The Value of Home Care with Expert Insights from Stephen Tweed

Lisa [: 00:00:00

Welcome, listeners. Today, we are kicking off our Aging at Home series. We are gonna be doing a series probably through maybe, I would say, through June or July. This will be the series that we are focusing on. And our goal here is to give our listeners some insight and some some solutions, that will help you successfully age at home. And we are going to start with a topic that is near and dear to my heart, the value of home care with Steven Tweed. If you don't know Steven Tweed, you're not in home care because he is the man. Everybody goes to him to learn how to build a business in home care.

Lisa [: 00:00:42

Am I overstating it, Steven? You're gonna tell me I am, but I know I'm not. Hi, Steven. How are you?

Steven Tweed [: 00:00:48

Well, thank you, Lisa. It's great to be with you and your audience today.

Lisa [: 00:00:51

Thank you for joining us. So go ahead and tell our audience who you are and give us a sort of snapshot of your professional accomplishments as they relate to home care.

Steven Tweed [: 00:01:04

Well, thank you. I'm the CEO of a company called Leading Home Care, a Tweed Jefferies company, and we are a consulting and publishing company serving the home care industry. We serve owners and CEOs of home care companies in the top tier of our industry. I'm also founder of the Home Care CEO Forum, which is a network of owners and CEOs of home care companies in the top tier of the industry. And, I'm also doing a fair amount of industry research to help gather facts, data, and information to help owners make better decisions about serving their clients and, employing their caregivers and serving their communities. So that's what we've been up to. I've been doing this for many, many years. And, we just love the people who own and operate home care companies and who are committed to caring for their clients.

Lisa [: 00:02:02

And, of course, this is how I know you. I've had the privilege of working with you in a past life, and I learned lots of things from you. Took away lots of nuggets that I was able to implement and use and and help us be better home care providers. But outside of the professional, you've had some personal experience, in the home care arena as well. Can you talk to us about your story?

Steven Tweed [: 00:02:29

Sure. I know you know the story, Lisa, but, my connection with home care actually goes back to October of nineteen seventy one. In Pittsburgh, Pennsylvania, I walked into the office of a world renowned pediatric neurologist at Pittsburgh Children's Hospital, and he gave us the results of his diagnosis of our son. Our son, Jason, was one year old at the time, and the doctor explained the the tests that he had run. And he said, based on everything I know, I believe your son has a rare neuromuscular disease called Wernicke Hoffman syndrome, anterior spinal muscular atrophy. He said, this disease is very, very rare. He said, I've been practicing medicine here for thirty years, and I've seen 12 cases. He said, we have no idea what causes it.

Steven Tweed [: 00:03:31

There is no known cure. He said, I believe your son will live to be three or four. Take him home and love him. Now back then, we Josh. Did what the doctor ordered, and we took him home, and we loved him, and that worked. And as you know, Lisa, today, Jason is 54 years old. He still lives in a wheelchair, and his physical abilities are limited. But, through the services of home care companies and home care aids, he is able to live independently.

Steven Tweed [: 00:04:04

He's married. He and his wife, Christy, have twins that are now 22, and he owns his own Internet marketing company, a company called Mediastead, where he and his team build websites and do digital marketing for other home care companies and for other local businesses there in Eastern Pennsylvania. And so we have benefited from the services of home care for fifty plus years and, it's been a real blessing. Obviously, home care benefits Jason as the consumer, but we also have to acknowledge the benefit to the family of folks who receive home care because it it gives us a peace of mind. It gives Jason quality of life and independence, and it's just a huge blessing to the family. And so I know your listeners oftentimes are family members, maybe primary family caregivers of folks who, are in need of senior care, and we are just so, fortunate to have this strong senior care industry, particularly home care, in America.

Lisa [: 00:05:25

It is so true. And so, Jason, is it fair to say Jason has received home health services all his life?

Steven Tweed [: 00:05:33

Yeah. When he was growing up, his mother and I did most of his personal care. We did learn about home care when he had an extensive, stay at Cleveland Clinic, had some major back surgery, and he received some home care after that. But we did the majority of his care until he went away to college.

Lisa [: 00:05:51

Okay.

Steven Tweed [: 00:05:52

And Jason went to Edinburgh University in Pennsylvania and Edinburgh has a wonderful program for physically disabled students. And it was at Edinburgh where he first experienced having an outside caregiver. And the university employed students to serve as caregivers for their disabled students. And so Jason learned to work with, other young people as his caregivers. Then when he graduated, he came home to live with me. And at that time, I was single and a single dad. And so Jason and I were together for about five years, and he, learned to manage his own care, to hire his own caregivers, to work with the home care companies that provide care. And then I remarried and moved to Louisville, Kentucky, and and Jason elected to stay in Pennsylvania to live independently.

Steven Tweed [: 00:06:48

And then, of course, he met Christy and they got married and and grow their family. So, it is through home care that he has really learned to be independent. He's learned to interview and hire and train and supervise his own caregivers. And it has given him just a huge amount of independence, which made a great difference in his life and the life of his family.

Lisa [: 00:07:13

And and what I love about what you're saying, Steven, is that I you know, obviously, we're both in home care, And I have heard so many times people are reluctant to accept services because they say they want to stay independent. And the whole point of home care is to help you stay independent. And in Jason's case, it taught him how to be independent. So home care is not about taking your independence away from you. It's helping you sustain and become more independent. Would you agree?

Steven Tweed [: 00:07:48

Yes. That's exactly right. And and you make a great point, Lisa, that many people, particularly older people, as they age, are really hesitant to accept support and and care. And I think there's two reasons for that. One is we're used to taking care of ourselves and we're used to taking care of others. And so, it becomes an awkward moment when an older person recognizes that they're no longer able to care for themselves and that they need to depend on someone else.

Lisa [: 00:08:24

Yeah.

Steven Tweed [: 00:08:24

And so, there's a tendency to resist that and to put that off as long as possible. The other thing we recognize is that many older folks are reluctant to let somebody into their home who they do not know. Part of that is the desire for privacy, and we know that older folks really want you to respect their privacy. The second part is the fear of the unknown and not knowing this person, and am I going to be safe or my possessions going to be safe? And even though there are some isolated incidents of caregivers stealing or harming clients, that is such a tiny, tiny percentage of home care incidents where there is some kind of a problem. The vast majority of the time, we have wonderful caregivers who are kind and compassionate and do a good job caring for, their clients. But there is that fear on the part of older folks. The other side of that equation though, as you know, Lisa, is that research by the US Department of Health and Human Services shows that it's likely that seventy five percent of folks who reach the age of 65 will need some level of extended long term supports and services. That could be home care, it could be in an assisted living facility or skilled nursing facility, but the vast majority of older Americans will need some assistance with the activities of daily living at some point in their lives.

Steven Tweed [: 00:10:09

We also have some data from AARP that show that seventy five percent of older adults prefer to receive their health care at home. With all of that data, it shows us that home care is a valued and appreciated service and that this industry is here to stay for a long period of time. And so for consumers looking for senior care, whether it's an individual who's looking for care for themselves or a spouse, or whether it's an oldest daughter who's looking, to provide care for mom or dad, that home care is certainly a viable option, but it's something that they need to be comfortable with and need to learn how to select a home care company, how to work with a home care company, so that you get the positive, desirable outcomes you're looking for. Yes. And I have some very specific questions. I outcomes you're looking for.

Lisa [: 00:11:05

Yes. And I have some very specific questions. I want you to help us understand how to choose the right home care agency before we're done talking. But these statistics that you mentioned have not changed. We have been doing this podcast or a live radio program five years prior to this called senior agenda. And these statistics, seven to eight seventy to eighty percent of seniors who are surveyed say they want to age at home, and I used to tease and say, Yeah, and the other 20% misread the question. Everybody wants to age at home. And home care is the most desirable, in my opinion.

Lisa [: 00:11:42

It's the least intrusive, because you do get to stay at home in your comfort zone. It's still your home, and you just need to learn how to work with people and accept the help. I also say this, mommy doesn't like this, but I say it anyway, we come into the world as babies and we need everything from everybody, and there's no shame in that. Hopefully, that isn't how you exit the world, but there's no shame in needing a little help. You've been a caregiver, older adult. At some point in your life, you've provided care for others, whether you had children or not. And so, you know, that's it's just a continuation. It's really a very human option is how I think of home care.

Lisa [: 00:12:31

It is is a humane human option, and it's people helping people. And I don't know why we put up such a fuss against it, but sometimes we do. But then after you experience home care, hopefully, you change your mind. And we do find that most people do.

Steven Tweed [: 00:12:49

Yep. You're you're right, Lisa. And what we've observed is that while older adults may be hesitant to accept a caregiver or have home care once they have a caregiver in place and it's somebody that they get to know and trust. They're very happy with the results of their care Yeah. And with the caregivers that that they're working with. Sometimes it takes a little bit to to get the right connection between the right caregiver and the client. But once they get that established, the level of satisfaction is very, very high.

Lisa [: 00:13:19

Yeah. Yeah. For sure. So now before I ask you about how to choose a home care, so you had this experience with Jason, but then you had another experience later in life with an older adult in your own life. Can you tell us about that?

Steven Tweed [: 00:13:34

Well, yeah, we have had care for both of our parents at home, my wife and I. And so, we understand what it's like to be the child of an older adult who's receiving care. And again, the positive outcomes of that in terms of not only the care for the client, but the the peace of mind that the family experiences knowing that mom or dad is being well cared for.

Lisa [: 00:14:04

And I think it says a lot about you as a person, Steven, that you're not yes. You're a businessman and you're a savvy one and and and you have a service to sell, and it's a valuable service. But you also utilize the services that you sell. You believe in them. Your heart is in this, and you've experienced it seven ways to Sunday, as they say.

Steven Tweed [: 00:14:25

That's exactly right. And that's really what attracted me to this industry. I actually before I started working mostly with home care companies providing in home personal care, for many years I worked with agencies that provide home health and hospice. And I worked with my first home health agency in 1982 in my local community where I was living at the time in Western Pennsylvania and I was just taken aback by the passion, the commitment, and and the core values of these nurses and therapists in the home health agency and what they were doing. And, I was drawn to that organization. And so for twenty years, I worked extensively, with home health and hospice speaking at conferences, leading strategic planning for agencies, helping them with a variety of leadership development and sales and marketing activities. And so we know that huge influence that that home health and hospice have, actually was the interim president and CEO of a large home health agency in Louisville, Kentucky, in 1999 and February. And then my son and I started this company leading home care in 02/2002.

Steven Tweed [: 00:15:47

And that's when we began to, really work with, the home care people in home personal care, and we've gravitated to that sector because we love these entrepreneurial owners and and leaders of these companies, and it's been a great joy.

Lisa [: 00:16:06

Yes. And so there there is a distinction. We'll make this for our listeners between what we call medical, home health care, and nonmedical home care. And what we're talking about that Jason received and and what you are now, the leading expert in is the nonmedical piece where you send caregivers in, to supplement care for the family, as you say, as well as the individual. Yes?

Steven Tweed [: 00:16:33

That's correct. That's correct. And and a matter of fact, for your listeners, they may be interested in in knowing a little bit more. There are really five different types of organizations that provide healthcare at home. We've been talking about home care, that's in home personal care, caregivers providing assistance with the activities of daily living, And that tends to be paid for by private pay, families paying out of pocket, or it's covered by Medicaid in pretty much every state has a Medicaid home care benefit. The US Department of Veterans Affairs has a benefit for veterans to receive home care, personal care at home, and then most long term care insurance programs will pay for in home personal care. So, that's the in home personal care piece. And so, I think it's helpful for people who are looking for home care to understand that there's a wide range of products and services that they can have access to, and it's helpful to have a better understanding of each of those service lines and and to be able to ask the right questions to select the right provider of care or the provider of products.

Lisa [: 00:17:49

Absolutely. If you're going to age at home, chances are you might need health care at home. And that's why we chose this topic to kick this series off. So, Steven, what about that? How should a consumer go about choosing a home care agency? What questions should they ask? What should they take into consideration?

Steven Tweed [: 00:18:10

Well, that's a great question. And basically, I think there are three ways that people get connected to a high quality home care company. The first way is a family member or a friend who has personal experience with home care who can say, my mom used XYZ home care, and we were very satisfied, and they had great caregivers, and I got to know the owner, and I can personally recommend and endorse this home care company.

Lisa [: 00:18:44

Word-of-mouth. The

Steven Tweed [: 00:18:45

second way is to get a referral from what we call a trusted advisor.

Lisa [: 00:18:50

Mhmm.

Steven Tweed [: 00:18:51

That could be somebody in the medical community. It could be a nurse or a therapist or a discharge planner or even a physician that you're working with or that you know who can recommend a home care company. And the third is is through other trusted advisors like bank trust officers, elder law attorneys, the state attorneys, financial planners, other advisors, and we do a lot of work with home care companies to help them build relationships with these trusted advisors. Yeah. Because we know that a big chunk of home care is paid for privately, out of pocket. And in order to do that, people have to have a certain level of income or net worth. And so, the home care companies build relationships with, let's say, financial advisors or wealth managers because that puts them in contact with high net worth individuals. And so from a consumer perspective, whether it's you personally or your primary family caregiver that has relationships with these trusted advisors is asking those folks for recommendations of companies that they have worked with or that they know and trust that they can can recommend.

Steven Tweed [: 00:20:12

Third way information is is online, is to do an Internet search, and there's huge amounts of inter information out there about home care and home care companies. And I think the key question there is knowing the search terms to put into a search engine like Google to get the the best results and to be able to use a variety of different terms to get different results, and you will begin to see, companies popping up on the different searches and then being able to look at their websites, look at the reviews, look at the testimonials Mhmm. To get a sense of which company seems to make the most sense for you.

Lisa [: 00:20:57

Google reviews. Right? That's something that you might wanna look at or the testimonials on the websites might be something that you wanna look at. And I wanna go back to, like, of course, these things are true, what you say, but if you have Medicaid and you don't have, you know, a ton of resources at your disposal and you're on a waiver program, in one of the states, then a trusted advisor for you might be area office on aging.

Steven Tweed [: 00:21:25

That's right. There are lots of resources available for, older folks. The area of office on aging is one. Mhmm. Also, the Medicaid organizations in each state have case managers.

Lisa [: 00:21:39

Mhmm.

Steven Tweed [: 00:21:39

And, of course, as you know, most states have now gone to managed Medicaid where they contract with insurance companies to be the third party administrator for their state Medicaid program.

Lisa [: 00:21:53

Yes.

Steven Tweed [: 00:21:53

And managed care organizations have case managers that work with their individual clients. And so as a person who is a beneficiary of the state Medicaid program, you get to select the the MCO or the managed care organization that you want to work with and you build a relationship with the case manager, and those case managers then will refer you to a home care company that can provide the services to meet your needs. And what I have observed, Lisa, is that the case managers like to refer to home care companies that do a good job for their clients and make their job as a case manager easier. And so, the companies that build relationships with their case managers that that make their job easier and that do a good job caring for their clients tend to get the referrals. And so that's a way to find a home care company that could be best suited to your individual needs.

Lisa [: 00:22:58

Yes. And that's another beauty of home care, as it should be with all aspects of health care. And hopefully, mostly it is that you get access to this service regardless of your resources. There are ways to find it no matter who you are in this country. Stephen, what are you up to these days professionally? Did you change companies recently or are you still with the same company?

Steven Tweed [: 00:23:24

As I mentioned at the beginning, I I'm the CEO of our company Leading Home Care, and my wife and I are business partners in our parent company Tweed Jefferies LLC, but we have two different practices. And so I run Leading Home Care. My wife has another business line we call Executive Mastery, and she coaches physician leaders in academic medicine. And so I'm still working at Leading Home Care. But as I mentioned, we've created the Home Care CEO Forum in 2012, and we started introducing the mastermind concept to the home care industry where groups of owners come together to share ideas, to solve problems, and to support one another. And we grew that to five mastermind groups, about 55 companies. And then I sold that business to one of our members, his name is Jensen Jones. And Jensen acquired the Home Care CEO Forum in 2023, and I had a two year agreement to continue to lead one of the mastermind groups and do some other support work.

Steven Tweed [: 00:24:32

And our agreement came to the end at the December, so two and a half months ago. And so I am in the process of rewiring, my career, and so I'm focusing on three things. One is, serving on some boards of directors of home care companies and companies that provide services to home care. Second thing, I'm serving as a strategic advisor, to a number of home care companies CEOs around specific initiatives or projects that they're working on. And then the third thing that I'm doing is continuing to do industry research, into the home care industry, and we just published the 2025 future of home care report. The study, about two fifty home care leaders, answered our survey and we analyzed that information. And, so we designed and and conducted the study at Leading Home Care, and then that was published by Access Care, which is the leading home care software company in the industry. And so I we're doing some other, research.

Steven Tweed [: 00:25:43

So right now, my my role in home care is three things, being a board member, being a strategic adviser to CEOs, and doing industry research.

Lisa [: 00:25:53

And what makes me happy about that is you can't get away from home care, can you? You are a home care guy through and through.

Steven Tweed [: 00:26:02

That's correct. When I, when I sold the home care CEO forum and I I my two year agreement was coming to an end, I posed that question of what's next. And I knew I wanted to keep doing some meaningful work or at least volunteer work. And, I looked at a number of different options. But like you said, I I kept being drawn back to home care

Lisa [: 00:26:26

Yeah.

Steven Tweed [: 00:26:26

Because we love people and we love the work that we do. And so then a friend sent me an article called, I'm not retiring, I'm rewiring.

Lisa [: 00:26:37

Love it.

Steven Tweed [: 00:26:38

So that's my theme for 2025 is rewiring. And, that means, you know, tearing out some old wiring and putting in some new wiring. And so that's what I'm doing at the moment is is getting rid of some things that I used to do, and refocusing on the things that I do that, number one, I love to do, and number two, I think will have the most positive impact on on the home care industry.

Lisa [: 00:27:03

How would someone go about getting in touch with you if they would like to, Steven?

Steven Tweed [: 00:27:08

If people would like to, communicate with me, they can do the easiest way is through my, website, leadinghomecare.com, l e a d I n g, home care Com. And you can see more about what we do, And there is an inquiry form there. People can fill out the form, give me their name and email address and a phone number, and I get those almost immediately. And I'm really good about reaching back out to people within twenty four hours. I'm very open to setting up a phone call or a Zoom meeting with people who are seeking information or wanna have conversation or are thinking about the home care business or thinking about some other aspect of home care. So, the best way is at leadinghomecare.com.

Lisa [: 00:27:55

And if you want to learn more about home care, if you're thinking about starting an agency as a provider, I highly recommend that you contact this man. He is a wealth of knowledge, and he's a good person. He's kind, and I'm delighted that you are staying in the home care industry, to continue to share your information with people. Closing thoughts for our listeners, Steven, what would you like to leave them with? Anything?

Steven Tweed [: 00:28:22

Senior care is a major issue in our society that the the 85 of the population is the fastest growing demographic, and there are just more and more people who will need some type of care at home. And, we know that there are wonderful entrepreneurs in the home care space who really want to do the right thing in caring for people and and providing them peace of mind and quality of life at home. And so I would encourage your listeners to just think about it, become aware of home care, and be prepared in advance for when either you need care or you have a family member who's gonna need some level of senior care. Very good. Well, thank you, Lisa. Appreciate what you're doing and best wishes to all your listeners.

Lisa [: 00:29:07

Thank you, Steven, so much for joining us. And I will add this. If you happen to be in Ohio, naturally, I have alluded to the fact that I'm in home care and our sponsor is Home Care of Ohio. And I can vouch for this company. I've been a part of it here in Ohio since inception, and I love what I do. So if you're in Ohio and you're thinking about becoming a caregiver or if you need care for a family member or you yourself need some assistance, call us at (419) 458-3000. Listeners, thank you for joining. Till next time.

Lisa [: 00:29:40

May the road rise to meet you. May the wind be forever at your back.