Duett Podcast with Nicholas Wynne of Altra Homecare Group
Cody Pittman 00:00
Welcome to the first-ever Duett podcast. Our goal is to talk to experts from the home health industry and share with our community that information. My name is Cody Pittman, and I'm the CEO of Duett and joining me today is Nicholas Wynne of Altra Homecare Group. Nick, tell me about yourself.
Nicholas Wynne 00:15
So like Cody said, my name is Nick Wynne I am the administrator and owner of Altra Homecare Group. A little bit about me, I completed my bachelor's in business administration, as well as went on to get my master's in business administration at Florida Institute of Technology down in Melbourne, Florida. After my collegiate years, I immediately went to work for a company called Maxim Healthcare Services. I kind of got the start as a recruiter, and then went through that process, learned a lot about the industry and really fell in love for providing care to other people and enriching lives.
Cody Pittman 00:51
After your work with Maxim, what led to starting Altra?
Nicholas Wynne 00:56
So loaded question there. Kind of a lot of different things went into the vision and the passion and the energy to starting Altra Homecare. I think it really started for me back in my middle school days. So my oldest brother Josh was actually in a terrible car accident. When he was coming home from college, his freshman year, fell asleep at the wheel and ran into a tree going about 90 miles an hour on the driver's side and ended up in the ICU critical care for months, went to rehab after that, finally did have the ability to transition back into the home environment. When he came home, I myself, I'm one of five boys. So my parents had a ton of things to do already. Josh came back home, my mom being Superwoman, she is wanted to look after Josh take care of everything and that just wasn't working out. It was just too demanding, too much care, too many moving parts. So we decided to bring home health care in. And even from early age and seventh grade, I kind of saw the benefit and saw the value of that. That really piqued my interest. And in the back of my mind, you know, gone through my high school years going through my college years and Master's program. I always knew I wanted to get back into the healthcare space and give back in a way.
Cody Pittman 02:16
Well, one, thank you for sharing that story. And we're not going to necessarily go into it here. But I have a similar experience of how home health care impacted my family add a lot of value to growing up. It's kind of in my experience, it's kind of a commonality of the people that are involved in this industry.
Nicholas Wynne 02:33
Absolutely. I think having a passion and something you can tie it back to in your own personal life is really important in this industry.
Cody Pittman 02:39
Right. Leading into founding Altra Homecare Group, it's my understanding that it's family owned and operated. Is that true?
Nicholas Wynne 02:49
That is correct. Myself, my brothers and a family friend, we started this whole entity from the beginning from scratch formed, you know, the corporation, everything like that, built it up and decided to call Indianapolis, our home and kind of picked up and moved out here.
Cody Pittman 03:06
And where were you guys actually from then?
Nicholas Wynne 03:08
Originally from Maryland.
Cody Pittman 03:09
Okay. And you decided to move you decided to move to Indiana and open a company here?
Nicholas Wynne 03:15
Correct.
Cody Pittman 03:16
All right. And what was what was it about Indiana that brought you here?
Nicholas Wynne 03:19
So it's a very welcoming state to be a business owner for one. Some of the programs that they have, did a little research on the front end, really, they've looked good to us. And we just went, you know, all in and decided to go for it. So myself and my two younger brothers, Mike and Kevin picked up and moved our lives out to Indiana it was, still is, an interesting journey, you know, working together every single day, but it's been fantastic and really grown from there.
Cody Pittman 03:50
And remind me, when did you start Altra?
Nicholas Wynne 03:53
So originally started forming back in 2020. In the middle of COVID actually. Got everything started up and working with the attorney to to form the company, everything like that. We opened up our brick and mortar in January of 2021. And kind of started the licensing process from there.
Cody Pittman 04:10
Okay, got it. Cool. Cool. And it's my understanding, like, from other conversations that we've had, you guys have been growing at a pretty healthy clip, what do you think is kind of driving that growth? 2020 to now.
Nicholas Wynne 04:22
There have been a lot of things driving that growth. If I'm being 100% honest, our recruiting efforts are a massive, you know, factor into allowing us to take on more clients. And then having some excellent market intelligence from a platform like Duett allowed us to get our name out there and kind of get some more context with just different case managers and different people in the community. That has been absolutely invaluable to us just building relationships and having an opportunity to have those phone numbers and emails to reach out and call people and introduce ourselves has just let us get our foot in the door so to say. And we're a firm believer that if we have an opportunity, we're going to prove ourselves.
Cody Pittman 05:07
All right. All right. I like that. And so remind me. You're a provider to CICOA? The AAA that you work with is CICOA?
Nicholas Wynne 05:15
Correct. Yes.
Cody Pittman 05:16
And do you work with any of the other AAAs.
Nicholas Wynne 05:18
As of now, no.
Cody Pittman 05:19
Okay. Got it. Cool. Cool. You mentioned recruiting being a big part of your growth. And I know from the conversations that I have that right now, staffing is a huge problem for a lot of people. How are you kind of addressing that?
Nicholas Wynne 05:35
So we do have two full time recruiters right now, we're bringing on a third in May. And we actually have an opening requisition for our recruiter and other recruiter posting as well. One of the things we do a little bit differently is we really tried to empower our caregivers, and give them the tools to succeed. So we have a Director of Clinical Services on staff, we spent some money on the front end to have a skills laboratory built out in our office where we have all the different items that you would see in a client's home, from a hospital, bed, cane, Walker, rollator, a wheelchair hoyer lift all those different items, we purchase those, and we have our Registered Nurse run those caregivers through every single task they would complete in a home environment. And I have heard countless times from these caregivers, how thankful and how grateful they are to have someone actually train them on the skills. So that's been really interesting to see. And then for the client as well, they get a better product at the end of the day, because these people going out to work with them have seen you know, the things they're going to be doing and have practice those, those different tests and skills with the supervision of a registered nurse. And they can ask any questions they have really make sure they're competent and they're comfortable in that, that area.
Cody Pittman 06:52
That's awesome. That's, that's smart. That's really smart. What would you say then kind of like makes Altra unique? Is it that training facility? Is that commitment to that employees? Or is it kind of a mix of something else?
Nicholas Wynne 07:06
That's kind of a mix of a lot of different things. I think having the training, in the beginning is one of the things that makes us unique. Simple things like just supplying your caregivers and your clients with, you know what we call like a goodie bag, we take out a pack of gloves, paper towels, soap, hand sanitizer, supplying the caregivers with PPE. Just making sure and putting those clients at ease that we are following proper infection protocol and procedure for making sure everybody stays healthy, especially with COVID, you know, on the mind and everything like that. Want to make sure we set those caregivers up for success.
Cody Pittman 07:43
What is something that you know, now that you wish you knew when you started?
Nicholas Wynne 07:47
I wish you knew COVID was gonna last this long. COVID has presented definitely some unique challenges from hiring caregivers, to having vaccination cards and vaccination requirements and things like that. And then from the clients perspective, you know, some people don't want anyone coming into their home. So kind of getting around that and ensuring proper safety is being you know, put in place and everybody's going to be in a safe position, we're going to do everything we possibly can to screen those caregivers before every single shift, to text notification and supply them with PPE. And then as we progress into the skilled side of the business on the VA, making sure that we have vaccinated caregivers, there are still a lot of caregivers that for whatever reason do not want to get vaccinated. So that's been an interesting hurdle there. But just kind of working through COVID, I think would be the biggest curveball. We just couldn't predict it.
Cody Pittman 08:47
Yeah, of course. Yeah. We actually kind of got our start during COVID as well. The demand for services and the different service types. So like, Adult Day, where there are people going into facilities rather than people coming to homes, there's, there's impacts across a lot of those service lines. That's interesting, though. What did you do at the beginning, that you're really glad you did then.
Nicholas Wynne 09:14
One thing that, let's see, one thing that I am proud and happy that we adhere to was setting up strict compliance requirements. So simple things like having our caregivers obtain a CPR card, making sure they are licensed and they have automobile insurance, just making sure that we hired caregivers with those. A lot of people don't have those things. So it can be hurdle to hiring individuals, especially on the front end when you're trying to build a business and grow. But we just never kind of gave up to that regard. We stayed with those strict compliance requirements. And again, at the end of the day, then we know all of our caregivers have the ability to meet our clients needs, which is really important.
Cody Pittman 09:59
So it's kind of like, Yes, you're protecting the business. You're creating a standard that you're following. But you're also protect, ultimately, you're protecting your caregivers and the client.
Nicholas Wynne 10:12
Yes. And we're instilling company values and ethics that we are going to adhere to, you know, in perpetuity.
Cody Pittman 10:19
And then CICOA, the AAA that you work with happens to be CICOA. in this situation also benefits from knowing caregivers are protected. Client is protected, therefore, they can rely on you.
Nicholas Wynne 10:31
Correct. And we can render a better service as well. Yeah, there's a lot of companies. I don't want to talk bad about anybody or anything like that. But I know a lot of caregivers come to us and say, oh, like why do I have to have, you know, auto insurance? Why do I have to have a driver's license or things like that? So it's been very interesting to see.
Cody Pittman 10:51
Yeah, yeah. Especially when you talk about transporting clients and our or the caregivers needing to travel 30 minutes to an hour to two hours in their car to get to a client that is technically on business time.
Nicholas Wynne 11:05
Right. Right. And we want to make sure that caregivers are reliable. What? You know, sometimes bus systems work well, but you have your own car that's works and you have auto insurance, you're likely going to show up to your shift on time.
Cody Pittman 11:18
Yeah, yeah. Yeah. When people are relying on you to be somewhere. When the client is relying on you to be somewhere, you gotta be there. It makes sense. We've got a couple questions. Now we've been looking backwards, we got a couple questions. Looking forward here. When you look ahead, does your company do like goal setting or planning?
Nicholas Wynne 11:38
Every single week.
Cody Pittman 11:39
Every week?
Nicholas Wynne 11:40
We have different metrics that we adhere to, for every single role in the office. We like to set goals. Being founded with myself and my brothers are very, very competitive. I like to kind of have that competitive nature and healthy competition be a part of our business. So we set goals every single week, we follow up, you know, we have a, what we call a red zone in the morning and end zone at the end of the day. Sports mind a little bit there. But we like to talk about, you know, what are our goals? And did we meet those every single day? Are we getting caregivers through the door? Did you have interviews today? Different things like that? And then you know, how we stack up next to each other with our metrics? Is one person outperforming another? How should we improve? And kind of just having that culture to where we are talking about it and being open about it. I think it directly makes everybody a better employee.
Cody Pittman 12:35
Yeah. What's the uh. What's the strangest thing you guys track?
Nicholas Wynne 12:43
Strangest thing we track.
Cody Pittman 12:45
Or, like, maybe the least obvious metric that you track?
Nicholas Wynne 12:48
So our declination record for declining caregivers actually.
Cody Pittman 12:56
Okay. Not clients, caregivers?
Nicholas Wynne 12:58
Caregivers.
Cody Pittman 12:58
Okay
Nicholas Wynne 12:58
Yes, not clients. So caregivers, people that come in, go through an interview process, that we still do not move forward with them. So kind of trying to, again, instill those values in those ethics and ensure we bring on quality individuals. Or declination record, I think right now is right around 65 to 70%.
Cody Pittman 13:19
Okay. And what is it? What is that metric teach you?
Nicholas Wynne 13:23
Teaches us that, again, at the end of the day, would we want these people caring for our family members? And we take that to heart really, and try our best through, you know, behavioral based questions and eliminating bias by asking the same questions in every single interview, things like that little tools that we've learned, is to try to identify and get an inside look at this person's ethics and values. And, again, retention and, you know, keeping caregivers is always going to be a hot topic in the home healthcare world, but kind of doing a little bit of those things. And then declining people that we don't feel are strong fit has helped boost our retention and helped kind of just breed a better base of caregivers. I see your wheels turning there.
Cody Pittman 13:25
Yeah, well, like you obviously, have built a company based off of values. You have a mission, otherwise, we kind of all wouldn't be here if we weren't a part of our mission to take care of people. And like, I guess what would be my point there being is sounds like you have values and a mission that are kind of your North Star. But if you put a metric there, the one that is the most important to you, in terms of signifying growth or what you're trying to accomplish, what would that metric be? We talked about, like, maybe obscure, which was your declination, right, but what would be your Northstar metric?
Nicholas Wynne 14:48
Growth is very important to us. We want to serve as many Hoosiers as possible. So kind of one thing we track pretty closely is net billable hours. So, did we have admissions? Did we have discharges? What was the reasons for the discharges? If we did? And how many hours have we increased on a week over week basis?
Cody Pittman 15:11
Actually you know, what, I'm not necessarily asking you to reveal the secret sauce by any means, but like what types of tools do you use to track these metrics? Or what kind of tools are you guys using?
Nicholas Wynne 15:24
So there's a lot of different reports, we can run through some of the software's that we utilize that track and very easily. We have a fantastic CFO who's always monitoring numbers and tracking this. She's really been on the ball with that, which is great. And then I always just have Excel open. Okay, I can see week over week, what are we looking at. Got some graphs and things like that. Simple tools that aren't expensive. You can still track.
Cody Pittman 15:51
Yeah, we use I mean, predominant email plugs into Gmail, we both I'm a big fan of tracking things through HubSpot, Excel, I use a lot of Google documents and things like that. But being able to articulate to a metric where you're, where you're succeeding, and where you're failing to be able to give color and credibility, that metric super valuable. All right, so we talked about goal setting. When you look ahead, what just excites you the most about 2022?
Nicholas Wynne 16:24
What excites me the most? First and foremost, obtaining the PA license, all right, being able to have different service lines and better serve our clients that need care, need different levels of care. That's really exciting. And then some really exciting news for the company, we will be opening a Greenwood or South Indy branch in the year, so we can better serve that population down there and more local approach as well.
Cody Pittman 16:51
Opening a new office. Nice. That's, that's awesome. Congratulations.
Nicholas Wynne 16:55
Yes, we're really excited about that.
Cody Pittman 16:59
Nick, what concerns you the most about the landscape of the home health care industry moving forward?
Nicholas Wynne 17:05
One thing that really top of mind concerns me is the reimbursement rates. So they're always gonna pose a challenge. And I get that, you know, money's not limitless in the government's pockets and things of that nature. But specifically, you know, in the past year, and moving forward, we've seen that, you know, with some of the challenges in recruiting through COVID, and things like that, these big corporate conglomerates, like a Walmart, like McDonald's, like a Target, they're paying people, you know, $16 $17 to stock shelves, and how can a homecare company function and continued to retain employees and hire employees, when they have to compete with those rates, and based on the reimbursement that we're receiving with state, it would simply put us out of business. So that's one thing that concerns me a little bit. I don't know if those rates that these conglomerates are paying are sustainable. I can't see them being sustainable. I would love to pay our caregivers much more. And I think they are worth much more. But from a business perspective, and at the end of the day for us to keep our doors open. You know, we have to pay what we're paying. We do feel that we're a very, very competitive payer. But again, I wish we could pay more. Always.
Cody Pittman 17:19
So across the industry, the concern is like if we are going to recruit talent to stay in the industry, we're competing ultimately with Amazon, Target, Walmart.
Nicholas Wynne 18:42
FedEx, you name it. And before we wouldn't have necessarily even considered those to be competitors. Right.?
Cody Pittman 18:50
Right. Interesting. As the provider, your predominant partners in the industry are the case managers, care managers, social workers. If you're sitting at the table with a care manager instead of me, what would you want them to know about your work?
Nicholas Wynne 19:04
Kind of sounds a little cliche, but we truly do care about the people that we work with, from our clients, to our caregivers, kind of like what I was just saying, we want the best for them. We want you know, everybody to be happy and have a good experience. So we I mean, we tirelessly work, relentlessly work to set our clients and caregivers up for success. Successful experiences in general, I think, and just being happy at the end of the day with the service switching over just a client recently who you know, called me after the first shift and said thank you so much like this has been so impactful for me. I got so much done with my caregiver that showed up today. She motivated me she got me out of bed, you know, got me moved and helped me clean up the house a little bit. And to you know, me maybe who's relatively young in shape, you know, no health issue. I can move around clean up my house. That's just something that I take for granted. Hearing that from him, really, again, put things into perspective for me and brought me back as to why we're doing this. And really kind of just revalidated that I truly do care about all these people that I'm working with. And it's really rewarding work.
Cody Pittman 19:04
I like that, you know, we'll end it right there. But I appreciate that you centered us on why we're here. Right? We're all here. Duett is here. Altra is here, case managers are all here ultimately to take care of the client that needs our service I know for the Duett team, we're thrilled to participate in the industry. But at the end of the day, you guys are the front line providing that care. But, Nick, thanks for joining me today, man.
Nicholas Wynne 21:01
Thanks for having me. I enjoyed it.