‘Doing Good by Doing Well’: Founder Jessica McGlory Launches Guaranteed with $6.5M Seed Round

Two years after her own father passed away, entrepreneur Jessica McGlory felt called to launch her own provider company, California-based Guaranteed, which began operations three months ago in Los Angeles.

McGlory came to the space with the goal of returning hospice care back to its roots, while integrating a more modern approach to meet the changing needs and expectations of patients and families.

Guaranteed is just getting started, but its growth momentum is already accelerating. Last week the company secured a $6.5 million infusion of capital in a seed round led by the investment firm BrandProject. Precursor Ventures, Springbank Ventures, Lakehouse Ventures and Cake Ventures also participated in the round.

Hospice News sat down with McGlory to discuss the factors that led her to pivot her career toward end-of-life care, what she designed Guaranteed to achieve and her strategies for making that happen.

Can you tell me more about your own professional background? Have you previously worked in health care or hospice before?

I’ve had the distinct pleasure of being able to work for many startups to Fortune 500 companies, primarily focused on marketing and advertising, making sure that we are able to get things that people wanted directly to them.

My health care journey really is something that started in health tech, where I was able to do just that — work on different areas of growth for different companies, some in their early infancy, like MDLive, as a consultant, all the way through some of the bigger more recent players, like Ro, as they launched different verticals.

But my true thrust into health care was from being the family member of a patient. That is when I actually started to get my education on exactly what it would mean to “work within it” as an unpaid caregiver for my dad. That was really what I considered to be my first full-time job in health care. It was actually on that caregiving side.

If you feel comfortable, can you tell me what it was about that experience that led you to decide that you wanted to be involved in this field professionally?

Definitely. When my dad first entered the hospital after having a double heart attack, it really was quite a shock to me as to what would happen next. It would be just kind of day after day in the hospital with my sister and some of my other family members, just watching the different doctors and the different medical professionals, who were very clearly trying to do right by my dad.

What I discovered was that “doing right by him” was the idea of, “Let’s get him stable so he’s no longer in the [intensive care unit].” Then, “Now he’s no longer in the ICU, he’s on the cardiology floor, let’s try to get his heart as healthy as possible.”

As his heart went from 30% capacity to 5% in a week, that was when it became clear that he needed to go into hospice. But I learned what hospice was when the doctors told me that they recommended he go into it. That was peculiar, though, because no one actually stated that he was dying.

So when I was researching what hospice was, I was learning through Googling, instead of necessarily learning from the doctors that that’s what he needed. After that, when he went into in-home hospice, I can’t tell you how much the home hospice aides and the nurses were working so hard to try to give my dad the best experience. But they were so overworked, their caseload was unmanageable.

There was no way that they were going to be able to do all that they wanted to do. So I had to take on that role along with my sister. My family took on this caregiver role and tried to learn every single possible thing that we can for this person we love who was rapidly dying.

After that experience — to be honest — I didn’t think about health care for two years, because I couldn’t even think about his death. I was only able to think about the fact he was gone.

When I was able to act — I still can’t tell you what compelled me — but at that two-year anniversary of my dad’s death, I started thinking about every single thing that happened leading up to it.

And I started to realize that there are different areas that probably could be better addressed with technology, better addressed with a better staff experience, where they don’t have so much caseload that they can’t be able to do their job, despite being so empathetic and great at it. I figured there had to be some sort of way to address the different moments that were so tough on myself and on my family, and I decided to go for it.

As you sought investment for Guaranteed, how did you establish your value proposition, given the fact that you weren’t coming from a health care background?

To establish the value proposition, I realized that I had to talk to investors in a way where they could understand what was really fueling this company to exist: the “why” of this being something that directly impacted my dad and something that is written in stone.

I cannot ever change the experience he had or that my family had; we could potentially do it for others. That was one of the first steps of being able to get them to understand.

But then I also tied it into the reality that we are all going to die. This is something we are all going to experience, and about 50% of Medicare decedents will choose hospice. When we think about how many Americans that truly is, I started to help them understand that it really could be their dad. It could be their loved one, or it could be their best friend’s loved one.

There is this movement of people who have become expectant of being able to have a frictionless experience within health care, expect there to be different health tech solutions, and that there’ll be a certain level of experience. That is something that they were able to truly understand and see the capabilities of what happens within hospice. It is a good business model. It is something that can sustain itself and actually be able to make money while also being able to impact people in such a positive way at a point where they’re incredibly vulnerable.

Once they saw that there was the ability to do good while also doing well, that was what I really tried to make sure to focus on. I also made sure, though, to double down on investors that wanted to believe. They weren’t looking for a reason to say no. They wanted a reason to say yes because they could really believe in what we were doing. So that to me was a powerful approach as well.

You have used the term “a constructive relationship with death.” Could you give some color on what it means to have that kind of relationship?

One of the things that happens when someone dies is that we as a society do not like to talk about it, even though we know that all of us are going to die. It is somehow the largest taboo in existence in our culture — and that will impact all of us.

So from that point of view, we don’t think of ourselves as just a company that’s trying to be able to build out a better hospice experience. We believe that we have to be a part of the cultural conversation around dying and death. Otherwise, it will not be able to have the sort of impact on end of life that we hope to achieve, which is that family members, friends and your care circle that you would have when someone is in hospice, they carry on when the person dies.

If they don’t have proper systems of support to be able to talk about what they’ve experienced, to be able to actually process and move forward with their grief, they are going to stay in a continuous cycle. And then we see the negative impacts of death last for years and years to come. So that’s what we mean by having that sort of constructive relationship, to truly talk about it, have different areas for people to talk about it. We want to make sure that we invest in education and resources, so people do not feel alone in that journey.

In this initial phase, what is your current scale? In which markets are you operating?

We have now been operational in Los Angeles for the last three months. We are seeing patients in L.A. County, and we are also able to serve San Bernardino County, Orange County, Ventura County and San Fernando County as well. We have a lot of different county coverage in the L.A. area.

Our plan is to also expand. We want to be able to impact as many as many patients as we possibly can, so we are looking to expand shortly to the Philadelphia area as well.

How did you go about differentiating yourself in the market as a new provider and building those referral relationships, when you’re in competition with hospices that have been longer established?

We really focused on what we believe is our biggest value proposition, even from the very beginning, which is a hyper-focus on patients, family and staff. We believe in order to be able to provide the best patient and family experience, we need to make sure that we have the absolute best staff.

We know that a lot of times, staff have been underpaid and under-appreciated, and we really do make sure that we have a concentrated effort of being very competitive on the salary landscape, as well as with different benefits that are offered.

But even more so, what we’ve heard positive feedback on, is that we make sure that the staff has the ability to share their opinion and actually be listened to, and have that be implemented throughout all of the different parts of what we’re building. We have a consistent feedback loop. Whether you are a director of nursing or if you are a home hospice aide, you really get to have a true opinion on what’s going on. We make sure that we do not overload any staff member with too many cases, so they can provide the best sort of value to the patient or family member.

We’re also really proud that we do “family admission.” We haven’t really heard of that in the industry. In the same way a patient gets admitted and receives a plan of care, any family member that is deemed (by the patient and family) to be in the care circle gets a plan of care as well.

So if they are deeply religious, for example, they too would benefit from being able to see the chaplain that is meant for the patient. We do not charge anything additional for that family admission.

We want them to be able to process and go through the grieving process before it is so final when they’re trying to figure out everything that can be done. We’re really proud of the family admission, as well as making sure that they and the patient have the best possible experience.

We have a biweekly nail appointment, where we go in to do the nails of the patients who like that. We really just ask them about the different things that they want to be able to see as this last chapter has arrived, and make sure that they get those.

Then on the tactical side, we are really excited that people do love having true 24/7 coverage, where you’re able to have video telemedicine visits and see each other so I can better address what’s happening in that particular moment. They also know though that if there is the need for someone to go in person, they go in person. But you actually get to talk to the person beforehand instead of waiting that hour.

Those are the different things that we’ve seen upfront. We’re really excited about how much we’re going to be able to build in addition to the feedback loops that we get, so that way we can get more and more of a personalized experience for the patient, the family, and the staff members. That will make Guaranteed pretty differentiated in the space.

You just addressed a lot of this, but I’m going to ask the question anyway in case there’s more to add. And that is, of course, the biggest challenge that a lot of providers are seeing right now is the workforce issues. I’m curious how you started to kind of navigate that as you launched your business.

We’re listeners. Even before I incorporated this company, I talked with 50 home hospice aides and nurses and asked them about what makes them continue to work within the field or what’s made them leave. And about 55% of them told me that they never had been asked that question before despite having worked in hospice for five, 10 or 20 years. No one had actually ever asked them what they needed or wanted from their employers.

That, to me, was stunning, and that is exactly what I think can come from my background. I’ve worked at companies that truly believe in making sure that the staff feels appreciated and heard, and that turns into incredible outcomes.

We know that when people choose to work in hospice, that is a deeply empathetic position to take. They really believe in hospice. They believe in the true nature of hospice. So what I’m focused on is making sure that they can have that feedback loop, making sure that they can be heard, making sure that they’re properly compensated. That way, they want to work here.

We have people for whom this is genuinely their top choice. They know that they will be able to have outsized returns for what they’re able to do and still be able to focus on the patient.

We spoke with a nurse who’s worked in hospice for 20 years, and who went into retirement because the place where she worked got acquired, and the first thing they did was start to slash all of the different budgets for things that impacted the patient. So she retired because she didn’t want to see where that hospice was starting to go.

When we were first talking with her, she was super skeptical. But we said, “Hey, give us a chance, just see.” Now she’s said that she truly believes in what we are doing here, that we are the real deal. She said that what we are doing is what hospice is supposed to be, in a way that is more modern in terms of how patients and their families would likely want. That was a big indicator to me that we were doing something right here.

That’s the big focus, to make sure that it’s actually a place people want to work and make sure that they’re empowered to do the work that they know is most impactful.

You mentioned the expansion to Philadelphia. Is there anything more you can tell me about your growth plans and what’s next for Guaranteed?

The capital that we raised is really to be able to hire the absolute best people to join us. We’re saying that whether it be across engineering to marketing, strategic partnerships, all the way to care team members from nurses, social workers, dietitians, and death doulas.

We want those who believe in the mission of making sure that everyone can have an amazing last chapter to work at Guaranteed. That’s what we’re looking for.

We also want to make sure to use that capital to be able to expand as much into as many markets that make sense feasibly. We want to be in markets that have incredible opportunities for us to do both the best hospice experience we possibly can, and also have the opportunity for us to do more horizontal growth.

We know that traditionally Black Americans and Asian Americans have been left out of hospice. We actually want to actively be able to go into the different neighborhoods, hire people who actually live in those communities and have been there day in and day out, and then empower them to be able to have a better paying job, as well as help out their different community members and the patients.

That is a huge part of our health equity pillar that we have at Guaranteed, and that I’ve had since day one. We have had a real keen focus on wherever those sorts of markets exist, which do tend to be slightly more urban markets. But we also look at certain rural markets to be able to expand into, because we believe that’s part of health equity. That’s our big focus of what we’re going to be using for this capital.

There are a lot of different growth opportunities, and a lot of different ways that we can partner with clinical offices, hospital systems, other health care systems, with other digital health companies. We welcome different payers, especially with Medicare Advantage, doing more within the [value-based insurance design model (VBID)] hospice component.

We believe that we’re a great player to be able to collaborate with, due to our ethos as well as with our tech enablement and the features that we’ve built out. That’s what we hope to be able to use the capital for, to ultimately get to the bottom-line goal, which is to help out as many patients as we possibly can.