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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 (00:08)
Welcome to the Home Care Strategy Lab, live here at the Home Care Innovation Forum in Palm Springs, California. Thank you to Phoebe, our sponsor of the podcast. And I am here with Brady Schwab, the Chief Growth and Strategic Operations Officer at Right At Home. Brady, how's the conference been?
Brady Schwab (00:24)
Great conference. Love love this conference. It's just great energy. the collegiality, the the you know, forward thinking, really innovative, outside the box. Some of our speakers yesterday were just ⁓ Dr. G was great, kinda thinking about how our our homes and buildings affect our health. It's just it's just nice to step away from the day to day and and ⁓ be around such such great leaders and thought leaders, it's awesome. I always feel more energized leaving than than when I arrived.
Miriam Allred (00:54)
That's what everyone has said, energy. You feel this like excitement and this motivation to like take this energy back to our businesses and accelerate them. And the the theme of the conference is innovation and AI and so that's what we're gonna talk about. But before we do, why don't you introduce yourself briefly for those that don't know you or your background, give us a high level
Brady Schwab (01:09)
Yeah. So ⁓ my background's actually in hearing health care. So I started my career as an audiologist. ⁓ so ⁓ you know that took me from from clinical work to more on the on the business side, so working for ⁓ hearing aid companies and integrated ⁓ hearing organizations. So did all kinds of things in the hearing healthcare world. ⁓ and it was always really around the the service of seniors. So that that's kind of the through thread of my career. ⁓
And you know, the opportunity to to engage with folks going through the aging process and the relationships around that has has always been resonant in what I what I do and found my way to to Right at Home and home care and and franchising. So it was it ⁓ my my career's always been this intersection of business, healthcare, ⁓ innovation, ⁓ clinical operations. So it ⁓ it's been a great fit, ⁓ a great
just a great industry. I I just love the the folks in it. I love the mission ⁓ and the impact that we get to have. So ⁓ that's what what has has brought me to home care and now in in Omaha, Nebraska as part of the Right at Home team it's it's it's been a whirlwind and I I just I love what I d get to do every day.
Miriam Allred (02:25)
How long have you been at Right at Home?
Brady Schwab (02:27)
So I'll
celebrate four years in October. ⁓ and ⁓ yeah, love loved every minute of it. The the the team, the the leadership team there is just fantastic.
Miriam Allred (02:36)
lot of growth in the last four years. I mean I think all of these franchises are kind of on these rocket ships and so I'm imagining in the last four years there's been a lot of growth. Can you kind of explain where you guys have come from?
Brady Schwab (02:46)
So ⁓ you know, we're we're just shy of six hundred franchise locations ⁓ across the US and and four countries internationally. ⁓ you know, our our footprint growth grow footprint growth continues to expand. ⁓ and and that's important. ⁓ and and the interest in the brand continues to to grow. ⁓ but our our same store unit sales continue to grow. We we really
you know, want to have impact in every single community that we're in and we still feel like even after 30 years, there's a lot more communities we can we can help support. ⁓ and then just the way home care is continuing to evolve and woven more and more in the care continuum. We're just really excited and bullish on the future and ⁓ for for us it's all about impact. That growth just means we're helping more and more families.
Miriam Allred (03:34)
And you're all focused on non-medical home care. At this conference there's a lot of home health and hospice and pediatric and OT we've heard there's a lot of variety here in different verticals. You guys are non-medical home care primarily, or are there other specialties that you guys focus on?
Brady Schwab (03:48)
We do a a little bit of skilled from an innovation perspective. We're we're really looking at how do we bring technology into our care. we're we're participating in a clinical trial around a C O P D detection device or or exacerbation detection device. So ⁓ you know, we we think our kind of ⁓ core offering ⁓ is is still really valuable. We we thought about, you know, should we diversify and how could we build these these synergies? At the end of the day.
It just comes back to all the opportunity that we have to have the impact in in what is our core business. So I think we're gonna stick to our knitting ⁓ around that. ⁓ and and you know, all of these conferences it's it's always fantastic to see what home health and hospice is doing. ⁓ but but I I we really like where where we operate today.
Miriam Allred (04:36)
And I respect that. I think a lot of companies get to these ⁓ like forks in the road and they decide, you know, do we have to diversify? Do we kinda go and chase these other paths? But I think to stick to your core is really smart strategically. And then like you said, there's so many ways to just innovate and improve efficiencies operationally and clinically in home care, and that's what you guys are after. So the premise of this conversation has been a lot about AI. But something that you and I have talked about is in order for us to be successful with AI and kind
Of where all this technology is headed, data integrity and data hygiene is really important. And so I'm curious your take at both the corporate level and even at the franchisee level. How are you thinking about like data collection, data management, and data hygiene and improving that to help us be successful in this AI era? That's a loaded question.
Brady Schwab (05:26)
yeah. ⁓ so you know, it it's interesting, you know, going back to to, you know, clinical work and and scientific method and you know, I'm just kind of a how do you know kind of guy, right? So ⁓ good, bad or ugly, you know, I w I wanna see kind of the the data behind it. And as I think about ⁓ in an an AI changing so quickly, you know, what we can do, how we can get to better answers and and clarity, ⁓
that need to have the AI or the data infrastructure just i it it's more and more important. There's a you know great line around d data has the the ⁓ data data ultimately humbles us humbles humbles us all. And the the notion of course is that once you start measuring things you get to see how well you're really doing. Now we're being humbled by the quality of our data and you know what what did we think we knew, what did we think we had a good handle on, because at the end of the day
AI's just a an amplifier of that. And AI is not gonna fix a messy operation. It's it's going to, you know, turbocharge it. And so we've been really on this ⁓ crusade ⁓ around our our data integrity as we think about different systems and just the decisions that we wanna be able to make and if we don't have good data, ⁓ the the confidence that AI brings to a wrong solution or wrong answer is is is really
it's dangerous and it can be kind of a that bad data becomes a contagion as those those answers continue to ⁓ grow throughout the organization. So so that's what we spent a lot of time thinking about and and trying to you know bring that governance layer, that ⁓ that clarity, that hygiene ⁓ to the to the data that's ultimately gonna power our AI solution.
Miriam Allred (07:13)
The tricky thing is we don't know what we don't know. And so finding the gaps in our data and in our documentation, these businesses, we've all been doing things a certain way for so long, and so it's hard to like break out of that mold and step back and identify where the gaps are. What are some of the gaps that you've identified, especially at the franchisee level? What are some things that you've like unearthed gaps that they that will affect this and that you're trying to like solve for right now? Yep.
Brady Schwab (07:39)
So it it can be anything from, you know, just just referral source tracking to caregiver preference and availability and and you know, these cascading issues around how do we make these decisions when we ⁓ you know, don't know what referral sources we need to lean into. When we see caregiver churn and find out that ultimately it goes back to, you know, we we didn't have good understanding of their avail availability of preferences and ⁓ it it it just kinda ⁓
eroded our our operation around these these key aspects. it it's at the end of the day, you know, generally it it comes back to the workflow. There's a broken workflow there. And I you know, I tend to have this bias maybe ⁓ that when when something's broken I assume it's us. It's it's something we didn't design well. It's something that ⁓ we we created confusion or lack of clarity around. And that's
causing somebody to to struggle in their role, struggle in their job. So I I I I tend to to go right to the workflow, right to the process to understand, okay, why aren't we getting the result that we're looking for?
Miriam Allred (08:47)
Think of the clinical documentation that the caregivers are inserting. That is like the most important information. You talked about all of this kind of like operational data and I think a lot about that, but I also think of like the clinical documentation layer, these caregivers inserting the notes and like the richness of those n the notes or the lack thereof. How do you has that been a struggle? Getting these caregivers to insert really, really rich notes and then doing that at scale? Yeah.
Brady Schwab (09:14)
Really good question. And and you know, two years ago, just thinking about gosh, you know, how do we how do we structure our data? You know, that that's going to be the big challenge. And now with the the speed of the models and what they can do, you know, that's really kind of fallen away and it's it's become much more of that as as you put, you know, how do we get more richness in our data? And I I think in in our business, ⁓ the incentive hasn't always been there, whether it was
⁓ because we're primarily private pay. So you know the insurance information isn't as critical for us. And ⁓ we're non-clinical, so maybe there's these things that we think, well, you know, should it go in the documentation or not? And now it's there's so much information, there's so much experience that our caregivers have in the home that ⁓ can be valuable to us and help us make better decisions. How do we how do we support them? How do we make the incentives align around all
that so that richness does get ⁓ added to the to the the documentation and you know really bullish on up at least personally I find kind of the voice to text and the ease of that and the ability to conversationally bring a lot more of that in and then have AI support it making sure that it's coherent and that we can we can surface those those details later. I think there's there's also a tendency, you know, we're a really curious organization
You can go too far and you know, we wanna know we want all the data so that someday maybe we're gonna wanna do this one thing. ⁓ I think we have to be be careful of that as well.
Miriam Allred (10:44)
You mentioned COPD. There's all of these diagnoses, and I've talked to a lot of companies actually this conference that are looking deeper at different diagnoses and working towards like predictive analytics about diagnoses for clients. And so if you give it enough information, data over months, over years, over weeks, give it all of that information, and then it can start to predict like health outcomes. And that's like mind-boggling, but it's like we have the ability in home care to gather enough information with obviously the vitals and things, but then all of that.
qualitative data that the caregivers are inserting, put that together in a picture, we can predict all sorts of things. Yeah.
Brady Schwab (11:21)
And and and we're there, right? We we spend so much time with with our clients and y you know, there there really isn't anybody else in the healthcare continuum that gets to spend that much time. And and I think about even back when when I was a clinical audiologist and you'd see couples come in and just, you know, they wouldn't look right or you know, you you could tell that ⁓ the the the caregiver of of the couple was, you know, was really struggling. ⁓ and and
You know, similarly, how do we how do we take that information, make it actionable? You know, our our caregivers may not necessarily be in a position to, you know, call the physician and and share that information, but but they can see what's happening and and when folks are having a a downward trend. So you know, can we surface that through the data? Can we enable our caregivers to to be more empowered around all those things? I think that's just gonna increase our contribution to the to the longevity and and support of
of our aging seniors. So I I I I I'm really bullish on that. ⁓ but we we've got to connect these dots to that that good data and then the the workflows to make sure that it's actionable.
Miriam Allred (12:31)
And you said it a minute ago, incentivizing the caregivers to understand the outcomes, like why all of this documentation is actually so important. And sometimes I think it's easy for them and for us to lose sight of that, of it, it's just this manual work, the the part of the job that nobody likes to do is all of this documentation, but giving them a taste of the outcome of what we can do with this information and bringing them into that journey so that they can see the value.
Brady Schwab (12:58)
Yeah. And and you know, they they they're caregivers. They care so much. They they become a part of these families. And you know, if we can ⁓ connect them to that opportunity to make that impact, I I I I I think it will it will it will change a lot around the the role of caregiver, the you know, it's really tough and they wanna have impact and and connect them with that opportunity I think is is really, really exciting.
Miriam Allred (13:26)
Can you share a little bit more about the COPD pilot that you just mentioned? If you're at liberty to share just what you're what you're trying to accomplish and what the outcome you're hoping for.
Brady Schwab (13:34)
So there's a a company called Respir-AI and the technology came out c came out of the University of ⁓ Nebraska, Omaha. So it's a some ⁓ synchrony and asynchronoc asynchrony between a couple biomarkers and it's in in the pilot it's just a chest worn patch that that monitors a a couple vitals and ⁓ the early evidence is we can get ⁓ between five and seven days early warning around the exacerbation of a C O P D condition.
⁓ and it's it's one of the leading causes of hospitalization. ⁓ repeated exacerbations has a h really high mort mortality rate and you know we're we're thinking about how we can be in that more of that predictive sort of part of the the the care continuum. We're we're we're not gonna be clinical, we're not gonna diagnose, but we think with those folks that are living with these chronic conditions, if we can be that tech enabled arm, ⁓
We we have all kinds of opportunity to really have have an impact on, you know, again, folks just trying to to to live a ⁓ safe, secure, healthy life at home.
Miriam Allred (14:40)
Doesn't just get you so excited? Honestly, just hearing you say that we're obviously we love this stuff, but just just the possibilities with home care. I just think of all of the qualitative data, the quantitative data, remote patient monitoring in the home, these types of opportunities. Like once we can string all of that together, like we're really on to something. I feel like every company's kind of like piloting and testing and figuring figuring these things out, but it's like we're gonna we're gonna string together some really powerful technology mixed with incentives, mixed with just all of this, and it's gonna turn in
to something and I just I'm young and I just think of like where home care is headed, like I'm excited. The next five years, ten years, I feel like it's gonna look similar. The heart of what we do is gonna stay the same, but wrap around all of these innovations and all this technology, it's gonna look different but in a really good way. Yeah.
Brady Schwab (15:27)
We're we're really lucky ⁓ because of the s the support that we have and our our franchise system. You know, we we can take some swings at things and and try stuff and and and invest over a longer period of time. And you know, we we s I I I don't think we had it on our bingo card to be part of an FDA, you know, clinical trial or on a med tech device a a couple of years ago, but we're we wanna be opportunistic, we we wanna take swings. The the tech enabled care is is
you know, we're just fascinated with that and and AI being able to take that data and integrate it into, you know, our our traditional approach. we we think the sky's the limit. We don't know what it's gonna look like. We we we think it's gonna be a multi point solution. ⁓ we we think the the expectations my my my parents are ⁓ early eighties and our average clients eighty three, eighty four. I I my parents are very different than the folks that we're caring for now and their expectations around technology and
comfort with it. And and yet we we always have to step back and be really respectful about privacy and and you know what that design thinking approach of being really empathetic to you know somebody like my mom. What what will she expect? What what is is simply unreasonable just because we would like it. I think ⁓ we love that opportunity to play in the space.
Miriam Allred (16:49)
How are you thinking about change management with your franchisees? This is a lot. This kind of like this AI whiplash. And you have a large sample size, 600 locations, all of these different owners and they all have different backgrounds and some of them are more tech forward and some of them might be a little bit more behind. How are you handling change management and trying to get everyone kind of on the boat? Yeah.
Brady Schwab (17:11)
it's a it's a it's a it's a day to day battle and and you know, we we have fantastic franchisees and you put on a bell curve, you know, we've got our early adopters and our innovators and and our our laggards and you know, ⁓ I I think always starting with this is their livelihood. This is how they they provide for their family and provide for their staff. we wanna be really respectful of that and yet there there are those that will always run faster than us and you know, we wanna learn from them and
We have a really good relationship and and feedback loop with our our leadership council around what's working and what isn't. We have task forces around all of our strategic initiatives. ⁓ so we we get a lot of that feedback. AI is moving so quickly. And ⁓ you know, trying to keep our arms around starting with just governance, you know, who who from a BAA, PHI, you know, who who has their ducks in a row around that as as the the first cut and then you know
we as as different point solutions are ⁓ being used in the franchise network, how do we get that data back? What's working, what's not working? ⁓ but we we have folks that that will move quickly and and we'll learn from them. On on the other end, you know, there there are those solutions that we're gonna have to bring and help with the implementation. And from a change management perspective, I I think it's it's always about, you know, why we can't stay here.
Don't get too sunny about what what is ⁓ you know, the opportunity, but why can't we stay here and and how do we get to that next level and and what might li life look like, but don't oversell the the transition and the the pain that will come with that. But you know, at at some point we do have to move forward. The the world moves on and we have to move with it.
Miriam Allred (18:55)
Let your mind kind of run into the future for a minute. What what do you want care to look like in I don't know, you decide ten years from now? Like if you really put your mind to it, you think of your own parents, like what are you hopeful to see in the not too distant future?
Brady Schwab (19:11)
I I from a home care perspective, I I always think about, you know, how can we be the glue in the seams of of care? And, you know, our our presence in the home and and the consistency of that, plus a a really intentional data approach, you know, how can we have eyes and ears on what's happening? Because we're we're not gonna be able to provide care in the way we have, ⁓ on a on a one-to-one basis, you know, twenty-five hours a week.
We're we're going to have to be much more nimble, we're gonna have to be more responsive, we're gonna have to have predictive analytics to know w when when do we need to be there? When when maybe ⁓ can we can we lean away and maximize our opportunity? You know, some of the conversations yesterday around communal living and, you know, some of those things that are h happening or have happened in Europe for a long time, I I think are interesting. I'm not so sure it ⁓ culturally we're ever gonna to really adopt that, but
⁓ I I just think on an average week we we support about twenty three thousand families. Yeah. It's just not enough. There's there's just so much more that we could be doing. So we're gonna going to have to solve for affordability, we're gonna have to solve for availability, we're gonna have to solve for chronic conditions. ⁓ and and I think we're at the perfect position, the perfect place at the intersection of all of that to to be really impactful. So I d I I I
it it's moving so fast that, you know, that three year view, you know, keeps keeps changing.
Miriam Allred (20:44)
Yeah, and this is a blanket statement, but we just need everyone thinking about home care. Yeah. You know, we just need I think of this sandwich generation. We talk a lot about them right now and we just need to keep empowering them to understand, you know, their parents' journey and w what's happening in home care. We just need everyone thinking about and talking about senior care. And I feel like I feel like we're actually moving forward on that front because people are living longer. Health is a big topic in our country right now and we just need to
make it more of a everyday conversation and all everything that all of us do is just like moving that needle a little bit and I think we really are getting somewhere.
Brady Schwab (21:22)
And
and I don't think human nature around planning for aging is is going to change. And I I I think we you know, we at times talk about, well, we just need to change the nature of that. I I don't think that's going to change. And I I say that as someone who's aging and ⁓ not doing those things. So ⁓ I I think w we're going to have to be responsive and and you know, the the opportunity just to bring up the the awareness of home care is
you know, evident every single day. So I I love talking about it. It's it's where care is, it's where care wants to be. ⁓ and we're excited to be a part of it.
Miriam Allred (22:00)
Brady, thank you so much for joining me live here in Palm Springs at the Home Care Innovation Forum. This has been fantastic. Thank you so much.
Brady Schwab (22:06)
Appreciate it.