The Pennant Group Leverages Physicians to Spur Growth, Compliance

The Pennant Group (NASDAQ: PNTG) two years ago established a physician council to help guide clinical care, vet potential hires, foster growth and ensure regulatory compliance.

To date, the council has had a transformative impact on the company’s culture through enhanced medical leadership. The council aids in mentoring physicians that are new to hospice or new to the company, provides second opinions on prognoses and offers guidance on clinical care and its role in compliance.

Hospice News sat down with Dr. Lauren Templeton, a recent addition to the physician council, and with Jason Steik, The Pennant Group’s chief clinical officer, to discuss the ways that this group impacts the company’s culture and ultimately benefits patients.

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Could start by introducing me to The Pennant Group’s physician council and the work it’s doing?

Steik: About two years ago, we recognized the need for more physician guidance and direction in our company, and, honestly, in the industry. It’s a physician-directed benefit, and yet, sometimes physicians aren’t really involved at the leadership level of the organizations and in helping drive the direction that we’re taking and in helping really influence the direction of care and quality of care.

So we started a physician council that includes representative physicians from across the company’s footprint. We’ve intentionally kept the physician council fairly small, so that we can have an influential group that doesn’t get bogged down with too many voices in the room. We can actually have some good insights and directions and be a little bit more nimble.

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That group has helped us in interviewing new potential hospice physicians and medical directors as well as helping onboard and create connections. The physician council has developed onboarding materials to help those physicians who are joining the organization to be able to understand the regulatory aspects of care. There’s many times physicians will come into hospice and they really don’t know hospice well. So we tried to create the ability to reduce the time that it takes for them to get up to speed, really understanding the hospice program and the benefit.

Templeton: What attracted me to this company were their core values. When I came into the physician Council, this is really where I was most inspired. My role, and the role of the physician counsel is to mentor up and so just to utilize whatever the particular concern or issue may be with the hospice or with the physician to start with a step behind to make sure they have a really good understanding of what the ask is.

So what are the regulations? What’s the compliance issue here? How do we get you elevated into a role where you cannot misunderstand those, but leave those and help to hold accountability and that engage us in this physician role, which I truly think is just such a key going forward for hospices to be successful.

Hospice is a physician-driven benefit with a culture of being a nurse-driven benefit. And so we really need to engage physicians who really understand prognostication, who get excellent symptom management and bedside manner to have complex conversations. They are not just along for the ride. They are leaders inspiring and moving hospice forward.

I’m interacting not just with physicians, but other members of the hospice teams in the company at large. But it’s really, truly trying to push people to have better relationships, communication and dialoguing and better accountability. It’s an investment in their employees and the people who participate in this company to say, “If we’re doing great work as human beings, we’re elevating the level of what we do to provide for hospices across the country.” So they are very growth minded.

Steik: I might quickly add that another important component to the physician council and the work that Dr. Templeton does, is in the hospice space. Being a hospice physician or hospice medical director for local agencies can at times be a little isolating. You can feel like you’re on an island, and it’s difficult to have partners to just run cases by.

So we have case reviews that we do, and it just creates an opportunity for physicians. Given the fact that prognostication is not an exact science, they have an opportunity to discuss cases with physicians who can help them think through and evaluate the case. So in a way, it’s to reduce the sense of isolation that can exist in this space and help create a greater sense of connectedness and learning among the physician community.

How do you select members of the physician council?

Steik: We asked for nominations from within the organization, and we’ll find out who are the other people that are among the best in the industry. We were very selective, not even near the total number of candidates who ended up being selected to actually join the council.

We were very intentional in selecting for culture fit. Our company has a strong belief in humility in leadership. We wanted to make sure we had physicians who both knew their trade incredibly well and were approachable and good teachers.

What are some of the most important things that the council can help physicians achieve?

Templeton: For me, it’s growth in both the personal and professional lives of physicians, which then translates into the hospice’s success and our beneficiaries, who we’re here to serve. If it comes from a difficult case in terms of prognostication or symptom management or having a space to talk about the struggles within the industry, or maybe even complications with tricky cases and the high level of burnout that we experience in being end-of-life care providers.

It’s all encompassing in terms of support, and that support also comes with accountability and expectations to be leaders within the hospice and accountability to evaluate our performance in terms of auditing their own work and looking at how we’re doing.

It’s about the elevation and growth of these physicians and support, which translates into all manners of the organization.

What are some of the benefits to the company of having this physician council?

Steik: There’s a couple of different benefits., First of all, if you can have a more engaged physician community and in the company, then you reduce your risk profile. You have physicians who understand the care that they’re providing and the regulatory environment under which they’re providing that care. You have physicians who are invested in the patients and the care team that’s provided that providing the care for those patients.

So you are directly impacting culture, which is our core template. We believe having a strong cohesive team, that surrounding the patient and their family is the perfect recipe for an excellent hospice experience. We can’t have a cohesive team with a physician who’s not as engaged or as bought into the philosophy of care. We’d be missing a very key component to that team.

There are so many growth opportunities. The environment of care is only increasing in regulatory complexity and scrutiny of care. So if we can have providers who are ensuring that we’re providing the highest level of care while maintaining integrity in the Medicare Hospice Benefit, then we are positioning ourselves to pick up the pieces that are all too often dropped by some by other providers.

We become the provider of choice in the community. That is our goal. We can’t do that in hospice without physicians. It can’t be accomplished without physicians who see themselves as partners to the organization. It benefits us on many fronts — growth, regulatory compliance, as well as helping guide the future of hospice care.

Do you believe that having an internal group like this also benefits your patients?

Templeton: Absolutely, I’ve been with the company for about a year, and this month I transitioned to this being my main job. We avoid more crises by elevating the level of physician performance. I really believe that that’s my goal, and teaching the idea of what an engaged hospice physician is.

You can’t make the world easy at the end of life, but you certainly can prepare people for hardship. When you have an invested hospice physician, you help prepare beneficiaries or their families to tackle hard things. The course is somewhat smoother. The hard times are maybe a little less hard when you have an engaged hospice physician who can help you navigate those waters.

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