Payson Hospice To Be Copied Nationwide


RTA Hospice and Palliative Care was purchased three months ago by Cloverleaf Partners, a company based in Nashville, Tenn.

When Bobby Holder and his business partner Jim Deal toured the Payson facility and met with the staff four months ago as part of their due diligence, they saw a hospice with a mission and a community vision for end-of-life care.


Bobby Holder is the new senior vice president and chief operations officer managing RTA Hospice and Palliative Care.

"We plan to keep what is good here and model it in other acquisitions and startups across the country," Holder said.

According to Cloverleaf's mission statement, its number one priority is the staff.

"If staff is management's number one priority, then the result will be great staff, and that quality will be reflected in the care they give their patients," said Holder, who is a physician's assistant by training. "Staff priority is keeping the patients and their families first."

Indeed, nurse-to-patient ratio at the Payson facility is 10 to one versus the national hospice average of 12 to 15 nurses to one patient.

As they focus on startups in rural communities -- four in Arizona so far -- Cloverleaf does not intend the staffing ratio to change.

In fact, locally, Dr. Michael Lowe is still the Executive Medical Director, while Kathleen Hughes -- previously employed as a case manager on the palliative care side -- is now the liaison from hospice to the community.

What will happen as we extend the RTA wave is, "a little bit of Payson hospice will be all over the country," Holder said. "That is something to be proud of."

Among his vision for hospice, Holder plans for new hire training to last one week and be consistent throughout the company.

Plus, every other Thursday some type of training will be offered to people in the community as well as staff, including grief and bereavement and communicating death with children.

After the first of the year, the advanced care directives workshop will probably be offered again.

"Everyone is entitled to hospice care, " he said.

"Three million people died last year and only one million were served by hospice. And what better way to serve people."

A decade ago, hospice was different from any type of health care.

"When Bill Moyers had his special, hospice started getting a lot of positive press," Holder said.

Now, when Holder sits on a plane, and a seatmate asks about his profession, more often than not, the asker has a hospice story of their own to tell.

Like many people who feel called to a hospice either as a professional or a volunteer, Holder's first experience with hospice was when his brother passed away from cancer.

"I was holding him when he passed; he had a perfect death," Bobby said of his brother.

Knowing three to four months in advance gives the patient, family and friends time to say goodbye and gives the social worker and hospice staff time to understand the family dynamics, gives the chaplain time to understand the family's spiritual needs and the nurse time to understand her patient.

"We literally educate the patient on how to die," Holder said.

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