Miriam Allred (01.07)
Today in the lab, I'm joined by Aaron Stapleton, the CEO of Trinity In-Home Care based in Cincinnati, Ohio. Aaron, thanks for joining me today.
Aaron Stapleton (00:35)
Hey, thanks so much, Miriam, for having me. I'm really excited to talk to you today.
Miriam Allred (00:39)
Likewise, we've known each other for some time now. We bump into each other at conferences. You've interviewed me, I've interviewed you. So you're really easy to talk to. I always feel that. And you're also really knowledgeable at both the micro level and the macro level. So I always get a lot from you and I think others do as well. So you're naturally you are top of mind to be an early guest on the show. So thank you for being up for it.
Aaron Stapleton (01:02)
Yeah, yeah, no, it's always easy to talk to you like you said, and I'm looking forward to digging into some of the stuff that we do and industry wise, you know, some things that are happening and hopefully some areas that we're moving forward in. And just excited to have a conversation with you.
Miriam Allred (01:22)
Awesome. Well, let's start with Trinity's origin story. Some people may be familiar with you or your background or Trinity's background, but I think it's a good place to start to hear your origin story and weave in some of your personal background and personal highlights as well.
Aaron Stapleton (01:40)
Yeah, so I guess it's always interesting to ask that because you never know where to start. But I think for this conversation, probably the best place to start is before I started this company, I was working for a skilled home care company in Cincinnati, Ohio. And I recognize that there was a need for higher level care in the non-medical home care space.
And so I left the company that I was with and actually the people who owned that company were part of the investors and helped me get this started. And at the time was called Queen City Home Care. And really the focus again was to bring that clinical mindset for higher level care into the non-medical space. so it was the thought process was how do we care for our older adults better?
and how do we keep them safe in their home and give them the best day possible. And I think one of the things that I realized pretty quickly was that it was more about the leadership or my interpretation of the leadership of other companies that was lacking. It wasn't necessarily the caregivers themselves or the frontline workers. And it was also my job to help uplift and show the worth of
the caregivers and so that was one of the things that I think pretty early on was a driver of you know then Queen City now Trinity and and so that was what drove our our mission and so you fast forward 10 years and
we needed to change our name, number one, because there were a lot of Queen cities that were getting into the healthcare space in Cincinnati. That's our nickname for anybody who's unaware of Cincinnati's nickname, it's the Queen city. So I decided to change our name for that reason and also we wanted to grow, expand. So we came up with Trinity for a couple reasons, three to be exact, Trinity.
Aaron Stapleton (03:54)
Number one is because we are a faith-based company. You don't have to have faith to work for us or get care from us, but we do like to put out there that we are serving a higher power that's asking us to serve others, right? And then the second thing had to do with my family heritage and a nod to them. And then third, we're our three pillars of care, customer service, and communication. And since day one,
Those three things drive our decision making, drive, you know, who we are and what we do. And in that time, now we're 13 years in business. We have expanded. now at three locations, Cincinnati, Dayton and Northern Kentucky, which Cincinnati is on the river of Ohio and Kentucky. so Northern Kentucky is just across the river, but around here, they say the river is wide. So you have to have a a third location for that. that's really kind of brings us to where we are now. And, you know, I guess a 30,000 foot view of our origin.
Miriam Allred (05:02)
was perfect. I love that you also woven the meaning of Trinity. I remember when you rebranded maybe a couple of years ago and I think it's so powerful when you create a new name and brand for the company that resonates both with you personally, with the community and with the people that you serve. And so that was a great overview. I want to hear a little bit more about your business model. Again, as I go into this conversation, I think a lot of people get value understanding the the framework of your business. And so if you could share a little bit more about your service lines and the people that you're serving and anything that you can articulate around how you think about your business model.
Aaron Stapleton (05:41)
Yeah. So to talk about that a little bit again, I'll go back to our origin story for the first 10 years or maybe even 11, we were really focused on private pay. And so I lump in long-term care insurance with a private pay because we use that more as a reimbursement to the client. We don't really accept that as a payment. And so
We were really focused on that. And then during the pandemic, we wanted to shift, not necessarily away from private pay, but we wanted to diversify the payer sources because we saw that there was a volatility, I guess, in private pay that, you you can go up and down and there's nothing really that kind of steadies the water. so...
We really got into the VA at that time. then Ohio is one of 14 states that has what's called AAAs or Area Agency on Aging. And so those are tax levies that the counties will provide for older adults to have care. And so the older adult will typically pay a much smaller fee to the county and the county will pay our fee. for their care. And so those services are much shorter in length, but they are consistent and we drive through that a lot. And so the past two and a half years diversifying our payer sources has really helped us with growing the number of people that we can care for.
And really that's why we got into this business is to care for people. And I say this all the time. you know, with private pay, it's starting to get to the point where we're really caring for the top 5%, you know, top three, maybe even the top 1%, depending on how, I guess, proactive people have been in keeping their money and saving it, I guess, towards the end of their life. But a lot of people aren't saving to live to be 100 or 105, right? And so we are
Aaron Stapleton (07:57)
you know, we got into this business to help more than just the top 5%. And so that's why we diversified our diversified our payer structure, and also why we decided to just be able to help as many people as possible. And it's something that we're actually looking forward to doing more of diversifying our payer structure here in the next a couple months and a year.
Miriam Allred (08:28)
That was great. It reminded me of one more thing that I want to ask you about, which is to my understanding, Ohio was a non-licensure state, but you and Trinity and your network have turned the tides a little bit in the state of Ohio. I think that's interesting and is an interesting part of your story. Can you share a little bit more about kind of the when and why behind that?
Aaron Stapleton (08:51)
Yeah, so I think it really goes back to 2017 whenever myself and Doug Wilbur, who owns an Ohio agency up in Cleveland, started the Ohio chapter of the Home Care Association of America. And, you know, my focus was to bring licensure to the state, right? That wasn't the only focus of the starting the chapter, but that was my focus.
And ultimately, I think what happened was a mixture of the need for caregivers during the pandemic. And it showed that our industry and caregivers as a whole were a industry that was needed during that time. But we had to, in the state of Ohio, and I believe in many other states, we had to fight for rights that I think a lot of other healthcare companies didn't necessarily have to fight for because they were seen as a needed thing during that time. And a lot of that just had to do with not understanding what our industry did. And so between that and then also there was a legislator who was made aware of a client who had unfortunately been stolen from and it was, you know, unfortunately, a bad story that happened from you know, a bad actor, but what that caused was a need for the start of home care being recognized as a licensure in the state of Ohio. And so in 2021, the work really started and HCAOA, the Ohio council and some other groups got together and started working together.
Aaron Stapleton (10:53)
which was great for us to be able to be seen in that space. And then in 2022, licensure passed and we actually had everybody come on board there. So it was a great opportunity for us to be seen. And now we work very closely with the Ohio Department of Health, which is where we fall under. And I think it just shows that we are an essential service and it also shows that we are a part of that healthcare continuum.
Miriam Allred (11:23)
Yeah, thank you for sharing that. think it's just a huge milestone for you, for the state and a big part of your story and your background and just shows again that you're thinking at the macro level, making an impact outside of just your business, outside of just your market, but really care in the state of Ohio as a whole. And nationally, you you talk about the HCAOA and your involvement on that board and it's nationally, we need to draw more attention to home care and shape the narrative ourselves and it's a lot of work and it's an uphill battle but it's people like you speaking up, pulling resources, getting people together and having those conversations. So I just wanted to highlight that because of how important it is.
Let's get into the topic at hand today. So you and I sat down a couple of weeks ago. Usually I ask guests, you what are your strengths? What are your passions? And a lot of different topics surface but the one that bubbled up for us is your caregiver career path. And so today I'm really excited to hear you talk about what it is, why you built it, the evolution of it, you know, the success that it's driven. And so the first question that I want to start with before we get into the actual levels and break down, you know, the roles and responsibilities of each, I want to ask, did you have a career path at the beginning when you started the business was that top of mind and something that you initiated out of the gate or
If so, you know, why was the top of mind? If not, you know, at what point did that surface and did you start to build one out?
Aaron Stapleton (12:55)
Yeah, and quite honestly, no, we didn't. And at the beginning, if we go back to the origin story, right, I think a lot of my focus was on the client care. And it wasn't necessarily, it wasn't that I didn't know that the caregivers and the employees weren't important. That was very paramount to me. But I think what I didn't realize was that they weren't seen as important to everyone else in the industry, right? And I would say to the majority of the people in our area in that industry. And so they weren't recognized, they weren't appreciated.
And this is just what I was being told. And so I think at that point, we, I would say within the first year, we had opportunities for people to advance, but I wouldn't have called it a career path. right? We had the ability for individuals to go from caregiving to a lead or somebody who would be on call that we could trust, right? We had a few caregivers who then became schedulers. And it was, I will, in complete transparency, will tell you that because we didn't really have a solid structure of what that looked like, we did fail a bunch in the beginning. We probably set people up for failure because we took a great caregiver and we threw them into a scheduling position because we said, you're a rock star here.
We don't want to lose you, so we're going to make you an admin. And those are two different work types, right? Those are two different things that you have to work at. And so... we didn't do a great job of setting that person up for success early on. And so there were little things that we had to tweak throughout the process. And you and I kind of talked about this a little bit whenever we were warming up for this call is we're still tweaking little things, the name of things, how we make sure that we are setting people up for success. What does training look like?
