Pasco County Home Healthcare Agency is prepared for the future

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Pasco County mother-daughter pioneering entrepreneur s have established health services business over the past two decades with agility, innovation and commitment to business ethics

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By: C. Sam Smith

 

(New Port Richey, FL,  June, 2012) What was considered sound, ethical, open ended business strategy by woman-owned Mobile Personal Services, Inc. of New Port Richey, FL. has positioned the 22 year old home health agency for the possible effects of the Federal “Patient Protection and Affordable Care Act of 2010” structural health insurance payment reforms, as they may occur.

 

MPS Home Office Location in New Port Richey

Owners Clara Ward and her daughter Lisa Ward Tabbert opened their now highly successful Pasco County home care agency in 1991 driven by a desire to ethically serve the health needs of the populations of a three county area.  

New Port Richey is located in Pasco County, FL, approximately 30 miles north of Metropolitan Tampa, FL. and is a coastal city, population 20,000 and is considered by many an ideal place to either raise a family and an even more attractive place to retire. Lisa and Clara were pioneers in many ways. The two woman team had very little capital and very little knowledge of the home healthcare industry when they launched the agency.

These ladies have no fear.

What’s more, their timing was right.

Capital requirements have changed.  In 1991 it was possible to start a home healthcare agency with as little as $2000 in start-up capital. Initially, MPS was licensed solely through Florida’s Agency for Health Care Administration. They hold a license to serve Medicare clients now, after obtaining a license from the Center for Medicare Services in Washington, D.C. Currently, due to the increased complexity of the regulations, and the costs of licensing, hiring, marketing and advertising, the barriers to entry into the home health market are much higher and more expensive. Today, according to Lisa, starting a licensed home health agency accredited by the State and the Federal authorities, can cost anywhere from $100k $200k.

MPS’ founding based on ethics.  Lisa remembers the ethical issue that led to the startup of their agency. Lisa remarked, “When I graduated from college, I secured a job as a social worker for a Medicare certified home healthcare agency,” Lisa remembered. “In those days, my job was to set up community resources for senior patients. Many of the companies I would refer to were good honest companies, however, some were not,” she stated. She observed that some agencies would intentionally overbill a slightly forgetful client. She would repeatedly have to call to correct these ‘oversights’. As she continued to observe these unethical practices, she approached her mother about creating a new business which would succeed by providing excellent, reliable, dependable and ethical care for area seniors, all of whom deserve honest professional care.

Naysayers did not deter their will to succeed. Lisa’s acquaintances told her that she and her mother never should even attempt to open a home healthcare agency. This advice did not deter them. After six months they had Mobile Personal Services licensed as a home healthcare agency and after one year they were able to give up their other jobs and work full-time in the agency. They began with two small rooms, two desks and two phones in a rented office space. All of referrals at the beginning before Medicare licensing had been secured were private pay patients that needed home healthcare. Lisa exclaimed, “My mother and I were literally on call 24 hours a day seven days a week for 10 years!”

Hard work is a prerequisite. They were determined to start a home healthcare agency that serves patients with reliability, dependability, and honesty. “It took a year of work and saving for us to buy our first copy machine,” remembered Clara. “Our first fax machine was bought by my husband, who was always very supportive,” Clara continued. “Sometimes it felt like we were skating up a hill of ice”, explained Lisa, “… but we were always grateful to be working at it together, which made the hard times quite bearable”.  Adaptation is one of their strengths. The agency has changed from a non-Medicare to a Medicare Certified Home Healthcare Agency to diversify and expand their business. They have always believed in diversification. Having a private pay, non-skilled healthcare service offering as well as offering skilled nursing services has enabled the agency to achieve good stability in the recent turbulent economic times. 

Employee Attrition is an issue for HHA’s - One of the biggest challenges of home health agency operation is attrition in staff, which brings about continuing re-orientation and retraining, both quiet costly in terms of productivity. Due to their open, listening philosophy towards their team, MPS has reduced the negative effects of attrition. Maintenance of excellence in the retention of professional staff is a key factor in a successful home healthcare agency. Clara and her daughter Lisa agree that they have finally achieved a very good balance of competency amongst their nursing staff and their administrative office employees. Lisa quipped, “I always look at it like building a house. If the foundation is not good the structure is going to fall”. She added, “Once we obtain a competent professional employee, in order to assure that he or she is happy, we try to think out-of-the-box”.  

For example, Maribeth, the Director of Nursing for MPS, is a fitness buff. She maintains a very fit lifestyle and was unhappy with sitting at her desk all day doing paperwork, so she suggested to Lisa that she look into getting a treadmill desk!  Lisa quickly agreed to accommodate this request. The DON’s job satisfaction has increased tremendously.

Maribeth works and walks at her treadmill/desk

The agency has also rotated many interoffice staff to four ten-hour workdays which is also increased job satisfaction and allows the agency to stay open longer hours to serve the prospects and patients. 

The mother-daughter team have long ascribed to an ongoing philosophical formula: Honesty + Dreams + Plan + Faith + Hard Work = Success

Sharing the vision - “We are believers in everyone sharing the vision for the agency, and buying into the goals and objectives we as an agency have strategically decided to set as our operating vision”, stated Tabbert. After years of operation with a state and a federal Medicare license, the agency had an open mind regarding the varied ways that our clients may want to obtain and pay for services from us. Their strategy was to be agile and adaptable, and not to lean on just one payment source for their revenue stream. MPS accepts managed care insurance, HMO insurance, private duty clients and clients who reside in skilled nursing and assisted living facilities. MPS also has contracted with therapists of all disciplines so that their services are broad and applicable to patient’s needs.

Using technology to manage the increasing complexity

. In 2011, MPS had grown to the point of needing a tool to assist management and nursing care services in overseeing so many patients and maintaining compliance with the myriads of government and insurer regulations and standards. “In order to accept all the types of payment, and to be able to cope with the increasing complexity of home health agency operations, we needed an agile software platform to continue to expand and operate successfully”, Lisa stated.

Axxess is the choice

After what Lisa considers “extensive due diligence”, which included compiling a list of requirements, ,performing an internet search, and attending conferences to view and seek demonstrations of the varied vendors in the marketplace, MPS chose Axxess’ Agencycore^® platform, over the many competitive offerings in the marketplace. Lisa is enthusiastic in her appreciation of this innovative technology, and quipped, “Axxess has been a great fit for our agency. They do not charge you for every little feature (like the other software companies she previewed)- they provide all these features at no additional charge”. She continued, “The training was easy and ongoing support has been exemplary. Axxess support staff have always been competent and friendly.  The most important feature for me is that they listen to your feedback and constantly improve their product to meet our needs. I am a very happy customer.”

 

Staying true to the course

 

MPS’ mission remains a constant; providing honest, professional, caring home health services to Florida’s Pinellas, Pasco and Hillsborough counties. Additionally, the move to state-of-the-art technology promises to aid the company in achieving even greater success in today’s turbulent home health market. The strategic and philosophical decisions made at the outset at the founding of Mobile Personal Services, Inc. appear to have “passed the test of time” over the two decades they have been in operation.

“Due to our excellent technology platform, we are operating at a productivity level and volume that we could not have dreamed of in 1991”, beamed Lisa. “Our hope is that as we follow our business philosophy which is to provide the ultimate in care as we serve our patients, we will continue to drive our agency into the future. Strategically, we trust that our technologies, our ethics and our market will continue to afford us the opportunity to operate profitably and productively for years to come”.

She concluded, “As we reflect on our years in business, we can truly say that we are blessed.”

 

Knowing these ladies successful ways and determined approach, it’s a safe bet that MPS’ patients are blessed as well.

Wisdom in the Workplace: Developing Emotional Intelligence to achieve Personal Mastery

By: C. Sam Smith, Editor, Axxess News and Updates


(Dallas, TX, June, 2012)  How can an awareness of brain chemistry enable us to be productive team members? We can begin to understand how to become more focused on natural impulse-responses to negative workplace events. This will enable us to respond with more appropriate responses to reduce conflict in our day-to-day work environment. The end result is the cultivation of “Emotional Intelligence”, which is defined as the ability to identify, assess, and control the emotions of oneself, of others, and of groups.
This topic is of critical importance as we seek to develop the Learning Organization culture in our workplace environments.
Two-time Pulitzer Prize winning author and psychological researcher Dr. Daniel Goleman, in his 2011 book, “The Brain and Emotional Intelligence: New Insights”  has outlined the way to one of the critical outcomes of the Learning Organization, Personal Mastery, by highlighting the stimuli which cause us to enter into a “fight-flight-or-freeze” response triggered by our natural brain chemistry.  Goleman calls these events “emotional triggers” causing an unnaturally severe response because of the way these events can trigger the “fight-flight-or-freeze” reaction. Our internally produced stress hormones, cortisol and adrenaline—kick into gear when our brains perceive a “threat”. Most of the time--there’s a big problem with all this: our brain often makes mistakes.  Particularly these mistakes occur in modern workplace life, where the “dangers” are symbolic, not physical threats. So we overreact in ways we often regret later.

Is there a practical methodology for avoiding workplace misunderstanding and conflict?
What causes our overreactions? Goleman outlines symbolic workplace occurrences which our brain perceives as threats—that cause us to get an emotional hijack overload.

Here are the 5 top “emotional triggers” in the workplace: 

1. Condescension and lack of respect. 
2. Being treated unfairly. 
3. Being unappreciated. 
4. Feeling that you're not being listened to or heard. 
5. Being held to unrealistic deadlines.

We all can very easily relate to these issues as having the capacity to cause our egos to rise up and want to defend ourselves. All but the most emotionally intelligent of us will naturally defensively react to these stimuli.
Goleman states that in an economic atmosphere with great uncertainty (like the current state of home health agency operations) there’s lots of “free-floating fear” in the air. Many people fear for their jobs, for their family’s financial security, and all the other problems that a bad economy brings. And this anxiety causes hijacks in workers who have to do more with less. So in such a climate there are many people operating day-to-day in what amounts to a chronic, low-grade “emotional hijack”.
It behooves us to become more educated regarding the chemical brain functions. This knowledge enables us to become more aware of our own reactions.
If these emotional hijacks are part of our workplace existence, then, in order to truly become emotionally intelligent, how can we minimize these hijacks?
• First of all, we must pay attention. 

• It’s better to realize what’s going on and disengage from the potential emotional trap into which you’ve realized you could be heading!
• This requires some practice but, start with monitoring what’s going on in your own mind and brain, and noticing, “I'm really over-reacting,” or “I'm really upset now,” or “I’m starting to get upset.” 

• Notice familiar feelings.

• It’s much better if you can notice familiar feelings that a hijack is beginning – like butterflies in your stomach, or a flushed face--whatever signals that might reveal you're about to have an episode. It’s easier to short-circuit it the earlier you are in the cycle of the hijack. Best is to head it off at the bare beginning.

What can you do if you are caught in the grip of an emotional hijack? 

• First, you have to realize you're in it at all. Hijacks can last for seconds or minutes or hours or days or weeks. 
• For some people it may seem their “normal” – people who have gotten used to always being angry or always being fearful. 

 But we’re talking about normal here.
There are lots of ways to get out of a hijack if we first can realize we’re caught, and also have the intention to cool down.

• One is a cognitive approach: "Talk yourself out of” the hijack. Reason with yourself, and challenge what you are telling yourself in the hijack –“This guy isn't always an S.O.B. I can remember times when he was actually very thoughtful and even kind, and maybe I should give him another chance”. 
• Apply some empathy, and imagine yourself in that person’s position. This might work in those very common instances where the hijack trigger was something someone else did or said to us. You might have an empathic thought: “Maybe he treated me that way because he is under such great pressure”. 
• Another is a biological approach…like meditation or relaxation to calm down our body.
•  My mother used to suggest that I count to ten before I responded to an offensive remark.
•  This is a very simplified kind of relaxation or meditation technique.
•  Practice makes perfect. Unless these methods have become a strong habit of the mind, you can't just invoke them out of the blue. But a strong habit of calming the body with a well-practiced method can make a huge difference when you're emotionally hijacked and need it the most.

Understanding and working through these “emotional hijacks” are important considerations as we seek to consider becoming more emotionally intelligent in the workplace…and that is a goal to which all effective agency managers and staffers can aspire. 


Remember, becoming emotionally intelligent is the only way to achieve true Personal Mastery, a worthy goal of all home health professionals.
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Goleman, Daniel (2011-04-12). "The Brain and Emotional Intelligence: New Insights", pp.297-304. More Than Sound LLC.