Ep:23: How Identifying Client and Caregiver Communication Gaps at His Own Agency Led Aaron Marcum to Found Home Care Pulse
Aaron Marcum, Founder of Home Care Pulse is here to talk about starting his own agency in 2001, how his experience led him to found Home Care Pulse and why measuring client/caregiver satisfaction will improve the external care you provide and internal culture you create.
Miriam Allred (00:05):
Welcome to Vision | The Care Leaders’ Podcast. I’m your host Miriam Allred. Today our guest is Aaron Marcum, the Founder of Home Care Pulse. Aaron started his journey in home care about 20 years ago when he founded his own agency, Arbor Senior Care in Salt Lake City, Utah. Today, he’s here to talk about his experience starting and running his own agency, how the idea of Home Care Pulse was born and how it’s grown to become the organization it is today. Welcome to the show, Aaron!
Aaron Marcum (00:34):
It’s good to be here, Miriam. Thanks for having me. It’s good to be back!
Miriam Allred (00:37):
Absolutely, really excited to have you on the show. Today we’re going to talk about your journey, you know, you starting an agency originally and then having this great idea to start Home Care Pulse. So really just kind of want to walk through your story today. So let’s get started with your own home care agency. Tell me when you entered the industry and where you were at and kind of your beginning in home care.
Aaron Marcum (01:05):
Yeah, so it was back in 2001. When I had become a little bit disenfranchised with corporate America. I was in a, in a kind of a leadership position with a company selling had a little bit of a team in telecom. Actually telecom was my background, not healthcare or home care and, and through research and through just my own kind of wanting to find something I, I graduated. I didn’t even graduate in business. I was a history major with a business minor, but I took a class, an entrepreneur class at Utah State University and, and just knew I always wanted to start my own business. And I had a kind of a love for seniors. I, I found that love with my wife who was my fiance at the time ran an elderly hospital program later on, we were married and she continued to run that.
Aaron Marcum (02:00):
And that’s a program that some universities run where healthy seniors come and you do activities with them and show them around in the summer. And they stay there. Anyway, that was kind of our, where I fell in love with, with, with seniors and, and just felt like I wanted to do something along those lines. And so fast forward, five years later, I, I was disenfranchised with corporate America and did some research and found home care, just, you know, as, as a growing industry, one that was fairly in its infancy at the time I actually connected with an organization called the Seniors Choice, which really kind of helped me get started and helped me kind of educate me on, on many things. Steve Everhart became mentor back then for me, and he was the founder of that organization. And so that’s how I got started in in 2001, 2002. So and then you know, private duty home care was kind of the up and coming in the home care industry, you know, really non-medical home care is what they, they used to call. I don’t love that term, but it’s it was just that, that kind of new fresh industry and a lot of new companies were coming out from, from just that demand, honestly, people wanting to age in their own homes.
Miriam Allred (03:25):
And remind me where you were at, this was in Utah, correct?
Aaron Marcum (03:28):
Yeah, this was in Salt Lake City.
Miriam Allred (03:30):
Okay. So how, how was it from the get-go? You know, you, like you said, you had a mentor, you had some experience with seniors, but what, what was your first impression of the industry and how were the first couple of years of business?
Aaron Marcum (03:45):
It was hard. It was, it was really hard. I in fact, I, I was a little naive, I think, going into it just what it would, would take. And I remember I had, I had another mentor who just said, Aaron, you need to get out, you need to really focus on networking and building referrals, but you gotta remember I was 28 at the time. And, and in an industry that, that had, you know, most of the owners of, of home care businesses were, were older than that. And so I had to really hit it hard early on to, to gain a network of referrals and just gain the trust of the community. And and so I, I, I put in kind of like the 10 times or 10 X kind of rule back then. I don’t know if you’ve read that book before, but, but I, I didn’t, I, you know, that book didn’t exist back then, but I felt like I kind of put that those rules into effect back then, where I just knew I had to put in more effort than the average home care owner, just because I was younger and I was, I wasn’t as experienced, but so the first few years were, were, were tough, but I got my first client after about four or five months took, it, took me that long.
Aaron Marcum (05:01):
I had to get licensed and then my first client and we were, we were profitable probably within the first year and then really started growing about year and a half into the business.
Miriam Allred (05:14):
Oh my goodness. I can’t believe you were 28. I had no idea. I actually just interviewed a branch director, a director up in Northern Idaho is 23. And it’s so neat to know and hear that there are young people entering this industry and starting agencies. And I had no idea that are that young woman.
Aaron Marcum (05:32):
Yeah. I know Dakota they’re in Northern Idaho. Is that who you interviewed?
Miriam Allred (05:35):
Yep. Oh, that’s incredible. Appreciate the background there. How long, so you started in 2001. How long were you running your agency for?
Aaron Marcum (05:48):
I ran it until 2009 is when we sold it to a public company. So what, that’s eight years. About eight years.
Miriam Allred (05:58):
Yep. And talk to me about how large you were when you left in 2009, you know, number of clients, number of caregivers, revenue.
Aaron Marcum (06:08):
Yeah. So back then, we’re still, you know, I, I mean, we were large for that time. So many companies have grown larger, but we had number of number of caregivers was about 150 number of clients, probably fairly similar to that. And just over 2 million in revenue, I think is where we’re at at the time that was the largest in Utah, but there’s a lot of companies who surpass that sense for sure.
Miriam Allred (06:33):
Tell me about when this idea of client and caregiver surveys was born. I understood that it happened while you were running your agency, but tell me about that idea or that concept. How did it come about?
Aaron Marcum (06:50):
So about halfway through that journey with the home care, with my home care agency we we really found that we had a, kind of a gap in information with our clients. We try to survey them through just email a survey and, and just weren’t getting the response. So I contacted a company in the area that specialized in home and doing surveys for home health companies, as well as assisted living. That was really kind of their specialty great company that did a great job, but didn’t have any kind of benchmarking data for our, our company, but I still value the information they gathered the feedback and the monthly reports that we were getting, I was, it was invaluable, really. It was, it was just such a great value. And I thought, man, we really need something specifically for the private duty home care industry that so that we could accurately benchmark and really know how we were doing. And so the idea was kind of born from that is that there wasn’t a company like that, that specialized in, in our unique industry. And, you know, when I started Home Care Pulse, it obviously looked different from that other company, the way we did it and so forth. But it kind of was born from using a company that specialized in other industries and catering it for the private duty home care space.
Miriam Allred (08:15):
And when you first had that feeling like, wow, this should exist, or someone should do this, did you think, wow, I should do that? Or you just thought like, wow, this needs to exist.
Aaron Marcum (08:27):
I thought I should do that. I mean, I love, I love data. I like, I, I really like knowing how things are going. I, I just, I’ve already had, I already had kind of the passion for it. And especially when it comes to satisfaction and understanding really, you know, do we, who are promoters, who should we get referrals from that kind of thing. And so I knew I wanted to do it. And and so in 2007, which was two years before I sold my agency, I started building out the actual model and plan for Home Care Pulse.
Miriam Allred (09:06):
Yeah. Let’s talk about that. So this is 2007, you had the idea, how did that evolve? You know, how did the actual business plan rollout?
Aaron Marcum (09:16):
So I, you know, there, there are so many iterations of the plan and I was still running a business, right. So it was, it was kind of an interesting time to try and start another business while I was running a home care business. So one thing that I had that I, you know, I’m not great at a lot of things, but I I’m, I’m really good at surrounding myself with good people, great people. And that was the same thing with my home care businesses is I hired the right people. I got some good systems and processes in place. I’m a process person. And I like to have a, a real consistent flow. And I started building, yeah, in 2007, when I knew I wanted to do this, I’ve actually pivoted and refocused on my home care business to get it to a point where I could pivot to Home Care Pulse.
Aaron Marcum (10:07):
And that was something that I will always be grateful for, that I did in the allow Home Care Pulse to create that kind of shiny object and keep me from, from growing the actual golden goose at the time, which was my home care business. And so that’s where my focus was in 2007. So that in 2008, when I really started building out the plan actually started building the software in about may of 2008. That software took me about a year to build. And we brought on our first pilot clients in may of 2009. So the business started in May, 2008, officially. We, we use that whole year to build out software that could measure satisfaction. And then and then we launched may of 20 2009, and then I sold my home care business in September of 2009.
Miriam Allred (11:01):
Yeah. Wow. I’m just looking ahead. And I know I’m going to ask you about advice for home care owners. And I’m just thinking in my head, you know, you started basically Home Care Pulse in 2008, which was a very tough year financially obviously. Now here we are in 2020 in somewhat of a very unique year, so maybe you can kind of tie it together.
Aaron Marcum (11:21):
Well, I started my home care business in 2001 and what happened in 2001? The 9/11. So, so I, I know just when to start a business, you know, I always know the best times.
Miriam Allred (11:35):
Yes. Yeah. So we can just be thinking about that. Maybe some of the advice in starting a business during, you know, really tough times. But let’s talk about measuring customer and employee satisfaction. You know, you knew the importance of, of measuring that. So talk to me about experiences you’ve had seeing businesses measure satisfaction and how that’s moved their business forward.
Aaron Marcum (12:03):
Yeah. So we first started when we first launched Home Care Pulse in the pilot program, we launched just client satisfaction. When I had that company with my own home care business, I wasn’t doing employee satisfaction that came a little later with Home Care Pulse because we saw the need. So first, you know, there’s, there’s a couple of different outcomes with each one of those types of, of, of, of satisfaction measurements and on the client’s side the feedback, you know, the first thing I really saw in what we could provide and what made us unique from other satisfaction management companies is I really focused on the feedback. I went when people gave you an eight, I wanted to know why they gave you an eight, you know, and why they didn’t give you a 10. And that was really early on. That was my laser focus.
Aaron Marcum (12:51):
And it was unique. It was, it was something that a lot of companies were just focusing on the scores. And I thought, man, that doesn’t really tell the full story that tells about not even half the story, in my opinion. So we we really drilled down on getting good quality feedback and then to see the outcome on how people are using that feedback. And, and it took us a while to, to educate people on, on, on the why behind that, you know, you get, so some people so fixated on scores, they you’re missing some or some of the best data in the, in the actual feedback. And then and then w you know, I know they’re getting better and better at just the technology to be able to get that feedback, not just their telephone. So that was, that was kind of the most rewarding is how people are using that feedback and the reports and so forth.
Aaron Marcum (13:41):
And then on the employee side, that’s where I really got excited as we launched employee satisfaction. And later on caregiver satisfaction is really what it was called. We, we really saw some changes in companies and culture, and that’s w that’s what got me excited about that product is that, you know, when you can kind of move the ball, when it comes to their culture, how they communicate with their caregivers, you know, you had some early on when, when home care providers home care providers would start with us, they would have not just low scores, but some of the feedback was just that you could tell there were a lot of disgruntled team members and employees, and then over time they would start moving the ball and really start making changes. And you could tell the difference six months, nine months down the road, when their feedback started getting positive, their square scores started going up, and you could tell the culture was changing at, at those companies. And so that’s the whole thing was just rewarding for me to see, you know, how they were using it
Miriam Allred (14:49):
And they work so well in tandem. You know, how the, what the internal culture looks like for the employees directly reflects the external service that’s being provided. So I appreciate what you’ve said, how they work so well in tandem. I’d love to hear you talked about not just receiving the feedback, but then using it. How have you seen agencies successfully use the feedback to drive ROI and just results in general?
Aaron Marcum (15:21):
You know, with the feedback it’s always best to look at trends. And when the people really started, like, like picking those things, and again, the reports that Home Care Pulse offers, I know, kind of help with that help kind of identify certain trends where they could improve and, and then really kind of pick and one or two things. We can’t pick them all. We have to really kind of pick our battles. And so one or two trends that you’re noticing, and, you know, sometimes just one thing per quarter to say, okay, we’re going to focus on this, this quarter, this area that we’ve been struggling in, let’s say it’s an employee satisfaction. We’ve got a, you know, maybe it’s, they’re not communicating to their employers and employees as well, and, or they’re not feeling recognized. That’s a great one. You know, when you’re not, when the, the caregivers don’t feel recognized from the company, that’s something that a home care agency can jump right on and really start making positive change almost right out of the gate. If they really make a deliberate effort on recognition and being specific in that recognition and doing weekly recognition out to the entire company, you know, things like that make a big difference. And so know, they’re seeing little trends focus on one, one per quarter, and over time you just start moving the ball. It’s it’s kind of that slight edge. I don’t know. That’s a great book. It’s just about identifying those little things, little changes you can make that makes such a big difference.
Miriam Allred (16:53):
That’s a great point. I think that’s applicable both in business and in life, just taking one step at a time or one goal at a time, you know, with the satisfaction data, it may be easy for agency owners to get overwhelmed with all of the feedback at one time, but just identifying one pain point at a time or one comment at a time and making that their focus will really move the needle longterm. So, so let, let’s just recap a little bit or I just want to ask, you know, in review, what were some of the key milestones in your time with Home Care Pulse, or what were some of the highlights, you know, in the years that you were with Home Care Pulse?
Aaron Marcum (17:37):
Yeah. And I appreciate, that’s a great question. You know, we grew over the course of a few years, we grow fairly fast. And so it, it was some of the milestones or some of the offices that we, we ended up in. I think we’ve been in Rexburg there in Idaho five different places, maybe six, I think it’s six different places because we just keep growing and expanding. So those were all, all kind of great milestones, you know, in 2012, I hired Erik Madsen. Who’s now the CEO of, of Home Care Pulse. That was definitely a milestone that was kind of, we were, I think at the time we weren’t even at a million dollars. In fact, I know we weren’t when you were generating even a million in 2012, but again, I had had learned through my home care agency, the importance of having that person who could help kind of scale the business to help to all new levels.
Aaron Marcum (18:36):
So Erik came on board with somewhat blind faith, right? Because he was stepping down from a executive position with a billion dollar very one of the largest employers of not the largest private employer in, in our area, our neck of the woods. And he was tired of traveling and, and I did a great sales job that back then, and we convinced him to leave and join Home Care Pulse and he’s been there ever since. And that’s something I’ll forever be grateful for. So that was, that was definitely a milestone when we really amped up you know, going back a little bit in 2010, big milestone is when we launched the first private duty Benchmarking Study. Now the Home Care Benchmarking Study you know, the National Private Duty Association, which is now the HCAOA contacted me in early or late 2009.
Aaron Marcum (19:36):
And we had only been in business for not even a full year yet. Not, not really may have a way I guess, officially, but and they, they wanted to partner with that and that was exciting. And so that was a real turning point. It’s something that we’ve always done since that help create a brand for Home Care Pulse. That was a real branding type opportunity. And so that was a turning point. And then 2010 was also monumental because we came up with the best of home care awards in 2010 way back then, you know, in the early days of, of Home Care Pulse, that was something that the company I’d used in my home care business. We didn’t really have something like that. And so I felt like, you know what, these people need to be rewarded for the efforts they make, they’re making in improving the quality of care in the home.
Aaron Marcum (20:26):
So the Best of Home Care was, was launched later on best of home care.com. And then you know, it was, I mean, there’s several milestones after that. And then, then a real big milestone, honestly. And it’s what I do right now is EOS. We started implementing the Entrepreneurial Operating System in 2016 after we felt like we hit the ceiling and we needed kind of a better direction. And we started self implementation. And in 2017 we hired a full-time EOS implementer, like myself to help move it forward. And that was transformational for the business. That was really when I think for us and for Eric and I, when we really saw that. And then we kind of allowed the system to work and work in the business and it did. And, and we implemented that. And, and that’s when I think the kind of hockey stick growth happened in the company when we started getting a better framework for scaling the company to the next level.
Aaron Marcum (21:29):
So that was certainly transformational. And then I’d say in 2018, when we really started 2017, 18, we started hiring the right people, Todd Austin, and Jeralyn, and some others that are just the key people. And we had, you know Jason and others who had been with us for awhile. I mean, but we just got two or three real key positions filled for the longterm. I think of Kire. And I had, Caleb was another great hire. We just had always got this leadership team, just powerhouse leadership team, really clicking together in 2018, which is also the year I stepped down as CEO. And later that year, so,
Miriam Allred (22:12):
So many milestones, Oh my goodness.
Aaron Marcum (22:15):
I could go on and on about that.
Miriam Allred (22:16):
One, I know. And I’m just plotting it out in my head. I mean, I’ve only been here for about a year and a half, but it’s so neat to hear kind of the complete story and hear all these milestones because I’m here, you know, reaping the rewards of all the hard work and the successes and the seats filled in. It’s just, it’s a fantastic company. I’m so grateful to be a part of it. It’s so fun to hear you outline all of these successes.
Aaron Marcum (22:41):
Yeah, I can’t, I can’t leave Lindsey off that list too. She was instrumental as well in those early days. Sure. I’m leaving, leaving stuff that we had a lot of people who, in those last two or three years that helped really kind of turn the corner for Home Care Pulse.
Miriam Allred (22:59):
Yeah, absolutely. Well, I’ve just got kind of two more questions. I, we hit on it before, but any advice for agency owners, you know, that are making it through this pandemic, I know advice for any business owner, but home care, even specific, you know, you are also working through this unique time. What advice would you share for fellow business owners?
Aaron Marcum (23:20):
You know, I would really focus my attention. There’s just a lot of things, I guess I could say, but I’d really focus on your data for one. And I know that might seem, you know, I just, I mean, what are you measuring the right things, first of all, and are they, are they critical to the business? Sometimes we measure too much. And so what are those five 15 key measureables that if you on a desert, a desert Island or, or on the beach or someplace where you couldn’t didn’t have any contact and you had a cabana boy on give you a note every day that had all your metrics that you needed, and that’s all the contact you had with your business, what would those metrics be? What would you want on that sheet? And the econ only have, say 10. And so what would be those critical metrics?
Aaron Marcum (24:10):
And so I would say what, you know, make sure you’re measuring the right things that are driving the right behavior and make sure everyone has a number. That’d be my first thing. And second thing is, is the right people, right seats. You know, and what’s your accountability chart looks like that’s kind of an EOS term, but it’s really, you know, where, what are the, what are the right seats and what other key roles and responsibilities five to seven roles or responsibilities that, that they’re accountable to, you know, now’s a great time to build a better foundation. And it starts with the structure of your company. Is it the right structure? Do you have the right accountability, the right seats? You know, and then the right people, you know, do they live your core values, are your core values, the right core values. There’s just some real foundational things you can go back to as far as your, your vision and your structure with the company to make sure that when something like this happens again, when we have an unexpected event like this, which it will, you know, things, things like this do happen.
Aaron Marcum (25:13):
I mean, we haven’t seen anything quite like it, but, but to be prepared for the future I think you have to lay a real strong foundation so that you don’t get sidelined too much by, by some of these things. And I’ve seen some real success stories. The clients that I work with that are home care agencies that are implementing EOS, or just really kind of getting the right people, right. Seats they’ve, they’ve navigated pretty well through the, through the pandemic.
Miriam Allred (25:42):
Yeah, fantastic advice. So many things, you know, we live and breathe EOS here at Home Care Pulse, but so many of the points are applicable to home care. The more I learned about EOS, I start telling people in any industry that is so relevant and so applicable and create that foundation and setting up those core values or getting the right people in the right seats, it really sets the business up for success longterm. So you you’re consulting right now. You know, like you’ve mentioned, you’ve stepped back from Home Care Pulse and you consult full time. You’re so well known in this industry still, and people respect you and admire you. And I’d love to just give you a minute to talk about your consulting services and let people know the best way they can get in contact with you.
Aaron Marcum (26:31):
Yeah. Thank you. You know, and I, I like to say it’s more of executive coaching consulting kind of maybe paints the picture of it’s one-on-one and I don’t do a lot of one-on-one. In fact, I don’t do hardly any of that. I really focus on working with leadership teams on teaching, facilitating and coaching through EOS and drawing upon my background, even in home care, helping them solve their issues. My goal is as an executive coach using ELs as the framework is to, you know help them get you know, everyone, 100% on the same page with their vision, get traction on that vision throughout the company, even at the caregiver level. And then, and then build a healthy leadership team that loves to be together. That’s cohesive, that’s really moving the company for, for the longterm. And so that’s, that’s really kind of my focus.
Aaron Marcum (27:22):
And so I spent a full day with leadership teams and helping them do these things and lay a better foundation for future growth. And so to get ahold of me I think is that what you asked Miriam is how to contact me. Yeah. Thank you. So you can reach me a couple of different ways. Obviously my website, which is Vue Advisors, and that was a great way to kind of check out EOS and my background. You can also email me at [email protected]. And then and then our number here is 208-600-6747. There’s another way to contact. So, so various different ways you can reach out and you know, how we start is I just do a complimentary 90 minute meeting on EOS, whether you move forward with, with me as your EOS implementer or not the 90 minutes complimentary I, I give you some tools that if you want to just try to implement it yourself, you can do so with some tools. It’s just something that I offer anyone who’s interested in looking at EOS.
Miriam Allred (28:27):
Fantastic. Well, I can’t recommend you enough because we’ve experienced it firsthand. And lots of agencies in the industry are using you and have experienced EOS to its fullest, and I’ve seen lots of successes from it. So thanks for that. Well, Aaron, thank you so much for taking the time out of your very busy schedule. We really appreciate obviously all that you’ve done here at Home Care Pulse, but for just sharing, you know, some of the highlights of your story with us today.
Aaron Marcum (28:52):
Appreciate it. Thanks Miriam. It’s been a pleasure and tell everyone hi over there.
Miriam Allred (28:57):
Thanks for listening to this episode of Vision as always, it’s been a pleasure to converse with a close friend in the industry. Check out the episode resources on our website, homecarepulse.com/podcast. And there you can find Aaron’s contact information. If you’d like to connect with him. Also, if your home care provider or peer to the industry and want to join me on the show, shoot me an email at [email protected]. Thanks again and we’ll see you next time!
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