A decade ago, Senior Solutions didn’t exist. Today, the Brentwood, Tennessee-based company considers itself one of the largest family-owned home care agencies in America.
Senior Solutions brought in $14.1 million in 2018 revenue, according to Inc. magazine. The home care agency took spot No. 1,827 on the publication’s annual list of the country’s 5,000 fastest-growing, privately held companies.
Broken down even further, the Senior Solutions ranked No. 28 in its state and No. 12 in the greater Nashville area, a not-so-easy task considering Nashville’s position as a major U.S. health care hub.
Broadly, the company’s rapid growth can be credited to its unique business strategy, which attempts to emulate that of Bayada Home Health Care, according to CEO Kunu Kaushal, who founded his personal care company in 2010.
“I have modeled [my business after Bayada] and look up to individuals like Mark Baiada,” Kaushal, whose father is an executive at LHC Group (Nasdaq: LHCG) and whose mother owns an assisted living community, told Home Health Care News. “We really graciously look at them as some vision into the future, and I see this company just getting started.”
Specifically, the company aims to remain family-led and mission-driven while prioritizing caregivers and clients over profit margins and growth. The hope is that the former will lead to the later — and to long-term sustainability. And so far, so good.
Currently, Senior Solutions employs more than 1,000 people across 22 locations in two states and counting, according to a company press release. Much of that growth came naturally, Kaushal said, with only about 12% of company revenues represented through past acquisitions.
“We’re not doing our absolute best unless we are expanding our services and reaching more lives overall,” he said. “I think from a size perspective, it just kind of happens, meaning the word gets out.”
On a practical level, Senior Solutions’ growth has been made possible because of its early investment in systems that allow for scalability and expansion.
“One of the biggest challenges [in growth] is that people don’t feel like they’re quote ‘big enough’ yet for taking on additional tech or workflows or enterprise-level solutions,” Kaushal said. “That is one of the things we did early on: When we were too small, we got a payroll system that was too big.”
From there, Kaushal’s priority became market diversification — but not necessarily market domination.
Rather than being the top provider in every market it occupies, Senior Solutions aims to have a smaller foothold in a larger number of carefully chosen markets. Currently, Senior Solutions operates across Tennessee, with expansions happening in Georgia and planned in other states across the south.
“We certainly want to be present, and we’d like to be in the top third from a volume perspective of the markets we are in,” Kaushal said.
Beyond that, the provider lets growth happens naturally. As word of mouth gets out, referrals inevitably increase — and so does Senior Solutions’ market ranking.
One would assume that pattern will only continue at an expedited rate in the near future, thanks to the company’s involvement in Amedisys Inc. (Nasdaq: AMED) and ClearCare’s new network of personal care agencies. As a result of its involvement, Senior Solutions and home health giant Amedisys will be able to easily cross-refer seniors, improving care — and likely boosting business.
In addition to organic growth in existing markets, Senior Solutions actively scouts new geographic locations in which to introduce its services.
“Our expansion strategy has been out of: Where’s the need and where are the caregivers?” Kaushal said.
With the silver tsunami sweeping the country, that need exists in most places. But the same is not always true for caregivers, who Kaushal says are vital to natural market share growth once an agency plants its flag in a new area.
As such, he considers workforce availability when eyeing market targets. Senior Solutions keeps a deep bench of caregivers, with 700 to 800 active organization-wide in any given month and another 200 to 300 ready to go.
“From a macro perspective, we’re always hiring,” Kaushal said. “We cannot predict when clients will come in, what exactly they’ll be needing or what the skill and personality match of individuals will be. Instead of trying to find the unicorn, what we tend to do is try to recruit as many caregivers as we can.”
Still, industry-wide, keeping caregivers can be difficult. In 2018, turnover hit an all-time high of 82%.
But Senior Solutions doesn’t measure its caregiver turnover in the traditional way — from the date of hire. Instead, the company tracks retention a month or two out and uses hourly metrics to measure success.
Rather than try to keep caregivers with the company for a certain length of time, Senior Solutions prioritizes and incentivizes hourly targets.
“What we’ve done is create different micro goals for our caregivers,” Kaushal said. “We track the number of individuals who have gotten to their first 100th hour. Our first goal is not about the time that they’re with us. It’s: Can we get them to work 100 hours on the clock with our company?”
As such, instead of struggling with a caregiver crisis, Senior Solution’s biggest problem is training. Specifically, how much training is enough training?
The answer to that question is becoming increasingly complicated, as home care is transitioning to serve more medically complex individuals.
Because home care aides don’t have to have CNA licenses in the states where Senior Solutions operations, sometimes that means having to bring people with no experience up to speed in a faster-than-ideal manner.
“I think the industry is really struggling — and we are struggling as an agency — to be able to balance training these caregivers … [and] finding a way to train them in an ongoing fashion,” Kaushal said. “We have to professionalize caregiving even more than we do today.”