Show Notes / Summary

• Why launch hospice now: continuity, fewer hospitalizations, value-based alignment
• Clarifying myths: CNA hours on hospice, attending provider still leads care
• RAF & staffing logic: ~$6k/mo hospice per diem ↔ RAF ~5; translating RAF → weekly CNA/CHW hours
• Nurse incentives: $150 per admission; double telehealth-assist credit on hospice patients
• Software + workflow: Athena ↔ WellSky (care plans, documentation, pull-through)
• Facility model: converting buildings; estimating FTEs from hospice census + RAF
• Chaplain/social work: leverage in-region LSWs; connect to patient’s faith community
• Respite options: Medicare respite/GIP + GUIDE program for dementia (up to $2,500yr)
• Therapy as palliative strength: weekly PTA/COTA; telehealth support
• After-hours model: optional call, $300 RN death/critical visit; $150 for non-nurse critical checks
• Guardrails: clinical judgment first; financials inform—not dictate—care

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Key Takeaways (for on-air recap & social)

• Presence prevents: Being in the building daily beats any remote administrative stack.
• Rituals > heroics: Small, repeatable actions (exercise + vitals + lunch checks) compound.
• Caregivers stabilize: A modest weekly schedule creates 40 hours of reliable on-site support.
• Therapy cadence matters: Spread the care; keep people moving longer to reduce falls.
• Document to decide: Specific behavioral notes → faster NP decisions → fewer crises.
• Mission creates growth: Aligning to “no hospitalizations” reduces noise and increases referrals.

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Why transitional care is at the heart of Your Health’s model

How incentives for early post-hospital visits worked (and why they didn’t)

Why in-person care matters more than telehealth alone

The growing role of respiratory therapists, physical and occupational therapists, and community health workers

The challenge of patient perception: “too many visits” vs. “too many calls”

Why insurance companies trying to become providers is dangerous for patients

Scott’s philosophy: nothing should be written in stone — adapt and evolve

The simple but powerful call to action for providers: “Go see your damn patients.”

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