Hi and welcome to Be The Flagship with our podcast host Jeff Parsons.
This is where we tackle the day-to-day talent management challenges you face, particularly
in hospice and small healthcare organizations.
And now over to our host.
Take it away Jeff.
Hello.
Thank you.
I'm Jeff Parsons, host of the podcast Be The Flagship and what an episode we have for
you today.
I can't wait to get started.
Okay, and today I have a special Christmas present for my listeners.
Joining me as a special guest is a person who is widely known and respected in the hospice
industry and her name is Jan Jones.
And so a little bit more about Jan.
Jan Jones is currently CEO of Alleviate Care, which is the owner of three hospices serving
Southern California.
And they include Inland Valley Hospice, Inland Valley Hospice Care, and All Point Hospice.
Collectively they serve San Bernardino, Riverside, Los Angeles, Ventura, and Orange Counties
in Southern California.
Prior to her current role, Ms. Jones served as the Chief Executive Officer of the Elizabeth
Hospice, which is a leading provider of hospice care, palliative care, and grief support in
San Diego County and Southwest Riverside County.
In this role, Ms. Jones oversaw a workforce of around 280 employees and around 315 active
volunteers.
She was the liaison between the organization and the community, partnering with local healthcare,
educational, business, and civic organizations, as well as connecting with the residents in
the communities served by the organization.
Jan served on the board for the North San Diego Business Chamber and is the former president
of the Escondido Rotary Club.
With more than three decades of experience in the healthcare industry, Jan, who's also
a registered nurse, by the way, remains active in her dedication to community service.
She remains committed to addressing the unmet needs for those affected by a serious or life-limiting
illness.
Jan is active as a volunteer, working at the state and national levels of hospice organization
and government arenas.
She has held leadership positions at the National Hospice and Palliative Care Organization, or
NHPCO, which is based in Washington, D.C.
Jan is past chair of the NHPCO Board of Directors and has served on the board of the Hospice
Action Network.
Jan also serves as a chair of the California Hospice and Palliative Care Association and
now serves on that board as a board member.
Welcome, Jan.
My pleasure.
So the first question I have, what inspired you to pursue a career in hospice and how
did your journey in hospice begin?
You know, that's such an interesting question.
I've been a nurse for a long time.
And at one point in my nursing career, I always was comfortable working with people who were
at the end of their lives throughout my, from the time I was a student nurse all the way
through my career.
And at one point in my career, I was head of a home care agency.
And this was actually right at the cusp or right before the hospice movement came to
the U.S.
And we saw patients at home, we saw people who were dying at home, and I always was comfortable
working with folks in their own homes where they were breathing their last.
And it just was rewarding to me.
So when I was given the opportunity to begin working in hospice, which happened in Miami,
Florida, years ago, 35, almost 36 years ago, I learned that it really was my calling.
There was nothing else.
I've always loved being a nurse, but there was nothing else in my being that wanted to
do anything other than hospice.
So like so many people say, I was called to the work.
It's my calling.
Wow.
And Jan, I have heard that from a number of true dedicated hospice professionals that
it is really a calling.
It is.
It's not a career.
Yeah.
Interesting.
So I know hospice care has evolved over time.
And so what's your perspective?
How have you seen the landscape of hospice care evolve over the course of your career?
Yeah.
So initially, we were, it was kind of a grassroots movement.
And so there was very little oversight of hospice care in the very beginning.
And as time progressed, as what happens with so many healthcare organizations or healthcare
businesses, once Medicare began to pay for hospice care, the landscape began to change
because there were people entering the marketplace who maybe were not as interested in the calling
piece as they were in the profit piece.
And was that said well?
Yeah, that's did very well.
And so over the years, the scrutiny has become more and more for good reason.
I have no problem with the scrutiny because I hope that people who are not in it for the
right reasons don't continue to be in hospice care.
So although it's been difficult because it takes time, it takes money, it takes energy
to meet all of the new regulations that come forth.
It is for a good reason.
It is to ensure that people who are entitled to receive hospice care are actually getting
what they deserve.
I see.
So you mentioned the current challenges, how the challenges have evolved.
On the flip side, what opportunities do you see for the future of hospice care and how
can the hospice industry capitalize on them?
Well, I think there's a lot of opportunity for hospice.
First of all, we are sitting on the cusp of the baby boomer explosion.
So most people who are receiving hospice care are older than 65.
In fact, 75 is probably the average age of a hospice patient.
And that probably is moving upwards as we tend to all live longer.
But I think there's a lot of opportunity to serve.
I think there are opportunities to continue to grow what hospice looks like within the
regulatory environment.
At some point, it is likely that we will be providing hospice care under the umbrella
of Medicare managed care, which could open up some opportunities for innovation that
are difficult now.
Innovation is not impossible, but it's difficult within the set of regulations that we currently
have.
So I think there's opportunity that may come across for more innovation.
So what challenges would that present, looking at more of a managed care model?
Managed care, I think it would be difficult because of the financial situation that we
might have.
It might open up opportunities for more continuous care, a continuum of care that sometimes does
not exist now.
Things are pretty fragmented.
So there may be an opportunity there.
But I think truly, it would probably reduce the amount that hospices would be paid, which
may also create some challenges in how to deliver a model of care that has been in existence
for a very long time, since the early 80s.
And how would we change that model of care to meet the current financial, the current
payment structure?
In other words, it's maneuvering that balance and making sure that you continue to have
the right balance between your mission or your purpose for existence and running a business
at the same time.
Exactly.
That's exactly right.
And these are people who, this is their last chapter of life, they deserve not to have
to worry about those things.
They deserve the very best of care.
They deserve our loving presence.
They deserve our help in helping them meet their own goal.
So that's what motivates me.
I see.
Well, and that's a perfect segue into the next question.
I can't wait to get your response on this one.
Let's talk about legacy and impact, right?
So reflecting on your career, a story career in hospice, what accomplishments are you most
proud of in the realm of hospice care?
I have been very fortunate to have, with every hospice I've been with, we have grown.
We have grown in our ability to serve.
We have grown in our programs.
As an example, hospices, I've been with three different hospices prior to my current position
in three different states.
And in all three of them, I was able to establish pediatric hospice care, which is a very huge
need.
I'll bet.
And in the last two, to establish strong palliative care programs who reach out to people prior
to their eligibility for hospice under the Medicare guidelines.
So I think what I would be most proud of in my legacy is establishing ways to ensure that
people who want to receive the care have a path to receive it.
That would be my legacy.
My second important piece of the legacy is where I am now with a fabulous group of young
leaders, young men who are really passionate about hospice care and want to lead for the
future.
So the other part of my legacy is in helping support people who have an interest to carry
on the work.
Okay.
That's excellent.
I'm sure you've heard the phrase a hospice heart referred to on occasion and so, and
I've referred to it in previous episodes actually.
And I consider a hospice heart as a means to describe the deep commitment to providing
compassionate care.
So what in your opinion is the essence of compassionate end of life care and how do
you ensure it's a cornerstone in your organization?
The way I define it is it's care that I would want my mother to receive.
That is the epitome of what we should be providing.
The way that we ensure that that is occurring is through a variety of measuring opportunities
to measure the care.
It is talking to individual families and patients.
It is looking at scores that are cap scores, for example, that are on a national level
to see what the satisfaction level is because part of our job is not just the care that
we deliver to the person who's experiencing the illness.
It is very important to deliver care to the family so that when their loved one does pass
away, that they are left knowing that they've done a great job and they can grieve with,
not with a heavy heart, although there's a heavy heart for the loss, but they can grieve
knowing that they did the best they could for their loved one.
So those are the things that we look at.
I think there are plenty of things to measure, looking at quality scores, looking at things
like that, but mostly it has to do with how patients and families tell you they feel about
the care.
I see.
In a previous episode in talking with a hospice professional, she provided examples of a hospice
heart in action and where hospice nurses have moved mountains to grant last wishes or to
support the family or that sort of thing.
In your career, can you share a memorable experience that illustrates the profound impact
of compassionate care in hospice?
Oh my gosh.
I probably could think of a bunch of things that I could say, but I remember one vividly.
This was when I was in Nashville, Tennessee and we had an inpatient unit which was under
my watch.
I should have said that's part of the legacy, is the inpatient unit there.
It was early on, our unit had just opened and we had a referral of somebody who was
homeless.
This gentleman didn't even go into the mission.
He was used to being out.
He didn't want to be inside anywhere.
We were able to convince him to come into the unit.
He lived for two weeks.
He was the happiest he had ever been.
He loved pickles.
We made sure he had plenty of pickles.
The things that he wanted to eat, we just loved on him until the end.
I just remember how important that was for that individual who had lived on the streets
for years.
Oh my.
His last two weeks were surrounded by loving care in a comfortable environment.
He didn't have to worry about the rain and the wind and anything else.
He was comfortable.
To me, that showed the hospice heart and everybody.
The chief medical director or chief medical officer went out and bought pickles.
He went out and bought.
We all surrounded this gentleman.
How about that?
Yeah.
That's just one.
But there are so many.
I'm sure.
Yeah.
That's wonderful.
That's a wonderful story, Jan.
Let's shift for a minute to the topic of innovation in hospice.
How has technology played a role in advancing hospice care?
Are there specific innovations that have stood out to you?
I think, first of all, technology is important.
We have to embrace it, but not replace.
We embrace, but not replace.
We don't replace the human element, but we have to embrace the technological element.
EMRs were a big deal, just electronic medical records.
They can be a pain, but they also can be a very, very important tool where you have information
that's important that is captured in the medical record and available in real time.
So that when a patient calls, say, at two o'clock in the morning, the nurse who is taking
that call can just open the medical record and know exactly what's happened.
That's a really key innovation.
We're currently using an innovation where staff don't have to write down their mileage
anymore.
It's called Triplog.
They just start, they just push a button, it starts tracking where they're going, and
they push it when they're done.
No more writing down mileage, which was a big pain for staff.
They didn't like that.
I think the track was awful.
So, I mean, that's kind of a little innovation, but it's a big deal for the staff.
I think in terms of innovations that are going to be really meaningful, I think there are
things that will help innovations coming down the pike that will help nurses to not be bogged
down with as much documentation as they are today.
Perhaps different ways to capture documentation without the burden that currently exists.
And other kinds of innovation that I think are important.
We're currently working on it with a PBM where we can order medications on an app, and things
are just smooth and taken care of that way.
There are a lot of different technological innovations that are coming that will help
us.
Yeah.
And, pardon me, but the types you've just described, it seems to me from an HR mindset
that by decreasing the bureaucratic paperwork and record keeping and that sort of thing,
you're also increasing employee satisfaction and have the opportunity to do so, at least
improve employee satisfaction that you're doing things to try to make their life a little
easier and let them focus on what they're called to do.
Exactly.
That's important.
That's very important.
Do you see telehealth as an emerging technology in hospitals?
Yeah, I do.
It's been utilized currently in hospitals with face-to-face visits.
I would like to see it utilized a little bit more frequently, and we can use it.
We can use telehealth.
So let's say, for example, a patient's family calls at two o'clock in the morning, and the
person doing triage, if they have the ability to actually see what's happening or measure
the blood pressure or use some telehealth devices to help them with triaging, that could
be a huge advantage.
So that's one of the things that I see that would be really helpful.
Okay.
Yeah.
Again, you've been in hospice for a long time, and there are new professionals entering hospice,
and there are those currently in hospice who might be struggling or trying to grow within
hospice.
So if you were offering advice to professionals who are considering going into hospice or
growing in hospice, what advice do you have for those individuals?
First of all, I think that the calling piece is critical.
So if you think that that is a field that you want to work in, it might be helpful to
really interview some people who are already doing it, already in the field, and maybe
even doing a ride along if you can get permission to do that, just to see if it's something
that meets your needs.
I think I just cannot reiterate the importance of the calling part, because people who do
come to hospice usually within a short period of time either know that it's for them or
not.
And I would imagine as long as you've been in hospice, you can spot that pretty quickly
in a person, can't you?
Yeah.
Well, and they can spot it in themselves.
They usually self-identify.
So I think anyone wanting to work with people, it is the most meaningful work I have found
in my entire nursing career.
There is nothing more important to me than making a difference in someone's life when
it is at the end of their life.
That is the most important thing I feel like I can do with my life.
That's right.
So a lot of nurses who leave, let's say, the hospital, and they're accustomed to rehabbing
patients, fixing them, getting them better, and then they go into hospice where that's
not the case.
You're trying to maximize the quality of life, however many days the patient has left, and
to minister to the families.
I see it as a little bit of a ministry as well.
But there are emotional challenges.
So how can professionals in the hospice industry navigate the emotional challenges that come
with providing end-of-life care?
Yes.
There are emotional challenges because you do get attacked.
It's natural.
So I would look for a hospice that honors that.
And there are a couple of things that hospices can do.
One is to have some formal ways in which they honor the lives of the patients who've gone
before.
And there are a whole lot of different ways to do that within the staff.
I would also look for a hospice who might have some mental health dates in their benefit
package, where you have the opportunity if you're really struggling and you need a few
days to kind of recharge your batteries, that the hospice may have either a paid day off
policy that allows for that or an actual mental health date policy.
So those are some of the HR things I would look for.
The other thing is you want to work with people who are supportive.
So your colleagues mean a lot in providing emotional support.
I have learned that.
Yeah.
I mean, it's a pretty strong bond within the hospice care team.
Yes, it is very strong.
And they tend to support each other when one person is needing a little extra boost, the
rest of them kind of gather around and provide that.
And that means the world.
So that's part of the job satisfaction that I see with a lot of hospice staff is just
the satisfaction comes from the team that they work with and the supervisor that they
have who supports them.
That supervisor is important, right?
Absolutely.
So, well, thank you for that, Jan.
When I read your bio, I was amazed at all the community involvement you have.
So when it comes to community engagement, how do you engage with the local community
to raise awareness about hospice care and end of life issues?
The way I've done it is I find groups that have similar desires to support the community.
For example, the Chamber of Commerce supports businesses in the community, the Rotary supports
causes in the community.
So I kind of gravitate to organizations like that and find whether I'm a member of an organization
like that or whether it's an opportunity to do a program for an organization like that.
I think it's really, really important.
That's how I've seen raising community awareness through both membership in those organizations
and also just talking about what it is that you do.
What does your hospice do?
Okay.
Thank you.
And as we mentioned earlier, it's a balancing act, right?
Managing a hospice organization requires a delicate balance between business and compassion.
If you're a for-profit or a not-for-profit, that really doesn't matter.
You still have to generate revenue in order to serve your mission within the community,
right?
So it's a fine line.
So how do you strike that balance and what lessons have you learned along the way, Jan?
Well, I think just the most important thing is doing the right thing.
Staying compliant.
First of all, understanding that your people are the most important thing, your staff.
Understanding that compliance is a requirement and following it very carefully.
So taking care of your people, being compliant with regulations.
Those things help you as you grow so that you grow your revenue to the point where you're
able to support your mission.
And so I think those are two of the most important things that you do.
Growth is critical to supporting a mission.
It is for any business.
So attending to that.
That you grow because your people are great and the word gets out, and you grow because
you are an upstanding business.
So those are key factors, I think.
So when we talk about the workforce, I mean, you are certainly respected as a hospice leader.
And you have the depth and breadth of leadership experience within hospice.
So as a leader, you understand the importance of connecting your employees with the mission
of your hospice, right?
So what strategies as a leader do you employ to accomplish that?
First of all, you model it, but beyond that, we have frequent all staff meetings where
we lift up our mission, lift up what it is we're doing, our mission, our values.
And we are looking for ways to tell stories of success that occur.
And as we talk through those stories of success, it's promoting the culture and the mission
of hospice.
So I think those are key factors.
Okay.
So what I hear you saying is that you model the right behavior, correct?
And I say that because I've seen so many leaders who model the behavior.
Unfortunately, it's not the right behavior.
Yeah, no, you got to model the right behavior.
It all starts at the top, right?
It does.
That's where culture moves.
It's all at the top.
That's right.
Thank you for that, Jan.
I promise I'm about to let you off the hook, but we're about to close.
So as we wrap up, is there a particular message or piece of wisdom?
I'm putting you on the spot now, Jan, or piece of wisdom you'd like to share with our listeners,
especially those who may have been touched by hospice care in some way.
Yes.
Well, first of all, if you have been touched by hospice care, thank you for the opportunity
to serve because it's a real privilege to be with your families and with you.
So thank you for that.
I think the most important message that I have is to maintain the commitment to people
who are living the last chapters of their lives, that maintain the commitment of care,
no matter what the payment system looks like over time.
We need to commit to providing loving, compassionate, competent care to people who deserve it.
We all deserve it.
Thank you for that, Jan.
Thank you so much.
Thank you for your dedicated service to hospice care and for your time today, Jan.
It was my pleasure, Jeff.
Thank you for asking me.
Yeah, you always have an open invitation to join.
And if I could right now, I'd give you a big old hug, Jan.
Thank you so much.
All right.
Well, through the computer, yours won back.
Thanks so much.
All righty.
Wow.
How special was that, right?
And I wanted to let you in on a little secret.
Jan did not receive any of my questions in advance.
All of her responses were in the moment and from her heart.
So we thank her deeply for her time and her contribution today.
And we're going to take a quick break for commercial.
Then I'm going to come back and I'm going to wrap up the episode with a quote that I
think is very relevant to the discussion today.
At Flagship Talent, we work with our clients to find and place the right talent.
What do we mean by the right talent?
We mean we find talent who will commit to your organizational goals and align with your
values and behavior expectations.
Talent who will perform to your expectations.
Talent who will stay and grow with your organization.
How are we different from our competitors?
We offer the lowest fee structure in the industry.
We offer the best talent guarantee in the industry.
We provide selection and interviewing support to our clients at no additional fee.
We want to save you money, deliver high quality talent, become an extension of your organization,
and be your preferred provider of talent acquisition solutions.
To learn more, contact Jeff Parsons by email at jeff at FlagshipTalent.com or by phone
at 1-800-530-4189, extension 101.
Okay, so as I mentioned, I would like to leave you with a quote by the ancient Pericles.
And it's certainly relevant for those like Jan Jones.
She has touched many lives in her career.
So the quote is this, what you leave behind is not what is engraved in stone monuments,
but what is woven into the lives of others.
Keep that one in mind.
Continue to press to be the flagship in your industry.
I wish you all a Merry Christmas and happy holidays.
And I will see you next year.
Bye now.
Thank you for listening to this episode of Be the Flagship with Jeff Parsons.
We hope you enjoyed it.
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Until next time, take the step to become the flagship in your marketplace.