As a young girl, Martha Barton followed her father, a physician, as he went on house calls in Minnesota. The relationships formed inside his medical practice made an impact on Barton, who is planning to retire this summer from her position as president of Pikes Peak Hospice and Palliative Care, an operation she has led since 1980.
Barton spoke with the Business Journal this week about the organization she was instrumental in building, making difficult decisions and moving on to the next phase of her life.
How did you get from Minnesota to Colorado?
I was a relatively new registered nurse and there were two things that spurred me to leave [Minnesota]. One was, my friend and I were going to live out West. That was going to be a big adventure. Unfortunately my girlfriend backed out just before I left. The other was the unionization of nurses in Minneapolis. I didn’t want to be a part of that.
I really wanted to try a place that had all four seasons. I also came out here because I’d dated a fellow who was a captain in the Army and he was at [Fort] Carson. So, I moved to Denver to be a nurse, and he went to Vietnam.
When he got back we moved to Minnesota where he was offered a dental practice, but that business partnership didn’t work out so, in 1970, we moved to Colorado Springs. We’re divorced now and have a couple kids, but that’s how I got here.
Were you ever a nurse in Colorado Springs?
I did a variety of things — mostly tied to medicine one way or another. I sold health insurance including the first HMO [health maintenance organization] in the community. I was also on the radio as a news reporter for KVOR. They weren’t hiring nurses at the time so I became a reporter. I really wanted to be a journalist in college but came from a health care family, so I gave in. … I went to the HMO world and from the HMO world I came to hospice.
How did you hear about hospice?
I became very interested in the hospice movement when it was very new and some volunteers locally brought speakers in. It sounds corny, but in the old days, doctors did house calls. My dad was a country doc and he would start and end his day doing house calls. I was the youngest of four kids and would go with him more than half the time. I really thought he needed me at 4 or 5. I spent a lot of time at the regional hospital. … I really thought I was important there too.
But that’s where I was introduced to the on-the-ground pieces of medicine — medicine as a relationship. My dad knew everybody he cared for and they all knew him.
That’s very different from how it is now. I remember when I got into nursing it was high-tech, low-touch. Almost everybody died in the hospital and many didn’t know their diagnoses.
The tipping point in our city was when Elisabeth Kübler-Ross, a Swiss psychiatrist, spoke. She was one of the first to talk about the phases of loss and grief. It was a very transparent discussion about the last phase of life and how important and how non-institutional people want it to be — how they want to be home.
About 800 people showed up for the talk and 75 stayed after. That was the group that ended up creating hospice in Colorado Springs. That was 1979. In 1980 we were incorporated, and I started.
What does your organization do?
We are experts in helping people prioritize what’s important to them once they know they are in the terminal phase of a disease. Some might say it’s about a bucket list, but it’s more than that. It’s a background of expertise that includes routine visits and support to patients and families living with a life-limiting illness. Many have weeks to months to live. … and we can help them with their symptoms and help them get as much positive as they can out of every day.
Where were you originally located?
Our first worksite was given to us by Grace [and St. Stephen’s] Episcopal Church. They’ve given space to a lot of good things. Partners in Housing started there, TESSA started there.
I started at hospice on a volunteer committee, then I was on the board and the executive director then had family health issues and had to step down. The board asked me to take the director’s position. That position has changed about 25 times. … Now I’m the president.
We were very small then and had probably 12 full- and part-time staff and a census of about 20 patients. We’re now at about 220 employees and 450 volunteers. We started with less than a $100,000 budget. We’re at about $18 million now.
On any given day we’re touching more than 500 patients.
Where does your funding come from?
Most comes from Medicare and Medicaid. Most of those we serve are elderly and living with life-limiting illness. When Medicaid expanded we’ve seen more Medicaid patients, and we also do hospice care for the military.
Our payer sources are broader than they used to be, but Medicare is still at about 75 percent of the patients we care for.
How has your position changed?
When we first began, everybody did everything. Everyone took calls and admitted patients. Everybody ran errands and was involved with the state organization.
That’s not true now. There’s quite a bit of delegation within departments. I have seven people who are vice presidents, all with different functions to take care of.
We are also the only hospice in the community with a licensed inpatient facility. Patients with high acuity needs will come to that program, which is on the sixth floor of the west tower at Penrose [Hospital]. … But about 85 percent of the time people want to be in their own homes. We can make that happen. We have very intensive care at that unit, and we’ll stabilize patients and teach their families and then send them home where we have a hospice home team to follow them.
What are your greatest challenges?
For the last five years we’ve been concerned because we’re paid less every year. There are more people getting care and [funding is] spread out. Every Medicare provider in the country is seeing a 2 percent cut every year just to try and balance that out. Our rates are lower this year than last year, but our costs keep going up.
For the last four years we’ve wondered: Does that mean we need to acquire or merge? We looked at whether we should merge with other elements in city. Should we be business partners with Silver Key or the [Rocky Mountain] PACE program or nursing homes? Would bigger be safer? Would more payment sources make us more sustainable?
Then a corporation came into the state that was very interested in taking a look at not-for-profit, legacy, community-based hospice organizations — knowing they were struggling. Could they come up with something to make them more efficient and allow them to maintain their mission?
With a lot of study and consideration, we joined that company, called Care Synergy. There are four affiliates from Fort Collins to here. Through Care Synergy we share human resources, compliance, quality and IT.
The good thing is, our affiliates are very much like us. They feel strongly about their name, their brand and their board.
Through the network, we went from 240 employees to 1,000. The budget went from $18 million to $95 million and the average daily census went to about 1,400 patients. … That began in spring 2016.
What are you proudest of during your time with Pikes Peak Hospice?
As for business decisions, this building is probably the best one. We were always renters. … We knew in 2009 we wanted our own facility, but for about 10 years all of our work was in the old St. Francis Hospital. St. Francis was flooded years back and we were the major tenant there. … It was a disaster that pushed us to get out of the building. … In seven months time we looked at 75 properties. … We looked at schools and churches and storefronts. … We came back to this building, brought in some architects and the price had dropped $2 million. We ran a three-year capital campaign and finished it in 15 months. We moved in five years ago this June and owning the building saves us about 50 percent.
What are your plans for retirement?
I have a huge learning curve. My generation, to include me, has been working since they were 12. What I do know is that I want to stay involved in this town. I love Colorado Springs. For all its warts, it’s a blessed place to live. There are a lot of wonderful opportunities to move things ahead. I’ve been invited to some boards and will finish some books that have nothing to do with health care. And I have some grandkids in my life as well.