Mahogany Home Health and Hospice recently launched services in southwestern Ohio. The new hospice startup is the first Black-owned hospice and home health organization statewide with a drive to improve utilization among underserved populations.

This is according to Victor Couzens, owner, founder and CEO of Mahogany Home Health and Hospice. The organization recently received a green light from state licensing agencies to begin serving Cincinnati and Dayton, Ohio and surrounding communities.

Greater representation was among the main reasons for starting a new hospice and home health organization in the area, Couzens recently told Hospice News. The region is home to a diverse range of minority groups with unmet physical, emotional, spiritual and psychosocial needs, he said.

In addition to his new role at Mahogany, Couzens is the lead pastor at Inspirational Bible Church. He most recently served as hospice executive director of Hartford Healthcare at Home, part of The Pennant Group (Nasdaq: PNTG). Couzens has also held hospice chaplain roles at St. Elizabeth Healthcare and Trustbridge prior to its affiliation with Empath Health.

Can you share what led to the launch of Mahogany Home Health and Hospice?

As a hospice chaplain, I was often confronted with the pressure of trying to fit a square peg into a round hole when it comes to how underserved communities are actually reached and cared for. It’s about offering insights, or even evidence-based approaches, to meeting the needs of Black and brown people, the needs of the LGBTQ+ community, the needs of immigrants and just any other groups who do not make up the majority of the patient population. Sometimes these approaches can be met with rebuttals.

As a result of that and because I knew that this is part of my mission, I decided to advocate for representation, to advocate for closing that utilization gap among underserved communities and to advocate for challenging the stigma of care at home. That’s what really prompted me to put a team with collectively 50 years of health care experience together and start the process of what is now Mahogany Home Health and Hospice.

Ohio is among the top 10 states for hospice utilization, but for some populations that rate has not gone up. A dire need exists to be able to better support physicians, hospital discharge planners and social workers on culturally relevant approaches to care at home and having end-of-life conversations with minority families and patients. You can’t just pick up a model of care and drop it into a different city or region. That community may need a different approach on how they’re being educated about ways to address their needs. That involves a heavily community-based model that takes the time to understand the differences in those underserved needs.

Can you expound further on the ‘dire need’ for improvement that exists in hospices’ inclusion approaches and community education efforts?

What we hear often is that more education is needed for Black and brown people when it comes to hospice. And I don’t disagree, but education is just one part of it.

Another part of that education is actually having people that can identify with them, who are sensitive to their plight and sensitive to some of the systemic things that have happened to them in health care. It’s understanding how their minds have been shaped when it comes to health care, and having that representation is something I feel strongly about being able to do in Ohio.

When I mentioned the dire need that exists, I also think of the hospice model of care in Ohio and in many other states. It lacks the leadership representation that is reflective of Ohio’s aging population, and it lacks a one-on-one approach that helps minority communities and patients feel comfortable and safe about hospice.

It’s important to have positive relationships with organizations as a whole and having a compilation of health care relationships and a compilation of community data numbers. How do we partner with providers and referral sources to help them feel comfortable bringing up the end-of-life conversation to Black and brown people? How can we really partner with them on the talking points to broach these goals-of-care conversations so they understand what is included through Medicare and Medicaid services while still being comfortable in their homes.

Something many people in our community struggle to stay on top of is obtaining medications and supplies, largely because of financial reasons. Knowing what they qualify for can lessen that burden, and they can use those resources to do other things. They can use that energy trying to figure it all out to focus on being present.

We cannot change their health outcome, but maybe we can impact their journey. That is what speaks to the dire need to really be able to partner with our referrals about what those conversations look like in underserved communities. It’s being there to support those decision-making processes and understanding that some people won’t necessarily align with the hospice philosophy of care. But the need to let people know this service is available to them is really important.

What are some of the regulatory considerations involved in opening a new hospice? How are you navigating these?

We recently passed our initial licensing state survey with the state of Ohio, which included developing appropriate policies, training and orienting staff and having the correct level of staff. It also involved creating [durable medical equipment (DME)] and pharmacy relationships, creating inpatient and respite coverage relationships.

With our state license, we are now actively providing pro bono care to patients while we await our Medicare certification survey results. Our goal is to have a smooth and fully compliant physician once we’re Medicare approved, because we’re committed to maintaining a high quality of care and high patient and family satisfaction.

What are the services that Mahogany Home Health and Hospices is offering? How do you anticipate this scope of services to take shape?

So our scope of care includes home health, both skilled and non-skilled, and it includes hospice. Eventually, we hope to do palliative care.

Our model of care across all of those service lines is built around an offering acronym, CARE. The “C” stands for cultural sensitivity. The “A” stands for active collaboration. The “R” stands for responsiveness to patient and family needs, and the “E” stands for empathy and human connection. We’re using that acronym to guide how we approach the scope of care that we’ll be providing.

Our services will include the standard hospice functions such as individual bereavement care and volunteer-based therapy, but we also have grief support groups. We have a lot of community outreach that we’re doing with facilities, with faith groups and with fraternities and sororities as well.

We are also in the process of putting together a one-day caregiver retreat. That one-day caregiver retreat will not simply only be for caregivers of hospice patients who may be receiving services from us. The retreat will be for any caregiver from any walk of life, under any circumstances that they consider themselves a caregiver, not just of a hospice patient but any person. We’re putting together this one-day retreat to really focus on supporting caregivers across the community as a whole. It’s also for us to really learn how we can best support them in the event that they eventually need our services.

What do you see as the largest opportunities in hospice care delivery today? How do you foresee these opportunities shaping the outlook of end-of-life care?

Having staff that is committed to the vision and mission that we have is very important to delivering a value-based care model. What we’ve found so far is that those staffing opportunities throughout the state as a whole are challenging. It’s more challenging in smaller and more rural communities, and that’s what is driving where hospices will go to meet the patient need – the ability to get the right level of staffing. Having community-based staff is important.

Hospice care delivery as a whole is on the cusp of a tremendous revolution. This is going to bring some dynamic opportunities of being community-based and focusing on education and representation.

The other opportunity this brings is how we can utilize technology and data to expand access to care. That trend creates a huge opportunity for providers in rural and underserved areas and in nonclinical settings. More families are seeking hospice care at home or in non-traditional settings. The industry is expanding hospice offerings even in nonclinical settings and that provides tremendous opportunity to cater to the growing demand for things like remote patient monitoring, telehealth services and integration of AI technology.

The opportunities for how hospice care is going to be delivered are vast. I’m looking forward to fostering better care delivery and being part of the evolution and revolution of the hospice

There’s tremendous strength in this industry to really be in lockstep with the unique needs of the communities that we’re operating within. It’s taking the time not only to educate, but also be educated by the community concerning things that are important to them. It’s understanding different family dynamics, psychosocial supports and caregiver needs. It’s putting ourselves in a position to not to think that every community is monolithic. That will be a huge advantage.