“The CEO Show” specializes in interviews with CEOs “who have reinvented the fabric of America.” Broadcast to more than half a million listeners on 40 radio stations across the country, Reiss’s guests have been the forces behind more than 200 of the world’s most successful companies. On December 13, Reiss sat down with Paul Kusserow to discuss his management philosophy and plans for Amedisys.
Kusserow, who took the helm of Amedisys just over a year ago, has spent the last twelve months learning as much as he can about the company and putting together a management team to take Amedisys into the future. He told Reiss, “If you bring real democratic, enabling principles to bear, you can unleash the power of those people within an organization and really let them shine. And then you yourself will shine as a result of enabling them.”
The CEO went on to say that he is a devoted believer in loyalty. He judges people by how loyal the people are below them and above them. He also hires people who understand failure. “You want people with scar tissue on them so that they understand how things should be done and how they shouldn’t be done,” he said.
Kusserow, who has a background in strategy, believes that, while Amedisys is in the early stages of transformation, the market conditions are good and the company is focused in the right areas. “We’ve got really good wind at our backs,” he said. “I’m very optimistic about what we’re going to do once we really unleash our clinical excellence, once we really have engaged employees.”
In the future, Kusserow sees Amedisys as the company that helps people age in place, the company that enables people to stay in their homes if they want to stay at home.
“This business is a virtuous circle,” he said. “The fact is we’re doing good to the most vulnerable people out there and yet it’s good business. It’s a good deal.”
Listen to the full CEO Show interview here
BY: Paul Kusserow, Amedisys President and Chief Executive Officer
I understand the process. We stand on the doorstep to a home. We ring the bell or knock. The door swings open to let us in. And that’s where it all starts – where the connection between the patient and Amedisys begins.
Theoretically, I’ve long known what Amedisys does. We deliver home health and hospice services to more than 360,000 patients each year, approximately 30,000 patients per day. But I wanted to witness us in action, to see these patients and services performed for myself.
I’ve had in mind a second mission, too, ever since stepping in as CEO last December. I’ve wanted to better understand why – why we at Amedisys do what we do, and what I can do to better support you?
During the past 9 months, I’ve visited more than 40 of our care centers in 21 states. I went on numerous patient visits and met more than 1,000 of our team members. There is a compassion that emanates from the care we provide, and I’ve had an incredible array of experiences during these visits. I wanted to share with you what I’ve learned about our patients and have bucketed my learnings into three main areas:
- They’re often the sickest of the sick, and thus the most vulnerable. They know that and we know that. They’re typically struggling with chronic illness, perhaps congestive heart failure, cancer, diabetes, COPD or dementia. In the most extreme cases, they’re coming to the end-of-life. They realize they will no longer be here in six months or two weeks or even sooner, and they’re trying to come to terms with it – and every patient handles this differently.
- They’re often lonely – our average patient is 80+ years of age and possibly feeling cut off – and so they get excited about having us for company. A home health visit from, say a nurse or occupational therapist, can quickly turn into a special and highly anticipated social occasion. Patients may offer us some pastry and coffee. They’ll talk about the TV shows they enjoy and the hobbies they pursue. If we’re really good at what we do, they open the door further, showing us photos of the kids, grandkids and great-grandkids. They want to connect.
- Delivering healthcare to the home is about as personal as healthcare gets. We take care of our patients where they live, whether a house or an apartment or in assisted-living. Our clinicians go behind the scenes to enter otherwise private spaces, where some patients feel safe and cared for, and others are struggling with poverty and dysfunction. We see it all – we get the whole picture of our patients. We see the food in the refrigerator, the dogs on the couch, the drugs in the medicine cabinet and the statue of Jesus in the bedroom.
Sometimes these visits just break your heart. I saw a young man on hospice, unconscious and dying of HIV, his pious mother attending to him in the back bedroom of a shotgun shack.
But no matter the circumstances, everywhere I found inspiration. After our visits, many home health patients eventually move better, eat better, breathe better and speak better. Our hospice patients may suffer less pain and eke out a little more precious time with their families and friends. Best of all, our patients get to hold onto a sense of independence and freedom – and with that, dignity as well. We supply this.
I’ll never forget those visits; they will always stay with me. I came back with my sense of purpose about Amedisys – why we exist, the role we play in our patients’ lives – strengthened many times over.
I know that if we put our people and patients first, then good things will follow. That’s what we are here to do.
Categories: nurses, home health
By Kate Jones, RN, MSN, CCM, Amedisys Chief Clinical Officer
During National Nurses Week, I would like to share some of the attributes that make health care at home nurses – like the compassionate clinicians here at Amedisys – so special.
Nurses who deliver health care at home function differently from nurses in hospitals, nursing homes, assisted living facilities and other practice settings. That’s why we at Amedisys educate our nurses accordingly. And why all home health care organizations should do likewise.
The differences with care given in institutions are numerous. A home health nurse, for example, may average five or six personal patient visits a day, driving several miles from one home to another, rather than staying in a single place, sometimes facing bad weather, slow traffic and mean dogs. They may need to be on call after hours and on weekends, instead of logging only specific shifts.
But beyond such logistics, home health nurses must be prepared to operate independently, without immediate access to other health care practitioners only a few doors down the hall. They should be infinitely adaptable, no matter what the situation, always ready to solve a given problem, whether ensuring mobility in each environment or safeguarding medication compliance. They should also be well organized, precise in documenting every visit electronically, and communicate effectively with other members of the home health team, including physicians, primary caregivers and families.
Above all, home health nurses are uniquely privileged. They are more than clinical experts focused on the best possible care to patients. They’re also guests, trusted advisors, teachers and caring visitors all rolled into one.
At Amedisys, as industry leaders, we’ve designed an orientation program expressly to prepare our home health nurses to bring care right to the front door. We teach the rules that are applicable for home care in general and for Medicare patients in particular. We educate our nurses in the multiple special demands involved. We used a blended learning approach of computer based learning and preceptor support. Nurses who are new to home care face a steep learning curve, but they’re always open to learning and improving. And in order to support such success, we make sure all our lessons are driven home.
At last private insurers are reimbursing physicians for a service that should already be a given: conversations with patients about end-of-life care. More promising yet, Medicare itself may agree to cover physician-patient discussions about "advanced care planning" as early as next year.
This is big news and certainly a step in the right direction, especially for our fast-growing population of elderly Americans. Every U.S. citizen concerned about dying in the near or even distant future is entitled to insurance coverage for an opportunity to talk with a family doctor about the options available, including hospice, in order to reach an informed decision about how to proceed.
The Centers for Medicare and Medicaid Services (CMS) is expected to issue a decision about Medicare reimbursement for such services this fall. Meantime, the American Medical Association, foursquare behind the concept, has asked CMS to approve a request to create billing codes for end-of-life conversations.
At the very least, no patient should ever feel the least reluctance about venturing into such sensitive conversations with physicians, and neither should the physicians themselves for that matter. Every patient has needs and goals that should be discussed in order to be met, and all the more so when it comes to the compelling question of how one choses to die.
A recent article in the New York Times, titled "Coverage for End-Of-Life Talks Gaining Ground," addressed this issue. Experts quoted said that Medicare coverage of end-of-life counseling could make a profound difference in our approach to dying. Still, CMS would also have to determine how much to reimburse physicians, whether non-physicians such as psychologists could carry out those conversations, and how often such talks could take place and whether in person or by phone. As the piece accurately pointed out, the value of coverage for only a single session would have limited.
For further details, here’s that article:
End-of-Life Talks May Finally Overcome Politics
We at Amedisys, as leaders in hospice care, providing compassionate medical care and emotional and spiritual support to patients nationwide, understand precisely what’s at stake here. For more information, here’s some background: www.amedisys.com/patients-and-caregivers/hospice-care/hospice-faqs
About the Author
Michael Fleming, MD, FAAFP is the Chief Medical Officer for Amedisys, and Past President of the American Academy of Family Physicians and the Louisiana Academy of Family Physicians. Dr. Fleming has served as Speaker of the Congress of Delegates of the AAFP and as Board Chair of the AAFP Board of Directors. He serves as an assistant clinical professor in the Department of Family Medicine at the LSU Health Science Center and in the Department of Family and Community Medicine at Tulane University Medical School.
Categories: veterans, caregiving
My father, a graduate of West Point, was a captain in the Army, stationed in Germany during the Vietnam War. My grandfather was a veteran of World War II who landed on the beach at Normandy in 1944 on D-Day. My cousin Bob is a sergeant first class in the National Guard who has served in Iraq and Afghanistan since Desert Storm in 1990.
So when I met with the Providence VA Medical Center in 2012 about "We Honor Veterans," a program of the National Hospice and Palliative Care Organization, I felt a personal connection. The VA center had invited the hospice where I'm director of operations to participate in the initiative, mainly to ensure that excellent care for our veterans at the end of life is available. No hospice in Rhode Island at that time had any programs for veterans.
And because of my family history – but also because I'm every inch a proud American citizen – I saw no option, as a nurse at the Beacon Hospice East Providence, but to step into the breach. I said to myself, "You know what, I want our hospice to take the lead in our state."
Soon we formed the Rhode Island Hospice Veterans Partnership, a nonprofit organization made up of local hospices, VA staff, healthcare professionals and community members. The goal was primarily to improve access to hospice and palliative care for veterans and educate those who care for our service members at the end of life – in short, to see that our veterans can die with dignity.
Over the next year, our hospice held events educating our community about our aging veterans. We conducted meetings with other hospices, private duty home care agencies, community groups and representatives from the Catholic and Episcopal Diocese. We brought in Deborah Grassman, a longtime nurse practitioner who was the director of the hospice program at the U.S. Department of Veteran Affairs – and who personally took care of 10,000 dying veterans – to deliver a presentation to local residents.
Word spread. The number of participating hospices quickly grew to four, along with many home health agencies. The governor of Rhode Island dispatched a citation acknowledging our efforts.
We're hardly alone at Amedisys in our focus on veterans. Forty-seven Amedisys hospice centers in 16 states currently participate in the "We Honor Veterans" program. But with an estimated 1,800 American veterans dying every day – including some by suicide – the need to care properly for our soldiers at end of life is still going largely unmet.
Soldiers who have gone to war often come home with special issues that remain unresolved for decades. They may have seen combat, even witnessed comrades die in battle. Yet they may tuck the trauma away deep down inside, never saying a word about wartime experiences to family or friends. Only in hospice, perhaps in a conversation with a therapist or member of the clergy, might those memories finally surface, healing heart and soul before the last trip home.
Just recently, Amedisys declared me a Spirit of Excellence Christen Award winner for my efforts with this program. But I'm hardly the one deserving of awards. What I've done with veterans is the very least I can do to honor those who are. My father. My grandfather. My cousin. And, of course, all the other soldiers blessed enough to come back to live among us again.