Westborough Small Biz Profile: Right At Home

WESTBOROUGH, MA—Right at Home is a private-duty, in-home care and assistance company, based in Westborough. The company provides comprehensive care planning, supervision and clinical care management to older adults with services ranging from companionship and personal care to skilled care and include hands-on care that promotes independence & wellness; personal care & physical assistance; hospice supportive care; specialty care for Alzheimer’s, Parkinson’s, ALS, MS, COPD & other complex conditions; medication reconciliation & management; short-term transitional care; 24-hour care; and respite care.

Right at Home of Eastern Worcester County is owned and operated by Gail J. Hanson, president/CEO and Shelby Marshall, senior vice president.

A Certified Senior Advisor with a passion for service and caregiving, Hanson has long served as caregiver for her disabled uncle, who was born prematurely and has a myriad health issues. Hanson also has cared for her mother, her aunt and her grandmother.

A mother for the first time at the age of 55 and married for 20 years, Gail enjoys spending time with her family, friends and dogs.

Prior to joining Right at Home, Marshall spent 15 years in national health care sales and served in account management leadership positions within the health plan managed markets/managed care sectors. She was accountable for growth and retention of a diverse portfolio of hundreds of commercial health plan accounts, producing $2.5 billion in annual revenue.

Both are active in numerous ways in their community. Hanson’s volunteer work focuses on raising funds for and awareness of Alzheimer’s disease and other dementias. Marshall is president-elect for the Rotary Club of Westborough; current and past chair of the Rotary Club’s Spring Festival and member of its Board of Directors.

When did you open? We’re celebrating 10 years this year! We opened Right at Home in 2007.

What made you decide to open this type of business? Why this location? Gail and I have both been caregivers to several of our own family members, and we know firsthand how difficult it is to navigate the health care system. In addition to worrying about the well-being of a loved one, there’s also fear and frustration. Gail cared for her step father, whose dementia made him combative, and she saw what the disease did to him and the rest of her family. She also saw how seniors with cognitive impairments were treated in long-term facilities and knew she had to find a way to better supports.

We both strongly believe that seniors should have a choice in the type of care they receive, where they receive it and who provides it to them. When the opportunity to start a business presented itself, we chose Right at Home because of our passion for seniors and the success of Right at Home’s organizational culture and model.

What do you like best about it? Home care is a difficult, challenging and complex business. We can’t pull our product from a shelf, put postage on it and send it out for delivery. Our product is our people; it’s relationships, and it’s very personal. Each request for care is unique, and each relationship we have has its own complexities. Success is predicated upon actively listening to the needs of our clients and their families and then determining the best match based on personality, skill set, availability, location, etc.

Once we make the initial match, our service has only just begun. We always need a contingency plan to ensure that we have a caregiver team in place, introduced to the client and trained as backup. With over 100 clients and 100 caregivers in the field at any given time, we place a great deal of trust in our caregivers, our training, our care management and our communication to ensure that we are able to make each “transaction,” or engagement, work. It’s noticing, reporting and communicating the little things to avert potentially bigger issues - issues that can mean the difference between a bad day and a great day and life or death.

To be a long-term, successful home care agency you have to love it. It’s a complex mix of human interactions at so many levels. Beyond the solutions we provide for exhausted and stretched families, we offer a professional and respectful work environment for our employees. Experience tells us that happy caregivers make for happy clients, so it’s part of our company culture to nurture and deepen those relationships. Sharing with and celebrating the pride our caregivers have for their work and our clients is a daily motivator.

As owners, we take great pride in daily observations of seeing the passion in our team to always “do it right.” Those in our care have a choice for who provides that care. We work very hard to earn the trust of our clients and their families. We recognize that it takes ongoing efforts to keep them – and our caregivers – happy.

Biggest struggle? Finding and retaining qualified resources is one of our biggest struggles. We have high hiring standards and even higher employment standards. Caregiving is not easy work, and it’s not for everyone. We don’t have a “warm body” approach to caregiver-client matching. We expect and train our caregivers to follow a plan of customized care. We support them in doing so, but it’s a two-way street. The caregiver must be willing and interested in putting his/her best foot forward, every day, to do the job they are hired to do.

What do you see for the future? Our industry sources report that today, 40 percent of those 65 and older need some form of daily assistance. By 2050, the U.S. population of those 65 and older will be almost double what which it was in 2015, and more than 16 million Americans will be living with Alzheimer’s Disease.

The vast majority of seniors want to remain in their own homes for as long as possible. As a society, we have to expand our acceptance that health care will go beyond that which includes physicians, hospitals, x-rays, lab work and nurses. All of these are vital services and professionals, but maintaining one’s health is inclusive of healthy eating (shopping, meal preparation), hygiene (bathing, continence care), medication compliance, daily exercise (social and physical engagement), etc. These are all activities that a non-medical home care agency addresses, but today, private home care is not affordable to everyone. We have to take our blinders off and expand our view of health care coverage to include non-medical, managed care, which is vital to maintaining health. It’s also far less costly than traditional health care services.

Blending home care with health care is a win-win for consumers, families, businesses (improved work productivity and decreased absenteeism) and state and federal government budgets.

Politics and small business: how does government affect your business? A few years ago, the Commonwealth of Massachusetts eliminated all licensing and quality standards oversight for private duty home care services. Addressing this gap should be an urgent priority for our most vulnerable population.

We need to bring online registries in compliance with home care agencies. Registries don’t provide the same level of security (extensive background checks, payroll, insurances, contingency plans, taxes, overtime, sick leave, training and more) as agencies do. Our fear is that a lack of any checks and balances will result in an increase of vulnerable seniors being at greater risk.

We also fear that a free, unmanaged market will turn home-care into a (lowest price) commodity. In the home care arena, cheaper is not better. An agency’s cost of services is driven by wage law and sick time compliance, health benefits, unemployment, worker’s compensation and more. We don’t view these cost drivers as negatives, but they’re the rules that we play by. Unfortunately, they are not the same rules followed by the underground market, registries and other non-compliant businesses.

In 2017-18, our health insurance premiums will increase almost 18 percent for the same plan that we had last year and will have slightly fewer benefits. That’s unsustainable. If our rates increased 18 percent or even 10 percent year over year, we would be out of business. And yet there are very few, affordable health insurance options available to small businesses. As owners and health care consumers, we feel that year over year we’re paying more and getting less. It’s very frustrating.

Add to this Governor Baker’s proposal to penalize businesses by reinstating a $2,000 per-employee assessment for those which don’t offer an “adequate health insurance plan.” It’s a Catch-22. How can we offer adequate, (which has an inherent requirement of “affordable” in that definition), when we are being told our premiums are increasing by 18 percent? Why should business be penalized for employing workers who choose insurance coverage through a spouse, or through channels that exist and provide access to MassHealth? From a caregiver’s perspective, and with an average hourly wage of $14 per hour, “affordable” according to the law is not relative to the realities of daily living.

We were a leader in our industry in offering health insurance. We did so before it was mandated, because we believe it was the right thing to do - for all of our employees. Our frustration with political matters is that it seems that no one ever wants to get to the heart of the matter. It’s easier to patch the problem rather than getting to the root of it. In this case, it’s at the expense of small businesses like ours and hard-working, tax paying individuals.

Name another local business you’d send customers to: Pleasantries in Marlborough; Tavolino in Westborough; AJ Tomaiolio’s and Romaines in Northborough; Accelerated Strength and Balance in Westborough; Theracopia in Southborough; Hair We Are in Westborough

Know a small business in Westborough that deserves the spotlight? Tell us about that, or any other news and tips, at charlene.arsenault@patch.com.