care to the home.

What are some strategies you will use to accomplish this?

We will maintain our major hospital business. They know us. We’re good at that. But right now, we’re really going to start seeing the doctors that are feeding those hospital systems, that have privileges in those hospitals and have privileges at the different facilities. We’re going to really focus on those doctors so that they don’t stand in the way of these patients getting the best care that they will ever get.

We will bring on these doctors as referral sources, change the nurses into becoming hospice advocates, to where they’re excited to tell people about the benefits. That’s where this messaging to the physicians offices is really going to pay off.

How has Houston Hospice fared during 2021 and the early days of 2022 in regards to the workforce shortage? At what point do you think this starts to hamper hospice sales and growth?

It is no secret that all hospice companies need nurses. We all need aides. This is such a very important job; these people need care. One thing I really like and I think is different between our industry and others, is the people that work here tend to have a “hospice heart” or a “hospice story” — something that got them into hospice. So they want to stay here. They want to help.

Also here at Houston Hospice, which I have noticed in my short time being here, it’s an all-hands-on-deck approach, but it’s definitely going to be something that everyone’s going to have to work on.

What was your hospice story? What brought you into the field?

I started working in pharmacy for about 25 years, even veterinary pharmaceuticals. Later I was hired on by [VITAS Healthcare, subsidiary of Chemed (NYSE: CHEM)], and it was a great opportunity.

I can remember sitting in a patient’s hospital room for the first time, and their whole family was there. You could just see the worry and the concern on all their faces. We came in and told them everything that we could do for them and how we were going to do it. We told them that we were going to get him home, and there’ll be a hospital bed waiting for him when he gets there, as will his medications. Everyone’s shoulders had been practically touching their ears, but this sort of calm started to come over them. I was just floored.

When I worked in pharma, I never got to see what any of my drugs did for patients. I never got to see the end result. But with just this one meeting with this family, I walked out of there on cloud nine. I felt like I’m actually making a difference in families’ lives. I’ve been in hospice for almost 11 years.