The Story Behind the Change That Launched ClearPath’s In-Home Primary Care

“We began in 1979 as Hospice of Redmond, and for more than four decades we have walked beside Central Oregon families through the most tender chapters of life,” said ClearPath Healthcare’s Executive Director Jane McGuire. “When our leadership sat down for strategic planning, we wanted to do more than continue that work. We wanted to find the gap in our community that no one else was filling, and then step into it.”

The gap became clear when respected local provider, Randy Visser, DO, retired and his in-home primary care practice closed. The closure created a void, and patients who once depended on his in-home visits were now without a primary care provider. As Jane describes it, that void stuck with her. 

“I felt that was an opportunity,” she says. “This was something God wanted us to do.”

She took the idea to the ClearPath (then Hospice of Redmond) Board of Directors, and their excitement matched her own. Rather than assuming they already knew the answer, they brought in outside contractors and community members to help develop the plan and pressure-test it. They spoke with the people at the Redmond Senior Center to gauge how many local seniors receive Meals on Wheels, because they know better than almost anyone in our community who is homebound or struggling to get out the door. Some of that work was as simple and direct as going door to door to ask people whether they felt a service like this was needed and if they would use it. They looked at how quickly the senior population is growing across the region. Everything they learned pointed in the same direction. The need was real, large, and going unmet.

There was some honest debate along the way about whether a hospice organization should be offering primary care at all. And that is fair. Primary care is about prevention and maintaining one’s health. Hospice is about comfort at the end of one’s life. And Transitions is the path in between the two. But their debate didn’t last long. 

“Once the board dug into how the program would actually work and who it would serve, the decision to move forward was unanimous,” said Jane.

A Clear Path, and a Name to Match

The name Hospice of Redmond was long respected in the community, but it had its limitations. 

“For years, people in those outlying towns did not realize we were already coming to them, because the word Redmond was right there in our name,” said Jane. “The word hospice carried its own weight too. It can be a frightening word, and it is a narrow one. People are not going to call a hospice when what they need is a primary care provider.”

The new name arrived the way many of the best things at ClearPath have. Board President Andrea was driving past the office building one day, praying that God would show them a clear path for where they were headed. 

“That phrase stayed with all of us, because it named exactly what we hoped to offer,” said Jane. “We want to give people a clear path to the care they need, whether that is primary care at home, steady support through a serious illness, or comfort at the end of life.”

What Is In-Home Primary Care

In-home primary care is exactly what it sounds like. It is a primary care provider who comes to you in your own home, rather than asking you to come to a clinic. It is ongoing, relationship-based medical care, the kind you would normally get from a family doctor, just delivered at your kitchen table.

Currently, the in-home care team includes primary care provider Taylor Garr-Jones, FNP-C, and Helan, a licensed practical nurse. They travel together to homes throughout Deschutes, Crook, and Jefferson counties. They look after the whole person, not just a single complaint. They manage chronic conditions, review medications, coordinate with specialists, and watch for small changes that are easier to catch in the relaxed environment of a living room than in a fifteen-minute appointment.

Who Qualifies in Central Oregon

The program is designed for adults fifty-five and older, and for anyone with complex medical needs who finds it difficult to leave home for regular care. If getting to the clinic has become the hardest part of staying healthy, this is built for them.

Care does not stop with the patient. So often the family caregiver, the spouse, or the adult child who is holding everything together has let their own health slide because there is never time to get into a clinic. When the ClearPath team is already at the home, that caregiver can be cared for, too. 

How It Differs From Home Health

This is the question that confuses almost everyone, and the difference is genuinely important. 

Home health is short-term, skilled nursing care that follows a specific event, like a hospital stay or surgery. A nurse comes for wound care, or to manage a catheter, or to help with IV treatment for a set period, and then that chapter ends. In-home primary care is the opposite of short-term. It is a steady, year-round relationship with a provider who knows the patient’s history, living conditions, and more. When home health is needed, Taylor happily refers to a local team they trust.

What a Visit Actually Looks Like

A great deal happens before anyone knocks on the door. The team reviews the history, digs into what has already been done, and comes prepared so the conversation is thoughtful rather than rushed. Then they arrive, together, and something shifts the moment they step inside.

Seeing a person in their own home tells you things a clinic never could. 

You notice the loose rug by the stairs, the medications lined up on the counter, whether there is food in the refrigerator, whether the dog is a joyful companion or a genuine fall risk. 

“None of this is about judgment,” said Jane. “It is about understanding the whole picture so they can bring in the right support and help someone stay safely in the home they love for as long as possible.”

There is a reason two people come to every visit. Taylor and Helan work as a team, sharing the load so that Helan can handle tasks like lab draws and follow-up scheduling while Taylor stays focused on the assessment. Two sets of eyes are safer than one, and very little slips past a team that is paying attention together. It is a model our team believes in deeply, and it echoes Dr. Visser’s approach.

What surprises patients and their families most is what the team can now carry with them. EKGs, ultrasound, cryotherapy, and remote monitoring tools that track things like blood pressure and blood sugar levels from home. The tools used send the readings straight to the team, so a small change can be caught early instead of becoming an emergency. The exam room, it turns out, fits in the car.

What no equipment can measure is what happens to the relationship. The team has come to love the people they care for, and the feeling runs both ways. As Jane puts it, “For Taylor and Helan, it feels like they are becoming a part of their family.” They are welcomed in, month after month.

What It Costs With Medicare

Here is the plain answer families most want. There is no membership or enrollment fee. Care is billed to Medicare, Medicaid, or most private insurance, and patients are responsible only for their usual co-pays and deductibles.

Building the program this way took a real leap of faith. “We chose to put access first and to trust that the finances would follow, and they have,” said Jane. Adding Medicaid to what they accept has widened that door even further, so more of their neighbors on fixed, limited incomes can receive real primary care at home.

An Honest Word About the First Months

Jane is quick to share that they didn’t get everything right out of the gate. 

“We got plenty wrong. We learned hard lessons, we worked through the steep climb of a new records system, and we adjusted as we went.”  

But the thing that surprised them the most is how deep the need runs, especially in care facilities where residents living with dementia are so vulnerable to any disruption. 

“What we have not questioned, even once, is whether this was worth doing,” added Jane.

The response from the community has already outpaced what ClearPath leadership hoped for in their early months, and they intend to keep growing thoughtfully at the pace the community actually needs, rather than at a pace that would simply make ClearPath bigger.

A Leap of Faith, and an Open Door

“If we are being truthful, this whole thing began as a leap of faith,” said Jane.

A void in the community, a name whispered in a prayer, a decision to remove the membership fees originally budgeted into the program, and a belief that it would all be okay. 

“Every step asked us to trust before we could see the whole road. Looking back over these first months, in living rooms and at kitchen tables all across the high desert, we are grateful we did.”

If you or someone you love is finding it harder to get to the doctor than before, we would be honored to come to you. To learn more about in-home primary care or to become a patient, visit https://clearpathhealthcare.org/primary-care or call 541-323-0853. 

There is a clear path to the care you need, and ClearPath would love to walk it with you.