Since co-founding Executive Care with his wife Mila 15 years ago, CEO Lenny Verkholglaz has led the Hackensack, New Jersey-based home health care franchise toward consistent growth in an industry that is grappling with how to recruit and retain home care workers.
Today, the private-pay in-home care company has over 20 locations across more than 10 states, offering a plethora of services including companionship, homemaking, personal care, live-in care and skilled care.
Currently, Executive Care has 19 owners in its network and serves close to 1,000 clients.
Looking ahead, expansion remains top of mind for Verkholglaz, who has plans to open 10 new locations in cities such as Boston, Las Vegas and Denver by the end of the year.
Home Health Care News recently caught up with Verkholglaz to discuss Executive Care’s journey as a company, its partnership with Lyft and its goals for the remainder of 2019.
Highlights of that conversation are below, edited for length and clarity.
HHCN: Executive Care was founded in 2004. You celebrated your 15-year anniversary this year. How have you seen the company grow since its launch?
Verkholglaz: My wife and I took the approach of, “Let’s grow our company to the point where we feel comfortable with what we are doing.” Then we can franchise with a proven concept that works, that makes money and that others could believe in.
We grew our company for about nine years before we decided to franchise, but in the first nine years of our existence, we had a deliberate approach to growing our business. We are in a mature industry, and it takes time and money to grow the business into a multi-million dollar business, which Executive Care is today.
It’s like building a house, one brick at a time. We are building our business one client at a time.
What are some of the biggest differences in the delivery of home care from when the company first launched to now? For example, I know home care has really gained more recognition for its role in addressing social determinants of health.
When we started in 2004, the private-pay home care industry or in-home care was in its infancy. We saw that there were a lot of companies doing Medicare and Medicaid work, meaning being reimbursed by Medicare or Medicaid.
But when we started out it was somewhat easier back then compared to what it is today. We now have an enormous number of competitors. The barriers to entry are somewhat low or lower [in non-medical home care] than, say, getting into the Medicare or Medicaid business.
We’ve seen that a lot of people started recognizing that in-home care is needed more. A lot of people we have been dealing with didn’t know the service existed.
We see a lot more awareness of services, and that helped us grow.
From Executive Care’s perspective, what are some of the top industry challenges, and how has the company responding to these challenges?
The biggest challenge is the minimum wage raises because the government is pretty one-sided. They look at the employer-employee side of things without any regard to the consumer side. We are very careful and sensitive to raising prices on our clients. If a person is using us 24/7 around the clock, sometimes it can get pricey.
Another challenge is that with more seniors needing care, it’s sometimes a challenge to find the right caregiver for the client. We’ve never had issues finding caregivers, it’s just a little more work now than it was before. The pool of caregivers was readily more available 10 years ago versus now. It’s a little more work on our end, but we always find caregivers for the job.
I call it the law of attraction. If you build a good reputation as a company, you start attracting more caregivers.
One challenge that we have noticed across the industry is the recruitment and retention of home health care workers, which you just touched on. Besides building a good reputation as a company, how else is Executive Care addressing this point?
Recruitment is an ongoing process. The way that we approach recruitment is similar to the way that we treat new customers. Caregivers are the face of our company, so we want to make sure they are treated well, that they are given growth opportunities, that their assignments are explained properly and that they are paid well.
That’s what helps us recruit and retain caregivers. We are known for being a company with compassion towards both our caregivers and clients.
For us, recruiting has been a combination of multiple components, including recruiting through major sites like Indeed and ZipRecruiter. We employ software like Hireology. We run a local recruiting open house and we also offer referral bonuses.
But there is no magic bullet. It’s a lot of work. Some of our offices have dedicated recruiters whose only job is to bring on more home care workers.
What are some of Executive Care’s short-term goals for 2019?
In terms of brand growth, although we’ve been in business for 15 years, we are a younger brand compared to some of the other ones out there. We are working hard on expanding our brand and making it more known in franchising circles. We are hoping to add between five to 10 locations this year in different parts of the country. We are talking to several candidates who have expressed interest in our system and model.
In terms of providing care, my job as a CEO is to be at the forefront of my company, looking out for opportunities, looking for improvements, new technologies and better processes. For example, this year the Centers for Medicare & Medicaid Services is going to be accessing penalties for readmissions, not only to hospitals but also skilled nursing facilities, so we are implementing new software that will track readmissions by clients and by conditions.
Having this data will help us work a lot closer with skilled nursing facilities and hospitals.
In 2017, Executive Care partnered with ride-hail company Lyft to allow arrange rides for clients and caregivers. Can you talk about this a little more and, perhaps, provide some insight on how the partnership has impacted your bottom line?
This is a great relationship. We approached Uber as well, but I haven’t heard from them. Well, too bad for Uber. Lyft embraced us. They have a special health care program for companies like ours. It’s almost like this lifted a weight off of our shoulders. It allows us to be very flexible with our clients and our caregivers. For example, if a caregiver’s car breaks down, we can dispatch a Lyft to pick them up and bring them to the case. If a client needs to go to a doctor’s visit, a caregiver can come along.
I can’t say that it helped our bottom line to a great extent, but it says to consumers that we have solutions for them. Transportation is one of the biggest issues with seniors. They need to get around, and Lyft solved that issue for us. I’m very happy with this partnership.
Is Executive Care working with any Medicare Advantage (MA) plans? If not, what are you doing to position your company to take advantage of those opportunities as they appear?
At this point in time, we are not working with Medicare Advantage, but I have my eyes and ears in that direction.
Based on what I hear and what I’ve been reading, MA could be good in a few years. I don’t think that, at this point in time, too many people know what it’s going to involve, what the benefits are, what the reimbursement rates are, what the billing procedure is. There are a lot of questions.
I don’t want to spend time and resources developing processes on something that has not been defined yet. I have a wait-and-see attitude until things become clearer.