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00;00;00;00 - 00;00;18;10
Bryan Nowicki
Hello and welcome to Hospice Insights: The Law and Beyond, where we connect you to what matters in the ever-changing world of hospice and palliative care.
00;00;18;13 - 00;00;36;10
Bryan Nowicki
Endings and Beginning: Reflections on Meg Pekarske’s 25+ Years as a Hospice Advocate. So, Meg, this seems strange. I'm the first one talking in one of these podcasts. I this is going to take some getting used to. What's what's it like to be the second one talking in a podcast?
00;00;36;15 - 00;00;43;23
Meg Pekarske
I don't know. It seems fun. I don't need to be in charge. Yeah. You can just
00;00;43;26 - 00;01;18;03
Bryan Nowicki
Well, you've been such a steady voice. Leading the hospice team and our group. And, we know from your recent podcasts that, you're you're turning the page going into the next chapter, and you're certainly going to be missed by those of us here at Husch Blackwell, by the hospice community overall. And so I thought, in this podcast going forward, what better first guest to have than you who have built so much, on our team and, and, really has been a real asset to the hospice community.
00;01;18;03 - 00;01;21;08
Bryan Nowicki
So thank you for all that. And. Yeah.
00;01;21;08 - 00;01;51;21
Meg Pekarske
Yeah, well Bryan, thanks for for having me. And so as we release this, this will be the, the first one you're doing and the second one that talking about me and endings kind of way. And so I'm glad you pulled that that thread through. And, I don't know if I said in the last podcast that I was officially retiring, but I am officially retiring as of March 31st from law.
00;01;51;22 - 00;02;04;27
Meg Pekarske
Not like life, but but law stuff. So it's I think it's different than I thought it might be. So I can't wait. I mean, oh.
00;02;04;27 - 00;02;06;17
Bryan Nowicki
Howso? What did you expect?
00;02;06;20 - 00;02;36;02
Meg Pekarske
I think I knew that I from, early on, I mean, at least ten plus years ago. And Bryan, because you and I have worked together so long, maybe you remember, with that stellar memory. Yeah. Oh, yeah. Not all my words, but I knew that there is something else I'm supposed to do in my life, and. And not just this.
00;02;36;02 - 00;03;09;26
Meg Pekarske
And it's not to take anything away from this. But I knew for a long time that this wasn't what I was supposed to do for the rest of my like active life. And so, you know, I aggressively saved a lot of money and all this stuff. And so I'm very grateful to my former self, to have listened to that voice inside or whatever you want to call it, because it's not running away from something.
00;03;09;27 - 00;03;42;12
Meg Pekarske
So it feels like I've been thinking about this for a long time, and it's sort of a goal that you're reaching. So in terms of how it feels like it feels, I don't want to say uneventful because it's not uneventful, but I think everyone, asked like, oh, this is so exciting, and it is exciting, but I feel like in a quiet way and I'm coming off, you know, a year of that, I shared in the other podcast about my mom getting sick and dying.
00;03;42;12 - 00;04;10;17
Meg Pekarske
And so there's been a lot of loss and a lot of it feels like a very transition point in my life in many, many different ways. So I think it's, it's, setting something down that's been very heavy. So it feels like freedom, but freedom doesn't feel like there's the motion of like, oh my God, let me, like most people will ask me oh, so what trip are you taking or doing?
00;04;10;17 - 00;04;34;24
Meg Pekarske
And it feels like I am craving, like really the simple things. Like today. And I, as you know, Bryan, were like, nearly in a polar vortex here. It's super below zero and going to be 40 below zero on Friday. And it's like.
00;04;34;27 - 00;04;50;03
Bryan Nowicki
Yeah, high on Friday is negative eight. So yeah, I've been commiserating with people about from our our colleagues in Texas and South where, you know, they're dealing with, 40 or 50 or 60 degrees. Yeah, try negative eight, as a high.
00;04;50;03 - 00;05;16;04
Meg Pekarske
And then with wind chill, it's like -40. So it's like literally 100 degrees warmer there. So but like and it's snowing a lot mean a lot in total but like a little bit every day. And so like taking joy in and someone was like snow plowed for me today. Like snow blew. So you didn't like these little surprises.
00;05;16;04 - 00;05;41;25
Meg Pekarske
And then I like, ordered several months ago this olive oil and stuff from Greece. But now it's just arriving. And it's like these simple pleasures. It's not like big things. And, like, I don't know, I just feel. But I'm much more open to be able to take in the world. So as you can see, I'm sort of a philosophical, reflective kind of person.
00;05;41;26 - 00;05;43;23
Meg Pekarske
So. Yeah. One.
00;05;43;25 - 00;06;07;12
Bryan Nowicki
Word you used was freedom. And I know I talk with my kids a lot about freedom and how you get freedom. And hard work. You met. You mentioned saving aggressively. When I talk with my kids, you know, good grades, you know, make yours. Put yourself in a position to have all these options for you to take your life in a different direction.
00;06;07;15 - 00;06;30;17
Bryan Nowicki
And I think people lose sight of the fact that they can try to build today, freedom, and options in the future and then take advantage of them. So I think it's just a wonderful example that you're not your job in the moment. You are a different person, separate from that, and you have other interests. And if you build up that freedom, then then you're able to explore all of that.
00;06;30;17 - 00;06;32;29
Bryan Nowicki
So I think it's a real great example.
00;06;33;02 - 00;07;02;09
Meg Pekarske
Yeah. And I think freedom, because I, I had, an executive coach for Alister for a really long time, I mean, probably close to ten years. And it's like we have freedom, but if you don't exercise it right, it's like not having it. And why do we not exercised freedom? It's oftentimes sphere. Right. Like be comfortable with what you have.
00;07;02;11 - 00;07;24;23
Meg Pekarske
Yeah. Yeah. And I think you can be something new. You have to let go. You can't like I don't believe in this whole you can have it all, do it all kind of, mindset. I mean, and I think there is different like seasons and phases of life. I mean, I'm so glad that I did this. I mean, I've met amazing people.
00;07;24;23 - 00;07;52;03
Meg Pekarske
I've learned so many awesome life skills. I feel like very I feel like I was really challenged and I grew as a person. I mean, there's so much that this job has given me, but it feels very time to let that go. And my not like, like Michael Jordan, except I'm not coming back. I'm not I'm not going to try baseball.
00;07;52;07 - 00;07;58;24
Bryan Nowicki
You're not going to, you're not going to, pop up in Charlotte, with a new hospice practice.
00;08;00;08 - 00;08;43;05
Meg Pekarske
Like, I've just like, living on top instead of and, like, we had a great year this year as the team and it just and a lot of momentum going into this year. But it is really about I think being aware, though, that these are endings and, you know, you've been working with me and as I'm transitioning the practice and this has been going on for some time and just it's this has been almost like a death in the sense that and that's why the subject of my prior podcast was endings.
00;08;43;05 - 00;09;10;04
Meg Pekarske
Like where? Because I was helping you all with business planning or sharing my thoughts on that. And it's sort of like planning for something that you're not going to be around for is a very interesting and odd experience. Yeah. And to not see it as such is, I think, missing the point. And so I think there is, I've been paying attention to all of those stuff.
00;09;10;04 - 00;09;23;04
Meg Pekarske
It's very interesting and it feels very different than how, as I said, I thought it would, feel. And so I think that's sort of cool. I like to be surprised.
00;09;23;06 - 00;09;52;02
Bryan Nowicki
Yeah. Well, great. And I think, you know, the whatever you pursue, Meg, I know just you, your personality, it's going to be, pursued to the hilt to to to make you a, a more complete person. You're always interested. You're so curious. I think that's one of the things that you have said was a real value to you in being a lawyer and growing as a lawyer and growing the practice, the sense of curiosity and interest in other people.
00;09;52;15 - 00;10;15;21
Bryan Nowicki
And that's what I, you know, as you're kind of going into retirement, which is not, it's going to be an active retirement. Whatever you pursue, trying to look back on some of the successes. And I thought this would be a good moment for you to look back on your work as an attorney and your work in the hospice area and share with folks you know what?
00;10;15;21 - 00;10;38;09
Bryan Nowicki
What is did you see as the keys to success, in building your practice? But then what were those hospices and those hospice leaders? What kind of characteristics did they have that made them successful in all of that? And just try to get the the the insight of your 25 years into that. Why don't we start with just how you you built the practice.
00;10;38;09 - 00;10;49;27
Bryan Nowicki
What made the hospice team that you've led for this long, really become a successful, operation? To the benefit of a lot of hospices and related areas?
00;10;49;29 - 00;11;33;22
Meg Pekarske
Well, every hospice story starts with, like, kindness and good, good people. Because I came to this work as a 25 year old out of law school. But I found my way here because I was. And this is the story of most of my life. I feel like I'm attracted to people who are good people. And so when I started my law practice, I had two amazing mentors, Mary Michael, who had just started at our firm after running hospice care, for six years, I think it was.
00;11;33;24 - 00;12;07;16
Meg Pekarske
She had left her previous law practice after volunteering at hospice, then became the CEO of Hospice Care, which is now called the Grace. She comes back to private practice and has this radical idea. In 22,000, not 2020, 2022. Is there or zeros? 2007 I now want to help hospice as a lawyer. And back then I mean, I don't know if there were 1500 hospices in the country.
00;12;07;16 - 00;12;34;24
Meg Pekarske
It was very small business. I mean, it was still where you had like volunteer medical directors that was in like completely insane. And so and Mary was and and she still is because we connect and there there's something that is going to connect all this stuff. But so she was like authentic and real and, and so I learned from her.
00;12;34;24 - 00;13;05;07
Meg Pekarske
And then I had another great mentor, Bert Wagner, who, who passed away about two years ago, who was fabulous. And I had people who really cared about me. And so I think, like, I could have done a lot of things in my life, but I fell for followed people who were kind and generous and authentic and really, I think, passionate about what they did.
00;13;05;07 - 00;13;51;04
Meg Pekarske
And I think, like passion for what you do is, is contagious. And so and so then Mary too I mean, I'm 51. Mary was probably 60 when she retired and wanted to do different stuff. And so I'm like sort of a pretty young lawyer. And a couple of years before that, I had to make a decision if I wanted to just do hospice or, do the mix of what I was doing, which was long term care and hospice, which I was doing, the long term care work with Bert, and I chose hospice staff, even though I was very scared to do it just because it was a it has always been a national practice.
00;13;51;04 - 00;14;18;22
Meg Pekarske
So sort of a practice without borders. And going to these conferences, it's like, and this is before zoom and all this stuff where you don't know what your clients look like, because all you do is talk to them on the phone and, and the conferences back in the day, like NHPCO, you know, there were, you know, thousands of people there and it's like, who am I?
00;14;18;22 - 00;14;43;16
Meg Pekarske
And I mean, so there was a lot of fear and, and of like, if I can do this. And so and then I was just like, okay. And it was the best decision I could have made for my legal career. But it wasn't without a lot of fear. So I think and I've talked to our team about this is like, I want to be a person that does things that are difficult.
00;14;43;16 - 00;15;16;02
Meg Pekarske
And I think that doing things that are difficult. And I think having a you need to have passion and the passion can't be about money. It has to come from something else. Because I think that that's got to be the engine. And so I think that that's so kindness has really and generosity and authenticity is something that I feel like has become like a buzzword in leadership.
00;15;16;02 - 00;15;58;17
Meg Pekarske
But I think that hospice has had a lot of those leaders historically in their roots, because we had CEOs that were social workers. Yeah, chaplains. And so that's not usually the CB. Health care executive is coming from that perspective. And so I think that that compassion and connection to people is I think, especially as we think about I am, you know, what technology can do and then what is the work of humans.
00;15;58;17 - 00;16;30;29
Meg Pekarske
And I think like, you know, emotional intelligence has become more important than ever. So I think like connecting with people is really important, has been important to building our practice and our team. Because we have a really big team now. And that comes from like, you got to be able to, you know, attract people to. And that I feel like people can tell if that's authentic or not.
00;16;30;29 - 00;16;59;24
Meg Pekarske
And so I think those are I learned from people who mentored me. Those leadership skills are important to how people make you feel. And then I've also gotten that from clients who I think still have those similar values of kindness and then passion and enthusiasm for what they do. And then, you know, obviously being smart and relentless and, you know, all those other sort of boring things.
00;16;59;24 - 00;17;02;08
Meg Pekarske
But I think living that.
00;17;02;10 - 00;17;24;27
Bryan Nowicki
Yeah, I think what you said, the boring things, those are kind of the foundation for any really good attorney. But do you and I started working maybe 15 years ago, and I came from a different, very different kind of practice. It was administrative, but different kinds of clients and different, you know, ways of, of, of thinking about business.
00;17;25;00 - 00;17;55;16
Bryan Nowicki
And when I started working with you with hospices, I could see that the it's a kind of client that you can get passionate about because they're passionate about it. They're very mission driven. And I think as our team has grown, we have attracted other attorneys who have that passion for hospice every it seems a lot of our folks on the team, they have their hospice story, some interaction with hospice that was very meaningful to them or a family member.
00;17;55;19 - 00;18;27;07
Bryan Nowicki
And, you know, we're often sharing that and even with clients. But, yeah, I have found the hospice people to be just really good people to work with because they're mission driven. They're about the people and the patients and the way that that makes you were able to to kind of match that. And you had that same drive, I think was a way that, attracted hospices to you, but then attracted all other attorneys to the kinds of things you were doing.
00;18;28;07 - 00;18;32;03
Bryan Nowicki
I'm thinking I used to watch Parks and Rec when that was on. I don't know.
00;18;32;03 - 00;18;32;18
Meg Pekarske
If you.
00;18;32;21 - 00;18;59;04
Bryan Nowicki
Used to watch that, too, Meg, but yeah, I remember at the very end, Leslie Knope. You know, she was given the final episode giving some graduation speech. She was some politician, and she said some inspirational words. And then her final words was, go find your team. And I think I kind of think of that about, yeah, find the people who are going to share your values, have this, you know, need for for compassion and excellence and passion about what you do.
00;18;59;04 - 00;19;06;22
Bryan Nowicki
And yeah, I think that's kind of what, what you have been able to build and really is the core of the success here.
00;19;06;22 - 00;19;39;02
Meg Pekarske
So yeah. And I think the obviously as a leader you make missteps. And my need especially and I think early on in my career like this need to control because all that stems from insecurity. Right. Is like oh I need to be involved in everything and everything's on me and all this sort of that's hard to let go.
00;19;39;02 - 00;20;17;25
Meg Pekarske
And I think, as I was able to let go of that, things really blossomed. Mike. So to loosen the reins, so to speak. And trust me, you know, people and and I think it's really important to be reflective. I think as a, as a leader, Susan Kane wrote this book and quiet. And it talks about introverts and introverts as leaders because our, image of leadership is an extrovert.
00;20;17;26 - 00;20;24;17
Meg Pekarske
I think, like just TV media, you know, there's this alchemy and yeah.
00;20;24;18 - 00;20;27;05
Bryan Nowicki
The personality is.
00;20;27;08 - 00;21;15;03
Meg Pekarske
And I think that and I'm not saying extroverts aren't reflective, but I think this idea that she talks about in her book about, you know, you have to find a way to get the same things done that the extrovert needs to do. I remember her talking about like this one, CEO of this big company. I mean, he would write a personal note every year to every employee, which was like a ton, and everyone had a note or, you know, from him and like finding your own way to do that, regardless of, you know, even if you're not the person that wants to take center stage.
00;21;15;03 - 00;21;48;17
Meg Pekarske
I mean, so there's different ways to be leaders. And I think understanding that is, is important. And so some people might think I'm an extrovert, I think I and I saw something that there's a new term like the outer pivot. So it's like I can if I'm enthusiastic about what I'm doing, like, I'm excited about this. I mean, talk to me about like, art and design and color and, things that make me excited.
00;21;48;19 - 00;22;23;09
Meg Pekarske
Like, I can beyond. But if like, the conversation is boring and like transactional or whatever, like, it's harder and that's draining for me. And so I think like I'm a mix of both. But I think a real strength is I do think I'm a reflective enough person, in, productive way. I mean, not just like excessive rumination about all the ways I screwed up, but like, who am I?
00;22;23;09 - 00;23;05;28
Meg Pekarske
What are my values? How do I live my values every day? What is important to me? You know, those kinds of things. Having a life philosophy, I think, provides some structure for all the stuff that that you're doing. And, and having clarity around that. And so I think that that also someone who is reflective on themselves because I think and I know I've said this to you 100 times, Bryan, is I feel like all of your weaknesses are magnified when you manage people.
00;23;06;01 - 00;23;29;27
Meg Pekarske
And so if you don't know your own blind spots, like then it just. And so I feel like I learned so much by doing this job because I like because I do think I'm naturally reflective. And when things don't work out, like why did not want work out and what are the deeper issues? And I realized, like I had a lot of insecurity, like I'm not good enough.
00;23;29;27 - 00;23;46;17
Meg Pekarske
All this other stuff that that made me like be too tense and, you know, like, you know, too micromanaging and all this stuff. So I think that that's really important as a leadership skill, too.
00;23;46;19 - 00;24;09;14
Bryan Nowicki
Yeah. I think, kind of the lawyer mind is in is they train you to be paranoid, I believe, and you're always trying to anticipate everything and prepare for it. And to do that, you have to know everything. And so I think it's a leap from dope that that kind of training you get as an attorney early on to taking on leadership positions and letting go of that.
00;24;09;14 - 00;24;31;19
Bryan Nowicki
Yeah. But as our team has grown, you know, you've had to do that. I've had to do that. It's, you know, find your team. Who can you trust, who's reliable and kind of, be the mentor that, that you had? I remember Mary and Bert. They were great folks. And I just hope you and I have been mentors to folks on our team now as, as as good as they were mentors to you.
00;24;31;22 - 00;24;50;01
Bryan Nowicki
And so something that strikes me about the hospice, you know, just, you know, you've I think you've, you've you and I've talked also about it seems every five years your practice is different. What you were doing now is different from five years ago. And five years before that. Just the adaptability of trying to keep up with all the changes.
00;24;50;01 - 00;24;52;12
Bryan Nowicki
It keeps things very interesting.
00;24;52;15 - 00;25;35;27
Meg Pekarske
Yeah. Well and I, I think again, where reflection comes in is I mean part of that's reacting to like what people need. Right. But also thinking about, well what do people need in the coming years. Right. And so when we moved to hush now six years ago, I really wanted to build up more of a corporate presence because there is just a lot I could see happening and more to come in combinations and restructurings, and especially a lot in the not not for profit space.
00;25;36;29 - 00;26;04;29
Meg Pekarske
And it's like if I want to be like, how can I be of service to my clients? Like I need to build more skills on my team that I personally don't have. And that's, again, a real growing thing is, like, I'm a regulatory attorney by by training and so like I'm not a corporate lawyer. And so like knowing that that's the need and then beginning to build that.
00;26;04;29 - 00;26;33;27
Meg Pekarske
And now I mean we have over the last like six years I mean now we've had a almost it was like $800,000 worth of work. That's corporate that like six years ago I wasn't doing and part of that market. But I also it's also intentionally building a skill sets on your team to like is you're looking at what's what's in front of you.
00;26;33;27 - 00;27;06;29
Meg Pekarske
Because to be the leader, you can't be the doer too. And so I think, like, you have to let go of things and that I that was also sort of hard thinking like, well, but I am the doer and like you get very comfortable in the doing and and then you also think, well, but clients want me to do all the doing and it's like, yeah, I mean, I think our practice we had almost 15,000 hours of work last year on our team.
00;27;07;01 - 00;27;37;09
Meg Pekarske
Well, obviously I am one human. I mean, you can't you if you want to build something bigger than yourself, if you have to let go, you have to do the what other people aren't going to do, which is serve the forward thinking and all that stuff. So that's been fun. I think we were we were building out for like the carbon to Medicare Advantage and like building more managed care experience.
00;27;37;09 - 00;28;07;22
Meg Pekarske
And so, you know, now who knows where that's going to go. But just and I think that that sort of fun I've enjoyed doing that. But again, all of this stuff, the the theme is you have to let go of things in order to grow. Right. And so letting go of some of the doing and like seeing your value and also, you know, I've always it's been really important to be a good financial steward of our clients resources.
00;28;07;24 - 00;28;32;27
Meg Pekarske
So it's like having me or you do everything same good. When we have very capable people who are in many respects probably more efficient than we are in many. These tasks just, you know, whatever. But they're building raid. It's like people don't want people want your vision and your and your management, and you're going to make sure everything gets done.
00;28;32;29 - 00;29;03;07
Meg Pekarske
But and so I think realizing what your value is. And so I think a real blossoming for me was actually seeing that I have skills and gifts and like, I deserve to be in the room and I didn't have to like, hide behind competence all the time, like because I thought I was too insignificant is like when you accept your own gifts, then I think that it allows you to then live those in the world.
00;29;03;07 - 00;29;24;27
Meg Pekarske
But also, I think you're a better person to be around because if you know, if you don't accept your own gifts, then I think then you can be harder on other people and be like, well, why can't you do that? I can do this. And it's like, well, but they have different skills and gifts and I, I also think you really need a diverse team.
00;29;24;27 - 00;30;07;08
Meg Pekarske
And I again, that's sort of a buzz thing now, but I think that it's critical and diverse in every way in terms of different strengths. And that I mean, and you talked about curiosity and where that, like, plays into I'm really curious about people and I, I really enjoy people. I enjoy getting to know them. And, and it's much more interesting to when you have a diverse team of people with a lot of different backgrounds, like to learn about them and then like, obviously that creates some cohesion and stickiness, but it's also just way more interesting.
00;30;07;08 - 00;30;12;29
Meg Pekarske
And it's like, who wants a bunch of mags on their team right there? You know, I mean.
00;30;13;02 - 00;30;34;14
Bryan Nowicki
So yeah, you have to have all that different perspective. If, if you don't like you the way you've kind of you built this from the ground up and each with each new attorney that comes on, you're elevating your game. If you weren't embracing that, you know, we wouldn't have a team of, like, you know, a dozen core attorneys.
00;30;34;14 - 00;30;45;00
Bryan Nowicki
And then beyond that, dozens of others who are in supporting roles, it would be you and me, you know, working on two audits at a time, like we did 15 years ago.
00;30;45;04 - 00;31;18;27
Meg Pekarske
So sitting in a room over the Christmas holiday. Over the Thanksgiving holiday. Yes. Yeah, yeah, we had 124 attorneys work on our hospice clients this year. So, we have a lot of, of help. And so I just think it's everyone has their role on a team. And I think knowing what that is and a challenge I have is sometimes over helping, which can be smothering.
00;31;19;04 - 00;31;52;22
Meg Pekarske
But and like, but I've always really wanted people to not feel alone and not to feel like because I think a lot of attorneys are pretty obtuse and don't spend a lot of time explaining things. And so I've the tendency to like overexplain and over help, which probably on balances better than like the figure it out. But but Mary and BR both said this to me early on in my career, and I didn't understand it because it's not like that's not right.
00;31;52;22 - 00;32;32;09
Meg Pekarske
Is, you know, not everything needs to be a plus. Plus, like. And it's not that we don't need to be doing good work all the time, but it's it's what what energy match your energy to what this is. And then also I think it is, letting go like in healthy risk taking. So, my prior podcast, I talked with Mettle Health and I talk about how I'm working with them on some of the grief related to my loss of my mom.
00;32;32;24 - 00;32;56;21
Meg Pekarske
One of the things I was talking about with Natalie, who's my counselor, there was about healthy risk taking. Right? So I think this applies here, which is healthy risk taking means like giving a project to someone. And I remember I can literally remember Bert saying, just think if they screw up, how bad could it be? Right? And so right.
00;32;56;21 - 00;33;25;23
Meg Pekarske
And I do think about that. Like what's the worst that can happen? I mean, there are things like if it could be really bad deadlines. Yeah, deadlines. And like it's, you know, significant, you know, whatever. But like that has been a helpful guide for me. But I've had to live into that understanding because I think all the stuff with leadership, I mean, I think it's through observing others.
00;33;25;23 - 00;33;51;20
Meg Pekarske
And then also people could tell you all the wisdom, but you have to it has to be lived and like earned wisdom. Like Mary and Bert said a lot of things to me, but I had to live those experiences. So maybe they told me that. And now, 15 years later, like, oh, now I get it. Yeah. And so I think it's like paying attention to what people are saying.
00;33;51;22 - 00;34;17;18
Meg Pekarske
And then, you know, again, this gets into being a reflective person is like you pull that out from the recesses of their mind and then you're like, oh, this is what that person was talking about all those years ago. And so, so I do think having Mary and Bert, I think reflective people and what I wanted to tie this to is so as you know, Bryan, I love art.
00;34;17;18 - 00;34;49;24
Meg Pekarske
I love making things like of all kinds, whether it's floral arrangements like drawing, painting, sculpting, like making jewelry, fashion like, there isn't anything that beauty making doesn't, touch, but interesting. Mary and Bert both are artists too. And so Mary and I still talk and she she has become a painter, too. And she. I make my own cards, and she makes cards.
00;34;49;24 - 00;35;30;03
Meg Pekarske
So, like, I get a homemade card from her every year with her art and, and Bert was also, he was into etching. And so both of them even did a little bit of that, when they're still working, but then really did a lot of that. And so that's cool that there's that similarity and maybe there's something about our hidden our like artistic ness attracted to us, but it's weird how Marion Bird, there's so many parallels in my life to their life, even though it didn't make sense at the time.
00;35;30;03 - 00;35;51;08
Meg Pekarske
And you're like, yeah, in the world of 8 billion people or whatever, how did I find two people that, like, got me and they really cared about me? I mean, Mary and Bert really loved me, and that really made a difference. Then and again, we're we're just it's really fun when you look back on your life and be like, oh my God.
00;35;51;11 - 00;36;12;29
Meg Pekarske
I mean, to your earlier point where this whole thing started is I put myself in a position to be able to have these experiences, but I made the choice to then do like, you know, the whole thing about freedom, right? You I worked hard in school and I did all these things and I checked all these boxes, but then saying yes to experience.
00;36;12;29 - 00;36;23;28
Meg Pekarske
Yes, the things that make you scared. Yes. Do. And then following your guard on the staff of good people lead you to good things. Right. And so,
00;36;24;00 - 00;36;46;14
Bryan Nowicki
We had to be intentional about it. This stuff was not, you know, good things. They could happen to you by happenstance. But, you know, I think you've you've kind of made your world around you by the people who you worked with and decisions you've made. And I think being proactive about your life and making those decisions is a real key to to happiness and success.
00;36;46;16 - 00;36;48;18
Bryan Nowicki
So, yeah, that I explore that.
00;36;48;20 - 00;37;16;24
Meg Pekarske
And, and I think to and this is I think often quoted Maya Angelou said people are going to remember how you made them feel. And again, that seems like a lived truth to me because our team, had this nice little teams gathering for me because the our team is all across the country, at the end of December.
00;37;16;24 - 00;37;43;16
Meg Pekarske
And it was so touching. It was a big surprise. And some people said things at the end. None of it was really like, you're such a great lawyer. Me you taught me that. Blah, blah, blah. It was like, this is how you made me feel. And, I got this email that I will treasure forever from someone on our team.
00;37;43;16 - 00;38;23;00
Meg Pekarske
And it was just like all of these instances about how I connected with her. Like at the retreat, I gave her this big hug and she was really insecure going into this thousand. And, you know, attorney firm trade and, and this person is a natural hugger, but anyone who knows me knows I'm a hugger. And so and then, just like I went to first her work in our team, I spent like, an hour with her just to get to know her and all these things that, I mean, they're intentional at the time, but that's sort of who I am.
00;38;23;00 - 00;38;53;18
Meg Pekarske
And so this whole gathering celebration thing, I really felt seen for who I am as a person, and that was more satisfying than anything like, oh, you're so smart, even though I, I wanted for my whole life, like, I want people to think I'm competent and I'm smart and this and it's almost like I've transcended bad and it is really like, how do I make people feel and how I made it difference and mattered to them in some way.
00;38;53;18 - 00;39;05;10
Meg Pekarske
And so that was really, really struck me in terms of like, wow, I spent my life doing something worthwhile.
00;39;05;12 - 00;39;34;17
Bryan Nowicki
Yeah. Oh, absolutely. So, so, Meg, before you kind of depart the practice of law and, and, kind of focus on, on your other interests, I want to I want to try to gain the benefit of your insight into your experience with hospices and hospice leaders who you've seen come and go and grow and shrink and start and disappear over the years.
00;39;34;19 - 00;39;54;25
Bryan Nowicki
What have you seen? Or the keys, as the keys of success. So those hospices, those leaders who are out there, what do you think would be things that they could pursue, to to have that staying power to fulfill their mission and their vision? Based on on your experience.
00;39;54;28 - 00;40;27;01
Meg Pekarske
I think it's less about the white and it's more about, is that, you know, should I do a palliative care program? Should I do the should I do that? And you and I have done more training like for strategic planning retreats. And I think the question that really lives with me is, you know, what does your community need and meeting that need.
00;40;27;03 - 00;40;57;18
Meg Pekarske
And I've seen people do that. And it's not always in their lane, but it's like, this is a need. And, Kathleen Benton, who is the CEO of hospice of the barn, I did a podcast with her in our leadership series a number of years ago, and they she is a go getter and really talk about, like, contagious energy, like she found a way to like, get this funding.
00;40;57;18 - 00;41;17;28
Meg Pekarske
And she was doing all these Covid vaccines for her community and all the staff and she I mean, one would say I'm a hospice. I have no business doing this, but it's like there is a need. And then she's a connector. So it's like, you know, connecting with this, this business who has a place to do all the stuff.
00;41;17;28 - 00;41;42;05
Meg Pekarske
And so I think it's it's like asking what your community needs as opposed to, well, I went to this conference and everyone else is doing this. And so I must do this. I mean, I think I'm very much a person that I need to be exposed to a lot of inspiration. So this is an artistic way, visually.
00;41;42;05 - 00;42;19;29
Meg Pekarske
But like, I think the same is going to conferences. I mean, you can get inspiration there, but then you need to have your filter, like, I'm not following the path of everyone else. I'm following. You know, I'm in this community and what does my community need and how can we make that work? And so, you know, and maybe that's sort of how thrift stores for hospices, but there are sort of ubiquitous now started because I was like, you know, we work with dying people, and their families have all of the stuff that they need to get rid of.
00;42;19;29 - 00;42;39;10
Meg Pekarske
And like, maybe that's meeting a need and then it helps support our foundation or you know, whatever I have, I have no idea of making that up. But like, that has nothing to do with providing hospice care. Now we're providing a retail outlet. But it was like maybe it was maybe meeting a need and then it does raise money.
00;42;39;10 - 00;43;10;18
Meg Pekarske
And so I think it's starting with a question like that. And then I think the all the things we talked about leadership of being reflective and what are your values and are really important. Like those are the skill building I think we need and strong leaders and I hope we don't lose the walk. I think we need business savvy at the executive level.
00;43;10;20 - 00;43;44;14
Meg Pekarske
I don't I hope hospice doesn't abandon having social workers as CEOs and chaplains and, you know, people that don't have MBAs, because I think that's a real strength. And I hope we don't. I mean, I, I feel like we're becoming our you know, I've talked about this a lot, our own fiefdom and health care. And so and, and that it everything that made us special and unique is starting to we're becoming a little vanilla right.
00;43;44;17 - 00;44;19;09
Meg Pekarske
Like and so I hope that we keep our weirdness or whatever it is that keep Portland weird or whatever that is. Yeah. So like our counterculture roots, which are approaching problems in a holistic way as opposed to this profit driven way, like how can I make the most money out of the doing stuff? Because I think if you're awesome at what you do like you can, the money will flow.
00;44;19;09 - 00;44;42;21
Meg Pekarske
I think, you know, now you need to be creative and all these other things. But so, I think our strength is in our roots of counterculture, a holistic model of care. And how can we apply that a different way. And that's why the last podcast that I did with Mental Health was really exciting for me, because I think they're doing something that's counterculture.
00;44;42;21 - 00;45;20;24
Meg Pekarske
It's much more direct to consumer. But it has so much of like the roots of hospice that, like, are awesome in terms of accompanying people through something that is difficult and accompanying meaning. You know, the nurses accompany me, the social worker or the chaplain like, and the how we define what we're doing. And in I think, verbs or actions and adjectives that are more evocative of caretaking as opposed to business mindedness.
00;45;20;24 - 00;45;47;21
Meg Pekarske
Like, I think that's why people historically love hospice so much because it made them feel different, right? Made them feel not like when you go to the hospital or whatever. And I'm very grateful I can have that experience if I it. But like we are different and like how we make people feel and all that stuff. So I think that's really important to our future.
00;45;47;21 - 00;45;59;13
Meg Pekarske
If you know, we're going to have a future that is, I think, vital. And not just like run of the mill kind of stuff.
00;45;59;15 - 00;46;35;04
Bryan Nowicki
And so, Meg, I think hospice is they've grown so much over the past 25 plus years. The community, they're they're under unprecedented scrutiny nowadays. I mean, just the kind of work we're doing with audits and enhanced enforcement than the way enrollment is scrutinized and and all that. I think there's a lot of pressure, maybe more pressure than before, than ever before on hospices and trying to stay afloat and pleasing all the stakeholders, right?
00;46;35;04 - 00;46;54;06
Bryan Nowicki
So, I mean, under this kind of current pressure, what's the what's the ray of hope or what is what is it that hospices should kind of look forward to, as guiding them through these troubled waters and continuing to bright provide that great service. Wow. Inspire us. Yeah.
00;46;54;08 - 00;47;28;29
Meg Pekarske
Well, I think it's like everything I've already said, I think we stay the course like 25 plus. I told you we needed the plus sign because it's been more than 25 years. Is like, stay the course. So this like this benefit I think is broken in in many respects. But care for the people that are eligible. And I get it.
00;47;29;00 - 00;47;57;25
Meg Pekarske
These audits and I don't want to minimize their impact because it is crazy and insane. And it is wrongheaded and in so many different ways and flawed and all that stuff. But of all these years of doing this, every big case that we've ever had, we have one like. We have like when you do the right thing, there is there is a way through.
00;47;57;25 - 00;48;21;23
Meg Pekarske
And and when we've given talks on audits, I always say the beginning of the story is not the end of the story. And then sort of the and it's painful, but but I don't want to say how people do is they just retract back and everything is so knee jerk to like, well, we better discharge this patient because, you know, they hit six months and they're not dead.
00;48;21;23 - 00;49;01;03
Meg Pekarske
I mean, there's a reason why there used to be the 210 day benefit limit while the Congress got rid of that. And then it became unlimited in in light of like, you know, how we die and the, predictability of that and stuff. And so I know I've been saying this for a lot of years. I mean, I'm not saying you shouldn't work on good documentation, but if you have a team that you trust and you have a strong compliance program, so you're not just like, hoping for the best, like you're actually testing your team, like you're doing internal audits and testing that.
00;49;01;03 - 00;49;38;28
Meg Pekarske
And so you're not blindly not blind faith. But like if you're doing those things and you care for the person that happens to live three years, you that's a good hospice. That's still doing bad. Now they're they're pressing, you know, their team to save and document and all that stuff. But I think it's like stay the course, do the work and just make sure that we're doing it well and have solid people who, you know, all these things that we talked about of what makes a good team and people you can trust and staff, but then trust the process.
00;49;38;28 - 00;50;09;02
Meg Pekarske
I mean, I think we need advocacy and change, but I just reflect on all of the great victories and I pause and great victories because I feel like we never should have had to battle those to begin with. But we have won those things, and I think we have found a way to win for people doing the right thing.
00;50;09;02 - 00;50;37;09
Meg Pekarske
So, I think all is not lost. And so I think it's stuff I've been saying for a while, but adopt a mindset of these things are going to happen as opposed to these should be never events is. And I know that sounds trite, but I still think you need to build, you know, cash reserves. And, you know, this is why you need to run a good business.
00;50;37;09 - 00;50;59;15
Meg Pekarske
But like, these things are going to happen and you need to know who to call, right? You call. I think we do a great job and you have your team in your prepared, and you don't let all of this rocking. You know, you're on the boat and it's like you need to be like the steady hand and and think about the future.
00;50;59;16 - 00;51;25;05
Meg Pekarske
Like all the stuff we talked about of like what's on the horizon. What does my community need? Because no one is inspired by hanging on to the last wrong and the sky is falling, right. You're not going to inspire your staff. You're not going to inspire anyone been that way. And so I think it's like if as leaders, you adopt this mindset like, these things are going to happen, I'm the steady hand.
00;51;25;08 - 00;51;57;04
Meg Pekarske
I have the team, we've done all this internal auditing. I feel real confident. I mean, it doesn't mean that we're going to get the right result immediately, but I'm going to stay the course. It's a long game kind of stuff. I think that that's sort of the essential mindset. I also think like being involved in state and national organizations that are doing advocacy is incredibly because there are so many flaws in the system, and we need to advocate for change.
00;51;57;06 - 00;52;22;28
Meg Pekarske
And so I think making your voice heard, but it's not you calling up your senator individually. I mean, I think the lack of effort is really important because I just have to believe that, you know, hospice of any care provider out there has the highest customer satisfaction rating out there, and it saves the government money. I mean, there's so much in this narrative.
00;52;22;28 - 00;53;00;09
Meg Pekarske
Just you don't need to understand everything we do to see, you know, the value both to people, but also, you know, financially about the benefits. So of the so, so I think it's just that's not panic times like, you know, and I don't think it's the Titanic, but you know, I think it's hard to do. I mean, you and I have had so many conversations with CEOs and again, it's stressful and I think that you and I have gotten great satisfaction by being able to be the steady hand to the steady hand.
00;53;00;11 - 00;53;16;12
Meg Pekarske
Right? Like, okay, I've been around this block many a time here's like the runaway, here's what's going to happen here is that we're going to do this. And then if this doesn't work, we're going to because we're ten steps ahead, figure in the stack about like, you know.
00;53;16;15 - 00;53;44;15
Bryan Nowicki
It's very it's very it's been very fulfilling when people reach out to you for help and you can say, okay, we got this. We know what what this is all about. Here's the situation. And a lot of times it's just that information that's going to allow that CEO and leadership to then implement what they need to do, with their team and their organization to say, okay, we have a plan, we know how we're going to get through this, whether it's audits or regulatory change or, you know, whatever it might be.
00;53;44;15 - 00;53;51;05
Bryan Nowicki
But that that I think has been really rewarding for us to be able to do that patience and persistence is what we've always.
00;53;51;06 - 00;53;52;02
Meg Pekarske
Yeah, yeah, that's.
00;53;52;02 - 00;54;19;03
Bryan Nowicki
About with our clients. So. Well, Meg, thanks so much for for building the team. And for this podcast. And although your, your place, as, as a hospice advocate actively is, is coming to an end because you're pursuing your best life out there. It's a beginning for me. I'll be doing these podcasts going forward and, leading our team into the future.
00;54;19;03 - 00;54;30;22
Bryan Nowicki
And I only hope that we can sustain the very high standards that you've set. But, thanks for all of that. And I'm sure you and I will be talking as I bend your ear on certain tough issues that come up. So. Yeah.
00;54;30;22 - 00;54;48;08
Meg Pekarske
Well I think there's great promise for for the future. And yeah, you'll be the steady hand if anyone has the steadier hand. I don't think I can think of them having eight kids. And, Yeah.
00;54;48;09 - 00;54;49;23
Bryan Nowicki
Staying sane. Yeah.
00;54;49;27 - 00;55;12;02
Meg Pekarske
Nothing stresses you out. I mean, maybe I don't know your internal life, but you are steady. I mean, that is a great strength of. I'm a little. Woo. You know, but you're like, you know what I mean? Line is, you've only been mad at me once. Except then you say you're mad at me many times.
00;55;12;05 - 00;55;46;11
Meg Pekarske
But anyway, you are a steady hand and you, you know, and obviously super smart and talented and all that stuff. But I think you know that because there's a lot of, roadblocks like that are going to need to be navigated. And, you know, that steady hand and we have so many talented folks on our team, and that it will be fun to, to see where things go.
00;55;46;11 - 00;55;57;05
Meg Pekarske
But, yeah, it's all right. I'm, I'm calling this volume two. I'm starting volume two. It's not a chapter. It's more significant than this. This is volume two of Meg.
00;55;57;13 - 00;56;09;15
Bryan Nowicki
Volume two. Well, best of luck to you, Meg. Thanks for everything. And thank everybody for listening. Until next time, take care.
Meg Pekarske
Bye.
00;56;09;18 - 00;56;29;24
Bryan Nowicki
That's it for today's episode of Hospice Insights: The Law and Beyond. Thank you for joining the conversation. To subscribe to our podcast, visit our website at huschblackwell.com or sign up wherever you get your podcasts. Until next time, take care.