Miriam Allred (00:00)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Alred. Today in the lab, I'm joined by Rob Rister the CEO of Home Well Care Services in Lexington, Kentucky. Rob, welcome to the show.

ROB RISTER (00:13)
Thanks for having me. It's a pleasure to be here. I'm looking forward to this.

Miriam Allred (00:17)
I have been as well. So let's just get right to it. Today we're going to unpack your business model. It's different than just traditional hourly care, companionship care that we talk a lot about in home care. And here's how I want to structure the conversation today. I want you to start with your aha moment and what led you to going all in on this business model.

And then I want you to walk through the details of the model, getting into the numbers and the technology and the operations behind this model. And then we'll wrap up with lessons that you've learned, maybe the hard way and advice that you have for home care owners that are interested in this model or considering expanding into different models. think this is an opportunity for them. So let's start at the beginning. When did you open your business?

ROB RISTER (01:02)
Okay.

Miriam Allred (01:05)
And what was your initial vision for the business? And then what was the aha moment that led you down this path?

ROB RISTER (01:11)
Right. I'm going to hit on that. But before we start, want to, you know, we're going to talk a lot about me and what I'm doing and so forth during this conversation. But I want to start by acknowledging a lot of people that's helped me get to where we are today. First and foremost, most is my wife, Dr. Dolores Polito. We call her Dee. She's been a backbone of what we've been doing ever since we opened our doors in 2020.

I have a tremendous staff.

I've had some great people in my organization over the last five years. I have a great director of operations now, Sam Samantha Adkins. I have a great enrollment specialist who does recruiting, Marisha Griffin. ⁓ I have care managers, Nikki Leathers, Sierra Slaughter, and also Deborah Bueno is a director of operations in our southern office in Melbourne, Florida. Those ladies are a tremendous part of our organization and what we do and help me be able to do

what we're getting ready to talk about. And I want to make sure that they get acknowledged for that, especially my wife, because she makes sure everything is done the right way. ⁓ started, and I started in ⁓ August of 2020.

We opened our doors and it came right during COVID. And ⁓ I'd be remiss if I didn't mention Homewell because Homewell is my franchisor and we've been a part of Homewell for five years. when COVID hit in 2020, I remember them coming to me and saying, Rob, are you sure you want to do this? I'm like, well, yeah, when there's chaos, there's opportunity. And there's a lot of chaos at that time, if you remember.

So it took us six months to get the license and know COVID and we opened our doors in August of 2020 and You know, we're doing what you're supposed to be doing, you know through the home care franchise system and learning and training In about October. I'm like, there's got to be a better way. I need to expand I need to find something to grow our business

Because I had nothing to compare it to. Was this COVID related or was it not COVID related, right? I just knew that we needed to grow. So I was at a fall conference or something with Homewell, I'd heard about a man by the name of Michael Rowley, and I want to acknowledge his because he's been a big part of my story. And he was doing independent care in Phoenix, Arizona. And that intrigued me.

And I was like, yeah, I'm gonna find out about this. So call him up and I said, can I come out and shadow you for a couple of days? He said, yeah. So jumped on Allegiant with my son, Airlines, and we went to Phoenix, Arizona and spent two days with him. And he didn't have to do that. And I was very grateful. And as I was sitting there listening to him and how he's partnering with these independent living communities, and I was like, oh wow, I can do this.

Now I'm gonna bring it back to Kentucky and I'm gonna put my own spin on it. I talk about the Colonel Sanders putting my own secret, lavender herbs and spices. ⁓ So that's what I did. I brought it back and kind of cooked on it in my little office and worked and massaged a little bit.

From November to February I started making some calls and trying to get in to talk to building directors, general managers. Wanted to talk to them about bringing this unique program into their independent living facility. Because see that's what I had heard it in my training process through Homewell, facility, facility. So that's what I was using. So.

February happened in Kentucky in 2021 and it was a blizzard storm, know, bad weather. It shut down all business in Lexington for about a week and a half. We had no revenue for that week and a half, zero. As a small business owner, you're looking at this and like, my God, what am gonna do? There's gotta be a better way to this.

And then it started occurring to me, talking to Michael Rowley. Wait a minute. That's my aha moment. I can't get at that time, whatever clientele we had, 20, 25 clients maybe, right? I couldn't get 25, 30 caregivers to work. You know, couldn't do that. was logistically impossible. And I'm like, but you know what? I can get one or two caregivers to one building.

and they can take care of 25, 30 clients in that building. And at that moment, I'm like, I'm done with this individual. I'm gonna focus and change my business model. And that's what I did. And then I started aggressively going and talking to these general managers, executive directors in the Lexington area. And finally, I was talking to a guy and he said, listen man, he said, we're a community. We're not a facility.

And I didn't understand that. He explained it to me. know, people live here don't want to think that they live in a facility. And that was like another aha moment. I'm like, my God.

So I changed my language and the way I approached the general managers and executive directors. And now the doors just started opening up for me. People would listen to what I was saying. So I was finally able to get into one community. And that's what started it right there. The ball started rolling. ⁓ It was all because of bad weather, you know, and that's what happened. And that's how we started the model. ⁓ And that was in 2021.

And then of course we start that model and there's always bumps and you know as you're starting a new business so we're tweaking it every day, every day. We end up picking up another community so now we're at two communities and this is probably I don't know 2023 maybe and I'm having a document problem.

a major document problem because what we were doing is that we were charting the task that the caregivers was completing. You know, the clients buy packages from us of care. We go in, we do this care, but we also have to document it. So it was starting to mount up. And that's where if you have that picture for a sense, I'd like for you to share this because this is what this looked like.

for one community by the way, that document that you're looking at, it's about a three foot and a half tall stack of papers that I had a problem with of our caregivers documenting what they were doing for the clients. So I was trying to find a way to get rid of that because my wife's big into digitizing everything. So out of it, you're

Miriam Allred (07:58)
Let me just

vocalize what we've got on the screen for those that are listening to it just via audio. There is a mound of paper on Rob's desk that's probably three feet tall. And so what you're explaining is you had to rely on paper to facilitate the documentation in these facilities because, know, WellSky didn't have the capabilities. So just want to illustrate that mound of paper on the screen, because that's going to be a big part of this story is you bringing in technology and processes that allowed you to

ROB RISTER (08:02)
Yeah.

Yeah. Yeah.

Miriam Allred (08:26)
stream like this which will help you scale.

ROB RISTER (08:26)
That's

it. Yeah, exactly. At the time, we were working with two communities, learning the program, honing it, and so forth. And then out of the blue, a guy by the name of Tim Murray called me at my office. Because I was making calls trying to find document manager. And then he calls my office, and he starts talking to me about his program and what this software program he's got called CINCH And I'm like, OK, let me look at that.

So when he showed that to me, he showed that to him and his wife, Gina, I was like, my God. It literally, at that moment in time, I knew instantly this is the answer to my problem. Instantly. And I knew it was going to take my trajectory to my business. It was going to grow it.

⁓ So I enrolled and talked to Tim and Gina, his wife, and his IT person or assistant, Micah, at CINCH. And man, I'm gonna tell you, of course I'm 58 and I've met a lot of people in my lifetime, but these are three quality people that run this program called CINCH.

and they walk through this with me to show me how this could help my business and improve it. And every day I got off a meeting with them, I got more excited because I know what's This is what's going to take me to a different level. So I partnered with CINCH, ⁓ I think at the end or beginning of 2023. And what that allowed me to do is, like you said, come into the digital age.

And we'll talk more as we go about the caregivers and how they use this CINCH app and so forth. But that was the story of how we started. We started with two little communities and then I was having this problem and then I found a solution with CINCH and now the doors just started flooding open.

Miriam Allred (10:23)
And now if I'm not mistaken, you're up to about 10 communities and anticipating more and you're in multiple states. So we'll get to kind of where you're at today and how you're streamlining and scaling this. I want to unpack a lot of what you shared though. I want to go back to you getting into the first community.

ROB RISTER (10:27)
in.

Miriam Allred (10:41)
you said you had maybe 25 to 30 clients. So you were doing the hourly kind of traditional home care model. This is a completely different model. And I want you to explain just some of those key differences that you learned maybe the hard way early on from the caregivers, from the scheduling. You kind of talked about the documentation, but you were in home care mode and now you're going to community mode.

what are some of the key differences that you had to learn very quickly getting into that first community?

ROB RISTER (11:13)
Scheduling, number one. ⁓ You're not scheduling for individual clients in a community.

You know, you're literally scheduling that community. You're not scheduling individual clients. Which, if you have 20 individual clients, you have 20 different care plans, you have 20 different schedules, times and things that they need help, you have to have at least 20, maybe 40 different caregivers to staff those clients. It's just a completely different animal. ⁓ The other thing too is that you have more issues that way as well.

You know, when you're dealing with 20 clients to 200 clients, whatever that number may be, your issues are multiplied. But in a community care setting, it's more concentrated. I had more control, and I do have more control of my business under the community care model than I ever did individual care. ⁓ As far as...

The way the caregivers, for us, it's very difficult with the caregivers calling off work and things of that nature. It's home care. I don't care, and I can speak to this because I have businesses in three states. It's the same everywhere, whether it's in Indiana, Kentucky, or here in Florida, it's the same issues. So you have those issues with individual clientele. Those issues are minimized.

when you have community care. The caregivers love, and we'll get to some more things that they love, but they love the thought of going to one spot.

and taking care of multiple people. And I know this through our recruiting process. We get feedback and data and things like that. And that's a big ⁓ contributor for us to keep good caregivers for a longer time retention-wise for that reason. Because they're not going to two or three different clients' homes. They're going to one community. So as far as retention, it's been a windfall for us that way.

Miriam Allred (13:19)
Let's talk about numbers. How big are these communities? How many clients do they have? And then within those clients, how many are you typically taking care of? And then how many caregivers are staffing those clients?

ROB RISTER (13:31)
I typically, we want to work with communities that have at least 100 residents in that community.

It just, the numbers just, it makes sense. You gotta have 100 residents in a community. And we typically serve at that 12 month mark once we go in. That first month we go in, you have zero clients usually, right? So you have to build up. And it takes eight to nine, 10 clientele to break even. You have to be willing to invest in this model.

Okay, but I'm not interested in just helping eight to 10 people in a community that has 100 to 200 people in it. We want to help as many people as possible. So that eight to 10 mark is, you know, it's a break even. And then probably by that 12 month mark, you're at 25 to 30 residents that you're providing services for on a daily basis.

And then as far as the caregiver staffing goes, we do is the model framework is that we lease a space with our partner community.

We lease a space. Typically, it's a smaller studio apartment. In some places, we actually have an office. And we lease that. So that's the part of our model that makes sense to them, because we're now a partner with them. We're renting from them. We're not just coming in, taking money out of their community, providing care to their residents, and charging those residents by the hour, the unit, and leaving. We're embedded in that community.

So from seven o'clock in the morning till seven o'clock at night, seven days a week, we're in that community. And we staff it, typically it depends on the client count, client total count. One caregiver can manage eight to 12 clients depending on the level of care that they need.

the level of task, one caregiver can handle that herself until she gets to about eight to 10. But once we get to that 10 to 12 in that area, depending on the care that's needed, we'll add a secondary or assistant caregiver in there. And we typically put him or her in there until 12 or one o'clock.

And then once we get to that magic number of 20 to 22, we staff it two caregivers, seven to seven, seven days a week. And now you got a framework of care in that community that people are getting a lot of attention. And it's economical. That's the other thing about the program that we've developed. And when I say we developed, give, like I said, I Michael Rowley a lot of credit.

I brought it back and I just added some spices and flavoring that I wanted. But the framework is there. We charge by day for packages of care. And that runs from something as simple as pet care. We call it pet care. You know, it goes from $15 a day up to our enhanced package, which is $65 a day. Now naturally, there's a big variance there.

So the attention that that client's getting is going to increase depending on the package that they enroll in. But again, I'm using the law of large numbers. See, you know, the more clientele are in that community, the better that we service. It doesn't matter if it's pet care or enhanced package care. It doesn't matter. We're serving as many people in there as we can get to. And I remember my visit with Michael Rowley, he said, I asked him,

Because at that time I was comparing everything to individual home care. How much are you charging per hour? What's your hourly rate, right? How much are you paying your caregiver per hour? He's like, I don't know. I don't care. I'm doing everything by revenue. I care about revenue. And that just blew me away. And it just tweaked my thinking. Yeah, revenue. You can't look at our model of care and say we get paid

$30 an hour or $36 an hour. No, that's I look at how much revenue am I getting out of a community? How much revenue do I get out of that community? How much can I share with the caregivers and pay them and make a profit?

And typically, I will tell you, typically in every building, every community that we have, you know, our gross profit margin on those buildings are going to be 45%. Now that's plus or minus probably 3%, depending on how many veterans you have serving in that community, because that changes the whole game. You know, the more veterans you have in a community that are clients of yours,

you know your gross profit tends to drift up, it will drift up.

Miriam Allred (18:28)
Okay, lot a lot to unpack here and I'm glad you're already kind of going down these paths. ⁓ I wanted to ask about the billing. it are in all of your now 10 communities? Is it primarily private pay or is it like what portion is private pay? What portion is VA and then any other payers in the mix?

ROB RISTER (18:46)
70 % of our clientele, 70 % are private pay. The other 30 % is VA. That's it.

I think we might have one out of 180 clientele that we service. We might have one long-term care insurance, but it's primarily private pay and then VA reimbursement. And the reason, we do billing every Monday and that's the thing about our program. It's very simple, effective, efficient is that we do billing on Monday morning. We hit their debit or credit card for the services that they had the week before. That's the other thing that makes our model unique is that we don't have a

contract, we have an agreement. How many days of service did they get the week before? How many? Did they have four days of service or five? And then we build our debit or credit card for those days of service. So we don't have ⁓ cash or checks or nothing like that. It's very efficient that way.

Miriam Allred (19:48)
Okay, I want to talk about the the marketing aspect. You personally have gone out and developed relationships with these executive directors and general managers at these communities. And that's, that's the first place to start is you personally going out and building that relationship.

Talk a little bit about building that relationship because you have done this with a lot of communities now. What have been some of the hurdles or challenges that you've had to face breaking into these communities and building relationships with that leadership?

ROB RISTER (20:20)
Well, that's great. First thing is when I go into them, I talk to them about their community, not facility. That's number one, right? The thing about it is I want to find out what their pain points are.

Miriam Allred (20:24)
Yeah.

ROB RISTER (20:30)
as general manager or executive director in that community. What are some challenges? What are you facing? And you have to understand is most of these independent living communities, they have many home care agencies coming in and out of there all day long. You know, from Charlie's Angels to Visiting Angels, it doesn't matter. Home Well, there's a bunch of people coming in and out of there. So I want to know what bothers them as a director about what's happening in their building. Do they like the service?

the clients are getting, those type of things. ⁓

Miriam Allred (21:04)
What are some

of the things that they say? What are the things that you hear most commonly that they're struggling with?

ROB RISTER (21:09)
I will tell you, dependability, dependability, accountability. They can't depend on the caregiver showing up to take care of their residents. And again, it's not any one agency's fault. We all draw from the same labor pool, okay? But they do talk about the dependability of the caregivers in their community, accountability, holding the caregivers accountable for their behavior in the community.

Right? They want professionalism in their independent buildings. That's what they want. They want a professional organization in there. And they want it ran effective and efficiently. ⁓ And those are the two things for me is dependability and accountability. That's what I hear a lot when I'm talking to them.

Miriam Allred (21:56)
Okay. Other, okay. So yeah, so you address their challenges and you say, here's what I can offer you. what other questions do they ask you or what other hurdles do you have to overcome to get in there?

ROB RISTER (22:02)
Yeah.

Cost.

Cost. What is it that you're trying to do here? How much are you going to charge our residents? Let me see your packaging and all of that. So that's the hurdle. They won't know what it's going to cost because for them, they want to their residents in their community for as long as possible, which we all want that. My dad lives in an apartment. He doesn't want to go anywhere. He's happy.

So they want to keep those residents comfortable. that's my job, is to help them do that. Help them age gracefully and peacefully in their own surrounding without the move to assisted living or whatever. But before I even get to the general manager, and I think that's important if anybody that's wanting to get into this arena, you have to go to the marketing and sales department of these independent living communities first and foremost.

Because they're in charge of filling that community. So I want to go in and I want to talk to them. that's the first contact I make. And I talk to them about our program and how we can help alleviate some of these pain points that I know they're already there. ⁓ And so I talk to them first because I do that because I want them to go to the above the gatekeeper.

Right? That's what I want. I want to tell the marketing salespeople, hey look, I have this tool for you that can help you fill your building and keep it full with support on site program. And then she or he will get that information to the executive director, say, hey, wait a minute, I got an idea here. I ran across this program that can help us. And then that's when I get to the executive director.

⁓ But yeah, the marketing people you have to include right off the get-go and show them the program and break it down for them.

Miriam Allred (23:57)
Mm.

And you just mentioned what you call this program, Support On Sight. That probably took some massaging and figuring out what the right title program jargon was. How did you land on that?

ROB RISTER (24:13)
Right, well, you know, going back to that, like I said, when I came back from Arizona from visiting him, Michael, you know, I started putting touches on it, what I wanted to see, and my wife was, Dee, she's like, this should be SOS. She said, what do you think about when you hear SOS? Help, right? Support on site is help. So we call it the SOS model.

And our logo, our caregivers, ⁓ makes us unique. Another thing that makes us unique is our scrub tops.

That's another part of that massaging and making it a unique program. Every caregiver in our organization has a red scrub top when they are in the community at all times. And on that scrub top, it has the Homewell logo, of course. But on the back, it says, as they're walking down the hallway, let us help you. It ties into that SOS model, Support On Site.

The feedback that I get from the general managers, directors is like, we love the fact that when I look down the hallway, I know that's a Homewell caregiver. I can see it 60 feet away. That's who she is or he is. Most of the time in these communities, they have all these different caregiving companies coming in and out there with all kinds of hodgepodge, the scrubs, you know, a little badge, you know. They have no idea who they are. They know who we are, because they can see it.

So those are things that I bring to the attention of the marketing people to get me to the executive director. The difference makers. Here's how we're unique.

Miriam Allred (25:51)
I want to understand once you build that relationship with their sales rep and then you get to the executive director, the GM, you form a partnership with their community. Then how do you obtain the clients? Are you talking to all of the residents and building relationships and signing them up for your program? Or have you done all the legwork with their sales rep and their GM or executive director and then

those people are selling your services to the clients. Like who does the selling to the clients?

ROB RISTER (26:28)
When I'm sitting in front of the executive director we sit down and we put a game plan together and my game plan is the same. It doesn't matter if it's community three or community ten. You we sit down we talk about the expectations of the general manager and what that building should look like. You know sometimes you have to reel in the expectations they have sometimes unrealistic expectations so you got to hammer those out. Okay because this is not nursing home care.

Right? This is independent living. And our model is designed to assist, support independent living. And sometimes that line will get blurred.

especially as the resident has lived there a long time, you know, it gets blurred where maybe they're bedridden and that level of care that they need, is getting intense. So you've to hammer out that with the general managers, okay, at what point time do we say we can't do this anymore, right? So we hammer that out. As far as the...

The marketing of it, we typically have a kickoff meeting after they give us ⁓ the approval. And usually they have to go up to their corporate team. They have to go to their corporate team and get that approval, get our space. We do a kickoff meeting. We make a big deal out of it. Homewell's here in the building now, and we make a big ⁓ to-do of it. And then we work hand in hand with the marketing people. And we typically ⁓ negotiate a space in the community close

to the action, know, close to the marketing person's office, close to the kitchen, you know, the dining room area. So we have that notoriety when people are coming in. And then the marketing person, when she's doing or he's doing the tours, they make us a part of the tour, which is great.

We got our caregivers in the community all day long running around the red Homewell scrub tops, right? And then she's giving that tour and stopping by our office space and showing our literature and things and say, hey, listen, Homewell's here. We have support on site. 7 a.m. to 7 p.m. seven days a week. So we work closely with the marketing person to obtain clientele.

That, know, and now we're talking about clientele that are moving in the building as she, you know, she rotates and fills the spaces. When we do have our kickoff meetings, here's what happens in every community. Once the resident or the resident's family gets our pricing sheets in their hand and they're like, wait a minute, that a day? 35 a day? 45, 55 a day?

They know they're paying 35 an hour. And they're going to get the same attention with us as they would with that person in that room for four hours with them privately. So we typically within that first month, we'll typically pick up five, six clientele pretty quick because they get this in their hands and then wait a minute. I'm paying by unit.

Miriam Allred (29:43)
Too good to be true.

ROB RISTER (29:45)
Yeah, like hell,

still don't know what a unit is, right? $15 a unit, what's a unit, right? What do you get for a unit? Or $30 an hour. Well, that's some of that, you have to know your audience who you're dealing with. They understand a day, 35 a day or 65 a day, what do get? You get these services.

It's easy for everybody to understand. The other thing that the general managers, the families, the clients, the marketing people, they love about our program is they're an independent living. They don't want to feel like they're in assisted living. They don't want to feel like they're in a skilled nursing home. Our model is designed for our caregiver to come in, do a task, and get out.

You know, go do a med reminder, get out of the room. Go do their laundry, get out of the room. So it gives them that sense that they're still in control of their life. They just have some help. That's it. That's what we talk about. We're here to help you, not to sit in your room for four hours and babysit you. So that's typically what gets our attention to the clientele and the families as well. Because see, a lot of times the families are helping.

You know, they're helping or they're controlling the business aspect of this and they see that. Wait a minute, mom's paying X amount of dollars for this independent living. They know, whatever that number is, 4,000. And I can have Homewell support on site for $1,500? Put those together, that's still less than assisted living. Yeah, so.

that's when the ball starts really rolling. And typically, like I said, you get to that 12-month mark, now you're at 20, 25, 30 clients. Depends on the community, but it just takes that patience. You've got to be patient.

Miriam Allred (31:40)
I want to talk about the caregivers because they are wearing a couple of different hats, They're on site all day and they are providing the care, but they're also playing this kind of like liaison, not necessarily sales business development role, but they are also like the face of Home Well and like you said, doing the tours with their sales rep. And so they have to have maybe the skin

ROB RISTER (31:48)
Yes.

Cool.

Miriam Allred (32:08)
or the ability or the desire to do both, what has been your experience finding the right fit caregivers for this model? Because it is different than hourly companionship care in the home. This is a different breed. And so what have you learned finding those right fit caregivers?

ROB RISTER (32:22)
See you.

Well, first of all, we're looking for a cheerleader. Male, female, you have to have a cheerleader personality in this community, okay? Because like you said, they are the face of our franchise in that community. And they also are responsible. And I tell them, listen, I can only do so much to get Clientel to be interested in joining us and letting us help them. I can only do so much. They're watching you every day.

They're watching you every day. So that's why you have to have that effervescent personality in that building. Butterflies, so to speak, going everywhere, social butterfly. ⁓

And in our program, you what we have, you have to grow to it. You know, you don't start out at this. You you start out with one caregiver and as you grow your business, you fold in other needs. And we have in our, in our business now, we have a community care manager and the community care manager, she typically over two to three communities for me. And she makes sure that everybody's getting what they're supposed to be getting as far as care and things of that nature. Getting all those things are getting done.

⁓

New clients are enrolled as the community care manager. The community care manager also is the liaison between me and the building's management. Cuz I can't be in everywhere. So she steps in or he steps in and does that role.

Then we have the lead caregiver. The lead caregiver in the community is what it sounds like. She's leading the program, right? She's got to, he or she's got to be that cheerleader in that community and creating that atmosphere where clients and families want us to help them. And then we have caregiver. The caregiver just comes in, they do their job, that's what they want to do. They come in, they do their job and just follow the leader basically, right? And what we typically do is that

we bust up the care. You know, we don't have buddy care in our program, all right? Our caregivers aren't budding up going through, no. What they're doing, they're going in and they're taking care of a group of clients themselves. And that's where CINCH made the difference. I can't stress and I won't keep coming back to that because that allowed our business model to get more efficient and effective even for the caregivers.

The caregivers love this model, this program, CINCH, because it gives them everything they need to do organized on a daily basis. And hell, it's on their phone. Everybody's on their phone today doing everything. So it's just natural for them to have their task, their clients right here on their phone. And it's different than WellSky.

they did integrate with CINCH, which was fantastic, and

What that does, that allows the task and the care that the caregivers are providing, it allows that to come over into WellSky for us to do the billing and the payroll. But as far as tracking care, it was terrible, absolutely terrible match for what we're trying to do. ⁓ So as far as the CINCH goes, the caregivers love it because they have

Access the clientele what their needs are if their needs change and it's all done on the fly You know, which is the best part. It's quick

Miriam Allred (35:56)
Okay, a couple of thoughts and questions here. I want to start just addressing the career path that you've built with the caregiver to the lead caregiver to the community care manager reporting up to you. just, I love that career path because it also gives you as a business an opportunity to build out these functions and to give caregivers a career path. Again, there's just, we're getting better at home care and giving them opportunities, but I love that you've built a career path in this model that's really effective because

As you continue to grow and scale, those lead caregivers can become community care managers. And as you continue to scale, there's just opportunity for those people to move up through those ranks, which is amazing. I want to talk about, you're leaning into CINCH and the technology and that side of this and how effective that's been for you. Can you talk about the scheduling specifically? So the caregivers are on site from 7 a.m. to 7 p.m. and they are seeing 20 to 30 clients.

we think of scheduling like traditional home care, what that looks like and how complicated that is. Is there is there a set schedule every day, every week, or is the caregiver, it's more flexible than that and they're almost like backlogging the schedule? How does the scheduling work?

ROB RISTER (36:57)
Right, right.

Well, think at this point, Tom, we're getting into one of my secret leaven herbs and spices here. You see? Yes, the issue is, right, you cannot manage community care like you do individual home care. It doesn't work. The systems of scheduling, because the caregiver individual, you're going, you're setting, you're providing care per hour, you got to...

Miriam Allred (37:15)
Okay, let us in, let us in.

ROB RISTER (37:38)
6 a.m. to 8 a.m. You're doing that care per hour. In the community, you're popping in and you're doing a task. Okay, you're doing a task. That task only may be five minutes at a time. How do you bill for that? Right, how do you schedule for that? and so that's part of the CINCH helping me. And honestly, it's one of those things I have.

It gives me an advantage. And that is my advantage is the billing, the scheduling, and the payroll that's built in the back end of what I'm doing. Because here's what's happening. It's funny because I get calls probably twice a month from competing home care agencies. And they're mad. They're like, how can you do this? This is fraud. I've actually had this. It's hilarious to me. How can you charge $35 a day? And I'm like, well, it's right there.

See, they don't understand the concept of law of large numbers. And then they're thinking about how you pay that caregiver, How do you pay her from seven in the morning to seven at night at $35 a day? How do you schedule that? So again, that's part of those little leaven herbs and spices that gives me an unfair advantage. And I'm going to use that. Colonel Sanders, I think he said his was up in his head.

for years, right? ⁓

Miriam Allred (39:05)
Can I just ask

one question just to understand a little bit better? Do you have traditional schedulers that are helping the caregivers with the scheduling or is that on the lead caregiver?

ROB RISTER (39:18)
Wow, great. Great.

That's a great question. Our director of operations, Samantha Atkins and Deb Robono here in Florida, they are in charge of scheduling our communities. So again, they schedule those communities from seven in the morning till seven at night. And again, some of our caregivers do 12 hour shifts. Some of them can't do 12, so we bust it up. But our servicing that community is from seven in the morning.

to seven in the evening. And they are the ones controlling the schedule. This is what we have. And then our enrollment specialist who's in charge of recruiting, Marisha, it gives her a little extra tool. I don't wanna say a carrot, because now not only can our caregivers that she's recruiting do private care, but now they can come in and do community care. And wait a minute, I can go to one building and same thing.

Work with many clients, I can do 12 hour shifts, three days a week. So it gives us an advantage to get quality caregivers, because it's just not individual one-on-one hour care anymore.

Miriam Allred (40:27)
makes a lot of sense and that's every scheduler's dream is, know, scheduling seven, eight to 7 PM seven days a week and then communicating that to caregivers.

ROB RISTER (40:31)
Ready.

I'll give you example.

My director of operations and Sam and Deborah here in Florida. Sam will said it herself. It's easier to schedule 10 to 14 buildings, communities, than it would be to schedule 140 clients. You see? So her job is much smoother, much less stressful. Now you do have stress. You'll kill me if I don't say that. You still have stress. But again,

Miriam Allred (40:54)
Mm-hmm.

ROB RISTER (41:04)
It's much more manageable. And that's what I was looking for. And part of that is, there was a part of this in the very beginning, I failed to mention, but when we first started in the COVID, we were staffing. I didn't know what that was at the time, but we were helping staffing local assisted living, because they couldn't find caregivers. So they're calling us and we're working out deals to provide caregivers for them. At some point in time, we were doing, I don't know, hundreds of hours.

a week helping them and then the day before they would cancel everything. Right? I'm like, no, no. I had no control over that. So that again, that was just part of the process that says, no, I want more control of my business model of what's happening. I don't have a hundred percent control, but I have more control over it today than I ever have.

Miriam Allred (41:59)
When you programized it and you became a part of the community where you have people in an office on staff, you're literally a part of that community, you're a part of that team and you become irreplaceable. They start to rely on those caregivers and they can't do business without it.

ROB RISTER (42:01)
Yes.

Yes.

Here's

the thing about it too, as you're going through this process, you're learning, right? Is that most of these independent living communities have therapy on site already. And they have their own office space and therapy. Therapy's already there. I I deal with a lot of therapy. You've got Legacies, there's all kinds, there's Agility Focum, there's a bunch of them out there that normally already have a space in these independent living communities, because they figured it out long time ago.

Right? So now we're just coming in and dovetailing at the end. Now I will say, we're dovetailing with the physical therapies and so forth, right? I will say there's been many communities that I've talked to that already had home care in them, that already had somebody with a home care program in their community.

And the general manager wasn't happy with that service because it's not professional. It wasn't efficient. It wasn't effective. And they were tone deaf to what the needs of the general manager and directors were. Now here I come in behind them and here's what I have. I have support on site and I have checked the boxes. And now I don't care if you are in that community. Once the general manager sees what we have,

Nine times out of 10, we're in that community and the other place is on their way out.

Miriam Allred (43:51)
was

just going to ask that, does the other home care get phased out?

ROB RISTER (43:55)
Phased

out, absolutely. Every time, 10, we're talking about 10. Six months to a year, some's quicker than others. Because when we come in, we set up shop and they start looking at our pricing model and our structure and they see we don't have caregiver issues and we don't have caregiver call-offs like they do, right? Because we have a system. it slowly phases themselves out.

I've actually had a couple of them join me in my organization, brought their clientele with them. Okay, we can't compete with this. We're gonna join you. Okay, great, love to have you. Put my arm around you, let's go. Let's go help people. So that happens. no, again, are there gonna be some stragglers? Of course. There's gonna be some individual care going in and out of there. Of course there is. ⁓

But we have the majority, when we go into the community, we had the majority of the home care, personal care locked up. I would go to say 80 to 90 % of home care in that personal care in that community that we're in is coming from us.

Miriam Allred (45:10)
getting referrals for hourly care? I know that's not necessarily your intention per se, but that probably happens. Tell us about what that looks like. Do you get those referrals? How often? And is that fueling another line of your business?

ROB RISTER (45:16)
⁓ yeah. Yeah.

Yes. See, I don't want to give the impression that we don't do individual care. We do. We have a lot of private clients, right? We primarily focus on the community care model for many reasons, but here's what happens. People in independent living communities, they sign up and enroll in our package program. But even they, when they come out of rehab, they come out of the hospital.

They want that personal one-on-one care. We have many clients that enroll in services from seven o'clock at night till seven in the morning, where we have somebody in their room with them 12 hours at night, and they pay a one-on-one hourly rate. See, that's the other part. It leads to other business. The other thing, too, you have to remember, our caregivers are in that building all day long. It's a constant billboard.

So there's a hundred to hundred and fifty residents in that community that have family members that don't live in that community. they, know, well, Homewell's here in our building and we get calls from that outside of the community. They hear about us because of our care in the community. I spent zero dollars for advertising that. The only thing I spend is the scrubs in the community and our caregivers doing a great job.

So that's unattended consequences.

Miriam Allred (46:57)
Can we talk a couple more numbers here, your caregiver retention rate for these communities and then also the client numbers, client retention, average length of stay, kind of the CAC for the client.

ROB RISTER (47:09)
Okay, gotcha.

Let's talk about caregivers first. I measure caregivers on six-month rolling. That's just me. I like to do it on a six-month basis. Our private caregivers that work one-on-one with Clientel, we typically keep 14 % of them after six months. That's it. So if we hire 100 in six months, we're going to have 14 of them left for whatever reason.

And that's not too far off industry averages, I don't think. It's in that neighborhood. Our community care is 10 % higher. We typically have 24 % of those caregivers still with us at the end of six months, and that's rolling. And that's like clockwork. it's not a cure-all of keeping caregivers, but I will tell you what it does do. Our quality of caregiver seems to be higher as far as education goes.

in the community care setting. You know, we'll get more CNAs, we'll get more people that have a lot of experience working in assisted living, and they come and look at our model like, yeah, I want to do that. That's much easier than what I've been doing. So our retention rate and our recruiting efforts for our community is much higher in the community side compared to private care. Now, you were asking me about the clientele. Again,

This, I hate to sound like an infomercial for Tim and Gina But what was happening is in your independent living communities, people come and go all the time. The turnover rate in there is pretty high. they go to rehab, they come out, whatever. You can think of thousands of scenarios. We were having a hard time keeping track of who's in the building, who's out of the building.

But when we got the CINCH app, it was instantaneous. There's a hold button. She went to the rehab today or went to the hospital. We put them on hold. She came back today. We unlocked her from hold. It just opened up the doors of care management beyond anything I had planned for. And it made it more efficient. Now, as far as numbers go, I couldn't give you that number. We've not tracked it because it is volatile. You know, just think about

complexes. know, unfortunately you have people that move in and out, they do a trial run in these independent living communities. They have like a 90-day trial rehab or you know run and then they go out. You know, then you unfortunately if people get sick go to you know hospital for months at a time and it would be hard to track and keep control of. ⁓ All I can tell you is on a day-to-day basis

And what I care about is that we service 25 to 30 % of the residents in that community all day long, every month. One person might leave, another one comes in their place. And I'd be remiss if we didn't talk about.

General management-ship. You know, we're talking about building those relationships, going back with the management. That's the other thing too, is the manage, not only clients turn over, management turns over in these independent living communities greater than I ever anticipated. In two communities in a year and a half, I dealt with five different managers in two different communities. Five different managers, two to three different salespeople.

So now you've got to have that patience of you have to keep reinforcing, reaffirming what your program is doing for that community. And you've to be patient because that's going to happen. It's going to happen.

Miriam Allred (51:02)
And these communities get purchased. Some outside force comes in and purchases and changes the whole game, which you've experienced that as well.

ROB RISTER (51:09)
Yes, yes,

that happened to me. You know, we were in, we were in, we'll keep the name of the corporate out, but there was, I had partnered with them and ended up with four of their communities. Right. And then they sold, they sold out new person, new conglomerate bought 'em, Right. So now the new management team has been installed. They're coming in, always looking where, where can we change? Where can we do, you know, put, we'll put our stamp on it.

And ⁓ one of the general managers said, no, no, we're not changing home. This is not something you want to change. Well, why? Tell us. Well, here, look, here's the model. Talk to him yourself. And ended up getting another one of their communities because they love what I was doing. Well, can you take this across town? Yes, I can. Yes, I can. But they always want to, you always have to be on guard.

to reaffirm what you're always. Because you can't control that. But you have that in personal care too. You can't control if a family member gets mad or there's family dynamics and they cancel your services. You're going out of the blue. So, it's the same in community care. You have the same challenges.

Miriam Allred (52:33)
And so let's talk about where you're at today. You are in 10 communities across how many states? Three or four states?

ROB RISTER (52:39)
Three,

three. have two communities here in Florida, and then we have ⁓ seven in Kentucky, and one in Indiana. Yeah.

Miriam Allred (52:49)
Okay. And I want

to just for context in a market, let's use maybe Kentucky. That's kind of your primary hub. I'm not super familiar with Lexington and like population and numbers. Is there a lot of potential for you to get into more communities in these existing markets or you feel like you've tapped those resources and now you need to go out of state and find new communities?

ROB RISTER (53:08)
Yes, absolutely, absolutely. Well,

know, where we are in the Lexington market, we're pretty well tapped with it, partnered with independent living communities. Again, I'm looking for independent living communities. There are communities that have assisted living attached to them, and that's a whole different ballgame altogether, okay? Because sometimes you get into a situation where the assisted living feels threatened with our community being independent.

I had one general manager here in Florida tell me, now I'm not interested in your program because you're taking away from my prospects to come to assisted living. No, we don't want that, right? Because she knows that our program are going to help keep them where they're living. Right? So in Kentucky, you in Lexington in particular, we're tapped out more or less in independent living only. Now there are a couple of assisted livings in Louisville.

for example, they have independent buildings beside them. And we have a terrific relationship with them because they view it differently. See, it's all the management. They view it differently. What we do with, in that case, they tell the assisted living, the management group tells us and puts us in contact with each other, assisted living to HomeWell because sometimes assisted living needs some assistance with care. So we do pick up clientele.

in the assisted living part, and that does happen. Again, that was unintended. I didn't even see that coming. But there are two communities I deal with that have assisted living attached to them that we do work, have clients in that assisted living community.

Miriam Allred (54:51)
Can we zoom out and you've sprinkled in some of like your numbers throughout this conversation, but you're in the 10 communities in three states. What does that equate to caregiver count, client count, revenue? Where are you sitting?

ROB RISTER (55:05)
I look at my operation as a whole. And my whole operation this year, we'll push three and a half million dollars in revenue this year. But my whole organization, because everything's ran out of Lexington basically. As far as the client count, you know, we'll be at anywhere, we'll help 300 people a day between three states.

You know, we have ⁓ anywhere 200 caregivers ⁓ at any one time. Because see, the old ratio, you've got to two caregivers for every one client. That doesn't apply. See, when I first came into the home care business, they threw all these numbers at me. That doesn't apply to me. I don't need two caregivers for one client. It doesn't work. know, so. The ratios, yeah, absolutely. The ratios are different.

Miriam Allred (55:47)
the ratios and the margin are different.

ROB RISTER (55:53)
I will say as far as the numbers go, seven of these communities, no, I'm sorry, six of these communities are what I would say are in the infant stage. You have to remember, I've only been in business, we're going in to our sixth year, you know, so really we've only been doing this for four years, okay? So six of these buildings are in an infant stage and I will tell you, after that 18 month period, each building,

is going to generate about $30,000 a month in revenue. That's just, you can expect it. That's the number. One might be 35,000, one might be 28. You'll have an average of about 30,000 coming out of a building every month. yeah. Absolutely. So I know it's just like, you know, know, if you sign up a private client, what that revenue from that client is going to be for a week.

Miriam Allred (56:41)
Okay, these are, this is great. Good context for people to understand these numbers going into it.

ROB RISTER (56:52)
Well for me, I know in about 18 months, I'm gonna get $30,000 at least revenue out of that building. Now again, my numbers are gonna increase and I'm not gonna have to do anything about it. Because the buildings have already set. The structure is already in place. The clientele is gonna layer. It's like an onion. It's just gonna keep layering. It starts with six. I know what our revenue is now this year, three and a half million.

going to be well, and that's an infant stage of these buildings and they're just going to layer. So, you know, I anticipate, next year, we'll probably add four communities between now next into 2026. That's my goal. That's probably what I can handle myself, to manage it with, we have to increase our staff and so forth.

Miriam Allred (57:45)
ask a question regarding that. Imagine you're in front of a thousand home care owners of all different shapes, sizes, business models. You look at them, who should consider this and why?

ROB RISTER (57:58)
That's a great question. You have to be aggressive. If you're not an aggressive personality, you gotta build this. You can't wait for people to come to you and sign up mom and dad and wait for the phones to ring. That doesn't work. You gotta be aggressive. You gotta be a great network. Networking and talk the language of people that run a building of 120 people.

They're business people, they're general managers, but they're business people. So you gotta talk their language, you learn how. So if you're aggressive, ⁓ you're passionate about helping many people. See, that's for me, I'm thinking, how can I help as many people as possible and be as effective as possible? And I got that from my wife. My wife's a doctor, advanced nurse practitioner, who delivers babies for, used to deliver babies for a living.

and she would deliver babies. She's delivered 3,000 babies in her career. But she has more impact today because she now has moved into the instructor teaching. She's teaching women how to deliver babies. So now, every year, whatever that number is, infinitely, there's more than 3,000 being delivered because of her knowledge. So now she's really not delivering 3,000. She's probably 10,000.

And that's the way I wanted to be in the home care business. How can we help as many people as possible? And I'd love, like I said, it's not unique. There's been other people out there that tried it, right? There's other home care agencies doing independent living community. But you know, just like there were hundreds of people frying chicken before Colonel Sanders. And I'd love to see my franchisee, franchise or

take this model and adapt it and grow it because I'm gonna tell you here's what's gonna happen. Independent living models, communities, I don't wanna say it's a bad term but it's a term nonetheless. It's becoming a dumping ground for assisted living communities and sometimes nursing facilities. They can't take it, whatever the reason. People that's watching this, know. They know what's happening out there. I'm not inventing this, it's there.

So now where can we put mom and dad? Where can we put people? Independent living. So the pressure is going to be there. Who's going to take care of them? Let's position ourself as an organization, either HomeWell or another entity I work with. It doesn't matter to me. This is a model that I've been proving. Let's utilize it. Because it's going to be needed, not just today. And if you ask the 10 general managers that I work with today, ask them how they like it.

You know, and there's not just 10 out there, there's thousands in 50 states. And there are some out there already. there are home care companies doing a good job. Yes, I'm not saying they're not, but I think if you compare apples to apples, we do it better than anybody. So I hope that down the road, we, we, we can tap in and, and create something bigger than 10 to 14.

support on site models because it's there. It's there.

Miriam Allred (1:01:22)
This has been fantastic, Rob. For those interested in connecting with you, to ask you additional questions, follow-up questions, what's the best way for people to get in contact with you?

ROB RISTER (1:01:33)
They could just simply call my office. It's 8-5-9-3-0-3-6-0-1-8. That's the best way to get a hold of me.

Miriam Allred (1:01:41)
Okay.

That's awesome. Giving your phone number right here on the podcast and we can put your LinkedIn and email in the show notes as well. just think we've covered a lot of ground and gotten into the numbers and the operations, but in every market there are those additional nuances and additional questions that people want to ask. So if you're open to it, we'd like to give an opportunity for listeners to reach out to you and ask questions.

ROB RISTER (1:01:44)
Yeah, that's, yeah.

You know,

I'd love to. I love to answer questions, share, you know, talk, shop, so to speak. And what I love, I hope I don't come off as, you know, I know everything. it's like my son, he's a technology guy. can say, son, did you realize this remote control does this? Well, hell, yeah, it's been doing that for 10 years, but it was new to me, right? And the home care model working with independent communities, it's been out there for years, but...

the way I'm doing it's new to me and it seems a more effective way to do it. And I'd love to partner up and help as many people as I can because I feel like it's value added for families. That's the key too. And I think that's why it can sustain itself because you're not asking families to spend $35, $40 an hour for care when they really don't need it. they just need that popping in, popping out and

That includes brief changes, includes giving showers. I there's a lot of different tasks that we do. It's not companion. We don't do companion care in an independent living community. And I hope I could probably should have addressed that earlier. Everything we do is in and out quickly during the day.

Miriam Allred (1:03:19)
This has been fantastic, Rob. Thank you so much for joining me in the lab. I love highlighting a new, like you're saying, it's not new, but new to us and new to many people hearing this, a new business model that's out there for Home Care to tap into. So fantastic conversation. Thank you for joining me. We'll wrap here, but we will include your contact information in the show notes so people can reach out and ask you additional questions. So thanks so much, Rob.

ROB RISTER (1:03:29)
Right.

Great. Hey, I

appreciate you having me. Thanks a lot. Appreciate this.