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Entrepreneur in Nursing
Deborah Tinsley’s Exceptional Home Care Makes a Difference in Pediatrics

When Deborah Tinsley decided to start an agency in the competitive field of home health care, people gave her plenty of reasons why she shouldn’t and couldn’t. But The University of Texas at Tyler graduate is not easily discouraged.

She forged ahead with her plan, with the same persevering spirit that followed her through the rigors of nursing school and her journey from nurse to director of nurses to assistant administrator.

Tinsley saw a need in East Texas for an agency devoted solely to providing pediatric home health care services. She wanted to make a difference for medically dependent children, their families and the nurses who worked for them.

Combining her skills in nursing and administration with her love for children, Tinsley established Exceptional Home Care in the Tyler Area Business Incubator at the Tyler Junior College Small Business Development Center. She opened on Nov. 4, 2002, with one employee and admitted her first patient the next day. Two years later EHC had grown to 151 employees. The agency moved out of the incubator and into its own office complex.

Today, the Tyler-based agency employs nearly 350 and provides a full range of home health care services to pediatric clients in 44 counties in North and East Texas. And since 2007, Tinsley and her husband, David, have opened two additional businesses – Exceptional Staffing Inc., a medical staffing agency, and Alliance Construction Co. David also is a registered nurse and serves as chief financial officer of the businesses.

District and National Honors
In 2006, the U.S. Small Business Administration, Dallas/Fort Worth District Office, named Tinsley the Small Business Person of the Year. In 2007, she was honored as the National Business Incubation Association’s Outstanding Incubator Graduate. And in observance of EHC’s fifth anniversary, the city of Tyler proclaimed Nov. 2, 2007, as Deborah A. Tinsley Caring for Exceptional Children Day.

“She was the most successful client we ever had,’’ said Small Business Development Center director Tom Proudfoot, who nominated Tinsley for the Small Business Person of the Year award.

“She can handle a very complex situation, and there are not a lot of people like her,’’ he said. “Tinsley has the ability to lead, delegate and get the respect of people working for her and wanting to stay with her. But the reason I think she’s done so well is because she really cares about the clients and has set up policies that really had to do with taking very good care of these clients.’’

Exemplary Student
Dr. Linda Klotz, dean of the UT Tyler College of Nursing and Health Sciences, was one of Tinsley’s professors at the university. “She was a good student, and she stood out in my mind as someone who was going to make a difference,’’ Dr. Klotz said of the 1993 graduate. “Deborah is a prime example of the entrepreneurial spirit in nurses. She’s the kind of nurse we’d like to see in all of our students – one with a caring approach to the business of health care and the ability to combine compassion and quality.’’

Tinsley attended college for one semester after graduating from high school in 1975. The Jacksonville, Ark., native was working as a legal secretary when she decided to return to college and become a nurse. She attended the University of Arkansas and in 1991 was accepted into nursing school at UT Tyler.

Nursing school, Tinsley said, was “the toughest thing I had ever done. Up to that point, I had a 3.94 grade point average and never had to study. It is a different world in nursing school. It was a lot of work, but I learned so much,’’ she said.

“And the instructors were wonderful, wonderful people. They were very knowledgeable and very helpful. My first semester at UT Tyler, I came down with pneumonia and was bedridden for two weeks. One of my professors, Dr. Marian Rowe, actually came to my home and brought food to me. I was amazed.’’

Tinsley began working in home health care in 1994, serving as a nursing director and then an assistant administrator. When an agency in which Tinsley was employed decided to diversify its services, she was allowed to implement a pediatric division.

“I was reading about pediatric home health care and just went to my boss and said, ‘I want to start a pediatrics section,’ ’’ said Tinsley. “And at that time, there was hardly anyone in the area offering that type of service. No one knew much about it, so I created the program. I developed the policies, all the forms and all the training. I did the marketing. I just built it from scratch.’’

When Tinsley set out to establish EHC, she was referred to the Tyler chapter of Service Corps of Retired Executives, sponsored by the U.S. Small Business Administration. SCORE assists aspiring entrepreneurs and small business owners through counseling and business workshops.

She attended SCORE classes and started her business in the incubator, which provided office space, financial counseling, management skills training and the advice of the onsite Small Business Development Center.

“SCORE asked me lots of questions in order to determine the feasibility of opening a pediatric home health care agency. They told me how difficult home health care was to break into, how banks could consider it a risky loan and how so many people had failed in that business,’’ Tinsley said. “What helped me was the fact that I was focusing solely on children. That wasn’t something agencies normally did, so I had a little niche and they recognized that.’’

Making a Difference
Her agency provides nursing care for children under age 21 who live at home with their families and caregivers. EHC offers continuity of care, which was unique when the agency opened.

“More agencies are offering continuity of care now, but back then home health care patients did not know what nurse they were going to have from day to day. When we set up our agency, we chose to provide continuity of care. We assign one nurse to one child and that’s where the nurse works every day. And that has been phenomenal. Families love it.

They have one nurse coming in their home and they know that nurse, they trust that nurse, they feel comfortable leaving that nurse with their child,’’ Tinsley said.

“And the nurses really like knowing where they’re going every day. They feel more comfortable because they get to know the child, their family, their routine and their doctor,’’ she said, adding that her nurses receive regular employee benefits, instead of working as contract labor.

The nurses are able to end each shift knowing they have made a difference in a child’s life, Tinsley said. “And there are those special times when a child can come off of the ventilator or no longer needs a G-tube or a trach. Our nurses are very involved in helping patients reach new milestones.’’

EHC nurses “have a special place in their hearts for the children and their families,’’ said Lynn Wilson, the agency’s assistant director of nurses.

“We have children who were sent home to die, yet five years later they are still with us and doing well. The children have a will to live and to overcome adversity, illness and/or injury. I enjoy discharging patients from our services because they do not need a nurse any longer,’’ Wilson said.

“I believe EHC makes a difference in the lives of these children, but they also make a difference in our lives,’’ she said. “The children we care for teach us as caregivers to continue to fight through adversities in our own lives.’’

Wilson added, “Deborah saw a need for nursing care for children in their homes … and has worked hard, along with many others, to build EHC. Yes, our work is challenging, but when you see what has been accomplished, if for only one child, it is well worth it.’’