Why Private Pay Referrals are Earned, Not Asked For (Gabrielle Pumpian)

Gabrielle Pumpian, a former 7-figure home care business development rep, shares how she got started, what kept her motivated, and what most home care owners misunderstand about sales. She breaks down her top-performing health care referral sources—and exactly how she stood out—then dives into the non-health care partners and offers tactics for selling to trusted advisors. She adds insights into the evolving private-pay landscape and introduces her new venture: Trail Angel Partners.

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min

Jul 9, 2025

Why Private Pay Referrals are Earned, Not Asked For (Gabrielle Pumpian)

Miriam Allred (00:01.0)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's great to be back with all of you. I hope you're having an exceptional week. today in the lab, I'm joined by Gabrielle Pumpian, who I'll be calling Gabi on today's episode. Hopefully all of you are familiar with her and her work. She's been kind of up and coming in the industry the last couple of years, and we've interviewed her on past shows, and it was time to have her on the Home Care Strategy Lab.

She has experience spanning from home care assistance, turned the key to cheer home care, to breakaway 365, and now she's up to something new and exciting, which we'll talk more about today. Gabi, thanks for joining me in the lab.

Gabrielle Pumpian (00:41.3)
Hi Miriam, thanks for having me.

Miriam Allred (00:43.7)
Let's start with your background. I just kind of rallied off like a few names and titles, but I want to hear more about your personal journey. Maybe share a couple of highlights like pre-home care and then really how you got, how you landed in home care.

Gabrielle Pumpian (00:59.0)
Sounds great. Well, thank you for having me. I'm honored to be here promoting the sales and business development side of this amazing industry. That's where I've been my career the last 17 years here in San Diego. And I've journeyed through being a junior with zero sales experience, pounding the pavement, really learning from the ground up all the way through starting a brand new home care agency in a very saturated impacted market, being the chief growth officer.

here. So it's been a journey. But I am tried and true to sales and business development and I'm excited to talk about that a little bit more today.

Miriam Allred (01:37.0)
Yeah, let's give us a little more juice on like your early days because today we're going to talk about like the role of the sales rep and you have been there, done that, seen a lot, experienced a lot. So tell us a little bit more about like your early days in sales. You said talked about, you said you were a junior, you know, and then you've grown from there, but what was the early days? What did it look like?

Gabrielle Pumpian (01:58.2)
Yes.

I have to think way back to 2007. I joined a already established home care team that was a part of a larger company that had home health and then eventually added hospice. So from the beginning, I was thrown into a role that was really collaborative. And my sales leader encouraged me to co-market with my home health partner out in the field, which was great because I didn't know what it was like to walk into a hospital and ask for the case manager.

know what a skilled nursing facility was. I had no idea what I was doing. So being able to go out early days, co-market, really see how someone who already has a relationship established with a key influencer and account that can refer business and how they build upon that, what their intention is. So I was just super observant. I also had a great sales leader at that time who wasn't local to me. She was in Orange County and I was down here in San

So I had a lot of autonomy which taught me how to kind of develop my own style, routine, processes. But then she would come down and provide support through ride along, meetings with the team, and we would always kind of celebrate our success even if it was teeny tiny and with the internal team. So she was a great example of really what a home care agency ecosystem looks like with all the different people. And when you're out there in the field and you're not spending a lot of time

with your team, having someone help you bridge that gap really helped me succeed because I'm nothing without my internal team and there we're nothing without our caregivers.

Miriam Allred (03:40.0)
And home care, were kind of, you were young when you started. Did you have personal home care experience or familial home care experience or this was all net new to you at the time?

Gabrielle Pumpian (03:50.653)
It was so new. So I was working at the front desk of an inpatient rehab center in a local hospital where we would have inpatients, but then also outpatients would come in for their PT, their OT, and speech therapy. And so I was, I had a background in customer service working in high end restaurants in college and high school. And then when I moved to San Diego after college, I was encouraged by someone to go work in healthcare because I could apply customer service to this job at the front desk. So,

That was my initial understanding of health care was through that lens being in that setting and then seeing these representatives coming in and helping the case managers create discharge plans for them to go home and all the services that it takes to get someone home. Selling oxygen and selling equipment and home health care and all these different services that it took and that's how I started developing a relationship with these reps because I was the gatekeeper. I was the front desk person. I was the person they had to get past.

And so when I transitioned into a salesperson outside in the field, my first person that I would ever spend time trying to build a relationship with was the gatekeeper, whether it was in a facility, whether it was at a senior living community or in a doctor's office. I never looked past the gatekeeper. The first couple of visits were always about building that initial relationship because I had been in those shoes. yeah, home care was brand new. And then now I'm actually a sandwich generation caregiver where I have two aging parents that

that live in Northern California. So I'm at a distance and I'm raising a child and both my parents have chronic health issues and I'm fully thrust into the ideal client that I was trying to work with and find when I was out selling home care services in the field.

Miriam Allred (05:36.7)
Okay, love. Yes, I love all of this too, because every business is hiring these sales reps and oftentimes struggles too, because it's like, who is the person that is the right fit for this seat? And so I love to hear you kind of dial back like what you were and what you were doing and how those skills like translated from the gatekeeper to customer success to sales, because it's finding people like you like kind of the diamonds and the rough that are out there that make a really good fit for this role.

Tout yourself a little bit. You have like some major accolades. Like you're not just a, you know, like an average sales rep in San Diego. Like you grew and developed relationships that led you to again, like some accolades, like share a little bit more insight into that.

Gabrielle Pumpian (06:17.7)

It's not natural for me to do that, but I'm happy to because it's been a journey and I'm really grateful again for the mentorship that I've had along my way. think my success as a sales business development person in home care comes from the leadership that I received and the support I had from my fellow sales members. So I had transitioned from that original home care position into the director of admissions for a skilled nursing facility. So I kind of put myself in this new role where it was

was very insurance-based, helping patients discharge out of the hospital, and then realized that really home care was my passion, and so I left that went back into the home care space. And when I was hired by Home Care Assistance for the La Jolla location, La Jolla and Cardiff, back in 2018, 17?

That opened my eyes to this very high-end private pay, really concierge level, white glove care management model of home care that I hadn't experienced in the past. And so with that, I was struggled at first. I went from more of a serving Medicare patients that were coming from home health, skilled nursing, and hospice referral sources in hospitals, where maybe they don't stay on services long-term because they can only afford so much or they get referred in a little too late.

and they don't stay on service long enough before they need to move or maybe they pass away. And so I was used to this kind of turn and burn environment, which I think a lot of home care agencies experience. And it was challenging. was challenging to grow the revenue. It was challenging to keep caregivers happy. And so when I moved over to home care assistance and was introduced to kind of this different service style, I learned very quickly that there is a whole other world out there of clients who have the means, who want to age and

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place and that they have advocates and advisors and families that maybe can start that process sooner because they have the means or maybe they're wanting to put the resources because the client is absolutely adamant about never leaving their home. And so now the families really have to figure out these in-home solutions to age in place. so building that business, really working in that niche of more concierge level, was able to grow my annual revenue really by the million zero

year. I was there for almost seven years and my last year I was projected at least eight million in revenue and I left not even halfway through the year. So it I have this great idea and this proven process that I'm excited to share with more home care agencies to say

Let's diversify your referral sources. Let's look where there's people who have the means. And so you can build that foundation of business and your caregivers can have jobs for years and reduce this retention issue that we see so commonly.

Miriam Allred (09:15.3)
Okay, amazing. Two specific questions because you've lived and breathed the sales role and we talk a lot about this in home care sales, but also just like sales holistically. First one is, what do we call this role? In home care, you see marketing, you see sales, you see business development and you've already referenced a couple of the terms, which is fine. But if you had to like, you know, hang your hat on one title, what would it be?

Gabrielle Pumpian (09:43.6)
I mean, the challenge is the role interfaces with not only referral sources and kind of transactional business, but you also interface with families. So the last thing you want to be called is a sales rep, right? I know hospice liaisons don't like to be called hospice sales reps, right? Because it's like, those two just don't mix very well. And most of the people who are doing this work are not in it to be like crazy salespeople and numbers, numbers, numbers, right? We're here to help people.

So it is a challenging title, I will say that. And I've heard a lot of different things. I think when I try to define my title, I am a business developer, I'm a relationship builder, and I'm a connector. So I'm all of these things.

But at end of the day, I'm there to develop the business for my agency that translates into care for our clients. And so I like a term that kind of bridges that gap, whether it's a home care liaison or it's a home care business development specialist. I mean, the titles are tough.

I'm going to say. I don't like marketer though. I'll tell you that I personally don't like marketer. It's probably the most common term used for the role. Marketers are going out slang and brochures. And I think as long as you're slang and brochures, you're really not developing relationships. so come up with a title that defines you based on what your true value is to your referral partners. And to me, it's connection, it's relationships, and it's communication.

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