Josh Fertel
00:04
Welcome to the Angry Biller, a show where we explore the people and the businesses behind the scenes of healthcare, those men and women that are the catalysts that allow providers to concentrate on delivering exceptional patient care. Welcome to the Angry Biller. My name is Josh Fertel, I am the owner of J3 Medical Billing and I am your host. I've been thinking a lot about the cost of J3 Medical Billing and I am your host. I've been thinking a lot about the cost of health care as people get older, as Americans age, when it comes to Medicare, when it comes to long-term health, when it comes to deductibles, when it comes to all the things that have to be paid as we get older. And in that light, we've invited Natasha Cato, who's the owner of Angel Touch Home Care, to join us and talk about what happens as people need help as Americans, as they age and need help, how that affects the families, how that affects the patients. Hi, Natasha.
Natasha Cato
00:57
Sure.
Josh Fertel
00:58
How are you?
Natasha Cato
00:59
I am good, I'm good, thank you. Thanks for having me, josh. Yes, thanks.
Josh Fertel
01:04
No, thanks for coming. So before we get started about what it is that you do, let's go to the bidding. Tell us you know how you got into what you're doing. Give us your background.
Natasha Cato
01:12
Sure. So very early when I was six years old, I was asked by one of my teachers in Jamaica what I wanted to be when I grew older, and of course my response was I want to be a nurse.
Josh Fertel
01:27
Of course.
Natasha Cato
01:28
And I pursued my career. I started as a medical assistant and later on I went back to nursing school and I became a registered nurse and I have served throughout a lot of the local hospitals here in the South, started at Broward General in North Broward and I did some Army hospital nursing also and travel nursing and later on I decided that I wanted to open my own home care agency, which I did and I absolutely love it.
Josh Fertel
02:03
So what made you make that decision that you wanted to open your own home care agency?
Natasha Cato
02:07
So I wanted to do that because I find that being in the geriatric population, serving those clientele, it's just a passion of mine. I love the geriatric population and I believe that at the point when I made the decision I was just over like doing the bedside clocking in, clocking out and. I wanted to do it on a different scale, do it for myself, and I just Was there something in your background that led you towards geriatric Besides?
02:42
being a nurse no, just that compassionate soul that I have and just caring about people and you know, just providing the care and support that they need. No, yeah, that was that, was it.
Josh Fertel
02:56
So. So let's go to the beginnings of Angel Touch.
Natasha Cato
02:59
So I opened this agency in 2021. Ok, it was during the peak of covid right sure and um. One of my very first client was a covid positive patient and unfortunately this family was on a cruise and um they discovered that their loved one had covid and everyone was just like terrified. They couldn't find an agency and I jumped right in and helped them. And we still have that client till today.
Josh Fertel
03:31
Well, that's good. So the family was on a cruise. The patient was home.
Natasha Cato
03:35
The patient was at a facility. Actually the family was on a cruise and he was wandering and they needed someone to watch him and we said we could and we did.
Josh Fertel
03:48
I had an uncle who had the same thing happen to him. You know the family. He had the early stage dementia and just disappeared and then they had to find him. But how did the family find you?
Natasha Cato
03:59
So it was a recommendation from the nurse at the facility. That's good to know. Why don't you give this agency a call? And they did, and they trust that we would do what we say we would.
Josh Fertel
04:09
Right, and we did so. Let's move on, and then let's talk about the providers that you have working for you. How do you vet them? How do you go through their background? What kind of qualifications do they have and what do you look for?
Natasha Cato
04:21
Sure. So all of my caregivers. They are certified, so they are certified nursing assistants and or they are home health aid HHAs. When they come into the office, before we employ them, we are looking at their background screening. So we're doing a level two background screening.
Josh Fertel
04:40
Which is.
Natasha Cato
04:41
Which is we're checking for any criminal history that they have and just anything that will pop up that will prevent them from working in the health care industry and their skill set, their skill set. They go to school like for six months or so and they do like CEUs. So we're checking they're doing like domestic violence, HIPAA, HIV and AIDS, continuing education, Alzheimer's and dementia and I believe there's others. I was scared.
Josh Fertel
05:18
No, go ahead, Just keep going oh my God.
Natasha Cato
05:20
So Go ahead. I was like, just keep going, don't worry about it. So those are the requirements. The CNAs their license is renewed every two years. Okay, and before you renew any license, you must do continuing education. We also do a competency test in the office. So we're ensuring that the CNAs are the HHAs. They know how to use basic equipment like a wheelchair or a walker and to open it and close it and put it away like in a car.
Josh Fertel
05:53
You would think those are easy things to do.
Natasha Cato
05:55
We think there is a skill set to that. There is a skill set to it, right.
Josh Fertel
06:00
And then the services that you provide are non-skilled.
Natasha Cato
06:03
So yes.
Josh Fertel
06:04
And that entails what in the course of a normal day?
Natasha Cato
06:07
So it would be more like what we would refer to as custodial care. We usually go by assistance with activities of daily living and that could look like taking a shower, grooming someone, combing the hair, brushing the teeth, medication reminder they're not nurses, so we're not physically administering medication. We can remind a client time for your medication, here's your water, here's your pill bottle. Um linen changes, um laundry, grocery shopping, making someone a meal, lighthouse keeping we're Super important. Yes.
Josh Fertel
06:45
When there is a medical emergency, which I'm sure happens. What is the protocol to that?
Natasha Cato
06:51
So the protocol for any medical emergency. This is outside of the AIDS practice or scope of practice. So they know, when there's a medical emergency, call 911. Right, and after you do that you call the office to report what's happening.
Josh Fertel
07:09
Do you have an example of when that everything went well?
Natasha Cato
07:12
Yes, so we had a situation where a patient had sustained a fall and the aide know that they're not supposed to lift someone from the floor when they fall, so she called EMS. Okay, they arrived, and then she calls the agency to report what had happened.
Josh Fertel
07:29
Right, and then the outcome was the outcome was great.
Natasha Cato
07:32
They took the client to the hospital and they check them out. Luckily, fortunately, there wasn't any fractures.
Josh Fertel
07:39
How do you gauge the feedback? How do you gauge how your custodians are handling their responsibilities?
Natasha Cato
07:48
Sure. So what we do? We have a system that we use. It's a time and attendance system and caregivers and the clients can go onto that portal and they can make changes not changes but they can put comments or they can report a change in condition. Or sometimes the nurse will go out and do supervision visits unannounced.
Josh Fertel
08:12
The nurse yes, that's you, that's me. No, that's good, because it's your company. You want to make sure everything's going great, that's me. And you're going to go ahead and inspect what you expect, as they say. Exactly, totally. What are the safety precautions? You've mentioned AIDS a few times now and we've mentioned COVID. What are the safety precautions that are taken for the custodians to protect themselves? Also?
Natasha Cato
08:33
So to protect themselves, one of the most important thing is always hand washing themselves. One of the most important thing is always hand washing. Okay, so that's a universal precaution. Everyone knows that they have to wash their hands, so that's a must do. Also, if someone if you suspect that's one of the caregivers or the client caregivers when they're sick they don't report to work, it's the biggest thing is we're trying to avoid them passing. It goes both ways right To the client client correct.
Josh Fertel
08:57
Tell me what the instance is of that you're most proud of in your company, where something happened, maybe with a patient, maybe with a custodian. You said this is the story I want to tell everybody about how we stepped up and we came to give over and above care okay, so, um, so there has been several situations like that.
Natasha Cato
09:17
For example, I will get a call and at maybe 730 in the evening.
Josh Fertel
09:23
Right.
Natasha Cato
09:24
And from a family who is out of state or just not able to go into their, their loved one, and they are like literally begging please find me someone. My mom just fell.
Josh Fertel
09:37
Oh.
Natasha Cato
09:38
And I just need someone to be there and I I always pull that off right so because I have those caregivers who are just willing and able to just go you have a a backup plan.
Josh Fertel
09:52
I have not a backup plan, but you have people in wait people waiting to work and they, they, you, people like you and trust you.
Natasha Cato
10:00
They're going to just do anything for you, right? And so those caregivers how did they find?
Josh Fertel
10:05
you.
Natasha Cato
10:05
So most of them are coming from schools Like we. I work very closely with some of our local schools. Which ones Alliance, for example, there's a graduation. Speaking of that, there's a graduation on Thursday that I'm invited to, wonderful, and this is in Delray. So they send all their graduates to us. And also, people are just finding us and we use Indeed and this is just where we get our caregivers and word of mouth also. How could I forget?
Josh Fertel
10:35
that Word of mouth. That's the best way to grow your business, especially if you have that greater reputation, like you have, and people want to come work with you and your employees are W-2, right, they're not contractors.
Natasha Cato
10:48
Yes, so my employees are W-2. They're employees, not independent contractors.
Josh Fertel
10:53
And you did that why.
Natasha Cato
10:55
So I did that just because for a lot of people, a lot of the clients, when they're signing services, they want to know that you're their employees, so they that. I think that gives them a little bit more peace of mind, knowing that there is someone for the person to report so and you, there's someone to hold them accountable. So, yes, they% employees, and I think the caregivers like that also. When it comes down to withholding taxes and so on, most of them prefer that.
Josh Fertel
11:28
Very good.
Natasha Cato
11:29
Yes.
Josh Fertel
11:30
How do you use technology in your business, in your business?
Natasha Cato
11:35
So that's a great question. For example, right now we're using a system. It's for time and attendance.
Josh Fertel
11:42
Okay.
Natasha Cato
11:43
And it's WellSky and I find that it's just users-friendly. So, for example, when a caregiver goes into the client, once they're at the location they're able to clock in, see what their tasks are for the day.
Josh Fertel
11:58
There's an app on the phone and it's an app. Yes, yes, and it sees the tasks.
Natasha Cato
12:03
And they punch in and out and they are able to complete all their tasks and they mark the tasks in the app as done. So if it's not applicable, then they'll just check it off as such.
Josh Fertel
12:14
That's very good. It's good to know that you're able to number one, see where they are.
Natasha Cato
12:19
Totally.
Josh Fertel
12:19
Right and make sure that they're doing everything that they're supposed to do Right. How do you see Angel Touch in the future? Where do you see it?
Natasha Cato
12:29
going. But when I saw myself two and a half years ago I didn't know where I was going. But now that I see the changes over the years, the two, two and a half years I it's just amazing. It's, it's just a matter of time, right. It's just a matter of time, right now.
Josh Fertel
12:51
A matter of time before what.
Natasha Cato
12:52
Before every. I'm just everywhere. It's just amazing where, from point A to where I am right now, spectacular growth yes.
Josh Fertel
13:04
That's good. That's what we like to hear. All right, let's be a little proactive here and let's talk about what your feelings are about the costs, why it costs so much to grow old. Where do you see the big issues? What do you think needs to be looked at? You're a business, right. There's a fee for your business.
Natasha Cato
13:30
Yes, there is, and I feel like right now, if a lot of people knew about the long-term care insurance, they would have tapped into it. A lot of people would have purchased the coverage.
Josh Fertel
13:42
But most people have not.
Natasha Cato
13:43
Most people have not is what I'm seeing and, unfortunately, when the situation comes up and they now need the home care and realizing that they have to pay cash, it's very shocking for someone because it's not. It's very expensive.
Josh Fertel
14:01
It absolutely is. Most people are on Medicare. They have some kind of retirement fund that they're getting, and usually it doesn't come out too much. Exactly, how do those problems get rectified when you're trying to help your client? How does the family get involved?
Natasha Cato
14:22
So a lot of the time it is the family, the son or the daughter or the in-laws that are involved, and, for example, yesterday I was just speaking to someone and they were looking into keeping mom at home because that's mom's wishes.
Josh Fertel
14:36
Yes.
Natasha Cato
14:37
Versus going to an assisted living. But unfortunately, after hearing the prices, the cost Right. They were leaning more towards going to an assisted living because it's more cost effective for them.
Josh Fertel
14:52
Because insurance.
Natasha Cato
14:54
It's not insurance, it's out of pocket.
Josh Fertel
14:56
Right.
Natasha Cato
14:57
But it would be three times more to keep. Because the cost of maintaining the house, the cost of my services, the care services, it would be just way too much more. Mom needs 24-hour care. Okay, and when you look at the cost of a 24-hour care, you've got to pay hourly day every week. And then you look at what an assisted living is charging per month. It's just way more than they can afford.
Josh Fertel
15:28
But certainly there's a difference in the care right. I don't want to say there's a difference in quality of care, but it's the kind of care that's being given care.
Natasha Cato
15:37
Yes, that's correct, because if you have someone at home, it's more like a one-on-one care. That's your aid. You're being attentive to more frequently.
Josh Fertel
15:48
That's a great point.
Natasha Cato
15:48
yes, but if you go to an assisted living it's not the same because unfortunately they don't do one-to-one.
Josh Fertel
15:55
Exactly. That's a great great point. How do you assess how much time is needed per patient? So you have 24-hour patients and I'm sure you have some that are eight hours or whatever that is. How do you assess that Is hours or whatever that is? How do you assess that? Is that a conversation that's had with the family? Is it say this person needs it, this person doesn't need it?
Natasha Cato
16:17
Sure. So usually it is the family that makes that decision.
Josh Fertel
16:22
Okay.
Natasha Cato
16:22
Because we can always go in and say mom needs 24 sevens or dad need 24 seven care, 24 sevens or dad need 24 seven care. But then again, because it's a we're talking about cost.
Josh Fertel
16:32
Yes.
Natasha Cato
16:32
Then the family would have to decide if they can afford the 24 sevens versus just, you know, creating a schedule that will include the most when mom is mostly active is what I'm saying. Yes. So, for example, if mom is a late sleeper, if she gets up at 9 am, then you'll probably ask for the caregiver to come at 9. Right, and let's just say she sleeps throughout the night.
Josh Fertel
16:59
Right.
Natasha Cato
16:59
So they'll say okay, can we do 9 to 9 as opposed to 24 to 7 to save some cost?
Josh Fertel
17:06
Now, assuming that somebody's sleeping from 10, 11 o'clock till 6, 7 in the morning the 24-hour caregiver. What are they doing? What are they looking for?
Natasha Cato
17:16
Why are they there, right? Usually that's a great question. So usually if that's the case, then the family, most of the time they will not use the overnight shifts.
Josh Fertel
17:31
But since what is it that an?
Natasha Cato
17:32
overnight person is looking for? What is it that they're so for that? To answer that question if someone is demented, if they have Alzheimer's or dementia, they're wandering, or if there's just a scare that the person may fall because they've already had two or three falls, then yes, it's very important to have someone in place just in case that happens.
Josh Fertel
17:53
So that really comes down to more of protecting the patient than doing service for the patient, totally yes.
18:01
Oh, that's important stuff to know, especially if somebody is starting to have the beginnings of dementia, that the families know that there need to be 24-hour and one-on-one services absolutely the best thing that you can provide within the boundaries of finances Right, the home care as a whole. Do you see anything on the horizon in the future that will change, maybe as far as regulations or insurances or the government getting involved? Do you see anything in what you read or what you're you know in your industry discussions that anything might change to help you know, to help with this burden?
Natasha Cato
18:42
I hope I don't foresee any changes right now.
Josh Fertel
18:47
So this is just going to be a continuous problem. I just think it's going to be a continuous problem and the country's getting older and the country's getting older, so services like yours are just going to be that much more important.
Natasha Cato
18:59
That's right.
Josh Fertel
19:00
So my last question to you If I had a magic wand and I gave it to you and I said I can change one thing to help you, to help patients, what would it be?
Natasha Cato
19:11
Oh, my God, Josh, that's okay, let me think about that question. Change, change anything Magic To help. Okay, so that would have to be send us more physical, more bodies, more caring, compassionate, loving caregivers Okay, more caregivers, more caregivers, more caregivers. Like, although we have a lot, there seems to be a shortage, like we can never have enough.
Josh Fertel
19:37
Right, right, and that's a problem that's probably going to grow exponentially again as America gets older quicker. So more caregivers, more caregivers, that's what you would need. Compassionate, compassionate caregivers, caregivers. How does somebody get in touch with you, Natasha?
Natasha Cato
19:54
So I can be reached either by telephone.
Josh Fertel
19:58
What's the number?
Natasha Cato
19:59
561-235-5520.
Josh Fertel
20:03
Okay, and website.
Natasha Cato
20:04
Website angeltouchhomecarehc.com. Okay.
Josh Fertel
20:09
And what was that phone number again?
Natasha Cato
20:10
561-235-5520.
Josh Fertel
20:15
I think this has been a great conversation. I'm very happy to hear about the way your company handles the pressure of what it is that you're doing, and I congratulate you on your growth and continued success and we hope that you'll come back and speak with us again.
Natasha Cato
20:34
Thank you, thanks for having me.
Josh Fertel
20:37
Thank you for listening today. Please follow us on Facebook and LinkedIn, and you can check us out at theangrybuilder.com.
