Raising the Bar in Home Healthcare

Accurate Home Care

Amy Nelson was just 18 years old when she launched Accurate Home Care. She had always known that she wanted to run her own home health care agency, and when she caught her employer committing fraud in 2002, she knew it was time to strike out on her own.

“The company had just started and I had helped them grow from one to 30 clients in three months – then I come to find out that they are fraudulently billing the state,” Ms. Nelson recalls. She immediately reported the illegal activity and left to found her own company. Her vision was simple: “To never do things that are not right for the patient, the families, or the employees.”

The determined teenager quickly grew the small start-up to a smashing success. She also completed a BS in Healthcare Management while running the new business, and then went on to earn an MBA. Now, 12 years later, Accurate Home Care is widely acknowledged as the leading home health care agency in the upper Midwestern United States. How did Ms. Nelson manage such a remarkable accomplishment? “I think it is because I had this passionate commitment to do good for people,” she says. “Really it was about making sure that we treated people the way that I wanted to be treated. It was listening to clients, employees and referrals, and doing the things that they asked us to do.”

This commitment to customers is evident throughout the business. For instance, the company provides live customer service anytime day or night. “Nobody does that,” Ms. Nelson points out. Competitors might offer automated customer service 24/7, or utilize a third party to provide this service. “But whenever someone calls us, they get someone who is working literally at our office.”

The team also provides clients with support beyond standard medical services. “We have a unique clinical management model,” Ms. Nelson explains. “We don’t just look at it from the medical side, we also look at it from a social work side – the family dynamics, the social things that people are going to be needing.” In fact, each client has a social worker as well as a nurse assigned to them to ensure that both their emotional and physical needs are properly met.

Perhaps most importantly, Accurate Home Care allows clients to choose their caregivers. This is virtually unheard of in the home healthcare industry and truly sets the company apart. “Most [clients] have had a lack of power or they feel like they have lost control,” Ms. Nelson explains. “So we have given them this control.” Allowing clients greater control creates additional administrative work, but Ms. Nelson insists that the effort is well worth it. “It makes our job harder, but giving them the control of choosing who is going to come to their house to care for them gives them a sense that we care and respect them. They know that we are going above and beyond [the industry standard]. Ultimately, their happiness means more to us than the work we have to do.” The response from clients and their families has been phenomenal. In fact, “our clients hardly ever leave because they are overall happy with our services and know that if they go to another agency they are going to get whoever is sent to them.”

Remarkably, Accurate Home Care gives its employees the same autonomy. “We also allow the employee to choose,” Ms. Nelson reports. “The employee has to feel comfortable in the workplace, which is a person’s home. It’s a two way street.” Accurate Home Care also provides ongoing education and career development opportunities to its employees. By supporting its staff, the company ensures that it maintains a top notch workforce willing to stick around long enough to develop strong relationships with clients. This is a notable accomplishment in an industry with notoriously high turnover rates – typically between 40 and 50 percent. Accurate Home Care, on the other hand, boasts an incredibly low turnover rate of 22 percent. This number is even lower than the turnover rate in the general healthcare sector, which stands at about 30 percent, Ms. Nelson says.

To be sure, the average turnover rate in the home healthcare industry is alarming, especially since experts are increasingly seeing in-home care as a better alternative to the traditional institutional model, Ms. Nelson says. “When you look at the macro economics, [home healthcare] is very much in alignment with what the future of healthcare is going toward in general, and what the country is trying to achieve with cheaper healthcare and better outcomes.” Quality of life is also a huge factor. “No one gets excited when they think about going to a nursing home,” Ms. Nelson points out. “No one gets excited about spending two years in a hospital. They want to be at home.”

As a result, home healthcare has been gaining a strong foothold within the healthcare industry – but funding remains a serious issue. “The government wants more care in the home because it is more cost effective with better outcomes, but we have to be compensated or we are going to be forcing people to go to the hospital or to an institution. That is the biggest challenge we face. Agencies are closing every day because people are just unable to absorb the rate decreases that we receive.” Home healthcare agencies rarely have the funding to pay staff competitive wages, and employees usually jump at the chance to take a hospital job, which will almost always pay better and is generally seen as more prestigious.

Ironically, home healthcare work requires a remarkably high skill level – perhaps even higher than is required in a hospital, Ms. Nelson says. “The homecare nurses have to think critically,” she explains. “They don’t have a call button. They don’t have fifteen people doing their job for them. They have to do everything on their own.” Unfortunately, this fact goes widely unrecognized. “The elite job is the hospital; that is where everyone wants to work. That is a perception that we have to work through.” And home healthcare agencies will continue to lose workers to hospitals unless they receive more funding. “A nurse can go work in a hospital and make five dollars more an hour. Money talks. Our employees don’t leave to go to another home care agency, they go to a hospital.”

Despite the challenges intrinsic to the industry, Accurate Home Care has managed to remain a financial success and has grown to provide a full range of services. First, the company offers traditional home healthcare, in which nurses and therapists visit clients several times a week. Typically, these clients are recovering from surgery or acute illness and need the support of a healthcare worker until they are fully healed.

Accurate Home Care also provides extended hour nursing. This service developed in response to “an evolution” in American healthcare, and has only been a part of the home healthcare industry for the past two or three decades. “As the hospitals, healthcare system, and insurance have been driving faster discharges from the hospitals and less institutional care, patients needed this new service,” Ms. Nelson explains. Extended hour nursing provides round the clock care from a licensed professional, just as an institution would provide, which allows clients to remain in their home.

The company also provides long term support from unlicensed caregivers. These multi-taskers help with basic needs such as bathing, grooming, dressing, and feeding, as well as housework and cooking. An increasing number of elderly people are relying on this level of service to remain in their homes. “It is really starting to boom as the baby boomers are aging.”

Clients across the upper Midwest are eager to take advantage of Accurate Home Care’s full suite of services, and the business has continued to grow at an astounding pace. Most recently, the company made the 2013 Inc. 5000 list (for the third straight year), which ranks America’s fastest growing private companies. In addition, the Minneapolis / St. Paul Business Journal named Accurate Home Care as one of the Twin Cities’ 50 fastest growing companies in 2011 and 2012. With so much already accomplished, Ms. Nelson is eager to continue pressing forward in order to provide superior home healthcare to even more people across the region. “Our goal is to expand to the full upper Midwest and to be the best provider.”

March 20, 2018, 9:46 AM EDT

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