Nevada-based 1Care Health recently tapped Steve Mooney as its new chief strategy officer, a move signaling the company’s ongoing expansion across its home state. Having strong organizational core values is key to sustainable growth in today’s hospice and home care landscape, according to Mooney.

1Care Health provides hospice, home health, private nursing duty services and pediatric palliative care through its brands: 1Care Hospice, 1Care Kids and 1Care Home Health. A group of hospice and palliative care leaders with nursing experience established 1Care in October 2020 and began offering services in January 2021. The company currently has a census of 650 patients.

Mooney oversees 1Care’s strategic plans and provides operational insight around its patient-centered services. His appointment is aimed at accelerating the company’s growth while ensuring high quality, compliant care delivery, the hospice provider stated in a press release shared with Hospice News.

Mooney has roughly 24 years of leadership experience in hospice, home health and mobile physician groups. His previous roles have spanned business development, executive leadership and national advocacy, including education around the Medicare Hospice Benefit. He has served on the regulatory board at the National Hospice and Palliative Care Organization (NHPCO), which has since merged with the National Association for Home Care and Hospice to form the National Alliance for Care at Home. He also served as chair of the organization’s Finance and IT Selection Committees. Mooney is a U. S. Air Force veteran who served in presidential security.

Organizational culture and staff engagement are central to combatting some of the hospice industry’s significant challenges – staffing shortages, rising demand and increased competition, Mooney said during a recent Hospice News interview.

What are some of 1Care Health’s strategic goals in the hospice field?

Our goals are multifaceted. We aim to position the organization for sustainable growth, resilience and really having a competitive advantage in the landscape. We have multiple hospices that are in our service area. When we look at sustainable growth, we always have to look internally and ensure we are establishing core values of the company.

Core values help us manage our behaviors and how we’re exhibiting those to referral sources, to our patients and their families and in our community. Those core values are compassion, teamwork, quality, enthusiasm, innovation and excellence. It’s making sure that our staffing capacity is aligned correctly with our census so we can maintain the expected visits needed to take care of our patients and family members. We have a ratio of about one clinician for every 12 patients. That’s very important.

What is important for the sustainability and growth of your services, particularly on the hospice and pediatric palliative care sides? Can elaborate on what gives a provider that ‘competitive advantage’ you mentioned?

When we look at the competitive edge, one word is “diversified” – especially in hospice. We have our pediatric program, which provides concurrent hospice care and our adult hospice program. The other advantage is that we have our own home health company. That really sets us apart in our landscape, because we have that full continuum care program.

When someone comes onto our services, they’re able to get established in home health or hospice if they’re appropriate. We can move them through a sustainable, quality care program. They can move to our hospice program earlier than the last days of life. We have an average [length of stay] of 77 days, so that makes an impact on the patient in quality and helps the family better prepare for that part of life.

The second competitive advantage is our quality assurance. Quality is everything, because that’s our clinical performance and program integrity. It’s being reliable and maintaining standards of care that reflect back to us. That’s something we all have to live up to in hospice. That’s what keeps us higher among our community among some of the bad players we’re up against every day that just want to be in the business but not really [providing] good care.

It also then goes back to patient-centered care. We can’t lose sight of our mission and why we’re here, to take care of people with six months or less to live. It’s an individualized plan of care, everybody’s different. No matter what c-suite positions that I’ve been in, it all comes back to being at the bedside delivering that human touch.

What are the biggest challenges that hospice providers are facing in your service region across Nevada? How is your organization addressing these issues?

The challenges we’re still facing today is having qualified staff at the bedside. We’re that, though, with our caseload standards. Our quality standards are high, and that goes back to culture first, then skill set and then revamping our program. When people come into orientation or training, that leads them to developing our preceptor program. This ensures that they are getting the skills needed to perform capacity and exposure to our culture first and foremost.

For us at 1Care, the marketplace where we serve in Reno and Las Vegas, Nevada has a real shortage of resources. These are cities where people move in and quickly rotate to other states. When you have that, it’s hard to get people adhered to your standards. We’re putting better things in place to retain our employees, such as work-life balance. The workforce has changed and their expectations of us have changed. We have to make sure that we regard and respect that.

What do you see as the largest opportunities on the horizon in hospice and pediatric palliative care delivery?

We are seeking expansion in our community, and we are looking more so at palliative care services. When we look at where we’re servicing across the broader home health, private duty and hospice space, a lot of people are falling in between that home health and hospice gap. There’s really no one helping them to manage in the middle.

We’re really looking at how to be a more comprehensive palliative care partner in the future. We’re working more with mobile physician groups in our community that can help us manage that. There are more mobile physicians or practitioner programs out there coming into [patients’] homes, sort of like dispatched home health for individuals who have heavy symptom burden and can’t leave their home.

Even before the pandemic, there was a physician shortage. Now, it’s much harder to make an appointment. [It’s] having a good partner in our community, where we know someone’s going to come to their home and help manage them and has a palliative care program. We can give social work services, as well help prepare, direct care and advance in the resources needed as their disease continues to decline.

What is key for a c-suite leader to bear in mind when it comes to operationally thriving in today’s hospice landscape?

From a c-suite level, you can’t lose sight of the mission division of your organization, because as you’re at the top, you’re not at the granular level. But the granular level is where we’re providing care, and it’s to make sure that we’re always reducing the burden for our staff in those areas to provide that great care. It’s doing a temperature check. We have dashboards every day that tell us about our [key performance indicators (KPIs)], and that keeps us in alignment with staff.

What it comes back down to is human touch for me. I have to always keep in mind, because it can very quickly go from running the operations with a strategy in place. It all encompasses a patient, a human that needs us today. We can provide this great hospice benefit to that family, helping them prepare for a person’s death. What does it mean for them, for their legacy to provide that care?

It’s also an open door policy. Know your staff, build relationships with them. That’s all staff, they all need feedback. We’re always seeking that feedback too. We want to hear from our staff members. When you hear from your staff members, then you have a well-established leadership executive panel. This cuts down on the chaotic, poor communication, the email burdens and gives more face time to one another. Engagement is 80% listening and sometimes 20% talking as a general rule of thumb. We put them in a position so they’re on the right seat, the right bus and can thrive in their specialty area.

Leadership comes back to what is expected. It’s accountability, dependability and trust as a team. We have the speed of trust to help us resolve issues quickly and overcome our breakdowns.