An increasing number of home-based care providers are adopting alternative models that eliminate traditional minimum service hours to meet demand or attract referral partners – creating a win-win-win situation for providers, caregivers and clients.

Short-hour care lets clients select flexible hours for in-home assistance. This adaptability helps them design a schedule that fits their needs without being limited by the usual four-hour minimum visit rule.

Tribute Home Care recognized the need for shorter-hour care options from its referral partners and began offering them, according to Jen Kulig, director of market operations. 

“We found that we were losing some share from our referral partners by turning down short hours,” Kulig said at Home Health Care News’ FUTURE conference. “We felt the need to go back to the drawing board and look at it more strategically.” 

Tribute Home Care offers caregiving services in Massachusetts, Maryland and Chicago. The company focuses on hiring caregivers who prefer shorter shifts, typically working eight to twelve hours a week, and are willing to travel within a 30-minute radius.

Tribute only accepts private pay clients. Kulig explained that in this model, clients often want “what they want when they want it,” and her team had to figure out how to provide short-hour care under those expectations. 

Examining referral data, Tribute found that 75% of care was requested during mornings. Kulig’s team then went about identifying how to recruit specifically for those hours. 

“We asked ourselves who would be attracted to morning hours, and we identified parents interested in caregiving around their children’s school schedules or people working second or third shifts who might want just a few hours in the morning,” Kulig explained. “We also increased rates significantly. The demand is there, and people are willing to pay for it. We’ve also successfully recruited a pool of caregivers and continue to recruit caregivers to meet the demand.” 

Kulig said her team often uses short-hour care as a recruiting tool, hiring caregivers for fewer hours and then converting them into full-time Tribute Home Care employees. 

“We’ve managed to convert some short-hour caregivers into longer-hour caregivers, which has worked well for us,” Kulig said. “We focus on the mornings, either one day a week or five days a week. We do not require those caregivers to work weekends like we do with our long-hour caregivers. It’s a different model, and we’re still able to meet or exceed the expectations of the families seeking those hours.” 

Short-hour care in senior living facilities

For Bob Roth, managing partner at Cypress HomeCare Solutions, the idea of offering shorter hours was driven by the increasing cost of care. He mentioned that the cost of care has risen at least 10% year over year, and people are now trying to do more with less.

Cypress started providing short-hour care in senior living communities to grow the business through relationship building.

“One of the things that we’ve realized more than anything about home care is that it’s about relationships,” Roth said. “I felt like this was a position for us to do that so that we can build these relationships in those settings, and once we build those relationships, the expansion of hours will happen.”

Scottsdale, Arizona-based Cypress HomeCare Solutions is a home health company that provides a range of services, including in-home personal care, overnight care, respite services, concierge care and memory care.

The first step in building those relationships, according to Roth, is with the community’s executive director. He said you need to get buy-in from the top down, and a good place to start is by understanding where they might have a pain point and addressing it.

“The executive director said what kept him up at night is having independent caregivers in his buildings and he had no idea who they were, whether they’re background checked, whether they’re bad actors, and if anything happens to a resident, it’s on him,” Roth explained. “I knew I needed to solve for that.”

Roth offered Cypress’ services, which included shorter hours of care for residents who only needed help for a few minutes each day. Roth said caregivers started by providing care in one-hour increments, and eventually they settled on offering care in as little as 15-minute increments.

Senior living community leadership sees this as a win because their residents can remain independent and receive “small bites” of care through a partnership with a provider the community trusts, according to Roth.

What clients want

Home care provider Cantata adapted to offer short-hour care after evolving its understanding of its middle to lower-middle-income client base. When the company’s client base began to shrink, leadership assumed its client base simply could not afford home care. Eventually, they discovered their client base desired and could afford a different version of home care.

“These clients had some money, not a lot, but they only wanted to spend it on what they saw as valuable,” John Larson, Cantata CEO, said. “We asked ourselves how we were going to grow the business and came up with a way that doesn’t require hiring as many people and still allows us to grow.”

Located in Brookfield, Illinois, Cantata provides a wide range of services from personal care to home maintenance, focusing on helping clients live comfortably in their own homes.

Cantata offers short-hour care to individuals in their own homes. Caregivers travel from one home to another, visiting clients for 10 minutes to half an hour multiple times daily. There is a daily fee, so there is no emphasis on when caregivers will arrive or how long they will stay at each home. The focus is solely on the outcome and providing the care that individuals need, according to Larson.

Larson said that his caregivers often help family caregivers get their loved ones out of bed in the morning, dressed and moving around. The caregiver then moves to the next house and checks back later.

“It’s a daily rate to do what we need to do, and our margins are tremendous in that particular business,” Larson said. “Our caregivers work hourly shifts, so they know that they punch in and punch out, and they don’t lose their jobs if a client terminates care or passes away. I can bring on a client without worrying about whether I have caregivers.”

Larson said that when he hires caregivers for this type of model, he can keep them busy. They are more likely to stay in his employ compared to the traditional model, where work is not always available, leading to increased turnover.

Making margins work

From a financial perspective, ensuring your margins are solid becomes crucial in fragmented care models, according to Kulig. 

“That’s why we pay more and charge more for shorter visits,” she said. “It attracts caregivers to the job and shows that there’s a premium cost involved. However, if that’s all you want, paying $60 for an hour for someone with the means isn’t very expensive if you only need care a couple of times a week. But we also monitor utilization to ensure it remains healthy.”

A comprehensive enterprise software solution that contains all relevant information is crucial for understanding whether financial metrics are accurate, according to Roth. He also noted that being able to stack shifts helps make financial margins clearer.

Larson observed that with Cantata’s model, there is less concern about hours and shift stacking than about outcomes.

“Clients just want to make sure they get the right outcome,” he said. “We don’t talk hours. We don’t consider the actual time our caregivers will be in the home. There’s some predictability there with staff. With clients, we can keep it open. It’s reimagining the hourly model to move away from hours.”

Larson said that the margins on Cantata’s short-hour model are “phenomenal.” He mentioned that clients pay daily, and some pay a small daily fee just to keep caregivers available.

“This is for people who are consumers, who are looking to make their balance extend,” he said. “This doesn’t work for affluent people because they want what they want when they want it. This is an alternative to how many staff you need, but the success is making sure clients are happy and our margins are done well.”