Steve Pare

Steve Pare’s approach to home-based care draws from experience in ministry and nursing. He began as a minister before entering nursing and working in geriatric care. After moving into hospice in Cleveland, he spent several years at Cleveland Clinic, where he built a strong clinical foundation. He later held hospice management roles and travel nursing assignments, finding where his experience and sense of purpose aligned.

Across staff positions and travel assignments, Pare worked for 13 organizations spanning hospice and home health. Each setting added tools to his practice, while travel drew him and his wife toward rural communities. Buffalo, Wyoming, offered the community they wanted and a leadership role suited to his experience.

Serving a County-Sized Community

For two years, Pare has led home health and hospice care at Johnson County Healthcare Center. The agency supports about 35 patients across a county roughly four times the size of Rhode Island, providing skilled nursing and therapy, non-skilled CNA assistance and hospice care at the end of life.

Three registered nurses and about three CNAs deliver that care. A limited recruitment pool makes staffing the agency’s most persistent challenge. Pare hires for teamwork, excellence and compassion so those values reach patients’ homes.

As part of a critical access hospital, the agency can provide services unavailable in some rural communities and draw on a wider system while navigating rural constraints.

Responding When Circumstances Change

Pare calls uncertainty the agency’s specialty. Patients come under its care because circumstances have changed and their needs exceed what they or their families can manage. His ministry background shapes that response, leading him to offer a steady presence, make room for honest questions and help people understand their choices without pressing them toward his own answers.

He once cared for a Hindu man whose end-of-life choices reflected his spiritual convictions. Pare sought to understand what those choices meant to him and provide respectful care, not redirect him toward his own beliefs. That experience reinforced Pare’s belief that ministry and nursing come together through careful listening and respect for personal boundaries.

Patients have also taught him that dignity resides in overlooked details. One woman wanted her king-size bed instead of a hospital bed. Her preference reminded him that what is convenient for providers may not matter most to the person receiving care.

That lesson prompts him to ask his team what the person is trying to preserve, what help could make that possible and what the family can realistically sustain. Independence need not mean doing everything alone. Skilled or non-skilled services may help someone remain home through the end of life.

When remaining at home becomes unworkable, the agency helps navigate the transition to a hospital, assisted living or nursing home, keeping the patient’s priorities central throughout.

Extending Support across the Journey

Keeping patients’ priorities central also means helping them and their families understand their care options before circumstances become urgent. Pare therefore sees education as essential to reaching residents earlier. Wyoming’s historical hospice utilization rate is about 33 percent, compared with a national average of roughly 50 percent. Explaining that hospice extends beyond a person’s final moments could help more patients benefit sooner.

Education also clarifies support before hospice eligibility. A resident may need private-pay housekeeping or another non-skilled service, while someone requiring clinical care may qualify for skilled home health through Medicare. Connecting these options advances an in-home continuum for the county.

Pare believes rural-health transformation funding could improve access if some of it supported home health and hospice. Backed by the critical access hospital and encouraged by significant growth during his two-year tenure, he sees Johnson County Healthcare Center as well positioned to strengthen this model.

His advice to practitioners is direct: consider hospice earlier. If, based on a patient’s trajectory over the past six to 12 months, death within the next six to 12 months would not be surprising, begin the conversation. Earlier consideration gives patients and families more opportunity for appropriate support while honoring the desire many patients share to remain at home.