AGRACE HOSPICECARE
                                      Madison, Wisconsin

                          CHIEF EXECUTIVE OFFICER

                            POSITION SPECIFICATION

                                                  Prepared by:

                                          Kathleen M. Gillespie
                                        Home Care, Hospice and
                                  Community-Based Services Practice Leader

                                                 March 22, 2012

This position specification is intended to provide information about Agrace HospiceCare and the position of Chief
     Executive Officer. It is designed to assist qualified individuals in assessing their interest in the position.

CONFIDENTIAL: This report has been prepared for the exclusive
use of the Agrace HospiceCare CEO Search Committee. Due to
the confidential nature of this information, its use should be
controlled and limited.


Madison, Wisconsin

                                       April 14, 2012 Final
                                       March 22, 2012

Prepared by: Kathleen M. Gillespie
             Vice President and Practice Leader
             Home Care, Hospice and
             Community-Based Services Practice
               TABLE OF CONTENTS


 I. INTRODUCTION                        1

II. PERSONS INTERVIEWED                 2





     Witt/Kieffer has been retained by the Search Committee of Agrace HospiceCare
     (“Agrace”) in Madison, Wisconsin, to assist in the search for the Agrace President and
     Chief Executive Officer (“CEO”).

     This report represents the results of our discussions with members of the Agrace
     Management Team and Agrace CEO Search Committee, as well as a review of written
     materials provided to us. These discussions allowed us to:

        Gain a full knowledge and understanding of the organization, the marketplace and
         the position of CEO, as well as the organization’s expectations of the goals and
         objectives to be achieved by the CEO;

        Prepare the specifications of the background, experience and type of person ideally
         suited for the position of CEO;

        Identify key challenges and attractions involving the role and/or search for the CEO;

        Make appropriate recommendations regarding the search effort.

     We are pleased to be working with you on this important engagement. We wish to
     express our appreciation for the courtesies and hospitalities extended to us during our
     start-up interviews. Your candid input, cooperation and willingness to assist has been
     most helpful.


      Agrace HospiceCare Management Team

      Julia Houck             Acting President

      Sarah Samson            Interim Director of Human Resources

      Christine Moss          Interim Director of Human Resources

      Dan Chin                Vice President, Public Affairs

      Joyce Zeasman           Vice President, Finance

      Marcia Whittington      Vice President, Foundation & Holdings

      Dena Green, MD          Medical Director

      Denise Gloede           Vice President, Access

      Julie Slattery          Vice President, Clinical Services

      Bruce Agneberg, MD      Senior Vice President, Medical Services

      Jane Quinn              Vice President, Quality & Compliance

      Agrace HospiceCare CEO Search Committee

       Joan Burke             Search Chair; Board Chair

       Brian Happ             Member

       David Cullen           Member

       Gordon Derzon          Member


       Agrace HospiceCare


       Agrace HospiceCare (hereafter “Agrace”), headquartered in Madison, Wisconsin, is one
       of the nation’s most respected nonprofit community-based hospices. Agrace is dedicated
       to providing expert physical, emotional and spiritual support to patients and families
       dealing with life limiting conditions throughout south central Wisconsin.

       This nationally recognized hospice has earned an outstanding reputation for providing
       innovative, comprehensive, high quality hospice services to patients in their homes, in the
       state-of-the-art Agrace Inpatient Unit and Agrace Residence on the Agrace campus in
       Madison, and in skilled nursing and assisted living facilities within their service territory
       south central Wisconsin.

       Agrace is committed to ensuring its patients experience dignified, quality living. Agrace
       continuously endeavors to build a community in which exceptional end-of-life care is
       accepted, expected and available to all.

       Agrace provides support to individuals diagnosed with life-limiting illnesses such as
       cancer, heart disease, lung disease, kidney disease, Alzheimer’s, Parkinson’s, stroke,
       ALS, or AIDS. Patients with a life expectancy of six months or less are eligible for
       hospice. Agrace has developed an array of high-quality programs and services to provide
       these patients with exceptional support and care. Agrace services are available to people
       of all ages, incomes, ethnicities and cultural backgrounds.

       Established in 1978, Agrace has built a network that, as of 2012, serves individuals
       throughout five (5) counties in south central Wisconsin. Growth is planned to continue to
       fulfill the Agrace mission of serving a greater number of individuals with life limiting
       conditions across southern Wisconsin.


       Agrace is certified by Medicare and Medicaid for hospice. Agrace voluntarily
       participates in the Community Health Accreditation Program (CHAP). CHAP requires
       self-assessments and on-site surveys every three years to ensure that Agrace meets the
       latest standards.

       Census and Service Area

       Agrace serves more than 600 patients each day. Agrace operates two office locations
       within its service area, which includes Dane, Jefferson, Green, Rock and Walworth


Agrace believes that individuals diagnosed with life-limiting illness deserve to live as
fully as they can until the end of life.

The mission of Agrace, “Enhancing Quality of Life at the End of Life”, embodies this
core belief.


In pursuit of its mission, Agrace defines several organizational goals that further
demonstrate its commitment to quality end-of-life care. These service goals comprise the
Agrace vision statement:

“Agrace will help build a community in which exceptional end-of-life care is accepted,
expected and available to all.”


Values guide the Agrace team and organization. The organization shares a responsibility
for and a commitment to the following values:

Agrace meets others where they are by being caring, respectful, accepting, patient,
forgiving, and empathetic;

Agrace lives its beliefs and commitments by being honest, reliable, authentic, genuine,
trustworthy, and courageous;

Agrace achieves remarkable things working together by being team players, generous,
participative, open-minded, adaptable, and humble;

Agrace sets the standard for being a world-class performer by being quality-driven,
service-driven; by being learners, teachers, committed to diversity, and innovation.

Agrace respects, cherishes, preserves and grows its resources of time, talent, treasure,
environment, community and goodwill.


Long Term End-of-Life Care

Agrace provides end-of-life care and support to individuals, families and significant
others, 24 hours a day, seven days a week, in their homes, long-term care facilities,
assisted living facilities -- wherever the patient resides. Care and support are provided
through an interdisciplinary team comprised of a hospice physician, RN case manager,
social worker, chaplain, grief counselor, CNAs and volunteers.

Agrace home care services are delivered in patients’ homes or in homelike settings such
as community-based residential facilities, assisted living facilities and nursing homes.
Agrace also provides hospice services to patients in hospital settings.

When in-home care cannot meet the needs of patients and families, short-term inpatient
hospice care and long term residential hospice care is provided on the Agrace campus in

Residential Care

Agrace Residence is a l2-bed long term hospice care setting at the Madison facility paid
independently by patients. Agrace team members collaborate with the facility staff to
provide residents with pain and symptom management, palliative care and full
interdisciplinary team support.

Agrace Inpatient Care

The Agrace campus in Madison offers a state-of-the-art 28-bed Inpatient Hospice Unit
that provides an acute inpatient level of care to hospice patients.

The Agrace Inpatient Care Program provides short-term, intensive monitoring and
treatment of acute pain or other complex symptoms.

Respite Care

Agrace recognizes the need to provide families a break from ongoing caregiving by
offering respite care. The Agrace campus provides respite care to the caregivers of home
care patients who may need a rest. Services are provided 24-hours a day, 7-days a week.

Clinical Services

The Agrace hospice care team includes a variety of experienced, well-credentialed multi-
disciplinary professionals. The hospice team is comprised of Hospice and Palliative Care
board-certified physicians who offer outstanding clinical and care management oversight
to patients, as well as Nurse Practioners, RNs, LPNs, Social Workers, Grief Counselors,
Chaplains, CNAs (Certified Nursing Assistants), and Volunteer Coordinators.

Agrace HospiceCare Foundation

Agrace has reserves of approximately 22.0 million in unrestricted funds. This critically
important support allows the organization to provide financial assistance to patients and
families without insurance.

Fund Raising

Agrace has raised over $3.0 million in private contributions, gifts and grants each year in
the last several years.


Agrace HospiceCare reported 2011 total consolidated operating revenue of
approximately $46.2 million.

Long Range Strategic Direction 2011 – 2014

In response to past years of significant growth and regulatory changes, Agrace
implemented additions to processes, added to staff to accommodate a growing census,
and made efforts to keep up with technology. During this responsive phase, Agrace
‘spiraled up’ without having the opportunity to be extremely methodical and diligent
about infrastructure and efficiencies. During 2011, the organization focused on
acknowledging upcoming decreases in reimbursement, structurally reorganizing Home
Care and recasting the IPU staffing model. Staff was shifted, some processes were added
and the organization began to gain efficiencies. Progress continues in 2012.

Agrace leadership has established a 2011 – 2014 Strategic Direction for the organization,
emphasizing strong growth and positioning Agrace to be the ‘partner of choice’ and the
‘provider of choice’ among key healthcare referral sources and emerging Accountable
Care Organizations in the Wisconsin market. .

This Strategic Direction also focuses on overall performance improvement, strengthening
the organization’s focus on quality, and ensuring the organization’s infrastructure and
systems can support high quality care. Agrace is committed to focusing on fundamentals,
improving performance to create a quality and data-driven practice environment,
emphasizing people development and transforming processes into streamlined, highly
efficient practices and procedures. Agrace is committed to achieving these strategic
objectives in the 2011 – 2014 period:

                             2011-2014 Strategic Direction
Critical Success Factors
What are the elements on which we must remain focused as we advance our plan?

   Ensure fiscal sustainability
   Deliver the best possible care and support
   Protect reputation and relationships
   Retain and expand expertise

What do we want to achieve for the organization over the next several years?

   Sustain profitability and build reserves
   Deliver the best possible care in the communities served
   Diversify resources and services for flexibility in adapting to changing conditions
   Become a forward-looking, proactive culture

What are the means through which we can achieve our objectives?

   Establish a clear competitive advantage reinforced through operations and outreach
   Demonstrate value to patients and families, partners, and broader communities

   Define quality standards throughout the organization to which people are held
   Streamline processes and instill continuous improvement driven by data and
   Generate understanding of how to collect, analyze and use data to inform strategic
   Build bench strength of people who demonstrate commitment, continuity and


What activities are critical for successful execution of the strategy?


   Build trust throughout the organization
   Clarify roles and authority for decision-making
   Develop and expect leaders to be focused, driven, proactive and courageous
   Enhance transparency, embrace issues and acknowledge improvements
   Implement consistent processes and focused direction
   Institute greater meeting effectiveness (purpose, framing, call the question, summary)
   Redefine: growth, quality, customers

Service Delivery

   Achieve a sustainable in-patient unit model
   Build a service expansion strategy
   Establish a model for consistent quality practice throughout the organization
   Implement a referral protocol
   Implement practice efficiencies
   Instill a patient-facing focus on quality (define it, convey it, train it, audit it, monitor
    it, live it)
   Leverage technology to expand access and delivery of services


   Develop change management program to guide the cultural evolution
   Establish a competency model to guide professional development and personnel
   Redesign dashboard for staff reflecting business and quality expectations
   Transform intentional design to optimize and refine the operational model
   Design leadership development and succession planning


   Elevate knowledge about specific services and general end-of-life issues
   Expand spheres of influence affecting resource development and policymaking
   Foster awareness and affinity for the Agrace HospiceCare brand
   Promote community hospice partnership(s)
   Expand relationships to strengthen referral network and community investment

Measurement Considerations

What are the high-level categories by which we can gauge our success?

   Improve Productivity
   Increase Patient Census & Length of Stay
   Improve Profitability & Reserves
   Expand Quality Standards
   Expand Referrals Networks
   Retain Key Performers
   Increase Fundraising

The Position

Agrace seeks a dynamic Chief Executive Officer who will provide strategic vision,
direction and leadership to this outstanding, mission-based hospice. This new leader will
take Agrace forward in new directions, will enhance the unique culture and values of
Agrace, and will expand its reach to serve an even wider, more diverse audience.

The organization's commitment to providing its patients and clients with the highest level
of end-of-life care and support will remain a guiding principle during this period of
continued growth and expansion.

The Agrace Chief Executive Officer will report to the Agrace HospiceCare, Inc Board
and to the Executive Committee of this board. Reporting to the Agrace Chief Executive
Officer are the following members of the Executive Leadership Team (ELT):

   Senior Vice President of Medical Services;
   Vice President of Clinical Services;
   Vice President of Finance;
   Vice President of Access;
   Vice President of Foundation & Holdings;
   Vice President of Quality and Compliance;
   Vice President of Human Resources and Learning and Development.

The Chief Executive Officer of Agrace will provide leadership to a multi-program
hospice care provider organization. This leader will achieve the following key strategies:

   Sustain profitability and build reserves

   Deliver the best possible care in the communities served

   Diversify resources and services for flexibility in adapting to changing conditions

   Become a forward-looking, proactive culture


      These are areas in which the new CEO will be expected to make significant progress in
      the first 12 to 18 months (goals and objectives are not listed in order of priority):

         Establish an appropriate, sustainable pace for change and growth across the Agrace
          enterprise while ensuring long-range financial stability. Achieve team cohesion and
          maximize the team’s strengths and capabilities to accomplish the organization’s goals
          and objectives.

         Develop a strong, well-conceived Strategic Plan for Agrace in collaboration with the
          Agrace Boards and Agrace Executive Leadership Team (ELT), ensuring input is
          gained from staff, as well as key constituents served by Agrace. Carry out a
          visioning and strategic planning process that allows the Board, ELT and staff to
          define and communicate the vision and strategic direction for Agrace.

         Execute the Agrace current 2011 – 2014 Strategic Objectives:

            o Sustain profitability and build reserves
            o Deliver the best possible care in the communities served
            o Diversify resources and services for flexibility in adapting to changing
            o Become a forward-looking, proactive culture

         Improve the financial, operational, and quality performance of all Agrace programs
          and services and achieve census goals.

         Lead in collaboration with the Agrace Vice President of Foundation & Holdings in
          order to successfully achieve Agrace fund-raising objectives. Earn the respect and
          trust of financial contributors.

         Establish closer relations with long-term care and assisted living centers, continuing
          care retirement communities, hospitals, health systems and emerging Accountable
          Care Organizations to create new Agrace agreements for the provision of hospice
          care to a wider audience. Establish partnerships and new ventures with these
          organzations to bring Agrace hospice services to a wider market. Increase the
          volume of Agrace hospice services in these settings.

         Establish ‘next generation’ performance metrics and national benchmarks against
          which to measure the Agrace performance. Foster and enrich the Agrace current
          culture of excellence in clinical competence and client service by more effectively
          tracking and measuring performance. Create ‘next generation’ dashboard
          performance metrics for the Agrace Board of Directors.

         Raise the profile and visibility of Agrace in the region.

   Preserve and enrich the superb relations Agrace has with patients and their families;
    with Agrace management and staff; with the Agrace Boards; and with philanthropic
    donors and supporters.

   Establish and maintain an effective working relationship with the Agrace Boards of
    Directors in carrying out the mission of the organization.

   Serve as a credible, articulate and dynamic spokesperson for Agrace with a range of
    constituents, including leaders in area hospitals, health systems, and emerging
    Accountable Care Organizations; nursing homes, assisted living centers and
    continuing care retirement communities; other home care and hospice providers; as
    well as civic and community leaders in Madison and throughout the south central
    Wisconsin region.

   Advocate for Agrace within its broad service area and within the hospice field at the
    local, state and national level. Become a national leader in the hospice field.


     The background, experience and personality traits of the ideal candidate for the Agrace
     CEO role in the view of members of the Agrace CEO Search Committee, Agrace
     Executive Leadership Team, and Agrace staff:

        A dynamic, articulate, experienced healthcare management professional who
         possesses a deep knowledge of and/or an appreciation for hospice, palliative care,
         end-of-life care, home care, and community-based care delivery. A leader who is
         passionate about hospice, palliative care, and end-of-life care; who is able to
         articulate the strong Agrace commitment to serving those in need of end-of-life care
         and to providing an exceptional level of care and service to those patients and their

        A healthcare professional with a track record of leadership and management success
         in healthcare operations, clinical operations, outpatient and/or community-based care,
         and/or in particular in community-based hospice care, gained ideally in a chief
         executive officer, chief operating officer, or other senior operations officer role in a
         high-quality healthcare provider organization.

        An executive who knows how to lead a hospice care delivery enterprise that results in
         patients and families receiving end-of-life care and support, and ideally results in
         patients enrolling in hospice earlier in their treatment. An executive with a record of
         providing compelling education to all communities served, resulting in growth in
         hospice enrollment.

        A high-energy, creative, results-oriented and values-driven professional, able to make
         ‘crisp’ decisions based on sound analysis of data. A reasoned-risk taker. Skilled at
         setting and communicating priorities.

        A professional who possesses and/or is able to build national influence with hospice,
         home care and healthcare decision makers. Brings knowledge of current and
         future/pending hospice, palliative care and end-of-lfe regulations, laws and
         payor/reimbursement structures.

        A leader with a demonstrated track record in leadership and management.
         Demonstrates an ability to hire, recruit, cultivate, motivate, train and retain a strong
         management team. A seasoned delegator, committed to staff development, staff
         recognition and mentorship. A professional who embraces diversity, demonstrates
         integrity and possesses strong ethics.

        A strategic thinker, comfortable challenging the status quo, able to lead, show
         initiative, and ‘hit the ground running’.

   An effective communicator and listener, open to input and ideas from others. A
    leader able to listen to others, provide clear direction and able to motivate and
    energize a team to perform at a high level.

   A competent business executive, who possesses excellent financial management
    skills. A leader who brings an understanding of new revenue generation strategies,
    cost containment tactics, reimbursement, and strong overall strategic financial
    leadership skills. An executive who brings excellent relationship skills relative to
    working with banking, investment and financial professionals.

   A professional with skills and leadership experience in fund-raising, effectively
    directing a fund-raising team, and engaging a Foundation Board. Possesses
    experience in the development of and execution of a long-range philanthropic plan
    for a nonprofit organization. Brings knowledge of fund raising and development
    trends and practices. Possesses experience in generating philanthropic dollars
    together with board members and foundation/fund-raising team members.

   An executive experienced and skilled in working effectively with a nonprofit board
    of directors, is able to form a "partnership" relationship with the board of directors.

   A leader with a strong, engaging public image. Able to establish effective
    relationships with fellow healthcare leaders, physicians, community and business
    leaders in the region, as well as local, state and federal healthcare regulators.

   A Master's prepared executive, who possesses a degree in a health-care or related


      Please submit resume in confidence to:

                                Kathleen M. Gillespie
                             Partner and Practice Leader
                               Home Care, Hospice and
                          Community-Based Services Practice
                             2015 Spring Road, Suite 510
                              Oak Brook, Illinois 60523
                       (Recommend receipt of resume via email)
                                Office: 630.990.1370
                                  Cell: 630.215.9631
                         (Recommend contact via cell phone)



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