EPISODE 24 – Riverside Home Health & Hospice: Care That Comes to You

Episode 24 – Team Senior Podcast
Riverside Home Health & Hospice: Care That Comes to You

In this episode, Jamie Callahan sits down with Sabrina Zehe, Director of Business Development at Riverside Home Health & Hospice, to explore how their team is redefining what compassionate, skilled care at home looks like in Southern Oregon.

You’ll hear:

• What home health really means and how it differs from in-home caregiving
• How physical, occupational, and speech therapy services help seniors stay strong, safe, and independent
• Why Riverside takes on the burden of coordinating with doctors and insurance—so families don’t have to
• The incredible impact of Riverside’s provider program, which brings medical care directly into assisted living, memory care, and foster home settings
• Why advocating for the right care (and asking questions) is essential for every family

Riverside’s mission is simple but powerful: deliver the right care at the right time, with heart. For families navigating aging, post-surgery recovery, or chronic conditions, they are a trusted partner who makes sure no one feels alone in the process.

📞 Learn more about Riverside Home Health & Hospice at https://riversidehh.com/
 📞 For Team Senior resources: 541-295-8230

At Team Senior™, our mission is to guide you and support you through the maze of Southern Oregon Long-Term Care.

📞 For Team Senior resources, call: 541-295-8230

Or visit our website for more information: https://www.teamsenior.org/

Transcript

Team Senior Podcast - EPISODE 24- Riverside Home Health and Hospice

Jamie Callahan: Hi, this is Jamie Callahan with the Team Senior Podcast. Our goal is to simplify aging. Society grooms us to plan for retirement, but what about life beyond retirement, where the rubber meets the road? Perhaps you've had a stroke, or you've been diagnosed with cancer, or maybe you're forgetting things and now you have dementia. That's our area of expertise, and we are here to share our insight. And now, the Team Senior podcast.

Hi, this is Jamie Callahan, and I am super excited to introduce Sabrina Zehe to you today with Riverside Home Health and Hospice. They are doing absolutely incredible things in the community. Sabrina, I'm gonna let you share a little bit about your role at Riverside and what drew you to this field in general.

Sabrina Zehe: Thank you. I am the director of business development, and my team—we serve the community from every perspective. So we help coordinate the care between the people in the community that need the care and all of the services that we provide. So both home health, hospice, and actually provider services. Now, if there's a need in our community, our job is to work with all the entities to help them get the services that they need, and also get the orders that we need and be compliant with their insurance so that they can get the care as soon as possible.

Jamie: Yes. And so she really hit the nail on the head when she said, "get the orders that they need." We're actually struggling with this right now in a completely different kind of organization. But one thing that I love about Riverside—and I just need to touch on this before we jump further into the podcast here—is that when we have someone that we're working with and we recognize that they would benefit from home health, we don't have to tell the person we're working with that you need to go to the doctor and you need to be seen. You need to get an order. You need to jump through all these hoops to get services in your home, because we know if we send the referral to Riverside Home Health, they're going to do all that backend work for you. So they are actually going to write to the doctor on your behalf and help to solicit all of those orders and circumvent as much of the legwork for the patient as they can.

Sabrina: Yeah. So we see it as our job to be the professionals at what we do. And by professionals, we know everything that Medicare requires or their insurance requires for their people or patients to get these services. And there are—when you say hoops—there are a lot of hoops that they require us to jump through. So when somebody says you need to go to your doctor and you need to have them write an order, there's a lot of pieces on the backside. And because we know that care is very important, it is our job to work very closely with the provider to get exactly what we need to make sure that you get our services as soon as possible.

Jamie: Yeah, I love that. Okay, so let's dive into home health. What exactly is home health? How is it different from in-home caregiving or private duty nursing? For those people that aren't familiar with home health, what is it?

Sabrina: We are 100% clinical and 100% skilled. So when you think of somebody that is clinically homebound, which means it's a taxing effort for them to leave their home—it doesn't mean they can't ever leave their home, they can't go to the grocery store or church or go see family—it's taxing for them to do the simplest of tasks. So that would declare them clinically homebound. And our team, full of clinicians—which would be nurses, physical therapists, occupational therapists, speech therapists, and home health bath aides—can then come into the home and provide any of the needs that somebody would have to go out of their home for, like physical therapy or wound care. We bring all of that into the home setting.

Jamie: I know. It's absolutely amazing. So examples of times that we reach out to Riverside Home Health would be: I am in your living room and we're talking through what it looks like for you to put a plan in place to support either the idea that you wanna continue to live at home or possibly move into some form of long-term care, assisted living—whatever that looks like. And through casual conversation, I start to notice that you're having a really hard time getting up out of your chair, or you share with me that three weeks ago you were taking your trash can to the road and back, but now you're really struggling to go answer the front door. All of those things are like red flags for me that tell me that there's been some kind of decline in your baseline or your ability to just live and thrive in your home independently, or even looking at long-term care, like assisted living. And I think maybe you could benefit from physical therapy, building your strength so that it's easier to take your garbage can to the road again, or it's easier to get out of your recliner.

In that scenario, I would ask you how you felt about me putting in a referral to a home health provider, and in this case, we most often use Riverside Home Health. And they would then work it from the backend to call you—if you are Mr. Jones—and say, "Hey, Mr. Jones, Jamie sent over a referral. She thinks that you might benefit from home health." As soon as you say yes, they're going to take it the distance. They're gonna reach out to your doctor, they're gonna get an order in place, and then, within hopefully a week, they're gonna show up in your living room and start providing physical therapy. The most amazing thing about all of this is that you don't pay for that. This is paid for 100% by your Medicare or Medicaid insurance.

Sabrina: Yeah, that's the beauty of it all, is that all of our services are covered 100% by insurance. And so our goal—and home health was created by Medicare to keep people out of the hospital, to keep people safe that are at risk for going to the hospitals. So once you start seeing those cues of maybe needing a little bit more assistance to walk down the hallway, you're finding yourself holding onto the wall, or like Jamie said, you are not able to get that garbage can out to the end of the driveway or down the street without feeling out of breath or feeling like you're unsteady, our goal is to come in as quickly as possible and to basically look at your home, survey your home, and create a plan that keeps you safe and allows you to strengthen in that time.

Jamie: So now that we know a little bit about home health, we've talked about physical therapy. This is like building physical strength for the purpose of improving stability, getting up and down, being able to fix yourself a meal—whatever that looks like. What is occupational therapy?

Sabrina: So occupational therapy will be more of the fine motor skills. When you think about your activities of daily living, such as getting dressed, being able to take a bath or a shower by yourself—are you safe doing those things and can you do those things? And we're gonna really fine-tune with our occupational therapy team to be able to increase your ability to be able to do those activities of daily living independently. That's the whole idea. Yes. We wanna keep you independent for as long as possible.

Jamie: What is speech therapy?

Sabrina: So speech therapy, man, it covers a whole realm of things. So if you have a loved one that—you're just noticing they're having a hard time swallowing foods that should be easier for them to swallow, and you're very concerned things are becoming a choking hazard, they're not as easily able to swallow their medications—then you would order some speech therapy to come in and do an evaluation. Let's come up with some ideas.

Jamie: So one thing I think it's important to note about speech therapy is that oftentimes the word "speech therapy," I think, confuses people, right? You're not really teaching them to talk.

Sabrina: Correct.

Jamie: It is usually meant for somebody that has developed a trouble swallowing. Yes. So they can asphyxiate when they are swallowing food or water or things like that. And so the speech therapist will come in and help them to be more cognizant of what is actually happening moment to moment in the swallow, whether it requires softening their foods or learning through drinking through a straw—all the little things that they can teach somebody to improve their ability to swallow food and remain independent. Sometimes this is as simple as, if you're struggling to swallow your pills, we might be able to put speech therapy in place to help you with that. And in the end, we might just have to get a crush order in place.

Sabrina: Correct.

Jamie: So those are all things that speech therapy can help to navigate. I'm curious to know, now that we know a little bit—a lot—about the home health area, why are you passionate about home health? How did you get into this?

Sabrina: So I actually fell into this industry. I didn't even know that it existed. And I decided I wanted to get into an industry where I can help people. I wanna make a difference. And when I started doing what we do, working in home health hospice—I used to work in respiratory DME—I realized that these families that I was having consultations with and meetings with and talking to about their needs, they were changing my life more than I could ever dream of impacting their lives. And I want to create a space where our community that is so vulnerable feels like they have somebody that they can trust, somebody that they can lean on, and somebody that they can go to, even when it may not be something that my team can provide for them. I want to be able to help steer them in the direction of the right people that are gonna provide them with the right care that they deserve and that they need.

Jamie: Yeah, it's such an honorable place. And I think because I know Sabrina's heart, I have really enjoyed walking alongside Riverside because of Sabrina, knowing that she's always gonna take the high road, she's always going to do what's ethically right and sound for a family and an individual. I absolutely love that about Riverside, and that is why we have elected to align so closely with Riverside. It is because of Sabrina.

Talk to me a little bit about—we've talked about who pays for home health. Are there services above and beyond home health that folks can get in their home? Let's say, for example, that they don't want to go to skilled nursing facility, where we know that they can get physical therapy on the daily, which provides for a faster path to rehabbing. When home health comes into the home, it's typically, what, twice a week?

Sabrina: So every plan of care with Riverside is going to be specific for the patient. None of our plans that we put together are gonna allow a clinician in the home every single day. So what our goal is, is to be able to work with anybody else that's in the home that can help supplement the days that we're not there. If there is nobody else in the home, that's where we would instigate a conversation with, let's say, Team Senior, because anybody that would need more than two or three days a week in the home probably does need to look at having a conversation about placement, where there are caregivers that can help assist them in a plan that's going to keep them safe.

Jamie: Or possibly even just a caregiver that's capable of following the orders that are set forth by Riverside. Yeah, in terms of what the exercises look like to continue to build strength and stability, or those occupational therapy tools around getting in and out of the shower. And if you had a caregiver in place in that setting, you could probably also continue to progress at a comparable rate. It's never really going to be as aggressive as being in a rehab or skilled facility, but we definitely wanna make sure that it's a conversation that we're having around how to support you those five, six, seven days a week in your home. Yeah.

Talk to me a little bit about what makes families feel overwhelmed in trying to get services in place.

Sabrina: I think the overwhelming piece is the requirements of Medicare. So to get a home health order, it's not just the order from the provider. You have to have seen your doctor or your nurse practitioner within a certain amount of days, and that one visit has to have addressed the need and the reason why they've had home health. And then that chart note has to have certain verbiage and then come over to us. And so I think the overwhelming piece is when somebody tells you, "We didn't get what we need from your doctor. You're gonna have to go back." And so when you have a loved one—your husband, your wife, or your mom or dad that you're watching—sit there, and their every day is precious time that you're losing where they could be getting better and they're not. And when you have somebody telling you they don't have what they need, it's really—it's devastating to somebody that doesn't know what we do. And so I think that time is very precious. And when you can find a company or an agency that knows that burden and they're willing to come in and do the things that they don't necessarily have to do, but they want to do it because it's the right thing, and they're going to go above and beyond and have those conversations with your doctor for you and help facilitate that, I think that's where they're gonna feel that burden be lifted.

Jamie: Yeah, it's truly one of the biggest benefits of working with an organization that's gonna wrap all the way around you and ensure that it doesn't feel so overwhelming that you don't pull the trigger to get the help. That's the thing that we're always trying to alleviate, right? Like, we know when we're dealing with seniors already that sometimes maybe there's some confusion involved, mobility issues involved. It's hard to get them to the doctor. Maybe there's dementia involved, or it's a disabled veteran, or whatever that looks like. So now when we say, "Okay, we really wanna get you physical therapy in the home, but here are these six hoops that you have to jump through to get it," it makes it very burdensome, right?

Sabrina: Yes, absolutely. Yeah. And so that's where my team works very hard to form relationships with all of the providers throughout our Southern Oregon area so that they know that when we come to them, we're an advocate for you. We're not out there trying to get a referral to boost our numbers. We're truly there because we want to be a great partner, help ease the process, not only for the provider, but really to get their patient the help that they need as quickly as possible.

Jamie: I love that. I love that. So let's change gears a little bit and talk about insurance. Yeah. We know that your insurance plan can often influence the home health options that you have. For example, if you have a certain provider, you might not be able to use Riverside, or if you have another provider, you might not be able to go to Providence Hospital. Talk us through what that looks like a little bit.

Sabrina: Yeah, so insurance is a—it's a funny game, and it also is its own industry in itself, where you have different insurance companies fighting over our demographic of people that are 65 and older, trying to fight for those that—that specific Medicare insurance—for these people to pay for them. So there are a handful of insurance companies within our area that are a lot harder to work with, and if you choose to go with that insurance company, it can really narrow down the number of people that you can see for the needs that you have.

Jamie: Yeah, the number of organizations that work with certain providers are certainly narrowed, and so without going into any detail, one thing that I would assure everyone of is that Team Senior works with very reputable organizations. So various home health agencies—while we stack them all against each other and we have our favorites for certain things, always depending on what your needs are. Let's say, for example, you called me and you had a mental health crisis and you really needed supports—behavioral supports or counseling or therapy in your home. We wouldn't go to Riverside for that right now because Riverside doesn't have the behavioral health piece. It wouldn't matter. Insurance wouldn't matter in that scenario. We would likely go to Accent Home Health because they have that in place, or palliative programs. We choose companies sometimes based on the programs that they offer or the continuum of care that we anticipate that you might need. It's just something to be aware of. It's something we can definitely also help to navigate with. If you have questions around, "Can you receive a specific service based on what kind of insurance you have?" I always encourage folks to give us a call. That's not just regarding home health or hospice. That's regarding, maybe you just went to the doctor and they prescribed a new medication and it's a thousand dollars. Give us a call. If there's a workaround, we know the people to call to code that maybe differently so that we can try to get your insurance to cover it.

I wanna change gears again for a minute because Riverside is doing something that is profoundly special for people that are in assisted living and need a provider, and it's hard for them to leave their assisted living. Now, this isn't necessarily true of the "hard to leave." I think you could use this program even if you could easily get to the doctor. But if you were in an assisted living community, a memory care facility, or an adult foster home—I think maybe even some of the independent living communities, especially if they're in the continuum of care. Yeah. Riverside has a provider program where, if you are struggling to get to the doctor or you feel like your doctor isn't taking you seriously, or maybe you just wanna change providers, they have a provider program now. So tell us about that.

Sabrina: We do. We have an incredible provider, and she is absolutely amazing. Her heart aligns directly with, I think, the mission that we're trying to accomplish in this community. And her name's Ingrid Passer. She is an expert at senior living and more specifically memory care. And what we see with our memory care folks is any change in scenery—it's gonna be very difficult on them for sometimes a long period of time. And so our goal is to keep them in their environment, a place where they're secure and safe, and you're not gonna be seeing a change in condition because you had to take them out to see their doctor. Somebody that is gonna be an expert at the care that they need and be able to shift with their ever-shifting changes in their condition and moods. And so she's able to come bedside and be with your loved ones and be with her patients and see them just like you would for your parents, for any other doctor's appointment. She comes in-house, and she rounds in a lot of our adult foster homes and our memory cares and in our assisted livings and sees our patients there and provides all of the needs that they need within their home.

Jamie: Yeah. I'm gonna use this specific example that happened in my own family regarding Ingrid. Ingrid is essentially a doctor that can see your mom and dad or you when you're living in memory care, assisted living, adult foster home. In my family, it was my brother-in-law, and we were really struggling to get his primary care physician to respond to requests regarding medication changes rapidly enough for it to really improve his quality of life. Faxes would get sent to the primary care physician. It would take them a day or two to respond, and then they would send it back. And now, by the time the prescription is filled, sometimes two or three days have passed, which doesn't help somebody. If they have a UTI, now we're sending them to the emergency room. Yep. And if you know about people that have dementia, that is really traumatic for them. Every single time you change their scenery, it causes a slide back in their condition, meaning it causes them to digress in their condition. They don't always come back to their baseline. So just sending somebody to the emergency room and then bringing them back home again when they have dementia could cause their health to get significantly worse.

So in the scenario where Ingrid finally came on board, we were able to—when I say "we," I really mean the memory care community—they were able to send her text messages that she could respond to in real time. We're talking five, ten minutes. We were able to get medications changed, either increased, decreased, or new medications within a matter of 30 minutes to an hour. It truly changes the game for the quality of life of people that are living in those settings.

I wanna be clear that Ingrid does not round in people's personal residences, so you can't have her be your new provider if you're living at home. But if you move into assisted living, independent living, memory care, adult foster home, she is available to become your new doctor. Yeah, more likely. She's very full right now. So what I suggest to people that—if they decide that Ingrid just sounds like the provider that they want—let's find out the buildings that she's currently working in and let's look and see what openings they have and if it's a good fit for your loved one and/or you, and get you plugged in so that we can have an increased chance of being able to become a part of her patient load.

Sabrina: Sure. Absolutely. That's another great example in terms of this particular individual, is that we know when we have somebody with really complicated needs living in the hospital essentially because we can't discharge them because their care needs, or the acuity of their care is so high—sometimes we cannot convince an assisted living community to consider admitting them. But if we know that we can have Ingrid onboard with that patient, the discharge is much more probable because the assisted living, 99% of the time, is more likely to agree to admitting somebody with a higher acuity of care, so long as they know that Ingrid is onboard and following that patient.

Jamie: Yeah, she's gained the trust of these buildings, and they know and trust her and know that if she's gonna take them on as a patient, she 100% will be a great provider, will be responsive, will be available to help if they have a changing condition. And so they trust that, and they're able to work with families that might be a little bit more difficult in bringing somebody in.

Sabrina: Yeah, she's busy. I guess the other part of this podcast should be, Riverside needs to hire about ten more of them. So if you're a doctor or an FNP or an NP and you want a job, please call Sabrina.

Jamie: Yeah, we're hiring.

Sabrina: Yeah, no kidding. That is a very serious statement. We really need more Ingrids rotating in the community.

Jamie: So tell me, what unique services does Riverside provide that are above and beyond, like for seniors, post-surgical patients, chronic conditions?

Sabrina: Oh, above and beyond? I think so. Riverside, with home health and hospice, I think what really sets us apart is our ability to work and function at the local level. So if we can look at our community as a whole, we don't have to follow processes and do things the way that we do things because we have a corporate entity that tells everybody to do things the same way across the whole nation. We can serve our community the way that our community needs to be served, which is gonna be different than Eugene, that's not that far away, or Portland. We have a very special area that we live in. And we're able to work with specific families, specific buildings, and look at the need of the person that we're working with. And if there's something that we don't already offer, we can bring it to the drawing table with our local team and say, "Hey, this is what the need is in this building. This is what the need is for this family, and this actually is the need of our whole community. I think we need to implement this, add this, take it out, and just be different." And I think that's what makes us really special is that we tell everybody we want all the feedback. We want the good, the bad, the ugly. We want all of it. Because for us to be able to shift the way that we know we can shift, we have to know everything that everybody needs at any given time.

Jamie: That's one thing I've appreciated about Riverside for years, is that we recognize, right? We're the same way. We're a small business. We're not going to get it exactly right every time. We strive to get it exactly right every single time, but there are going to be times when we make a mistake. I wanna know about those mistakes because that is how we, one, ensure it doesn't happen again, and two, be better next time. Yeah, and that's something that I've always really loved Riverside for, is that they will be the first to tell you when something went sideways, but they will also be the first to build in every measurable opportunity to prevent that from ever happening again without pointing the finger at somebody else. They will just own it, fix it, and make sure it doesn't happen again.

Sabrina: Absolutely. That's one thing—one message that I continue to give in the community is, while I fully believe in our team and the culture and the care that we're giving, I never promise perfection. We're people serving people. But I will promise you that the way that we walk through any difficult times will be with the utmost of character and integrity, and we will do it right 100% of the time.

Jamie: Yeah, there's probably no truer statement. I've walked through some difficult things with Riverside. Sometimes having nothing to do with Team Senior or Riverside, but righting those wrongs together have been a really wonderful experience. It exudes from the walls, honestly. You go in and you recognize that most of the spouses are involved. They're volunteering with their hospice program. Lots of husbands and wives that are working there, both in a clinical setting. It is truly an incredible company, and like I said, I'm so honored to have the ability to work with them in the capacity that we do.

What advice would you give to someone that's unsure about whether they want to try to implement home health?

Sabrina: I think my number one piece of advice for anybody, for anything, is just ask questions. Ask questions of somebody that you trust, whether it's Team Senior or myself. And this is what I tell families that aren't even looking to be on service with Riverside: keep my number, call me, because I want to be able to steer people in the right direction. There's a lot of people that do what we do in this community. There's a lot of people that do what a lot of other people do in this community, but we really want people to use people that are doing it right and doing it the right way, with the right hearts and the right intentions. And so I think if you just continue to ask questions, if you have concerns, bring those to the table because we want your loved ones and you to get all of the care that you need exactly when you need it.

Jamie: Yeah, and from a team—she said it a few times—really their motivation truly is their heart. Someone from her team approached me, probably—I don't think I've even told you this story—approached me probably three or four months ago, and they needed to get a wheelchair for somebody who was not very large in stature. So maybe an adult that was like five feet tall. And they were inquiring about funding options. "What do we know in terms of resources for funding?" They'd already tapped into all the usual suspects in terms of resources—Access, HASL, other DME, durable medical equipment providers—looking to see if there was a used one. And at the end of our conversation, this person just said to me, "It's fine. I've already looked it up. I know how much it costs. I'm just gonna buy it for this person." Tears, right? Those are the people that we wanna align with. I absolutely love, love, love the heart of folks that are truly in this industry to serve. And I have seen that come again from Riverside again and again. So thank you so much.

Tell us, is there anything else that you want us to know before we wrap up?

Sabrina: Gosh. Nothing else. I think we talked about most of it. I just really wanna encourage our community to advocate for their rights—your patient in regards to what you are owed between home health, hospice, your providers, anything that they're referring out. I just really want the community to know that every patient has a choice to use who they wanna use, and continue to ask questions, and they have a voice over their own care.

Jamie: Yeah, that's so true. So what we see happen oftentimes in a professional setting is that the nurse has a favorite company. And even if you have chosen a company, sometimes a medical professional or someone else in our industry will try to sway you otherwise. But follow your heart. Really do what feels right to you. And if you have made a connection, or if you've been referred from a friend who's used a company and you have good reason to believe that that's the direction that you wanna go in, really follow your gut. I can't say that enough times in our industry as a whole.

Sabrina, thank you so much for being here today. It's always an honor getting to spend a little bit of time with you. This is Jamie Callahan, and until next week, thank you for listening to the Team Senior podcast. We're here every week sharing new and relevant information. Remember that we're just a phone call away. Team Senior can be reached at 541-295-8230. Again, 541-295-8230. Until next time, this is Jamie Callahan.