Simione™ Healthcare Consultants


The Missing Link in Home Care Management

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The Missing Link in Home Care Management: How Interim Leadership Can Bridge Gaps for Organizational Success

Interim talent builds a lasting impact

The abrupt departure of a C-suite executive or senior leader is a disruption that can stymie any business. When that business faces rapidly evolving regulations and high-stakes client needs, like home care and hospice providers do, the sudden loss of leadership carries a substantial impact.The solution for forward-thinking home care and hospice providers is interim leadership, in which a highly trained industry veteran enters a role for a limited yet crucial period to ensure continuity of operations. The leader steps in, steps up and steps out, helping organizations bridge the gap from one full-time leader to another.They do so often when an agency is at significant risk, times in which a void in leadership could potentially hinder progress and the well-being of health care services. These leaders are available not just at the c-suite level, but also in roles such as clinical operations director, revenue cycle manager and project manager.They may also take the reins due to a talent dearth in areas where agencies need to bulk up for a specific task or time.This white paper explores interim leadership in home health and hospice: what it is, what it offers and why it is critical right now.


  • Interim leaders are seasoned executives who fill key roles in a business for a limited time
  • These leaders step in everywhere from the c-suite to compliance and IT
  • The need for interim leadership in home health and hospice is huge
  • Home health and hospice providers use interim talent to bridge the gap from one full-time leader to another, or as expanded bench strength to build their programs

What is interim leadership?

From C-suite standouts to IT and compliance, interim leaders are seasoned professionals who provide strong leadership and oversight from the moment they set foot on the job. They fill roles they have held in the past, thus helping businesses quickly recover from a jarring loss, whether due to retirement, resignation or termination, or to fulfill a new need or position.“Interim leaders are literally there to fill a void,” says Wayne Regan, director at Simione Healthcare Consultants, LLC, a Hamden, Connecticut-based consulting firm whose services include interim management in many home care and hospice roles. “Interim leaders provide the highest level of experience to guide change and helporganizations move in new directions,” Regan says. “We fill C-suite roles — CEO,CFO, COO -- as well as clinical management roles.”Now, interim leadership is going beyond just replacing one leader for another. Businesses are hiring interim leaders to fill out their talent rosters for a particular task or goal.

“Agencies lack certain bench strengths,” Regan says. “We’re in there to do project management, or integration, or for a specific focus such as revenue cycle management that requires a finance leader who can analyze data and provide guidance on how to get the organization back on track. So we’re in there for multiple reasons, and then we craft each solution to each situation.”These executives and other leaders are available because they are longtime professionals who typically either don’t want to work full-time or want greater schedule flexibility, but still want to be of service to companies in need of their expertise. Others are industry veterans between full-time jobs.“It’s a matter of networking within our industry and finding the right candidates,” Regan says. “Simione maintains a pool of highly qualified, experienced consultants to match with interim assignments based on clients’ needs.”The duration of interim leadership varies by the need. The typical length of time is five months. One to two months would be considered quick, but interim leaders can also stay on board as long as two years.

“ Interim leaders provide the highest level of experience to guide change and help organizations move in new directions. We fill C-suite roles — CEO, CFO, COO — as well as clinical management roles.”

Wayne Regan, Director Simione Healthcare Consultants

Why businesses tap interim leadership

When New Hampshire-based North Country Home Health & Hospice needed a boost, it turned to an interim leader.“They bring so much experience,” says North Country president Michael Counter. “You can underline that three times.”Counter has been in the finance area of home health and hospice since 2009. When he was chief financial officer with another multi-state agency, the company lost its hospice director and brought in Simione to cover until they could find a replacement.“It’s worth it,” he says.

Counter had the positive experience so many agencies are looking for when they employ interim leaders. Their reasons for doing so vary: sometimes they are replacing a leader on an interim basis, while other times they are bringing in additional talent for a specific need. This kind of task-based work which complements existing talent and resources to achieve clearly defined interim objectives is right in the wheelhouse for interim leaders. In fact, for some organizations, interim talent is their lifeblood. It was for North Country. Simione provided an interim hospice director for seven months in 2017. During that time, Simione worked with North Country to rebuild its Hospice Program and help the agency find a permanent director.The transition from interim to full-time replacement is a critical time for anorganization and another area where interim leadership can shine.“When it was time to go, the interim stepped back yet still supported the new director,” Counter says. “I didn’t have to ask her that. She just did it. She understood that with this transition, it could go well or not well. She was determined to make it go well.”Her actions embody an interim leadership creed: “We leave it behind.” That means the interim executive builds something, passes on the lessons and sets the business up for success.

Why interim leaders are critical for home care and hospice

In hospice, Wayne Regan sees more utilization of interim leaders than he has in the past.“With so many changes in our industry over the last five to seven years, you need a vast amount of knowledge to run an organization — whether it be operations, finance, home care or hospice. That dynamic makes leadership roles difficult, so organizations fortify with additional, but temporary expertise.”Other factors increasing the need for interim leaders in home care and hospice are industry growth, high staff turnover and evolving regulatory needs.In a final irony, the expanding baby boomer population is creating a greater need for hospice and home health care services, while lowering the number of seasoned executives available — because they, too, are baby boomers and are retiring.“There’s a learning curve, and interim leaders can facilitate smooth transitions for developing teams,” Regan says.Counter agrees.

Many factors increase the need for interim leaders in home care and hospice, some of which include:

  • Industry Growth
  • High staff turnover
  • Evolving regulatory needs

“One of my main objectives at North Country was to grow the hospice program,” he says. “I realized after a couple of months that we needed a higher level of expertise.”Simione helped North Country transform its hospice program. Counter says that while the cost was naturally greater than having a full-time leader in that position, he took the long view.“I wanted to re-build our program from the ground up, and I couldn’t think of anyone better to do it,” he says.The results are substantial. Hospice business volume is up significantly at North Country. They have a well-trained staff. They were able to expand into the skilled nursing setting, gaining up to 20% of their admissions from skilled nursing facilities, which adds value for SNF providers, too.Meanwhile, North Country’s collaborating providers are happy with the program and show more confidence in the agency’s hospice services. Their staff has a greater understanding of the benefits of hospice, which they’ve passed along to families.North Country’s improved institutional understanding of hospice has led to it creating new roles. These include a highly experienced hospice nurse who provides services and mentors staff, along with a patient care coordinator who works with providers and families on matters including medication, durable medical equipment and referral and admission processes. The company has also revamped its hospice volunteer program. “We had a clear goal in mind,” Counter says. “Our Simione interim hospice director set the standard, paved the way and helped us recruit and develop her permanent replacement, leaving behind a great deal of knowledge and process improvements to facilitate our continued success.

"I wanted to re-build our program from the ground up, and I couldn’t think of anyone better to do it.”

Michael Counter, President North Country Home Health & Hospice

Getting started with interim leadership

If your home care or hospice organization needs to replace a leader or fill in some talent gaps, an interim leader might be your best next move. Simione begins the process with a conversation to review each agency’s needs.“We help to strategically craft a solution,” Regan says. “A lot of times providers don’t bring in a new hire, because they don’t know what they want to accomplish yet.”Regan recommends that agencies take the time to discuss their needs with Simione to assess and select an interim leader based on that discussion.“We don’t just put someone in there,” Regan says. “We are working to leave behind valuable knowledge and help them strategically as well.”