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Achieving scale can allow home-based care providers to increase efficiency and expand patient access to care. It also comes with its own set of unique challenges.
The strategies used in one market do not always translate to another, David Causby, CEO of Gentiva Health Services, told Home Health Care News. Large organizations, like Gentiva, must find ways to adhere to high standards of care while adjusting approaches dynamically for each market and its specific challenges.
For example, rural communities face more severe health care workforce shortages. To address this challenge, Gentiva implements a multi-pronged strategy that includes leveraging telehealth technologies and establishing strategic partnerships with academic institutions.
Despite the inherent challenges of managing operations across diverse markets, Gentiva plans to further expand its reach through targeted acquisitions and strategic partnerships.
Atlanta-based Gentiva Health Services provides home health, hospice and palliative services across 38 states with more than 15,000 employees. Under Causby’s leadership, Gentiva continues to evolve. The company’s current priorities focus on innovation, rigorous employee training and a commitment to enhancing the lives of patients and their families during challenging times.
HHCN recently spoke with Causby about the complexities of managing an organization of this size, some of Gentiva’s most notable achievements and his vision for the organization’s future.
Below is that conversation, edited for length and clarity.
HHCN: Gentiva operates in 38 states with more than 515 locations. What are some of the most significant challenges of running an organization of that size?
Causby: Running a large hospice, home health and palliative care organization presents unique and significant challenges. Maintaining consistent, high-quality, compassionate care across a dispersed team is paramount, especially given the intensity of our work. We need to understand that what works in one market may not work in others, so we must be adaptable. Serving patients in urban and suburban locations differs from providing care in rural communities. While we must be flexible, we must adhere to the same clinical, regulatory and compliance standards.
Navigating the complex regulatory landscape and ensuring financial sustainability in a fluctuating health care environment demands constant strategic adaptation. We also need to make sure that our locations do not feel like they operate in a silo. So, that means that our area and regional leaders need to be visible and establish a vision of team collaboration.
Finally, recruiting and retaining skilled, empathetic professionals dedicated to our mission remains a critical ongoing effort. A strong culture is essential so that we all work toward a unified set of goals underpinned by a strong mission and vision.
We need to ensure that everyone understands what Gentiva stands for, our clinical quality and compliance expectations, and that we provide service consistency to all patients and families, no matter which community.
What are your plans for growth in 2025 and beyond?
Our 2025 growth strategy prioritizes strategic expansion and enhanced service delivery while maintaining our commitment to quality.
We will deepen market penetration through partnerships, particularly within our Illumia Health program, and explore targeted acquisitions to broaden our geographic reach, especially in underserved and rural areas. We are investing in technology and data analytics to optimize operations and expand personalized care and advanced clinical programs. Additionally, we are committed to strengthening our workforce through robust recruitment, retention and leadership development, ensuring our team’s expertise and dedication drive our continued success. A strong company culture remains a top priority as we grow.
Recruitment and retention are challenges for organizations of all sizes, especially larger ones like yours. What are some of the ways you’ve handled recruitment and retention? Are certain areas of the country more difficult to recruit in than others?
Talent acquisition and retention are paramount priorities for our organization. We use a multifaceted strategy to optimize the candidate experience, enhance recruiter efficiency and refine hiring methodologies. By leveraging technology, targeted engagement and data-driven analytics, we continuously improve our approach to attract, hire and retain the best talent for our organization.
We have implemented comprehensive leadership development initiatives to foster retention, investing in both today’s and tomorrow’s leaders. Additionally, we have improved our onboarding protocols to ensure that new team members feel supported from the very start.
At Gentiva, this comprehensive approach is integral. We have invested substantially in onboarding and training programs, cultivating a collaborative culture acknowledging each team member’s essential contributions.
Geographic disparities in recruitment challenges exist. Rural communities, for instance, frequently encounter health care professional shortages, necessitating tailored recruitment strategies and innovative solutions such as telehealth integration and strategic partnerships with local academic institutions. Similarly, rapidly expanding metropolitan areas present unique recruitment demands. We remain committed to adapting our recruitment strategies to address the specific needs of each market.
In June 2024, Gentiva divested its personal care division to Addus HomeCare. What led to that decision? Do you have any key takeaways to share from that transaction?
We are pleased to have successfully transitioned our personal care division to Addus, a recognized leader in that sector. This strategic divestiture allows Gentiva to focus its resources and expertise on our core end-of-life care services. We are dedicated to optimizing our performance within our primary business lines, where we have the greatest capacity to deliver exceptional care and pursue strategic growth opportunities.
Can you discuss the Gentiva Foundation and some of its achievements?
Our Foundation reflects our belief that philanthropic engagement is both a responsibility and a privilege. It is another way we embrace our commitment to compassionate service.
In the past three years alone, we have awarded over $2.4 million to support our associates affected by adverse life events or natural disasters.
We are incredibly proud to support non-profit organizations that provide bereavement services for children nationwide. This year, we have allocated unprecedented funding to nine bereavement camps and centers, made possible by the generous contributions of our associates and others who have donated to the Foundation in memory of their loved ones. We are honored to help provide children with transformative experiences that allow them to navigate their grief and rediscover the joys of childhood.
What projects or innovations have you worked on recently that you are most proud of?
The 2024 launch of our Illumia Health [Advanced Illness Management] palliative care program represents a significant achievement. Our strategic partnerships with physician groups have enabled advanced care delivery to high-acuity, complex patients in their home environments, resulting in demonstrably positive outcomes. This model improves patient care and quality of life while reducing health care expenditures.
Gentiva has consistently received awards for excellence and quality for its care segments. To what do you attribute that continued success?
Gentiva’s consistent recognition for excellence and quality stems from a deeply ingrained commitment to clinical rigor and patient-centered care. Our company’s underpinning is a relentless commitment to quality and compliance. Our Quality Assurance and Performance Improvement (QAPI) plan is the foundation of that commitment to improve our quality and the patient/family experience continuously.
We prioritize continuous education and training, ensuring our clinicians are equipped with the latest evidence-based practices, and we remain focused on clinical education, staff retention and disease-specific symptom management.
We are committed to ongoing training, robust quality assurance programs and meticulous attention to detail. We continually evaluate our processes to ensure we consistently deliver exceptional care. When necessary, we refine and develop new tools and provide support to ensure our teams have what they need to excel in their roles. We are implementing advanced clinical programs focusing on delivering care to patients with specific diagnoses. These programs include impactful training opportunities designed to enhance clinician knowledge and skills, thereby creating higher quality and safety and a superior experience for the individuals and families we serve.
We foster a culture of interdisciplinary collaboration, where every care team member – from nurses to social workers – works in close coordination to address the holistic needs of our patients.
Finally, we continuously focus on quality improvement, using data-driven insights to refine our processes and ensure we consistently exceed the highest standards of care. We also value listening to patients and their loved ones and constantly working to improve our care based on their feedback. Our people are the most critical part of our success, and their dedication to the patients and their families sets Gentiva apart.
What is your most valuable lesson as a health industry leader?
Throughout my health care career, I have learned that change is constant. Success requires a forward-thinking, agile approach that anticipates future trends and adapts proactively. Building strong, collaborative relationships with leadership, industry peers, policymakers and community partners is also essential.
I have prioritized direct engagement with frontline care providers to understand the complexities of health care delivery better. My experiences, along with my family’s journey with hospice care, have provided me with invaluable insight into the challenges faced by both patients and providers. I am continually reminded of hospice care’s profound impact, and I am inspired by the dedication of our teams in serving thousands of patients.
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