Last Visit First

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/scotttapp⁠
• Trella 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/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-first⁠

About 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 Spot
• 00:48 – 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-first

About 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 Rule
• PDGM recalibration and payment updates
• Wage index shifts and FDL changes
• Value Based Purchasing updates
• Telehealth limits in home health
• Recruiting and retention challenges
• National Alliance for Care at Home advocacy efforts
• VitalCaring operational insights

Timestamps:

• 00:00 HCHB featured commercial
• 00:48 Introduction to the 2026 Final Rule
• 03:06 Dissecting the Payment Structure
• 10:53 Understanding the Impact of Cuts
• 16:53 Maxwell TEC sponsor (nanaCONNECT and REACH)
• 18:08 PDGM Recalibration and Cost Reports
• 23:13 Clinical and Operational Changes
• 29:35 Value Based Payments and Quality Metrics
• 32:00 Challenges in Rural Healthcare Access
• 33:13 Episode sponsor Levo
• 33:54 Revisiting Visit Patterns Amid Rate Pressures
• 36:16 The Impact of Telehealth on Home Health
• 41:06 Understanding Fixed Dollar Loss Ratio
• 44:26 StenoHealth sponsor
• 45:24 Budgeting Strategies for Home Health Agencies
• 49:31 The Future of Smaller Agencies in Home Health
• 53:10 Recruitment and Retention in Home Health
• 56:39 Reflections on Last Visit First
• 01:01:05 Thank You and Reach Out if Needed

Guest Links:

• National Alliance for Care at Home: https://allianceforcareathome.org/
• Scott Levy on LinkedIn: https://linkedin.com/in/scott-levy-09a8829b
• VitalCaring Group: https://www.vitalcaring.com/
• Luke James on LinkedIn: https://linkedin.com/in/luke-james-9bb93821

Special 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/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-first

About 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 remembered

Guest Links:

-Bristol Hospice: https://bristolhospice.com/

-Alex on LinkedIn: https://www.linkedin.com/in/alex-mauricio-189b3a33

Sponsors:

-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-first

Resources 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 ad

• 00:48 Jason Yu introduction and backstory
• 11:52 The biggest gaps and opportunities in home health and hospice
• 18:21 Why clinicians leave and what Levo is solving
• 22:28 Maxwell TEC ad
• 23:27 How Levo uses AI in recruiting and retention
• 33:47 What turnover costs and how agencies can reduce it
• 38:33 The future of home based care
• 45:43 Steno ad
• 46:13 Personal stories, leadership lessons, and building Levo
• 59:16 Jason’s legacy and what drives him
• 1:05:49 Why Levo moved into a new office
• 1:10:25 What is next for Last Visit First
• 1:14:05 Last Visit First outro

Guest Links:

• Levo website: https://www.hellolevo.com/
• Jason Yu on LinkedIn: linkedin.com/in/jasonhxyu
• Contact information for Jason: [email protected]

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?si=fc219a6e1a504861
• YouTube: ⁠www.youtube.com/@lastvisitfirstpodcast
• Website: ⁠https://www.lastvisitfirst.com⁠
• LinkedIn: ⁠linkedin.com/company/last-visit-first

Show Notes and Resources:

• JAMA article referenced on Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815745
• Joe Rogan and Guy Fieri hospice segment: https://youtu.be/NzBNVGNY_FA?si=JDjfwf39zyKzOCaU

About 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 Operations
• Host: Tom Maxwell
• Producer: Cole Sorensen

Be 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/id1830051182⁠

• Spotify: ⁠⁠https://open.spotify.com/show/3iSKGRvHC9Bk3iq7l8UPxs?si=fc219a6e1a504861⁠
• YouTube: ⁠⁠www.youtube.com/@lastvisitfirstpodcast⁠
• Website: ⁠⁠https://www.lastvisitfirst.com⁠ ⁠
• LinkedIn:⁠ ⁠linkedin.com/company/last-visit-first⁠

Mentioned 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/1612006965
• AccentCare: https://www.accentcare.com/

Contact the Last Visit First Team:

• Producer: [email protected]
• Host: [email protected]

Chapters:

• 00:00 – HCHB Premier Sponsor Ad Read

• 00:48 – Welcome and intro

• 01:30 – How Tom and Tracy first met

• 02:48 – Tracy’s start in nursing and home health

• 06:05 – Joining AccentCare

• 08:45 – Rate cuts and rural impact

• 12:21 – The patient who inspired her

• 16:07 – WWII veteran story and book mention

• 18:36 – Building strong teams and leaders

• 22:29 – AI and the clinician’s role

• 25:38 – Telehealth and access to care

• 28:03 – Driving quality at the bedside

• 31:29 – Rural length-of-stay challenges

• 32:38 – The future of care at home

• 35:02 – Transitions and hospice coordination

• 38:28 – ESRD and hospice eligibility

• 39:57 – Behavioral health and homebound rules

• 43:28 – Waivers, policy, and workforce outlook

• 46:58 – Tracy’s legacy

• 49:27 – Staying connected to the field

• 50:00 – Closing

• 50:54 – 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 innovation

People of the Episode:

Contact the Last Visit First Team

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 Sorensen

Sponsors 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-first

Make 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]

-[email protected]

Outline:

(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 Anthony
Host: Tom Maxwell
Producer: Cole Sorensen

Sponsors:
Maxwell TEC
Steno Health
Levo

Companies Founded by April Anthony:
VitalCaring
Homecare Homebase
Encompass Health

Listen & Follow Last Visit First:
Apple Podcasts
Spotify
YouTube
Website
LinkedIn

Reference:
Medicare Advantage Article

Contact:
[email protected]

Keywords:
home health leadership, homecare homebase, April Anthony, VitalCaring, hospice innovation, care at home future, healthcare technology, Medicare Advantage, clinician retention, healthcare culture

Outline:
00:00 – Sponsor Ad Reads
02:16 – Introduction and April’s Career Overview
03:48 – How Tom and April First Met
04:18 – April’s Start in Home Health
08:21 – Buying Her First Agency at 25
10:36 – Learning the Business Through Ride-Alongs
13:45 – Philosophy: Take Care of Employees First
15:55 – Founding Homecare Homebase
20:49 – Growth of HCHB (2001–2007)
27:32 – Patient Story: Owen Perry
39:27 – Technology and AI in Home Health
50:00 – The Rise of Medicare Advantage
57:27 – April’s Legacy and Motivation
01:05:15 – 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 Sorensen

Learn 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-first

Contact the Last Visit First Team:

[email protected]

Keywords:

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 podcasts

Outline:

00:00 Introduction and Background of David Curtis

04:52 Career Journey and Home Health Agency Growth

09:56 Leadership and Employee Retention Strategies

15:51 The Role of Technology and AI in Home Health

22:07 Patient Advocacy and Caregiver Challenges

27:16 Future of Home Health and Hospice Care

31:29 Future of Post-Acute Care Payment Models

31:55 Collaboration in Home Health and Joint Ventures

32:52 Understanding Hospital at Home vs. SNF at Home

35:11 The Rise of Medicare Advantage in Home Health

36:39 Patient Preferences and Cost-Effectiveness of Home Health

37:42 The Value of Hospice Care

40:29 Recruitment and Retention Strategies in Home Health

44:06 Adapting to Industry Changes and Growth

48:31 Legacy and Impact in Home Health and Hospice

59:00 Thanks for listening!