Choosing Home Care in Omaha: Kayla Nelson, RN of True North Home Care

Choosing home care for a parent or spouse is one of the hardest decisions a family makes. In the Omaha area alone, there are more than 200 home care providers to choose from.

In this Care Across America® interview, Valerie VanBooven, RN, BSN talks with Kayla Nelson, RN, owner of True North Home Care in Omaha, Nebraska. Kayla shares why she started her agency, how she hires caregivers, and the ways families can pay for care.

Key takeaways

• True North Home Care is owned by a nurse and a physician.

• The agency makes hospice, end-of-life and dementia care a priority.

• Caregivers are hired for compassion and personality first. Skills can be taught.

• Every call is treated like care management. Families often leave with referrals and resources they didn't know to ask for.

• Families can pay for care in several ways: private pay, the Nebraska Medicaid waiver, VA benefits, the GUIDE program and long-term care insurance.

Meet Kayla Nelson, RN

Kayla has worked in senior care her whole career:

• She started as a CNA.

• She became an LPN.

• She has been a registered nurse since 2016.

• She is certified in hospice and palliative care.

• She is a Certified Dementia Practitioner.

• She is now pursuing further certification in geriatric nursing.

In nursing school, an instructor told Kayla that geriatrics is "where people go to lose their skills." Kayla disagreed.

"This is where skilled nurses should be, and this is where nurses who know how to critically think should be, and that's what I've been doing ever since."

Why she started True North Home Care

Before opening True North in 2021, Kayla was an RN at a hospice during COVID. She was caring for families at what was already the most difficult time of their lives, and COVID made it harder.

That was her first close look at home care. She wasn't impressed with what she saw.

"I thought, I could probably do this better, so I decided to."

How True North selects caregivers

Families often ask whether caregivers are CNAs. Kayla's answer may surprise you.

What matters most:

• Compassion. You cannot teach someone to have a heart for seniors.

• Personality. Clients care about whether they like their caregiver.

• Genuine interest. Great caregivers want to ask questions and get to know their clients.

What can be taught:

• Hands-on care skills

• Agency procedures

• Dementia care techniques

"Some of my best caregivers never stepped foot in a CNA class, but I taught them all the skills they needed to know."

Kayla also believes home care attracts the right people. It isn't the highest paying job in health care, so the people who choose it usually do it because they love it.

When a match isn't right: True North checks in after a caregiver starts with a new client. If the fit isn't working, the team moves people until the client has the right caregiver.

What sets True North apart

Kayla knows Omaha families have many choices. Here's what she says makes True North different:

• Nurse and physician ownership. Both owners came from health care and chose this work to care for seniors.

• A focus on hospice, end-of-life and dementia care.

• Hands-on dementia training. Staff training uses role play, not just online quizzes.

• A nurse on the care team. The care coordinator is an LPN who catches things others might miss.

Owned by a nurse and a physician

Kayla's business partner is Dr. Marwan Salfity, an Omaha cardiologist. Their business conversations always come back to quality:

• Are the clients happy?

• Are the caregivers well taken care of?

• Has everyone had their flu shot?

"Those are the kinds of things you wouldn't get from a business partner if it wasn't someone doing what we do."

Care management built into every call

Families often call True North about one thing. By the end of the call, they may have:

• Hospice referrals

• Home health referrals

• Medicaid information

• Leads on financial help

"I'm good at finding all of the things you're not asking for."

Valerie points out that this is the advantage of a local, health care-led agency. A nurse who has lived and worked in the community knows the resources that are available, and a client is never just a number.

Choosing a home care agency in Nebraska

Kayla explains that Nebraska does not require a license for non-medical home care. Outside the Medicaid program, the state doesn't require background checks or a minimum level of insurance. She calls it "the wild West."

True North is a Medicaid provider, so it follows regulations that other agencies don't have to.

Questions to ask any agency before you hire:

• Do you run background checks on every caregiver?

• What insurance do you carry?

• How do you train caregivers, especially for dementia care?

• Is there a nurse or health care professional on staff?

• What happens if a caregiver can't do something a client needs?

• How do you handle a caregiver who isn't the right fit?

Rules change over time. Families should confirm current Nebraska requirements with the state.

"That's not my job" isn't in their vocabulary

When Kayla was a hospice nurse, she heard caregivers say that reminding someone to take their medication was "out of our scope." At True North, the rule is different: if a caregiver can't do something, they don't leave it. They call a supervisor, the nurse, the hospice nurse or the family.

One of True North's core values is "we all wash feet."

• Every team member, from the receptionist to HR, must be able to step in as a caregiver.

• That builds respect for caregivers and how hard their work is.

• Kayla will pass on a client who mistreats caregivers, even when budget isn't an issue, because she protects her team.

Support for family caregivers

Kayla's message to family caregivers is simple: it's okay to take a break.

Respite care gives you time to:

• Go to the movies

• Go grocery shopping

• Take a bath and check out for a while

• Have lunch with friends you haven't seen in months

Kayla learned this firsthand. When her grandfather was dying out of state, she stayed with him for a week. Even as a nurse, caring for family was far harder than caring for any client.

"I'm a professional. I literally get paid to do this for a living and I needed help. So if I'm saying it, trust me, anyone would need help."

Valerie adds that spouses often carry the heaviest load. Your own mental health is worth having someone come in for a while.

How to pay for home care

True North accepts several payment options:

• Private pay. About half of True North's clients.

• Nebraska Medicaid waiver. For people without funds for home care, it can help them stay home instead of moving to a nursing home. The program can be challenging to get into.

• VA benefits. Payment through the Department of Veterans Affairs.

• The GUIDE program. Respite care for people living with dementia.

• Long-term care insurance.

True North also reviews current private-pay clients for benefits they might qualify for, such as VA benefits or the GUIDE program.

The GUIDE program for dementia respite

Kayla calls GUIDE one of True North's "shining stars." Hospitals and families call her for help with it.

Who may qualify, as Kayla describes it:

• Has Original Medicare (Parts A and B), not a Medicare Advantage plan

• Is not on hospice or in a PACE program

• Has dementia. If there's no formal diagnosis yet, the program can help with that.

What it can provide:

• Up to $2,500 a year in home care respite, about 70 hours at the current rate

• A benefit that, as it stands now, renews every July 1

• Flexible use: four hours once a week, every other week, once a month, or to cover a vacation

GUIDE has been a lifeline for families who earn too much for Medicaid but can't afford private-pay home care. Program details can change, so call True North to confirm current eligibility.

Contact True North Home Care

If you're looking for in-home care in the Omaha area, call Kayla and her team. They'll help you sort out your options, even the ones you didn't know to ask about.

• Phone: (402) 981-8593

• Website: truenorthhomecare.com

• Address: 11314 Elm Street, Omaha, NE 68144

• Service area: Omaha, Fremont, Papillion, Bellevue, La Vista, Ralston, Council Bluffs, Gretna, Elkhorn, Bennington, Millard, and surrounding communities

This article is for general information only and is not medical, legal or financial advice. Program rules and state regulations change. Confirm current details with the program or agency.