Built by a nurse who owned and operated agencies, for the people running one today.
Paloma did not start as an idea for another place to store healthcare records. It started inside the office of a home infusion and home health agency, where the owner was the only link between the fax machine, the pharmacy, the schedule, the nurses, the surveyor and the invoice.
The demo agency is a working Paloma with synthetic data. No sign-up, no credit card.
Built by someone who has run the agency.
I’m Nicodemus (Nick) Obuya, RN, BSN, founder of Paloma Health Technologies.
Before building Paloma, I spent 18 years owning and operating healthcare agencies, including Paloma Home Health, a Dallas-based home health agency, a Dallas private duty agency, and a healthcare staffing business.
My experience spans Medicare, Medicaid, VA, home infusion, private duty, and healthcare staffing. I personally led Paloma Home Health through CHAP accreditation in 2008. My nursing career began in 1995, with experience in hospital and critical care.
I’ve faced the same challenges agency owners deal with every day: managing referrals, physician and pharmacy orders, scheduling nurses, maintaining credentials, preparing for surveys, completing documentation, managing payroll, billing pharmacies, and collecting payments.
I’ve also used established healthcare software, including AlayaCare. I know firsthand what these systems do well—and how much administrative work can still fall on the agency owner.
Years later, while running another home infusion agency, I encountered many of the same problems again. Different agency, different software, same administrative burdens. Rather than acquire that agency, I decided to build technology that could help agencies operate more efficiently.
That’s why I built Paloma. Paloma is designed to connect the work of running a healthcare agency, automate repetitive administrative tasks, and give nurses and agency owners more time to care for patients and grow their businesses.
Built by someone who has run the agency. Designed for people running one today.
The demo agency is a working Paloma with synthetic data. No sign-up, no credit card. Paloma Health Technologies is an independent, multi-agency software company in Dallas, Texas; a Texas-based home infusion agency runs its daily operations on Paloma today.
The records were stored. The work between them was not.
Nurses want to care for patients. Agency owners need the surrounding operation to work. Existing software keeps the records; the owner still coordinates everything between them.
Referrals, orders and the schedule
A referral arrives by fax or portal, becomes an order, becomes visits. When each lives in a different place, a changed dose never reaches the nurse and the office finds out after the visit.
Workforce readiness
A nurse can be assigned only if her licence, CPR card, competencies and clearance are current. Keeping that true for every nurse every day is a full-time job that nobody is paid for.
Visits, review and the pharmacy’s documentation
Every pharmacy wants the note in its own form. The DON has to review each one. A note that is late, incomplete or in the wrong form is a visit that cannot be billed yet.
Billing and nurse pay
Invoices are built from reviewed visits at contract rates, payments are chased, factoring statements reconciled, and the nurse is paid for hours and miles. Each number comes from a different spreadsheet.
Compliance and the survey
The surveyor asks for the file on a date the agency does not choose. Readiness has to be built every day, not reconstructed the week before.
The owner becomes the operating system
Everything above is remembered, chased and reconciled by one person, usually the owner, usually at night. That is the burden Paloma was created to reduce.
Automate the repetitive, evidence-based work. Keep professional judgment where it belongs.
Paloma is an AI-native, evidence-driven operating platform for agencies: it performs routine administrative work under the permissions your agency sets, identifies what is missing, holds each workflow to its requirements, and keeps the agency ready for review every day. The principles behind every workflow:
- Automate repetitive, evidence-based work; never a decision that belongs to a clinician or the owner.
- Preserve professional judgment and clinical accountability: AI reads and proposes, your staff decide.
- Make the nurse’s workflow simple and mobile: today’s visits, the current order and the right note on her phone.
- Let administrators spend their attention on genuine exceptions, not on checking that routine work happened.
- Carry trustworthy information forward, from referral through care, review, billing and compliance, so nothing is re-keyed.
- Give owners back the hours spent managing processes, for patients and for growing the agency.
Three reasons agencies choose Paloma.
Paloma is not the only software with these capabilities; established systems, including AlayaCare, overlap with it. These are the differences that matter to the agencies Paloma is built for.
Built by a nurse
Nicodemus (Nick) Obuya, RN, BSN, designed the workflows from the bedside outward. The infusion note, the order check and the readiness rules are the ones a nurse needs, in the order a visit happens.
Built by an agency operator
Staffing, home infusion, pharmacy contracts, billing, payroll, CHAP accreditation and state surveys were the founder’s own responsibilities as owner, Administrator and Director of Nursing, from 2008 to 2026. Paloma automates much of the routine work an owner otherwise does by hand.
An alternative an agency can afford
One published price per agency, every Clinical capability included, no per-user charges, no implementation project to buy before you begin: create your agency yourself and start. Imports from a previous system are arranged when you need them. Pricing →
The buyer’s page, The Paloma advantage, shows how the software addresses these problems and why an agency should choose it. If you are comparing vendors, the comparison pages state each competitor’s facts from its own published material, with the date it was read, and say plainly where the other product is the better fit. AlayaCare and Paloma for a home infusion nursing agency →
Every capability carries its state.
From Paloma’s capability register (verified 2026-10-16). Live means available today. In progress means in development, with what is live now stated. Next service line means planned. Platform direction means where Paloma is going; it is not sold as available.
| State | Capabilities |
|---|---|
| Live | Home infusion nursing · specialty pharmacy nursing · healthcare staffing · private duty skilled nursing visits · referral intake with AI document reading · orders and the governing order · infusion visit documentation on the nurse’s phone · clinical review before billing · scheduling with staff readiness · authorization tracking · pharmacy invoices, statements and payments · pharmacy portal for pharmacy partners · surveyor access with audit trail · credential and licence tracking · workforce files, hiring and onboarding · Find Staff from the patient chart · Paloma Talent · native integrations (document reading, email, provider registry, Talent) · exports and a verified agency backup |
| In progress | VA Community Care (referral, orders, scheduling, documentation, review and authorization tracking are live; the UB-04 is a worksheet, not a submission-ready claim) · infusion suites (a chair list and day view exist; chair booking, overlap prevention and suite billing are not complete) · data import from a previous system (pharmacy and physician imports available; patient, staff, authorization and visit-history imports by arrangement) · obligation ledger and survey tools (ledger, owned open items, survey binder and rehearsal available; broader acceptance continuing) |
| Next service line | Medicare-certified home health |
| Platform direction | Private duty shift care and private-pay invoicing · Medicaid home and community care · documentation by service line and discipline · electronic payer claims, eligibility and remittance · policy-linked continuous compliance · staffing needs opened automatically from referrals · licence monitoring against the authoritative source · custom integrations with a customer’s systems |
Two products, each valuable on its own: Paloma Clinical runs the agency; Paloma Talent finds and vets clinicians and staff for any healthcare organisation. Talent comes from the same operating years: owning and operating a healthcare staffing agency since 2020 has meant finding, vetting and placing nurses and other clinicians, and keeping their files current, long before there was software for it. Their integration, Find Staff from the patient chart, is an additional advantage, not a dependency. Pharmacies that coordinate nursing through more than one agency can work with Paloma too, within the pharmacy workflows available today.
About Paloma and the people behind it.
Who built Paloma?
Paloma was founded by Nicodemus (Nick) Obuya, RN, BSN, whose nursing career began in 1995 in hospital and critical care. From 2008 to 2026 he owned and operated healthcare agencies — Paloma Home Health (Medicare-certified; he took it through CHAP accreditation in 2008; Medicare, Medicaid, VA, home infusions, private pay and private duty), a Dallas-based home health agency (infusion nursing and private duty), a Dallas private duty agency and a healthcare staffing business (since 2020) — serving as Administrator and Director of Nursing. He has used established agency software, including AlayaCare. Paloma Health Technologies in Dallas, Texas publishes Paloma as an independent, multi-agency software company.
Why was Paloma built?
Existing agency software stores records, but the owner or administrator still spends much of the week coordinating the work between referrals, orders, staff readiness, visits, review, pharmacy documentation, billing, nurse pay and compliance. Too often the owner becomes the operating system. Paloma was built to carry that coordination so that nurses can care for patients and owners can run the agency.
Is Paloma the only software that does this?
No. Established systems, including AlayaCare, have overlapping functionality. Paloma’s difference is operational simplicity, reduced administrative burden, evidence that is carried forward from referral to invoice, practical automation under your permissions, and first-hand agency-operating experience behind every workflow. The comparison pages state competitor facts from their own published material, dated.
Does Paloma’s automation make clinical or business decisions?
No. Paloma does the repetitive, evidence-based work under permissions your agency sets, shows what is missing, and holds a workflow to its requirements. Professional judgment and clinical accountability stay with your staff: AI reads and proposes, your staff decide.
How do I know what is available today and what is still being built?
Every capability on this site carries one of four states from Paloma’s capability register: Live (available today), In progress (in development, with a sentence saying what is live now), Next service line (planned) and Platform direction (vision). An unverified automation is never described as operational. The table above is that register.
Related: Software for nurse-owned agencies · Home infusion software · AlayaCare alternative · Pricing · Security
See your workflow in Paloma.
Explore the live demo agency now, or book a guided demo around your own referrals, pharmacies and staff.
The demo agency uses synthetic data; no credit card required · create your agency when you are ready (first billing period charged at checkout) · or talk to a person