Patient Referral

Crossroads Hospice in Plymouth breaks the mold in hospice care

PLYMOUTH >> During a visit from his home in Tulsa, Ok., Crossroads Hospice CEO Perry Farmer remembered a consultant’s advice to conform to the status quo in developing what has now become the largest privately held, for-profit hospice provider in the country.

At the time, Farmer was launching his fifth location in Atlanta — the company now has 11 sites, including Plymouth Meeting, which serves Montgomery, Bucks, Delaware, Chester and Philadelphia Counties — and taking care of about 1600 people each day.

“She told me I couldn’t run a hospice the way I wanted to. It was probably the shortest consulting job she ever had,” the affable Arkansas native added with a laugh over coffee at Panera Bread in Audubon.

Crossroads-style hospice care, which is provided “wherever you are,” Farmer explained, “in a private residence, nursing home, assisted living, anywhere,” has surpassed the traditional model of care in many areas, including patient-to-staff ratios and visits per week to patients.

Since 1995, Farmer has been taking the Crossroads concept that views hospice as not a place, but a high level of medical care that helps patients and caregivers by focusing on comfort and quality of life, to a standard of care that is four times the national average of 20 percent.

The nurses, nurse’s aides, physicians, administrators, chaplains, therapists and volunteers that operate out of the Plymouth Meeting facility, which opened in 2008 after relocating from Horsham, have achieved even greater success than the company average, reaching 82 percent Farmer allowed.

“Part of our delivery of care is that we are there so much more often than what a hospice is supposed to be, what is considered the national norm for a hospice,” Farmer said. “Most hospices (provide) two visits a week about, half an hour long, whereas we average an hour a day every day of the week, including weekends and holidays. For us, 80 percent was going to be our benchmark for standard of care, and I’m really proud that we hit that.”

A typical hospice brochure will tout two aspects of care, Farmer noted: a patient shouldn’t die in pain and shouldn’t die alone. 

“We’re all pretty good about the pain, but what about this dying alone thing? If that’s really the hospice philosophy, why is it only happening 20 percent of the time? If a family doesn’t want you there that much, then we’re out. But my question would be why didn’t they want you there and why didn’t (the hospice) develop a relationship and a trust with them all along?”

One of the most unique elements of Crossroads’ care is that patients are closely monitored through those multiple daily visits and efforts are made to be by their side when passing seems imminent, well beyond the usual 9-to-5 parameters.

“Everybody loves their hospice, but they just don’t know what a hospice can be. We start by asking if we can raise their expectations. If they’re not seeing somebody every day, is that something they would like to see?” Farmer said.

Farmer, a University of Oklahoma graduate, entered the business in 1989 as the third generation of a family that operated nursing homes, working in long-term care.

He started out as a nurse’s aide, strived for a well-rounded experience in the industry by working in several segments of care, and gradually worked his way up to administrator of multiple facilities in the Oklahoma City area.

“I was the youngest administrator in the state of Oklahoma for a while,” Farmer recalled, “and I knew I really wanted to improve things.”

Of all things, it was a book titled “The Hospice Philosophy,” which dealt with the many perceived issues of dying in a hospital or nursing home, that sparked Farmer’s entrepreneurial urge for more control in the way patients are given hospice care.

“I got to chapter three and called up the company I was working for and said I was going to resign. My wife was three months pregnant with our first child at the time when I started Crossroads in a little house in Broken Arrow, Ok. We started from ground zero and we’re not affiliated with any nursing home chain or physicians.”

Of the many enhancements that Crossroads has brought to hospice care over the years, Farmer is most proud of signature programs like “The Ultimate Gift,” inspired by the life lessons contained in the Jim Stovall-penned book of the same name, which asks patients “What does the perfect day look like to you?”

Whether it’s getting a makeover and then enjoying a romantic dinner with a spouse, or going to an Elton John concert — and maybe even getting to meet Sir Elton — “The Ultimate Gift” program works to turn fantasies into realties.

“There are so many things we keep adding that people want to know how we do it,” said Farmer, a regular speaker at state and national conferences in the long-term and hospice industries. “Because we’re still a family owned, privately-held company, that means I don’t have to report to a board of stockholders to hit some sort of imaginary return on investment. We’re free to do whatever we need to for our patients, like having a staff that is double what normal hospices have. Give patients what they need, do the right things for the right reasons,” he added, “and the bottom line will take care of itself.”

For more information on Crossroads Hospice call 888-603-6673 or visit

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