Last Visit First

Compassus CEO Mike Asselta on clinical insights, care leadership and the future of healthcare. He leads one of the nation's largest home-based care companies, 10,000 caregivers and $1.5B in integrated services. He finally sat down with Tom and did not hold back.With 31 years of healthcare leadership behind him and a platform covering home health, hospice, palliative care, infusion and private duty services, Mike is driving healthcare innovation and the future of patient-centered care from the inside out.He explains:How you scale a $1.5B home-based care company without losing the culture that made it greatThe AI investments that are giving nurses their evenings back and cutting intake from 4 hours to 15 minutesWhy joint venture partnerships with health systems are the future and what the Providence deal taught themThe palliative care strategy, the SNF-at-home model and where the patient journey is actually headingThe nurse practitioner workforce crisis and the clinical data signals every provider should be watchingWhat great care leadership looks like at scale and the legacy he is building at CompassusCHAPTERS0:00 Introduction — Meet Mike Asselta, CEO of Compassus0:27 Mike's Career Journey: Lab One, Quest, Fresenius and Three Failed Retirements3:28 Entering Home-Based Care: The Fragmentation Shock5:20 Leading a Mobile Workforce: Care Leadership at Scale6:18 Compassus by the Numbers: $1.5B, 11,500 Caregivers and a Mission-First Culture8:24 The Leadership Summit in San Antonio: Leading With Heart12:11 Operational Excellence vs. Clinical Excellence14:15 The Single Biggest Strategic Decision of Mike's First Two Years15:19 Why Hospital-Health System JV Partnerships Are the Future of Post-Acute Care21:07 Inside the Providence Partnership: Values, Scale and Continuity of Care23:21 How Health Systems Should Be Thinking About Hospice and Palliative Care26:45 The Hospice Conversation Nobody Wants to Have (But Everyone Needs To)28:09 Industry Fragmentation, Fraud, Waste and Abuse — and Why the Real Story Isn't Being Told30:06 Ads31:45 Independent, Hospital-Owned or JV? What the Industry Looks Like in 10 Years32:30 Interoperability, Faxing and the $781M Problem CMS Is Finally Addressing33:58 Balancing Home Health, Hospice, Palliative Care and Infusion Across the Patient Journey35:58 SNF at Home, Nurse Practitioners and the Next Frontier of Home-Based Care37:52 The Nurse Practitioner Workforce Crisis and the Student Loan Reclassification Problem40:28 Palliative Care Volumes Up 50%: The Compassus Strategy44:41 Clinical Data Signals Every Home-Based Provider Should Be Tracking48:31 AI Is Transforming Intake: From 4 Hours to 15 Minutes49:37 AI at the Bedside: Reducing Start-of-Care Time by 50% and Ending Pajama Charting52:23 Ads54:37 Revenue Cycle, AI Workflows and the Art of the Possible in 2026 and 202757:17 Claude Cowork, Agentic AI and the Back Office Revolution at Compassus1:00:14 Real-World AI Win: A 45-Minute Fix for What Should Have Been a 3-Week Project1:02:03 Reducing Nurse Fear and Burnout Around AI Adoption1:04:47 Developing the Next Generation of Home Health and Hospice Leaders1:08:00 Mike's Legacy: What He Wants Compassus to Be Known ForLearn more about Compassus: https://www.compassus.comCareers at Compassus: https://www.compassus.com/careersSponsors:Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/ Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Subscribe to Last Visit First for new episodes every week with the leaders shaping home health, hospice, palliative care and the future of healthcare.

How do you manage a $17 billion investment firm while staying focused on meaningful clinical impact?In this episode of Last Visit First, Tom Maxwell sits down with David Schuppan, Co-President of Flagship Funds and Co-Head of Healthcare at The Vistria Group. With a career spanning over $10 billion in healthcare investments across 28 companies, David is one of the primary architects of the modern post-acute landscape.We go behind the scenes of the "Power of Three" investment model and discuss:The History of PE: David’s early days working with industry legends Bryan Cressey and Carl Thoma.Portfolio Strategy: Why Vistria invested in industry leaders like Homecare Homebase, Mosai (Medalogix), tango, and Anew Health.The "Duals" Frontier: Why the intersection of Medicare and Medicaid is the next great value-based care opportunity.AI in Healthcare: Shifting the industry from the "IQ business" (data analysis) to the "EQ business" (human-to-human care).Scaling for Success: David’s advice for CEOs looking to scale from $50M to $500M and beyond.David also shares a personal look at his legacy and why he believes private capital is the "action engine" for improving the lives of patients and families.0:00 - Introduction to David Schuppan1:27 - From Missouri to Wall Street: David’s Origin Story4:30 - Meeting the Founders of Private Equity (Cressey & Thoma)8:07 - The Sourcing Strategy: Active Listening & B2B Healthcare10:43 - The Vistria Group’s "Power of Three" Model15:22 - The Mosai & Medalogix Story: Data-Driven Outcomes16:25 - Tango: Aligning Payers and Providers22:39 - Relationship-Driven Private Equity vs. Transactional PE25:42 - The Home-Based Care Ecosystem (Anew, Help at Home, PACE)29:27 - AI in Healthcare: Use Cases in Recruitment and Operations37:34 - David’s New Role as Co-President of Flagship Funds42:40 - The Future of Consolidation in Home Health & Hospice46:03 - The Toughest Investment Decisions & Lessons Learned49:20 - Advice for CEOs: Scaling to $500M54:58 - The Legacy of Patient ImpactEnjoyed the episode? Let us know in the comments! Make sure to leave a like and subscribe!Last Visit First:Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182 Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs YouTube: https://www.youtube.com/@lastvisitfirstpodcastWebsite: https://www.lastvisitfirst.com LinkedIn: https://linkedin.com/company/last-visit-firstCheck out our sponsors:Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Connect with David and The Vistria Group:https://vistria.com/contact/

Most families are flying blind when it comes to aging. They think the system has their back, but Dr. Katy Lanz is here to tell us that the healthcare machine is actually built for billing, not for people. As a triple board-certified doctor who has advised CMS and helped lead one of the biggest palliative care providers in the country, Aspire Health, she knows where the cracks are because she’s spent her career trying to fill them.Millions of us are currently caught in the "Sandwich Generation," struggling to raise kids while simultaneously managing care for our parents. Katy reveals why these caregivers are actually the most influential force in the entire industry and how a "Family Operating System" like LifePlans can handle the logistical chaos before a crisis forces your hand.Key Takeaways:The 80/20 Rule: 80% of stability is social, not medical, and ignoring this leads to unnecessary hospitalizations in the "ER trap".Integrity vs. Despair: Navigating the final psychological battle that determines if aging is defined by fulfillment or regret.Rural Healthcare Deserts: Why geography is a primary risk factor as local hospitals continue to vanish across America.Proactive Life Planning: How moving from reactive crisis management to a centralized hub protects family relationships and prevents clinical burnout.Chapters:00:00 Intro00:09 Intro to Dr. Katy Lanz00:47 Katy's Journey into Serious Illness Care03:41 The Role of Aspire Health07:34 Innovations in Palliative Care11:51 The Intersection of Aging and Mental Health14:40 Navigating Healthcare Systems19:40 Future Policy Dynamics in Healthcare24:45 The "Sandwich Generation" and Caregiving30:25 The Evolution of Palliative Care in America33:10 Challenges in End-Stage Renal Disease (ESRD) Care35:23 Innovative Solutions for Life Planning40:20 The Concept of Whole Person Care48:13 Last Visit First: A Personal Reflection50:07 Legacy and Impact in HealthcareEnjoyed the episode? Let us know in the comments! Make sure to leave a like and subscribe!Last Visit First:Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182 Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxsYouTube: https://www.youtube.com/@lastvisitfirstpodcast Website: https://www.lastvisitfirst.com LinkedIn: https://linkedin.com/company/last-visit-firstCheck out our sponsors:Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/ Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Connect with Dr. Lanz:LinkedIn: https://www.linkedin.com/in/katylanz/LifePlans: https://www.ourlifeplans.com/

"It is not a transparency tool, it is a targeting system." On April 2, 2026, CMS released the FY 2027 Hospice Proposed Rule, and the message is clear: the days of flying under the radar are over. While many are focusing on the 2.4% payment increase, Tom Maxwell reveals why that "raise" is actually just a break even point against inflation.. More importantly, he explains why the new SSVI (Service and Spending Variation Index) is the real story you need to be watching.In this episode, we connect the dots between the new 16 point "report card" and "Operation Never Say Die", which was the FBI’s massive fraud takedown that landed the same week as this rule. If your hospice scores high on the SSVI, you aren't just getting a grade; you’re getting a target on your back for audits and revocations.What you’ll learn in this breakdown:The 16 Point Grading Scale: Learn why Measure 9 (non hospice spending) carries half the total weight and how to audit your patterns before CMS does.The FBI Factor: Understand the details behind the $60 million fraud scheme in LA and why CMS is expanding oversight to Georgia, Ohio, Arizona, and beyond.The "Red X" Penalty: See how failing to submit quality data in 2026 will lead to a public non compliance icon on Medicare.gov by 2028.October 2026 Deadlines: Discover the mandatory workflow changes you must implement for the new Election Statement Addendum.Chapters:00:00 Overview of the 2027 Hospice Proposed Rule02:47 Payment Increase and Its Implications05:15 Introduction of the SSVI Report Card08:13 Impact of Fraud and Enforcement Actions10:38 Operational Changes and Compliance Requirements13:30 Preparing for Future Changes and Public Comments16:31 OutroDon't wait for the final rule in August to start adjusting your intake and clinical documentation. Watch now to learn how to protect your PTN and keep your hospice out of the "DANGER ZONE."Get Involved:The public comment period is open until June 1, 2026. Tom shares how you can collaborate with Maxwell TEC and your peers to impact the final ruling.Connect with Tom Maxwell:Email: [email protected] Podcast Website: www.lastvisitfirst.comConnect with Maxwell TEC:Website: www.maxwelltec.comEmail: [email protected]#hospicecare #HospiceUpdate #cms #hospice #SSVI #lastvisitfirst #HospiceLeadership #HospiceOperations #HospiceCompliance #medicarefraud #OperationNeverSayDie #HospiceOversight #healthcarefraud #postacutecare #palliativecare #homehealthcare #healthpolicy #MaxwellTEC #healthcareinnovation #audits #droz #houseoversightcommittee #medicaid #medicare #healthcarepodcast

Is the ER where healthcare begins to fail, or just where chronic disease finally runs out of time? In this episode of the Last Visit First podcast, host Tom Maxwell sits down with Dr. Danielle Kelvas—a physician entrepreneur, medical marketing leader, and the Chief Medical Marketing Officer for Credential Network.Dr. Kelvas brings her frontline experience from emergency medicine, family medicine, and concierge clinics to discuss the massive disconnect between the "business" of healthcare and actual patient care. Tom and Dr. Kelvas dive deep into the unseen bottlenecks crippling the industry, from the absurdly inefficient credentialing process keeping nurses and doctors off the floor, to the crushing student loan debt reshaping the future of medical professionals.Plus, expect some wild, laugh-out-loud ER stories (yes, there is a cockroach involved), a candid look at why "loneliness" is treated as a medical emergency, and a fascinating breakdown of how AI is already transforming patient outcomes in speech pathology, ultrasound interpretation, and rural prescribing.Whether you work in home health, hospice, or are just curious about the future of medicine, this episode is packed with unfiltered truths and actionable insights.What you’ll learn in this episode:How a global medical mission trip shaped Dr. Kelvas’s communication skills.The massive inefficiencies in medical credentialing and how Credential Network is fixing it.Why the shift in graduate loan policies is a double-edged sword for mid-level providers.Why the USMLE Step 1 going pass/fail is controversial among program directors.The reality of the ER: Why it's a catch-all for systemic healthcare failures.How home health and hospice agencies can better prevent avoidable hospital readmissions.The real-world impact of AI in healthcare, from Doctronic to AI-assisted ultrasounds.Chapters:00:00 Introduction to Dr. Danielle Kelvas05:25 Transitioning from Medicine to Medical Marketing11:16 The Healthcare Credentialing Crisis20:41 The Financial Hemorrhage of Medical Student Debt25:03 The Pass/Fail Dilemma in Medical Training36:48 Health Literacy & Crazy ER Stories45:23 Why Loneliness Presents as a Medical Emergency49:14 Keeping Patients Out of the ER (Assessing Stability)54:41 Why Continuity of Care is Broken01:06:20 AI in Healthcare: A Tool for Progress, Not Fear01:14:28 Building a Medical Consulting Firm01:21:03 The Legacy of a PhysicianConnect with Dr. Danielle Kelvas:LinkedIn: https://linkedin.com/in/danielle-kelvas-md-488936186Email: [email protected] Consulting: https://dkmdconsulting.com/Credential Network: https://credentialnetwork.com/Special thank you to our sponsors: Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Check out Last Visit First on other platforms: Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182 Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxsYouTube: https://www.youtube.com/@lastvisitfirstpodcastWebsite: https://www.lastvisitfirst.com LinkedIn: https://linkedin.com/company/last-visit-first#lastvisitfirst #healthcareai #clinicaldocumentation #hospicecare #homehealthcare #emergencyroom #nursing #physician #healthtechnologyinnovator #healthtech #innovation #podcast #healthcarepodcast #emergencymedicine #medicalmarketing #medicalpodcast

This episode is a deep dive into the biggest technical shift in the history of home-based care. Tom Maxwell sits down with Dr. Alex Milani, the MD/MBA power-player behind Steno Health, to break down their massive new integration with HomeCare HomeBase.Documentation is the #1 reason for clinician burnout. Between the rigidity of OASIS and the hours spent "pajama documenting" at night, the industry is losing its best people. Dr. Milani explains how ambient "clinical intelligence" is changing the game—acting as a co-pilot that listens in the background, pre-populates complex forms, and gives nurses up to 50% of their time back.Key discussion points:The HCHB Integration: How Steno Health is being deployed at scale to 195,000 clinicians.Ending "Pajama Documentation": Moving from 2005-era "click-click-click" charting to real-time clinical capture.The "Angel on the Shoulder": How AI serves as a safety net for high-risk cases like CHF and fall prevention.Patient Literacy: Breaking communication barriers with support for 80+ languages.The Future of the Role: Why AI won't replace clinicians, but will replace those who refuse to use it.Chapters:00:00 Introduction to Steno Health and AI in Home Care01:57 Reducing Documentation Burden with AI04:32 Enhancing Clinical Documentation Efficiency07:45 The Future of Clinical Intelligence13:26 Alex Milani's Journey: From Medicine to Entrepreneurship15:35 Steno Health's Unique Position in the Market19:03 Addressing Language Barriers in Home Health20:59 Popular Features and Overcoming Skepticism24:45 Combating Burnout in Healthcare Professionals26:08 Future Roadmap and Innovations26:53 The Role of AI in Healthcare Documentation28:19 AI's Impact on Radiology and Job Dynamics31:28 Building a High-Performance Team33:47 Navigating the Rapid Evolution of AI Tools38:12 The Importance of Effective Onboarding in Home Health41:57 Service Codes and Flexibility in Home Health Documentation45:15 Enhancing Patient Care Through Better Communication49:25 Future Prospects and Industry ChangesSpecial thank you to our sponsors: Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Check out Last Visit First on other platforms: Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182 Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxsYouTube: https://www.youtube.com/@lastvisitfirstpodcastWebsite: https://www.lastvisitfirst.com LinkedIn: https://linkedin.com/company/last-visit-firstDISCLAIMERThe investment or stock-related information discussed or referenced in this podcast is provided for informational and educational purposes only and should not be considered financial, investment, or trading advice. The views and opinions expressed by participants are their own and may not reflect the views of any affiliated organizations.Content discussed may not be suitable for all investors. Each participant may or may not hold positions in securities referenced during the discussion. Individuals and organizations associated with the participants may serve different clients with varying objectives, risk tolerances, investment horizons, and strategies.As a result, such entities may maintain positions or viewpoints regarding specific securities, markets, or sectors that differ from those expressed in the discussion. Viewers and listeners should conduct their own research and consult appropriate financial professionals before making any investment decisions.#lastvisitfirst #StenoHealth #HomeCareHomeBase #healthcareai #clinicaldocumentation #hospicecare #homehealthcare #nursing #healthtechnologyinnovator #healthtech #innovation #podcast #healthcarepodcast

Rich Johnson’s path to becoming a healthcare CEO began in a juvenile courtroom where a judge gave him two choices: jail or the service. Choosing the Air Force didn't just change his life; it gave him the logistical blueprint to manage a $90 million appropriation by age 18 and eventually build ViaQuest, Inc. into an integrated healthcare powerhouse. Today, Rich oversees 4,500 employees providing a "Circle of Care" that spans hospice, behavioral health, and services for the IDD community.This discussion pulls back the curtain on how military discipline translates to healthcare culture and why the integration of mental health is the missing piece in the modern hospice puzzle. We also dive into the technical "headwinds" facing the industry, ranging from the regulatory shift of Section 504 to the potential for AI agents to solve the hiring crisis for home health and hospice agencies.In this episode, we cover:The Military Mindset — Why accountability and shared values are the only way to lead 4,500 "heroes" in the home.The Integrated Model — How ViaQuest leverages behavioral health to support grieving families and terminal IDD patients.The AI Revolution — Real-world applications for Perplexity Computer and autonomous agents in nurse recruiting and clinical workflows.The Pediatric Paradox — Examining the data that proves concurrent curative treatment actually improves quality of life while lowering costs.Chapters:00:00 Introduction of Rich Johnson and the ViaQuest story02:02 From the courtroom to the cockpit — How the Air Force saved Rich’s life 04:53 Transitioning from military finance to healthcare consulting06:09 The origin of ViaQuest and stepping into the CEO role at age 3008:36 Creating a Circle of Care — Integrating IDD and Behavioral Health11:21 The decision to pivot away from Home Health to focus on Hospice13:27 Navigating the regulatory landscape and provider "flooding" in Ohio15:32 The calling of healthcare — Recognizing the heroes in the IDD and Hospice space18:48 Leadership lessons — Using military discipline to manage 4,500 employees21:50 Boot camp stories — Learning knots and discovering "I’m short"24:51 The unique challenges of recruiting for the IDD population27:04 Serving the same patients for 25 years — "Three self-made men"28:33 Rebranding the hospice conversation from "dying" to "living"30:19 Why ViaQuest is adopting Bereavement for Life32:05 AI in healthcare — Ambient listening and ending "pajama documentation"34:56 Using Perplexity Computer to build autonomous recruiting agents39:49 Creating automated daily intelligence reports with AI41:55 The Section 504 deadline — Preparing for new ADA website compliance46:50 Industry Headwinds — Facing the "Senior Tsunami" and staffing shortages50:16 The role of remote monitoring and home-based surgery recovery53:08 Legislative gaps in ESRD and Pediatric Concurrent Care56:45 Identifying "Bad Actors" and the future of government audits1:00:00 Inducting a CEO into the Ohio Veterans Hall of Fame1:03:25 Changing lives — Rich’s proudest career accomplishmentsGet ahold of Rich and ViaQuest:ViaQuest, Inc. website: https://viaquestinc.com/ViaQuest, Inc. LinkedIn: https://www.linkedin.com/company/viaquest/Rich's email: [email protected]'s LinkedIn: https://www.linkedin.com/in/richdjohnsonSpecial thank you to our sponsors: Premier Sponsor: Trella Health: https://trellahealth.com/ Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/ StenoHealth: https://www.stenohealth.com/IntellaTriage: https://intellatriage.com/Check out Last Visit First on other platforms: Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182 Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxsYouTube: https://www.youtube.com/@lastvisitfirstpodcastWebsite: https://www.lastvisitfirst.com LinkedIn: https://linkedin.com/company/last-visit-first

How do you turn two legacy hospice providers into a singular, "serious illness powerhouse"?Kristen Yntema didn’t start her career in a boardroom; she started as a 15-year-old unit secretary, cross-training as a nursing assistant and falling in love with the patient connection. Today, as the President and CEO of AuthoraCare Collective, she is redefining the architecture of end-of-life care.This conversation pulls back the curtain on the 2019 merger that created AuthoraCare and the radical "Culture First" strategy that made it successful. Kristen and Tom Maxwell dive into why traditional hospice is no longer enough and how building a "Serious Illness Ecosystem" allows patients to be the true authors of their own stories long before their final six months.Inside the Episode:The "Pajama Charting" Crisis: How AI and ambient listening are being vetted to save clinicians from documentation burnout.Redefining Success: Why Kristen’s team ignores traditional metrics in favor of "Days in the Community."The Kids Path Mission: A rare look at the specialized world of pediatric hospice and the "Aarvy Aardvark" connection.The "Coffee with Kristen" Rule: Why the best strategic insights come from a $15 Panera treat and a small group of front-line staff.The Future of Palliative Care: Navigating the shift from "Routine Home Care" to high-needs ACO models.Chapters:00:00 — The "Last Visit First" Origin Story02:35 — Starting at 15: From Unit Secretary to CEO06:10 — The AuthoraCare Merger: Moving Beyond Hospice09:30 — Why Culture Trumps Strategy in Healthcare13:00 — Defining Excellence: The "2:00 AM Confidence Test"22:30 — Building an "Ecosystem" Around the Patient24:38 — HCHB Premier Sponsor Ad30:15 — The "Pajama Charting" Crisis & AI Solutions32:20 — Kids Path: The Mission of Pediatric Hospice38:10 — Rethinking Metrics: "Days in the Community"40:02 – Maxwell TEC Sponsored Ad50:10 — Policy, Fraud, and the Future of the Industry55:00 — Redefining Serious Illness CareConnect with Kristen and AuthoraCare:Kristen's LinkedIn: https://www.linkedin.com/in/kristen-wither-yntema-bb7ab3b7AuthoraCare LinkedIn: https://www.linkedin.com/company/authoracare/AuthoraCare website: https://www.authoracare.org/Special thank you to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebaseMaxwell TECStenoHealthIntellaTriageCheck out Last Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedIn

When the high-stakes discipline of a Navy submarine officer meets the fragmentation of hospice and home health, the result is a radical "Nurse-First" philosophy that challenges every industry norm. Daniel Reese, CEO of IntellaTriage, joins Tom Maxwell to expose why the current healthcare system is failing clinicians and how to survive the coming workforce redesign.Inside the Episode:The "Submarine Effect" on Leadership: Why servant leadership isn't just a buzzword—it’s a tactical requirement for mission-driven organizations. Solving the After-Hours Black Hole: How immediate access to a US-based nurse (not an answering service) transforms patient outcomes and stabilizes the home environment. AI & Clinical Intelligence: A skeptical look at the "AI hype train" and why technology must be used to automate the "maintenance" of documentation so clinicians can focus on "hugging the patient." Personal stakes in ESRD: A raw discussion on why the current Medicare hospice benefit is fundamentally broken for end-stage renal disease patients and how we can advocate for change.Chapters:0:09 - Introduction of Daniel Reese, CEO of IntellaTriage0:32 - Discussion about Daniel's background as a Navy submarine officer0:40 - Daniel's journey through the Naval Academy and active duty3:31 - Leadership lessons learned from military service5:14 - Daniel's transition from the Navy to business school and family business7:09 - The path to becoming CEO of IntellaTriage9:23 - Explanation of IntellaTriage's mission and services10:53 - Discussion on the importance of telephone nursing and after-hours care13:14 - Issues with interoperability and after-hours care16:56 - Staffing shortages and recruitment strategies20:00 - Homecare Homebase premier sponsored ad20:48 - Predictions for the next five years in the industry23:34 - The impact of Medicare Advantage and value-based care28:59 - Discussion on the role of AI in healthcare32:35 - Potential benefits and risks of AI implementation40:27 - Maxwell TEC sponsored ad45:29 - Daniel's personal interests and family life55:48 - His vision for the future of IntellaTriage and personal legacyConnect with Daniel and IntellaTriage:Daniel's LinkedIn: https://www.linkedin.com/in/dreesembaDaniel's email: [email protected] LinkedIn: https://www.linkedin.com/company/intellatriage/IntellaTriage website: https://intellatriage.com/Special thank you to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebaseMaxwell TECStenoHealthIntellaTriageCheck out Last Visit First on other platforms:Apple Podcasts⁠⁠Spotify⁠⁠YouTube⁠⁠Website⁠⁠LinkedInAbout Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

Is leadership in home health a calling or just a job? In this episode of Last Visit First, Tom Maxwell sits down with Dr. Heather Hodges, organizational psychologist and CEO of Hodges Group International, to discuss the "Heart Work" required to lead frontline teams in the care at home industry.Dr. Heather Hodges shares her journey from a creative professional to a leadership strategist within the home care industry. She introduces her groundbreaking framework, The 12 Types of Creative Genius, and explains why innovation isn't just for scientists—it’s the engine that allows clinicians to solve complex problems at the bedside.Key Takeaways:The 11-Second Rule: Why listening just a few seconds longer leads to better patient outcomes.The Hero’s Journey of Leadership: Moving from a "weak" hero to a "strong" guide (the Yoda vs. Luke Skywalker analogy).Culture as Retention: Why people don't leave organizations; they leave supervisors—and how to build a culture people won't want to leave.Creative Genius: Identifying whether your leadership style is driven by the Head (Cognitive), Heart (Relational), or Hands (Functional).Chapters:00:00 – Meet Dr. Heather Hodges: Leadership Strategist02:03 – The Career Shift: From Creative to Home Health Executive05:47 – Personality Science: Using the Enneagram to Lead Diverse Teams08:38 – The 12 Types of Creative Genius (Head, Heart, and Hands)14:52 – Cultivating Culture: Tapping into Frontline Innovation20:08 – Heart Work: Bridging the Gap Between Nursing and Management28:05 – Communication Secrets: The 11-Second Rule for Clinicians32:36 – The Future of Care: Balancing AI Tech with Human Empathy45:57 – Self-Reflection & The Hero’s Journey of Leadership50:31 – How to Connect with Dr. Hodges & Final ThoughtsConnect with Dr. Heather Hodges:WebsiteBook: Heart WorkBook: The Creative Clinical LeaderAudio Book: Heart WorkPodcast: I’m In!Special thank you to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebaseMaxwell TECStenoHealthIntellaTriageCheck out Last Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedInAbout Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

We’re closing out our "Live From HC100" series with a true industry veteran, Kurt Baumgartel, CEO of CareRing Health.Having run divisions for some of the biggest names in the space, Kurt is now focusing on perfecting the "care coordination" model for dual-eligibles in the Mid-Atlantic. In this briefing, he and Tom dive deep into the technology that has everyone at HC100 buzzing: Ambient AI. Kurt discusses his success using ambient listening in the clinic and how this "game-changer" is poised to transform the home health start of care visit. We also explore CareRing Health’s sophisticated use of Snowflake and Health Cloud to drive cross-service admissions and better patient outcomes.Chapters:01:05 – Ambient AI in the Clinic: How "ambient listening" is already saving clinicians from hours of documentation.02:30 – Solving the Start of Care: Why reducing the documentation burden will make nurses want to do admissions again.03:50 – CareRing Health’s Model: Managing 5,000 lives across the Mid-Atlantic with a focus on personal care.04:20 – The Data Stack: Leveraging Snowflake and Salesforce Health Cloud for intelligent care coordination.05:00 – Proving the Value: Using a Philadelphia-based pilot to show payers the cost savings for dual-eligibles.Connect with CareRing Health and Kurt:Website: https://careringhealth.com/LinkedIn: https://www.linkedin.com/company/carering-health/Kurt's LinkedIn: https://www.linkedin.com/in/kurt-baumgartelSpecial thanks to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebasePremier Sponsor: Maxwell TECPremier Sponsor: Lincoln Healthcare Leadership#HomeHealth #Hospice #PersonalCare #AmbientAI #HealthcareAI #DualEligibles #HC100 #CareRingHealth #LastVisitFirst #Podcast #TomMaxwell HomeCare100

Live from the Woodpecker Room for Day 2 of the Last Visit First podcast at Home Care 100, Tom Maxwell welcomes a true post-acute tech pioneer: Joe Randesi, CEO and Co-Founder of Element5.Joe explains why the world is moving beyond simple SaaS toward Agentic AI—digital workers that autonomously navigate EHRs, verify eligibility, and manage authorizations. He breaks down the "swivel chair" problem and how Element5’s vertical-specific agents are designed to eliminate the "paper cuts" of back-office operations. Joe also shares his perspective on why the industry is finally "leveling up" through collective innovation.Chapters:01:10 – The DeVero Journey: How co-founding an EHR led to the automation revolution.01:45 – What is an "Agent"? Defining the digital worker that automates the financial journey.02:45 – No Smoke Breaks, No COVID: Why agents are an OpEx solution for back-office bottlenecks.03:30 – Building Blocks: How Element5’s vertical platform allows for rapid, at-scale innovation.05:10 – "Fail Fast": Joe’s advice for agencies looking to adopt disruptive technology.05:50 – The Value of Face-to-Face: Why Home Care 100 remains the preeminent "deal-making" venue.Connect with Element5 and Joe:Website: https://www.E5.aiLinkedIn: https://www.https://www.linkedin.com/company/e5ai/Joe's LinkedIn: https://www.linkedin.com/in/joerandesiSpecial thanks to our sponsors: Premier Sponsor:⁠⁠⁠⁠⁠⁠⁠ Trella Health⁠⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠⁠Lincoln Healthcare Leadership⁠#HomeHealth #Hospice #Element5 #HC100 #AgenticAI #WorkflowAutomation #PostAcuteCare #RCM #LastVisitFirst #JoeRandesi

Live from Day 2 of the Last Visit First podcast at the 2026 Home Care 100 Leadership Conference in Scottsdale, Charles McDonough, President and CEO of Delaware Hospice, joins the podcast to discuss the evolving definition of "community care."As the leader of the nation's first hospice in the first state, Charles isn't just leaning on legacy—he’s leaning into disruption. In this briefing, he explores how Delaware Hospice is leveraging the GUIDE model to redefine dementia care and why "upskilling" internally is the only sustainable answer to the national nursing crisis. Charles and Tom also dive into a provocative discussion on state licensure laws: are they protecting quality, or are they artificially suppressing the workforce?Chapters:02:15 – The Dementia Mandate: Why specialized cognitive care is the next industry frontier.04:45 – Scaling Through Partnership: Expanding into Pennsylvania and Maryland via non-profit collaboration.06:30 – The Licensure Bottleneck: Is it time for a universal clinical license?08:50 – Virtual-First Care: Connecting rural patients to elite clinical resources.Connect with Charles and Delaware Hospice:Website: https://www.DelawareHospice.orgLinkedIn: https://www.linkedin.com/company/delaware-hospice-inc../Charles's LinkedIn: https://www.linkedin.com/in/charlesmcdonoughSpecial thanks to our sponsors: Premier Sponsor:⁠⁠⁠⁠⁠⁠ Trella Health⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠⁠Lincoln Healthcare Leadership⁠#Hospice #DelawareHospice #HC100 #NonProfitHospice #DementiaCare #GUIDEModel #NursingShortage #HealthcareInnovation #LastVisitFirst #Podcast #HealthcarePodcast

Live from Day 2 of Home Care 100 in Scottsdale, Tom Maxwell sits down with Kathy Ford, Chief Product Officer at Trella Health.As a premier sponsor of Last Visit First, Trella Health is at the forefront of the "data revolution." In this interview, Kathy discusses Trella’s evolution from a Medicare-dominant platform to a comprehensive data suite covering Commercial and Medicare Advantage markets. She breaks down the recent acquisition of Repisodic, explaining how integrating discharge workflows into Epic and Cerner is solving the "length of stay" puzzle for health systems. Kathy also shares her "plea to fellow vendors" on why data must be democratized for the sake of the patient.Chapters:01:10 – Beyond Medicare: Trella’s expansion into Commercial and Medicare Advantage data sets.02:30 – Solving the Discharge Gap: How the Repisodic acquisition embeds Trella into acute care workflows.03:50 – Signal in the Noise: Contextualizing thousands of data sources into meaningful executive insights.05:20 – The 30-EHR Integration: Leveraging data across the entire post-acute landscape.06:40 – A Call to Action: Why data democratization is better for patients and providers alike.Connect with Trella Health and Kathy:Website: https://www.trellahealth.com/LinkedIn: https://www.linkedin.com/company/trellahealth/Kathy's LinkedIn: https://www.linkedin.com/in/kathy-dalton-ford-7657367Special thanks to our sponsors: Premier Sponsor:⁠⁠⁠⁠⁠ Trella Health⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Lincoln Healthcare Leadership⁠#HomeHealth #Hospice #TrellaHealth #HC100 #DataAnalytics #HealthcareIT #Interoperability #LastVisitFirst #PostAcuteCare

Live from the Woodpecker Room at HC100, Tom Maxwell welcomes Jason Gerard, CFO of Agape Care Group.Jason shares the remarkable growth story of Agape Care, which expanded from a single-state provider in South Carolina to serving over 6,500 patients across 10 states in just a few years. He breaks down the strategic decision to remain "hospice-only," the importance of their pediatric program ("Hands of Hope"), and the unique integration playbook that ensures one plus one actually equals two in an acquisition. Plus, a shoutout to integration star Carrie Vanden Magdenberg and her journey from Maxwell TEC consultant to Agape Care leader.Chapters:01:10 – The Growth Engine: Scaling from 700 to 6,500+ patients since 2018.01:55 – Partnership with Linden: Why Agape Care Group recapped with Linden Capital Partners.02:25 – Tight Geography: Why staying close to the "flagpole" in the Southeast is a strategic win.03:00 – Hands of Hope: Serving the unique needs of nearly 200 pediatric hospice patients.04:35 – The Niche Advantage: Why Agape chose to double down on hospice rather than diversify into home health.05:40 – The Integration Secret: How a customized integration plan keeps employees engaged and assets protected.Connect with Agape Care Group and Jason:Website: https://agapecaregroup.com/LinkedIn: https://www.linkedin.com/company/agapecaregroup/Jason's LinkedIn: linkedin.com/in/jason-gerard-txSpecial thanks to our sponsors: Premier Sponsor:⁠⁠⁠⁠ Trella Health⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Lincoln Healthcare Leadership⁠#Hospice #AgapeCare #HC100 #HomeCare100 #HealthcareM&A #HealthcareCFO #LastVisitFirst #PediatricHospice #HandsOfHope #HospiceGrowth

Live from Home Care 100 in Scottsdale, Tom Maxwell sits down with Scott Levy, the Chief Government Affairs Officer for the National Alliance for Home Care at Home.In this interview, Scott pulls back the curtain on the Alliance’s unified advocacy mission following the historic NACH and NHPCO merger. He discusses the reality of "divided government" following the 2026 elections, the implementation of HOPE, and the industry’s proactive stance against fraud, waste, and abuse. Scott also shares a personal perspective on "continuity of care" and why educating new members of Congress on the difference between home health and hospice is the industry’s biggest hurdle.Chapters:01:15 – One Voice: How the Alliance merger is strengthening the industry’s messaging.02:40 – The Patient’s Lens: Why "familiar faces" are the most important metric for family caregivers.05:40 – D.C. Calendar: Key dates for the Financial & Tech Conference and the Washington Fly-In.06:20 – Fraud & Abuse: Working with CMS to stop "bad actors" before they enter the program.09:30 – Dr. Oz & CMS: Why the administration is reaching out to the Alliance for provider insights.11:45 – Election Forecast: What a shifting House and Senate means for reimbursement in 2027.Connect with The Alliance and Scott:Website: https://allianceforcareathome.org/LinkedIn: https://www.linkedin.com/company/thealliancehome/posts/Scott's LinkedIn: linkedin.com/in/scott-levy-09a8829bSpecial thanks to our sponsors: Premier Sponsor:⁠⁠⁠ Trella Health⁠⁠⁠Premier Sponsor: ⁠⁠⁠Homecare Homebase⁠⁠⁠Premier Sponsor: ⁠⁠⁠Maxwell TEC⁠⁠⁠Premier Sponsor: ⁠⁠⁠Lincoln Healthcare Leadership⁠#HomeHealth #Hospice #TheAlliance #HC100 #HealthcarePolicy #WashingtonDC #Lobbying #LastVisitFirst #Medicare

Live from HC100 in Scottsdale, Tom Maxwell sits down with longtime friend Stephen Phenneger, President and CFO of St. Croix Hospice.Stephen offers a candid look at the state of the hospice industry, from the "dot-com" energy surrounding AI to the "co-op-etition" that defines the sector. With 7,000 patients across 10 states, St. Croix remains committed to a single-vertical delivery model. Stephen explains why he brings a full "cache" of clinical and financial leaders to HC100 and why the most important industry insights still happen when the "guards are down" at dinner.Chapters:01:20 – Target Rich Environment: Accomplishing 25 meetings in 3 days.02:00 – Single-Vertical Strategy: Why St. Croix stays hospice-only across 100 offices.02:30 – The AI Reality Check: Why today’s tech landscape feels like the "dot-com" era.03:20 – M&A Outlook: Predicting the next 18 months of market activity.04:30 – Co-op-etition: Why your competitors are your best teachers.Connect with St. Croix Hospice and Stephen:Website: https://StCroixHospice.comLinkedIn: https://www.linkedin.com/company/st-croix-hospice/Stephen's LinkedIn: linkedin.com/in/stephen-phennegerSpecial thanks to our sponsors: Premier Sponsor:⁠⁠ Trella Health⁠⁠Premier Sponsor: ⁠⁠Homecare Homebase⁠⁠Premier Sponsor: ⁠⁠Maxwell TEC⁠⁠Premier Sponsor: ⁠⁠Lincoln Healthcare Leadership⁠#Hospice #StCroixHospice #HC100 #HealthcareCFO #HospiceLeadership #LastVisitFirst #AIinHealthcare #HealthcareMA #HomeCare100

Live from the Woodpecker Room at Home Care 100, Tom Maxwell welcomes a familiar face and industry star: Laura Brinkoetter, Chief Product Officer at Mosai.In this briefing, Laura discusses the evolution of Mosai—the strategic merger of Medalogix and Forcura—and how they are marrying interoperability with clinical analytics. She breaks down the "Mosai Review" product and how "hands-free" automation is changing the game for coding and OASIS reconciliation. Plus, Tom and Laura reminisce about their days at Enclara and the legendary Maxwell pre-kickoff party in Scottsdale.Chapters:00:54 – Technology as a Force Multiplier: How technology enables strategy.01:50 – The Power of the Merger: Marrying Forcura’s interoperability with Medalogix’s clinical analytics.02:15 – Mosaic Review: Automating the referral flow and OASIS reconciliation.03:15 – Summarizing Patient Care: Using tech to save clinicians from "reading every part of the chart."05:30 – From Industrial Supply to Hospice: Laura’s journey from Grainger to the Enclara board.Connect with Mosai and Laura:Website: https://www.mosai.com/LinkedIn: https://www.linkedin.com/company/mosai-intelligent-care/posts/?feedView=allLaura's LinkedIn: linkedin.com/in/laura-brinkoetter-5b371216Special thanks to our sponsors: Premier Sponsor:⁠ Trella Health⁠Premier Sponsor: ⁠Homecare Homebase⁠Premier Sponsor: ⁠Maxwell TEC⁠Premier Sponsor: ⁠Lincoln Healthcare Leadership⁠#HomeHealth #Hospice #HomeCare100 #HC100 #HealthcareLeadership #LincolnHealthcare #LastVisitFirst

Live from the Phoenician in Scottsdale, Tom Maxwell sits down with the woman who makes it all happen: Jeanette Lynn, President and Managing Director of Home Care 100.Jeanette pulls back the curtain on what makes Home Care 100 the premier perch for healthcare operators. She breaks down the three pillars of the Lincoln Healthcare Leadership mission: Visionary Intelligence, Purposeful Connections, and an Exceptional Experience. From the legendary "Cocktail Book" to the highly-regarded Spouse Program, Jeanette explains how they set the table for the intimacy and trust required to move the industry forward.Chapters:01:10 – Beyond the Day-to-Day: Why executives need a "minute to stop and think" about the future.02:05 – Strategic Matchmaking: Moving away from transactional networking to purposeful partnerships.04:15 – The Power of the Spouse Program: Building trust beyond the business meeting.06:00 – Bench Strength: How Lincoln has built an internal "intelligence group" to predict industry hurdles.08:50 – Requesting an Invitation: The specific criteria for joining the top 100 innovators.11:45 – AI & The Cocktail Book: Using tech to navigate 400 pages of strategic insights.Connect with Home Care 100, Lincoln, and Jeanette:Home Care 100 Website: https://homecare100.com/Home Care 100 LinkedIn: linkedin.com/company/home-care-100/Lincoln Healthcare Leadership Website: https://www.lincolnhc.com/Lincoln Healthcare Leadership LinkedIn: linkedin.com/company/lincoln-healthcare-events/Jeanette LinkedIn: linkedin.com/in/jeanette-lynn-3105104Special thanks to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebasePremier Sponsor: Maxwell TECPremier Sponsor: Lincoln Healthcare Leadership#HomeHealth #Hospice #HomeCare100 #HC100 #HealthcareLeadership #LincolnHealthcare #LastVisitFirst

Live from Home Care 100 in Scottsdale, host Tom Maxwell sits down with Amee Devani, CEO and Co-Founder of WellBeam.Born out of physician frustration with the "black box" of post-acute care, WellBeam has built the infrastructure to replace faxes and phone tag with true EMR interoperability. Amee breaks down how they serve as the "epic pipe" (or universal adapter) that allows clinicians to share wound images, medication adjustments, and orders directly within their existing EMRs—without ever having to log out or pick up a fax.Chapters:01:15 – Why AI is useless if you can't move data: The interoperability reality check.02:15 – Southern California to the East Coast: WellBeam's expansion with Stanford, Cedars-Sinai, and Advocate Atrium.03:05 – The 21-Day Problem: How WellBeam cut the time to signature down to 13 hours.03:45 – Revenue Recapture: Why health systems are missing out on billing codes by using analog faxes.05:10 – The "Hardest Name to Spell" Award: A funny story about branding and character limits.Connect with WellBeam and Amee:Website: https://https://well-beam.com/LinkedIn: linkedin.com/company/wellbeam-inc/Amee Devani: linkedin.com/in/amee-devani-a2418812Special thanks to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebasePremier Sponsor: Maxwell TECPremier Sponsor: Lincoln Healthcare Leadership#HomeHealth #Hospice #WellBeam #Interoperability #HC100 #HealthTech #Epic #LastVisitFirst

Live from Home Care 100 in Scottsdale, host Tom Maxwell is joined by Si Luo, CEO of CareXM.As agencies face increasing "growth constraints" and clinical capacity issues, Si breaks down CareXM's unique "overlay stack" approach—a bidirectional integration with major EMRs like Homecare Homebase and MatrixCare. This allows a centralized nursing workforce to manage after-hours triage without the need for multiple, disparate logins, preserving both security and clinician sanity.Key Highlights:01:05 – Turning agencies 24/7: The clinical triage impact on the HOPE assessment.01:45 – Why Si L. Luo’s team built an "Overlay Stack" to bypass the EMR login nightmare.02:20 – The "No More EMR" airplane stunt: A debate on the lifeblood of revenue cycle.03:40 – Growth Constraints vs. Demand: Strategies for the "AI Curious" era of 2026.04:30 – Interoperability: Capturing "tribal clinician knowledge" to scale without compromise.Connect with Si Luo & CareXM:Website: https://CareXM.comLinkedIn: https://linkedin.com/in/siluoSpecial thanks to our sponsors: Premier Sponsor: ⁠⁠⁠⁠⁠Trella Health⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠⁠Lincoln Healthcare Leadership#Hospice #CareXM #Interoperability #HC100 #Triage #HealthcareTech #LastVisitFirst

Live from Home Care 100 in Scottsdale, Tom Maxwell sits down with Tarrah Lowry, Chief Operating Officer of Empath Health.Tarrah oversees one of the largest non-profit hospice and home health mergers in the country—the recent affiliation between Empath and Trustbridge. In this conversation, she reveals the "One Hospice Model," a strategy designed to unify different electronic health records and cultures without losing the personal community touch. She also shares a fascinating "hurricane-proof" benefit of their scale: how having teams on both Florida coasts allows for seamless care even when disaster strikes.Chapters:01:10 – The "Full Life Care" model: PACE, Physician Practices, and I-SNPs.01:45 – Scale matters: Managing a daily census of 5,500 hospice patients.02:20 – The Empath & Trustbridge Merger: Lessons from a "merger of equals."03:05 – The Hurricane Plan: Why standardized software is a safety net for Florida patients.04:30 – Whoop & Wearables: Why even the busiest COOs are tracking their sleep (and the "HC100 sleep deficit").Connect with Empath Health:WebsiteLinkedInTarrah LowrySpecial thanks to our sponsors: Premier Sponsor: ⁠⁠⁠⁠Trella Health⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Homecare Homebase⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Maxwell TEC⁠⁠⁠⁠Premier Sponsor: ⁠⁠⁠⁠Lincoln Healthcare Leadership#HomeHealth #EmpathHealth #Trustbridge #HC100 #DisasterRecovery #OneHospice #LastVisitFirst

Live from Home Care 100 in Scottsdale, host Tom Maxwell sits down with Jennifer Maxwell, CEO and Co-Founder of Maxwell TEC.As a tech-enabled strategic consulting leader and prolific investor in the space (Mosai, Element 5, Levo), Jennifer shares why she believes "tchotchkes and booths" don't move the needle—meaningful, intimate networking does. She breaks down the "three-legged stool" of successful agency management and reveals how simple, text-based communication via the nanaCONNECT platform is solving the communication breakdowns that lead to poor star ratings and patient frustration.Chapters:01:05 – Why HC100 is the catalyst for Maxwell TEC’s yearly innovation.01:50 – Staying focused: Why Jennifer only invests in the post-acute care "catcher's mitt."02:30 – The Three-Legged Stool: Why technology fails without people and process.03:20 – nanaCONNECT: Why text-based outreach wins over clunky apps and logins.05:05 – The REACH Product: How to stay "top of mind" for the 20% of patients who naturally return to home health.Connect with the Maxwell TEC team:WebsiteLinkedInJennifer Maxwell LinkedInSpecial thanks to our sponsors: Premier Sponsor: ⁠⁠⁠Trella Health⁠⁠⁠Premier Sponsor: ⁠⁠⁠Homecare Homebase⁠⁠⁠Premier Sponsor: ⁠⁠⁠Maxwell TEC⁠⁠⁠Premier Sponsor: ⁠⁠⁠Lincoln Healthcare Leadership#Hospice #MaxwellTEC #nanaCONNECT #HC100 #PostAcuteCare #LastVisitFirst

What if you never had to "chase" a referral again? In this episode of Last Visit First, live from HC100 in Scottsdale, Tom Maxwell sits down with Brian Lobley, President and CEO of tango.Brian breaks down tango’s pivot from PHCN to a value-based MSO that acts as an "enablement platform" for home health providers. He shares a staggering success story from Pennsylvania where 100% of qualified referrals were successfully placed because the administrative burden—eligibility, orders, and patient contact—was handled before the agency even received the ping.Key Highlights:01:10 – Moving the market to value-based care: Why all stakeholders are finally aligned.02:05 – Scaling to 900,000+ new lives in Michigan, Tennessee, and Oregon.03:45 – "Land and Expand": How tango levels the playing field between small agencies and national payers.04:55 – The 100% Placement Metric: Eliminating the "Jump Ball" at discharge.06:20 – Why Home Health spend is only 2% of the dollar, but controls 100% of the outcome.Connect with tango:Website: https://tangocare.comLinkedIn: https://www.linkedin.com/company/tangocare/Special thanks to our sponsors: Premier Sponsor: ⁠⁠Trella Health⁠⁠Premier Sponsor: ⁠⁠Homecare Homebase⁠⁠Premier Sponsor: ⁠⁠Maxwell TEC⁠⁠Premier Sponsor: ⁠⁠Lincoln Healthcare Leadership#ValueBasedCare #HC100 #tango #PostAcuteCare #LastVisitFirst #Podcast #LeadershipConference

We are kicking off our "Live from HC100 Scottsdale" series with a very special guest: Hannah Pearson, Chief Revenue Officer at Homecare Homebase.In this short, candid conversation with Tom Maxwell, she breaks down the shift from the "negative" industry outlooks to the power of meaningful, in-person connections at the Phoenician.Key Highlights:00:55 – Why the "Failure Panel" doesn't tell the whole story of home health.01:40 – The intensity of HC100: Why meetings start at 7:00 AM.02:50 – Hot off the presses: The return of Martha Stewart Williams to the HCHB team.04:10 – How to connect with the Homecare Homebase team.Special thanks to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebasePremier Sponsor: Maxwell TECPremier Sponsor: Lincoln Healthcare Leadership#HomeHealth #Hospice #PostAcuteCare #HC100 #LastVisitFirst

From clinical rotations in Maine to guiding strategy at a national scale, Dr. Jason Kimbrel has defined his career by "living in the gray." As the COO of Yellow Leaf Consulting and a former NHPCO section leader, Jason bridges the gap between rigid medical rules and the compassionate, complex reality of end-of-life care.In this episode, Jason joins Tom to dismantle the industry's biggest medication myths—from the fear that "morphine kills" to the regulatory nightmares of Medicare Part D leakage. They dive deep into the origins of the hospice pharmacy movement, the history of liquid morphine (Roxanol), and the heartbreaking "Vitamin Story" that exposed a massive gap in how clinicians handle de-prescribing.Plus, Jason breaks down the "BUILD Model" for difficult conversations and advises CEOs on when it makes financial sense to bring a pharmacist in-house.In this episode, we cover: The "Gray Area" of Hospice Pharmacy: Why success in end-of-life care requires moving beyond black-and-white hospital protocols to focus on comfort.The Art of De-prescribing: How to stop unnecessary medications without making families feel abandoned—preventing the "cereal bowl" effect of too many pills.Debunking the "Morphine Myth": Addressing the deep-seated fear that hospice opioids are meant to hasten death rather than manage pain.The Crisis of Experience: How the decline in nurse tenure (from 10 years to 2) is creating a knowledge gap in pharmacology that leaders must address.Pharmacy Access Danger: The growing risk of "pharmacy deserts" as 24-hour community pharmacies disappear, threatening 3 AM crisis management.The Pharmacist in the IDG: The critical need to integrate pharmacy expertise into the Interdisciplinary Group to improve HOPE scores and outcomes.Timestamps: 00:09 Introduction to Dr. Jason Kimbrel 01:20 The Superpower of "Living in the Gray" 05:00 The History: Phyllis Grauer & Roxane Labs 08:52 The M&A Journey: From PCCG to Optum 10:37 The Meaning Behind "Yellow Leaf" 12:54 What Makes Hospice Pharmacy Unique? 16:47 Addressing the "Morphine Kills" Myth 21:16 The Vitamin Story: A Failure in De-prescribing 28:00 The BUILD Model Explained 34:06 Misunderstood Meds: Haloperidol & Methadone 43:30 Medicare Part D Leakage & "Call Letters" 44:00 Regulatory History: CR 8358 & 10573 51:47 CEO Advice: Managing Formularies & PBMs 59:06 Drug Shortages & Sub-Q Administration 01:02:18 The HOPE Assessment & Symptom Management 01:07:26 The Pharmacist's Role in the IDG 01:17:29 When to Hire an In-House Pharmacist (1,000 ADC) 01:24:40 The Crisis of Community Pharmacy Access 01:33:00 The "Billy" Story: Ewing's Sarcoma & LegacyResources Mentioned: Book: Palliative Care Consultant: Guidelines for Effective Management of Symptoms (The "PCC")Model: The BUILD Model (Build, Understand, Inform, Listen, Develop)Regulation: CR 8358 (NDC Reporting Requirement)Regulation: CR 10573 (Two-Tier Payment System)Person: Phyllis Grauer (Industry Pioneer)Special thank you to our sponsors: Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebaseMaxwell TECStenoHealthIntellaTriageCheck out Last Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedInAbout Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

From working front desk tasks in high school to leading as CEO, Beau Sorensen has built First Choice Home Health & Hospice into a powerhouse of culture and operational discipline.In this episode, Beau joins Tom to discuss how he is navigating the industry's biggest headwinds—from Medicare Advantage rate pressures to the "ProPublica hangover." They dive deep into the future of technology, debating why today’s EMRs aren’t enough, the shift from "Ambient Listening" to "Ambient Watching," and how First Choice uses individual scorecards to gamify clinical outcomes.Plus, Beau shares the unique challenges of scaling a Pediatric Home Health division and his "Leadership by Wandering Around" philosophy.In this episode, we cover:The "Dream EMR": Why Beau would pay a premium for a single "pane of glass" platform.Ambient Intelligence: Moving beyond voice dictation to cameras that detect tremors and gait changes.Gamifying Quality: How individual clinician scorecards drastically improved patient outcomes.Centralization Strategy: Why First Choice centralizes functions, not just people.Pediatric Home Health: The business case for 24/7 care vs. intermittent visits.Timestamps:00:00 Introduction to Home Health and Hospice Leadership01:06 Bo Sorensen's Journey in Home Health04:47 Core Leadership Principles at First Choice09:36 Embracing Technology and AI in Home Health17:05 Addressing Challenges in Home Health Care24:42 Vision for the Future of EMR and AI Integration28:08 The Bi-Directional Relationship in EMRs29:51 The Rise of Ambient Listening in Healthcare32:37 The Future of Ambient Watching34:53 Rapid Changes in Healthcare Technology36:36 Improving Outcomes through Individual Scorecards40:56 Preparing for Value-Based Care42:44 Post-Discharge Patient Management45:02 Expanding into Pediatric Care49:48 Challenges in Hospice Care58:28 Empowering Athletes with Disabilities58:52 Challenges of Medicare Advantage01:00:40 Negotiating with Payers01:03:41 Quality of Care in Medicare Advantage01:05:46 Holistic Healthcare Solutions01:07:37 Legacy and Industry Advancement01:09:43 Leadership and Trust01:11:49 Influences and Mentorship01:16:43 Grounding Practices for CEOs01:19:39 Closing Thoughts and Future EngagementsResources Mentioned:Book: The Speed of Trust by Stephen M.R. CoveyPodcast: The Lawfare PodcastMentalist: Oz Pearlman (Oz the Mentalist)Study: Specialization of Home Health Agencies to Deliver Care for Medicare Advantage Patients (JAMA Network Open, Dec 2025)Special thank you to our sponsors:Premier Sponsor: Trella HealthPremier Sponsor: Homecare HomebaseMaxwell TECStenoHealthCheck out Last Visit First on other platforms:Apple PodcastsSpotifyYouTubeWebsiteLinkedInAbout Last Visit First:In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

What do aircraft carrier flight decks teach you about running the industry's leading healthcare analytics platform?In this episode of Last Visit First, host Tom Maxwell sits down with Scott Tapp, CEO of Trella Health, for a conversation that spans from the discipline of military service to the cutting edge of healthcare AI.The post-acute care market is facing a massive "data puzzle"—from the "black hole" of patient discharge to the complexities of Value-Based Care (VBC). Scott breaks down how Trella is solving these problems by combining 100% of Medicare and Commercial claims data with intelligent CRM workflows.We go deep on the reality of the market: why "quality" is the new currency for referrals, how AI is actually being used (beyond the hype), and why vulnerability is a CEO’s greatest strength.Chapters & Timestamps:(00:00) Introduction: Scott Tapp and the evolution of Trella Health. (04:45) Navy Roots: Stories from the flight deck, the Marine Corps, and military discipline. (12:50) Leadership Lessons: How service influences decision-making and "The Why." (19:15) Market Watch: Consolidation, Private Equity, and the shift to Value-Based Care. (24:30) Product Roadmap: Moving from insights to intelligent workflows (CRM). (30:00) Solving the "Black Hole": Automating the discharge process to improve adherence. (38:20) The Data Advantage: How to use claims data to win referrals and prove quality. (46:00) The Ecosystem: Integrating 100% of Medicare and Commercial claims data. (52:00) AI & Innovation: Balancing human judgment with machine learning in healthcare. (59:00) The Consumer Shift: Patients taking ownership of their own healthcare data. (1:05:00) The "Magic Wand" Question: Fixing care coordination and interoperability. (1:15:00) Legacy & Culture: Why vulnerability is a superpower for CEOs. (1:21:00) Rapid Fire: Favorite podcasts, coffee habits, and closing thoughts.About Our Guest: Scott Tapp is the Chief Executive Officer of Trella Health, the leading source of market intelligence and CRM solutions for the post-acute care industry. A US Navy Veteran with over 20 years of executive leadership experience, Scott has guided multiple high-growth companies to successful exits, including roles as CEO of Software Brands and Managing Director at SBI. At Trella, he is dedicated to empowering meaningful change in healthcare by providing the data and insights providers need to improve patient outcomes and reduce the cost of care.Scott's LinkedIn: ⁠linkedin.com/in/scotttapp⁠Trella Health: ⁠https://trellahealth.com/⁠Special Thank You To Our Sponsors:Premier Sponsor: Trella Health:⁠ https://trellahealth.com/⁠Premier Sponsor: Homecare Homebase: ⁠https://hchb.com/⁠Maxwell TEC: ⁠https://maxwelltec.com/⁠StenoHealth: ⁠https://www.stenohealth.com/⁠Listen to Last Visit First:Apple Podcasts: ⁠https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182⁠Spotify: ⁠https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs⁠YouTube: ⁠https://www.youtube.com/@lastvisitfirstpodcast⁠Website: ⁠https://www.lastvisitfirst.com⁠LinkedIn: ⁠https://linkedin.com/company/last-visit-first⁠About Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

The role of the Hospice Medical Director is changing. For years, the industry relied on contracted physicians primarily for administrative oversight—but with new regulations like the HOPE assessment and rising acuity in patients, the "paperwork doctor" model is no longer enough.In this episode, Tom sits down with two of the most respected clinical leaders in the country: Dr. Andrew Mayo (Chief Medical Officer, St. Croix Hospice) and Dr. Tiffany Richter (Chief Medical Officer, Agape Care Group).They break down the debate between full-time vs. contracted physicians, the "hybrid" model that is winning, and the heartbreaking regulatory gaps preventing dialysis patients from accessing hospice care. Plus, they share deeply personal stories that remind us why we do this work.What We Cover:00:00 – HCHB Premier Sponsor Spot00:48 – Intro: Tom welcomes Dr. Mayo (St. Croix Hospice) & Dr. Richter (Agape Care).01:41 – Dr. Richter’s Journey: From Family Med to Chief Medical Officer.04:02 – The Mayo Legacy: Dr. Mayo’s path from "small town doctor" to Hospice CMO.14:37 – The Great Debate: Contracted vs. Full-Time Hospice Physicians.21:22 – Sponsor Spotlight: Maxwell TEC (Jennifer Maxwell, CEO)22:30 – The HOPE Assessment: Will it actually improve patient care?25:18 – The ESRD Conflict: Why dialysis patients are being blocked from hospice.29:31 – Staffing & Burnout: How to keep clinicians from walking away.34:51 – "High Tech vs. High Touch": The role of AI in hospice.39:02 – Sponsor Spotlight: Steno Health (Alex Milani, CEO)39:33 – Solving the Documentation Crisis: Why paperwork is the enemy of care.46:49 – "It wasn't your job to fix it": Dr. Richter’s defining patient story.51:06 – "I have 15 minutes left": Dr. Mayo’s deeply personal encounter with hospice.59:10 – Advice for new Hospice Medical Directors.About Our Guests: Dr. Andrew Mayo is the Chief Medical Officer at St. Croix Hospice, serving 10 states in the Midwest. He is a fifth-generation physician with a lineage tracing back to the founders of the Mayo Clinic.-LinkedIn: linkedin.com/in/andrew-mayo-546a4b10b-St. Croix Hospice: https://www.stcroixhospice.com/Dr. Tiffany Richter is the Chief Medical Officer at Agape Care Group, a leading hospice and palliative care provider across the Southeast. She oversees clinical quality and the pediatric palliative care program, "Hands of Hope."-LinkedIn: linkedin.com/in/tiffany-richter-a397857-Agape Care Group: https://agapecaregroup.com/Special Thank You To Our Sponsors:-Premier Sponsor: Homecare Homebase: https://hchb.com/-Maxwell TEC: https://maxwelltec.com/-StenoHealth: https://www.stenohealth.com/Listen to Last Visit First:-Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182-Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs-YouTube: https://www.youtube.com/@lastvisitfirstpodcast-Website: https://www.lastvisitfirst.com-LinkedIn: https://linkedin.com/company/last-visit-firstAbout Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory.'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care.Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.

Scott Levy of the National Alliance for Care at Home and Luke James, President of VitalCaring Group, join Tom Maxwell on Last Visit First to break down CMS's Calendar Year 2026 Home Health Final Rule. This conversation is timely, detailed, and one of the most important episodes we have recorded for leaders in home based care.Tom sits down with Scott and Luke to explain how CMS reached the final 1.3 percent cut, why the permanent adjustment shift matters, what changed in PDGM, and how the rule affects payments, operations, visit patterns, and staffing across the country. They also cover wage index swings, VBP changes, outlier policy, advocacy wins, financial planning, and what all of this means for the future of home health and hospice.If you want a clear and practical breakdown of the Final Rule from two of the most trusted policy and operations voices in the industry, this episode is for you.Mentioned in the Episode:CMS 2026 Home Health Final RulePDGM recalibration and payment updatesWage index shifts and FDL changesValue Based Purchasing updatesTelehealth limits in home healthRecruiting and retention challengesNational Alliance for Care at Home advocacy effortsVitalCaring operational insightsTimestamps:00:00 HCHB featured commercial00:48 Introduction to the 2026 Final Rule03:06 Dissecting the Payment Structure10:53 Understanding the Impact of Cuts16:53 Maxwell TEC sponsor (nanaCONNECT and REACH)18:08 PDGM Recalibration and Cost Reports23:13 Clinical and Operational Changes29:35 Value Based Payments and Quality Metrics32:00 Challenges in Rural Healthcare Access33:13 Episode sponsor Levo33:54 Revisiting Visit Patterns Amid Rate Pressures36:16 The Impact of Telehealth on Home Health41:06 Understanding Fixed Dollar Loss Ratio44:26 StenoHealth sponsor45:24 Budgeting Strategies for Home Health Agencies49:31 The Future of Smaller Agencies in Home Health53:10 Recruitment and Retention in Home Health56:39 Reflections on Last Visit First01:01:05 Thank You and Reach Out if NeededGuest Links:National Alliance for Care at Home: https://allianceforcareathome.org/Scott Levy on LinkedIn: https://linkedin.com/in/scott-levy-09a8829bVitalCaring Group: https://www.vitalcaring.com/Luke James on LinkedIn: https://linkedin.com/in/luke-james-9bb93821Special Thank You to Our Sponsors:Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/Episode Sponsor: Levo: https://www.hellolevo.com/StenoHealth: https://www.stenohealth.com/Listen to Last Visit First:Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxsYouTube: https://www.youtube.com/@lastvisitfirstpodcastWebsite: https://www.lastvisitfirst.comLinkedIn: https://linkedin.com/company/last-visit-firstAbout Last Visit First:Last Visit First brings real conversations with leaders shaping home based care. Hosted by Tom Maxwell, Chairman of Maxwell TEC. Subscribe for more episodes on home health, hospice, policy, leadership, and the future of care at home.#LastVisitFirst #HomeHealth #Hospice #CareAtHome #Leadership #Innovation #Policy #FinalRule

In episode #6, Tom sits down with Alex Mauricio, President and CEO of Bristol Hospice, for an in depth conversation about leadership, culture, and the future of hospice care. Alex shares how growing up as “free labor” in his mom’s home health agency shaped his career, how he entered hospice, and how he now leads one of the largest and fastest growing hospice organizations in the country.They talk about Bristol’s 20 year story, including their major expansion through organic growth and De Novos, their specialty programs like Breathe Easy, Bristol Palliative, and pediatric hospice, and their commitment to the We Honor Veterans program. Alex also shares his personal patient story that changed his life and why he believes culture and people are the core drivers of growth.You will also hear Tom and Alex explore:• How to balance mission and margin• Why hospice leaders must be intentional about culture• How Bristol supports clinician grief and burnout• What HOPE means for the future of care• How technology, AI, and innovation will shape clinical work• Why ESRD patients and behavioral health patients need better access to end of life care• The importance of collaboration across the industry• What legacy means to Alex and how he hopes to be rememberedGuest Links:-Bristol Hospice: https://bristolhospice.com/-Alex on LinkedIn: https://www.linkedin.com/in/alex-mauricio-189b3a33Sponsors:-Premier Sponsor: Homecare Homebase: https://hchb.com/-Episode Sponsor: Levo: https://hellolevo.com/-Maxwell TEC: https://maxwelltec.com/-StenoHealth: https://www.stenohealth.com/Listen to Last Visit First:-Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182-Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs-YouTube: https://www.youtube.com/@lastvisitfirstpodcast-Website: https://www.lastvisitfirst.com-LinkedIn: https://linkedin.com/company/last-visit-firstResources Mentioned:-We Honor Veterans Program: https://www.wehonorveterans.org/About the Show:Last Visit First shares real conversations with leaders shaping the future of home based care. Hosted by Tom Maxwell, Chairman of Maxwell TEC.#Home Health, #Hospice, #Leadership, #CareAtHome

Jason Yu started his career as a teacher, became a management consultant, and eventually found himself running a home care agency during the start of the pandemic. That experience shaped everything that would become Levo, a clinician retention platform helping agencies reduce turnover and improve patient outcomes.In this conversation, Jason explains why the real causes of turnover are often quiet, gradual, and preventable. He talks through how data reveals patterns that agencies miss, how to give clinicians back time, and why solving staffing challenges starts with leadership and culture.Tom and Jason also dive into the future of home health and hospice, AI in recruiting, how to build teams that last, regulatory pressures, and the mindset needed to run a growing company today.Episode Chapters:00:00 Homecare Homebase Sponsored ad00:48 Jason Yu introduction and backstory11:52 The biggest gaps and opportunities in home health and hospice18:21 Why clinicians leave and what Levo is solving22:28 Maxwell TEC ad23:27 How Levo uses AI in recruiting and retention33:47 What turnover costs and how agencies can reduce it38:33 The future of home based care45:43 Steno ad46:13 Personal stories, leadership lessons, and building Levo59:16 Jason’s legacy and what drives him1:05:49 Why Levo moved into a new office1:10:25 What is next for Last Visit First1:14:05 Last Visit First outroGuest Links:Levo website: https://www.hellolevo.com/Jason Yu on LinkedIn: linkedin.com/in/jasonhxyuContact information for Jason: [email protected] Thank You to Our Sponsors:Premier Sponsor: Homecare Homebase: ⁠https://hchb.com/Maxwell TEC: ⁠https://maxwelltec.com/⁠StenoHealth: ⁠https://www.stenohealth.com/⁠Listen to Last Visit First:Apple Podcasts: ⁠https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182Spotify: ⁠https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs?si=fc219a6e1a504861YouTube: ⁠www.youtube.com/@lastvisitfirstpodcastWebsite: ⁠https://www.lastvisitfirst.com⁠ LinkedIn: ⁠linkedin.com/company/last-visit-firstShow Notes and Resources:JAMA article referenced on Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815745Joe Rogan and Guy Fieri hospice segment: https://youtu.be/NzBNVGNY_FA?si=JDjfwf39zyKzOCaUAbout Last Visit First:Last Visit First shares real conversations with leaders shaping the future of home based care. Hosted by Tom Maxwell, Chairman of Maxwell TEC. Subscribe for more episodes on home health, hospice, leadership, and the future of care at home.Subscribe to the channel, leave a comment, and share this episode with someone in the home health or hospice community.#LastVisitFirst #HomeHealth #Hospice

Tom sits down with Tracy Dent, Senior Vice President of Clinical Operations at AccentCare and the first nurse to join Last Visit First. Tracy’s story runs from LVN in rural Texas to leading national teams. She opens up about the patient who “gave her the bug,” what rate cuts really mean for access in rural America, why leaders retain people better than bosses, and how AI, telehealth, and practical quality work can free clinicians to spend more time with patients. You will hear a clear case for home as the lowest-cost, highest-outcome setting and what it takes to get there.Keywords:home health, hospice care, care at home, AccentCare, nursing leadership, clinical operations, workforce retention, healthcare leadership, value-based care, AI in home health, telehealth, quality outcomes, rural access to care, healthcare policy, hospital at home, palliative care, home-based care, Last Visit First podcast, Tom Maxwell, Tracy Dent.People of the Episode:Guest: Tracy Dent, Senior Vice President of Clinical OperationsHost: Tom MaxwellProducer: Cole SorensenBe Sure to Check Out Our Sponsors:Premier Sponsor: Homecare Homebase: https://hchb.com/Maxwell TEC: https://maxwelltec.com/StenoHealth: https://www.stenohealth.com/Last Visit First Podcast Links:Apple Podcasts: ⁠⁠https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182⁠Spotify: ⁠⁠https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs?si=fc219a6e1a504861⁠YouTube: ⁠⁠www.youtube.com/@lastvisitfirstpodcast⁠Website: ⁠⁠https://www.lastvisitfirst.com⁠ ⁠LinkedIn:⁠ ⁠linkedin.com/company/last-visit-first⁠Mentioned in the Episode:Gene Metcalfe book - Left for Dead at Nijmegen: The True Story of an American Paratrooper in World War II: https://www.amazon.com/Left-Dead-Nijmegen-American-Paratrooper/dp/1612006965AccentCare: https://www.accentcare.com/Contact the Last Visit First Team:Producer: [email protected]: [email protected]:00:00 – HCHB Premier Sponsor Ad Read00:48 – Welcome and intro01:30 – How Tom and Tracy first met02:48 – Tracy’s start in nursing and home health06:05 – Joining AccentCare08:45 – Rate cuts and rural impact12:21 – The patient who inspired her16:07 – WWII veteran story and book mention18:36 – Building strong teams and leaders22:29 – AI and the clinician’s role25:38 – Telehealth and access to care28:03 – Driving quality at the bedside31:29 – Rural length-of-stay challenges32:38 – The future of care at home35:02 – Transitions and hospice coordination38:28 – ESRD and hospice eligibility39:57 – Behavioral health and homebound rules43:28 – Waivers, policy, and workforce outlook46:58 – Tracy’s legacy49:27 – Staying connected to the field50:00 – Closing50:54 – Sponsor Ad Reads

In this special bonus episode, Tom Maxwell sits down with Elliott Wood, CEO of MOSAI, to discuss the merger of Forcura and Medalogix into one unified company. Together, they unpack how two strong cultures came together under a shared mission to simplify care through connected intelligence.Elliott shares how MOSAI is reimagining technology’s role in home health and hospice—using AI, automation, and data to help clinicians focus on what matters most: the patient. He reflects on leadership lessons, understanding customer needs, and how partnerships drive innovation in care delivery.The episode closes with a look ahead at MOSAI’s future and what it means for the evolving landscape of home-based care. You won't want to miss this one.Keywords:Elliott Wood, Tom Maxwell, MOSAI, Medalogix, Forcura, home health, hospice, care at home, healthcare technology, AI in healthcare, predictive modeling, leadership, mergers and acquisitions, clinical analytics, interoperability, automation, clinician efficiency, patient outcomes, connected intelligence, healthcare innovationPeople of the Episode:Guest: Elliott Wood, CEO of MOSAIHost: Tom MaxwellProducer: Cole SorensenA Special Thank You to Our Premier Sponsor — MosaiMosai brings a new level of connected intelligence to every stage of post-acute care. To learn more, visit mosai.com.Last Visit First Podcast Links:Apple PodcastsSpotifyYouTubeWebsiteLinkedInMentioned in the Episode:Being Mortal by Atul GawandeCompassus Home Health CareThe Vistria GroupBerkshire PartnersHomecare HomebaseContact the Last Visit First [email protected]:(00:00) – Tom introduces Elliott Wood and teases the reveal of a new company identity(00:40) – Last Visit First intro video(00:48) – Welcome and guest introduction(01:03) – Tom asks Elliott to reveal the new name(01:07) – Elliott announces MOSAI and showcases the logo(01:15) – MOSAI sponsor ad read(02:53) – Meaning behind the name MOSAI(04:26) – Why now: The Forcura and Medalogix merger(06:32) – Shared mission and product synergy(08:19) – Elliott and Craig Mandeville’s longstanding relationship(10:30) – Importance of listening to customers and EMR innovation(11:01) – Lessons from the Muse and Medalogix merger(13:31) – Board alignment with Vistria and Berkshire(15:52) – Customer and employee reactions(16:50) – Cultural integration into one company(19:21) – Why a new brand identity was essential(20:31) – Elliott’s career journey from data entry to CEO(24:23) – Early Medalogix startup years(27:01) – Building tech that solves clinician problems(29:06) – The “Dancing Nana” story(32:45) – How Being Mortal inspired MOSAI’s mission(35:17) – Partnership with Compassus and patient outcomes(36:04) – Lessons from scaling both companies(40:04) – MOSAI’s vision for connecting clinicians, physicians, and payers(41:21) – Overview of MOSAI’s three product families(47:10) – Hands-free referral automation(49:21) – The Circle platform for order signing(50:44) – Real-world inefficiencies and hand-delivered orders(52:20) – Interoperability and EMR data exchange(53:55) – Proving ROI through measurable outcomes(57:27) – Differentiating BI, predictive modeling, and generative AI(1:02:34) – Using AI to summarize records and justify decisions(1:05:00) – Improving efficiency and compliance(1:07:54) – Expected outcomes for agencies using MOSAI(1:11:35) – Future partnerships and consolidation(1:13:13) – Elliott’s legacy and long-term vision for MOSAI(1:15:20) – Reflections on leadership and culture(1:16:11) – Tom’s closing thoughts and congratulations(1:17:08) – Last Visit First outro video

In this episode of Last Visit First, Tom Maxwell sits down with Luke Rutledge, President of Homecare Homebase (HCHB)—one of the most impactful technology platforms in post-acute care and the company where Tom once served as Chief Strategy Officer. What began as a friendship between mentor and mentee has evolved into a story of leadership, innovation, and purpose-driven growth.Luke shares his journey from leading call centers at AT&T to being hired by Tom Maxwell in 2013 and climbing the ranks within HCHB to now lead the company as President. Together, they discuss how Homecare Homebase has grown from serving just 15 percent of the market to empowering more than 300,000 clinicians and processing $27 billion in annual claims across home health and hospice.Keywords:- Luke Rutledge, Tom Maxwell, Homecare Homebase, HCHB, care at home, home health, hospice, healthcare technology, leadership, innovation, clinician empowerment, AI in healthcare, post-acute care, purpose-driven leadership, patient outcomes.People of the Episode:-Guest: Luke Rutledge-Host: Tom Maxwell-Producer: Cole SorensenSponsors of the Episode:-PREMIER SPONSOR - Homecare Homebase: https://hchb.com/-Maxwell TEC: https://maxwelltec.com/-Steno Health: https://www.stenohealth.com/-Levo: https://www.hellolevo.com/Last Visit First Podcast Links:-Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182-Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs-YouTube: https://www.youtube.com/channel/UCvBv-nOIuI4fAFqsejKwfgQ-Website: https://www.lastvisitfirst.com-LinkedIn: https://www.linkedin.com/company/last-visit-firstMake a Difference in Care At Home—Check Out the Alliance:-National Alliance for Care at Home: https://allianceforcareathome.org/Contact the Last Visit First Team:[email protected]@lastvisitfirst.comOutline:(00:00) – Premier Sponsor Ad: Homecare Homebase (HCHB)(00:48) – Last Visit First Intro Video(00:56) – Welcome and Guest Introduction(01:22) – How Tom and Luke First Met and the 2013 Hiring Story(03:37) – Luke’s Career Journey: Logistics, Finance, AT&T, and Joining HCHB(04:42) – Climbing the Ladder: From Client Services to President(05:36) – Growth of HCHB: From 15% to 47% Market Share(07:03) – Industry Impact: 300,000 Clinicians, $27B in Claims(07:37) – Personal Story: Luke’s Family and Connection to Home-Based Care(10:38) – Leadership Philosophy: Staying Close to Customers and Employees(12:28) – Company Culture and Mentorship at HCHB(13:09) – The Role of AI and Innovation in Reducing Clinician Burden(17:22) – Retaining and Empowering Clinicians in Home Health(19:24) – Mid-Roll Sponsor Ad Reads(21:29) – Policy Discussion: CMS, Outcomes, and Payer Partnerships(23:57) – Growth of Medicare Advantage and Industry Trends(26:19) – Unified Payment Models and Blended Care Settings(31:34) – Advocacy and Data-Driven Storytelling for Home Health(35:22) – Grassroots Action: The Alliance and Clinician Involvement(36:52) – Legacy and Mentorship: Training the Next Generation(38:07) – Tom Reflects on Luke’s Leadership Journey(39:35) – Tom’s Closing Remarks and Thanks to Listeners(39:59) – Last Visit First Outro Video / Credits

In this episode of Last Visit First, Tom Maxwell sits down with April Anthony — CEO of VitalCaring, founder of Encompass Home Health, and creator of Homecare Homebase. April shares her remarkable journey from unexpectedly buying her first home health agency at 25 to building some of the most influential organizations in care at home. Her story highlights the power of resilience, innovation, and culture in shaping not just businesses, but the future of home health and hospice.People of the Episode:Guest: April AnthonyHost: Tom MaxwellProducer: Cole SorensenSponsors:Maxwell TECSteno HealthLevoCompanies Founded by April Anthony:VitalCaringHomecare HomebaseEncompass HealthListen & Follow Last Visit First:Apple PodcastsSpotifyYouTubeWebsiteLinkedInReference:Medicare Advantage ArticleContact:[email protected]:home health leadership, homecare homebase, April Anthony, VitalCaring, hospice innovation, care at home future, healthcare technology, Medicare Advantage, clinician retention, healthcare cultureOutline:00:00 – Sponsor Ad Reads02:16 – Introduction and April’s Career Overview03:48 – How Tom and April First Met04:18 – April’s Start in Home Health08:21 – Buying Her First Agency at 2510:36 – Learning the Business Through Ride-Alongs13:45 – Philosophy: Take Care of Employees First15:55 – Founding Homecare Homebase20:49 – Growth of HCHB (2001–2007)27:32 – Patient Story: Owen Perry39:27 – Technology and AI in Home Health50:00 – The Rise of Medicare Advantage57:27 – April’s Legacy and Motivation01:05:15 – Closing Reflections

In the very first episode of Last Visit First, Tom Maxwell sits down with longtime friend and industry leader David Curtis, Founder and CEO of Graham Healthcare Group and a pioneer in home health and hospice.Together, they unpack:-David’s journey from Princeton rower to turning around struggling agencies and building one of the nation’s largest care-at-home providers.-The leadership practices that have helped him retain teams for decades in an industry known for high turnover.-How technology and AI—from Homecare Homebase to predictive tools—are reshaping clinical workflows and patient outcomes.-The personal story of his son’s early health challenges and how that experience shaped his perspective on caregiving.-What the future of home health, hospice, and Medicare Advantage looks like in the next 5–10 years.This conversation goes beyond strategy. It’s about culture, legacy, and the very real impact leaders can have on patients, families, and the teams that serve them.People of the Episode: -Guest: David Curtis-Host: Tom Maxwell-Producer: Cole SorensenLearn More About Our Sponsors:-Maxwell TEC: https://maxwelltec.com/-Steno Health: https://www.stenohealth.com/-Levo: https://www.hellolevo.com/Last Visit First Podcast Links:-Apple Podcasts: https://podcasts.apple.com/us/podcast/last-visit-first/id1830051182-Spotify: https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs-YouTube: https://www.youtube.com/channel/UCvBv-nOIuI4fAFqsejKwfgQ-Website: https://www.lastvisitfirst.com-LinkedIn: https://www.linkedin.com/company/last-visit-firstContact the Last Visit First Team:[email protected]:home health, hospice, care at home, Medicare Advantage, healthcare leadership, patient outcomes, healthcare innovation, AI in healthcare, OASIS documentation, nurse retention, team culture, David Curtis, Tom Maxwell, Residential Healthcare, Last Visit First podcast, home healthcare technology, hospice benefit, recruiting nurses, future of care at home, care transitions, healthcare podcastsOutline:00:00 Introduction and Background of David Curtis04:52 Career Journey and Home Health Agency Growth09:56 Leadership and Employee Retention Strategies15:51 The Role of Technology and AI in Home Health22:07 Patient Advocacy and Caregiver Challenges27:16 Future of Home Health and Hospice Care31:29 Future of Post-Acute Care Payment Models31:55 Collaboration in Home Health and Joint Ventures32:52 Understanding Hospital at Home vs. SNF at Home35:11 The Rise of Medicare Advantage in Home Health36:39 Patient Preferences and Cost-Effectiveness of Home Health37:42 The Value of Hospice Care40:29 Recruitment and Retention Strategies in Home Health44:06 Adapting to Industry Changes and Growth48:31 Legacy and Impact in Home Health and Hospice59:00 Thanks for listening!

You’re invited to the conversation.Welcome to Last Visit First, the new podcast from Tom Maxwell, Co-Founder and Chairman of Maxwell TEC. In every episode, Tom sits down with the voices shaping home health, hospice, and care at home — leaders, innovators, and changemakers with stories that matter.This trailer gives you a taste of what’s ahead: candid conversations, real lessons, and insights that connect today’s decisions to tomorrow’s outcomes.Follow now so you’ll be the first to hear when new episodes drop.