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Teaching a 78-year-old woman how to infuse IV medications for her cognitively impaired son with endocarditis.

Finding a vein in the middle of the night for a 6-year-old boy with osteomyelitis.

Managing the wounds of a sprightly 100-year-old woman so full of life and wisdom.

These are just a few of the patients (and moments) Pamela remembers in her career as a nurse; a career that has taken her from the front lines of health care to life as a consultant and then on to her role as the Chief Operating Officer of Care Advantage, Inc.

“Being a nurse has been the foundation of my career, no matter the role or responsibility, I have always placed the patient at the center of everything I do.  Ensuring our patients have a great experience and achieving the best possible outcome is job number one for our skilled team.  Focusing on patient centered goals and getting the patients and caregivers involved in the care is where the magic happens.  When patients establish goals that they want to achieve, they work harder to achieve those goals so they can quickly get back to their prior level of function and regain their independence.”


The skilled care division at Care Advantage covers close to a three-hundred-mile radius serving patients across the state of Virginia. The three branch offices consist of All About Care, Paradise Home Care (both in Richmond, VA) and Virginia Home Health and Hospice which is based in Rural Retreat, VA. All three locations offer state of the art clinical programs designed around helping the elderly population who experience acute or chronic, health conditions. These programs and the clinical care we provide, serve to help our patients regain their independence and age in place. Home is where all patients want to be. Patients actually do better in their own home environment and recover more quickly than they do in hospitals or any other inpatient facility providing care.

“I have seen a major transition in home healthcare over the span of my career,” Pamela said. “When I first became a nurse, the focus of health care was institutional, primarily hospitals and skilled nursing facilities. There was very little knowledge of, or respect for, the home health industry three decades ago. I believe this to be true primarily because healthcare providers knew very little about providing care in the home setting or the outcomes that were achieved. In the mid to late 90’s, the majority of care being provided was managing and teaching chronic illnesses like diabetes, CHF and COPD, performing/teaching wound care and managing oral medications.  While those are still skills that we provide today, the level of care has really been elevated in the home setting. Today, we care for tracheostomy or ventilation dependent patients; we manage pleurx draining systems and wound vacs, which is a vacuum assisted closure system used to heal major wounds; we also infuse all types of medications through an intravenous line as well as care for patients on the same day they’ve had joint replacement surgery. So, not only are we providing more complex care than ever before, the cost of providing this care is less than 3% of the total US health care expenditures which was $3.65 trillion in 2018 according to the latest CMS analysis."


After working many years as a consultant, Pamela’s interest in joining the Care Advantage team grew, more so after discovering that the company was founded by a local nurse, Debbie Johnston. Pamela knew, with a nurse leading the company, that the patient would have to be the core of their focus which resonated well with her guiding principle...

“Care for the patient first and everything else will fall into place.”

“As it turned out, Debbie Johnston’s philosophy for Care Advantage, did, in fact, mirror mine and joining this team has proven to be a great decision,” she said. “Debbie has been caring for patients in Virginia for nearly 30 years and being able to continue her legacy was an honor that I was proud to have.”  

At Care Advantage, we take great pride in meeting the needs of our patients and my teams focus on every aspect of the patient; we take a holistic approach to care as so many times,  it’s not the physical component that presents a roadblock to achieving goals but more times than not, it’s the financial, psychological or spiritual need that must first be addressed in order to achieve the overall goal.   The Holistic care approach always delivers the best care and the best possible outcome for our patients.


“These are definitely not ordinary times for healthcare providers,” Pamela said, acknowledging the crisis of COVID-19.  “Knowing the volume of patients and clients that we had to care for when this pandemic hit, we knew we had to move quickly to develop new policies, procedures and protocols that would enable us to continue caring for our patients and clients."  

"We quickly created our physician-led COVID-19 Response Team that was comprised of the most highly skilled and seasoned professionals we had who helped us prepare for what we knew was coming.  We developed training in-services and refresher courses along with online education and simulation drills to ensure that our staff were prepared, equipped and ready to care for our patients all the while protecting themselves as they cared for patients on the front line.  Initially, we all had a fear of the unknown, not understanding this virus.  It did not take us very long to realize that this was what we were trained for…to care for patients in need, COVID-19 positive or not.  This was our chosen field and together, we rose to the occasion and met the challenge head on.  We continued educating our clinical teams on Infection control, cross-contamination prevention, proper donning and doffing of personal protective equipment, this was an ongoing event across the company.  We quickly moved to secure ample amounts of PPE ensuring the continued safety of employees and patients. It brings a level of comfort knowing that our employees are prepared and protected with every visit they make."  

"I’m incredibly proud of my teams and our organization. We pulled together and faced this pandemic as one collective, adaptable, caregiving team.”

This sense of readiness is part of Care Advantage’s mission of service. Whether it’s for a patient in need, a middle-of-the-night emergency or an innovative solution to a one-of-a-kind problem, Pamela and her teams are on the front lines caring for patients all across the state of Virginia.

Posted On
August 26, 2020
Jonathan Etherington