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In Kevin Porter’s view, home care was once the little kid on the basketball court hoping that his older brother and his friends would just throw the ball his way.
But now home care is all grown up. And it’s in a perfect position to play ball, to help health plan and health system partners care for patients with conditions such as COPD and CHF.
In fact, those are the patients that Porter considers perfect clients for Executive Home Care, where he serves as brand president.
“They’re still this active senior, who’s trying to be out in the community, trying to be active in their home, but just due to their diagnosis, they need a little help,” he told Home Health Care News during the latest episode of TALKS.
During the conversation, Porter also touched on the formation of Evive Brands – Executive Home Care’s parent company – the elasticity of the home care market, diversifying revenue streams and much more.
HHCN: Just for our audience, if they’re not familiar with you, Kevin, do you mind giving a quick background on yourself and an overview of your experiences?
Porter: I’ve been in the home care space since 2008 working for three major organizations at this point, supporting franchisees across the country. Started off in the field support role, then moved into a more strategic role supporting, again, home care operators across the country growing their businesses and providing care for seniors in their communities.
HHCN: You were named the brand president in February. Previously, you were the SVP of operations. What has that transition been like?
Porter: A very seamless transition, really smooth. Got the opportunity to come in and connect with the operators at Executive Home Care. We changed our name. We were Executive Care, prior to my joining the team, and the organization and the executives felt like, “Hey, we need to really embrace the home concept.” We changed our name.
Got the opportunity to meet the owners across the country and fantastic operators. When I got the opportunity to be promoted, I just kind of moved from the passenger seat over to the driver’s seat after getting gas at the rest stop. It was really seamless, but a great opportunity.
HHCN: Kevin, since February, what have been your top priorities?
Porter: Yes, top priority since February is really coming in and establishing a strong foundation for the network. There were some loopholes, there were some open gaps, there were some potholes. If you’re from the Midwest, you know what a pothole is. There were opportunities for us to partner with some really powerful players in the market.
We’ve been strengthening our partnerships to help our operators with their day-to-day operations. All of them have been tremendously beneficial for the network. We made an adjustment over to the WellSky ClearCare platform at the end of 2022, which was fantastic.
We also then made some adjustments to working with some local SEO organizations such as Choice Local, partnering with them. Those have been the top priorities, really to establish the operational elements. The next thing that we’re working on is protecting, providing services and resources for our operators to strengthen their retention rates across the country, and to continue recruiting more, and continuing to support their caregiver population. They’re essential workers, they’re vital to the success of our organization and this industry. Those have been some of our priorities to really strengthen our organization for growth, and prepare for our future growth.
HHCN: I assume when you’re choosing those partners, technology partner or otherwise, that can be a stressful process. I imagine it’s a relief to get some of that implementation in the rear view.
Porter: It’s one of those things where you don’t appreciate the journey until it’s complete. There was an adjustment phase for the network to switch over to a different platform. Once that adjustment and transition had been made, all of the operators were tremendously happy with the adjustment.
HHCN: Just before we go any further can you explain all the services you deliver, all the locations that you have, and what the footprint looks like?
Porter: We are a personal care, companion care organization. We are located in 12 states across the country right now. Our focus is growth. We have a tremendous growth opportunity. We provide care for about 1,500 clients across the country at this stage of our existence, and are looking to continue to grow.
We’re in the Northeast, we’re in the Southeast, and we’re actually in what I would call mid-Atlantic area, the Virginia area. But we’ve just expanded out into Colorado, and we’re excited about that opportunity as well.
HHCN: You mentioned that entrance into Colorado. Are there specific geographic areas that you really want to attack, in terms of growth over the next year?
Porter: We’re open to every option. As a franchise network, it’s always fantastic to have as many flags as you possibly can. We’re looking at the major markets and the mid-markets as well. Metropolitan USA is on our radar, as well as Suburbia America. Again, as we continue to strategize on where we’d love to be, we’d love to make our way from the East to the West, but the opportunities of growing within the Texas market are tremendous.
Wonderful state down there for home care opportunities, and the population can benefit from an additional home care provider in that area. Again, we’re open, but we do have a strategy to move from East to West so that we can continue to provide quality care for our clients across the country.
HHCN: Based on all the experience that you do have, what do you feel like are the two or three trends that are really shaping home care right now? Are those the same as they have been for a long time, or have they changed of late?
Porter: I think every executive in this home care space will talk about the infusion or engagement with technology in the home. That’s a no-brainer. It’s just finding the perfect opportunity to make it work. There’s some fantastic organizations out there that have tremendous technology.
I think every one of the executives across the country are looking at how to infuse more technology into their business. I think the other thing is just having solidified data. As you and I have talked about in the past, how does home care align with the major health care systems of America? In order to do that, those individuals want to see what we bring to the table. Data collection and data integrity is truly important.
Finally, from my perspective, we are really interested in making sure that we take care of our caregivers, those individuals that work for us on a daily basis. Investing into their education, working on establishing growth opportunities for them within our organization. Some individuals come into this, and they become a caregiver, and they want to go and be a registered nurse, and they want to go and practice at another level.
We are encouraging that, we’re excited about that, because we know that their foundation will come from our organization. We’ve partnered with CareAcademy, which has an opportunity to provide additional education towards your RN degree. We understand that this is an opportunity to support caregivers. Those essential workers, they want a career, and they have a career, and sometimes they want more, and so we want to be able to be there for them when that time comes.
HHCN: A couple follow ups on that. First of all, I wrote up a story yesterday on HCP’s recent data. The turnover rate has gone up again. It’s been a problem in home care for a while, but seems to be, again, becoming more of a problem. Two of the things that you mentioned, training and career opportunities, and that recognition, those seem to be the biggest things that keep caregivers with your organization.
That seems like something you’re focused on. I am curious: Have you seen turnover tick up again, or has that been better across the organization of late?
Porter: I could say, yes, I’ve seen some positive trends, and then next week I’ll tell you, we lost the game when it comes to recruiting. It’s probably just as volatile as the Dow Jones at this point in time. We are seeing a tremendous opportunity, at least, from my vantage point, on applications and interviews.
We got to at least get them into the office for an interview. If we can at least engage in an interview with them, we have a good opportunity to get them employed, get them scheduled and working in a client’s home. Hopefully, if they stay with us, 90 days to 120 days, we may have a lifetime caregiver.
Then, we see a couple of months in a row, where we’re just losing caregivers to other opportunities. Availability is always a struggle and a challenge. We have to work through that. You have to strategize on making sure that you meet the caregivers where they want to be met.
If you say, “Hey, I got 30 hours a week that I want to give to you,” and I only schedule you for 20, you’re looking for that other 10. Caregivers in this industry work from shift to shift. Let’s just be honest. If they don’t work, they don’t get paid. It’s our responsibility as executives, and owner-operators to ensure that they have hours that fit their availability. It’s a puzzle piece. It’s a Rubik’s cube that we’re trying to maneuver on a regular basis. The operators that take the initiative to learn their caregiver population, understand their availability, understand their constraints, their personal and professional situation, I think those individuals are the ones that have a really good hold on their retention, and have a positive impact on retention.
HHCN: You mentioned the application process. Have you noticed that speed is really paramount in today’s environment, where you need to make sure that you’re following up quickly?
Porter: If you don’t have Usain Bolt or Carl Lewis on your team, you are not going to win the race. This is a competitive industry for caregivers, but we can lose our caregivers to another industry. We can lose our caregivers to Amazon, Walmart or Target, because of the minimum wages and the opportunities that other industries offer. It is paramount that you are, hopefully, the first person to respond.
There are solutions out there, we partake in them just like some of the other agencies do. We’re answering our phones 24/7 when it comes to potential caregiver opportunities for employment. You have to be there. If you don’t answer within two minutes, you might lose them.
HHCN: Going back to another one of the trends that you mentioned, that data piece. I assume data tracking has become far more popular in home care since you’ve been around. Are there any key metrics you can share? Things that you’ve really noticed pay off when you’re tracking them?
Porter: Well, I think when I first started in 2008, I had a mentor always telling me, “Data’s going to be king, data’s going to be king.” Then you realize that the platform systems were not set up to track the data that you needed. You tried to elaborate, you tried to abbreviate, you tried to make up stuff, basically.
Length of stay was always one. From my perspective, my vantage point, I think we have to be more cognizant of the disease states that are not only beneficial to the home care space, but then the disease states that require a lot of hands-on attention from a caregiver – COPD, Alzheimer’s, congestive heart failure, those diagnoses are paramount.
They’re really the sweet spot, or a really great client to have, because there’s still this active senior, who’s trying to be out in the community, trying to be active in their home, but just due to their diagnosis, they need a little help. With medication, they can, not necessarily obviously cure congestive heart failure or COPD, but they can have an excellent quality of life with a caregiver by their side.
One of the things that we’re trying to do here at Executive Home Care is just making sure that we are approaching the medical community to let them know what we’re able to do from a COPD, CHF, Alzheimer’s perspective. I think that’s an industry standard. We have been on our WellSky platform for six months, so do we have tremendous information to share about a major impact? No, not at this time.
We are working towards that goal because I think the health care systems, the doctors at home, they want to know how can you support these clients. Because these are clients that will be in need of services for an extended period of time, and they want to have a dedicated organization to meet their needs.
HHCN: That last sentence is a great jumping-off point to another thing I’m super curious about, in terms of the brands in Executive Home Care. You have all these senior-focused organizations that you’re now able to work with underneath the same umbrella. I think that’s really interesting because, obviously, you’re trying to help the seniors with their life at large. It’s not just about specific care. Can you explain the thought process behind that, and how that’s helped so far, or how you think it’s going to help in the future?
Porter: You’re referencing Evive Brands. Evive Brands is now the umbrella organization that oversees Executive Home Care, Assisted Living Locators and Grasons. Each one of our organizations can impact the quality of life of a senior at a different stage. We’re providing personal care, companion care in the home. Assisted Living Locators is that organization that can support a client, patient, family member when they want to relocate to an assisted living facility.
Grasons is an estate sales organization. If the family relocates mom or grandma to an assisted living facility, and they want to work with an organization to help them sell off the trinkets, or the things that mom just no longer needs, or help close down the house before the home is sold, then they can work with our partner, Grasons. That’s the vision of Evive Brands — to do our best from an oversight perspective to help a client, and meet the client where they may be, and that will be the future for the next organization that we bring under the umbrella.
It’s a really good partnership, and all of our organizations work well together. We have synergistic opportunities in marketplaces, so it’s been a real good partnership across the board.
HHCN: Switching gears here a little bit, Kevin. Last time we spoke, we were talking a little bit about home care’s value, and how you present that to some health plans. What has that been like? I know home care is more recognized by the general public now. It’s more recognized by even the Biden administration. The whole industry has been elevated to a certain extent. Has that been recognizable in plan negotiations, or talking to health plans about the value you can provide to their members?
Porter: Yes. I went through the pandemic, and as an organization, where we saw opportunities just springing up left and right. Some of them were tremendous opportunities, where, because of the pandemic, the health care system automatically start saying, “Wait, we can’t handle all of these clients coming into the hospital. We need to have resources in the home.”
I’ve seen organizations partnering with other organizations and providing the care in the home, which is spectacular. It’s what should be done, and what needs to be done. Here at EHC, we’re working on opportunities like that. You have to be able to present a solid front across the board, you have to be able to meet the expectation of, not only the health care system, but the partnering organization that you’re working for.
When you tap into those opportunities, that’s when Medicare funds are being provided. It’s a more stringent approach, it’s a more stringent payer source, and they have expectations that the home care space has now been able to elevate themselves up to. Yes, I believe that’s going to be the trend. It’s going to be the new wave of opportunities for health care systems to partner with companies like Medically Home, where they provide the care right there.
They’re basically bringing the hospital environment to the home, and monitoring the client 24 hours from a triage center, and then you have the ancillary organizations such as DME and skilled home health or hospice coming in, supporting the patient and the client where they are. It’s definitely cost effective. It’s definitely a safer environment. A lot of people want to be in their home. Why should we not give them the opportunity to have that option?
You’re almost like the shortest kid on the court saying, “throw me the ball, throw me the ball,” with all your big brothers and your friends from the neighborhood. Some of the smaller players have the most impact in the game. Right now, I think home health is growing. The home care space is growing. They’re recognizing that there are tremendous caregivers across the country. There’s some fantastic organizations providing care.
You just have to be in the right place at the right time, and they also have to know what you bring to the table. That’s why I think data is so important. If you can show what you bring to the table, how you’ve impacted a particular grouping of people, and then that those individuals are the ones that the health care system is most concerned about, the frequent fliers, COPD, CHF, Alzheimer’s, you can show the data and the impact that you bring to the partnership.
HHCN: Is there a sense that you want to diversify revenue streams at all moving forward?
Porter: You always want to diversify revenue streams. You don’t want to be stuck in one bucket versus another. When you diversify a revenue stream, and you make that initiative to working with the health care system, there are some positives that can occur. Then, there’s also some, I won’t say negatives, but some additional constraints that you have to adhere to.
A health system may not pay you for 30 to 45 days. In the personal care space, you’re invoicing sometimes weekly or biweekly. You don’t want to, obviously, jump head-first into some relationships. You just want to let them grow organically.
HHCN: We’re almost halfway through the year. What’s the biggest thing you’re focusing on for the rest of 2023? Is it that growth aspect?
Porter: That’s in ‘23, ‘24, ‘25, ‘26 … and so on. That’s always going to be our initiative. If that’s selling more franchise locations, increasing our population of clients that we provide care for, yes, that’s always happening. For the next six to nine months, my team and I are just really focusing on solidifying the culture of each one of our locations to the best of our ability, partnering with organizations that bring resources to our caregivers to help, again, with their quality of life.
Financial education, continued education, opportunities for them to utilize resources outside of the workplace — those are the things that we’re working on.
HHCN: What’s one under-the-radar challenge that you feel is not being talked about enough?
Porter: I think the one that really continues to knock on my door at night when I’m sleeping is, how much can we charge? What is the elasticity of the market across the country?
In some areas, they’re charging $50 an hour for home care, and in some areas they’re charging $30. Down South it might be $27, $28. The question is, how much more can we increase the hourly rate to accommodate the minimum wages that are out there? Then, no one truly pays minimum wage. When it comes to caregivers, they’re probably $3 to $5 more than minimum wage from a payment perspective.
It’s not flying under the radar, because I think every brand president thinks about it, and questions it on a daily basis. As we continue to provide care for clients and service people in our country, I think every day we’re wondering, “Is an extra 50 cents too much, is a dollar too much, and what’s our competitor charging?” I wonder when the bubble’s going to burst, or when we’re just going to hit our ceiling.
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