Valerie VanBooven RN BSN:

This is Valerie VanBooven with The Senior Care Industry Netcast where leaders with three or more years of experience share their advice. So, let’s give to it. In a few sentences, tell us who you are and what you do.

Evan Loevener:

Thanks, Valerie. I’m happy to be here today. I am Evan Loevener. I’m the owner and CEO of Aviva In-Home Care. We service four counties in and around the Bay Area, San Francisco, San Mateo, Santa Clara, and Alameda counties, and we are a private duty non-medical in-home care agency. Our mission is really to improve the wellbeing of our clients and reduce their chances of hospitalization due to trying to manage a chronic disease, or due to efforts to prevent the injury in and around the home. We are essentially providing assisted living type services in the home for those people who want to comfortably age in place.

Evan Loevener:

We as an agency also, I would say, embed a fair amount of care management services in what we do. I’m an ex-hospital administrator. So, for example, one of the things we’ve had in place since day one is our registered nurse on-board as a nurse director, and that is somewhat atypical for non-medical care agencies as you know, Valerie, but that really affords us good quality checks in terms of knowing that we’re doing the right things with clients, we’re following best practice, and also being able to offer up that person as a resource for our clients and our care team in general. I do think it’s remiss that a lot of agencies don’t have a single clinician on staff, but we’ve had that from day one.

Valerie VanBooven RN BSN:

That’s awesome. Yeah. Oh, well, I’m a nurse, so I totally [crosstalk 00:01:58]-

Evan Loevener:

Right.

Valerie VanBooven RN BSN:

… having that nurse on staff. You’re right. Most non-medical home care agencies, they don’t have to go that route, and many of them don’t. It’s an added expense, but it brings a huge amount of value to the families and to the client and to the agency itself because you’re allowing a highly trained medical person to come in the house and maybe identify some things that could be done differently, better, or instead of. You just never know. So, yeah, and that’s great. Keeping those clients healthy and out of the hospital, I mean, it’s never been more important than it is now to try and manage your chronic diseases like diabetes and CHF and COPD. It’s try to manage them at home, and when you have home care in the home and they can help you with your meals and make sure you get your weight done and make sure whatever it is you need done, if they can remind you to do those things, then that makes for a healthier human overall. So, that’s definitely [crosstalk 00:03:04].

Evan Loevener:

Indeed.

Valerie VanBooven RN BSN:

All right. What is the best thing about serving aging adults?

Evan Loevener:

Well, for me, it’s really the gratitude that I get from the clients, or mainly, more often, the families themselves either during the course of care or after we’ve concluded taking care of their loved one. I’m a very mission-driven person by nature so it’s just so filling, let’s say, to get that direct thanks for how you made my mom more comfortable in her last couple of months, or for being there when I couldn’t be there because I was out of state, or from families who are performing a level of, let’s say, respite care, or sorry, who have been performing as primary caregivers, and we’re jumping in a respite care fashion and taking over the caregiving duties for them because they’ve been overwhelmed, and they’ll often come back and say, “Oh my god, I don’t even know how I could have lasted another week or two doing what I did.” So, it’s really that direct thank you kind of feedback from the family that for me is the best part of the business.

Valerie VanBooven RN BSN:

Yeah, it’s hard. It’s such to challenge to be that caregiver and not get a break ever. That respite care, people don’t realize how much they need it oftentimes till they take a few days off or even a day, just go do your own thing for a day, take a bath or go to the movies or go shopping. It’s so nice to be given that break, and then you realize how much your mental health needs that kind of a break, and having home care that you can trust in the house is so nice. So, that’s great. Yeah, and I think you’re right. It’s a gratifying position to me. It’s lovely to know that you’ve helped a family or a senior or both with their current life or at the end of their life or however that comes to you. So, yep, absolutely. Well, thank you for that. I would imagine that in your career, in your lifetime, there have been leaders and organizations that have really meant a lot to you where you think, “Gosh, you do a great job.” Is there anybody you like to talk about?

Evan Loevener:

Yeah. Good, good question. I think a very poignant example of that is really my current business partner, which is an organization called Honor. Honor is a technology and operations business operating in the home care space, and what they do is they partner with independent high service, high-touch agencies like mine to help them do what they do better, and it really was a marriage or a partnership made in heaven, and serendipitously, we entered into that two years ago, and it is allowed, especially me, but for them as well for each of us to do what we do most effectively.

Evan Loevener:

So, for example, they are in charge of the sourcing and management of the direct caregiving staff, and we call our caregivers care professionals because we do really believe that we’re building careers for them, and I’ll touch a little more on that later. They of course manage the care staff once they’re brought on board and all the scheduling and for protocols that go around that, and it leaves us, via a more direct Aviva team if you will, to do some of the care management in a lot of the client-facing activities.

Evan Loevener:

So, it’s really a cooperative model, but optimized, and it benefits our clients certainly because they get a much more efficient company to work with. People are more responsive, more attuned to any changes they need, whether it’s reducing hours or the substance of care changing because of a change in health condition. We’re more responsive because of that. We have more eyeballs on it, and certainly during COVID times, we’ve been able to respond to the need for a larger care team for substitutions and the like, and it’s also allowed me, as you and I have discussed previously, Valerie, to do more with clients, to be out there more, talking with families and be more dialed into what they need on a daily basis.

Valerie VanBooven RN BSN:

You know, when we talk about this, I think right now for most home care agencies, recruiting and retention is such a… I mean, you could look around. It’s not just home care. It’s any small business or any business out there are having a hard time keeping staff or getting staff, getting people to do… And I think that’s going to ebb and flow over the next couple of years, but having a partnership with Honor, as you said, has taken the stress of that recruiting piece away a little bit, and it has allowed you to focus on, like you said, what’s most important is the clients, your families, and in the care management piece and really being able to focus on what you love, which is this piece of these families who need care and what changes can we make and you get to be a more high-touch home care agency than if all of you left were bogged down with recruiting 24/7.

Valerie VanBooven RN BSN:

I think it’s a great partnership. I think it’s a great move, and it allows you to market and do more with your time. We were talking about that too, not just the client piece, but really improving and growing your business. It’s giving you time to think about that and do more things. So, it sounds like a great partnership, and I’m glad that it’s helped you expand, right? You’ve expanded. You weren’t always [crosstalk 00:09:11], right?

Evan Loevener:

Yeah, absolutely. Right, it’s allowed us to service four counties very effectively. For maybe people listening to this who are thinking about agencies, it’s one thing for an agency just to say that they work in that area, but we’re very cautious about not going into an area until we know we’re setting ourselves up for success which means can you backfill. So, when there are absences of caregivers, which there will be, is the agency set up to really deliver and cover those gaps in care? We’re careful about that. We don’t want to overpromise, and therefore, we’ve gone into, at least Aviva has gone into, with the help of Honor, four different Bay Area counties right now.

Valerie VanBooven RN BSN:

Nice.

Evan Loevener:

But you do have to be cautious about that because it’s not something that every agency can gauge very well.

Valerie VanBooven RN BSN:

Right. Right, that’s true. I mean, the further away you get, you have to make sure you still have that staff in that area, and with that Honor partnership, and I think Honor’s probably got it down to a science in California in your area. I think that it seems to me that’s where they started. So, a lot of tech started [crosstalk 00:10:26].

Evan Loevener:

Yes, the Bay Area, San Francisco.

Valerie VanBooven RN BSN:

Yeah. So, they’ve probably got those counties down to a science. You’re right. If you’re going to say you can service another county, you need to make sure that you can serve another county, that’s for sure, and this partnership sounds like it was a great benefit to you to help know that you have caregivers out there. So, that’s awesome. All right. Let’s talk about marketing a little bit. In the last 18 to 24 months, you’ve grown a lot. Everybody’s had some challenges in 24 months. You’ve seen some growth since last year. Tell us what has changed or what is new or what you’re doing with your marketing strategy.

Evan Loevener:

Yeah, sure. I’m a career marketer as you know, Valerie, so I like talking about this stuff. Well, the most obvious thing is really, again, in concert with Honor, the emphasis we put on our emphasis not only in operations, but also in terms of messaging on the robust infection control procedures that we’ve implemented, keeping our clients safe in that manner, but part and parcel with that in is the ability to recruit effectively and get a continual supply of caregivers so that we’re able to backfill. Obviously, all clients are not going to be thinking about that when they hire an agency, but it is an important function that we feel to emphasize. We have the great recruiting team now that can continually get people to us and enable us to fill in those hiccups which are going to happen.

Evan Loevener:

So, that’s a huge boon for us now is to put that into our marketing message and talk about that with clients and talk about the ways that we’re doing pre-shift check-ins, temperature checks, pulling people out to quarantine them for at least several days before they’re symptom-free and obviously negatively tested for COVID. And then of course, as you know, Valerie, all the state, the state of California where we operate, has very, very rigorous test protocols, now, very frequent testing protocols, as well as booster mandates. So, we were challenged by that in November and December, and Honor did a wonderful job of making sure that they met those deadlines and still keeping our clients served, making sure that we had enough caregivers to meet demand during that period. It’s still very, very tricky with the spread of COVID, but that was a particularly tricky time in November and December.

Evan Loevener:

The second thing is I think generally speaking in terms of marketing messages, we’re really talking about I think it strengthened our message of home care being the best elder care option right now versus going into a facility, and this is not to disparage communities in any way, senior living communities, but they are becoming de facto more isolating because they have to, they have to for the spread of COVID. So, a lot of them have blocked visitors. We’ve seen that not only in SNFs, but in assisted living facilities as well. So, I think it’s a bit of an irony, right, because people think about putting their loved ones into a community to give them more socialization which is often the case, but nowadays, if family can’t come in and see them, that’s excruciating, it’s heartbreaking, and all the more reason to try and see if you can get a good age in-place option going, and surround yourself with the right resources to keep yourself safe and heal at home. So, that’s really a good part of our message now as well.

Evan Loevener:

And then lastly, the third thing which comes to mind is around something new which we now call our virtual caregiving model. It’s Aviva connected care, and this is about really two things. Number one, trying to introduce lower cost ways of providing caregiving. This is a check-in service two to five times a week from a remote care coordinator, and this person will go through a script that’s preprepared with us and the family and talk to the client about things that an in-person caregiver would do, like medication reminders, some level of companionship-type conversation, what did you do during the day, did you do your exercise, did you remember to take a shower, fulfilling some of the functions therefore that an in-person caregiver would do, but at much, much lower cost.

Evan Loevener:

It ranges, depending on the frequency, between for us about 135 to I think we’re maybe 200, 225 for the five times a week option right now, but it’s a great alternative for those people who potentially want to ease into care and don’t have a great need right now, or can’t afford an in-person option, or as a wraparound service for those people who don’t have off-hours care or weekend care. So, it’s a good alternative for that as well. So, that’s the third thing we’ve really been talking about which is the Aviva connected care program.

Valerie VanBooven RN BSN:

Yeah, all those things you hit on are so important. I have to say, if you look at home care agencies across the country and the ones that have had the most hurdles to jump over and the most hoops to get through is anybody in the state of California. I mean, you guys have had a lot in very strict, very strict rules for almost two years now, and I think those are probably starting to change a little bit at some point, and we keep saying that, but anyway. So, I think that to have a partner in Honor that can get you through those hoops, and I mean, this is probably, in our careers anyway based on what age I know we are, it’s probably this, I’m hoping, is the toughest two years of our professional careers as far as things changing so fast, people being so sick and making it through this is a testament to everyone and still being able to produce caregivers who are giving great care and who are safe, I mean, it’s just been an amazing time, amazingly challenging time.

Valerie VanBooven RN BSN:

On the virtual care piece, I do think there’s a huge amount of value in this, and it’s kind of a new concept for a lot of people, but to be able to have… Maybe you can afford to have somebody in the house at night, but during the day there’s some hours that are not covered, or maybe it’s the whole day, maybe it’s eight hours a day it’s not covered, being able to schedule those remote care coordinators to visit on the phone or the iPad or the computer, however you have it set up in your house for your senior and just check in and say, “Hi, how are you? How are things going today?” You know they’re okay or maybe not. You know that someone talked to them today, and the family will be alerted if there’s an issue.

Valerie VanBooven RN BSN:

So, while you’re at work, you don’t have to worry as much, or like you said, maybe somebody doesn’t need care 24/7. They need somebody to come in and help them with things three days a week, but maybe on those other two days, it’d be great to have somebody, a dedicated person during business hours when you can’t be there check in with them, make sure they’re okay, and that they’ve taken their meds. So, I think virtual care, I think it’s catching on. A lot of folks are doing it, and it is a great way to supplement that personal in-home care that’s coming in the house. So, I’m glad you guys are doing that. It’s going to be a good addition.

Evan Loevener:

Thank you. I agree. I agree.

Valerie VanBooven RN BSN:

Yeah, absolutely. Okay. So, what piece of advice would you give to other senior care providers out there who might be watching?

Evan Loevener:

Yeah. Given that I’ve been doing this for eight years, which amazes me sometimes that it’s that long, first, I would say find your area of specialty and really focus on that. So, have a solid positioning with your agency. For us, it’s about being a high-touch, high-service agency with some concierge- like services. We talked about the RN nurse directors so certainly we’re maybe more equipped to attract higher acuity clients and work with clients of people, for example, underneath conservators or estate planners and the like. But maybe you want to go after business that’s more hospital based and needs a quicker turnaround, for example, quicker staffing times, or perhaps a work comp focus or things that are more episodic in nature.

Evan Loevener:

Certainly, we do handle some short-term clients, but there are agencies that do a lot more of that and focus on that business, for example, going after physicians who are working with plastic surgery and things like this, more clinic based clients, if you will, who need that one or two weeks of service perhaps after they get their procedural work done. So, really focus and try to understand what your positioning is, and that will vary by market, right, how much competition you have what, what are other agencies doing in your area, how can you be different, but find your niche and what you’re good at.

Evan Loevener:

Second, I would say fire on as many cylinders as you can marketing wise. To me, marketing about momentum. It’s about putting the energy out there and extending your brand, positioning yourself as a thought leader. Probably one of the best ways to do that is to have a strong social media marketing plan and executing on that plan with the help of folks like yourself and your agency, but positioning yourself as a thought leader, right, and doing that more of, let’s say, pull marketing where people are going to come to you because you put yourself out as someone who knows the business and really understands the ins and outs of home care. Seek out speaking opportunities. Seek out networking groups to get the message out and spread your brand as well. I think that’s very, very important to establish momentum.

Evan Loevener:

And the third thing is what I try to do in these networking groups and other groups is position myself as a healthcare resource. So, I guess you’d say be a connector in a way. Don’t worry so much about trying to always get the sale or capture that specific client, but try to add value in your community in whatever way you can, whether it’s volunteering, which I know a lot of folks do, which is great. We haven’t done a lot of that, but I do give up a lot of my time to try to find someone who might need a Medicare expert or might need to find different forms of dementia care therapy. These are things that not that we do in house. Of course, there’s your music therapy or art therapy, but these are folks who I’ve gotten to know over the years in my community.

Evan Loevener:

The way I look at it is if I can add value to my community partners, to my clients in ways other than the services that we provide directly, that is absolutely fine and that will come back to me later on. It all comes out in the wash is the way that I think about it. So, I want to just, again, be mission driven, right, trying to improve the wellbeing of my families, and the sales will come if you establish yourself that way in the community and that people will find out about that, and people will want to work with you.

Valerie VanBooven RN BSN:

That’s very true. Great advice. If you’re a connector of people and you are not afraid to connect this person with that other agency or that other professional that might be a really good fit for what they’re looking for, you will be remembered and appreciated for that day or that time or that moment when you connected somebody who that agency or that assisted living really needed beyond what you could do, and you will be remembered and appreciated, and people will trust you because they know that, for you, yes, you want more clients, but it’s more about serving your community as a whole. There’s plenty of people to go around that could use home care. I think we couldn’t all possibly serve the amount of people who actually could benefit from home care. So, not thinking of your competition so much as competitors, but also as additional resources is a great way to go. That’s a very-

Evan Loevener:

The pie is growing. I mean, I remember at the beginning of when we were starting to do our planning 10, 11 years ago for home care, someone told me, very wise comments, that even if you launch in a very competitive market, you’re still going to grow. You’re still going to get business if you successfully execute and you successfully position yourself. So, may be harder, may be a little longer because of your competition levels, but the pie is definitely growing, especially now more than ever. So, I think you just need to, again, find out where you should be positioning yourself and try to add value where you can.

Valerie VanBooven RN BSN:

Yeah, that’s great advice about being in a niche. I mean, our business is in a niche, and to say really, all our care givers are trained in Alzheimer’s and dementia care times 50 and or whatever it is. If that is the focus and the client that you want to serve, shout it out. Make sure people know. If it’s plastic surgery recovery, we see it all, and you just pointed out, there are so many different avenues inside of home care that you can actually go and specialize, and you all have found your specialization and your niche, and that’s awesome. So, thank you for all that good advice. That’s great. All right. Last question’s supposed to be fun. I’m sure you’ve answered this before for me. How do you like to celebrate with your staff?

Evan Loevener:

Yeah, well, my direct staff is actually pretty small. So, I have an extended team with Honor. Certainly, my direct staff, we do a lot of celebration in the office. When we have big wins, it’s a potluck dinner, or maybe on a quarterly or annual basis to celebrate those wins, we’ll go out to a restaurant for a nice dinner. So, nothing too extravagant, I would say, but we’re very close. We’re not meeting in person as much these days, certainly, but it’s easy to be a very tight team when you have those three or four people working with you directly all the time.

Evan Loevener:

Certainly through Honor, some of the great things we’re doing with our care staff is we have quarterly care professional rewards where we recognize who are the best performing people for that quarter. We bonus them. We give them again a level of recognition across the network. We just instituted also a mentorship program where higher performing caregivers are put into mentoring roles that affords them a higher pay rate and also a level of recognition that they’re doing a lot of things right, and they’re sort of the premium staff that we’re looking to really directionally guide the other care professionals and help with the training and best practices. So, that’s another thing that we’ve done as well.

Valerie VanBooven RN BSN:

I think that’s great. Having a sort of a career ladder within your organization or you get to this next rung and you can look forward to this pay rate or this bonus, or this title is a nice way to practice retention with the folks that you really like.

Evan Loevener:

Yeah, and it’s now more than ever, Valerie, not just recruiting folks, but also reducing churn, retaining people. It’s so vital to the success of agencies. So, you have to find good ways to do that. We’ve just instituted a 401k matching program as well which is not common in the home care, but again, talking about focusing on how you build careers for these folks, not just jobs. That’s one thing. Of course, we’re paying very competitively because everybody to retain folks nowadays, you have to pay above even contracted wage rates to keep people or else you risk losing them to gig economy jobs especially. Thankfully, we’ve done a number of those things correctly, and in addition to the recognition, just compensation components that are still vital to consider to keep the churn lower.

Valerie VanBooven RN BSN:

Yeah. Oh, absolutely. It is all about the retention right now. It’s so much more cost effective to keep people happy in their jobs and give them the things that you know others won’t so that they’re comfortable, they’re happy, they feel like this is definitely a career not just an hourly job, and they want to stay. There’d be no reason for them to leave. They’re very happy where they are. So, celebrating them all the time is a great strategy. So, thank you for doing that, and they deserve all of the kudos we can give them because they have also worked through the last 24 months in some capacity and have suffered through all the things [crosstalk 00:28:52] have done.

Evan Loevener:

Incredible.

Valerie VanBooven RN BSN:

So, thank you. Well, thank you.

Evan Loevener:

No, Even pre-COVID, they were miracle workers and even more so these days, absolutely.

Valerie VanBooven RN BSN:

Yep. They deserve all of our recognition. So, thank you for doing this interview, for shedding some light on your business and how things are going for you and really giving us some great advice for others out there. We appreciate it and we appreciate your wisdom. So, thank you.

Evan Loevener:

Oh, you’re welcome, Valerie. Thank you.