From ICU Nurse to Home Care CEO: Inside Jennifer Sheets’ Journey to Becoming Interim’s Top Exec

Before becoming the CEO of Caring Brands International and head of Interim HealthCare, Jennifer Sheets worked as an ICU nurse in Tennessee, routinely taking care of the health care system’s most vulnerable.

Sheets still carries that experience with her today, both in the appreciation she has for Interim’s employees and via the leadership skills she utilizes on a daily basis. Home Health Care News dug into Sheets’ nursing background — and how it’s helping Interim attract and retain top talent — during a recent episode of Disrupt.

With over 600 locations worldwide and systemwide sales of more than $1.16 billion in 2018, Sunrise, Florida-based Interim HealthCare is one of the fastest-growing in-home care franchise companies currently operating. In addition to her nursing background, Sheets also discussed her company’s evolving strategy, the importance of breaking down silos and Interim’s plans to expand its staffing business.

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Highlights from HHCN’s conversation with Sheets are below, edited for length and clarity.

HHCN: Interim is one of the big at-home care organizations we cover, so I’m looking forward to digging into your plans for 2020 and beyond. Before that, I wanted to talk about your background. You’re a nurse by training, correct?

Sheets: Correct. I actually started my career as a trauma and transplant ICU nurse in east Tennessee. I maintain my continuous education requirements and multi-state licensure to this day. Although I don’t serve as a bedside nurse now, I will always be passionate about my role as a patient advocate.

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Many of the skills I learned working with patients — including empathy, complex problem solving, continuous process improvement and communication — have carried through to my job today.

Having started my career as an RN, I am acutely aware of the dedication and heart it takes to serve others. I understand the sacrifices that nurses make, and the long hours and hard work put into caring for patients. Nurses have this natural calling to serve others, and I see it every single day in the nurses and caregivers that I get to work with across the country. They really are the heartbeat of any health care company.

Personally, as decisions are being made at the national level, I never want to forget what it was like to work night shifts in the ICU on Christmas Eve, wondering if the leaders even knew I was there sacrificing my own time to care for patients.

How did you go from nurse to CEO. What has that overall career progression been like?

I’ve always been drawn to service and impacting the delivery of health care to ensure that people have access to the highest quality, most efficient levels of care. I began my career as an ICU nurse because I wanted to work in the most challenging setting. I later advanced into chief clinical, innovation and executive roles, both in the hospital and the home health sectors.

My father died unexpectedly as a result of a medical error — one that could have been so easily prevented if best practices and standard processes had been followed. Obviously, that was a very impactful event in my life. A father, a husband and a successful company president was taken from this life way too soon. That further fueled my passion to seek roles where I could have the greatest impact and influence thought leadership around keeping patients happy and healthy at home whenever possible.

Ultimately, that’s around when I made the shift into home care.

I believe the knowledge that I gained on both sides of the health care continuum — both the acute and post-acute worlds — has really allowed me to see firsthand how disconnected our health care delivery system is. As a hospital CEO, for example, I was not thinking about home care or methods to keep my patients out of the hospital. And hospice was a completely foreign concept to me until I experienced firsthand the benefit of that service.

What were some of the observations you made initially joining Interim?

Well, first, let me say I am extremely lucky to have the opportunity to build on Interim’s legacy of over 50 years in the industry. Interim’s history has allowed me to run a lot faster than when you typically come into a company of this size and scale.

Working with Caring Brands International companies, it has become clear to me that we are all trying to solve the same issues. I can sit in Australia or in the U.K. and everybody is trying to solve the same problem. We’re trying to increase the supply of talent to meet the care demand that we face.

And there’s a gap in education related to what home care provides and what it covers across the globe. The two things that I’ve consistently heard over my career are: “I wish I had known about this service sooner,” and, “I didn’t know home care is a service and type of support for family caregivers, too.”

Now, a big focus has been breaking down silos across the continuum and improving the coordination of care. Not only does [breaking down silos] help patients and their family members gain control over their medical journey, but it also has been medically proven to result in more successful outcomes.

What else have I been up to? Last year, we strengthened our ability to offer exemplary dementia care. We incorporated teachings from Teepa Snow’s positive approach to care into our curriculum. And we’re now expanding to a more holistic cognitive care program that encompasses all other types of cognitive impairments and will allow us to expand our training for caregivers. In turn, we hope that will then lead to retention and, you know, keeping the best caregivers out there.

As our population continues to change, we’re going to see more and more people who need to transition to home-based programs, even things such as hospice care. And we’re going to continue to see more specialized programs being developed, especially around comfort and symptom management to allow people to age in place.

Some folks might not be familiar with Interim as an organization and how it fits into the larger Caring Brands International system. Can you recap that relationship briefly?

Sure. Caring Brands International is made up of three companies. The first is Interim, which is the largest and covers the United States. Then we have Bluebird Care, which is in the U.K. and Ireland. Just Better Care is in Australia.

You mentioned breaking down silos. Is there one particular silo, so to speak, that’s often the most problematic? Whether that’s between the hospital and the home care provider or the physician and the home care provider — or even just internally?

Honestly, I would say all of the above. I think that the real challenge is just some parts of health care don’t talk to each other. So it’s very hard to have that continuum in communication across each setting. Then on top of that, if you think about large hospital systems, for example, you may have a group of hospitalists who are serving a hospital and transitioning out every few months. You educate one group of hospitals about home care options, then six months later it’s a whole new group.

You have the same thing with case management departments and other specialists. It’s not so much about what people are doing within their setting, because everybody is doing their best to provide the best care that they can. But we’re not connecting the dots. So if we’re missing some critical piece of information, the care is not as good as it could be. When I say “breaking down the silos,” it’s how do we make sure we’re communicating? How do we make sure when somebody goes to the hospital, that ER physician knows all of the social determinants of health tied to that patient?

We spoke not too long ago. You seemed excited about this new direction you’re helping to lead Interim. It’s a new strategy called HomeLife Enrichment. What’s that all about?

Studies show that when care is personalized to meet people’s unique needs — incorporating all the factors that influence their health — seniors are more empowered to live their best life.

As a nurse working long shifts, I would remind myself of my “why.” Why do I do this job? Why am I committed to a career in caring for others when there are much easier, safer directions I could have taken my career? To this day, I keep a whiteboard in my office filled with notes of appreciation from former patients, peers, leaders and employees.

For Interim, I believe a part our “why” is understanding how frightening it can be to depend on others for daily care. No one wants to be a burden to family or friends. And no one wants to lose their independence. Those concerns are the motivation behind the creation of HomeLife Enrichment. In short, it’s a strategy to make sure we’re supporting the mind and body. We work with each family within their individual situation to develop specific protocols and activities designed to turn each day into a comfortable flow of engaging, fun, interactive events that stimulate the brain, improve motor function and help seniors experience laughter, hope and happiness.

There are thousands of home care providers out there. How is Interim competing in this landscape?

It is critical that we are able to meet and enrich people’s needs through a variety of service offerings at every stage of care. We’re seeing the health care industry shift toward value-based care models and population health. This requires a more holistic view of patient care. It’s time that this philosophy comes to home care. It’s about having a more active approach to home care, and we believe that there is so much potential when you treat every single client as an individual with unique needs, desires and dreams.

The whole person and individualized approach allows us to look for ways to empower people at home. This is what will separate one home care agency from another.

What else are you excited about? I’ll note that Interim is a very diverse organization that provides all sorts of care.

That’s correct. We provide care from pediatric through end of life. In terms of other updates, we are going to further expand our staffing offering. The U.S. staffing industry recorded it 10th consecutive year of growth. The industry has grown from a recession-low of $83.2 billion in 2009 to a record $152.1 billion this year. A 3% growth forecast is projected for the U.S. staffing industry overall, with revenue growth in many segments, led by expansion in bill rates and pay rates rather than volume. It’s a unique time in the staffing industry.

In the U.S. staffing health care segment specifically, 4% growth is projected, due primarily to the secular trend of rising spending from an aging U.S. population and cyclical expansion in the U.S. economy.

I’m also excited about our strategic partnerships. With changing regulations and increasing demands, combined with the need for more coordinated care, organizations and facilities will be unable to survive on their own.

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