Right at Home CEO Margaret Haynes envisions doubling the company’s weekly care hours over the next decade as demand surges.

While seeking to fulfill her sizable growth plans for Omaha, Nebraska-based Right at Home, Haynes is also navigating what she sees as the “collision course” the home care industry is facing: through-the-roof demand and insufficient supply. To overcome this hurdle, home care providers can embrace innovation and support caregivers through federal advocacy, Haynes said on the latest episode of Home Health Care News’ Disrupt podcast.

Right at Home provides companion care and personal care services, with over 750 franchise locations in the U.S., Canada, the United Kingdom, Australia, Ireland and the Netherlands.

Haynes, who stepped into the CEO role in 2022, operates with a rolling three-year strategic vision focused on four key pillars: supply, demand, quality, and operational efficiency. She sat down with HHCN to discuss each of these pillars and her vision for the company.

During the conversation, Haynes also shared the policy changes at the top of her mind, Right at Home’s AI strategy and the benefits (and challenges) of operating under a franchise model.

Below are selections from that conversation, edited for length and clarity.

Subscribe to Disrupt to be notified when new episodes are released. Listen today on Apple Podcasts or SoundCloud.

HHCN: Where would you like to see Right at Home in five to 10 years?

Haynes: We want to just continue to touch as many lives as possible. Right now, on a weekly basis, just in the U.S. alone, we’re doing about 473,000 hours of care a week. That’s exciting. It’s a big number, but I’d love to see that double in five to 10 years. We know that there’s so much demand out there that people are going to need our services. We’re certainly focused on footprint expansion, so that in those communities where we’re not, we’d love to bring the Right at Home mission.

Our growth is all around the footprint itself, but also each of the individual franchise offices. We’re always working closely with them to help them continue to grow their business, because they, equally, are wanting to touch as many lives as possible in their local communities.

Let’s talk a little more about the franchise model. What do you see as the biggest competitive advantages and challenges specific to the franchise model in the home care industry today?

One of the biggest benefits of the franchising model in general is the concept of: you can go into business for yourself, but not by yourself, so you’re actually with a franchise model … That gives a lot of comfort.

Franchising as an industry itself is the backbone of small businesses across our economy. When you look at the success rate of small businesses that start through a franchise concept versus just a mom-and-pop type startup, the odds of success are higher because of the best practices. From my perspective in the corporate office here, our whole goal is to help our franchise owners build sustainable, profitable businesses. We’re really focused on how we can help them do that.

With everything, there are pros and cons. So some of the challenges from a franchising perspective, if there are things that we need to change and whatnot, sometimes that can take a little bit longer than if it were just an individual shop. Some of the challenges can be if someone is coming in with the mindset of, ‘I just want the brand. I really don’t care about everything else that’s tied to the franchise model.’ That’s where all the value is. Then, sometimes, if someone is a maverick and really wants to just call all the shots and once they sign the agreement, really not be engaged, that just isn’t a good working model for either party.

We don’t think of it as us and them, because we are holistically here to have everybody be successful. But there can be challenges. We don’t dictate, but we give suggestions and win the hearts and minds and know that we’re aligned in our goals with our franchisees.

A major challenge for the home care industry is the high demand for services but limited caregiver supply. How can providers address this issue?

We’re on this collision course. Demand is going to be through the roof, and there’s not an equal tax basis behind them, of workers and whatnot. When we look across the caregivers that work today for the Right at Home brand, they cross a wide range of age groups. So that gives us a large pool to choose from. So we have caregivers today who may be baby boomers or maybe traditionalists who are just in really good health and want to continue to give back. Over the years, we’ve talked about, in some cases, for retirees, it’s a way I can volunteer with a paycheck. We have caregivers that range from 18-, 19-, 20-year-olds who might be going into nursing school … [to] moms whose kids are now back in school and they’ve got some more time, to retirees who have left big jobs and now just want to give back to their communities.

But there’s not going to be enough caregivers, and that’s where innovation is going to play a role. Then, certainly from a federal advocacy perspective, there are things that we’re doing to support caregivers.

Speaking of how technology can support caregivers, and going back to your focus on innovation, how does Right at Home use AI? What’s your approach to AI overall?

We’ve had AI elements infused into operational things over the last 10 years, but we recognize that it’s only going to accelerate. In our three-year plan that we put in place back in the middle of 2022, we decided to build out a team, one that’s focused just around innovation. So innovation around the business model, and innovation around technology. Then separately, we were going to bring in AI-specific resources. And so we have talent now in the organization that all they’re thinking about is AI. AI scares me in some regards, but it also really excites me.

From an AI perspective, we have a couple of things that are infused into our technology that we use for scheduling caregivers and clients and making that more efficient. We’ll continue to use AI for things that are more repetitive in the office, because if you can make those repetitive things done through an AI module, then you free up time for more of the relationship-based things, and our business at the end of the day is very relationship-based. The more time that we can just focus on loving on caregivers and staff and clients and their families, that’s a wonderful thing.

But then also AI is also helping from a technology perspective, around how it’s used in the home. I think AI in the future is going to make even how we as individuals are treated from a medical perspective [different]. Instead of being treated and diagnosed on averages, they’re going to understand us as individuals, very pinpointed. That’s exciting too.

What scares me is the bad stuff that can come from AI. The scams that can happen, and seniors are a very vulnerable population. But we’re very focused on AI. We actually have a partnership with our local university here with some AI technology that they’re developing that helps those who are suffering with COPD. There are going to be so many new ways in which technology and AI combined are really going to enhance the overall aging experience for all of us.

Which potential or actual policy changes are top of mind for you right now, in terms of what excites you and what concerns you.

Right at Home is a member of the Home Care Association of America, or HCAOA, as it’s commonly referred to. I sit on the board and have for the last three years.

First and foremost, a huge shoutout to the 118th Congress. At the end of last year, they passed the 21st Century Elizabeth Dole Veterans Health Care and Benefits Improvement Act. Primarily, it now allows veterans to spend the same amount on non-institutional care as they could on institutional care. Before … veterans received more benefits for institutional care than for staying in their home. We said you have got to put it on the same playing field. Home is where most people want to be, and this change supports that choice. Supporting veterans in this way is something we care deeply about, and that legislation was a big win.

There are several other initiatives we’re currently advocating for, particularly those that make caregiving easier. A couple of bills have been introduced or reintroduced: the Credit for Caring Act, the Lowering Costs for Caregivers Act and the Home Care for Seniors Act. We’re also advocating for the Continuous Skilled Nursing Quality Improvement Act, which is aimed at improving quality care for medically fragile children. Right at Home itself doesn’t take care of medically fragile children, but across our industry, that’s something that’s really important.

From an immigration perspective, [we are focused on] how can we make it easier for caregivers to come into the country, and so we’re asking caregiving to be added to schedule A, where nurses and some other key professions are being listed, so that it can be easier to bring in some quality caregivers to supplement this caregiver shortage that we know is happening today and will continue to be exacerbated in the future.

You also asked me about are there some things that maybe we’re not looking forward to, or that we’re watching. There are some elements around just the business model itself. There’s been an 80/20 rule that’s been discussed from time to time from a Medicare perspective and the Medicaid perspective. We’re always looking at reimbursement rates and it always concerns me when we have governments getting involved in the economics of a business, because what’s being proposed doesn’t allow agencies to actually build a profitable business. And we need businesses to be profitable in order for them to stay in business. Those have been challenges.

And then we know that there’s a lot of pressure in our entitlement programs right now, and the government is trying to figure out this math problem, which is why we feel home care is such an important piece of service that we provide, because we don’t draw on the entitlement program. So we’re not Medicare. That’s home health, but we come alongside home health and partner with them, so that home health does a great job in delivering on what the Medicare program is going to provide, but that doesn’t always meet all the needs of that loved one, and so we want to work alongside home health and with that family to say, but what else does mom and dad need?