Our COVID-19 Response: A Letter from Our CEO Mike McMaude

To the Abode Healthcare Community,

I hope this note finds you and your loved ones safe and healthy. The COVID-19 pandemic is affecting each of us in different ways. As we navigate the current situation together, I want to provide an update on the steps we have taken to be there for our community, our employees, and our patients.

All of us at Abode Healthcare are focused on providing the highest quality of care to our patients. I provided an update at the end of March outlining the changes we implemented to prioritize safe patient care in this new environment. Every decision we have made, and continue to make, has been based on the priority of the health and wellbeing of our patients and employees.

I am deeply grateful for our employees who display incredible dedication by continuing to fulfill their commitment to our patients during this especially challenging time. These individuals, and everyone working on the frontlines of care, deserve to feel protected, confident, and taken care of.

In recent weeks we have made informed decisions and taken actions that ultimately support and benefit our entire community:

  • PPE: At the first sign of COVID-19, we prioritized spending where it’s needed most and to date, have purchased $1 million of Personal Protection Equipment (PPE) so no one reported to work without protection. I’m proud to say that we’ve not had to turn down any patients due to lack of PPE. We’ve even been able to assist other homecare and hospice organizations, and hospitals serving the Navajo nation as well as other underserved populations, in providing supplies for their employees by donating thousands of PPE items. In addition to our company’s commitment, several executives on our team have made personal PPE donations for local health organizations so they can work safely.
  • Paid Leave: To support employees who risk their own health and safety to care for patients, we instituted a special paid-time-off policy modeled after the Families First Coronavirus Response Act designated for companies with fewer than 500 employees. In Abode’s plan, employees receive unlimited leave for issues relating to COVID-19, including a newly instituted emergency paid time off (EPTO) benefit that is in addition to the PTO employees accrue with regular benefits. These additional benefits allow employees to potentially recover from COVID-19, care for a family member who is ill with the virus, or care for children whose schools and daycares have closed.
  • Business Investment: Rather than cut back, we’ve leaned into the business to make sure that we are even better prepared to care for patients. Some of these actions include:
    • Building out our telehealth and remote care solutions
    • Retaining a dedicated, talented workforce
    • Hiring new employees and growing our team locally and nationally
    • Expanding our team’s knowledge with the addition of an infectious disease physician, Dr. Shannon Thorn
  • Charitable Donations: As we have every year, we continue to support charitable organizations in our communities. That will not stop just because of COVID-19. Support for neighbors, near and far, is needed now more than ever.

I am extremely proud of how everyone at Abode has reacted and handled the unique situation that the COVID-19 pandemic has presented. It’s difficult to adequately express my appreciation for our community—patients, employees, and partners. I have been reminded, once again, what an incredible organization we have—one that is driven by a common purpose of caring for, and serving, vulnerable patients. Every member of our team has come together to do what’s right, and I thank you. We look forward to continuing to work together and supporting each other through this challenging time.

Stay safe and healthy,


Celebrating Nurses | Destin Ellison

Hospice of North Alabama is celebrating nurses during the month of May! Meet Destin and learn about her passion for nursing as she explains her “why.”

I believe I was called at a young age to become a hospice nurse. At 17, I lost my pawpaw to cancer. The hospice nurse was there through it all and provided so much comfort for my family and me. I craved to be that comfort for someone else.

At the age of 21, I became an RN, and a year later I entered my dream job of being a hospice nurse. I have been doing it for 7 years since. I have been with HNA since 2016, and I could not imagine a better company to work for.”

Destin adds at the end: “If you love what you do, you will never work a day in your life.” -Marc Anthony

Celebrating Nurses | Christy York

Hospice of North Alabama is celebrating nurses during the month of May! Meet Christy and learn about her passion for nursing as she explains her “why.”

“I chose to be a nurse because I wanted to make a difference in this world. I always knew I wanted to help people as a little girl, and I enjoyed marking people smile. I also wanted to leave people better than I found them by making a positive impact on their lives. My goal was to make my Dad and the rest of family proud, so I became a Nurse to give back to the world!”

Celebrating Nurses | Adam Heard

Hospice of North Alabama is celebrating nurses during the month of May! Meet Adam and learn about his passion for nursing as he explains his “why.”

“I became a nurse somewhat late in life, not going to nursing school until I was 34 years old. Prior to that, I grew up in a family of EMTs and firefighters, and some of my earliest memories were on medical and accident scenes, stuck in the car watching from the window of course. At the age of 17, I joined the military as an army combat medic and went to Iraq for 14 months running an ambulance. When I returned home, I was working as a medical assistant in an oncology practice. I decided to try something different and was out of the medical field for five years before deciding to go back to school.  This was the best decision I’ve ever made.

I love helping people, solving problems and educating my coworkers, patients, and their families. After working in the ER and as a travel nurse for a few years, I had a friend with Hospice of North Alabama who told me about some openings. I thought I might enjoy this and liked the idea of using my nursing knowledge to help people in a very tough time and make an impact on how they experienced the dying process. So, I decided to give it a try and have loved every minute of it since.

I truly enjoy caring for my patients and their families, along with the opportunity to educate people who are new to Hospice of North Alabama. I cannot see myself going anywhere other than hospice!”

Celebrating Nurses | Julie Doss

In her 8th year as an RN, Julie Doss of Hospice of North Alabama reflects on her journey towards becoming a nurse and all those who have influenced her along the way. In honor of National Nurses Week, we want to share Julie’s passion for hospice nursing and how her career choice has impacted her life.

Julie always knew she wanted to be a nurse but was cautious because she thought her stomach couldn’t handle it, so she became a teacher instead. Even as a child, her mother told stories of her pretending to stick her dolls with sewing needles, as if she was administering an IV, and taking care of them like real patients.

When her career of teaching pre-k abruptly came to an end, Julie saw the opportunity to pursue her dream of becoming a nurse. She arrived at this decision shortly after losing her grandfather. He suddenly became sick, and exploratory surgery revealed cancer that had metastasized throughout his whole body. The doctors announced he had seven days to live, and he was palliated in the hospital. During her grandfather’s seven days in hospice, Julie spent time keeping him calm and settled until he passed.

Several weeks after his passing, Julie’s other grandfather was admitted into hospice care as well. For nearly a year, Julie helped take care of him during his time with hospice. With those experiences in mind, Julie thought, “If I could do those things for the people I loved most – some of those most private caregiving duties – I could do it for anyone.” As a result, she enrolled in a CNA program and worked nights at a nursing home for almost a year, while her husband worked hard to help put her through school.

Her first job out of nursing school was working nights at a hospital in the neuro/ortho unit. While she loved this position, she couldn’t help but think of how highly her mother-in-law spoke of the hospice organization she worked for. With that in mind, along with her personal experiences, Julie knew that hospice nursing was her true calling.

When a fellow church member reached out to Julie about working for Hospice of North Alabama, she jumped at the chance.

“I thought I was going to be fired after my first day on the job. Two of my five patients passed away that day. Since then, I have grown and gotten to do many different things in my time with Hospice of North Alabama/Abode Healthcare. This is one-hundred percent because of the people who have supported me along the way, and my coworkers who have taught me so much and mentored me.”

How Hospice Nursing Has Impacted Julie

Not long after Julie became a hospice nurse, she had a patient with lung cancer who was declining rapidly. He was a minister with a very close-knit family. It was clear he was the rock of the family; the center of everything they did. Because of this, the family was taking the situation very hard.

After being with the patient for nearly a month, February rolled around, and with it came a prediction of ice and snow. As the weather became increasingly worse, Julie received an upsetting call from the patient’s daughter, saying he was declining rapidly. After finding a safe means of transportation, Julie made her way to the family.

When she arrived, she could sense the family was truly struggling. In the week before, Julie had talked with the family about how important it is for someone who is dying to have permission from their loved ones to let go. After getting the patient comfortable, the daughter came up to Julie and asked if it was time to do so. Julie then stood in the corner of the room and watched the family, one by one, sit on the man’s bedside and pour out their hearts by telling him how their lives were forever changed because of him.

When it came time for his wife to say her goodbyes, she could hardly do it. She looked at Julie and she responded, “If all you need to do is lay with him, that is okay.” Then, the wife laid next to her husband, wrapped her arms around him, and whispered her love to him and how thankful she was for the family they created together. As she told him it was okay to go, he took one breath and was gone.

“I will never forget experiencing this love of a family and what that means to people. I have cared for a lot of people and attended many deaths, but never have I heard regrets about money, work, etc.; all they talk about are people they love. This is such a great reminder of how you should live your life and what is truly important. There is not another job is this world that I would rather do than what I am doing right now – with the people I work with and the company I work for.”

Julie & Hospice of North Alabama – Personal Testimony

“We are incredibly blessed, here at Hospice of North Alabama, with a fantastic group of people whose mission in life is to make sure we take care of the patients who allow us into their homes, lives and hearts for whatever time they may have left. Hospice is not about dying, it is about living well for whatever time you have left. It is our job and privilege to help contribute to that.”

“Through hospice nursing, Hospice of North Alabama and my coworkers, I have had some of the best experiences of my life. I have learned more about life, how to live and what’s important through this job that any other thing I could possibly do.”

“When you work with people who are at the end of their life, and their families who are dealing with the loss of a loved one, you just learn so much about what is truly important. I have learned so much about forgiveness and the importance of the relationships in my life.”

“One of the things that sets this organization apart is the staff here. I am just beyond amazed at how they love their patients, their jobs, and how they take care of one another. We have been able to do and see many wonderful things for patients that would not have had that opportunity without the help of the staff here.”

Happy Nurses Day!

Today, we recognize our nurses for their hard work, support, and compassion. Because of you, we live in a happier, healthier world. Happy Nurses Day!

Your hard work and dedication does not go unnoticed. Now, more than ever, we appreciate you!

COVID-19 & Hospice

Pandemic Relief via legislation, CMS waivers, and enforcement discretion

  • Telehealth
  • Waived requirement to use volunteers
  • Waive non-core services (physical, occupational, and speech pathology) *hospice only
  • Waive on-site visits for hospice aide supervision

Telehealth and Telephonic Visits

  • CMS permits hospices to provide telehealth to a Medicare patient receiving routine home care during the emergency period, if it is feasible and appropriate to do so.
  • Face-to-face encounters for purposed of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (must be 2-way audio-visual)
  • Must be physician-ordered and on the plan of care

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world.

Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients.

In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether.

Telehealth Tools

Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

  • Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
  • Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
  • me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients.

Our “Why” During COVID-19

Times of uncertainty often bring about reflection on our individual mission and purpose – our “why” in life.  We all have a different “why” that has been formed through our passions and life experiences.  Maybe your mission and purpose in life is teaching and mentoring the youth in your community, or maybe it is working in law enforcement to keep your community safe.  Across the company, we are fortunate to have some of the healthcare industry’s most talented professionals whose “why” also aligns with our mission to provide first-class care to our patients and their families.

While we all adjust to changes in our daily lives, our employees are continuing to fulfill their commitment to our patients.  From conducting music therapy in outdoor nursing home courtyards to providing meals for hospital staff and first responders, the current pandemic has even given us the opportunity to be creative in carrying out our mission.

As stated by Rosie Avila, Community Liaison at our Nurses in Touch location, “our purpose here is not for ourselves; it’s for others and in turn their purpose was for us.”  This rings true throughout the company, and our employees are living out their mission and purpose every day.

What is your mission and purpose – your “why” in life?  Perhaps it will be uncovered during these times.  Perhaps it will align with ours.  Perhaps it will provide an opportunity for us to partner in carrying out our missions to support our communities.  We are all in this together!

Making the Hospice Decision

Before a baby is born, planning around the baby’s life begins. The parents prepare for the baby by creating a registry. Friends plan and host a baby shower. Family helps decorate the nursery. As the baby grows, the parents teach the baby, now a child, how to read. They prepare the child for kindergarten, then elementary school, then middle school, and then high school. The child, now a young adult, decides on a trade school versus entering the work force directly after high school versus college, and if college is selected, the young adults selects a major, and prepares to earn a degree. Then the young adult applies for and accepts a job, decides to get married, and chooses when to start a family. He or she then decides how many children to have and how to raise those children.

We spend so much of our life preparing and planning—so why should it be any different when making a hospice decision? Ideally, from the start of a diagnosis of a life-limiting illness, people should begin planning their goals and priorities with their physician. By having these conversations early, the person with a life-limiting illness can be fully involved in planning and making decisions regarding their wishes before the stress of a medical crisis.

Hospice is a continuation of care that shifts the goals of the patient from curative to comfort. When you or a loved one has a life-limiting illness and medical treatment is no longer effective, the doctor may refer you to hospice care. It should not be seen as a last resort but rather as an opportunity to focus on managing pain and other symptoms to find relief. This approach lets you dedicate your attention to what truly matters: living the rest of your life to the fullest.

A study by the National Palliative Care Organization found that patients who spent their final days on hospice reported having a better life experience than those who spent the end of their lives in intensive care. The researchers found that the patient’s choices often influenced the end-of-life care they got, which is why it is so important for people to plan for hospice, long before the need arises.

So, when should you make the hospice decision? Talk to your physician about signs and symptoms to consider prior to electing hospice care. Frequent hospitalizations, frequent infections, a decline in functional status, and an increase in uncontrollable symptoms or pain can all be indicators. Decide what you wish to do when treatment is no longer effective. Consider the benefits of managing symptoms from home rather than frequent visits to the physician or hospital. Consider the benefit of having a team of specialists available to you in your home—from a registered nurse to an aide, your doctor, a medical director, a social worker, and a chaplain. Consider access to your hospice team by phone 24 hours a day, 7 days a week, 365 days a year, where you could call your team if you had a question or a medical need. Consider the benefits of having medications related to your diagnosis and medical equipment made available to you in your home. These are all resources included in the Medicare hospice benefit, at no cost to the patient or their family.

If you have questions about the hospice benefit or when to elect your benefit, call Hospice of North Alabama at 1-800-314-9863.

Hospice Care That Focuses On Quality of Life

The hospice benefit is a multi-disciplinary approach to end of life care. When hospice patients are able to utilize the benefit, in its full capacity, self-fulfillment needs, psychological needs, and basic needs are met. At Hospice of North Alabama, we seek to meet all levels of needs for each hospice patient in order to maximize their end of life journey and hospice benefit utilization. 180 days on hospice not only allows for better end of life transitions for patients, but allows family members to be family members and our team to become caregivers. Thank you for allowing us to be a part of your journey.