Please note: The transcript below is automated by speech recognition software and may contain minor inaccuracies.

Jeff Howell (00:01): 

Welcome to home health, 360 a podcast presented by AlayaCare. I'm your host, Jeff Howell. And this is the show about learning from the best in home healthcare from around the globe. Hi folks, and welcome to home health 360, where we speak with leaders in home health and home care from across the globe. Today, I'm joined with two dynamic leaders at senior helpers, a leading home care franchise with offices in the United States, Canada and Australia. Mari Baxter has been with senior helpers for years first being the VP of operations and recently move into the 14 <laugh>. Yeah, and recently moving into the role of chief operating officer out of Wilmington, North Carolina, Mary, welcome. And thanks for coming on the show today. 

Mari Baxter (00:55): 

Thank you. Thank you. I appreciate it. 

Jeff Howell (00:58): 

We also have David Chandler, senior director of strategic programs out of Houston, Texas, and prior to joining senior helpers worked as the director of clinical services for Brookdale and was the executive director for the village of Myland David. Thanks for being here. Glad to be here, Jeff. Thanks for the invitation. So folks, why don't you give us a little bit of background for the people that are out there that don't know about senior helpers. Why don't you bring us up to speed on where, where your career path has taken you and let us know a little bit about senior helpers. 

Mari Baxter (01:32): 

Okay. As we mentioned, I started with senior helpers, gosh, back in 2000 late, 2007 to early prior of 2008. And it was sort of new adventure year for me, I'd been in a private business owner, had been then went into franchising. I was actually in the childcare spectrum, which is completely opposite of where I ended with senior care. When we started with senior helpers, 40 franchisees in the system, there wasn't very many there was nine of us at the corporate office wearing multiple hats and the need for, or home care at that point was out there. But it wasn't as identified as, as I think, as it is today and, and prominent. And particularly, I think we can talk about this in a bit, how COVID played a, a role in real making people realize that home care is a very important option, but so we grew, we grew and grew and grew over the years. 

Mari Baxter (02:20): 

We just, we have over 300 franchisees in the United. We have four corporately owned locations. We're in Australia, we're in Canada. Nothing cha nothing different about what the needs are. You know, the, the aging population is the same needs in Australia and, and Canada as they do the United States. But primarily our focus Jeff is to allow our aging population. It's not just aging, could be people. Who've had accidents, have multiple sclerosis, have ALS have a need to have private care in their homes or, or in a community. It could be that the concept is obviously is to allow people to live longer in a healthier way at home, with assistance and to have their independence at a certain point in life, everybody says, no, no, you can no longer drive. No, you cannot go to the store by yourself. 

Mari Baxter (03:13): 

No, you can't, you can't cook anymore. It's no, you can't live alone. It's no, no know. And it's so wrong, you know, it's just so, so wrong for on so many levels to, but some people need that, that assistance. They need someone to step in and say no. So there has to be a better solution. Home care is that solution. It allow people to stay in the home age appropriately in their own environment where they're happiest with their pets, their own with their family pictures, et cetera. And so that's what home care concept is. You know, we're, we're very proud of what we do and we can talk more in detail about what makes us different, but that's basically the concept and we've grown dramatically since I've been there. That's great. 

Jeff Howell (03:54): 

And David, you came from facility based care. Give us a little history on where, where your career has gone. And, and I guess it's been about five months that you've been that senior helper. So bring us up to 

David Chandler (04:04): 

Yeah. So I started in senior care when I was 15 years old, I actually started as a resident assistant and also did private duty care for a little while. I was pretty upset actually by the, what I experienced as as a resident assistant, the level of care that I was seeing. I'd go in on, I'd go in after school on, on a Monday. And I was very passionate about providing excellent care. And, and so I'd make sure that the clients under my charge were well, well, well bath, they had clean clothes on and I would go back on a Wednesday or a Thursday to visit them again and see that other people just didn't care. The way that I did, they'd still be wearing the same clothes that I had left them in on Monday, which was really upsetting to me. 

David Chandler (04:52): 

I remember having some meetings with my executive director at the time, and him giving me some advice saying that, you know, David, this is something that one day you could Le make a difference in the lives of seniors and lead teams like this. And so from that time, I knew at a very early age, very early stage in my career that I wanted to lead and make a difference in the lives of seniors. And from that time I became a CNA, worked in some different skilled nursing communities and, and went to work my way through nursing school became a registered nurse was with the cancer treatment centers of America for about five years doing first as a floor nurse on a step down unit. And then the last few years doing quality and patient safety. And then when I finished my work commitment with CTCA jump back into senior care, which has been my passion was an assistant director of nursing and then a director of nursing over skilled nursing communities with Brookdale. 

David Chandler (05:51): 

And then for the last few years was an executive director with retirement center management down here in Houston. Really enjoyed what I did. I was, did a lot of turnaround communities where I'd go in and maybe the culture wasn't completely where it needed to be or survey results, weren't where they needed to be. And so I would go into communities and just make sure that wherever I went, that the seniors were getting the care that they deserved. And couple years ago I was introduced to senior helpers and they came and did a, a, actually did a presentation for my community. Talk telling me about life profile and I'll be excited to share about life profile in a little bit, but once I heard about life profile I started imple many, some of the strategies. And again, we'll talk about that in a little bit, but senior helpers is really dynamic in the private care world because they look at the whole picture as opposed to what my impression was always like private care is companion care. 

David Chandler (06:53): 

I call them as an executive director when I need someone to come in and and help just have somebody there. But what I experienced as an executive director was a partner who was helping me to provide outcomes for my residents. And so when I was given the opportunity about six months ago to come and join senior helpers, and again, we'll share about life profile a little bit more and a little it, but you'll see why I was so excited to come and join this team. And private duty was never even on my radar. I never even had considered with a nursing background and a business background. Operations was always my, my goal. But when I was given the opportunity to join senior helpers as a an industry leader and wanting to provide outcomes for seniors I jumped on it and have been so excited about the direction of where we're heading. 

Jeff Howell (07:48): 

That's great. So let me ask a question that I'm sure everyone is the, it's the hot topic of the day. Let's rewind 18 months and you know, life is, is going, you know normal for, for senior helpers and then COVID hits bring me through what, what happened first and then how did things unfold because I'm hearing a varied sort of response of what happened with clients. What happened with caregivers? What happened with PPE? How did you change your policies? How did life change for senior health brewer overnight? 

Mari Baxter (08:25): 

Yeah, it was it was an interesting first month. I think when we, we all think about that March, 2020, it was, is this big? Is this not big? Fortunately I think our, our CEO, Peter Ross, and I, I think we, we jumped on it really, really quickly. I mean, I, the very first thing that we came, we, we came to immediately within probably the first 48 hours that everything started locking down and shutting down is COVID, isn't gonna change whether a 85 year old falls or not. You can get COVID or not get COVID. It doesn't make them any safer from falling. It doesn't make them any safer from needing bathing and care and needing groceries and unable to do the things they need to do. So we couldn't abandon them. I mean, there was many businesses that abandoned their, their clients and their, and their, and customers, and even doctors' offices wrote clothes, even for an emergency, but intellectually we're going, we can't stop. 

Mari Baxter (09:21): 

I mean, our, our, our clients are more vulnerable than anybody. And probably within the first two weeks, I think there was this panic from our franchisees. How do we, how do we continue? How do we get, how do we put our caregivers at, at risk and, and, and what do we do? But we jumped immediately. I mean, within, I mean, gosh, I, I laugh because look back at now, I actually accused our CEO needing to go to PPP anonymous because he was PPP anonymous. Cause we were sourcing mask and gloves and, and, and COVID testing and everything. We all day, all night, we were on the phone with China. We were on the phone with, you know, overseas, anywhere we could source more products because as you know, initially you could even hardly get masks. I mean, it was just crazy panic. 

Mari Baxter (10:06): 

You, you go to the grocery store and you couldn't get, you know, you couldn't get hand sanitizer and people were making their own. And, and we, we jumped on it probably prior to many people because we were able to get a million dollars worth of supplies to all of our franchisees and big shipments pretty quickly. So we were trying to make it possible for our franchisees to still send their caregivers in the home. And we had testing kits before anybody else even did we sourced that? But we, we, we immediately started a message of, if not us, who who's going to take care of these people. It was interesting because many of the communities, when I was on a phone call with the large community were locking us out. They were locking our caregivers out, cuz we don't just staff at home. We don't just care, take care of clients in their homes. 

Mari Baxter (10:48): 

We also take care of clients inside a community inside independent living inside of an assisted living. And they were blocking us out. They said, you can't come in the building. So is taking care of those clients. If you're not, if our caregivers aren't, are you assuming your caregivers are? And they would say, yes, you just can't come in. And I would literally get on the phone all across the country, not, not where I live across the country, help my franchisees. And I would get on the phone to discharge planners and social workers and, and directors like David. And I would say, do you have care plan for my client? Who's in your building will know then how are you taking care of them? How often are you seeing them? Are they getting up? Are you bathing them? No, no, no. Then you need to let my caregiver in my client needs care. 

Mari Baxter (11:31): 

You are going to neglect them. And you know what happened, Jeff is that our phones start ringing off the hook, get my mother out of that building. Can you take care of her? I want my mother home. I don't want her there. People were panicking. I think that the communities did the best job that they could, but let's be honest. The biggest problems we heard were inside these large communities, it was very frightening for families, whether it was true or not. They assumed that their loved ones were gonna be more at risk for COVID. And it turns out probably in some sense situations they were. But they were more concerned about the neglect or the lack of caregivers and inside the community that there wasn't enough personnel to go in. So we became busier than ever. If you were to look, you know, from a strictly business standpoint. 

Mari Baxter (12:16): 

And I think that's, you know, from my perspective, as the COO of the company from strictly business perspective, we grew unbelievable numbers. Revenue wise, we were busier than ever. Our franchisees could not get enough. Caregivers hired quick enough to get into the homes because people were pulling family, me members out or where the daughter, the primary caregiver was typically running over to take care of their mother or their father. They were also now grounded at home with their children and not able to go and see their own family members. So they were reaching out and saying, do you have caregivers who are gonna be masked and glove? Can you go and take care of my mother because I'm afraid to go over and see her. So we became very, very busy and was all hands on deck. And I will say that I'm very, very proud of our, our franchise community in that we didn't stop servicing. 

Mari Baxter (13:01): 

We didn't neglect our clients. We went in, we, we took risk. We, we tested our caregivers constantly. We had testing kits and we kept business as usual. And you know, the gratitude from the family members as I I've not heard anything, but just thank you. Thank you. Thank you, cuz we kept people safely in their home. And we went in and we <laugh>, we kind of bombarded the communities and said, you know, if you're not gonna do it, you gotta let us in the doors. Mm-Hmm <affirmative> so, I mean, it was just a very, very there was a lot of strategy. There was a lot of phone calls. There was a lot of passion. There was fear, there was a lot of money spent to make a safer, but I think we, I think we did an amazing job. 

Jeff Howell (13:38): 

So that's interesting because we hear from other agencies as well that any client who could cancel, would cancel. And so some agencies are you know, they didn't get this influx of people that wanted to get outta buildings and into homes. A and you know, the reverse is also true. And so David, you were you were on the other side of the coin at that time, right? So you were the executive director of facility based care. What, what was life like for you at that time? 

David Chandler (14:09): 

Oh, wow. <Laugh> it still halts me a little bit. <Laugh> I remember I were the day that we finally got the vaccine and it was like carrying this weight of having, I had about 90 residents that I was caring for at that time in assisted living in memory care. And I remember feeling like every day I had this weight on my shoulders of, of trying to keep COVID out of the building. And we were very fortunate that we only had two of our residents that were diagnosed during that, that year period. But I remember going home that day when we finally got the first vaccine and just feeling like I could actually sleep that night. My heart really goes out to our, our healthcare professionals who are out there in the hospitals and in these situations that are still facing the battle with COVID and it was, it, it was difficult. But the company that I was with was very supportive of our residents and recognize the, the aspects of socialization and keeping them engaged and active safely. So we did everything that we could to continue to promote that while keeping our residents safe. And we put in a lot of guidelines, we were restricted visitation. It was very difficult for our families. We go about a year without seeing their loved ones. And, and I'm, it, it continues to be a challenge for them. 

Jeff Howell (15:44): 

I'm curious. How, how long in your view was it before with the, the concept of I don't know if you had outside staffing from companies like senior helpers, but mm-hmm, <affirmative> the, the idea I'm, I'm curious from both of you, how long was it before caregivers that are attached to home care agencies that go and provide care within buildings? How long were there the appropriate COVID tracing tools and procedures in place so that we, we could help provide the level of care and not just shut it off. 

David Chandler (16:21): 

And so at our community, we required the, the agency staff that were coming in to follow the same guidelines as our staff. So they were screen, we offered the vaccine to them when the vaccine was available, just the same way that we offered it to our staff. They were screened. They were required to let us know if they were, if they were having any symptoms or if they had been exposed to anyone. I was having conversations with the owners of those agencies to ask them, what guidelines are you putting in place for your staff? But then I heard the horror stories and we actually had residents moving into our community from other communities that would not let those people come in. So there were those other agencies that weren't letting people in. I think that as long as you were following the, the guidelines within the state again, we were doing everything that we could. 

David Chandler (17:14): 

I remember going to our, our CEO at the time and asking him, you know, we, we have one, we have two choices here. Are we gonna let you know, which is the greater evil we have residents that are facing depression and they're gonna pass away from depression, come out a year from now and not ever look like the same person again. Or we, we risk exposing them to COVID. We have to find this balance of keeping them engaged and socialized, but reducing the risk of COVID. But we found that after the first week of having residents, where they were actually shut in their apartments for a week straight, I was walking into their apartments and they would just bust out crying because they hadn't seen anyone for a week. Other the Meades would come in and give them their medications. But it was, it just wasn't possible for that level of, of isolation for our seniors. It was, it was terrible. It was a very difficult balance. And so we found that keeping those caregivers out was really, it was doing more harm than good to make that restriction. And so we had them follow the same guidelines of our staff and we continued allowing them in mm-hmm <affirmative> 

Mari Baxter (18:25): 

I think from our perspective, again, I'm gonna come at it from the more, the business side is we, we sourced all this, all these masks and all these gloves and the testing kits and, and gowns and, and hand sanitizer. And we were sending them out to all of our franchisees, but we didn't just send them out before that. We, we, you know, great for DocuSign, right? Docusign comes along and we're able to send out an, an affidavit or formed for every franchisee to say, look, we're going give you this, and we're gonna continue to, we're gonna supply these, these so you can be successful in taking care of your clients, but we need tra tracing. We need information. We wanna know how many of your caregivers you're testing, whether test results, how much equipment you're giving out. Cuz I didn't wanna see is a year from now to walk into a franchise office and see a box of our product. 

Mari Baxter (19:06): 

Still sitting there UN open, we wanted accountability and that came with it. So everybody signed a documentation that said yes. And then every day we would get our reports showing how many, how many caregivers, how many clients, how many how many, how much equip, you know, mask, et cetera were handed out. But not only that who was tested, how many tested, positive, how many had a negative test, et cetera. So we kept track of that. And it helped us to know that what we were seeing, what we were trying to do was working. And I, I just honestly think that we took the immediate approach of, yes, this is just absolutely terrifying. What's going on there? We don't disagree. But if we're in this industry, if not us who yeah, it just, there was, to me, it just didn't ever make sense to me that we would. 

Mari Baxter (19:49): 

And we, and we didn't. And maybe because we took this approach that you have to continue to have care for your mother COVID doesn't change. Yeah. That, and if you're not gonna bring her in your home, then you're, you're gonna have to let us in. And, and we'll take all the safety precautions. And I just admired to, to David's point that the healthcare workers, the caregivers, they were the ones on the frontline, they were the ones, it was easy for us at the office to say, you're scheduled to go work nine to five. Yeah. but they were, we were asking them to take the risk and they did it. So, 

Jeff Howell (20:16): 

So that was my next question because during the hardest, or the easiest of times, caregiver, attraction and retention is the biggest challenge in the industry. Now you layer on top people that are afraid for themselves and are afraid to, to get COVID and transmitted it to someone else. You have people collecting unemployment benefits. How did you, the revenue was strong during this time because the demand was there for you, but you still have to fit fulfill those visits with care workers. How did you, how were you able to fill all those visits? 

Mari Baxter (20:49): 

I, you know, that's a great question. <Laugh> I look back and go, how did we <laugh> cause I think initially when COVID was at its worst, we were probably struggling less with the caregiver shortage than we are now. But I, I, you know, there's probably other reasons behind it. I think, look, I, I think if you're a, a caregiver in this world, for the most part, not that's a generalization, certainly not everybody, but many caregivers do this from their heart. It's a, it's a, it's a calling for them. They go in and they you're just like people who are nurses and doctors. They, they it's, it's a sense of calling that says, I, I need to continue doing and I'm doing, and many of them have clients that they, they care for and they weren't gonna just abandon them. And I think we didn't play on that. 

Mari Baxter (21:31): 

That came from their own heart. I think that's a big part of it now, giving them gloves and masks and sanitizer and giving them means to check with their equipment and it, or check their own if they have COVID and, and temperature checks, we gave everybody, I mean, we did everything and I think that we, we, we put them in a safe environment. We, we try to also, I'd be very careful not to send, you know, where you might mix up shifts and send four or five caregivers into a client's home. During the week, we try to minimize that we, we work through you didn't send five or six people, you try to send the one or two. And there was a lot of overtime to be honest with you, because you had to, you, you try to minimize how many people went through that front door. 

Mari Baxter (22:08): 

So it called, it required a lot of innovative scheduling and rewards. And we sent every one of our t-shirts, even from the corporate level. I mean, you know, every one of our I'm sorry, know these people dinging me and I thought I turned it off. They we sent all the caregivers throughout the whole country shirts and, and thank you cards. And, you know, it's like a over 18,000 caregivers who don't work directly for us, but work for the franchisees. We were still applauding their efforts from a, at the highest level. There were thank yous, weren't enough, you know, just, we had to keep working on that, that appreciation level. And I just think, I, I, I think it was just a very intense effort of yeah. Which I think we've learned a lot. We've learned a lot from that from not, you shouldn't take a pandemic to, to show this kind of appreciation and gratitude for the hard work they do. That's so we're trying to keep those things going. 

Jeff Howell (22:56): 

That's amazing now through all this as well, I listened to your CEO, Peter Ross recently on a podcast talking about a hospitalization rate of just 3%. Maybe that's a good segue into my understanding is you guys have some exciting new programs, so why don't we go there next? 

Mari Baxter (23:15): 

Well, I guess I will start. Yeah, we really do. We have some really great things and I, I, you know, you always kind of go do I, do I do I do change the se share the secret sauce on some things, but you know, over the years of 14 years of being a senior helpers and, and, and knowing this industry you know, there's caregivers that work for us work for all the other companies in the same space, you know, our, our competitors, our, we call it to call 'em our frenemies, our, our friends that are in this industry. It's not uncommon for caregiver a to work for us. And for three or four other agencies, it's, it's common in this industry and you, and you bring them in and you all pretty much orientate them the same way. Yeah. Hire them. You give 'em orientation, you introduce them to, to your, your company. 

Mari Baxter (23:57): 

And over the years, I would see a lot of the same redundant come work for us. Here's what you can do. Here's how you can dress. Here's what, how you meet your client, et cetera, et cetera, et cetera. And probably about eight years ago, I had a franchisee that said, it's not enough. You know, I need to verify their skillset. I need to upskill them. If, if my, if they, if the client's needs, outgrow their, their skillset, I wanna keep them with that client. What can we do? So he showed me this he kind of added at a, a small little space, but he added a bedroom and a bathroom and a, and he started having his caregivers be taught in this environment. And I, and I kind of put in the back of my head until we took, took four corporate stores. And what we've done literally is at a four room apartment, which is a kitchen, a family room a, a bathroom and the bedroom. 

Mari Baxter (24:46): 

And uniquely, if you look at caregivers across the country, they're trained on a conference table and they're showing a video and they're showing a slideshow and they're shown, and they're given a handbook and these are things you can, and can't do. We don't do that. We bring them in and we bring them into the full kitchen and we give them 30 seconds to find all the hazards. And we take them into the den and give them all the hazards. And, and then we take 'em to the bedroom and we have them show us how to transfer a client from a bed to a wheelchair or ho lift there's actual physical training. And they verify, and they demonstrate they have the skill set. And if they don't, we show them those skill sets. And it's, it's really amazing. They have a lot of fun with it. 

Mari Baxter (25:23): 

They get 30 seconds kind of like a escape room to find all. And what we've learned is over the years, and you might notice this, Jeff, if you have family members, if you have a family home, and you've been going back to that home for years, your parents home, for example, yeah. That cord behind the lamp. You don't see it anymore. You step over it. Cuz you've been going to the house for 30 years, but we ignore what's in front of us because we become immune to it. Even our caregivers will go into a client's home. And well, this is just the way it is. All that the dog food on the floor, the dog toys, the rug, that's not taped down the the, the lawn chair and the shower versus a true tub bench, all these things that they just become white noise. 

Mari Baxter (26:00): 

And we noticed that even with our caregivers, they didn't see it. So we became, we trying, we, we had this whole four room apartment, but even exciting. We bring family members in Jeff. I can have a caregiver in a client's home from nine to five or midnight to six. But when a family member comes in, if they don't know how to use a Hoyer lift, or they don't know how to use a gate belt or transfer belt, or know how to use a tub bench properly, they don't have the, they don't know how to get their family member up the stairs with the Walker. What good is it? We we're only can keep them safe while we're are there. So we're training family members out of our space, out of our center of excellence, which is what we call it. Okay. and we're spreading these all across the country and I pretty much, and I feel like I'm giving away my, our secret here, but it's okay, because I can tell you that families can rest assured if they hire someone from senior helpers that they, we have verified the skillset that caregivers showing us, they know how to do it. 

Mari Baxter (26:48): 

And if, Hey, if they, if they need some tweaking, we have our ends of staff. We can say, Hey, this is the proper way to use the gate belt. This is the proper way to use a higher lift. Let us teach you. Your client's getting worse. Not better. Let's make sure you know how to use all those skills. And not only that, then the family member, we show the family members how to keep that client safe. And you know what our attrition in keeping those clients in their home is increased by almost two months since we've been doing this, which is huge, right? Absolutely. We're keeping them in their home. I'm so passionate about it. It's so fun to watch caregivers call you up and say, can I come to your training? I heard you guys have this fun training. Can I come there and be trained, never happened before. 

Mari Baxter (27:24): 

Right? We used to hear caregivers, oh, we gotta go to this training. Now they're calling us up and saying, are you the place that does that really fun training? We also have family, not only family nights, but we have nights for our caregivers to come in and talk. It's a tough job. You're taking care of clients who have dementia, who have no filters, who are saying things sometimes that are hurtful. They, so you can't leave 'em for two seconds. So we bring the caregivers in. We show them movies that are relevant. We, you know, they, we have in the, in the apartment, they have popcorn night, family night, they talk, they vent, they share ideas, best practices. So it's become this. The center of excellence. Is this just amazing tool. And then I'll tell you who, what we've had the best response from is from the clinical community, the professional community. 

Mari Baxter (28:05): 

They are seeing what our training looks like. And David will tell you too, it's like I get giddy. But when you get a, when you get a discharge planner or social worker or nurse, or we had a doctor recently, who's famous dermatologist in the United States, he saw it and he goes, never ever have I seen a training like this? This is just mind blowing. This is amazing. I believe when you say your caregivers are, you guys are doing it. This is awesome. So we're pretty excited about it. It's you see, I gotta tone it down cause I just get so thrilled about it. Right. But if you could just see the caregivers who just love it, it's just, we're we're, we're very proud of it. 

Jeff Howell (28:38): 

David, did you have to go through this as well? Six months ago 

David Chandler (28:40): 

When you were onboard it <laugh> I did. I went through it. I did. Yes. and I will tell you, I have never experienced anything like it in my life. And it's so fun to follow a leader like Mary and Peter who are so passionate about providing outcomes for our seniors. And so I came on board for helping to promote our life profile program and implement help with implementing that around the country. And so I lived and breathed life profile for a year and a half as an executive director. And what life profile is it's an assessment tool that helps us to reduce the risk of hospitalization for a senior improve their quality of life and also to reduce the burden of care on their loved ones and what that is it's for the first time ever we can categorize and quantify the 13 key areas that a senior must have their needs met in order to successfully age in place. 

David Chandler (29:45): 

And so the big challenge that we found is that there's over three and a half million preventable hospitalizations that happen in the year each, each year and for seniors. And so I remember for my time as an executive rector, I always had the, the ambulance was consistently outside of our community. Three, four times a week from a resident who had fallen or they had gotten dizzy, they had a UTI, something was going on that we needed to get them to be evaluated in the hospital. And so when senior helpers approached me and shared with me about like profile it, it blew my mind. It's a game changer and it completely changed my approach to assessing and observing seniors. So we have life profiles com combination of we have 144 safety risks that we go in and assess for things like, do they have non-skid tape in the shower? 

David Chandler (30:43): 

Do they have a tub bench? Do they have the appropriate rails? We look at their mobility, their activities of daily living. We put all this together and we have a score called our autonomy profile score. It's a score of zero to 51. And what we found is as we go through and we look at the areas, we look at how they're managing their medical condition. We look at their safety risks. We look at their mobility and we give them a score zero to 51. Anything, anytime a senior score is below a 34 on their autonomy profile score their risk of going to the hospital. And the next six months is at least 80%. Our goal is when we go in, we do this assessment with our clients. We identify where their level of risk is. If we can get them above a 45 on that score of zero to 51, we can reduce their risk of going to the hospital in the next six months to less than 10%. 

David Chandler (31:41): 

And so I, I go through and I, I started implementing this methodology in my community and educating my staff on how to identify these risk factors. We educated our doctors on how to identify whether a, a resident is man managing their medical condition appropriately. And it's a, a lot of it is, it seems like common sense. It's just that people in the industry from medicine to senior living private duty, it, we just haven't taken the time to put something together like this, like life profile and really assess it and then actually score whether we're being successful. So when I heard about this, it was like, well, I feel like I'm really passionate about being an executive director. I'm a nurse. I've been doing this for about 20 years in the, in the industry. And when I went and scored a couple of our residents and I realized how much we were missing, it blew my mind. 

David Chandler (32:41): 

And I immediately, I hadn't even heard of senior helpers before I was introduced to life profile. They immediately became my number one referral source, my number one partner in helping to reduce the risk of hospitalizations for my residents. And we decreased the number of residents, even in the midst of COVID. In 2019, we were averaging about three to four residents who were moving out each month to 2020. We've reduced that number to one to two. Whereas a lot of our fellow a lot of other communities dropped in occupancy by about 30%. We went four months without taking an admission and only dropped percent with implementing a lot of these strategies. So it's amazing to me when we can go in and reduce these risks for a senior, identify them for the family, work in partnership with them. And I will say like, as an executive director, when I worked with senior helpers and I was working on these strategies, it was the first time that I felt like I had a partner in a private duty across the, across the industry, whether it was private duty home health, I had never had anybody come in and partner with me like senior helpers did to say, let's provide, let's provide better outcomes for your residents. 

David Chandler (33:58): 

And so that was the big draw for me to want to come and work with them is identifying these risks, taking this autonomy profile score, applying it to each client saying, how do we get them from on average, when we go into a home, their score may be around a 20, how do we get them from a 20 to at least a 34? Once we get them to a 34, how do we get them 45 and start reducing this risk of them going to the hospital? Because there's so many things that happen to our seniors that are so easily preventable to keep them safe, living healthier lives and having more time that they're independent and mobile and healthy with their families. It's just blown my mind. And I'm so excited to be a part of what, what Mary and Peter are doing and what senior helpers is doing. It's, it's revolutionizing the, the senior care industry. 

Jeff Howell (34:51): 

I love this on so many fronts you know, any business that wants to stay in business, you need to be a database business. And I love how you're swimming a upstream and partnering with the families and saying the, the prevention of hospitalization starts with education of the family. And I love the concept of before someone comes into the home to provide any care, you're gonna get a report card. Yeah. And it's gonna be very thorough and we're gonna work on this together. So that you're port card, you get a higher grade before we even work together a hundred percent. 

Mari Baxter (35:27): 

It's one way to one way to look at it. I think we're trying to combine look it's. If we can go in the home and do the, with the life profile program we have going, we, we see all these, just what, what you see. I wasn't making it up. I've literally been in homes where I've seen a, a beach chair in the bathtub to do, to shower a client. You know, you're at, it's an accident waiting to happen, right? So help us to help your loved one. We're we gotta make this safe. We gotta work with DME companies. We're just home care. And I used to teach assessment training years ago, and for years for the company. And we'd go in just like our, everybody in our space, we'd meet with the family. They'd tell us they would tell us what was wrong with the client. 

Mari Baxter (36:05): 

And then we'd come up with a care plan. There's much more to this. There's so much more to this. And, and, and we wanna look at lowering readmissions and we wanna keep them in their home safer. We wanna give them more independence. We want them to be safe. So if we can teach and educate the family, we also have to teach and educate the caregivers. And the old way to your point, Jeff is, you know, we can keep doing what we've been doing. It's just not enough. It be to be quantitative and to be, have to create safety protocols is, is, look, people have to COVID you show me anybody that says I wanna in and live in a community now. I mean, people prefer, I mean, they're doing it cuz they have no options. And that's something else I'm passionate about is when will the home care space earn the, earn the rights to have, you know, insurance coverage for all aging population and et cetera. 

Mari Baxter (36:53): 

But until that day it's in its private pay. We've gotta keep people in their home as long as we can. Shouldn't have to be, there's no other option because they can't afford private care. So we'll go in where Medicare or Medicaid will pay for them to go live in a community. You know, you see people diverging their assets so they can go in into a community when they wanna stay home. So many wrong things wrong with that. So we we've combined center of excellence with, with life profile and we're bringing, we're taking, I think we're taking home care to a whole different level. Then it's been in my 14 years that I've been here. 

Jeff Howell (37:28): 

Yeah, I think I'm always amazed when I come across and before I got into the industry, I didn't, I didn't really th when I thought of healthcare, I thought of doctor and hospitals and retirement communities and really nothing beyond that. And I think in the continuum of care, home care is the least well known and, and most misunderstood still to this day. And so what do you think is if you could give advice to someone who's listening right now, just discovering home care what is it that they should know? 

Mari Baxter (38:05): 

Oh my gosh, this is, I think David would have one answer from a clinician and I would have it from, I think we both would say ask questions. How are their caregivers trained? You know, for us now I can proudly say, they're not just trained around table. They demonstrate the skillset that the they have. So we know that that, that client that's getting taken care of is with the appropriate caregiver that knows how to manage their situation. So, you know, how is the, what's the training? How is it done? What is what is, what's going to keep my family member home the longest and safest, and you know, it's just how many people get discharged from a hospital or rehab, take your mom home and just keep, stay safe. Mrs. Smith. <laugh>, there's no education on how do you, you know, how do you use a gate belt? 

Mari Baxter (38:49): 

How do, how do you, how where's your mother's bedroom? It's upstairs? Well, she's had a stroke. She can't get up the stairs. What, what's the alternative? Well, she'll sleep on the couch. Really. That's what we're gonna do here. We're going to send them home to live on the couch. The next six months it happens. Do you have a shower or a tub? Does she have to step over that tub? How's she gonna bathe? Well, we won't give her a bath. I mean, you just, there's no education. It's just go home. We have to, we have to admit somebody else and there's space and they get discharged and it's honestly it's kind of frightening. I'm not critical. I just think to your point, there's a lack of education about, you know, I've, I think the people we have to get to are some of the, you know, occupational therapist, the physical therapist, what is the answer to sending home that client safely and it's us, it's it's us. I mean, they need to reach out to us and know that we are looking at all of these programs to keep that client back in the home safely. And I don't know that they're educated enough on it. So I think that's a big challenge, not just for senior helpers, but for everybody in this space is to just, what is home care and why is it, why is it the solution for so many people? I think there's that misnomer based have some work ahead of us, all of us to do on that. 

David Chandler (39:56): 

Something that I would add with that is that where does the company place an emphasis on focusing on the whole person? And that's something that I love about senior helpers is. And, and again, in part of that life profile assessment is looking at quality of life and we have metrics that we want to meet with how our clients are experiencing quality of life. And so we have a, a planner that our we'll either provide to the family and will ask them to identify a number of activities that the, the, their fam their loved one, who's gonna be one of our clients I enjoys doing. And then we share that planner with our caregivers. And so we have a goal of a certain number of activities that we want them to be engaging in. So it's not just keep it's it's, it is keeping them safe that so they can engage in those activities, but it's identifying those activities. And also, how are they enjoying life? That's a big emphasis for us is wanting them to stay safe, stay home, stay where they want to be, and then also to engage in activities that they enjoy. And that, that to me is what, when, when we're accomplishing that that's really making a, an making a difference. 

Mari Baxter (41:20): 

I would, I would back that up a hundred percent big part of our, our education to our franchisees when they come into the system, new is we spend a lot of time on enrichment and having family members, the client, continuing to be contributing members of their family, even at the minimalist level. When you get to a certain point in your life, you have to depend on other people to get your family members' birthday cards and, and gifts, and, and, and you forget phone numbers and, and you don't, you stop contributing, which is very hurtful. It's painful. I think the hardest part of letting go to your, the aging population is when they lose as their independence, they stop contributing. They're not as supportive as they used to be. It's, it's, it's, it's hard. So helping our we're very, very emotionally centered around enrichment and having our, our, our clients have more than just a care plan, more than a bath, more than food, more than getting dressed and doing the AOL. You know, the we're, we're looking at not just the care of their physical needs, but their emotional needs. It's such a big part of it. So we have, you know, we have field trips for them. We, we, we, we have potlucks, we, we do a lot of activities that keep them living, keep them happy emotionally. So we, we do a lot of training around that. So thank you, David, remind you, maybe that's a big part of us. 

Jeff Howell (42:36): 

Yeah. And certainly these social determinants of health, like you know, loneliness and happiness that that's also an upstream sort of determinant of whether or not you're gonna be enjoying life and vibrant and, and staying out of negative health event. It's like being hospitalized. Can you guys talk a little bit about you guys were just acquired by one of the top 10 health systems. Are you able to talk a little bit about what the strategic move was there and what that means for you guys? 

Mari Baxter (43:10): 

I think, you know, when, if you were, if Peter Ross were on this call, he would, I'll me tell you one of his you know, we've done so much with this with senior helpers, but one of the alliances that I think he really felt like was missing in this, in this space was a strategic partner partnership, which is different obviously than private equity and having a strategic partner. I I've already seen, we've only, this only happened April and I've already seen so much collaboration. And first of all, they, if you were to ask a, a, you know, a who advocate health, but why, why did they want us, they would tell you, they loved what we were doing with center of excellence and life profile and where we were headed. Clearly they had had their options. I'm sure to look at, but their home, their own host SP space and home health space needed a compliment. 

Mari Baxter (43:59): 

And for them, and, and so I think whether it was us or somebody else, the home care space made sense to them from their strategy. So you, you know, I can only, I can't speak for them completely, but I think their strategic plan was how do we get into this space? Because if nothing else, like I said, COVID taught a lot of people that I, this is going to be, get bigger. It's going to get the due respect. It's it's around the corner. I think we, I believe that I'm hopeful that, that we're around the corner of getting that, that recognition, that this is a great alternative. And I think they were intuitive, nothing. And progressive enough to understand that. So they jumped on it before anybody else. Fortunately, we were that one that they're jumping on with and we're partnering and we're looking at how do their discharges go? 

Mari Baxter (44:41): 

They get it discharging their clients to an organization like senior helpers is going to keep their patients from getting readmitted as sooner or end back up in rehab or or worse <laugh>. And they understand that. So their collaboration comes from that end from us. It's a great opportunity. It's a partnership to get, you know, we get these ideas, we get, you know, we have David now and he, let me tell you, we're thrilled that we have David on the team because in this space, most of us like myself, we've, we're not clinicians. I'm not a clinician. I, I, I, I'm not a physical therapist. I'm not an RN. I, I can only guess I can train. I can teach, but it's not coming from a clinical viewpoint. And when you have a room full of discharge planners and social workers and RNs and gerontologists saying, my gosh, what you're doing is so spot on it is it's not only gratifying, but it's, it motivates you to keep pushing harder and getting the message. 

Mari Baxter (45:32): 

Look, change is difficult. Our franchise, we have franchisees, who've been in the system for 12, 14 years, who did it one way, and now we're coming to them and saying, we have this assessment tool that's completely different than what you were trained and taught on, taught to do before. We have a whole center of excellence to get rid of your conference table, knock down some walls, build an apartment. You know, we're asking know we're, we have a lot of big ask and, and, and we get it, but the world's changing. We have to change with it. And I think the best way to do it is to be in a partnership like we have. And we're fortunate, we're fortunate. We have a strategic partner that gets where we're going and, and not only gets it, but is pushing us even harder to do it. Right. And the feedback that we've been getting from them is, is instrumental. It's key. And so we're, I think we're in a good spot. David jump in. You're the clinician 

David Chandler (46:21): 

<Laugh>. Yeah. So I, I think from my experience, and I, I mentioned this about the partnership that I felt with senior helpers. And so I experience that on a, on a smaller community level. But I remember when I went to score and senior helpers took me to go and score my first couple residents. I walked out of those apartments and I, I literally felt nauseous. And I thought, how in the world have we been missing it this badly? Like, how have we been overlooking this this badly? And so I'm, I'm immediately jumped on the phone with a couple family members that I, that I had gone and assessed their their loved ones. And I, for the first time, again, over that last year and a half before I joined senior helpers, I felt like I had a partner who was helping me to provide outcomes for my residents. 

David Chandler (47:19): 

And to have that from a private duty company, I think it just solidified it definitely. Well, it didn't, it, it definitely did solidify in my mind that private duty is a part of the healthcare industry. And whereas before I, it was my perception that this was I, I call 'em private duty. When I needed companion care. I needed somebody to sit with my residents, just be there with them. It was now, I mean, reducing isolation, having a companion there is, is an important part. And we do offer that from, from a, with senior helpers, but there's so much more than that. As far as looking at outcomes, managing medical conditions, being a part of the discharge process, reducing hospitalizations. It's amazing what, what senior helpers is accomplishing. 

Jeff Howell (48:12): 

That's great. Well, I'll get, I'll get you guys outta here on these last two questions. The first being you're now in Canada, Australia, and the us, you're over 300 locations. If I'm a potential franchisee tell me about where you're expanding and would I be able to get some more information on getting into the industry as, as one of your franchises? 

Mari Baxter (48:35): 

Yeah. Great question. We're always, we're, we, we've got plenty of territories still. We have over 400 locations still that we haven't tapped into. So we, we wanna grow, obviously we have some great communities that haven't haven't had franchisee yet. So we have a strong VP of franchise sales who would love to take a call from anybody who wants to be a, you know, a, a franchisee and, and we can certainly get his, his name is Rob Cantrell, and he's a VP of sales franchise sales. And you can go on our website and you can, you can tap into the button that says franchise interested in a franchise, but or directly call him. But we are very excited to bring, we've had a lot of growth this year. It was interesting to me during COVID. I think we had, I think we had our largest number of sales of new franchise sales. 

Mari Baxter (49:19): 

And we've had in probably my 14 years that we were here. People saw this as a huge opportunity and understood, you know, people were getting it, that this is an opportunity people wanna be at home. And, and I don't, a lot of businesses were closing and people didn't like where they were at in their business world. And I mean, we've had some amazing new franchisees come across this year and, and recognize the opportunity. And now with our partnership with aah, we, we were absolutely getting getting phone calls too saying, how do I in, in, in where they're located, particularly in Wisconsin, Illinois, how do I, how do I get involved here? And what do I need to do to be a franchisee? So a lot of opportunities we're expanding wherever if it's already sold, maybe the NA the territory next to it. Isn't so certainly reach out to us. Okay. That's 

Jeff Howell (50:03): 

Great. And final question, if I'm at home listening to this, and I'm convinced you guys are the ISO 9,001 of setting the bar for caregiver training as well as assessments. What's the best way for me to get in touch, to get someone to my, my mom's house for an assessment and get signed up for, for services. 

Mari Baxter (50:24): 

Yeah. Again, we have go to the website it's www.seniorhelpers.com. And when you go in there, if you type in your zip code, it'll direct you to the closest office near you, and then they can contact them directly. Or they certainly can call our, our corporate office and we'll get them directed. That's 4 1 0 3 3 7 5 4 9 4. They can reach out and, and we will connect them. But we have a pretty much a, we try to respond everybody within an hour. It's important because when people make that call, it's not an easy call when they say I need help. We get that. And so we have a, a very quick response time, cuz we know when you're, when you're in that situation, you wanna immediate immediate advice and guidance. That's right. 

Jeff Howell (51:07): 

Well, Mary and David, I wanna thank you again for coming on. It's been an absolute pleasure and I've learned a few new things today and you guys are definitely setting a pretty exciting bar for the industry. So hopefully we can meet up at a conference one day sometime when things are more back to normal and until then thanks again and enjoy the rest of your day. Thanks Jeff. Hope to see you. Soon home health 360 is presented by AlayaCare. First off. I want to thank our amazing guests and listeners to get more episodes, you can go to alayacare.com/homehealth360 that's spelled home health 360 or search home health 360 on any of your favourite podcasting platforms. The easiest way to stay up to date on our new shows is to subscribe on apple podcasts, Spotify, or wherever you get your podcasts. We also have a newsletter you can sign up for on a alayacare.com/homehealth360 to get alerts for new shows and more valuable content from AlayaCare right into your inbox. Thanks for listening. And we'll see you next time.