In the sensitive industry of health services, John Camperlengo has shared tears with his clients as they say goodbye to loved ones and shared insights with associates to promote cost savings. He didn’t always have such an intimate knowledge of the business, but a Marine Corps background instilled in him one crucial understanding: serve the business first.
What did Gentiva look like when you joined in 2010?
When I took over as general counsel in 2010, I made it my goal to define the mission of the legal department. I saw two options: I could sit in the background and play catch-up on what the business was trying to achieve, throwing a wrench in people’s plans by telling them what they can’t do, or I could literally go out to all the regions, learn what our people do, and show them how I could help them accomplish their goals.
What was the biggest advantage to making those trips?
I had come from Wall Street working in financial securities, so I had no experience in health services. I learned how to pick up the phone and say hello on a sales call. I got my tuberculosis shot and made house calls with physical therapists. I sat with families while nurses tended to loved ones with less than six months to live. You’re there, and you’re crying, and they’re crying. I gained perspective of where the holes were in our business, which informed my decisions and helped me articulate our direction. After that, people didn’t see me as an obstructionist, but as a businessperson who happens to be a lawyer.
Where does that ethic come from—being a businessperson first?
I joined the Marine Corps after law school, and in the Marines, everything supports the infantry. You can be a baker, an engineer, or an attorney, but you’re a rifleman at all times. When I returned to civilian life, I equated that to my legal profession. I support the business at all times.
Where did you identify opportunities in the field to advocate for the business?
One of my first responsibilities with Gentiva was collecting cash that we were owed by various managed-care payers. Being in the field, it became apparent that the problem persisted. With reductions in home-health reimbursement, we’ve sustained about $150 million in bottom-line cuts in the last four years, so we’ve had to adjust accordingly.
How have you been able to add value to the business in spite of this?
You can’t underestimate the effect of cost controls—not just getting outside counsel at the lowest rate, but doing our own collections to avoid losing a third of the money on legal fees. We’ve also been proactive to appropriately classify people under the Family and Medical Leave Act and give our representatives the information they need to implement their own cost-saving measures. We’ve seen family and medical complaints decrease and litigation avoidance trend down so that our clients are avoiding hundreds of thousands of dollars in legal fees.
What other trends in home health are affecting you in the legal function?
The first thing that impacts me is changing regulations. We may be required to ensure that a physician sees a patient every 60 days. If I don’t meet that requirement, I can’t bill for the service. It’s our responsibility to make people aware of these regulations, train them. The other aspect is reimbursement. Today, 86 percent of our reimbursement comes from the federal government, which is making cuts. That affects our ability to function and forces us to do more with less.
What is your strategy for hiring outside counsel to get the best value for your dollar?
You can always get outside counsel to the number. I hire the team that understands my business and my need and that’s a partner for me. I don’t want to hire outside counsel that doesn’t give me practical responses. If I’m debating whether to litigate, and outside counsel says your chance is 50-50, I’d really think hard about ever using them again. You never know how a case will turn out, but don’t tell me 50-50. I don’t need recitation of the law. If I don’t know an answer and I reach out, I can’t wait for a three-page memo from an associate. I need a quick response. It goes back to the Marines. I have been a lawyer for 30 years and my next job could have been an air officer in an infantry unit. The expectation was you’re as good an air officer as an attorney you trained to be. That’s how I want to surround myself.