Serving the home health, home care and hospice industry since 1999.

Untitled Document by Tim Rowan, editor


photo of Bob Roth

Bob Roth recently celebrated 25 years of Cypress Home Care Solutions serving the people of Phoenix and surrounding communities. Will there be another 25 years for the former Gatorade product marketing manager for Quaker Oats and, for 16 years, the managing partner of one of the most respected family-owned private duty agencies in Arizona?

If past is prologue, one would expect the answer to that question to be a positive one. Roth told us there were fewer than 10 home care agencies in the Phoenix area when his brother started Cypress. "Today, all of them are gone and we are still here," he told us.

Since 1994, however, the landscape has changed as the population has exploded in the area locals call "The Valley." "Today, there are between 500 and 700 agencies in The Valley," Roth explained recently, "and two-thirds to three-quarters of them are franchises. How many will survive? It all depends on whether we can continue to find qualified and willing workers to care for our people as they age and as the demand grows in proportion with the demographics."

"The estimates I have
seen are not good."

Bob Roth wanted to make sure we understood the severity of the crisis.

"The numbers are daunting. By 2020, there will be 56 million people in the U.S. who are 65 and older. Fast-forward 30 years, that number will be 88 million. We need to find new ways to deliver care. We need to find technologies and create innovations to help us get there.

"In Arizona alone, according to the NYC-based Paraprofessional Healthcare Institute, we are going to need 62,110 caregivers between 2019 and 2026 to care for our aging population, which does not account for 30,000 of those workers projected to leave our industry during this same time period. That means we are going to have to find 92,000 people. That's huge. How are we going to do that?"

"In a part of the country that attracts retirees, we are familiar with the statistic that they live an average of 280 miles from their nearest adult child," he continued. "That means that one spouse usually winds up as the caregiver of the other spouse. We are also familiar with the statistic that says 63 percent of the time the caregiving spouse passes before the one who was ill. It is a difficult, physically and emotionally taxing role to play."

Multi-pronged attack to solve staffing shortage

It was that reality that led Cypress to begin early to attract and retain caregiving staff, long before the shortage moves from problem to crisis. They decided on three innovations.

First, Roth told us, Cypress opened its caregiver training sessions to family caregivers, at no charge. "We know the tremendous burden spouses and other family members take from our own shoulders with regard to the staffing shortage," Roth said, "so we decided a free community service like this would benefit both them and us. We teach them how to safely transfer, how to use a Hoyer Lift, and other basics of caregiving.

Next, they developed a program that rewards staff members when they invite friends and acquaintances to apply for work at Cypress. We described Retinent, the software that calculates the program's pay bonuses and is now available to other home care agencies, in our 9/26/18 issue. (See "Experts Release Software for Staff Retention/Recruiting; Training Family Caregivers")

Finally, Roth considered taking on a partner or an investor. "But I'm not ready to sell and retire," he began. "I have a love for this industry and I think I have a lot more to offer before I am ready to retire. An investor approached me a year ago with a very nice package and it just didn't seem to be the right time.

"Then I heard about what Honor is doing with their 'Honor Care Network.' It is different from anything I had heard before and I wanted to learn more before I dismissed their idea outright. So I contacted them. Nita Sommers, the company president, flew down to Phoenix to visit with me.

"I told her, 'Most of my colleagues are scared to death of you. I'm not. I love the fact that you are thinking outside the box and breaking down the paradigms and figuring out a new way to deliver care.'"

Roth went into detail with us about that new way. The Honor Care Network will partner with a handful of private duty home care agencies in select U.S. markets. Their plan to solve the staffing shortage is to create a worker pool. Available shifts will be "load balanced" across the area so that caregivers do not have to sign on with multiple employers in order to stay busy and make the money they need to pay their bills and support their families. The network's advanced technology scheduling system will assign them as needed.

Sommers told us in September that this system solves the problem most agencies face when they have too many hours to fill one week and not enough the next. "Caregivers often quit when they are not given enough shifts and go seeking additional work with another agency out of necessity," she said, "which only fuels the shortage. By working together with local agencies in the Honor Care Network, we can help alleviate the workforce shortage by providing increased access to as well as more consistent work for professional caregivers. This benefits the workers too. After we partner with enough local agencies, we take on the effort to keep each worker busy so they do not have to spend their time searching for shifts."

NAHC president Bill Dombi has been confirming this growing problem in his addresses to state and national conferences this year. "Your competition is not only the other agencies in town," he says. "When McDonald's starts paying more than home care can afford to pay, it is hard for an unskilled worker not to notice how much easier it is to flip burgers than to change adult diapers."

The other aspect of the Honor Care Network veteran marketer Roth found appealing was the opportunity to focus on the reputation Cypress has built in The Valley. In the Honor partnership arrangement, Honor manages the partners' administrative tasks such as billing and payroll, leaving the agency owner to focus on business development duties. "More importantly, he added, "it will afford us more time to work directly with our clients and their families."

"I realized that legacy companies like ours have established themselves," Roth elaborated. "The biggest thing we have established is trust. When a person opens their door to a caregiver, they open up their lives to them. I like that Honor understands the need to maintain the trust local providers have earned over the years as they develop partners in each market area."

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.