Health/Wellness Administrator/Administration: Holly Chaffee, MSN, BSN, RN

Porchlight’s Leader Has Some Illuminating, Innovative Ideas

Holly Chaffee says her husband has a line — perhaps it falls into the category of ‘joke’ — that he’ll throw out on a fairly regular basis, like almost every night.

“He’ll say ‘OK, who are we having dinner with this evening?’” said Chaffee, president and CEO of Lee-based Porchlight VNA/Homecare, adding that he says this because there’s a decent chance that dinner between the two will include a phone call — or several — from a colleague looking for some direction, advice, or a much-needed answer.

“The phone seems to always ring when you sit down to dinner,” she said with a laugh, adding that she always answers it. “We’re a 24-hour business; there’s always someone on call, and there’s always someone backing up calls. You have to be there for people, because they’re relying on you.”

This sharing of dinner time goes a long way, sort of, toward explaining why Porchlight VNA/Homecare is the only agency of its kind in this region to receive what’s known as 5-star status from for the Centers for Medicare and Medicaid Service (CMS).

It will take much more to explain those high scores, which ultimately determine how an agency is reimbursed, and we’ll do that in a bit.

Those phone calls during the evening meal also help explain why Chaffee was the top scorer in an extremely deep field of contenders for the Healthcare Heroes category called Health/Wellness Administration/Administrator. But again, many more supporting words and numbers are needed, starting with this summation from Kurt Toegel, chair of the board at Porchlight.

“Holly is known as an innovator in the home-care arena,” he wrote. “As an administrator and CEO, she has not only the drive and motivation it takes to be successful, she has the leadership skills to develop the work products necessary to be successful.

“Holly has true heart,” he went on, “and compassion for the work she does. She is collaborative and is always willing to share her knowledge.”

‘Innovative,’ ‘collaborative,’ ‘compassionate,’ ‘motivator’ … these qualities and others become apparent as one looks at the long list of accomplishments accredited to Chaffee and her team since she arrived at what was then known as the Lee Regional VNA andBerkshire Home Care in 2009. These include:

• Changing the existing electronic medical record to improve efficiencies;

• Orchestrating a merger with Chicopee VNA and Great to Be Home Care in 2014;

• Implementing a branding campaign and new company name (Porchlight), as well as oversight and the development of a new website to increase visibility of the service areas;

• Effectively creating a continuum of care (from acute to chronic care) by developing an internal conversion system;

• Designing and implementing a productivity system that increased productivity from 3.25 to 5.75 visits per eight-hour day;

• Operationalizing the accounts-receivable collection;

• Hiring new management-team members with clinical expertise, leading the agency to a deficiency-free survey in 2012 under a new survey process;

• Piloting a childhood-obesity program in schools in Berkshire County; and, perhaps most importantly,

• Empowering staff to lead in their areas of expertise.

Slicing through all of these and countless other bullet-pointed lines from her CV, Chaffee said she and her team have created an environment marked by innovation and calculated risk taking, one that has enabled Porchlight to succeed — and blaze some trails — in a constantly changing and ever-more challenging home-care landscape.

“Porchlight’s leadership is known for not being afraid to take a risk, to try something new,” she explained. “Seven years ago, for us to embrace the medical record that we did, that was a huge step — that was innovative. And there have been many other examples of that kind of thinking.”

As for those 5-star ratings, they are a reflection of how the agency is responding to these changing times, which require ever-higher levels of accountability and measurable outcomes.

Porchlight is the only Western Mass. agency given such elite status in the most recent ranking, one of two in Massachusetts, and one of only about 200 across the country.

That benchmark is the result of what Chaffee calls the ‘triple aim’ — low cost, high quality, and patient satisfaction.

“We were able to attain that status with boots on the ground,” she said, attributing the accomplishment to solid teamwork. “We have a superior staff of nurses, home health aides, physical therapists, occupational therapists, social workers … all those people are out there creating the 5-star status we have through their encounters with the patients.

“Our goal is keep patients at home and families together,” she went on, adding that the agency’s tagline — and her life’s work — is enabling individuals to live “life as you know it.”

Shedding Light on the Subject

As she talked about that aforementioned rebranding initiative and the new name Porchlight, Chaffee said that, as one expect, there’s a story behind it.

It begins with the original name over the door, Lee VNA, which led many people to believe that the agency served only people in that community, which was not the case. The name was changed to Lee Regional VNA, but it still wasn’t clicking, said Chaffee.

To come up with something that did, she turned to the advertising and marketing agency Darby O’Brien, which had developed a niche in rebranding efforts. The firm eventually came up with ‘Porchlight,’ which resonated with Chaffee and her board chairman, who both conjured up images of front porches with lights blazing (for Chaffee, it was at her parents’ home in New Jersey) when they heard it.

But … there’s usually a ‘but’ in these cases, and there was here as well.

“When you change the name of a 100-year-old agency, there’s a lot of controversy, and we needed to overcome that,” Chaffee told BusinessWest, adding that help came from a board member, then in her 90s, who had served in that capacity for a half-century.

The new name was presented to her by O’Brien, Chaffee, and others, and the response helped dissipate that controversy.

“She told us that when her husband, a doctor, would leave the office, he would tell people, ‘if you need me to stop by on my way home, leave the light on,’” Chaffee recalled. “There couldn’t have been a better entrance for the name ‘Porchlight’ than that, and we were very excited about that response; the name caught on.”

Putting the new name and accompanying logo on signs, letterhead, and the website was far from the most challenging of assignments on Chaffee’s portfolio at her agency, but, like the others, it sheds needed light — pun intended — on those many qualities listed or implied by Toegel in his nomination. They include imagination, forward thinking, teamwork, and, perhaps most important, a willingness to listen and the will to act upon what she hears.

And Chaffee has honed these various careers through a nearly 40-year-long career in healthcare and healthcare administration that might not have happened (well, it probably would have happened anyway) had the market not been flooded with teachers back in the late ’70s, as she was graduating from high school, prompting her to look in another direction career-wise.

“I was talking with my parents,” she recalled. “I volunteered at the hospital as a candy striper, and my father said, ‘you love people, you love helping people … why don’t you think about going to nursing school, because you can do those things and also teach?’”

She thought about it, and then did it, at Skidmore College in New York. Her career in healthcare began in New York (she commuted from her parents’ home) at a pediatric tertiary-care unit, working with children with neurological impairments and kidney disorders. She and her husband would first settle in upstate New York and then relocate to Enfield, after which Chaffee took a job in the pediatric intensive-care unit at Hartford Hospital.

Her career would take a sharp turn, however, after the couple had two sets of twins in a 15-month span.

“That’s when I started my home-care life,” she explained, adding that, while working at Hartford Hospital, she “dabbled” in home care, taking care of a few children on ventilators. She enjoyed that work and, after having her two sets of twins, worked weekends as a home-care nurse, essentially launching a new career that would see her hold essentially every position in that healthcare realm.

Subsequent stops would take her to the Enfield Visiting Nurse Assoc.; Ander-Care Inc. in Springfield, a home-health agency; Special Care Home Health Services in Wethersfield, Conn.; Noble Visiting Nurse Assoc. in Westfield; UConn Medical Center, where she served as a staff nurse and assistant head nurse in the UConn Bone Marrow Transplant Unit; the Enfield Adult Day Center; and Masonicare in Wallingford, Conn., a nonprofit integrated health system, where she directed Masonicare at Home.

In 1999, she also launched her own venture (one that took her maiden name) — Vannucci Consultants, which started as a nursing consulting company that later expanded to include consulting to startup adult day centers and home-care agencies.

In 2009, she was asked to interview at Lee Regional VNA and was chosen as its next president. And with that hiring, the board, taking her vast skill set into account, decided to merge the VNA with a separate company, Berkshire Home Care, and have Chaffee lead both.

Progress Report

Chaffee arrived at LRVNA and Berkshire Home Care in December 2009, roughly six months later than CFO Pat Lamonte. Together, the two have led the organization through a continuous run of growth, innovation, and success — by a number of measures.

“She came from the hospitality industry, was a quick study, and a did a wonderful job of managing the finances,” Chaffee said of Lamonte, adding that one of the first assignments the two took on was implementing a new electronic medical record (EMR) system.

“When I arrived, the staff was using a particular electronic medical record, but they weren’t utilizing it the way they needed to,” she explained. “So I had to look at the operations and change everything that was happening so that things could be efficient and we could get on track financially.

“I went and viewed an electronic medical record called Home Care Home Base out west at a company called Residential Care,” she went on. “I said ‘wow, this is amazing; it gives everyone accountability, internally and externally,’ and so we adopted that system and did the implementation, which was as big change, because everyone’s role changed internally. But we needed to put those efficiencies in place to be sustainable as we are today.”

In many respects, the improvement of the EMR system, as well as the process for doing so — meaning everything from the due diligence to the adaptation of best practices to the quest for new efficiencies — goes a long way toward explaining why Porchlight is a 5-star facility.

The EMR improvements enable the facility to more effectively document information concerning the care of specific patients, she explained, and the process of making that change reflects the environment of innovation and risk taking that she has created.

And these qualities are necessary in this changing environment in home care, one where there is ever-more emphasis on outcomes and measuring them.

“There’s a culture change out there,” said Chaffee. “If someone had home care 20 years ago, they were used to ‘oh, you’re going to provide home care; someone’s going to be in my house for eight hours a day and take care of my mom while I’m at work?’

“It did happen like that 20 years ago if someone had complex medical needs and they were at home,” she went on. “That’s not the way it is anymore — that type of care is not delivered anymore; its been scaled back. Now, you go in, and you’re focusing on the problem you’re there to see that patient for — now, today.”

How agencies fare in those specific assignments is what the CMMS is measuring as it goes about the task of awarding stars.

As Chaffee showed BusinessWest Porchlight’s latest scorecard, if you will, she said scores shaded in light green (in the 60th percentile and higher) were good, and those in dark green (80th percentile and higher) were very good.

With five stars at the top of the card, one would expect lots of dark-green boxes, and there are, in such categories as ‘pain intervention,’ ‘improvement in pain,’ ‘timely initiation of care,’ ‘improvement in management of oral meds,’ and ‘diabetic foot care & education.’

When asked what makes all that green possible, and, in essence, what separates a 5-star operation from one that strives for the rating and falls short, she said there are many factors, many ingredients in the recipe for success.

“I believe it starts with your heart — you have to love what you do,” she explained. “And if you love what you do, it’s going to show from the top down; you all have to be invested in what you’re doing in your job.

“And it’s not just a job — it’s a career, it’s a lifestyle,” she went on. “To be a home-care nurse is a lifestyle, because you have to be invested in your patients. It’s not like you can go to your office at 4:30, click the light off, and it’s done. We’re a 24-hour business.”

Which brings her back to dinner with her husband and the phone calls that can — and often do — interrupt those meals.

And Chaffee is never sure who might be on the other end of that call.

“You might have a manager who wants to run a scenario by you — something they’ve never come across before,” she explained. “You may have a home-health aide you’ve established a long-term relationship with; I’ve had aides follow me from my other jobs into Massachusetts. They’ll call and say that their patient passed away, and they want to discuss how they’re feeling about that.

“I have an open-door policy — all my staff has my cell-phone number,” she went on. “Anybody can call me at any time; sometimes, they just want to check in, and that’s fine with me.”

Bright Future

It may not be an official measure of success in business, but the number of people who want to see what your operation has done, and take best practices from it, is certainly an important statistic — if anyone actually keeps a real number.

Chaffee said she doesn’t, but she acknowledged that many people in her business look to the Porchlight operation as a standard bearer in many respects. The consistent 5-star ratings will do that for a company.

Those who call and visit are essentially looking to know how that mark of excellence was achieved, how a team can be motivated to constantly raise the bar and then clear it, and how a company can excel with that triple aim.

Put another way, they want to know why neither Chaffee nor her husband minds it when he says, ‘who are we having dinner with tonight?’

George O’Brien can be reached at [email protected]