Red Oak Hospice with Tara Pietrowitz

Thomas Ritter (00:03.086)
Overall, when I say to families, here I'm here to talk to you about hospice, they say, no, no, no, no, I don't want that. And I usually start by saying, okay, what do you think that you need? What are you most concerned about in the coming months of this disease progression? And they say, I really need a nurse to help me out with medications. I'm not sure, they're constantly changing. Someone to come and help me get him dressed and showered in the morning needs too much for me.

anymore. I can't do it. You know, we're struggling to pay for medications and those incontinence products are so very expensive. And they go on and on and on. And I say to them, you just asked me for hospice. No, no, I told you I don't want that. No, you don't want the word. Just like the unemployed guy doesn't want the stigma of that guy sitting on the couch collecting unemployment, right?

But you want the benefit, you just asked me for it. So it's nurses, social workers, counselors, chaplains, home health aides, medical equipment, medical supplies, medications. We're providing all of that for that family who's struggling to pay. How can I afford his medicine and his supplies and his food? Well, you don't have to worry about the food anymore. You can pay for that.

Easily because we have all of the medications, all of the equipment and all the supplies covered under your Medicare Hospice Benefit, which by the way is a 100 % covered benefit.

Intro:

This is a conversation with Tara Petrowicz of Red Oak Hospice in Bridgeton, New Jersey. We were discussing ways Red Oak Hospice can leverage the beacon for announcements, promotions, marketing, events.

that type of thing, but we also talk a bit about artificial intelligence tools, to which there will be a link in the episode text. And we spent a good bit of time discussing Red Oak and hospice services itself, which a lot of people don't understand, but it's a great way to ensure the comfort and dignity of a loved one at the end of their life. So here's a conversation with Tara Petrowicz with Red Oak hospice.

Thomas Ritter (02:26.894)
I'm going to record it because if we come up with anything good 10 minutes after the conversation, I can give him a list of action items. Yeah, that's awesome. It's unbelievable. It is in terms of like artificial intelligence. I'm using probably around a dozen artificial intelligence tools, not counting chat GPT. And the one that's affected my business the most is just that clerical aspect of this particular software because

If I'm pitching somebody, they get a full low-down 10 minutes later. Or if I'm having a meeting with Meg Horner, who's the Bridgeton Beacon....founder and we're talking about well we need to set this up and we need to set this up for fundraising 10 minutes after the call I've got the whole damn outline.

Oh if I can recommend one thing .. Riverside is like I think there's a free version where you could you where that you get a couple hours a month and so just as like a sneaky managerial tool. Oh

Those those and then I dropped those summaries into a Dropbox folder or a Google Drive folder, which makes them searchable by keyword or by participant or topic. It's it's yes. It's like building your own sort of knowledge base. But that's amazing. And then you need to go to class with this and then they'll have a full outline and all the notes and all of the you know, the oh my God, you're right.

Right. Oh my god, you're right. That's brilliant. Yeah, it's in I've been running around telling other like nonprofits I'm like start recording your virtual board meetings with this and you'll have the best like Secretary in the world for those meetings It costs a whole lot less than a salary of a second. Oh my yeah And I think even the paid version is only like $19 or $29 a month. I get that value out of one hour long conversation

Thomas Ritter (04:36.654)
No, that would cost me so much more than that to have somebody break down an hour long conversation. What am I talking about? Yeah, it's neat. Essentially, that's what my career is right now, is an arbitrage where I just happen to know all these tools and some of them are for video production, some of them are like that for creating content, text, summaries, just valuable information.

But just knowing if you know 15 tools, then you've got something to sell a nonprofit or you've got something to sell a law firm or whatever. And so that's kind of what I do is just find neat things like that and figure out, you know, that would easily be for someone. Maybe that's all they need for their social posts for the next month. Right. Just to pull stuff out of that text and throw it into, you know, a cool image post on LinkedIn or Twitter or something. That's really smart because I struggle with that.

because I'm in charge of the social media and I'm supposed to post every day. I don't, probably three or four times a week I would say I post. Nobody posts every day who's not being paid to be an influencer or something like that. Forget it. And we have maybe eight followers. The only people who follow us are our employees. They know what we're doing.

But I do struggle with that. And that's a super great idea is you write little snippets, little quotes that, you know, then I'm a very visual person. So if it is something that could then be like, this is the itinerary of your meeting or the agenda of your meeting, then I could pull them out that way. But I think you just make a quote and then add that quote.

Sure, but even for your employees, it would then also allow you guys to have sort of a structured either section on your website or again, a folder in Dropbox where you're like, hey, the weekly meeting folder, you know, the March 3rd meeting, the March 10th meeting. Yeah, yeah. And if you dropped it in there, I mean, I'll put it to you this way. Nobody'd ever be able to tell you, oh, I didn't know about that. That's so, I love that.

Thomas Ritter (06:53.326)
But it could also drive like a lot of big organizations are very concerned with internal communications and so things like podcasting or blogging or all any of those things they do them like just for their sales team or just for their service people or just for the people who make contact with the outside world by phone that kind of thing they'll run an internal podcast where weekly you know, they're having conversations and it's

That kind of stuff works. So I think it's even if the only people who are following your social or are or a particular social, like maybe it's your Twitter is all employees following you. Well, how may use that for the employee communications board then? And I wouldn't worry about posting everywhere all the time. It's like find one of them that starts to matter and then really dig into that one. And then you might get a recipe for.

you know, Twitter and LinkedIn based on that. But it's like just posting everywhere, just to post everywhere doesn't really. It's almost less impressive when I go to a business LinkedIn page that posts every day and nobody gives a s***. Yeah, yeah. And I try to make it be meaningful, which is why I don't post every day, because sometimes it's like, what am I, what am I posting about? Um, cause I want it to be, to be more meaningful.

So yeah, those are all really good points. Now we only do Facebook currently. I'm thinking that we need to do Instagram as well, but we don't have Twitter or LinkedIn. I mean, we're such a small program and the goal isn't ever for us to be enormous. We're not like Beata or Atlantic Care that we're looking to be in, you know, several states. I would say we're probably in as many counties as we can get to.

as they're willing to grow to. Now, of course, we've had all this change in leadership and management and all that good stuff, but I still don't think that the owners themselves are looking for us to be a multi -state anything. No, fair. And I wouldn't say, it's so niche, like, I would think the opportunity would be like, frankly, and this is a huge leap from.

Thomas Ritter (09:15.438)
Don't worry about posting everywhere to what I'm about to say is, but like, I think the opportunity for red oak using media or using digital, whatever, call podcasting, call it YouTube, call it Instagram, whatever would be if you were to establish some sort of vein of value where, and it's not going to be, you know,

Oh, everybody needs a Cyrus now. Like that's you're not a car wash. But if it were something that perhaps in line with there's a real conversation out there and there's a real hole in our cultural perception of the shift in caregiver roles. And I'm not an expert you are but

Like just from producing podcasts, I have a lawyer podcast where it regularly comes up that the caregiver role, she has shifted the caregiver role with her mother, her guests, half the guests she mentions that to then have the same store. And every single one of these people is always like, I had no idea that when it happens, it happens like that. And it's, and so that's sort of like prep.

conversation. And I've also I'm working with a company in California that does in home senior care. And there's such demand and her ask of me is basically like, we need to start something that gets out there earlier to people who are about to get smacked with this education about the shift and caregiver roles, because apparently there's just a vacuum for

And maybe there's information about there. And I've seen that information presented. And there's people who give speeches. But nobody's making a huge dent because every time I turn around on this other lawyer podcast, she's telling somebody she's now taking care of her mom. And they're all like, oh my God, me too. It's crazy. Oh, absolutely. It is crazy. And for me, a conversation that I have a lot with people is, you know, you finally get to the point where you get your children raised.

Thomas Ritter (11:39.692)
and they're independent enough to do their own thing. You don't have to worry about cooking dinner and driving them here, there and everywhere. And no sooner do you get them to that point than your parents begin to fail. And then you do, you shift that caregiver role from parenting to your children to essentially navigating your parents through their golden, supposedly golden years. So that's just one idea, by the way. Like that, but if,

I like that idea. If there was so. And where I'm going with that is Red Oak has a position of authority in a conversation like that to some extent. If you if you don't ever want to sit down on a Monday morning and be like, what am I going to post this week? We could literally I could get you probably scheduled as a guest.

Or if it's not you, if there's somebody in your organization that you love to put out as a speaker, like I don't want to make any assumptions, but if it's, yeah, I had a feeling, um, would be, um, to get on maybe that podcast in California. And then I give you a bunch of clips and then for the next. How, I don't know if you spoke to this woman for an hour or an hour and a half, that's going to be 20 or 30 clips or something like that.

And I would absolutely love to have that conversation. Is she an elder care attorney? No, she's a, she owns a home senior, but, um, but one of the other people I'm talking to and having the exact same conversation I'm having with you is, Hey, you're an elder care attorney and I'm working with this podcast in California. That's talking that really should be pushing information out.

sort of pre -sale, sort of like pre -college admission to the education you're about to get on. Yeah, yeah. And this is your official prerequisite. Yeah, kind of like it should be, you should, like the government should send it out with your freaking voter registration. It should be like, oh, by the way, your parents are about to get really old. You better be ready. You know, and we plan, right? We plan, we plan, we plan, we plan for college. We plan to.

Thomas Ritter (14:03.052)
get married, we plan to have children, we plan for our children to go to college, we plan for our retirement, and then we stop planning. But we all know what's next, right? But it's like the big pink elephant in the room that nobody wants to approach that topic. But when you think about how you shop for your internet service and your car insurance and your cell phone service, right? We compare and we this, that and the other thing.

But then we're in the heat of crisis in the hospital. We've just gotten terrible news and we say, okay, whoever you send us home, whatever, it's fine. Whatever? No, like, oh my gosh, this is the most intimate experience that you're going to have with a medical team. So whoever isn't an option. Yeah, and so in real quick,

Just for the sake of the fact that the conversation is recorded, let's take one step back and sort of give, because a huge percentage of the people we're talking about, hospice is like one piece of the pie that we're discussing, which is like these people should probably have a legal plan. They should probably have a health plan. They should probably have a death plan. And those are all different ingredients in different prospective relationships. So.

elaborate a bit or introduce the hospice piece of the pie to those who might be uninitiated. To the luckily uninitiated, I should say. Right. So it's a benefit if we break it down to its most basic.

part is it's a benefit, just like unemployment is a benefit, just like veterans have benefits, just like we have a disability benefit. And certainly we wouldn't lose our job and not seek the unemployment benefit. We'd be like, oh crap, I lost my job. I need to get unemployment because this is the benefit that's available for me at that unexpected, unplanned time. It's there for me. Same thing. You become disabled. You get in a terrible car accident.

Thomas Ritter (16:14.86)
Of course, you're going to seek that disability benefit, but we're not seeking our end of life benefit or our advanced illness benefit because end of life is a chapter, not a page. So I feel that if we are...

If we're bringing it down to that most basic level, it's a benefit and we're entitled to it. If you look at your paycheck, every paycheck we ever get, Medicare takes money out of it, right? So from 16 years old, we have been paying for this program for people who want to say, oh, you're cheating the system. But are you cheating the system? Oh, they were on hospice for eight months. That's ridiculous. Why is that ridiculous? Why is that the least bit ridiculous?

That's also when people understand what hospice is. The sentence, somebody was on hospice for eight months and that's ridiculous, is borderline grotesque and I think I'm being generous. But I still, for those who don't know, what are we talking about? What is the service itself? Because I think that's a lot of people are going to be like, wait, that exists? I had no idea that exists. And it's...

Overall, when I say to families, you know, here I'm here to talk to you about hospice, they say, no, no, no, no, I don't want that. And I usually start by saying, OK, what do you think that you need? What are you most concerned about in the coming months of this disease progression? And they say, I really need a nurse to help me out with medications. I'm not sure. They're constantly changing. Someone to come and help me get him dressed and showered in the morning is too much for me.

anymore. I can't do it. You know, we're struggling to pay for medications and those incontinence products are so very expensive and they go on and on and on and I say to them, you just asked me for hospice. No, no, I told you I don't want that. No, you don't want the word. Just like the unemployed guy doesn't want the stigma of that guy sitting on the couch collecting unemployment, right?

Thomas Ritter (18:29.612)
But you want the benefit. You just asked me for it. So it's nurses, social workers, counselors, chaplains, home health aides, medical equipment, medical supplies, medications. We're providing all of that for that family who's struggling to pay. How can I afford his medicine and his supplies and his food? Well, you don't have to worry about the food anymore. You can pay for that.

Easily because we have all of the medications, all of the equipment and all the supplies covered under your Medicare hospice benefit, which by the way is a 100 % covered benefit. It is the only benefit in the Medicare spectrum that is at a 100 % rate. The majority of Medicare benefits are 80 -20. So, so many times people are taking less benefit than they're entitled to because they don't know.

because they're scared to death of the word or because someone has them believing that hospice is a brink of death service rather than an end of life service. And there is a tremendous difference. As I said, it's a chapter, it's not a page. But all of that, did I answer that question with regard to the attributes? Because I'm about to soapbox about something else now. No, you're on a roll. This is absolutely valuable.

So I hope I don't lose my train of thought because I'm really good at that. If you look at the word hospice, the Latin root of the word hospice is hospa, from which we derived hospitality and we derived hospitable and even a hostel, a place for weary people, travelers to rest. End of life is a journey.

And that weary place for travelers to rest is hospice. That place for caregivers to get a little break so that they can be family members. Stop worrying about changing sheets and changing diapers and picking out medicine and how are you going to pay for this and pay for that. And get out your photo albums, cuddle up next to them and read a book. You know, put on music.

Thomas Ritter (20:53.132)
Do something that enriches the psychological aspect of the dying process and stop doing things, right? They're tasks and you feel you need to do them. But hospice does all of that so that you can then be the spouse or you can then be the child and have more time really doing.

what you need to do because when they're gone, we're the ones who live with the, did I get it all in? You know? Yeah, it's, yeah, that's a, and that's a great selling point to the sort of loved one caretakers.

But you're it's it's what if you just renamed it like, you know, family resources and right, you know, in home support, it would be like, oh, my God, that's exactly what I was looking for. But but if they think that hospice is well, that's just for people who are right on the on death's door. Right. That's for just people who are like on full. That means I'm going to die. That's what I hear all the time. Hospice means I'm going to die. And I usually respond by.

Can I get a show of hands of who is not gonna die in this room when I do it? And they all look at me and I'm like, hospice doesn't mean that you're gonna die, you're mortal. That's what means you're gonna die, right? Hospice means that you have the opportunity to do that with dignity, with assistance, with comfort, with all of those crazy freaking things are now managed. So the, I call what you just said, the Grim Reaper effect.

Right. Somebody says hospice. I'm going down. Right. This is the end. We in hospice prefer Angel of Death. That's a little joke. Preferred over Grim Reaper. But there's a reason for all of that. And it goes back to the very beginning of the hospice benefit in this country, which, by the way, is still quite young. It was introduced in the late 70s and didn't become a Medicare benefit until the 80s. So we're talking about a very young benefit in terms of

Thomas Ritter (23:09.772)
these types of social benefits. So when this first became a benefit, it was a six month benefit and it was only six months. So if you lived six months and three days, at the six month part, your nurses, I'm sorry, you're discharged and out went your bed and out went your oxygen and whatever pain medicine you had left. Well, good luck. I hope it lasts you because you exhausted your Medicare hospice benefit.

So that resulted in doctors waiting and waiting and waiting until they knew their patient would not outlive that benefit, which then resulted in the Grim Reaper effect. You think? Yeah, OK. Well, this all makes sense. And it takes a generation or two for something like that to sort of rinse off. Yes. So.

So statistics in the early 90s when I started in hospice, mid 90s, basically were that only about 30%. Now that's even high. I want to say, I don't know the percentage, but a very, very low percent of eligible people were ever getting the hospice benefit. And it is the most comprehensive benefit that Medicare offers. So Medicare's taken a look at this going, this doesn't make any sense.

And the reason that Medicare likes hospice and the reason that hospice became a Medicare benefit after lots of education and legislation and, you know, tons of meetings with Congress is that it saves Medicare money. So that's when Medicare was like, wait a second, what, what? Because for a while they're like, ah, death has nothing to do with the government. Well, that has nothing to do with us. But it does.

Because if we can educate the population to help them understand the point at which this isn't getting better, okay? We could last longer with all of this medical treatment, but we are not living longer. But take into point that in the 80s, when the Medicare Hospice Benefit was kind of blossoming, it was the same time that technology was exploding.

Thomas Ritter (25:26.956)
in what they call the cult of cure. So now we're fighting against doctors who were like, yeah, but we could do this and yeah, but we could do that. But the hospice movement was saying, but should we? Okay, we can, but should we? So for example, and this was an experience that I had very, very new into the medical field. A woman who had cancer all over her body,

and she was having some cognitive issues and the family wanted her to have a CAT scan of her brain to see if the cancer had spread to her brain. Listen folks, it's everywhere else and now she's having some cognition issues. We can believe that it has spread. Why are we putting her in medical transport and putting her in a CAT scan machine? And you know, how is that going to change the care plan at this point, right?

So what happened with this woman is that she died in the CAT scan machine. I was very young and it was very impressionable for me. So the whole idea of the movement was to say, stop, there's no dignity in being a pin cushion. These people are dying in hospital rooms with beeping monitors and sterile.

linens and strangers all around them with visiting hours from, you know, no, no. So it was really a struggle. But so then Medicare started listening because this cult of cure was costing Medicare an awful lot of money, right? Because we're testing this and testing that. Why are we doing that? Again, it's through 90 % of their body. Yeah, it's probably in the brain too. Yeah, what are we trying to get grandma ready for the next Olympics? That makes no sense.

So a lot of education that I do in the field is living longer versus lasting longer and benefit versus burden of treatment. Okay. If you go to dialysis today and you are wiped out today's done, you're sitting in that chair for eight hours, you're coming home, you feel like hell, you're going to sleep tomorrow morning, you're going to feel like hell, you're going to just start feeling better tomorrow night, maybe have a nice dinner, watch something on TV. Sure enough.

Thomas Ritter (27:48.108)
Wednesday morning, you're going back and you're gonna feel like hell. So what are we doing? Meanwhile, and this is very harsh and I apologize for it, but you're losing your body limb by limb. Because despite your dialysis, this isn't quite working. So I work with people to help them understand you. Sure, you live three more years like that. But if we were to say,

the 10 things that you find most enriching about living. How many of those 10 are you willing to sacrifice that you still feel like you're living, like you're alive, like you're participating in your life?

And then people started saying, oh, there were death panels. That's not a death panel. We're talking about looking deeper into quality of life and dignity. So our loved one or grandmom or grandpa has a cardiac event and boy, they're run down. You know, they're not living well already for them to recover. It's going to be just awful.

here's the option. Not only is it not going to be great, but it's really going to be exacerbated and not great because we're going to have to break all their ribs. Right. It's not like it looks on TV. You're not having a tea four hours. We're going to, we're going to break all of grandmoms ribs to resuscitate her when she has a heart attack. So what you're simply saying is, Hey, now's the time to have a conversation about do we want

to say, wait, wait, wait, do not resuscitate because all you're really doing then is breaking an elderly person's ribs and prolonging their suffering. And that's a real pragmatic approach that most people aren't prepared to take themselves or are nowhere near taking that leap. But that's just a way to illustrate. That's all you're saying is there's a way for you to think about this. And there's points along the path where you thinking more sort of about comfort.

Thomas Ritter (30:02.956)
as opposed to just keeping busy with stuff. Oh, we're still working on this project. Like, I think that's way more for the family than anybody else. Absolutely. Well, and anybody who's collecting a copay and you know, I'm not saying that would be their only motivation. It's really the family who shouldn't be wheeling them in there to begin with. Correct. And, you know, unfortunately, chemotherapy, those doctors make a lot of money off of your hope.

I'm not saying all of them do, but it's just dreadful. It truly is. And what you're saying is families aren't educated enough to be the ones who step in and say, no, now we need to start thinking about comfort and dignity. They're not. They're waiting for the doctors. They're waiting for the doctors to say enough is enough. But the reality is the doctors are waiting for them to say it. The doctors don't want to bring it up. And I see this is...

your primary care doctor is waiting for the specialist to say it. The specialist is like, I'm only looking at the heart. Primary care doctor has the whole body. The families are waiting for the doctors to bring it up. The doctors are waiting for the families to bring it up. And generally what happens is somebody ends up in the hospital and a hospitalist, that's a new specialty, like a cardiologist and a pulmonologist, a hospitalist is the specialist within the hospital for acute advanced chronic illnesses.

They're the ones having this conversation, a complete stranger, which I guess maybe is better. But why wouldn't your family doctor of 20 years be like, Tom, let's really look at what we're doing here. And if the choice is still yours, but I think we need to step back and take a different look at this fight that we're fighting. How much time does hospice or Red Oak, your organization, spend communicating?

with those primary care types in any direct fashion. So it's part of my job to visit these doctors offices, have conversations with the decision makers, inspire them to make, have these conversations sooner. I really believe that, you know, you go, you have your physical.

Thomas Ritter (32:19.02)
and they have to ask you certain questions, silly things like, do you wear your seatbelt, right? Or like they have to ask you those things. Why isn't one of those, do you have an advanced directive in place? Why isn't that? Yeah, yeah, that's what I'm getting at. Like it almost seems to me like you'd have, there's a more likely avenue to reach more people if you did it through.

somebody who's already a partner to these people in the process and got their buy -in and just said, hey, you know what, we know, hey, Mr. Primary Care, you know what you're not very good at? Drawing that uncomfortable line in the sand. What if you had somebody you could sort of dump that on us in the terms of like a package or a pamphlet or a program? And I do, and I offer all the time, if you would like me to speak to your patients, I'd be more than happy to have that conversation. That doesn't mean.

you have to understand that's that's a tough sell for them. That's a very tough sell. That's like a mechanic calling me and saying, hey, I'm not saying I'm not saying anything. I'm just saying I want you to talk to this guy from the junkyard. Oh, right. That's a good analogy. Yeah. Yeah. I'm going to be like, hey, hey, go jump off a bridge. I love my truck. Right. But but it's almost like you need a designated

hitter from somewhere off in Medicare world to make that connection because you guys are still the angel of death walking into that conversation to the uneducated audience on the other side versus it being presented as a benefit like family support thing. It's almost like, yeah, you guys need a salesman from Medicaid or somewhere.

the insurance companies for that matter. But if, if I may that, that does lead me to some thoughts like long -term, which is any, any type of content in that vein. If, if you were part of a program that was doing that or had interest in initiating that sort of communications, even if you said, well, let's call it a marketing program, but.

Thomas Ritter (34:39.756)
I think that could easily evolve into something that got funding because I think as soon as you start doing an effective job of communicating that sort of what we're calling, um, pre -sale family support stuff, I think there's enough people in the food chain who recognize the benefits that you already brought up. Like, and maybe it's, maybe it's the federal government and.

the health care system. But what I know is this with other people I'm working with, whether it's history, job training, somebody's writing a check if it's a warm and fuzzy, feel good initiative or cause. So if that I guess that's the word I should use. If there's a cause that makes sort of threads together all your media content, if that's

like education of people in this process and all the good things that come out of it for all the stakeholders, even financially. Some of those stakeholders are probably invested in foundations that write grants every quarter. That would truly be amazing. And I can talk about this like all day long. I've gone off on 10 different tangents. I should have set an agenda up for myself so I didn't lose my train of thought as many times as I have, but I really could talk about this all day long.

Um, you know, I go into the doctor's office. I try, I speak with them. I go, I do library presentations. I go to over 55 communities. I will go anywhere. People will listen to me. I will talk to two people or 200 people. I just want people to understand it, to not be so afraid of it. I want to break it down to its most basic level of a benefit. Um, I do.

like to differentiate red oak because we really are a very different breed of hospice. The majority of hospice programs that are out there are really big corporations. They're in several states. They're doing home health. They're doing home provider visits like a visiting doctor like from back in the day, you know. They're doing a lot, but they're doing it.

Thomas Ritter (37:02.38)
in mass quantities. And I've worked for large corporations and it's kind of a social security mill. You lose that personal touch. It's not Mrs. Jones, it's 137, it's what we're billing Medicare for. That's not to say that you won't still get maybe a really good nurse or a really good social worker, of course. But the foundation of a smaller program is just very, very different. It is, you know, when you're,

answering the phone and saying, hey Joe, how's Sarah, instead of press this prompt for this and that prompt for that. So I love Red Oak because it is a smaller program. It really is a more personal, individualized approach. I call it corner store versus corporation. And that I feel like really gets that feeling of how different we are, that corner store approach.

So, you know, we're in Cumberland and Salem counties. We do partner with Autumn Lakes, so we service all of those buildings as well outside of Cumberland and County counties. That's also, so we're Salem, I messed that up, Salem and Cumberland, where we do the whole community. And then in Catena County, we service an Autumn Lake building. And in Camden County, we service three Autumn Lake buildings. But our core is that Cumberland and Salem County, where we treat

everyone everywhere in their home, assisted living, a skilled nursing facility, you know, over 55 buildings. We do, we do all of that. But it's nice to work small potatoes. You get so much more done because in a large corporate structure, about 15 to 20 % of all of the money that comes into each individual branch of that corporate structure goes back to corporate headquarters to cover the VP of this and the VP of that and the blah, blah, blah, all these regional.

leadership positions. But when you work for a small program, all that money stays in the program and you're able to put it back into number one, patient care, and number two, your staff salaries so you're able to keep good nurses, right? You're able to hire good nurses because you get what you pay for and you really, you know, you don't just hire anybody to go out and do hospice. This is big deal. The people are dying, you know, you,

Thomas Ritter (39:26.476)
It's not the high school student nurse. This is better be the right nurse. And sadly, I saw in the corporate structure that they would hire warm bodies that checked the box. Okay, you have all the credentials, but are you a hospice nurse? Come on. That's a different thing. You're at the point, and I know Red Oak nurses and.

It's a part of the community to the point where you get requested often because somebody took care of your aunt and they call in, they think that person was great and they comfortable with them in their house and so obviously they want them. It's very...

genuinely relationship based and community based. And, you know, like you said about the corner store, the general store, it's like, you know, you don't walk into shop, right? Bump into the owner and chat about the weather so much, but that's like more of a general store thing. And the people who've worked with local.

red o 'cospis, no red o 'cospis, no, the people bump into them out and about bump into them at the Amish market. You know, it's, it's word of mouth for sure. I see that because I hear stories like, Oh, I'm, you know, I'm, I have this case now and I had his mother and their mother. In fact, one of our team members.

We took care of their family member years ago and now she's one of our chaplains. So yeah, it's very much, we get volunteers that way that, you know, six months or a year when they feel ready, you know, cause it takes some time. So yeah, I really do. I would struggle to work in a corporate arena structure of hospice ever again. I really would. Number one, I don't think I would do well in any corporate arena. I'm at spreadsheets.

Thomas Ritter (41:37.58)
conversations, you know, so it's special. Red Oak really is special. I think there's a real potential plan for you guys to get funded. And so you could, at the bare minimum, underwrite continued production in that vein, which is it would fit right into your business and your lifestyle. And it's not about growing Red Oak to 10 ,000 clients. Like that's not the model. The model is,

Like just to make it, pardon the pun, a beacon supporting that messaging. Absolutely. And to me, from a production standpoint, I can totally make the argument because as long as there's potential funding out there as the production guy, I'm like, well, that makes it viable. But I truly think there's, I haven't done any research. I guarantee there's foundations. I don't know that you couldn't get into.

to underwrite something like this. Shh. Shh. Or whoever. Just, just. It's tricky because they're partnered with.

It's like a big. Well, if if they don't want to support local nonprofits in the Cumberland County region, I'd say, hey, that's on it. You know, if they don't want to work with the Bridgestone Beacon, you know. No, but I agree. I would love to do panels. I belong to a group. I'm really like senior care specialty group or we've changed our name five times, but there is an elder care attorney. There's a home physical occupational and speech therapy group.

myself with Hospice and Palliative Care. There's a representative from Subacute Rehab and Long -Term Care and then also from Assisted Living. So we try and get to over 55 communities. We'll do little mini health and wellness fairs. We will present each of us five, 10 minutes on, you know, cliff notes on what we do. And then we have tables. In fact, I'm trying to set one up at Four Seasons. Your mom's helping me.

Thomas Ritter (43:43.756)
And then we have refreshments to entice people to come. We have our door prize to entice people to come. And then after we each do our 10 minute Cliff Notes on our individual section of that spectrum of services, that allows people to come to us, oh, I want to hear more about this. I want to hear more about that. We have tables set up and we can do individual, you know, mini consultations or just conversations with people. So.

You know, that you're absolutely right that chances are if you need one service, you need the other services for sure. Definitely the elder care attorney, the in -home care, home healthy to come and, you know, beyond that hour and a half hours so that the hospice provides. That's not enough all the time. So we need a partner agency that we can get them additional services through. So that is definitely important. It's like a network, just like any network. You know, your builders work with electricians and plumbers and, you know,

But and we work with nurses and physical therapists, so we all have our own different networks But that we have like this preferred provider group because we found them to be you know The the most cohesive to work with the most patient centered so I belong to one of those groups Which is nice and I'll bet every single one of those professionals can speak to The loved ones and say

these are all the different things you need to be planning for, like the different parts of the pie. That group that you're sort of within, that actually addresses that whole sort of educational curriculum for the loved ones saying, hey, this is coming, this is coming. You know, if you don't want to be at your sibling's throats for the rest of your lives, why don't you all sit down with an elder care lawyer real quick? Absolutely, such a good point. Yep. And so again, you've got at your fingertips,

every resource you would need to put together a version of, like I said, that podcast. Like if you had all those people offer their two cents on, here's what you need to not get bamboozled when that responsibility shift happens. Yeah, it's who within that group has the highest profit margin on intake? They should be the ones who.

Thomas Ritter (46:02.316)
who pony up a little bit, we set a little project. You guys do a little curriculum one time through the beacon, which makes the whole thing a charitable contribution, because you're doing good things for the community. But I think that's sellable to get you guys funding. And what would something like that look like for us to, you know, and you feel that once we have that established, we would sell with that? Well, I don't know anything about funding. Well, I think as long as you had a demonstrated track record to some extent of pushing that message,

that Medicaid sees value in. If they see value in it, there's other people in the food chain that see value in it. There might even be local versions of those people in the food chain. For example, physical therapy is one of them. I think that might be one. I don't know how they fit in to the payables, but that might be the kind of thing where it's a great...

lead gen for them in a lot of ways. Like, because if they're being introduced to a family, not just a patient, they're being introduced to a family. Well, gee, I don't know. Does their brochure in a tasteful way reflect the fact that everybody in the family can take advantage of their services? Like, there's opportunities in here if you guys are presented as like the resource. And what I'm saying is I think the funding opportunities arise either

someone in your group might know exactly who to call who would support this message in terms of an association or a foundation in New Jersey who'd be like, yes, that's what we're trying to get people to know. You guys are going to do YouTube videos? Hell yeah, we'll pay for that. And I don't know that it wouldn't be a great tool if you had a series of videos or call it a limited run podcast or something like that. That was all that education. Maybe you actually design it as a thing.

that should be shared by doctors in primary care. Like, so maybe the whole gist behind it is that we're not talking just to the family members. We've crafted this so that it's very easy for a primary care to forward it and say, hey, I sign off on this. Like, you should be thinking about this, but do their homework for them because a primary care can probably then...

Thomas Ritter (48:19.532)
put that out in their email newsletter and say, Hey, are you, do you have a parent who's over 65? Here's a checklist, you know, that type of thing. Or click this link to, you know, get additional information and then it could be links to different videos. Have you ever heard of Tipa Snow? No. Tipa Snow is a dementia care guru. She, I believe, started as an occupational therapist and now she has a whole series on YouTube of

silly little things to help caregivers of people with dementia kind of navigate the challenges of that caregiving role. Boy, I bet that's valuable to people. Holy cow, man, that she'd not explode. I think just starting with what you and I are doing. Like one of her examples, and again, it's not rocket science, but people who are caregiving are so deep in the forest they can't see the trees. But like one of her ideas was if you couldn't get the person to eat,

next time you go to McDonald's or Burger King or wherever, save the little container and then put the food in the container and now it's fun. They're flashing back to their childhood and it might be a peanut butter and jelly in there, but there's something about, oh, that cardboard box and you open and it's just another one. A gentleman could no longer feed himself and the wife was feeling very overwhelmed because while he was feeding himself, she was able to unload the dishwasher and clean the, you know, and do a few things. But now she's,

spoon feeding him and she's burdened by that, they put a mirror in front of him and he was able to, oh, I see where I'm missing. Okay, got it. But he couldn't do that. He needed that. So it's so interesting because so many of the solutions are just not rocket science. But again, and I recently lost my dad and you're trying so hard to do everything right.

and you think that you're doing the best that you can. And then hospice comes in with these simple solutions that you're like, Oh, wow, that's brilliant. You know, like for example, helping to my dad to move. They said fold the sheet up and put it under him. And rather than grabbing them under the shoulders and moving them here, there, everybody takes four corners. You lift, you move and so much more comfortable for them. We're not retching our back. It's, it's so wonderful to have those tidbits. So I feel like,

Thomas Ritter (50:50.316)
Like I could really put some thought into this and come up with several different topics that we've brushed on this morning that could be full of like, how long is a podcast or how long is a? I think it's how long is a conversation. I mean, the five most popular podcasts in the world all over average over an hour and the podcasts that are my favorite all average over two hours. I listened to two and a half, three hour interviews.

regularly, because if you think about it, it's just, I'm listening to people who are experts in a niche, like you can't work through real information in, you know, a 30 minute TV show, which is really 22 minutes or an hour TV show, which is really only 40 minutes. It's like, and interrupted. I say the conversation is over when the conversation is over and some podcasts are.

28 minutes and some podcasts are two hours and 28 minutes and it's funny how many. I think I'm trying to figure out like, would I come up with five 30 minute snippets? No. Let's start with the history of hospice. You're talking about that. Okay. I think it's a mistake to plan anything. Like whoever said, well, I'm going to have a 30 minute anything that was like, you got to be a genius to say, I'm going to make something 30 minutes long. And that's how the Blake.

just make the thing and maybe it's 30 minutes long. But I don't. You don't put right like you don't put parameters on the on the music. You let them. Yeah, we don't. Yeah, you don't work for Fox or ABC. Like do whatever the heck you need to do to do the thing. Like it's the thing that matters. And if the thing is a certain message, I wouldn't think you get two episodes in a row that are the same length unless you're talking about the same exact thing in the same exact way. It's like.

Why would you set some weird line in the sand and say, you know what, I'm just going to stop giving these people information after 30 minutes. That's the weirdest fricking, you know, that's just like, that's the value of doing what we're doing is when you get to do exactly what you want. But what I recommend people never do is much planning or prep. I recommend if you do a podcast, you always do it with somebody because talking about what you do.

Thomas Ritter (53:14.732)
is always less impactful than talking to someone about what you do. Oh, absolutely. And you don't need to plan. Like, for example, if you were talking to an elder care attorney for an hour and a half, well, what do you think we'd have at the end of that hour and a half? We'd have exactly what people don't know. Might not be everything, might not be perfect. We have a bunch of stuff you cared about discussing. And so people who are talking about what they want to talk about, talk about it with passion. And it's much more interesting to listen to.

And if you miss something, that's just an excuse to invite the elder care attorney back next quarter for another conversation. Because guess what? You're never going to cover it all. But it's like, what's the easiest way you record an hour and a half with an elder care attorney? You've got social posts for a hundred days and you've got, you know, not only that, but it's like a sales and marketing tool.

Maybe there's organizations that you feel like should be in your world or that there's not other nonprofits that they just, they'd be great chocolate to your peanut butter. Invite the CEO of that nonprofit on if only to get an hour and a half of their time. Because if you call them up on a Tuesday and say, Hey, I think your nonprofit would help my nonprofit. Or I think your foundation would help my red oak. They're going to be like, well, I don't have time for that.

If you call them up and say, you guys are so cool. I want to have you on my podcast. Clear at least an hour and a half. All of a sudden you're, it's the softest selling tool ever to develop relationships. So I love all of this, but it's, it's very new to me. So I would definitely. So are you suggesting that red Oaks start a chain of podcasts to which I invite.

said elder care attorney and said geriatric care manager and blah, blah, blah, blah. I invite all of those different pieces of the puzzle and have discussions with them. And if that's, yeah, I would, I would pitch that because you, well, you're saying just to put in your marketing chair exclusively having nothing to do with the beacon or anything, but just like, you know, coffee shop talk here, I find out you're in marketing.

Thomas Ritter (55:35.724)
That's going to be my pitch to you nine out of 10 times. And especially if those people, if they have access to the audience you need to talk to, or the families that will be your clients in the next decade, then they're perfect partners to start that sort of dissemination. Like maybe you partner with, um, maybe it's not the people who are in your circle, like the elder care attorney, maybe you just bring on primary care physicians and that's your podcast.

But that would be a tool. And maybe you design a conversation with a primary care physician and say, Hey, you come in, talk to us and it'll be something you can share with your patients. Like the whole point of your podcast then is to serve the audience of the doctors you invite in. So every week, every month, whatever, you're really doing a podcast to send out to the newsletter or the email list of a primary care physician's office. And that's the beginnings of this.

initiative where you're doing the education you talked about, but it's also fantastic marketing that kills a ton of birds with one stone from a workflow perspective. You would have clips till the cows come home that are all titled with subject niche keywords that are really powerful for you. You'd be developing relationships with these doctors. So this is a straight up marketing sales and marketing referral networking.

slash customer education thing is if you're doing it. Like, yeah, I think if I was just pitching you marketing services, because I met you at a conference, yeah, I'd say a hospice. What here's what I do, I'd start a podcast, I'd invite a bunch of knowing what I know now that those would be the various pitches. But I also think, you know, you can also just sort of dip your toe in any time you have something to announce.

just shoot me an email and say, Hey, let's record some stuff for the beacon. I'll say yes. And you'll get a couple of clips, but it's, um, if you, if, if you really had an interest in sort of planning a flag as the, and changing your, your Google forever, like in terms of when people are searching the subject, you know, maybe heck, maybe you get a call when the, the,

Thomas Ritter (58:01.324)
New Jersey State Senate is having hearings about stuff because one of their, you know, clerks said, we got to find experts on this. If you've recorded 18 podcasts on this topic and it's New Jersey centric, you're the one they're going to find. Cause I don't know how many other people, but that's it. And I know this is all foreign. It's like, usually people are saying, Oh, let's do marketing and get somebody to sign up.

I'm like, no, let's do marketing to get the government to write you checks to keep doing marketing or let's do marketing to establish relationships with foundations or with doctors or whatever. But yeah, you can get it. It's wild. They're all different models than I thought they would be four years ago when I started helping people start podcasts. The models that have evolved are very non -traditional and are the most effective ones because you don't.

You could have a podcast with an audience of 75 doctors that could change your business. If you have a podcast with a audience of a hundred thousand of the general public, that's almost meaningless, but it's like 75 doctors in New Jersey, in South Jersey. All of a sudden that would become something you could get sponsorship for easier than if you had 75 ,000 Joe Schmoes. Like I could go to somebody who sells something.

They sell fricking office management software or something and say, I've got 75 doctors in South Jersey. And we talk to them every every week or every two weeks. That is worth a lot of money to somebody, which is counterintuitive. I'm literally talking about 75 doctors in South Jersey. But how do I get the doctors to participate in the podcast?

I'll tell you what, if you throw a rock, you're going to hit a doctor who thinks they're smart and should have a mic in front of them. Okay. That's a good question. It's not a hard sell to call somebody up and say, you're so smart. I want to talk to you and we should share it with your patients. We should share it with your audience. We think you're an important part of this message. We're sure you understand it and we'd like to, it's uncomfortable.

Thomas Ritter (01:00:19.212)
for you to go through a lifetime of, I'm gonna keep your family alive and then you're the person who draws the line and is saying, let us be like a function of that for you. And I think that's the relationship you can put. And again, I don't know anything. We're only one called deep. So take any suggestion I'm making with a grain of salt, but they're as human as anybody. So if you're calling them up, say, hey, we have a little.

Program we want to be the people who you dump that on like when it's it's that draw the line in the sand comfort versus Just feeling like you're doing stuff as a family member to keep mom alive like which ain't helping mom at all. So and at that rate, you know you can I think if you made 20 calls to doctors offices I'd be shocked if you didn't get a dozen yeses and to be honest with you. I think you'd probably get 18

All right. And I'm already, I'm thinking about doctors right now. So how does it work then? Like do people, are people members of the beacon? Um, is it all online or is it at all associated to the newspaper? Talk to me more about the beacon and how people access it and how you promote what you're doing. Oh, the beacon, the beacon is all online and it takes like the beacon could mean.

a spin -off. Like there, you could do your own thing through the beacon. It doesn't have to be on the beacon. The beacon is really a nonprofit media company. It just so happens for people who want to leverage an existing platform. You know, the beacon is on YouTube, Spotify, iTunes, but mostly the traffic is all driven to the website, the bridged and beacon .com.

and its articles, its podcasts, its interviews. And it started mostly as just interviews with the old timers in town.

Thomas Ritter (01:02:25.292)
sort of, you know, they're talking about the good old days. And...

Sort of grew from that to like, you know, businesses, we had a bunch of nurseries come through two years ago. We had a bunch of wineries come through a couple of years ago. And then it got converted into a nonprofit. And as a nonprofit, it's very young. So this whole concept of sort of just offering it up as a soapbox and megaphone to people. This is like our first round of that. And yeah, I mean, we're doing a so.

doing big projects and we do some little projects and it'll be something where people can opt in and do their own like say hey you should you should do a little feature about these guys I'll pay for it here's a donation or it's springtime and I run a farm and garden center so I want a springtime farm and garden center package here's my donation we'll run out there with a damn camera and do a springtime farm and garden package. Okay.

That's what the model looks like, but it is brand new. I think she only turned it into a nonprofit like nine months ago. I think she's, she's got maybe three state grants already, but I, yeah, it's, oh, it's, and, and it's a labor. Uh, you know, I've contributed my time on going. I'm not on the board of the beacon or anything. I'm just a vendor, but I think for somebody like red oak, I think the beacon's a potential partner just because it's so low.

I mean, it just really, really, really a good fit.

Thomas Ritter (01:04:00.748)
And that's really what we want. Like we want to be like your hometown hospice. We want to get people to understand that there are other programs out there for them beyond these giant monster corporations because people might want something a little different or a little more personalized or may have had a bad experience with one of those larger. So.

But if you're going to your main hospitals in that area because of that partnership, that's who they get. But if they say, hey, we'd really like to go home with Red Oak, they'll of course set them up to see Red Oak. But if they're just in crisis, it's here, you're going home with these guys. So if I can get the message, and you said you had some of the old timer, if I can get the message to the community more, I just want the community to know you don't have to,

use whoever they hand you. You have your own voice. You could drive your own healthcare journey. I think the older folks come from that generation of, well, my doctor is God and what he says goes. Why? Why aren't you challenging that? Why aren't you asking why? Right? So yeah, if I could get that Red Oak name more in the community, because again, we're not looking to be in eight, 10 states. We're looking to really take good care.

of a few counties. I think there's going to be some really good clips out of this in terms of you just selling red oak. So what I'll do, I'll give you the option. I can either use the video or you can send me your favorite glamour shot since I didn't warn you properly about the video. You did not. But I'll do it either way because some of this is so good. I should put out clips and if you all either put your your put a glamour shot on the screen with a background like they do on the news, like you're reporting in.

if you want to give me your favorite. So you can do that, but I want to use video. So I'm going to warn you in advance. Some of this is so good. I should, I should definitely put your words out next time. Now you should let me know. Well, just, just know in advance. I don't have a conversation without recording it because people say smart things all the time and I've become addicted to capturing that and sharing it. So I am so excited about this. I'm really excited about this. Um,

Thomas Ritter (01:06:21.996)
Talk to me about what we're looking at in terms of cost for different models, different potentials, just because I do need to share it with the powers that be. I wouldn't even, I don't know. I'd say let's keep talking even first and see, let's, because maybe what even what I do with the footage and audio from this might inform our conversation next time. Okay.

I mean, it's such a foreign concept and it's the hardest. I've never gotten off a first call with somebody where we ended up explaining all this stuff that's available in terms of AI and efficiencies and how media can be leveraged as like sales or marketing or network marketing, or can get funded and underwritten just because you can use the words podcast or YouTube intelligently in a meeting with.

a foundation or a nonprofit. Like that's all it takes to get a check written because they're dying for good media. And so many of them haven't figured it out. It's so good to know because it's definitely an unexplored and yeah, it's weird. And I, my guess would be like, with all the crazy ideas, we'll probably just have more crazy ideas. Like, Hey, this is a conversation worth letting it shake out.

Um, as opposed to assuming that any of the assumptions I made here today are accurate. The last thing I want to do is put a price and sell yourself. I just, no way. Um, because the more we talk about it, somebody's going to walk into your world or into your office or bump into you at a conference. And they're going to be the one who's like dying to write a check for this. Like if you start talking to people in your circle about, we might do a.

podcast, you might be surprised if somebody's ears perk up and say, I have a corporate directive just to get involved in podge. I have no idea what to do. What are you doing? Who are you talking? Like, if just bringing up podcasting in a room with enough people in it.

Thomas Ritter (01:08:31.052)
It'll be worth it. Like just sort of if we talk about this for another 60 days, I bet 60 days we got a really smart idea. I'm so excited about this. I really am. And again, it's not anything. It's not my comfort zone. It's not. I know I really rarely listen to podcasts just because I'm so into music that if I'm driving it's music. But my husband listens to them all the time. My kids listen to them all the time. And.

You know, I need to get more into it because this is definitely the direction that we're going. And you said we just hit so many more people and there's so many more opportunities this way. And I'm like beating the street, right? But this is a more direct, yet more expansive way to do that rather than driving all over three counties, you know. I'm not saying I would stop doing that, but.

Anyway, I'm just super excited about it, but really gonna lean on you for direction and looking forward to learning more and definitely seeing where this can go. Yeah, and because I'm dealing with other people in the space, I think there'll be opportunities that arise that I haven't conceived either. Like I'm just dealing with other people who are having this conversation and I think that might lend itself to something fruitful.

for everybody involved. Yeah, like I said, I'm total layman, but I keep seeing this messaging come up and this void of information and these people who are all surprised. So it seems to me like somebody somewhere is gonna serve that. But yeah, we'll keep chatting. I'll send you a link and I'll shoot you an email after this and I'll put together some artwork and get some clips out for this. But I think that might also give you some ideas. But I'm at your service, Holler any time.

Okay, well, let's do you want to schedule another call? No, I want I want to I want to see what comes of this. Okay, shoot it to you. And then then I'll get the energy up to try and sound smart again. But I really just I want to give this to you give you time to maybe share it with people like I'll give you a whole probably media kit from this call. Oh, wow.

Thomas Ritter (01:10:48.524)
Yeah, so let me focus on like delivering something really good before I even worry about talking about it. All right. That sounds like a great plan.