Ep. 115: Home and Community-Based Services in Senior Living

Feb 12, 2024 |

Nancy Koury King, an HCBS consultant and executive coach, talks about the potential of home and community-based services in senior care.

In this episode, host Jennifer Drago interviews Nancy Koury King, a home and community-based services (HCBS) consultant and executive coach. She recently retired as the President of Senior Options, LLC and Westminster-Canterbury at Home, LLC, both wholly owned subsidiaries of Westminster-Canterbury on Chesapeake Bay.

With her senior living and healthcare leadership expertise, Nancy now provides home and community services consulting to help senior living providers develop and operate new HCBS programs and optimize existing HCBS services.

Senior Living Organizations and Home-Based Service Revenue Opportunities [04:55]
Nancy notes that PACE programs can bring great service and high margins to organizations like Brio Living Services. Nancy also mentions that the average margin for private duty is around 10%, while Medicare cases in home health have margins of about 17%. Nancy emphasizes that focusing on mission and margin when looking to add new services can add diversity and excitement to an organization while contributing to its bottom line.

[07:18] The size of an organization offering home and community-based services is more than just about its scale. If an organization wants to start a private duty home care program for its residents, it may have a lower volume initially, but it can still be beneficial. The focus should be on serving internal clients first, addressing their needs, and then expanding to the broader community when feasible.

Enriching HCBS for a Broader Mission
Nancy advises organizations to change their marketing mindset when expanding services beyond their physical location. She emphasizes that this requires a distinctive approach, especially in the beginning, where a dedicated sales force is necessary to grow the business outside the organization's walls.

Assessing Readiness for HCBS Portfolio Expansion [14:21]
Nancy considers a few prerequisites when selecting the right client for home and community-based services. What she values most is an organization's willingness to learn and adapt because expanding into these services is more complex than opening a new building.

Building a HCBS Strategy
When building a continuum of care for organizations starting from scratch, Nancy suggests considering factors like simplicity, ease of implementation, regulations, and organizational goals. The order of adding services might depend on these factors. Having team members with relevant experience can make the process smoother..

The Future of HCBS
Nancy believes that the potential of home and community-based services is just starting to be realized. She's excited about the opportunity for organizations to provide quality care and support to those who can't afford or choose to live in senior living communities.

Nancy's Advice to Senior Living Providers Considering Expansion of HCBS
Nancy advises senior living providers, executives, and board members considering home and community-based services to educate themselves first. This preparation is essential for deciding how to manage and organize the services and address certification requirements.

[28:21] In areas with existing home care, home health, and hospice providers, starting from scratch might be optional. Collaborating with other senior living organizations can also be beneficial, as it aligns values and cultures and can accelerate the startup of new services. Nancy emphasizes the importance of knowing the local landscape and identifying potential partnership opportunities.

You can reach Nancy at nancykouryking@gmail.com.
You can also follow Nancy on LinkedIn.

About Our Guest:

Dr. Nancy Koury King is a healthcare leader with over 30 years of experience, specializing in home and community-based services. She retired as President of Senior Options, LLC and Westminster-Canterbury at Home, LLC, both under Westminster-Canterbury on Chesapeake Bay. She previously served as Senior VP of Resident Care at Sunrise Senior Living, overseeing quality assurance, regulatory affairs, memory care, and resident care for 300 communities and 30,000 residents in the U.S., Canada, and U.K. She also led Senior Independence, now Ohio Living Home Health and Hospice.

Nancy holds a bachelor's degree in Individual and Family Studies, a master's in social administration, and a Doctorate in Management. She's a recognized nonprofit scholar, received a Lifetime Achievement Award from LeadingAge Virginia, authored "Fired: How to Manage Your Career in the Age of Job Uncertainty," and operates the Instagram account @levelupcareer.

About the Show:

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