The day begins long before the first patient is seen.
As the sun rises over North Texas, the hospice team from Heart to Heart Hospice (HtoHH) is already moving. Phones are ringing, schedules are shifting and dozens of clinicians, social workers, aides, chaplains and community liaisons are preparing for another day centered on one thing: helping patients and families navigate life’s most difficult chapter with dignity, comfort and compassion.
On this particular day, that mission unfolded across hospital rooms, skilled nursing facilities and branch offices throughout the Dallas-Fort Worth area, revealing the intricate coordination and deeply human bonds that happen behind the scenes of hospice care.
Start with a Plan … and have a Backup Plan
For Niesha Winters, Regional Vice President of Sales, every day begins with preparation.
Approaching her second anniversary with Heart to Heart Hospice this October, Winters oversees a team of 22 Community Education Representatives (CERs) across the North Texas and Southern Oklahoma regions. Her role requires equal parts strategy, leadership and adaptability.
“Hospice is never one-size-fits-all,” she explained as the morning’s schedule came together. “You have to be ready for anything.”
That flexibility was especially important on this day as Brittnee Kreymer-Austin, a CER who joined Heart to Heart Hospice in May 2025, stepped in to help cover responsibilities for a teammate who was out on vacation. For Kreymer-Austin, who averages between 17 and 22 admissions each month, stepping up for teammates is simply part of who she is and the culture of the organization.
Every potential hospice admission requires judicious coordination. Teams must carefully determine whether a patient is appropriate for hospice services, what level of care is appropriate, and just as importantly, what the backup plan will be if circumstances change.
“No matter how much planning you do, you always need another option ready,” Winters said. “Our responsibility is to make sure patients and families always feel supported.”
That philosophy would become especially meaningful at the team’s first stop of the day.
A Quiet Conversation in the Hospital
Inside Medical City Plano, the pace is brisk. Clinicians move through hallways. Monitors beep softly behind closed doors. Families and friends gather at bedsides, trying to absorb difficult news.
Here, the Heart to Heart Hospice team was called to assess a cancer patient whose condition had prompted discussions about end-of-life care.
Before entering the patient’s room, the Heart to Heart Hospice team met with those providing care through the hospital to review the patient’s medical history, current status, what the family understands about the status and goals of care. Every detail mattered.
John Mburu, a registered nurse who has spent seven years serving hospice patients with Heart to Heart Hospice, carefully reviewed the information.
Admissions nursing is unlike many other healthcare roles as Mburu is often meeting families during some of the most emotional moments of their lives. Each visit requires clinical expertise balanced with empathy and patience.
After reviewing the patient’s chart, the team entered the patient’s room. Introductions came first. Then came attentive watching and listening.
Speaking with the patient one-on-one, Mburu gently assessed her condition while helping her understand the support hospice could provide. The conversation was calm, personal and unhurried. Winters assisted with explaining the process and compassionately comforted the patient with reassurance that she would soon feel relief from her pain due to the implementation of hospice care.
Behind every admission decision is a careful evaluation. Following the assessment, Mburu contacted the hospice medical director to discuss the situation and determine the most appropriate course of care.
“We want to make sure we’re doing what’s best for the patient,” he said.
While Mburu was at the bedside, Kreymer-Austin spoke softly with the patient’s brother on the phone outside the room to explain the consent forms, offer support and answer questions. She and Winters worked simultaneously behind the scenes to coordinate transportation, arrange equipment and medications and organize every detail needed to deliver a smooth transition.
The goal is simple but profound: make the transfer as rapid, comfortable and stress-free as possible.
For families, these details often seem to happen almost magically. For hospice teams, they are the result of countless phone calls, conversations and decisions made behind the scenes.
Friendly Faces at Accel Willow Bend
By midday, the team headed to Accel at Willow Bend Rehabilitation and Skilled Nursing in Plano.
The atmosphere here felt different.
As Kreymer-Austin walked through the building, greetings came from every direction. Staff members waved. Residents smiled. Conversations flowed naturally.
It was clear that Kreymer-Austin is present often and has formed tight relationships with staff and residents alike.
Relationships are at the heart of hospice care, and nowhere was that more apparent than on this stop. The visit wasn’t just about checking schedules or reviewing patient information. It was about making rounds, supporting team members and checking to make sure patients continued receiving the care and attention they need.
“Being present matters. The trust we build through everyday interactions allows us to better support patients, families and our facility partners.” Kreymer-Austin said.
Hospice professionals often become extended family for the facilities and communities they serve. They celebrate victories, provide comfort during losses and build trust over months and years of consistent presence.
The familiar interactions throughout the building reflected those connections … and for patients and families, the reassurance of seeing a trusted face can mean everything.
Team Meeting
The final stop of the day brought everyone to the Carrollton branch office for the monthly all-team meeting led by Executive Director Jim Reuber.
After a day spent in hospitals and nursing facilities, the gathering served as a reminder that exceptional patient care is built on strong teams.
The room buzzed with conversation as employees greeted one another, exchanged updates and settled into their seats.
New hires were introduced, receiving a warm welcome from colleagues who understand the challenges and rewards of hospice work.
The group then discussed one of the organization’s most heartfelt initiatives: volunteer “Tuck-In Calls.” Every Thursday, volunteers reach out to patients and caregivers before the weekend to check on needs, answer questions and help families feel supported as the weekend approaches, when resources may be less readily available.
The team also reviewed results and feedback from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey, the national Centers for Medicare & Medicaid Services survey that measures caregiver experiences with hospice care. The discussion focused not simply on scores, but on what families were saying and how the team could continuously improve.
There was also time for some fun. A teamwork exercise known as the “Chair Test” encouraged participation, laughter and reflection on how individuals work together to achieve common goals. Even in a profession centered around serious and emotional circumstances, moments of levity serve a very important purpose.
The team also celebrated the launch of an Employee of the Month program in which one high performing teammate will be recognized and pictured on a central wall in the branch office for the calendar year. Since the program just launched, recipients were acknowledged from January through July, highlighting the dedication and commitment that drive hospice care every day.
Following the unveiling of the Employee of the Month wall, more recognition followed. Senior CER, Adriana Maubossin, was announced as the team member representing the Carrollton branch at the upcoming Heart to Heart Hospice Annual Recognition Gala drawing enthusiastic applause from her peers. At this employee-centered celebration she will be honored as one of 54 overall winners, and one of only ten individual winners receiving the “Best in Sales and Marketing” award.
Compassion is the Focus
As the meeting concluded and team members began returning to their duties or heading home, the day’s impact extended far beyond the places they had visited.
A patient received guidance during a critical healthcare decision and her family gained clarity during an uncertain time.
Patients in a nursing facility saw familiar caregivers who know their stories and care about them as individuals.
Team members found support, recognition and encouragement from one another.
From hospital admissions and bedside conversations to logistical coordination and outreach, hospice care is often described as treating the whole person. In reality, it also means supporting the whole family and relying on the entire team.
For Winters, Kreymer-Austin, Mburu and countless others across North Texas, this work is about far more than healthcare. It is about showing up, listening and honoring the commitment that no patient or family has to walk through life’s final chapter alone.
And as one day ends and another begins, at Heart to Heart Hospice, that mission continues, one conversation, one visit and one act of compassion at a time.
