How Data Became the Ultimate Decision-Driver
Lessons from Scaling a High-Performing Hospice
When visionary hospice operators scale successfully, they rarely do so through instinct alone. Running a business on gut feeling can only take a founder or hospice CEO so far.
To truly lead, hospices need industry-specific hospice financial reporting and executive dashboards so highly compensated leadership teams aren’t flying blind when it comes to their hospice operations. Leaders should know their numbers and targets like operating margins and payroll spend for palliative care, home health, PACE and for performance monitoring of future expansions into new territories or programs.
For many years, the Blackmor CPA team had the opportunity to work alongside an incredible and visionary agency leader, Russ Krengel, founder of Kindful Hospice and now CEO of Kindful Health. What stood out was not sophisticated technology or elaborate management structures. It was operational clarity. Decisions were driven by scorecards, metrics, accountability, and disciplined leadership.
Blackmor’s initial engagement focus was setting up their locations, divisions, and a hospice-specific chart of accounts in Sage Intacct and paperless invoice payments in Bill.com. Then, we met weekly with Russ to cover cash, census, admissions and other operational updates as well as review the financial statements every month once they were available.
My observation: Russ knew his agency’s KPIs.
What Set Kindful Hospice Apart
Every organization claims to be data-driven.
Few truly are.
At Blackmor, we've found that the highest-performing hospice organizations share a common characteristic:
Together, we create systems where data becomes the ultimate decision-maker and one of the cornerstone drivers of growing value... fast.
Building the Management Operating System
As organizations grow, leadership can no longer personally observe every patient, employee, referral source, or financial transaction.
Instead, leaders need an operating system — a unique way of combining all perspectives into one single source of truth. We call this final result the Hospice Operating System (TM), when we have the scorecard pulling from all the points of the compass: a hospice’s financial reporting, EMR, payroll, and A/P spend all pulled together for high-level margin and KPI tracking across the entire organization.
That operating system consists of:
Financial scorecards
Census analytics
Referral source reporting
Labor productivity reporting
Revenue cycle metrics
Cash flow forecasting
Accountability dashboards
These reporting systems transform management from reactive to proactive.
From Reporting to Accountability
All agencies produce reports — they must if they want to remain compliant and in good standing.
Elite organizations don’t file away raw reports; they mine the raw data for information that can drive better outcomes.
Every metric should answer three questions:
What happened?
Why did it happen?
Who owns the next action?
With accountability, leaders focus on controllable outcomes and results. Without accountability, reporting becomes merely performative.
Data Creates Objectivity
Great leadership teams remove emotion from decision-making whenever possible.
Instead of:
"I feel like admissions are down."
The conversation becomes:
"Admissions have declined 8.7% over the past 90 days and referrals from skilled nursing facilities account for 70% of the decline."
Instead of:
"Labor feels high."
The conversation becomes:
"Direct labor per patient day increased 11% while census declined 6%."
Data converts opinions into facts.
Facts enable action.
Benchmarking Against Excellence
Are you too insecure to compare your agency to the best? Top-performing organizations don't compare themselves to mediocre standards.
The best hospices benchmark against best-in-class performance — a top 10% mindset.
That means monitoring:
All areas of financial performance
Lengths of stay
Live discharge rates
CAHPS and HOPE measures
Referral conversion and admissions
Labor efficiency and turnover
Days in AR
Program and office or location margins
Positive cash flow from operations
The purpose of benchmarking is not criticism.
The purpose is continuous improvement.
Improvement always begins first with awareness and acknowledging the chinks in the armor draining cash from the agency.
The Result
Kindful Hospice changed hands a few years back while we concluded sell-side due diligence as the wrap-up to our engagement. Without getting into specifics, all I can divulge is that the exit valuation was extraordinary.
The team at Blackmor CPA has had a front row seat to many acquisitions and divestitures across a wide range of valuations on an ADC and revenue or discounted cash flow basis. The biggest difference comes down to consistency of operations that use data to drive better decision making, hold teams accountable, and stay one step ahead of the competition.
Organizations that adopt this philosophy create something incredibly valuable:
Leadership clarity.
When leaders can see and monitor the business clearly, they make faster decisions.
When decisions improve, performance improves.
When performance improves, enterprise value and free cash flow grow.
The agencies commanding premium valuations aren’t the ones guessing better…
They're the ones measuring better.
Kindful Hospice: a data-driven organization we set up with hospice financial reporting
