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Home-care Businesses Are Back in Growth Mode

By Contributor
Michele Anstett says business was like “falling off a cliff” when COVID hit, but client volume has returned to normal.
Business of Aging Special Coverage

House Calls

While the pandemic may have challenged the home-care industry, it certainly didn’t suppress the need for such services. In fact, demographic trends in the U.S. — where about 10,000 Baby Boomers reach age 65 every day — speak to continued, and growing, demand for care services delivered in the home. That means opportunities both for agencies who specialize in this field and job seekers looking for a rewarding role and steady work.

Michele Anstett says business was like “falling off a cliff” when COVID hit, but client volume has returned to normal.

Michele Anstett says business was like “falling off a cliff” when COVID hit, but client volume has returned to normal.

By Mark Morris

In early 2020, Michele Anstett, president and owner of Visiting Angels in West Springfield, was pleased because her business was doing well. As a provider of senior home care, she managed 80 caregivers for 50 clients.

“We were going along just fine,” she said. “And when COVID hit, it was like falling off a cliff.”

The business model for companies like Visiting Angels involves interacting with people in their homes, so when early mandates encouraged people to keep away from anyone outside their immediate ‘bubble,’ it hit the industry hard.

Even though caregivers were designated as essential workers, Anstett saw her numbers shrink to 39 caregivers who were now responsible for only 19 clients. In order for her business to survive, she continued to provide services for her clients who needed personal-care services around the clock and for those who had no family members in the area.

“Where possible, we asked family members to step in to help out,” she told BusinessWest. “At the beginning of the pandemic, there was less risk to everyone when a family member could be involved with their loved one’s care.”

Anstett also incorporated a detailed checklist of risk factors for each caregiver to review to prevent COVID-19 from spreading to them or their clients.

“I thought patients weren’t following up because of a language barrier. As it turns out, they weren’t responding because they didn’t understand the severity of the situation.”

“We talked with caregivers about the people in their circle,” Anstett said. “It was similar to contact tracing, but we did it beforehand, so people would understand what they had to consider to protect themselves, their families, and their clients.”

A Better Life Homecare in Springfield runs two home-care programs. In one, it provides personal-care services such as helping seniors with grooming, cooking, laundry, and more. The other program provides low-income patients with medical care in the home, such as skilled nursing services, occupational therapy, and physical therapy.

On the medical side of the business, licensed practical nurses (LPNs) handle many of the home visits, while certified nursing assistants (CNAs) and patient care assistants (PCAs) are the main frontline workers on the personal-care side. A Better Life also employs case workers to supervise PCAs and CNAs and to set up other resources a patient may need, such as Meals on Wheels and support groups.

When COVID hit, said Claudia Lora, community outreach director for A Better Life, she and her staff made patient communication a top priority.

Claudia Lora

Claudia Lora says communication with clients was key to navigating the pandemic.

“We implemented daily phone calls to our patients that also served as wellness check-ins,” she recalled. Because a majority of the company’s clients are Spanish speakers, A Better Life employs many bilingual staff. At the beginning of their outreach efforts, Lora became concerned when some patients didn’t seem to follow up and respond to communications.

“I thought patients weren’t following up because of a language barrier,” she said. “As it turns out, they weren’t responding because they didn’t understand the severity of the situation.”

On the other hand, she said some patients temporarily stopped their home-care service out of concern about interacting with anyone in person. The system of daily phone calls helped address patient concerns and keep them current on their treatments. In addition, patients received whimsical postcards to lift their spirits and care packages of hygiene products and food staples.

“The pandemic opened our eyes in different ways,” Lora said. “It made us aware that we needed a system of daily phone calls in both programs, which we will continue even after the pandemic is no longer a concern.”

 

Growing Need

The lessons home-care agencies learned from the pandemic — some of which, as noted, will lead to changes in how care is provided — come at a time when the need for home-based services is only increasing.

That growing need is due in part to people living longer, of course. According to government data, once a couple with average health reaches age 65, there is a 50% chance one of them will live to age 93, and a 25% chance one of them will see age 97. With the increased longevity, there is also a greater chance these seniors will need some type of assistance with daily chores or treating a malady.

Receiving care at home, with an average cost nationally of $3,800 per month, is less expensive than moving into a nursing home (approximately $7,000 per month), and nearly everyone would rather stay in their home. When seniors need assistance, Anstett said, they often rely on family members out of fear of having an outside person come into their home.

Now that concerns about COVID are easing, she reports that people are increasingly more willing to have someone come in to their home to help, but there are still some who resist. “I wish they could understand we are not there to take away their independence, but to give them more independence.”

Lora said some of her patients were reluctant to allow people to come into their homes until they considered the alternatives.

“The only other option for people receiving medical care would have been checking into a skilled-nursing facility or a nursing home,” she noted. “I knew that was the last place they wanted to go.”

She added that the extensive news coverage of high rates of COVID in nursing homes and the high case rate locally at the Holyoke Soldiers Home convinced most people that care at home was a wise choice.

Anstett and Lora both pointed out that their companies always make sure anyone providing home care wears appropriate personal protective equipment and follows the latest guidelines for preventing the spread of COVID. Anstett said she encourages her caregivers to get vaccinated, but doesn’t force the issue because she recognizes some people have health issues.

“However,” she added, “I make it clear to the unvaccinated folks that the pool of clients willing to see a caregiver who is not vaccinated is fairly small.”

While the pandemic may have slowed down business in the short term, demographic trends still remain strong for the years ahead. According to U.S. Census Bureau data, about 10,000 people reach age 65 every day. This trend is expected to continue until 2030, when all living Baby Boomers will be at least 65 years old.

 

Looking Ahead

Fifteen months after the chaotic early days of the pandemic and with many people now vaccinated, Lora said A Better Life is busier today than before the pandemic.

“In the last six months, admissions have increased by around 50%,” she noted. “That’s more than I have seen in the past three years; it’s been insane.”

She added that her company is now short-staffed because of the rapid growth it is seeing and has been offering incentives to try to bring more CNAs and PCAs on board.

Anstett said her client numbers and caregiver numbers are back to where they were before the pandemic and noted that she has not had any problem filling open positions.

“I just cut 80 paychecks, and we are anticipating even more growth,” she said, adding that her secret to hiring is treating caregivers with respect and encouraging them to grow in their careers. “I stay in touch with every one of our caregivers. They’re the reason I’m working, so I treat them with the utmost respect.”

While many professions look to push out older workers, Anstett said she appreciates more seasoned workers and looks forward to hiring them. “Caregiving is an opportunity to keep working for those who want to, and we welcome their experience.”

Pointing out that she hired another case manager last week, Lora added that, while her organization is expanding, it has not forgotten its mission.

“Even with our growth,” she said, “we see our patients as part of a family and a community, not just a number.”

Banking and Financial Services

New Valley Bank Raises Its Profile, and Its Assets, in First Six Months

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Local Approach

Jeff Sullivan says customers use branches in different ways than they used to, but that physical presence is still important.

Every morning, Jeff Sullivan signs new-account letters for the most recent depositors at New Valley Bank. “We like to send a thank-you note to people for opening an account,” he told BusinessWest.

But that task also allows Sullivan, the bank’s president and CEO, to gauge how New Valley is doing, at least by that one metric. “Week by week, the volume goes up. Every morning when I come in, there’s a stack of letters that kind of tells me how the day went yesterday. Sometimes it’s just a couple, sometimes eight or 10.”

The story those piles tell is of a bank — the first new Springfield-based bank to open in 11 years — that is indeed growing, and not just in deposits, but in commercial lending, the niche on which its founders want to focus considerable energy.

“In general, things are going well,” Sullivan said, noting that, at the end of the second quarter, just a month after opening, New Valley reported $34 million in assets. That number rose to $45 million at the end of September, is over $55 million now, and is expected to top $60 million by the end of the year. “So we’re starting to grow.”

While the last bank launched in Springfield, NUVO Bank (since acquired by Community Bank), focused on a mostly digital banking model, New Valley will have slightly more of a brick-and-mortar foundation, Sullivan explained. It currently has two branches — its headquarters on the ninth floor of Monarch Place in downtown Springfield, and a stand-alone branch on Wilbraham Road in Sixteen Acres. A third branch will follow in the second half of 2020, although the location hasn’t been determined.

“We’re a hybrid model, and people use branches in different ways now,” he said. “One of our customers, who opened his accounts here and doesn’t have a lot of need to go to a branch, went into a branch to have them help him figure out the online stuff. He wanted to download the mobile app and get everything enrolled and get bill pay set up, so our staff spent an hour with this gentleman, helping him set it up so he doesn’t have to come to the branch. But he was glad to know it was there so he could go and get some assistance when he needed it.”

On the commercial side, the bank will focus on smaller loans and quick turnaround times, said Sullivan, adding that the merger culture in recent years has created opportunities to serve small to medium-sized businesses in a high-touch way they don’t necessarily experience at large institutions.

“There’s definitely a big learning curve, of trying to educate the broader public about who we are and what we’re trying to do,” he noted. “We do have kind of a captive audience in the 300 shareholders who have invested in us. They know our story. As we convert those shareholders into customers, we want them to have a good experience because they’re very important to us. Then, if we provide good first impressions, they’ll become a sales force for the bank; they’ll tell their friends and business networking groups that we’re doing a good job.”

That’s the challenge for any new bank — to answer the question, ‘why this bank?’ when so many other institutions dot what many have called an overbanked landscape in Western Mass. But Sullivan hopes New Valley’s combination of local, quick-response lending and a retail model built on strong personal service will resonate with people looking for a change.

“We’ve looked at our shareholders and some people we’ve done business with before as our first wave of customers. And they’ve been patient with us because, as a new bank, not everything goes completely smoothly,” he added. “Our branch took a little bit longer than we thought to get open — it opened in September, and it’s doing great.”

New Valley is also in the final stages of testing and rolling out online account opening and other technology by the end of the year, as well as an online lending platform where people can apply for commercial loans up to $250,000 and get an answer quickly. “That’ll be up by the end of the first quarter of next year. We’re working hard on all those things while we’re trying to grow the balance sheet at the same time.”

Successful Connections

The founders of the bank — including Sullivan; Chairman Frank Fitzgerald; Jim Garvey, president of St. James Check Cashing; and Dennis Murphy of Ventry Associates — set several goals early on, first being a high level of engagement with customers, which Sullivan said has been missing at many banks. Second, they hope the bank will build off the recent successes in Springfield and connect the small-business community to that success.

Sullivan, who has spent more than 30 years working in and around the region’s banking community, most recently as chief operating officer for United Bank, told BusinessWest he’s come to understand that, just because there are branches on almost every corner in some cities and towns, that doesn’t mean the region’s population — and especially certain segments of it — are adequately served.

“We’ve got to make sure we make good first impressions with people. Our calling card’s going to be that we’re small, we’re nimble, we’re local, we can turn stuff around quickly. So we just have to live up to that, do a good job of it, and then the word will spread.”

In fact, research continues to show that the volume of business at check-cashing establishments has remained fairly stable — and comparatively high — in this region, despite considerable improvement in the economy over the past decade. Sullivan estimates there are some 20,000 households in Hampden County alone that use a bank sparingly, if at all.

“A lot of people are not well-served on the retail side. They need financial education, low-fee and no-fee accounts, and also a lot of financial-literacy tools,” he said.

“Several companies we’ve talked to say, ‘that profile is my employee base. I’ve got a lot of hourly employees, high-school kids getting their first job with us, people who are coming out of the military, or out of jail,’” he went on. “The employer is saying, ‘if I can cut down on the turnover, if I can make these people more stable, they’re going to be better employees, and that’s better for my business.’ They’re interested in working through their HR departments to make these kinds of accounts and tools available to people. It’s a win-win — lower turnover making for better employees, but they also recognize the challenges people are going through.”

But he also came back repeatedly to the commercial-lending focus New Valley wants to become known for during a time when many banks have been involved in mergers and acquisitions, and longtime community banks have grown significantly and put more emphasis on very large loans.

“As we come to the end of this long expansion cycle we’ve been in for 10 years and we’re seeing a lot of consolidation in the marketplace, banks and credit unions are readjusting their portfolios a little bit. We’re coming to the marketplace and saying, ‘hey, we’re turning stuff around quickly, and it doesn’t take us as long as it takes some of the other banks to go through the process.’ So I think delivering on quick decision making, local decision making, and just rapid service is what defines us at this point.”

One unexpected development has been strong demand for residential mortgages, which was not a big part of the initial business plan, Sullivan said. It’s just one way a new bank has to adjust to market demands — one of many challenges during that first year.

“By making sure all of our systems are in place, working with our regulators to make sure that we’re growing the right way, that our procedures and policies are right for the size of our bank, we’re building a good foundation for the future,” he told BusinessWest. “I’m champing at the bit to scale up and unveil some of these new products and new technologies we’re thinking about.”

To serve the public, he added, “you have to meet them where they want to meet you. Increasingly today, that’s having a good app, having some good social media, being able to reach people through online marketing.”

Spreading the Word

New Valley’s business plan calls opening one more branch in the second half of 2020. Sullivan knows it will be one of many local stories in an industry constantly defined by change.

“A lot of branches are available right now in Greater Springfield and Northern Connecticut. By this time next year, new banks will be coming into the marketplace, and we’ll see some expansion; I think some of the Hampshire County banks will push down, and some banks out of New York are making a lot of noise that they’re coming into Connecticut. So the landscape will continue to change.”

It’s been an exciting first six months, he added, and he and his team intend to keep up the momentum.

“We’ve got to make sure we make good first impressions with people. Our calling card’s going to be that we’re small, we’re nimble, we’re local, we can turn stuff around quickly. So we just have to live up to that, do a good job of it, and then the word will spread.”

Joseph Bednar can be reached at [email protected]