Why Home Care is Essential for the Future of Senior Living

In this episode, Melissa Brown is joined by Thomas McCauley, Business Performance Manager at Healthcare Advocacy Network, to discuss the vital role of home care in senior living and the broader healthcare landscape. Thomas shares his personal journey from pastoral ministry to home care, highlighting his passion for advocating for the most vulnerable populations.

Together, Melissa and Thomas explore the growing importance of home and community-based services, the challenges faced by skilled nursing facilities, and how home care bridges critical gaps in care. They discuss the impact of safe transitions, managing short-term rehab discharges, and why home care is essential for enhancing seniors’ quality of life.

Thomas also provides insights into how senior living communities can benefit from integrating home care services, offering new revenue streams and building brand loyalty long before residents need full-time care. This episode offers practical takeaways for healthcare professionals and senior living leaders looking to navigate the future of elder care.

If you're interested in the evolving landscape of senior care and how home care fits into the equation, this is an episode you won’t want to miss!

Transcript

Melissa Brown:
Hello, everyone, and welcome back to the podcast. My guest today is Thomas McCauley, Business Performance Manager at Healthcare Advocacy Network. Welcome, Thomas!

Thomas McCauley:
Thank you, Melissa. It’s such an honor to be here, and TGIF — thank God it’s Friday!

Melissa Brown:
Yes, absolutely! So, Thomas, tell us a little bit more about yourself. How did you end up in home care?

Thomas McCauley:
Absolutely. My journey into home care was a little unorthodox. Before I came into home care, I used to be a pastor. I pastored between two campuses in Southern California. And once my residency was coming to an end, the leadership at the time wanted me to move to Louisville, KY, for two years to continue learning and growing as a pastor. But, as you can imagine, moving from Southern California to Kentucky wasn’t something my wife and I felt was right for us at the time. So I went back to the leadership, and they introduced me to a guy in our church, Jason, who owned two home care franchises and was looking to open a third. He wanted someone to help get it up and running. At the time, I knew nothing about home care, but I loved people and felt a strong connection to advocate for the weak and vulnerable. That’s what led me into pastoral ministry, and ultimately into home care. Fifteen years later, I’m still in this field, and it’s been one of the greatest experiences of my life.

Melissa Brown:
That’s wonderful. I love that transition and understanding that your mission in life has always been about caring for people. That mission can express itself in different ways throughout your career, but as long as you’re helping others, that’s what really matters. I was chatting with your boss, Mark Getz at HCA, and he said that you were the quarterback for post-acute transition when you worked for Hillcrest. Tell us more about that experience and how it prepared you for what you’re doing today.

Thomas McCauley:
Absolutely. I spent about six or seven years in home care in California, where we accomplished some great things, both nationally and internationally. Eventually, I was recruited by a large healthcare continuum here in Nebraska. I came here to oversee hospital operations, working with acute hospitals as a bridge to the post-acute realm. That really opened my eyes to the importance of home care in bridging gaps in patient transitions and improving lives. The value of home care is immense, especially when it comes to short-term rehab facilities and discharges. Often, home health companies have a 48-hour window to see a patient after discharge, but I’ve seen situations where it can take up to a week or more. This leaves patients vulnerable and alone. Staffing challenges make this even harder. In response, we created programs to provide better, safer discharges. Some skilled nursing facilities even came to us, offering to pay for the first 48 hours of care to help with these unsafe discharges. It’s a tremendous pain point across the country.

Melissa Brown:
That’s so interesting and creative. With all the pressure from ACOs and managed care providers, discharges are often rushed. I think a lot of people don’t understand what home health really is. They think it’s full-time care, but in reality, it’s intermittent. A typical patient might get 6-10 visits over four to six weeks, which isn’t a lot of support. Most patients need home care to ensure safe discharges, especially with shortened hospital stays. Is that what you’ve found?

Thomas McCauley:
100%. Home health might provide a physical therapist or nurse for a 45-minute visit, but what happens during the other 22 hours of the day? I’ve walked into homes where patients can’t move, are sitting in soiled clothing, and are at risk for further complications. If we had someone there for personal care, we could avoid these issues. That’s why I believe home care is the spinal cord of senior care. It’s essential for aging in place.

Melissa Brown:
I completely agree. Home and community-based services are foundational for senior care. I love your new role at HCA as the Business Performance Manager, where you support clients and help them succeed. Some of those clients are senior living communities, and I think they should begin to think beyond their walls, expanding into home health and home care. COVID was tough on skilled nursing, and we don’t know what future challenges may come. Expanding into home care can help diversify risk and build brand loyalty. What do you think about this idea?

Thomas McCauley:
It’s nearly a necessity, Melissa. I was just in Florida visiting a senior community, and their care continuum wasn’t complete without home care and community services. The healthcare ecosystem is like a puzzle, and it’s not complete without these pieces. If a senior living community isn’t already pursuing home and community-based services, they’re missing out. These services create better outcomes, culture, and value.

Melissa Brown:
It also adds a new revenue line. Senior living communities, especially skilled nursing, are often barely profitable. Home care can help maintain profitability and build brand loyalty with future residents long before they need full-time care. If you don’t offer home care, someone else will, and they’ll keep that patient at home as long as possible. If you control all levels of care, you can ensure the patient gets the right care at the right time. What have you seen?

Thomas McCauley:
You’re absolutely right. Like in the movie Field of Dreams, if you build it, they will come. Home care enhances the quality of care, and it generates revenue. I was recently in Clearwater, FL, meeting with a hospice company that started offering home health and home care as well. They saw the value in expanding services, and I encourage others to do the same.

Melissa Brown:
Some communities might prefer to acquire an existing home care agency rather than starting from scratch. What advice would you give them?

Thomas McCauley:
To quote Nike, “Just do it.” The home care market is a $300+ billion industry and growing fast. Whether starting up or acquiring, just do it.

Melissa Brown:
What if they’re struggling to grow their census and revenue? Any tips?

Thomas McCauley:
If you’re struggling, keep fighting. Even Michael Jordan missed shots, but he kept going. If your census isn’t growing, it’s time to take a hard look at why. Sometimes we have big visions, but we forget to focus on those right in front of us. Start by providing the best care possible for the clients you have, and growth will follow.

Melissa Brown:
That’s great advice. It’s also important to assess your reputation and culture. Do anonymous surveys with staff and clients to see what’s working and what needs improvement. If marketing isn’t working, maybe it’s time to change tactics or bring in outside help. Sometimes Google Ads aren’t the answer, but Facebook marketing might be. You have to adapt to what’s working at the time.

Thomas McCauley:
Absolutely. Reputation and culture are everything.

Melissa Brown:
We’ve covered a lot today. What do you see as the future for home care and senior living?

Thomas McCauley:
The future is bright. As long as there are people on this planet, healthcare will always be essential. Home care isn’t going away. Technology might advance, but nothing can replace the human touch. There’s no substitute for sitting down with a 98-year-old and hearing her life story. That human connection will always be needed.

Melissa Brown:
It’s such a blessing to have a job where you get paid to help people. Thank you, Thomas, for sharing your experiences with us today.

Thomas McCauley:
It’s been my absolute pleasure. And thank you to all the healthcare heroes out there enhancing lives every day.

Melissa Brown:
Thank you! And as always, if you’d like to learn more about Thomas or the Healthcare Advocacy Network, feel free to reach out. You can also find us on LinkedIn. Thanks for joining us, and if you enjoyed today’s episode, don’t forget to subscribe. Remember, it’s not just what you know, but how you apply it that makes all the difference. See you next time.