Hospice executives with a nursing background can bring unique competitive advantages.
This has been the case for Nevada-based 1Care Hospice & 1Care Kids, particularly as they contended with the pandemic and widespread workforce shortages, according to COO Eddie Belluomini.
A group of hospice and palliative care leaders with nursing experience established 1Care in October 2020. The company began offering services in January 2021 and currently has a census of 217 patients, 133 of whom are pediatric patients.
Hospice News spoke with Belluomini about the ways executives with clinical experience help to foster growth, referral relationships and staff satisfaction.
How did 1Care Hospice & 1Care Kids get up and running as a nurse-led company?
The owners of this company have been partial owners at various different hospice companies. Some companies sold off to others, and then they began a solo venture of their own. 1Care was their first venture.
What’s unique about 1Care is that a lot of other hospice companies are not nurse-driven, but we hired all nurses in executive roles. We are all nurses and don’t have any business people involved.
I’m COO and I was a nurse, our vice president of operations is a nurse, as well as our vice president of pediatric operations and two directors. We are all nurses, and the value in that goes all the way down to the patient level.
All of us started our careers working our way from the bottom up in hospice. As far as nursing leaders and being nursing-driven, where that really helps is that we’ve built a lot of respect for our nurses. We’re not going to load any of them with too many admissions.
We’re able to step in and take patients ourselves. It builds respect and also helps them work. Should we ever have a nursing shortage because people are out with COVID, they quit, or they find another job, then we can step in while we hire additional nurses to fill the void.
How has 1Care fared in terms of growth?
We have grown by leaps and bounds with the hard work and passion for what we do.
As we grew, we had to layer in more interdisciplinary staff as we layered on different patients. As we started to take pediatric and adult patients, we needed case managers for each side. We had to layer on patient care and staff to grow so that we wouldn’t end up with service funding issues, which can be challenges in our space.
Having manageable and sustainable growth also meant having work-life balance. We don’t want to see our staff burnt out or overloaded. Part of our retention is that we’ve overstaffed our nurses to accommodate our clinicians. Having clinicians only see five or six patients each day allows them to focus on quality of care and at the same time, it creates a balance so they don’t burn out.
Growing our census has also come with owners who are very forward thinking. We have front-loaded our sales and marketing team as we did with clinical staff.
We are stretched out to saturate the Vegas market with the 1Care name with those marketers helping us grow our reach. They help referral sources recognize who we are for both our hospice and concurrent pediatric palliative care models.
Having extra staff may take chunks out of our revenue, but it’s better for workplace satisfaction. It’s saved us in the long run in employee turnover and helped us grow. It’s allowed us to keep patient and staffing ratios low and reduce labor burdens.
What are some of the biggest keys to sustainable growth as a newer provider?
First and foremost, our company was started with a vision and key principles of people over profits, creating an employee-centered, family-oriented culture and lower caseloads than the industry standard.
Additionally, all of our nursing leaders still perform admissions and see patients on a weekly basis. There is a special value in having a team of nursing leaders who not only have hands-on experience in the field, but also still actively provide care and support to patients and their families. I can know how to coach, but if I’ve also played the game, then I have a unique ability to connect with and relate to my team.
We are also locally owned, and are one of the largest Latino-owned hospices in the state of Nevada. We have a dedicated Spanish-speaking team of clinicians, community liaisons and intake [staff], which has been key to growing our business in the Latino community.
We are successful because working in hospice isn’t just a profession to many of us, it’s really a lifestyle.
How do you tackle the learning curve between your clinical expertise and the business acumen that is necessary to lead an organization?
On the business side, what separates our company from our competitors is our culture. We are always listening to our staff and referral partners’ input.
The best part of balancing the business aspect is that all leaders and employees have a seat at the table to bring up new ideas, strategies or recommend changes. Without their input or knowledge, we are only as good as what we can view in the office versus seeing the big picture.
Our owners are very hands-on with the collaboration in our workplace. They want to hear and talk about ways to improve the patient experience, workplace cohesion and see where our successes or failures might exist. We’re always open to improvement.
What’s next on the horizon for 1Care in terms of growth?
We are now expanding our pediatric palliative care program to Reno and northern Nevada. We are opening a second branch in Reno by May and will be replicating the same business model of adult hospice and pediatric palliative care.
Our owners used to own and operate a hospice in northern Nevada, which they sold in 2019. Unfortunately, the new buyers eliminated the pediatric program.
With tremendous population growth in northern Nevada over the last several years, we saw the opportunity to provide a much-needed service in both adult and pediatric hospice. We also have clinical staff from Reno who bring a local connection and a tremendous amount of experience and passion.
Then we’re looking to further expand into places that allow pediatric palliative care such as Arizona, California and Florida. So that’s our future.