Last Visit First

Tom Maxwell
  • 5.0 (3)
  • Business
  • Semiweekly

Most care stories in home healthcare end with the last visit. Last Visit First podcast starts there. Hosted by Tom Maxwell — a nationally respected healthcare veteran with over three decades of experience, Co-Founder and Chairman of Maxwell TEC, Maxwell Investment Partners, and Maxwell Advisory Group — this podcast features honest, unfiltered conversations with the founders, CEOs, clinicians, and innovators shaping the future of home health, hospice, palliative, and post-acute care. If you lead, operate, or believe in the power of care in the home, this is your podcast. Subscribe to listen.

  1. 1d ago

    Keep the Family Close: Anne Karber on Grief, Sobriety and Leaving Nothing Unsaid

    Anne Karber grew up poor in South Dakota and spent years chasing freedom through money. She helped build a multi-million dollar construction company and got the big house and the Mercedes, and she says she had never been more miserable. When her sister died giving birth to her fourth child, Anne had no idea how to carry the grief. She spent the next 18 months numbing it with alcohol before she went looking for help. Ten years sober, she's now an author, mentor and the host of the Let's Get Naked podcast. In this episode, Anne sits down with Tom Maxwell to talk about the conversations most families avoid. She explains why she tells people to "keep death close," why forgiveness is for you and not the other person, and how to leave nothing unsaid. She also shares her Skittles theory of energy, why caregivers can't give from an empty tank, and the one-word trick that stops judgment in its tracks. Enjoying the show? Please rate and review Last Visit First on Apple Podcasts and follow us on Spotify. It takes 10 seconds and helps more home health and hospice leaders find these conversations. Topics covered: Why money and success didn't bring happinessLosing her sister, and what grief taught her about emotional intelligence"Keep death close" and having the hard conversations nowThe Skittles theory: energy, burnout and caregiversForgiveness, unfinished business and legacyConnect with Anne: WebsiteLet's Get Naked PodcastThe Life Hack PlaybookChapters: 0:00 Welcome Anne Karber, author and host of Let's Get Naked1:38 From construction to podcasting6:53 Why money doesn't equal happiness9:30 Losing her sister and 18 months of numbing the grief16:40 "Keep death close": leaving nothing unsaid19:38 Sponsor Break21:55 Wellness and "show me the receipts"25:46 How to stop judging people: the "tree" trick30:06 Why she named it Let's Get Naked31:48 Why everyone struggles to talk about death34:43 Aging parents and the "cheerleader from Arizona"35:56 Hospice, and a good death versus a bad death38:03 Grief, the "granddaddy" of emotions40:41 Sponsor Break42:31 The Skittles theory and caregiver burnout48:52 Unfinished business: forgiveness and the hot brick53:36 Anne's legacy and what's next59:41 How to find Anne and her bookLast Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedInSponsors: Premier Sponsor: Homecare HomebasePremier Sponsor: Trella HealthMaxwell TECIntellaTriage

    Keep the Family Close: Anne Karber on Grief, Sobriety and Leaving Nothing Unsaid

  2. Oct 21

    How He Built a Hospice From 50 to 8,000 Patients: Heath Bartness of St. Croix Hospice

    In 2009, Heath Bartness was a 20-something nursing home administrator with an idea: hospice could be done better. His owners agreed to fund it, with one condition. He had two years to succeed, and if it didn't work out, he'd come back and run a nursing home for them. The goal was 50 patients. Today, St. Croix Hospice serves nearly 8,000 patients across 10 states and more than 100 locations, making it one of the largest hospice organizations in the country. In this episode, Heath sits down with Tom Maxwell to talk about how St. Croix grew without losing what made it work. He tells the story of the $20 minimum wage that gave one nursing assistant an $8 raise and "changed our life." He also explains why he once called music therapy "hocus pocus," what a social worker taught him about the value of a visit, why so many families still call hospice too late, and what he'd tell CMS if he had them in a room with no lobbyists. Enjoying the show? Please rate and review Last Visit First on Apple Podcasts and follow us on Spotify. It takes 10 seconds and helps more home health and hospice leaders find these conversations. Topics covered: Founding St. Croix Hospice with a two-year deadlineCulture, and why "we have to be the best" is the only absoluteMusic therapy and the value of every visitRaising the minimum wage to $20 an hourWhy families elect hospice late, and the role of primary careAI in hospice, and what St. Croix looks like in 2035Connect with Heath: St. Croix HospiceHeath's LinkedInChapters: 0:00 Welcome Heath Bartness, founder & CEO of St. Croix Hospice2:01 Why "St. Croix"? The river and the holy crossing2:49 From nursing home administrator to hospice founder6:06 From a goal of 50 patients to 8,000 in 10 states8:20 The patients and stories he'll never forget14:44 Sponsor Break16:12 Scaling St. Croix and hospice as a calling20:16 Letting go: name badges and paper clips24:07 The one thing St. Croix will never change27:24 The decision he got wrong: music therapy31:07 Why nursing is the best career: "When I go see Ethel, she smiles"35:06 Sponsor Break37:15 "You have changed our life": the $20 minimum wage42:07 Why families call hospice too late50:45 Mentors, boards and private equity in hospice1:04:17 What Heath would tell CMS: moments of joy over comfortably numb1:09:47 AI in hospice and St. Croix in 20351:13:36 Legacy, and how to reach St. Croix HospiceLast Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedInSponsors: Premier Sponsor: Homecare HomebasePremier Sponsor: Trella HealthMaxwell TECIntellaTriage

    How He Built a Hospice From 50 to 8,000 Patients: Heath Bartness of St. Croix Hospice

  3. Oct 15 ·  Bonus

    The Best Healthcare Is Local: The Pennant Group's Alicia Bowman on AI & the Hospice Addendum

    Alicia Bowman of The Pennant Group closes out Last Visit First's coverage of the 2026 HCHB Users Conference. Alicia shares what has kept Pennant busy this year, including the final wave of its LHC and Amedisys acquisitions in Tennessee, Alabama and Georgia, and how Pennant is testing Curate: Scribe with a group of clinicians ahead of a pilot this November. Alicia also talks about why transparency is at the heart of Pennant's partnership with Homecare Homebase, how Pennant's local operating model works, and why the best healthcare is delivered locally. Plus, her take on the hospice addendum, why it will be a giant operational lift, and how agencies and clinicians can connect with Pennant. Chapters: 0:00 Welcome: Alicia Bowman of The Pennant Group0:17 Pennant's Final Wave of LHC and Amedisys Acquisitions0:48 Testing Curate: Scribe at Pennant3:54 Pennant's Local Operating Model4:45 The Hospice Addendum: A Giant Operational LiftConnect with Alicia: https://www.linkedin.com/in/alicia-bowman-37a114183 Connect with The Pennant Group: https://pennantgroup.com/ Sponsors: Brought to you as a Premier Sponsor collaboration with Homecare Homebase (HCHB). Homecare Homebase helps home-based care organizations prepare for what’s next. Home-based care is changing. Is your technology keeping up? Growing operational demands, workforce pressures, regulatory change, and emerging technology are reshaping what organizations need from their technology partners. The question isn’t only what your technology can do today. It’s whether it can help you prepare for what’s next. Explore why now may be the right time to take a fresh look at your technology strategy with HCHB at https://lastvisitfirst.com/go/hchb.

    The Best Healthcare Is Local: The Pennant Group's Alicia Bowman on AI & the Hospice Addendum

  4. Oct 15 ·  Bonus

    The Most Exciting Thing HCHB Has Done: VitalCaring CEO April Anthony on Curate: Scribe

    April Anthony, Chairman and CEO of VitalCaring and founder of Homecare Homebase, returns to Last Visit First live from the 2026 HCHB Users Conference, her first in six years. April shares why this is such a transformative moment for home health, and how VitalCaring is rolling out Curate: Scribe carefully, working closely with HCHB and pre-training clinicians to narrate their visits before the tool even arrives. April explains why she sees Curate: Scribe as perhaps the most exciting thing Homecare Homebase has done: bringing guidance on OASIS answers and coding to the point of care, and why VitalCaring chooses not to store visit transcripts. She also talks about VitalCaring's return to acquisitions, including Traditions Health and Carter Healthcare, looks back on 26 years of Homecare Homebase, and shares why the coming baby boomer wave makes the next 30 years the biggest opportunity home care has ever had. Chapters: 0:00 Welcome: April Anthony, Chairman and CEO of VitalCaring2:00 Rolling Out Curate: Scribe at VitalCaring3:38 Guidance on OASIS and Coding at the Point of Care5:50 Why VitalCaring Doesn't Store Transcripts7:02 Back in Acquisition Mode8:43 26 Years of Homecare HomebaseConnect with April: https://www.linkedin.com/in/april-anthony-95bab1213 Connect with VitalCaring: https://vitalcaring.com/ Sponsors: Brought to you as a Premier Sponsor collaboration with Homecare Homebase (HCHB). Homecare Homebase helps home-based care organizations prepare for what’s next. Home-based care is changing. Is your technology keeping up? Growing operational demands, workforce pressures, regulatory change, and emerging technology are reshaping what organizations need from their technology partners. The question isn’t only what your technology can do today. It’s whether it can help you prepare for what’s next. Explore why now may be the right time to take a fresh look at your technology strategy with HCHB at https://lastvisitfirst.com/go/hchb.

    The Most Exciting Thing HCHB Has Done: VitalCaring CEO April Anthony on Curate: Scribe

  5. Oct 15 ·  Bonus

    AI That Actually Helps Clinicians: Homecare Homebase President Luke Rutledge

    Homecare Homebase President Luke Rutledge joins Last Visit First on the floor of the 2026 HCHB Users Conference in Orlando, the biggest in the event's 20-year history with about 600 attendees. Luke shares what customers are talking about most: AI that is meaningful, that improves clinicians' lives and automates back-office work, and how that drives HCHB's strategy with both its partners and its own new products. Luke highlights Curate: Scribe, now in the hands of clinicians with three customers live and 15 more signed up, and tells the story of a pilot customer whose clinicians pushed to turn the tool back on after it was paused. He also talks about the leadership team coming together at Homecare Homebase, the conference's headline party, and how to reach him and the HCHB team. Chapters: 0:00 Welcome: Luke Rutledge, President of Homecare Homebase0:52 What Customers Are Talking About: AI That Matters1:31 Curate: Scribe Goes Live2:50 When Clinicians Pushed to Turn Curate: Scribe Back On3:40 Building the HCHB Leadership TeamConnect with Luke: https://www.linkedin.com/in/luke-rutledge-19407664 Connect with Homecare Homebase: https://hchb.com/ Sponsors: Brought to you as a Premier Sponsor collaboration with Homecare Homebase (HCHB). Homecare Homebase helps home-based care organizations prepare for what’s next. Home-based care is changing. Is your technology keeping up? Growing operational demands, workforce pressures, regulatory change, and emerging technology are reshaping what organizations need from their technology partners. The question isn’t only what your technology can do today. It’s whether it can help you prepare for what’s next. Explore why now may be the right time to take a fresh look at your technology strategy with HCHB at https://lastvisitfirst.com/go/hchb.

    AI That Actually Helps Clinicians: Homecare Homebase President Luke Rutledge

  6. Oct 15 ·  Bonus

    Hiring 300 Nurses a Year: IntellaTriage CEO Daniel Reese on After-Hours Care & AI

    IntellaTriage CEO Daniel Reese joins Last Visit First live from the 2026 HCHB Users Conference in Orlando to share what is new at IntellaTriage, including upcoming AI initiatives designed to help its nurses document more consistently and deliver higher-quality triage to patients and families. Daniel also talks about what he is hearing from agencies at the conference, from the impact of the moratorium on growth strategies to the push to use every resource as efficiently as possible. Daniel and Tom reflect on 20 years of the Homecare Homebase Users Conference and the wave of baby boomers reaching Medicare age, and Daniel explains how IntellaTriage has grown beyond after-hours, nurse-first triage into 24/7 coverage and daytime care team coordination. With nearly 450 nurses and plans to hire about 300 more this year, IntellaTriage is on the flip side of the nursing shortage, helping providers keep up with growing workloads. Chapters: 0:00 Welcome: Daniel Reese, CEO of IntellaTriage0:47 What's New at IntellaTriage: Upcoming AI Initiatives1:25 The Moratorium and Doing More with Less4:09 What IntellaTriage Does: Nurse-First Triage, 24/74:57 Hiring 300 Nurses This YearConnect with Daniel: https://www.linkedin.com/in/dreesemba Connect with IntellaTriage: https://intellatriage.com/ Sponsors: Brought to you as a Premier Sponsor collaboration with Homecare Homebase (HCHB). Homecare Homebase helps home-based care organizations prepare for what’s next. Home-based care is changing. Is your technology keeping up? Growing operational demands, workforce pressures, regulatory change, and emerging technology are reshaping what organizations need from their technology partners. The question isn’t only what your technology can do today. It’s whether it can help you prepare for what’s next. Explore why now may be the right time to take a fresh look at your technology strategy with HCHB at https://lastvisitfirst.com/go/hchb.

    Hiring 300 Nurses a Year: IntellaTriage CEO Daniel Reese on After-Hours Care & AI

  7. Oct 15 ·  Bonus

    Copilot, Not Autopilot: Steno Health's Dr. Alex Milani on Curate: Scribe

    Steno Health Co-founder and CEO Dr. Alex Milani joins Last Visit First at the 2026 HCHB Users Conference to talk about Curate: Scribe, the ambient AI documentation tool powered by Steno and embedded directly inside Homecare Homebase. Alex shares that the product is now officially live, with a waiting list of about 18 agencies set to onboard, and walks through how it works: summarizing referral documents before the visit, recording the conversation in the home, and a quick debrief in the car that fills in the chart. Alex also explains why Curate: Scribe is a copilot, not an autopilot, how clinicians learn to narrate their visits during the first few weeks, and the time savings agencies are seeing, around 30 to 40 minutes on a start of care and 5 to 20 minutes on other visits. Plus, what is next for Steno, including ICD-10 coding, OASIS QA review and patient insights, and how AI is speeding up product development. Chapters: 0:00 Welcome: Dr. Alex Milani, CEO of Steno Health0:31 Curate: Scribe, Powered by Steno, Is Officially Live1:31 How Curate: Scribe Works During a Home Visit2:06 Copilot, Not Autopilot3:33 Time Savings: 30-40 Minutes on a Start of Care6:11 What's Next for StenoConnect with Alex: https://www.linkedin.com/in/alexandermilani Connect with Steno Health: https://www.stenohealth.com/ Sponsors: Brought to you as a Premier Sponsor collaboration with Homecare Homebase (HCHB). Homecare Homebase helps home-based care organizations prepare for what’s next. Home-based care is changing. Is your technology keeping up? Growing operational demands, workforce pressures, regulatory change, and emerging technology are reshaping what organizations need from their technology partners. The question isn’t only what your technology can do today. It’s whether it can help you prepare for what’s next. Explore why now may be the right time to take a fresh look at your technology strategy with HCHB at https://lastvisitfirst.com/go/hchb.

    Copilot, Not Autopilot: Steno Health's Dr. Alex Milani on Curate: Scribe

  8. Oct 11

    "You Can't Rationalize With an Irrational Brain" | Debbie Compton of The Purple Vine

    Debbie Compton planned to retire from her corporate career. Instead, she spent 21 years as a family caregiver for three loved ones with three different diseases: her father with Parkinson's, her mother with vascular dementia, and her mother-in-law with Alzheimer's. Today she is the founder of The Purple Vine, a certified caregiving consultant and advocate, and the author of multiple international bestselling books for caregivers. In this episode, Debbie sits down with Tom Maxwell to share the hard-won lessons nobody teaches family caregivers: why you should never argue with someone living with dementia, how music therapy can bring back precious moments, how to choose a memory care facility, and why families so often call hospice far too late. Enjoying the show? Please rate and review Last Visit First on Apple Podcasts and follow us on Spotify. It takes 10 seconds and helps more home health and hospice leaders find these conversations. Topics covered: Leaving corporate life to become a full-time caregiverWhy you can't rationalize with an irrational brainSeparating your loved one from the diseaseMusic therapy, coloring and other tools that actually workChoosing memory care, and letting go of the guiltWhy families should call hospice soonerCaregiver burnout, humor and gratitudeConnect with Debbie: WebsiteLinkedInChapters: 0:00 Welcome Debbie Compton to the show1:38 From corporate career to full-time caregiver5:40 The warning sign behind her mom's vascular dementia7:38 Getting a stubborn parent to accept help9:05 Parkinson's symptoms nobody talks about14:59 Sponsor Break16:28 Creating dementia-friendly coloring book20:49 Dementia isn't rational: separate the person from the disease22:41 Tom's dad, a wrong-way drive and a giant pizza24:47 When your loved one doesn't recognize you26:05 Music therapy and Johnny Cash's Ring of Fire28:19 Her first book: Caregiving: How to Hold on While Letting Go29:19 Handling the "loop-de-loop" of repeated questions30:57 Sponsor Break33:06 Certified caregiving consultant vs. caregiving advocate38:03 Why arguing makes dementia progress faster39:25 Choosing a memory care facility42:42 Memory care let her be a daughter again44:03 Why families call hospice too late47:11 Social workers, chaplains and aides on the hospice team49:38 The Caregiver's Advocate bestseller series55:55 Where the name "The Purple Vine" comes from59:28 How to reach Debbie and buy her books1:04:24 What "Last Visit First" means to DebbieCheck out Last Visit First on other platforms: Apple PodcastsSpotifyYouTubeWebsiteLinkedInSponsors: Premier Sponsor: Homecare HomebasePremier Sponsor: Trella HealthMaxwell TECIntellaTriage

    "You Can't Rationalize With an Irrational Brain" | Debbie Compton of The Purple Vine
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Ratings & Reviews

5
out of 5
3 Ratings

About

Most care stories in home healthcare end with the last visit. Last Visit First podcast starts there. Hosted by Tom Maxwell — a nationally respected healthcare veteran with over three decades of experience, Co-Founder and Chairman of Maxwell TEC, Maxwell Investment Partners, and Maxwell Advisory Group — this podcast features honest, unfiltered conversations with the founders, CEOs, clinicians, and innovators shaping the future of home health, hospice, palliative, and post-acute care. If you lead, operate, or believe in the power of care in the home, this is your podcast. Subscribe to listen.

Information

  • Creator
    Tom Maxwell
  • Years Active
    2025 - 2026
  • Episodes
    67
  • Rating
    Explicit
  • Copyright
    © 2026 Tom Maxwell
  • Show Website
    Last Visit First

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