If you have heard of community care, looked into it, or are doing it and struggling, this is your guide to pursuing and improving your next revenue stream: providing care in an independent living community.
We started our first independent living community in 2016. By the time our agency was acquired, we’d grown to serve four communities, one of which served over 90 clients, with up to 8 caregivers on shift at a time.
Community care is a rapidly growing segment of home care services found in independent senior communities, apartments, and ‘cluster’ homes (i.e., over fifty-five communities) where the residents are for the most part healthy and have minimal needs for assistance. It can be a fantastic opportunity if your agency understands how different it is from traditional home care, prepares properly, and has the technology to manage its challenges.
Home Care vs. Community Care
Traditional home care involves one caregiver providing service to one client in their home, with visits ranging from an hour to 24/7 care. Both community care and traditional home care provide non-medical services, such as assistance with bathing, dressing, toileting, mobility, medication reminders and household tasks.
Though the tasks the caregivers perform in community care are the same as traditional home care, caregiver assignments are quite different. Caregivers working in community care will be scheduled to work a shift in the building by their home care agency. Their assignment may include visits to several clients, some more than once during their shift. There will be times during the community care shift that the caregiver does not have a client visit, but they are paid for the full time they are scheduled for the shift.
Community care services are provided in short visits, with typical durations of 15, 30 or 45 minutes. Some agencies offer visits that are even shorter for clients with one or two simple tasks.
What can be accomplished in such a brief period? During a 5-7-minute visit, caregivers can provide a medication reminder to a client who often forgets to take them on their own or assist a client who is otherwise independent with their compression hose or orthopedic brace.
As with traditional home care, community care’s goal is to provide services that promote the clients’ highest level of independence. Since many senior communities provide varying levels of meal service, housekeeping, and laundry, community care visits can be of short duration, and therefore more cost effective for clients. Community care also helps couples continue to live together when one needs more assistance than the other one can provide. It is an additional level of support available to seniors that may avoid or postpone the need for Assisted Living-level care.
Why Are Home Care Agencies a Good Fit for Independent Living Communities (ILs)?
In short, a well-qualified home care agency brings services to a community that the IL does not offer. ILs offer varying levels of meal preparation, housekeeping, laundry, and transportation. They are not licensed to provide personal care, making a home care agency a natural choice.
A home care agency that understands the difference between traditional and community care is critical. Community care caregivers enjoy being ‘on the go’ and visiting many clients during their workday. Working as a team, the IL staff and the home care agency staff support the residents and enable them to remain independent.
Think of Revenue Streams Like an Investment Portfolio
Owners of home care agencies are well-acquainted with the volatility of their revenue. Home care provides services to some of the frailest people in our population, some at the very end of their lives. As a result, it is common to lose more than one client in a brief period of time. Coupled with the fact that the client may choose to stop services abruptly, decide they want a different caregiver with no notice, or be hospitalized for an emergency, home care agency revenue can drop significantly without warning.
In contrast, with community care services, the care census can be much more stable and predictable. A caregiver provides client visits to many people during their shift. Since the visits are short, when a client stops service, the impact on revenue is very small.
Home care agencies serving in communities can have the advantage of also providing traditional home care services for residents needing longer visits. These are typical following a hospital/rehab stay or after a decline when hospice services are added. This can be a significant revenue stream which helps stabilize the ever-changing revenue of an agency.
After dealing with initial bumps in the road, getting to know the community (clients and internal staff), and implementing the right technology, we found that community care settles into a predictable routine and—at least in our experience—almost runs on its own. Since you can bring so much to the community, once you are in and provide excellent quality of care, the revenue generated is dependable. and consistent and the management is going to want to keep you.
Look at managing your home care revenue streams like managing a portfolio of different financial investments with different risk levels. Community care, when done properly, is lower risk and predictable (fixed annuity). Home care can be highly volatile (equities), with higher risk, but sometimes higher gain (24-7). A home care agency that provides both can enjoy a very steady and predictable growth plan.
How to Identify If Working with an IL is Right for You
If you are looking to diversify your agency, providing community care services in an IL may be for you. If you have caregivers asking for “steady hours,” who like to stay busy and work with a variety of clients, community care fits the bill. Caregivers who demonstrate that they teamwork will truly enjoy their shifts in community care. They collaborate not only with their clients and the IL staff, but they can also have interactions with home health professionals who are also typically embedded in the community and non-client residents as well.
After successfully providing community care, we found an additional benefit was an improvement in our caregiver recruiting and retention. You will enhance your differentiation in your market by being able to offer your caregivers higher pay and more home care options. Community care will give your caregivers more working opportunities, new skillsets, teamwork, a faster pace, and an opportunity to meet many clients. It will keep them fresh and drive higher caregiver satisfaction—a competitive advantage in today’s historic caregiver shortage.
How to Get Started in Community Care Management in an IL
Things we highly recommend you be ready to answer/address before approaching an IL community:
Do your research. What are other agencies charging for community care visits? How are they charging? Do they charge based on time, or do they package together services? Understand the model.
Talk to the community executive director. When you are ready, call or visit the IL community and ask the managers about the service their current home care agency is providing. Have they changed home care agencies often? If yes, what were the problems? If they discuss issues, explain how you would manage them.
Have a ready staff. Do you have current caregivers who are interested in working in the community care setting, who ideally have already worked in a community?
Evaluate your capacity to manage numerous new clients (and their families). Your staff and care coordinators need to be ready to staff and schedule. They need to understand how different the environment is. They must make a visit and get familiar with the community layout and number of residents.
Ensure the technology that supports your traditional home care clients can manage scheduling several clients to one caregiver. How will the documentation be completed? How are changes made for callouts/emergencies? Managing less than 10 clients on paper can be done. You cannot scale to bigger numbers if you do not have a technological solution that can address community care. What did we do? We built our own cloud-based community care technology. Caregivers used iPads to manage their schedules and document care for each client. You have to have a solution that is easy to use.
Our advice is to look for an established IL community that currently has residents who receive community care services. New communities will look to establish a relationship with home care agencies, but may not have enough or even any residents in need of services just yet. This can cause a financial hardship if you are expected to have caregivers in place before there is enough business to support it.
The Importance of Streamlining Operations and Communication
If you have poor communication and inefficient operations, you will fail.
Your goal is to operate at a profit, which requires efficient operations. You may tend to think of technology first, but the number one requirement for success is having the right people, in the right seats, armed with the education and technology to do their job: to provide quality care.
They cannot provide quality care if communications with the office and their teammates is poor. You need to start by establishing policy, procedures, and technology that clearly define “when and how” to communicate by phone, email, or text (note: we used Slack for real-time, email for asynchronous, and phone for emergencies, and we set rules on responsiveness and the appropriate time to use each). Lastly, you need a technology provider just like your traditional home care software to manage scheduling and care documentation.
It sounds daunting, but if you understand the community care model, define your services to be easily understood and charged for, define the roles in the community (caregivers, nursing, scheduling, and admin) properly, and provide technology to manage everything, it works. We have done it successfully. You can do it to!