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Is there a single right way to run a home care agency? We sure don’t think so. That’s why we’re interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Join host Miriam Allred, veteran home care podcaster known for Home Care U and Vision: The Home Care Leaders’ Podcast, as she puts high-growth home care agencies under the microscope to see what works, what doesn’t, and why. Get ready to listen, learn, and build the winning formula for your own success. In the Home Care Strategy Lab, you are the scientist.
Miriam Allred (00:02)
Welcome to the lab live at HCAOA. I'm here with Clay Fouch with Home Matters Caregiving. Clay, welcome to the stage. Welcome to Dallas. Hope the conference has been a blast for you. Now this experience where we can be behind the mics together. Isn't this awesome? You and I have exchanged a lot of messages. We met a couple of times in person and you've had a lot of patience with me getting on the show. So thank you for that. I'm excited to.
Clayton Foutch (00:18)
Incredible, great experience, nice to be here Miriam.
Miriam Allred (00:33)
It's nice to get to know you a little bit better and unpack a couple of topics that you're passionate about. For those that don't know you or don't know who home matters very well, give us kind of the high level of the organization.
Clayton Foutch (00:44)
started in 07, so ⁓ my wife and I launched the business in 07. We launched with kind of two ideas that we would be nurse-guided and that we would leverage technology and innovative ways to better serve the caregiving community and the clients that they serve. So those are kind of the two of the foundational principles when we launched in 07.
Miriam Allred (01:09)
Was this in Washington?
Clayton Foutch (01:12)
Just outside, so we're in just outside of Portland, or?
Miriam Allred (01:15)
Okay, sorry about that. And you and your wife started the business and what's kind of the size and shape of the business today?
Clayton Foutch (01:23)
Well, we built a nice family business that we ran from 07 through the end of 19. We continue to run that business today, but in 2020 we launched a franchise organization kind of based on this philosophy of care. In 2021, our first franchisee joined our brand and today we have 39 franchise locations across the U.S.
Miriam Allred (01:52)
Fantastic. Congratulations. And you said nurse-led. Are you or your wife a nurse by trade or clinical backgrounds?
Clayton Foutch (02:00)
No, my wife's an OT, but what we were really thinking, if we are being honest, back in 07 is we had just had our fifth daughter. So if you can imagine when I said to Christina, want to start a business, when she looked around the house at the mayhem, she said, hard no. Hard no.
Harden I was no and then it was hard. No not one of those Clay knows where we're gonna continue to wear us down on this idea So I took what she said I applied for a license It took about six or nine months During that six or nine months. I talked to her about it. Let her know that I did in fact apply but what I was committed to was getting the business to a spot where
she could help in the way she wanted to help and be involved in the way she wanted to be involved with the priority of these girls that we were raising. And she did and we did and having a nurse was like the key because I came from an engineering background. I was outside of this industry. And so having a nurse literally guide me through the entire process was key. Yeah, that's everything. Yeah.
Miriam Allred (03:17)
Okay, engineering background. was gonna say she's OT, you're engineering. What kind of engineering?
Clayton Foutch (03:22)
Well, I was an electrical engineer by education. I became like an equipment engineer by work. Within six months of that work, if Mr. Franklin is listening, he approached me and suggested that I find a new job because I wasn't...
I wasn't excelling in this role of engineering. So I thought I was getting fired that day. thought, my god, I'm getting fired from Intel, the job I was really hoping to have. But no, he really put me on a new path of project management, continuous improvement. So most of my time at Intel was spent on continuous improvement projects. And I fell in love with the idea of just getting a little better today than I was yesterday.
and accepting imperfections, accepting setbacks as part of this journey. So I really love that and I use that kind of as a foundational part of our business today, like getting better every day.
Miriam Allred (04:21)
And now you wear this hat. You don't wear this hat. You are the CRO of this business. And before we started recording, was asking the difference between like CFO and CRO because you are CRO, Chief Revenue Officer. What is in your purview? What are you thinking about on a day-to-day basis?
Clayton Foutch (04:39)
Well, from our own agency, CRO means salesperson. So I think about relationships we're building in the local community. I think about new clients that we're onboarding each week. I think about the activity that it takes to do that. And so when I think of a CRO for a larger organization, it's really measuring how you do that for
39 other families that have chosen your brand to bring to their market. so helping them with those activities and planning and KPIs and all of the things. Because ultimately, you you shake hands with someone and you say, you're making a good decision. I won't be the reason you're not successful.
We're still a boutique brand. know not only all of our owners, but their families. And I feel a deep sense of loyalty to them to help them be successful.
Miriam Allred (05:41)
And in case it's not clear, you are still active in the original home care company while also helping all of these franchisees, correct?
Clayton Foutch (05:50)
Yes and no. mean, I'm still housed out of our corporate office, is our office in Beaverton. I'm not on the org chart there, but I pretty much go there every day to hear the cadence of scheduling and recruiting and business development and client services and retention. It's where we test and try everything that we think is a good idea for our brand.
So yeah, I'm super involved in our Beaverton, but no, when you're the owner, you know every client, you know every caregiver, you know every referral partner, every networking event, like you live it and breathe it. I'm not doing that for the last four years, but I'd like to be there to feel the vibe of what's happening in the office.
Miriam Allred (06:36)
Which I think is really important that sets you apart as a brand is you are still so close to the day to day, whereas not to knock on these larger franchise brands, those corporate teams are pretty removed from the day to day. And so that's a differentiator for you.
Clayton Foutch (06:48)
Yeah, I think, you know, we're still building this plane even though it's in the air. Okay, so for any future potential franchisee, I want to pop the hood and know that that's also the truth. But I think these are the good old days right now. I admire Right at Home and Margaret, I admire what Homestead has done and Comfort Keepers and all of the brands. I admire Jake and...
There's a beauty to not knowing what you don't know. There's a beauty to people who listen to your why and connect with it and say, know you don't have it all built, but I want to go on this with you. so, yeah, I think these are the good old days. I think we'll look back and really look at how much fun we were having.
Miriam Allred (07:32)
Let's talk about the, I'm just going to get right into it, the cost of care. there are, home care is like on the rise and there's a lot of good things going for us. And we all know the demand, the silver tsunami we're just talking about. The cost of care is a concern though for these families and for these clients. And you're seeing that, you know, firsthand in Oregon, but also across your franchisees. I'm sure they're all coming to you with this concern of like, how do we combat this rising cost of care and approaching that with families? What is your take on how we approach that subject?
Clayton Foutch (08:01)
Yeah, well, you know, when you bring up cost of care, I think of it kind of two different ways. The cost of care is driven by the cost of labor, cost of caregiving, cost of goods and services, and all those things cost more. But I think my original perspective on this idea was really deeply rooted. I was raised by a single mom, brother and sister. I'm the oldest.
We were poor. mean, we were on government assistance on and off. We rented houses and had to move when the rent went up. We relied on family members to help, you know, for clothes in the winter or what have you. And I think when you grow up living that way, and you're the oldest boy, so...
by default, feel some responsibility as part of the family. I think the cost of care is something that's just inside of me. The cost of things matter to me because we didn't have the money. We were far removed from having the money. And so I think when I think of cost of care, I take this one step back and I think of the people who provide the care in our industry. They look like my mom. They're single.
They're raising children. They're the primary earner. They have one foot into government assistance and one foot into making money. And I look at them and I think, how do you serve them? so cost of care is a significant issue, but one that we better figure out as an industry because the cost of caregiving
isn't going down, the cost of gas isn't going down, the cost of food isn't going down. And so how do you bring value for that $40 or $35 or $50 an hour for clients?
Miriam Allred (09:52)
And that's the question is you just said all of that and we understand that as a home care operator you understand all of those costs. How do you go about explaining that to the family in a way that makes sense and they understand?
Clayton Foutch (10:04)
Well,
I think it's two-part and I'll answer the question more directly next. But I think it's explaining to referral partners this story, this why. what's unique about us is this unique story. And I work with a lot of great agencies in Oregon that have different stories and great franchise owners that have yet other stories. But that's the only thing that really makes us unique is our story.
What brought me here? Why am I doing this and why should you care? And I think when you look at the profile of where most families kind of funnel through when they're making a decision about where they're going to live, how they're going to do that, it's hospital systems, it's skilled facilities, it's home health and hospice organizations, it's a...
group of other organizations that are helping influence families on what the options are. And most of them also are, this is female centric. So I think the people I began sharing the story with, which at first I never would have shared, because I would have always not wanted to, I wanted to say I a great school, which I didn't. I was a star athlete, which I wasn't.
I just didn't know where I fit in. But the reality was when you explain your why and that you're here to serve this population of women, primarily single, primarily raising children by themselves, primarily, and that we're building a business that is nurse led, leveraging technology and innovation. I think the discharge planning teams and social workers and case managers and nurses
hear that and there's some part of them that goes, we do need someone like that. And yeah, ⁓ it cost a few more dollars to Mildred. So it's not for every Mildred or Walter. But for those, I'd rather work with an agency like this that's taking those incremental dollars and pushing that right to the caregiver and serving that part of our workforce and that part of our community.
Miriam Allred (12:16)
And I'd imagine you've had success with this. sounds like this has been your approach and you've taken this out to these referral partners and they are receptive to it. Is that accurate?
Clayton Foutch (12:23)
Well, yeah, and it's not where I started because I didn't know this business. I started with a story about my grandfather, which was 90 % true, but it was a little bit manufactured, like what brings me to this. knew there needs to be a story, and I was close to my grandfather, but it's not what led me to business. And it's not what led me to this business. But within moments of meeting the people who provide the care, I'd
outside of my mom's Irish, they look like her. They're doing everything. And I know how hard it was for my mom. And I felt a real connection to them. I know what it meant when gas goes up 10 cents. We make different decisions. I know what it means when the price of chicken goes up. It means we make different decisions. And so I felt a connection.
So that opened up a window for me to work with families that could afford to pay even a premium on an already expensive service. The next thing I thought about though was I think the question which is how do you, there's a lot of families that also need and want care that don't have the money for the median cost or the low end cost, let alone a premium cost.
Over the last four or five years, we've really begun thinking, how do you serve the rest of us? Because the people we typically serve are the 5 %ers. Not very many people in a market where the cost is $40 or $45 an hour that need eight hour or 12 hour or 24 hour care have a burn rate of
10 grand a month or 20 grand a month or 30 grand a month. So if your whole business is based on 5%, it's okay. I think you can build a nice niche business. But at some point, I think most of us look at the rest of us, which I fall into the rest of us and think, how do you take care of them? How do you work with veterans? How do you work with economically
fragile and medically fragile seniors. And isn't that also part of our mission? And it tied me back to this mission of serving our caregiving team who is economically fragile. And that put us on a quest to find innovative technologies that could give us insights into care and how could we use that to augment
this high cost because if you pay attention to anything, you know we know that there's not enough money and there's not enough people to do the work. And so if those two things are true, there has to be other ways to address that and fill that gap.
Miriam Allred (15:20)
get into that a little bit more. It sounds like you all are tapping into some technology to augment and supplement the care in the home to offset the costs. ⁓ What have you guys tried? What's working?
Clayton Foutch (15:30)
Well, we've tried a lot. My partner, Jeff, really smart. Our COO, Heidi, really smart. We've looked at probably 40 different emerging technologies, tested and trialed probably four of them formally. So we see some good things in like wearables and good things in like sensor technology.
what we've learned, some interactive technologies, tablets, all things that can provide a lot of good information about the client and the caregiver compatibility and what's changing with them. But I'd say for anyone listening today, the real magic is passive systems. Because if we have to do anything, if Miriam has to push it,
Wear it, charge it, step on it, log it. We're really good for like a couple of days.
Miriam Allred (16:25)
The slow burn, the slow fade.
Clayton Foutch (16:27)
And for anyone listening, you go back to last January's New Year's resolutions and then just go around President's Day and look at how many of those we've already stopped. Log in our caloric intake, our water consumption. The gym. Yeah, the gym. And so what we've learned is passive systems are really the key. And there's some great ones. There's some great ones that are...
on the market today. I think Sensi is probably the leader in this space. I don't think they're the leader in this space. It's a great passive system. It's audio based. There's some challenges. There's some objections about audio based technology in our home. Three years ago when we launched with them this product, I thought we would have more challenges, more resistance. ⁓
Miriam Allred (17:11)
more resistance.
Clayton Foutch (17:14)
I think because we have so many aging adults with an Alexa, with a Siri, smart watches, there's less resistance than I anticipated because we have these types of devices that we've become more comfortable with. I think that there's still probably 25 % of the people we introduce this to say, I don't want that, I don't need that, or I'm not comfortable with that.
Especially if you think of how many families are dealing with your question, which is cost. One way to address that is mom moves in, grandma moves in with mom and the kids. And so you have this multi-generational home. Audio-based technology in a multi-generational home isn't very effective. Too many sounds, too many different cadences. But there's a lot of other technologies, sonar-based, radar-based.
Musk is building a smart home. I wouldn't bet against that guy when it comes to building things that are for the future. And when I think of those types of systems and this growing tsunami of people that are aging in, as we heard from the keynote, there's more of us over 65 than under 18. And so tech companies used to focus on other demographics. Tech companies are now
seeing not only is this a fast growing population, but it's where the wealth of America is. So it's a win-win for smart companies that are solving these problems. And that addresses this huge challenge of $30,000, $20,000, $10,000, $5,000 of care a month to have in your home. How do you make sure that mom's still safe and
Those are some of the things that some of the smart brands and smart owners are really leaning into. And Miriam, you've been on the front line in an agency. You know, when you go to a discharge planner, you talk into a social worker and they say, I already work with someone else. I have a great relationship with the right at home office. So there's not room for another home care company. If that owner could say,
Miriam, do you ever have families that are discharging that you know would benefit from care, but they don't have the money for it? Or they would benefit from care, but they're not comfortable with someone being in their house. That's 75 % of their discharges. To be able to say to that person, I have something to talk to you about, I could maybe fill a brand new gap that you didn't even know existed, and we might be able to help some more of your discharging patients. And...
six months from now, a year from now, 18 months from now, be able to show you what impact that made on your readmission rates or your length of stay or your census, whatever's important to that organization. And we've really begun focusing on that type of value to our referral partners in a way that we just couldn't before technology kind of enabled these conversations.
Miriam Allred (20:23)
It's just so fascinating. think home care is going to look pretty different in three to five years because a lot of people like you are just rethinking, reimagining home care and bring in technology, bring in like holistic approaches. Like it's, all going to evolve into something that we don't quite know, but I think it's going to look pretty different in just a handful of years. The personal touch will stay the same. The home care, the core will stay the same, but there's just kind of like this growing like ecosystem of tools and resources and technology around the care.
And I think that is going to just create kind of like this reshaped home care.
Clayton Foutch (20:57)
I think that's the key is that the bedside manner, the connection, the relational part of our industry and business, that doesn't change. The caregiver caring for someone that needs their help, that doesn't change. I think what changes is the tools and resources. I think most of us get into healthcare because we have this vision of helping Mildred.
helping this fragile person. But what we learn is that so much of what we have done has been reactive. We're reacting. We mostly get introduced to her after a fall. We mostly get introduced to her after daughter sees some real cognitive... it's very reactive. And I think seeing the potential of being proactive for people who really care about outcomes...
This is a side of the coin we never got to see before. And being able to actually prevent something negative or harmful to someone that we are caring for has so many wins. Win for the client, the family, the business. It's hours and consistent hours for the person providing the care. These are the things that we haven't even scratched the surface on what's possible.
Miriam Allred (22:17)
Yeah, it's good to hear that because I agree. mean, here we are at HCAOA with all of these vendors, all of these companies. And I think, yeah, we're just warming up in a different way. Like there's kind of this next wave and it's early days with AI, it's early days with technology and there's a lot of tinkering and a lot of cool things happening, but it's still very early on and time will tell like, how this all like flushes itself out.
Clayton Foutch (22:37)
Yep, I agree with you.
Miriam Allred (22:38)
Clay, this has been fantastic. Great answers. Thank you so much. You made it easy. You're a natural. This is You were born for this. Thank you so much. We'll go ahead and wrap here. But thank you for joining me here at HCAOA in Dallas.
Clayton Foutch (22:50)
Thank you, Miriam.
you
Miriam Allred (23:07)
you
you