Andy Hess – Village Caregiving
It’s almost stretching coast to coast, Village Caregiving just having been licensed to provide personal at-home care in Maryland. Contiguously, the operation stretches state-by-state from there to Idaho, which still leaves it short of the Pacific shore. In due time, the executive team expects to get there.
“There is a lot of political support for our industry,” notes General Counsel Andy Hess from Barboursville, West Virginia, where Village Caregiving began in 2013. “We have support from both sides of the aisle. The more basic care you can get at home as you age, the longer you can stay out of acute care.”
A leader in this still young industry, Village Caregiving now has a presence in 18 states, with a staff of around 100 administrators and 2,200 vetted caregivers tending to the basic needs of mostly independent-living elders. It’s essentially the same personal services such clientele would receive in an assisted living facility—bathing, shaving, toileting, ambulation, meal preparation, light housekeeping, simple errands and companionship—with the recognition that each person has unique needs.
And while Village Caregiving isn’t skilled nursing, it still involves healthcare, a vulnerable clientele and a complex business model. Thus, there’s need for the legal department that Hess has helped create since transitioning from private litigation to Village Caregiving in September 2019. Initially, he juggled legal responsibilities with his official post as executive director and since January 2021 has concentrated on the former in his new role as in-house counsel.
Litigation to strategic
There hasn’t been much litigation at Village Caregiving, but Hess keeps busy in a strategic role that involves identifying locales where elders aren’t well-served, analyzing state and program rules, and establishing satellites nationwide. As often is the case with a nascent industry, Hess says state rules and regulations tend to be reactive and just garnering a license can be painstaking.
“Maryland was very tough only because it took so long,” he tells Vanguard in March, a few days after that state finally approved Village Caregiving’s application. “They consider us a quasi-skilled agency and the licensing process took around a year. They wanted so much documentation on the front end.”
Pennsylvania too was a challenge, though Hess says Village Caregiving provides the same type of basic care there that it does in every other state. Some states, however, have rules that preclude a basic caregiver from even handing a pill to a customer. Some states want caregivers to be certified in basic first aid. Other states don’t require licensing, but all have their own employment laws.
The company striving for transparency, it has a hub and executive and operations directors in every state as well as at least one office. While Village Caregiving doesn’t provide acute or medical care, it still has at least one registered nurse at each office to assist with training, charting and general advice.
Everything’s also owned and managed by Village Caregiving rather than outsourced or franchised. This, Hess says, enables the company to better oversee its operations and assume responsibility for those 2,200 caregivers.
“We always preach to use common sense and do the right thing,” he says. “I’m constantly in our community and people approach me all the time. Either they’re thanking us for taking care of their loved ones or they’re asking if they could also use our assistance.”
Much of that assistance is privately funded, though it may also come from VA benefits, long-term care insurance, certain Medicaid programs, Medicare Advantage, workers’ compensation, UMWA and others. Hess assures that Village Caregiving is much less expensive than the hundreds of dollars patients are assessed daily in assisted living and in nursing homes.
Earning his stripes
And Hess knows much about nursing homes, having often defended them while litigating for 11 years at a couple of West Virginia firms, Jenkins Fenstermaker and Steptoe & Johnson respectively.
“It can be difficult to defend nursing homes,” he says. “There are so many built-in legal risks at nursing homes and they’re always under attack by plaintiff attorneys.”
Hess was only in his mid-30s and maybe just hitting his prime as a trial lawyer when he started looking beyond the courtroom around four years ago. That life was putting too much pressure on him as a husband and father of two—now three—small children.
Though Hess wasn’t at wit’s end, he texted his college roommate and lawyer, Jeff Stevens, who along with a couple other lawyer buddies from way back—Matt Walker and Andrew Maass—had Village Caregiving operating in West Virginia, Ohio and Kentucky. Stevens, Walker and Maass, the three owners, were already joined by Ben Keenan, Wade McGlone and Corey Watson, other old friends of Hess’s.
Over a beer at Main St on Central, a popular Barboursville cafe, Stevens assured Hess there’d be a place for him if he wanted it. Initially, it was as executive director, but when the general counsel’s title was added, Hess didn’t resist.
As Hess explains, the actual titles don’t really cover everything he does. The same holds true for the others on Village Caregiving’s executive team, whose lines of responsibilities sometimes blur. However, with so many law degrees in the group, the company would seem prepared to handle any legal matter.
And the legal issues arise with more frequency, which is only to be expected as Village Caregiving sustains its growth. While Hess has been involved on the business front with other members of Village Caregiving’s executive team, he’s being increasingly looked upon for legal insight into the nuances of eldercare.
“I see this morphing into a traditional general counsel’s role,” he says. “I’m having to learn more and more about employment law, compliance, governance …”
But bring it on, says this University of Cincinnati law graduate. It’ll soon be four years of in-house personal and professional growth and demanding as Village Caregiving can be, he greatly prefers it to litigating. That said, the years of facing off against opposing counsel in high-stakes medical malpractice and wrongful death cases were well-spent—Hess becoming keen about risk management, which is a big concern in any aspect of home or health care.
“It’s an awesome company that’s changed my life,” he says. “We’re helping more people as we expand.”
View this feature in the Vanguard Spring II 2023 Edition here.
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