June 22, 2025 • 28 mins
Angel Abrego is transforming home healthcare with a revolutionary approach that combines hands-on care with cutting-edge technology. As the founder of Elite Premier Nursing Services, Elite Infusion Services, and Elite VCM, Angel has built a comprehensive healthcare ecosystem that serves clients across South Florida with everything from traditional caregiving to holistic IV therapies and innovative virtual monitoring.
What makes Angel's approach truly groundbreaking is his use of non-invasive AI technology that can detect subtle changes in clients' health and behavior patterns without compromising their privacy. Unlike camera-based monitoring systems that many families resort to, his smart home technology can identify potential health issues like UTIs or pneumonia before they become emergencies, while preserving seniors' dignity and independence. "When I get to that age, I don't want somebody videotaping me," Angel explains, highlighting the compassionate thinking behind his tech solutions.
Angel's journey began at just 18 years old when he started working as a caregiver despite initially wanting to be a doctor rather than following his mother and grandmother into nursing. By 26, he had founded his own agency and was on his way to building what is now a multi-faceted healthcare organization serving clients from young adults to seniors. His core belief that "the future of healthcare is in the home" drives everything from his innovative IV therapy services to his pioneering approach to short-shift care.
The "Uberization of caregiving" is another area where Angel stays ahead of industry trends. Recognizing that today's clients often prefer on-demand services rather than traditional 24/7 care, he's developed a successful model for providing quality short-shift care by specifically recruiting caregivers seeking flexible hours and charging premium rates that make these arrangements sustainable. When combined with his virtual monitoring services, clients can receive just one or two hours of in-person care daily while enjoying 24-hour oversight at half the price of round-the-clock caregivers.
Whether you're exploring options for aging in place, seeking preventative wellness treatments, or looking for innovative care solutions that adapt to your family's unique needs, Angel's visionary approach to healthcare shows us what's possible when compassionate care meets cutting-edge technology.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
My name is Angel Abrego.
I'm the owner of Elite PremierNursing Services, elite Infusion
Services and Elite VCM.
We have been in business forabout 11 years now.
We cover South Florida, palmBeach County, treasure Coast,
naples up to Sarasota.
Speaker 2 (00:16):
Sounds to me like you're a busy guy.
Oh yeah, floran, I appreciateyou taking the time to educate
all of us about what you do andwhere you're located, so that
people know where they can go toget services in South Florida.
So why don't you tell us whatgot you started in the home care
industry?
Speaker 1 (00:36):
I started to be honest with you ever since I was
a child, actually since I wasabout 14 years old.
I wanted to be a doctor, but mymother was a nurse and my
grandmother was a nurse.
So by trade, I naturally wasrebellious against that and said
I had no business wanting to bea nurse.
I wanted to be a doctor.
But, life being what it is, Iactually was always geared
towards nursing.
(00:57):
When I got my nursing degree,actually right out of high
school, I went to a vocationalprep school which had pre-med
and nursing as specialties.
So I got that right out of highschool, started working as a
nurse right at 18 years old.
I started actually as acaregiver because some agencies
were nervous about putting an18-year-old nurse on the floor.
So I started as a caregiver forabout a year until they
(01:18):
transitioned me into a nurse.
I started working as a nurse.
Then I opened up my own caremanagement company and worked
that privately for a couple ofyears before I launched my
agency and was actually one ofthe youngest in the state
history in Florida at the age of26.
Opened my private duty agency,which has now morphed into a
healthcare ecosystem of what Iam building.
(01:39):
So my passion has always beento revolutionize healthcare.
It is the foundation of ourcompany and we have done that
ever since.
We've been around for 11 yearsnow.
So we specialize in privateduty, home health, medicare,
medicaid, and for the last threeyears have been doing hospital
at home, virtual hospital athome, and now we're getting
(02:00):
ready to launch our nationalprogram, which is virtual care
management and taking thatnationwide.
Speaker 2 (02:06):
Wow, that is a tremendous amount of work on
your part and such a great.
I love it that you're in allthe places so people can come to
you for anything, and you gotit covered.
Maybe hospice.
Speaker 1 (02:21):
That's in the future.
That's in the future.
My main thing is.
The future of healthcare is inthe home.
I've been bedside and privatemy whole life, so me knowing
what my clients want, what theyneed, the complexities of what
the industry is.
It is not like every otherspace.
It is very unique and there's alot of things that we can do in
the home that now people arestarting to wake up to and
(02:42):
realize like we can do the IVinfusions.
We were able to do those in thehome that now people are
starting to wake up to andrealize like we can do the IV
infusions.
We were able to do those in thehomes for so many years now.
Now it's starting to take off.
Holistic IVs is something thatwe do as well around here.
Me, the way I tell people Ipretty much push the care
continuum forward from gettingclients that are younger age 18,
19, 20 years old and some of myseniors that do a lot of these
(03:03):
vitamins that they got to take.
The bulk of the medicationsthat they take are vitamins.
I'm like, hey, I can infuse youwith two of these vitamin IV
infusions twice a month and I'mgoing to get you 100% purity
versus you taking those vitaminson a daily basis and trying to
wolf down horse-sizedmultivitamins.
Speaker 2 (03:21):
Okay, so do you infuse NAD?
Oh, okay.
Speaker 1 (03:24):
So do you infuse NAD?
Absolutely, we're actually inthe forefront of that, working
with a detox company.
About six, seven years ago wegot introduced to NAD when it
was actually specialized and youactually had to go to a course
in California in order to learnhow to do that.
So we were lucky enough to workthrough that vicariously
through a detox company.
We got put onto it, we startedlearning it and then helping
(03:46):
other people.
Now it's everywhere now.
Now you can just get theinjections.
I'm a huge proponent.
As a nurse, I tell everybodyalways opt for infusion and
injectables as much as possible,because a lot of people don't
take into account the liverbypass aspect of taking oral
medications.
Speaker 2 (04:01):
Wow, yeah, that's crazy and so awesome and I'm
glad to hear that the IVinfusions aren't just IV
antibiotics and things like that.
It's definitely you're doingthe preemptive stuff, helping
people avoid all of thesediseases and maybe some
hangovers in South Florida inSouth Florida.
Speaker 1 (04:29):
I look at it as a large research of my own.
If I'm getting clients in their20s and 30s, if they regularly
take these vitamin infusions bythe time they turn 70 or 80, or
we all do together at the sametime, I'm curious to see how we
end up in terms of the healthspectrum and whatnot by the time
we get to that age.
Speaker 2 (04:42):
That is going to be a great study to, at least, even
if it's just up here.
Oh, I've known that girl sinceshe was 20 years old and she's
looking pretty good still for 50, 60 years old.
Speaker 1 (04:54):
Oh yeah, oh yeah, you factor in peptides too.
It's a whole nother gamechanger.
Speaker 2 (04:58):
Oh my gosh.
So do you do all this stuffyourself, just out of curiosity?
Speaker 1 (05:02):
Yeah, yeah.
The whole of my company, myteam, have an amazing team
behind me.
Everybody sees us out and about.
We were known for traveling.
Speaker 2 (05:15):
We travel with a large group wherever we go.
Yeah, okay, so you have coveredthe entire gamut.
Now I'm going to guess.
Oh, let me ask you this.
I don't, I'm not going to guessat it.
What about pediatric?
That's medical care.
Speaker 1 (05:25):
So that aspect we have explored it.
My chief growth officer hasmentioned that several times.
We're gearing in that directiona little bit.
I'm not really looking to thefull fledged on that, just a
personal thing.
I've worked always with adultsand geriatrics.
But in terms of our program,vcm virtual care management it's
(05:45):
a lot of hospital at home.
So we're bringing this at homeand then taking it into not just
acute care but high acuity careand being able to continue that
care afterwards once they gethome from discharge.
So our program I have a team ofnurses.
We virtually manage patientsonce they get home and get
discharged from the hospital sowe can set them up.
On cardiac monitoring, so wehave a tele unit for that we do
(06:07):
at home.
We do ECG monitoring at home aswell as the regular vitals
things like that.
But we take it a step furtherin the fact that we actually
bridge the gap right so we cando telehealth conferencing
through there.
Telenursing for us is huge isthe future.
So pediatrics actually plays areally big game, a big piece of
that in the future as well,because we have certain things
that we can set up, like skintemperature monitor tags that we
(06:29):
put on patients, so we can getthat blood pressure cuffs.
The neonatal ones are super,super small.
For me it's a personal thingfor me.
I want to make sure that I'mable to take care of everybody,
but at the same time I know thatI can't take care of everybody.
That's just the nurse in me.
We just don't want to back down.
But pediatrics is a whole newfrontier.
I see that taking off a lot inour industry now.
Speaker 2 (06:51):
Oh yeah, absolutely.
But let's just think about thisYou're in the most competitive
market in the United States,maybe second only to Manhattan.
But pretty much you guys arefor South Florida as far as
seniors and folks that are therethat are retired and folks of
all ages, of course, but oursenior population obviously
loves to live in Florida whenthey retire or their snowbirds
(07:14):
going back and forth, so youhave a huge population to serve.
You're in the most competitivemarket in the nation and you've
done extremely well in thenation and you've done extremely
well and being able toadequately serve all of your
non-medical clients, as well assome that need some medical
assistance on the adult side.
I think that's a week that's alot and you are not very old.
Speaker 1 (07:38):
No, it's not.
It's a lot.
And we enjoy the challengethough, because, like I said,
everybody that works here wehave the same vision.
I don't hire people here justto hire bodies.
We hire people that align withthe vision as well as an owner
like where can I take you onyour career?
What is it that you're tryingto get to, and how does that fit
into our big picture of wherewe're headed?
(08:03):
The virtual nursing, tele-woundcare, teletherapies at home,
people that qualify for that,things that's the next frontier
for us and that's what we'vebeen able to specialize.
So when people tell me I'm in acompetitive market, I'm like
nobody has what I have built,nobody has what I am building.
They're going to catch up inthe next couple of years, but by
the time I've already, I'malready three years in the game.
Speaker 2 (08:18):
So Great, that is a great attitude to have and what
a great business.
Mantra Just keep going.
If it's coming our way, keepadding it on.
And that is so.
Maybe an adult child of anaging parent and they're looking
for care and they call theoffice.
What can somebody expect whenthe person at your office
(08:38):
answers that phone?
What?
Speaker 1 (08:52):
happens.
So once if a person calls us,the first thing we're trying to
find out is number one, and Ialways call these because my
team knows we call them thediscovery call, right.
So I tell them like what is itthat the client is looking for,
right?
One thing where I feel mostagencies fail at, because, like
my right hand, kathy will tellyou we have a goulash of
(09:13):
services, so it's like we havesomething for everybody.
But my big thing is I tell themmake sure you fit them in with
the right product.
So a lot of times they willcall you thinking I just want a
caregiver.
Sometimes it's beyond that theymight need a nurse at this
point, right.
Other ones are like I want tostart to explore this option for
the future for my mom, becausewe're trying to decide and plan
ahead Are we going to do ALF?
Are we going to do home care?
(09:34):
What's the cost?
Look like.
A lot of times I get clientsthat call me and they're like,
hey, you're like I want to getmy mom started.
We just want to do one or twodays.
Like we just want to slowlytransition her, which you'll see
that a lot in our space rightnow the short care model is huge
a lot because of financialissues and things like that with
the country, which is whythings like our virtual care
management program is so massive.
(09:55):
I tell people we can start yourmom in just a couple of hours
with in-person and then weremote monitor 24-7.
So we have things like AI audiocare pilots that listen to your
mom in the house forconditional changes.
We have a lot of AI tracking inthe home.
So a lot of this stuff scarespeople sometimes when I tell
them.
But it's actually reallyamazing to be able to say your
(10:15):
mom's at home she maybe isresistant to the care, right,
but for my system to go in and Ismart home your home and I can
say hey, mom says she doesn'tget up at night, but we noticed
she gets up between the hours oftwo and six every single
morning and that's where herfalls tend to happen, like she's
fallen but she's gotten herselfup a couple times now.
(10:36):
So it's a one slip away fromthe big one so I'm able to help
care, predict people now andtell them hey, mom's most action
is between 2 and 6 am, so youmay want to think about a night
shift.
Why don't we think about 11 pmto 7 am.
You have help during the day oryou're there during the day to
start to help families formulatean actual plan, like
(10:58):
everybody's done it in the past.
We've all had the paper sheetsthat we go over and just say
what does your day look like?
But most of your clients callme like I just want somebody
from nine to 12.
Get my mom up, get a breakfast,get going, all right.
So what happens outside of that?
Nobody really plans for thefuture.
So tell people let's look intothat and say, ok, what happens
when we're not here?
What happens if you fall?
What's the game plan?
Speaker 2 (11:19):
So it's amazing what you don't know, you don't know
what you don't know, and youfind out pretty fast.
Speaker 1 (11:27):
It is, but that's the beautiful thing about our
technology also is the fact thatit's non-invasive.
So I'm not utilizing videos oranything like that.
When I get to that age, I don'twant somebody videotaping me.
I won't feel comfortable.
I know it's great for the kidsand a lot of them are actually
doing that right now kind ofsetting up rings, booby traps
throughout the house.
They set up ring cameras inevery room and they watch their
(11:48):
mom walk throughout the house.
I'm like that's not a, it's nota good plan.
I'm like if she falls, ifyou're asleep at 3 am, you'll
hear the movement, but are youreally going to wake up to that?
It's a lot.
So I tell them let's do thisthe right way, because with the
amount of rings that they'repaying for, you literally
service and dome the whole home.
Speaker 2 (12:05):
I haven't heard that before I get it.
I see how that might be a good,like ring cameras all over.
Speaker 1 (12:11):
Oh, it's rampant.
Speaker 2 (12:12):
It's rampant down here I can tell you every other
day I'm running into that.
It takes a lot of time to watchthose videos, so something that
actually can sense that.
So what's happening is it's notvideo, but something in the
house is sensing activity andperhaps a fall, and so it's not
looking at the person, but itknows what regular behavior is
(12:34):
after a while and it knows whatirregular behavior is and it
sends alerts.
Speaker 1 (12:38):
Yeah, correct Exactly .
So like, for instance, if everyday you tend to wake up between
the hours of 5 am and 7 am,correct, and you were for some
reason, this day you didn'tthere could be something going
on.
That kind of prompts my team.
Unusual activity I'm contactingthe person at home and I'm
saying, hey, is everything okay?
If they don't answer, then weassume something may have
happened.
Or if they do answer, they'resaying they're just not feeling
(13:00):
well.
Other times they're getting upa lot during the middle of the
night.
Unusual activity they went tothe bathroom six times last
night.
Are we looking at a potentialUTI situation or is there
something elsegastrointestinally happening
that we need to be jumping on inadvance?
A lot of times too, for theAlzheimer's and dementia clients
.
Historically and this isinfamous, this is something I
(13:21):
actually love so much about ourtechnology is the fact that you
have clients that may haveAlzheimer's and dementia and
family members might not beconscious to how bad it really
is.
So I get that all the time fromchildren.
Mom sleeps through the night,she doesn't get up, but then she
may say the caregiver nevershowed up this morning at 7 am,
(13:41):
when really we do have now theability to say the person walked
through the door at 7 am butmom's been up since 545
screaming for help, so she'sconfused on her time.
It's not that the caregiver didnot show up on time, it's that
your mom's getting up two hoursearlier than normal and confused
.
So this is what's reallyhappening.
So when you're able to give thechildren those metrics, it
(14:01):
changes the entire dynamics ofhow we deliver care and, as well
, being able to have that extrabackup support for your
caregivers and for your team,because forever if we got those
kind of calls and we're likeyou're not showing up on time,
he's now can verify you a littlebit, but outside of that.
Speaker 2 (14:21):
It used to be like it's not working out.
You got to go and get anothercaregiver in there.
No, now you can say, okay,let's look at what's really
going on, because we know wewere there and that's nice,
that's great, that's life-savingcare and it's also, if you know
, here we could talk about thisall day.
But from the medicalperspective, you're reducing
hospital readmissions a lot bybeing able to identify these
problems.
Like you said, if the personwas up six times last night,
(14:42):
they either have something goingon with their tummy or they
have something going on withtheir urinary system.
They either have an infectionor maybe their tummy's yucky or
whatever.
I have kids.
Can you tell?
Are we looking?
Are they dehydrated now?
Do they need antibiotics?
What can we do to fix thisbefore it becomes a bigger
problem or something elsehappening that we need to know?
Speaker 1 (15:04):
about so absolutely.
And then, like I said, like theAI audio aspect of what we do
for me to be able to get a goodlisten in on what my clients
have like their main complaints.
I have clients sometimes thatmay say I can't sleep, I have
difficulty sleeping, but theynever report that.
You know.
When you call them and you'relike, hey, is everything all
right, how are you feeling?
I'm feeling great.
But then I got them on audiothe whole week saying I had a
(15:25):
horrible night last night.
I couldn't sleep.
I couldn't sleep.
And then you're like, okay, Iget this information, create a
whole care plan.
It allows my nurses to be verymuch proactive now and say, hey,
we've got this situation, let'shave this conversation, because
they're not telling us to ourface, but we hear it.
We hear the tussling, rustling,all of those things.
If they're dissatisfied aboutsomething, we can understand
(15:46):
that, but it's only healthcarerelated things.
We don't pick up regularconversation.
You can sit there and talkabout the Marlins or the Dallas
Cowboys or whatever you want totalk about.
We don't hear any of that.
It's just if you're coughing,which is huge for me when it
comes to pneumonia basis,because a lot of times a client
might be drinking water andcaregivers are infamous for
saying they just choke whenthey're drinking water.
(16:07):
The water went down the wrongway.
I'm like, no, this is thedevelopment of something else.
We need to get ahead of this,because they're going to end up
with pneumonia.
Then they're going to come homeon hospice and you don't want
that, yeah that's right.
Speaker 2 (16:18):
That's right.
You know what?
My nurse radar goes off when Ihear stuff like this.
I love it and I hope that morepeople realize the value of
having that AI and it does soundscary, I get it, but have
something listening andmonitoring the house just to
know if things are okay or ifsomething has changed.
(16:39):
I hope when people reallyunderstand the value of that
because I think they would be wehave a lot more adult children
who are very surprised at what'sreally going on at home and
most of our seniors are going tosay no, I'm fine, everything's
great, because they don't wantto be a burden to their kids,
they don't want to be a burdento anyone else and they just
they love their independence andvalue that.
(17:01):
So they're going to say I'mfine, there's nothing wrong here
, or it's just old age, but it'snice.
What you've got going on hereis amazing.
So I appreciate that.
And all right.
So somebody calls.
I'm going to rewind a littlebit.
Somebody calls, they get one ofyour folks on the phone and I
guess a lot of listening ishappening, and once you listen
(17:21):
to their story and find outwhat's going on, then it's about
putting them in the rightservice group and helping them
with whatever types of care theymight need.
Speaker 1 (17:31):
Exactly, and we do all that in person.
I send my team out to the homebecause they're my first eyes
and ears when they go into thehome.
To go into the home, they'reable to see the dynamics of the
home.
I do not like doing sales orclosing or any of those things
on the phone, just because youwouldn't know what I got going
on If I were to call a mechanicand we say this to a lot of our
customers when they call andthey want to get a price over
(17:52):
the phone, I'm like, hey, if Icall the mechanic right now and
I tell him, hey, my car's goingto do like how much, he's not
going to give you the price.
You know what I'm saying,because everybody that calls it,
it's the the.
It's not the truth right therewhen they call a couple of hours
of care.
She's fine, she does everythingon her own.
Speaker 2 (18:09):
She sleeps all night, and then you get there and it's
a whole different dynamicalmost yeah yeah yeah, the noise
of newt could mean fifteenhundred dollars worth of car
damage, or it could mean fivedollars it it could be a whole
range of stuff.
So, yeah, they got to look.
So in-home assessments andconversations are really what
(18:31):
it's all about.
And so in-home assessment orconversation happens.
And then how fast?
I'm going to imagine prettyfast how fast could you get care
started if somebody calledtoday, not an emergency, but I
would say like usually same day.
Speaker 1 (18:47):
I think the luckiest we've been is like within an
hour.
We got lucky, we haveschedulers for that, but the
luckiest been is about an hour.
I would say everything's alwayssame day.
We just had a call yesterdaywhere we had a facility that
called us that needed a patientto be serviced the same night
and it was four o'clock in theafternoon.
We got in there by 7 pm.
It all depends on how youstructure your team, how you
(19:08):
structure your scheduling andeverything else like that, how
fast you guys can really move.
Speaker 2 (19:13):
Yeah, and that takes a lot of organizational skill.
Your schedulers have to bereally good at what they do and
really believe in the missionand vision of what you have set
forth, because scheduling is oneof the hardest jobs in this
industry and if everybody's hard, it of the hardest jobs in this
industry.
Speaker 1 (19:30):
And if everybody's, it is the hardest, I tell
everybody it's just, you have tohave it's all trial and error
for everybody, because there'snot one system that works for
everybody.
We've changed our schedulingstyle at least two times.
We recently changed it about ayear and a half ago, which
everybody here was moaning andgroaning and didn't want to do
it.
It's worked out for the bestfor us and it's a constant
reevaluation of your systems.
Speaker 2 (19:53):
Yeah, it's rough, it's tough, but when you have a
team that, from the top down,has the same belief system and
the same vision and mission andvalues, then it becomes so much
easier to do all of those thingsand get people scheduled.
Let's talk about short shiftsfor a minute.
Most home care agencies I'vehad a lot of these conversations
lately but most home careagencies do not want to do short
(20:16):
shifts because it's hard.
It's hard to schedule themscheduling, it's hard on the
caregivers.
They want a full shift of hours, they want to work full time.
They don't want to piecemeal it, but there are ways to put this
together that works out nicelyfor everybody.
So talk to me a little bitabout short shift cares or short
hours.
Speaker 1 (20:35):
So that is going to be the future of scheduling for
home care.
To be honest with you, justbased off of what I told you in
terms of the financial situation, the way the world is right now
.
But nobody really looks at thegenerational payer source, right
?
So the way every generationbuys home care differently.
So when we went through ourWorld War II generation, there
(20:55):
was whatever the cost is, 24-7,pampered and catered to.
Now you're going into the nextgeneration that went through the
depression aspect of things andthey don't spend on anything.
If I'm not dying, I don't needit.
That's the way that they bought.
So look into the future, wherewe're at right.
So the next generation will bemore the Amazon generation, if
(21:18):
you think.
We want it when we want it andwe want it now.
We don't want to wait for itand we also don't want to have a
situation where it won't bedelivered.
So, when it comes to the shortshifts, I think, where companies
failed and we were guilty ofthis three years ago, because I
started working on this threeyears ago I tell everybody the
gig economy is a serious thingand it's going to come.
For the caregivers.
You're looking at Uberizationof caregivers.
(21:39):
So, number one how do we targetthose kind of people?
Most of us are doing it wrong.
Most of us put the ads uplooking just for general
caregivers.
How specific are you being inyour ads?
If I am targeting Uber people,the same way I'm targeting
caregivers, right?
I'm not going to put up fulltime jobs if I want them to
drive Uber and then tell themyou have the potential to be
(22:02):
full time.
You know what I'm saying?
It's right.
What it is.
This is we're looking for peoplespecifically, and a lot of
those individuals are actuallypeople that are in nursing
schools, people that are medicalassistants, that are picking up
weekend gigs, or single mothers.
They have time to drop the kidsoff in the morning at eight and
then they have to pick up thechildren by two.
So they have that small windowwhere you know, and then dad
(22:23):
might come home later in theafternoon and then they can take
care of them from there andthey can do another shift on the
way from there and they can doanother shift on the way, things
like that for your collegestudents that you know they work
at night because they go toschool during the day, or vice
versa they go to school for acouple of hours in the daytime,
then they have availability inthe evenings to do things.
So how you structure, that iskey, right.
So, for instance, with us, weactually charge a higher premium
(22:44):
for those shorter shifts, right?
Because of the fact that I haveto pay an individual more than
the normal rate to go out to dothat one hour bath visit or the
two hour visit, right?
So number one, that's the key,one key part there.
When I did this two or threeyears ago, we attempted this and
I kept everything at a regularrate, even the charge and
everything else like that, andit failed miserably because we
(23:07):
did not have the manpower for it.
I had caregivers that wantedeight hour, 12 hour shifts,
trying to give them a full shiftwith a bunch of small hour
clients.
I said if we get eight one hourclients, that's the one, that's
the one eight hour shift.
We attempted that it was.
It was an entire miracle rounduntil we came up to where we're
at now.
So everybody knows what I'minfamous for testing and pushing
(23:27):
, and testing and pushing tillwe find the right formula.
Last year we discovered thatformula and this year it's been
working for us, fantastic.
Like I said, we run the specificads, people that are
specifically looking for PRNtype of shifts one hour to two
hour to three hour kind ofsituations.
Pricing comes intoconsideration when it comes to
that.
You obviously have to pay morefor those short visits and if
(23:49):
they want a consistentindividual, you need to give us
a consistent schedule and it hasto be set up with a minimum.
So for us, we have a minimum.
It's hey, you got to meet ourdaily minimum and it has to be a
consistent schedule, or elseyou fall into this program,
which is a more flexible program, but you're not going to get
consistency.
If you're looking forconsistency, you need consistent
hours.
(24:09):
So that's where a lot of thosemetrics go into.
A lot of companies don't takethat into consideration.
I've actually talked to a lotof people about that.
Actually, one of the thingsthat I'm going to talk about at
HCaF is about that situation.
It's just it's there, it'scoming, there's going to be a
lot more clients.
We're seeing that now, where Iget a bunch of clients that call
and they want these things.
That's where the beauty of whatwe do with the short shifts and
(24:31):
our virtual care managementcomes into play, because I'm not
just giving them two hour careor one hour care.
I'm giving them the hands onfor one or two, but I'm giving
them 24 hour coverage for halfthe price, so it's one of the
most amazing things for them tobe able to have extra eyes.
I know they can't all afford it, so this is the best.
Next thing that I can do forthem is be able to have somebody
(24:52):
listening on the other end toassist them in their time of
need, when they need us.
Speaker 2 (24:58):
Wow, okay.
So is there going to be anInstacart app for caregivers?
Speaker 1 (25:03):
There probably already is, oh, yeah, there's
things out there that are comingover the roof and COVID was one
of the things that advancedthat and you have all the
Silicon Valley's jumping intohome care massively.
They're all coming out withsome kind of an app for
something.
So I think I saw Carecom comingout with something similar
where you can get your caregiverdirect.
It's going to hurt agencies alot, to be honest with you,
(25:23):
those kind of things, justbecause when they're working
like that.
But what differentiates us isthis Like I tell them, how much
quality control do those peoplehave over their program?
Uber is one of the largestcompanies in the world when it
comes to individuals being theirown bosses and driving whenever
they feel like it.
But what is the quality?
How do you control that qualityIf you don't know the person?
(25:44):
You haven't talked to them.
So that's why I think agencieswill always be able to trump
that aspect.
It's just the simple fact thatif you're going to call to
complain to somebody, you'retalking to Cindy.
You're not talking to somebodyin a 1-800 number in God knows
what part of the world, and theydon't know who this person is.
They just know they'veregistered on the app.
Speaker 2 (26:01):
Yeah, getting a ride to the airport in an Uber is a
lot different from someonehelping your mom get a bath.
Speaker 1 (26:07):
Exactly.
Speaker 2 (26:12):
So they need to be background checked, they need to
be established as a safe personbefore they walk into the house
.
So I can see where you'reexactly right.
But agencies like you who takethe reins on this are actually
doing the due diligence behindthe scenes and taking on the pay
and doing those things.
I've always been, of course,more agency-centric as far as
recommendations and not privatecaregiver.
I'm always been, of course,more agency-centric as far as
recommendations and not privatecaregiver.
(26:33):
I'm not a private caregiverrecommender only because of all
the things that are.
Potentially you want somebodybehind the scenes that has done
all of the steps necessary tomake sure somebody's safe.
Speaker 1 (26:45):
Exactly, but that's also the beauty of our program.
Like I said, the VCN part ofwhat we do, even if they're not
with us as a client and theyhave their own private
caregivers.
This is my way of making surethat things are being done the
right way in the home, becausewe have our care managers and
our RNs that are overseeing thecare.
The people that work in thathouse are interacting with us
with what we need them to do forthis client, so we're managing
(27:07):
these cases and we're able tomake sure that, although they
don't have somebody in the homefrom our company, they do have
bodies there we're able toassist, especially a lot of
those people that just take careof their own loved ones.
Speaker 2 (27:19):
And so let's talk about payer sources.
You take private pay clients.
I bet you take long-term careinsurance, do you do?
Veterans benefits?
Speaker 1 (27:27):
Not yet.
We do aid and attendance.
We do that.
We are in queue to be able toget in with the Veterans
Association right now, but inour market yeah, in our market
it's saturated, so it's hard forus to get in right now.
I'm working on that, but we aregetting there.
But we also do MedicareMedicaid as well as Aetna and
Care Lawn as well.
Speaker 2 (27:47):
Okay.
And in Florida, can familymembers get paid to take care of
their own?
Yes, yes, okay, great.
So you can manage all of thatacross the board, regardless of
which payer source comes yourway.
It doesn't really matter.
Great, that's awesome.
You have absolutely done anamazing job.
So for the folks in SouthFlorida, we will make sure that
(28:11):
all of your contact informationis there.
They can call, get moreinformation and find out what it
is they need.
I thank you for beinginnovative and thinking forward,
because we're going to need alot more agencies like yours out
there with multifacetedbusiness models that can really
pick it up.
So, thank you.
My name is Angel Abrego.
I'm the owner of Elite PremierNursing Services, elite Infusion
Services and Elite VCM.
We have been in business forabout 11 years now.
We cover South Florida, palmBeach County, treasure Coast,
naples up to Sarasota.
Speaker 2 (00:16):
Sounds to me like you're a busy guy.
Oh yeah, floran, I appreciateyou taking the time to educate
all of us about what you do andwhere you're located, so that
people know where they can go toget services in South Florida.
So why don't you tell us whatgot you started in the home care
industry?
Speaker 1 (00:36):
I started to be honest with you ever since I was
a child, actually since I wasabout 14 years old.
I wanted to be a doctor, but mymother was a nurse and my
grandmother was a nurse.
So by trade, I naturally wasrebellious against that and said
I had no business wanting to bea nurse.
I wanted to be a doctor.
But, life being what it is, Iactually was always geared
towards nursing.
(00:57):
When I got my nursing degree,actually right out of high
school, I went to a vocationalprep school which had pre-med
and nursing as specialties.
So I got that right out of highschool, started working as a
nurse right at 18 years old.
I started actually as acaregiver because some agencies
were nervous about putting an18-year-old nurse on the floor.
So I started as a caregiver forabout a year until they
(01:18):
transitioned me into a nurse.
I started working as a nurse.
Then I opened up my own caremanagement company and worked
that privately for a couple ofyears before I launched my
agency and was actually one ofthe youngest in the state
history in Florida at the age of26.
Opened my private duty agency,which has now morphed into a
healthcare ecosystem of what Iam building.
(01:39):
So my passion has always beento revolutionize healthcare.
It is the foundation of ourcompany and we have done that
ever since.
We've been around for 11 yearsnow.
So we specialize in privateduty, home health, medicare,
medicaid, and for the last threeyears have been doing hospital
at home, virtual hospital athome, and now we're getting
(02:00):
ready to launch our nationalprogram, which is virtual care
management and taking thatnationwide.
Speaker 2 (02:06):
Wow, that is a tremendous amount of work on
your part and such a great.
I love it that you're in allthe places so people can come to
you for anything, and you gotit covered.
Maybe hospice.
Speaker 1 (02:21):
That's in the future.
That's in the future.
My main thing is.
The future of healthcare is inthe home.
I've been bedside and privatemy whole life, so me knowing
what my clients want, what theyneed, the complexities of what
the industry is.
It is not like every otherspace.
It is very unique and there's alot of things that we can do in
the home that now people arestarting to wake up to and
(02:42):
realize like we can do the IVinfusions.
We were able to do those in thehome that now people are
starting to wake up to andrealize like we can do the IV
infusions.
We were able to do those in thehomes for so many years now.
Now it's starting to take off.
Holistic IVs is something thatwe do as well around here.
Me, the way I tell people Ipretty much push the care
continuum forward from gettingclients that are younger age 18,
19, 20 years old and some of myseniors that do a lot of these
(03:03):
vitamins that they got to take.
The bulk of the medicationsthat they take are vitamins.
I'm like, hey, I can infuse youwith two of these vitamin IV
infusions twice a month and I'mgoing to get you 100% purity
versus you taking those vitaminson a daily basis and trying to
wolf down horse-sizedmultivitamins.
Speaker 2 (03:21):
Okay, so do you infuse NAD?
Oh, okay.
Speaker 1 (03:24):
So do you infuse NAD?
Absolutely, we're actually inthe forefront of that, working
with a detox company.
About six, seven years ago wegot introduced to NAD when it
was actually specialized and youactually had to go to a course
in California in order to learnhow to do that.
So we were lucky enough to workthrough that vicariously
through a detox company.
We got put onto it, we startedlearning it and then helping
(03:46):
other people.
Now it's everywhere now.
Now you can just get theinjections.
I'm a huge proponent.
As a nurse, I tell everybodyalways opt for infusion and
injectables as much as possible,because a lot of people don't
take into account the liverbypass aspect of taking oral
medications.
Speaker 2 (04:01):
Wow, yeah, that's crazy and so awesome and I'm
glad to hear that the IVinfusions aren't just IV
antibiotics and things like that.
It's definitely you're doingthe preemptive stuff, helping
people avoid all of thesediseases and maybe some
hangovers in South Florida inSouth Florida.
Speaker 1 (04:29):
I look at it as a large research of my own.
If I'm getting clients in their20s and 30s, if they regularly
take these vitamin infusions bythe time they turn 70 or 80, or
we all do together at the sametime, I'm curious to see how we
end up in terms of the healthspectrum and whatnot by the time
we get to that age.
Speaker 2 (04:42):
That is going to be a great study to, at least, even
if it's just up here.
Oh, I've known that girl sinceshe was 20 years old and she's
looking pretty good still for 50, 60 years old.
Speaker 1 (04:54):
Oh yeah, oh yeah, you factor in peptides too.
It's a whole nother gamechanger.
Speaker 2 (04:58):
Oh my gosh.
So do you do all this stuffyourself, just out of curiosity?
Speaker 1 (05:02):
Yeah, yeah.
The whole of my company, myteam, have an amazing team
behind me.
Everybody sees us out and about.
We were known for traveling.
Speaker 2 (05:15):
We travel with a large group wherever we go.
Yeah, okay, so you have coveredthe entire gamut.
Now I'm going to guess.
Oh, let me ask you this.
I don't, I'm not going to guessat it.
What about pediatric?
That's medical care.
Speaker 1 (05:25):
So that aspect we have explored it.
My chief growth officer hasmentioned that several times.
We're gearing in that directiona little bit.
I'm not really looking to thefull fledged on that, just a
personal thing.
I've worked always with adultsand geriatrics.
But in terms of our program,vcm virtual care management it's
(05:45):
a lot of hospital at home.
So we're bringing this at homeand then taking it into not just
acute care but high acuity careand being able to continue that
care afterwards once they gethome from discharge.
So our program I have a team ofnurses.
We virtually manage patientsonce they get home and get
discharged from the hospital sowe can set them up.
On cardiac monitoring, so wehave a tele unit for that we do
(06:07):
at home.
We do ECG monitoring at home aswell as the regular vitals
things like that.
But we take it a step furtherin the fact that we actually
bridge the gap right so we cando telehealth conferencing
through there.
Telenursing for us is huge isthe future.
So pediatrics actually plays areally big game, a big piece of
that in the future as well,because we have certain things
that we can set up, like skintemperature monitor tags that we
(06:29):
put on patients, so we can getthat blood pressure cuffs.
The neonatal ones are super,super small.
For me it's a personal thingfor me.
I want to make sure that I'mable to take care of everybody,
but at the same time I know thatI can't take care of everybody.
That's just the nurse in me.
We just don't want to back down.
But pediatrics is a whole newfrontier.
I see that taking off a lot inour industry now.
Speaker 2 (06:51):
Oh yeah, absolutely.
But let's just think about thisYou're in the most competitive
market in the United States,maybe second only to Manhattan.
But pretty much you guys arefor South Florida as far as
seniors and folks that are therethat are retired and folks of
all ages, of course, but oursenior population obviously
loves to live in Florida whenthey retire or their snowbirds
(07:14):
going back and forth, so youhave a huge population to serve.
You're in the most competitivemarket in the nation and you've
done extremely well in thenation and you've done extremely
well and being able toadequately serve all of your
non-medical clients, as well assome that need some medical
assistance on the adult side.
I think that's a week that's alot and you are not very old.
Speaker 1 (07:38):
No, it's not.
It's a lot.
And we enjoy the challengethough, because, like I said,
everybody that works here wehave the same vision.
I don't hire people here justto hire bodies.
We hire people that align withthe vision as well as an owner
like where can I take you onyour career?
What is it that you're tryingto get to, and how does that fit
into our big picture of wherewe're headed?
(08:03):
The virtual nursing, tele-woundcare, teletherapies at home,
people that qualify for that,things that's the next frontier
for us and that's what we'vebeen able to specialize.
So when people tell me I'm in acompetitive market, I'm like
nobody has what I have built,nobody has what I am building.
They're going to catch up inthe next couple of years, but by
the time I've already, I'malready three years in the game.
Speaker 2 (08:18):
So Great, that is a great attitude to have and what
a great business.
Mantra Just keep going.
If it's coming our way, keepadding it on.
And that is so.
Maybe an adult child of anaging parent and they're looking
for care and they call theoffice.
What can somebody expect whenthe person at your office
(08:38):
answers that phone?
What?
Speaker 1 (08:52):
happens.
So once if a person calls us,the first thing we're trying to
find out is number one, and Ialways call these because my
team knows we call them thediscovery call, right.
So I tell them like what is itthat the client is looking for,
right?
One thing where I feel mostagencies fail at, because, like
my right hand, kathy will tellyou we have a goulash of
(09:13):
services, so it's like we havesomething for everybody.
But my big thing is I tell themmake sure you fit them in with
the right product.
So a lot of times they willcall you thinking I just want a
caregiver.
Sometimes it's beyond that theymight need a nurse at this
point, right.
Other ones are like I want tostart to explore this option for
the future for my mom, becausewe're trying to decide and plan
ahead Are we going to do ALF?
Are we going to do home care?
(09:34):
What's the cost?
Look like.
A lot of times I get clientsthat call me and they're like,
hey, you're like I want to getmy mom started.
We just want to do one or twodays.
Like we just want to slowlytransition her, which you'll see
that a lot in our space rightnow the short care model is huge
a lot because of financialissues and things like that with
the country, which is whythings like our virtual care
management program is so massive.
(09:55):
I tell people we can start yourmom in just a couple of hours
with in-person and then weremote monitor 24-7.
So we have things like AI audiocare pilots that listen to your
mom in the house forconditional changes.
We have a lot of AI tracking inthe home.
So a lot of this stuff scarespeople sometimes when I tell
them.
But it's actually reallyamazing to be able to say your
(10:15):
mom's at home she maybe isresistant to the care, right,
but for my system to go in and Ismart home your home and I can
say hey, mom says she doesn'tget up at night, but we noticed
she gets up between the hours oftwo and six every single
morning and that's where herfalls tend to happen, like she's
fallen but she's gotten herselfup a couple times now.
(10:36):
So it's a one slip away fromthe big one so I'm able to help
care, predict people now andtell them hey, mom's most action
is between 2 and 6 am, so youmay want to think about a night
shift.
Why don't we think about 11 pmto 7 am.
You have help during the day oryou're there during the day to
start to help families formulatean actual plan, like
(10:58):
everybody's done it in the past.
We've all had the paper sheetsthat we go over and just say
what does your day look like?
But most of your clients callme like I just want somebody
from nine to 12.
Get my mom up, get a breakfast,get going, all right.
So what happens outside of that?
Nobody really plans for thefuture.
So tell people let's look intothat and say, ok, what happens
when we're not here?
What happens if you fall?
What's the game plan?
Speaker 2 (11:19):
So it's amazing what you don't know, you don't know
what you don't know, and youfind out pretty fast.
Speaker 1 (11:27):
It is, but that's the beautiful thing about our
technology also is the fact thatit's non-invasive.
So I'm not utilizing videos oranything like that.
When I get to that age, I don'twant somebody videotaping me.
I won't feel comfortable.
I know it's great for the kidsand a lot of them are actually
doing that right now kind ofsetting up rings, booby traps
throughout the house.
They set up ring cameras inevery room and they watch their
(11:48):
mom walk throughout the house.
I'm like that's not a, it's nota good plan.
I'm like if she falls, ifyou're asleep at 3 am, you'll
hear the movement, but are youreally going to wake up to that?
It's a lot.
So I tell them let's do thisthe right way, because with the
amount of rings that they'repaying for, you literally
service and dome the whole home.
Speaker 2 (12:05):
I haven't heard that before I get it.
I see how that might be a good,like ring cameras all over.
Speaker 1 (12:11):
Oh, it's rampant.
Speaker 2 (12:12):
It's rampant down here I can tell you every other
day I'm running into that.
It takes a lot of time to watchthose videos, so something that
actually can sense that.
So what's happening is it's notvideo, but something in the
house is sensing activity andperhaps a fall, and so it's not
looking at the person, but itknows what regular behavior is
(12:34):
after a while and it knows whatirregular behavior is and it
sends alerts.
Speaker 1 (12:38):
Yeah, correct Exactly .
So like, for instance, if everyday you tend to wake up between
the hours of 5 am and 7 am,correct, and you were for some
reason, this day you didn'tthere could be something going
on.
That kind of prompts my team.
Unusual activity I'm contactingthe person at home and I'm
saying, hey, is everything okay?
If they don't answer, then weassume something may have
happened.
Or if they do answer, they'resaying they're just not feeling
(13:00):
well.
Other times they're getting upa lot during the middle of the
night.
Unusual activity they went tothe bathroom six times last
night.
Are we looking at a potentialUTI situation or is there
something elsegastrointestinally happening
that we need to be jumping on inadvance?
A lot of times too, for theAlzheimer's and dementia clients
.
Historically and this isinfamous, this is something I
(13:21):
actually love so much about ourtechnology is the fact that you
have clients that may haveAlzheimer's and dementia and
family members might not beconscious to how bad it really
is.
So I get that all the time fromchildren.
Mom sleeps through the night,she doesn't get up, but then she
may say the caregiver nevershowed up this morning at 7 am,
(13:41):
when really we do have now theability to say the person walked
through the door at 7 am butmom's been up since 545
screaming for help, so she'sconfused on her time.
It's not that the caregiver didnot show up on time, it's that
your mom's getting up two hoursearlier than normal and confused
.
So this is what's reallyhappening.
So when you're able to give thechildren those metrics, it
(14:01):
changes the entire dynamics ofhow we deliver care and, as well
, being able to have that extrabackup support for your
caregivers and for your team,because forever if we got those
kind of calls and we're likeyou're not showing up on time,
he's now can verify you a littlebit, but outside of that.
Speaker 2 (14:21):
It used to be like it's not working out.
You got to go and get anothercaregiver in there.
No, now you can say, okay,let's look at what's really
going on, because we know wewere there and that's nice,
that's great, that's life-savingcare and it's also, if you know
, here we could talk about thisall day.
But from the medicalperspective, you're reducing
hospital readmissions a lot bybeing able to identify these
problems.
Like you said, if the personwas up six times last night,
(14:42):
they either have something goingon with their tummy or they
have something going on withtheir urinary system.
They either have an infectionor maybe their tummy's yucky or
whatever.
I have kids.
Can you tell?
Are we looking?
Are they dehydrated now?
Do they need antibiotics?
What can we do to fix thisbefore it becomes a bigger
problem or something elsehappening that we need to know?
Speaker 1 (15:04):
about so absolutely.
And then, like I said, like theAI audio aspect of what we do
for me to be able to get a goodlisten in on what my clients
have like their main complaints.
I have clients sometimes thatmay say I can't sleep, I have
difficulty sleeping, but theynever report that.
You know.
When you call them and you'relike, hey, is everything all
right, how are you feeling?
I'm feeling great.
But then I got them on audiothe whole week saying I had a
(15:25):
horrible night last night.
I couldn't sleep.
I couldn't sleep.
And then you're like, okay, Iget this information, create a
whole care plan.
It allows my nurses to be verymuch proactive now and say, hey,
we've got this situation, let'shave this conversation, because
they're not telling us to ourface, but we hear it.
We hear the tussling, rustling,all of those things.
If they're dissatisfied aboutsomething, we can understand
(15:46):
that, but it's only healthcarerelated things.
We don't pick up regularconversation.
You can sit there and talkabout the Marlins or the Dallas
Cowboys or whatever you want totalk about.
We don't hear any of that.
It's just if you're coughing,which is huge for me when it
comes to pneumonia basis,because a lot of times a client
might be drinking water andcaregivers are infamous for
saying they just choke whenthey're drinking water.
(16:07):
The water went down the wrongway.
I'm like, no, this is thedevelopment of something else.
We need to get ahead of this,because they're going to end up
with pneumonia.
Then they're going to come homeon hospice and you don't want
that, yeah that's right.
Speaker 2 (16:18):
That's right.
You know what?
My nurse radar goes off when Ihear stuff like this.
I love it and I hope that morepeople realize the value of
having that AI and it does soundscary, I get it, but have
something listening andmonitoring the house just to
know if things are okay or ifsomething has changed.
(16:39):
I hope when people reallyunderstand the value of that
because I think they would be wehave a lot more adult children
who are very surprised at what'sreally going on at home and
most of our seniors are going tosay no, I'm fine, everything's
great, because they don't wantto be a burden to their kids,
they don't want to be a burdento anyone else and they just
they love their independence andvalue that.
(17:01):
So they're going to say I'mfine, there's nothing wrong here
, or it's just old age, but it'snice.
What you've got going on hereis amazing.
So I appreciate that.
And all right.
So somebody calls.
I'm going to rewind a littlebit.
Somebody calls, they get one ofyour folks on the phone and I
guess a lot of listening ishappening, and once you listen
(17:21):
to their story and find outwhat's going on, then it's about
putting them in the rightservice group and helping them
with whatever types of care theymight need.
Speaker 1 (17:31):
Exactly, and we do all that in person.
I send my team out to the homebecause they're my first eyes
and ears when they go into thehome.
To go into the home, they'reable to see the dynamics of the
home.
I do not like doing sales orclosing or any of those things
on the phone, just because youwouldn't know what I got going
on If I were to call a mechanicand we say this to a lot of our
customers when they call andthey want to get a price over
(17:52):
the phone, I'm like, hey, if Icall the mechanic right now and
I tell him, hey, my car's goingto do like how much, he's not
going to give you the price.
You know what I'm saying,because everybody that calls it,
it's the the.
It's not the truth right therewhen they call a couple of hours
of care.
She's fine, she does everythingon her own.
Speaker 2 (18:09):
She sleeps all night, and then you get there and it's
a whole different dynamicalmost yeah yeah yeah, the noise
of newt could mean fifteenhundred dollars worth of car
damage, or it could mean fivedollars it it could be a whole
range of stuff.
So, yeah, they got to look.
So in-home assessments andconversations are really what
(18:31):
it's all about.
And so in-home assessment orconversation happens.
And then how fast?
I'm going to imagine prettyfast how fast could you get care
started if somebody calledtoday, not an emergency, but I
would say like usually same day.
Speaker 1 (18:47):
I think the luckiest we've been is like within an
hour.
We got lucky, we haveschedulers for that, but the
luckiest been is about an hour.
I would say everything's alwayssame day.
We just had a call yesterdaywhere we had a facility that
called us that needed a patientto be serviced the same night
and it was four o'clock in theafternoon.
We got in there by 7 pm.
It all depends on how youstructure your team, how you
(19:08):
structure your scheduling andeverything else like that, how
fast you guys can really move.
Speaker 2 (19:13):
Yeah, and that takes a lot of organizational skill.
Your schedulers have to bereally good at what they do and
really believe in the missionand vision of what you have set
forth, because scheduling is oneof the hardest jobs in this
industry and if everybody's hard, it of the hardest jobs in this
industry.
Speaker 1 (19:30):
And if everybody's, it is the hardest, I tell
everybody it's just, you have tohave it's all trial and error
for everybody, because there'snot one system that works for
everybody.
We've changed our schedulingstyle at least two times.
We recently changed it about ayear and a half ago, which
everybody here was moaning andgroaning and didn't want to do
it.
It's worked out for the bestfor us and it's a constant
reevaluation of your systems.
Speaker 2 (19:53):
Yeah, it's rough, it's tough, but when you have a
team that, from the top down,has the same belief system and
the same vision and mission andvalues, then it becomes so much
easier to do all of those thingsand get people scheduled.
Let's talk about short shiftsfor a minute.
Most home care agencies I'vehad a lot of these conversations
lately but most home careagencies do not want to do short
(20:16):
shifts because it's hard.
It's hard to schedule themscheduling, it's hard on the
caregivers.
They want a full shift of hours, they want to work full time.
They don't want to piecemeal it, but there are ways to put this
together that works out nicelyfor everybody.
So talk to me a little bitabout short shift cares or short
hours.
Speaker 1 (20:35):
So that is going to be the future of scheduling for
home care.
To be honest with you, justbased off of what I told you in
terms of the financial situation, the way the world is right now
.
But nobody really looks at thegenerational payer source, right
?
So the way every generationbuys home care differently.
So when we went through ourWorld War II generation, there
(20:55):
was whatever the cost is, 24-7,pampered and catered to.
Now you're going into the nextgeneration that went through the
depression aspect of things andthey don't spend on anything.
If I'm not dying, I don't needit.
That's the way that they bought.
So look into the future, wherewe're at right.
So the next generation will bemore the Amazon generation, if
(21:18):
you think.
We want it when we want it andwe want it now.
We don't want to wait for itand we also don't want to have a
situation where it won't bedelivered.
So, when it comes to the shortshifts, I think, where companies
failed and we were guilty ofthis three years ago, because I
started working on this threeyears ago I tell everybody the
gig economy is a serious thingand it's going to come.
For the caregivers.
You're looking at Uberizationof caregivers.
(21:39):
So, number one how do we targetthose kind of people?
Most of us are doing it wrong.
Most of us put the ads uplooking just for general
caregivers.
How specific are you being inyour ads?
If I am targeting Uber people,the same way I'm targeting
caregivers, right?
I'm not going to put up fulltime jobs if I want them to
drive Uber and then tell themyou have the potential to be
(22:02):
full time.
You know what I'm saying?
It's right.
What it is.
This is we're looking for peoplespecifically, and a lot of
those individuals are actuallypeople that are in nursing
schools, people that are medicalassistants, that are picking up
weekend gigs, or single mothers.
They have time to drop the kidsoff in the morning at eight and
then they have to pick up thechildren by two.
So they have that small windowwhere you know, and then dad
(22:23):
might come home later in theafternoon and then they can take
care of them from there andthey can do another shift on the
way from there and they can doanother shift on the way, things
like that for your collegestudents that you know they work
at night because they go toschool during the day, or vice
versa they go to school for acouple of hours in the daytime,
then they have availability inthe evenings to do things.
So how you structure, that iskey, right.
So, for instance, with us, weactually charge a higher premium
(22:44):
for those shorter shifts, right?
Because of the fact that I haveto pay an individual more than
the normal rate to go out to dothat one hour bath visit or the
two hour visit, right?
So number one, that's the key,one key part there.
When I did this two or threeyears ago, we attempted this and
I kept everything at a regularrate, even the charge and
everything else like that, andit failed miserably because we
(23:07):
did not have the manpower for it.
I had caregivers that wantedeight hour, 12 hour shifts,
trying to give them a full shiftwith a bunch of small hour
clients.
I said if we get eight one hourclients, that's the one, that's
the one eight hour shift.
We attempted that it was.
It was an entire miracle rounduntil we came up to where we're
at now.
So everybody knows what I'minfamous for testing and pushing
(23:27):
, and testing and pushing tillwe find the right formula.
Last year we discovered thatformula and this year it's been
working for us, fantastic.
Like I said, we run the specificads, people that are
specifically looking for PRNtype of shifts one hour to two
hour to three hour kind ofsituations.
Pricing comes intoconsideration when it comes to
that.
You obviously have to pay morefor those short visits and if
(23:49):
they want a consistentindividual, you need to give us
a consistent schedule and it hasto be set up with a minimum.
So for us, we have a minimum.
It's hey, you got to meet ourdaily minimum and it has to be a
consistent schedule, or elseyou fall into this program,
which is a more flexible program, but you're not going to get
consistency.
If you're looking forconsistency, you need consistent
hours.
(24:09):
So that's where a lot of thosemetrics go into.
A lot of companies don't takethat into consideration.
I've actually talked to a lotof people about that.
Actually, one of the thingsthat I'm going to talk about at
HCaF is about that situation.
It's just it's there, it'scoming, there's going to be a
lot more clients.
We're seeing that now, where Iget a bunch of clients that call
and they want these things.
That's where the beauty of whatwe do with the short shifts and
(24:31):
our virtual care managementcomes into play, because I'm not
just giving them two hour careor one hour care.
I'm giving them the hands onfor one or two, but I'm giving
them 24 hour coverage for halfthe price, so it's one of the
most amazing things for them tobe able to have extra eyes.
I know they can't all afford it, so this is the best.
Next thing that I can do forthem is be able to have somebody
(24:52):
listening on the other end toassist them in their time of
need, when they need us.
Speaker 2 (24:58):
Wow, okay.
So is there going to be anInstacart app for caregivers?
Speaker 1 (25:03):
There probably already is, oh, yeah, there's
things out there that are comingover the roof and COVID was one
of the things that advancedthat and you have all the
Silicon Valley's jumping intohome care massively.
They're all coming out withsome kind of an app for
something.
So I think I saw Carecom comingout with something similar
where you can get your caregiverdirect.
It's going to hurt agencies alot, to be honest with you,
(25:23):
those kind of things, justbecause when they're working
like that.
But what differentiates us isthis Like I tell them, how much
quality control do those peoplehave over their program?
Uber is one of the largestcompanies in the world when it
comes to individuals being theirown bosses and driving whenever
they feel like it.
But what is the quality?
How do you control that qualityIf you don't know the person?
(25:44):
You haven't talked to them.
So that's why I think agencieswill always be able to trump
that aspect.
It's just the simple fact thatif you're going to call to
complain to somebody, you'retalking to Cindy.
You're not talking to somebodyin a 1-800 number in God knows
what part of the world, and theydon't know who this person is.
They just know they'veregistered on the app.
Speaker 2 (26:01):
Yeah, getting a ride to the airport in an Uber is a
lot different from someonehelping your mom get a bath.
Speaker 1 (26:07):
Exactly.
Speaker 2 (26:12):
So they need to be background checked, they need to
be established as a safe personbefore they walk into the house
.
So I can see where you'reexactly right.
But agencies like you who takethe reins on this are actually
doing the due diligence behindthe scenes and taking on the pay
and doing those things.
I've always been, of course,more agency-centric as far as
recommendations and not privatecaregiver.
I'm always been, of course,more agency-centric as far as
recommendations and not privatecaregiver.
(26:33):
I'm not a private caregiverrecommender only because of all
the things that are.
Potentially you want somebodybehind the scenes that has done
all of the steps necessary tomake sure somebody's safe.
Speaker 1 (26:45):
Exactly, but that's also the beauty of our program.
Like I said, the VCN part ofwhat we do, even if they're not
with us as a client and theyhave their own private
caregivers.
This is my way of making surethat things are being done the
right way in the home, becausewe have our care managers and
our RNs that are overseeing thecare.
The people that work in thathouse are interacting with us
with what we need them to do forthis client, so we're managing
(27:07):
these cases and we're able tomake sure that, although they
don't have somebody in the homefrom our company, they do have
bodies there we're able toassist, especially a lot of
those people that just take careof their own loved ones.
Speaker 2 (27:19):
And so let's talk about payer sources.
You take private pay clients.
I bet you take long-term careinsurance, do you do?
Veterans benefits?
Speaker 1 (27:27):
Not yet.
We do aid and attendance.
We do that.
We are in queue to be able toget in with the Veterans
Association right now, but inour market yeah, in our market
it's saturated, so it's hard forus to get in right now.
I'm working on that, but we aregetting there.
But we also do MedicareMedicaid as well as Aetna and
Care Lawn as well.
Speaker 2 (27:47):
Okay.
And in Florida, can familymembers get paid to take care of
their own?
Yes, yes, okay, great.
So you can manage all of thatacross the board, regardless of
which payer source comes yourway.
It doesn't really matter.
Great, that's awesome.
You have absolutely done anamazing job.
So for the folks in SouthFlorida, we will make sure that
(28:11):
all of your contact informationis there.
They can call, get moreinformation and find out what it
is they need.
I thank you for beinginnovative and thinking forward,
because we're going to need alot more agencies like yours out
there with multifacetedbusiness models that can really
pick it up.
So, thank you.
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