Business Spotlight | Spring 2019
Presbyterian Villages of Michigan

Presbyterian Villages of Michigan: Revolutionizing in-home senior care

Presbyterian Villages of Michigan continues to grow and adapt to serve the region’s seniors

By Erik Cassano

There was a time, not long ago, when elder and senior care revolved almost exclusively around long-term residential facilities. Whether the decision to seek senior-living accommodations was medically driven or lifestyle driven, the choices were largely limited to assisted-living campuses, nursing homes and other similar arrangements.

That’s no longer the case, and Presbyterian Villages of Michigan is among the elder-care organizations leading the transition in Metro Detroit and beyond.

“New technologies are constantly emerging, offering options that weren’t available before,” says Brian Carnaghi, PVM’s vice president of finance and business development, CFO and treasurer. “It’s allowing us to focus on the consumer and providing avenues that allow them to age in the place they want to call home.”

Founded in 1945, PVM has seen many developments in elder care over the years. The nonprofit organization continues to provide all of the traditional care and services within its physical footprint, operating 34 villages throughout southeastern Michigan; PVM owns 32 of them while serving as the contracted manager for the other two. But nothing has fundamentally altered the landscape of elder care quite like in-home care.

New technologies, developed mostly within the past 20 years, have paved a path back home for countless aging residents. And while remaining in their homes, they can receive many of the same services that were previously only available on-site at a facility.

In the coming years, in-home care will present a major growth opportunity for companies in the senior care space, Carnaghi says. PVM has recognized the opportunity that presents and is positioning itself to be among the organizations leading the way.

“We’ll continue to develop properties, but we can’t sustain ourselves just building in that manner,” Carnaghi says. “Home services and community-based services are a viable care option for more and more people, and they represent new ways in which we can carry out our mission. We’ve already begun expanding our reach in that direction, and we’re excited to explore more possibilities.”

Presbyterian Villages of Michigan
(Photo by Tom McKenzie)

Smart growth

PVM serves about 5,000 people throughout its villages and its homebased and community-based services. With the anticipated addition of new programs and services, Carnaghi sees that number doubling to approximately 10,000 in the foreseeable future.

It’s an aggressive growth strategy—but don’t confuse “aggressive” with “reckless.” PVM’s growth strategy has been carefully calculated to prevent overreaching the organization’s resources. And a big part of that involves creating relationships with other nonprofits and community organizations.

“We don’t pretend to be all things to all people,” Carnaghi says. “We are always on the lookout for new organizations that have skill sets that complement ours.”

Facilitating in-home elder care also means ensuring that the home provides an adequate living environment for the elderly resident in question. That, in turn, means the home must be clean, free from hazards and have functioning utilities.

“Many elderly residents aren’t in a position to ensure all of that, so home repair is a vital add-on service,” Carnaghi says. “That’s not our area of expertise, and we don’t try to act like it is. We work with Metro In-Home Solutions, as well as several other churches and foundations. We have different areas of specialization but work together to help fulfill each other’s missions.”

PVM also works with Henry Ford Health System as part of PACE (Program for All-Inclusive Care for the Elderly) in southeastern Michigan. Through PACE, PVM assists in operating day centers and providing home health aide for Medicare- and Medicaid-eligible seniors.

“That’s a very important program for us to be a part of, because it’s a way to provide home health care to people who might not have otherwise had the financial means to age at home,” Carnaghi says. “Again, it’s allowing people to age in the place they want to age, the place they want to call home.”

In addition, PVM is exploring opportunities in mobile technology, where applications and platforms are being developed to address issues— including personal safety and social interaction—that seniors face when living alone.

“The whole area of telehealth is expanding,” Carnaghi says. “We’re seeing the emergence of devices that can allow doctors to perform checkups from a monitor at home, and devices that can detect the risk of a fall, tracking changes in balance or gait. Detecting the risk of a fall is critical, because that is a large predictor of people ending up in the hospital, going into rehab and, in some cases, dying due to complications.”

Carnaghi also points to the development of social interaction apps that allow seniors to maintain contact with friends, family and world events via a tablet computer, as another opportunity.

“There is a high level of social isolation with seniors, and just through staying connected to what’s happening in the outside world, we see an improvement in their health and well-being,” Carnaghi says.
Home services and community-based services are a viable care option for more and more people, and they represent new ways in which we can carry out our mission.
Brian Carnaghi
Vice President of Finance and Business Development, CFO, and Treasurer, Presbyterian Villages of Michigan

Making it all work

Emerging technologies could provide new ways for PVM to expand its service reach in the coming years, but without great people, there is nothing to unify it all into a unique experience—into something that draws southeastern Michigan’s aging population to PVM for their care needs.

“Our people make us what we are,” Carnaghi says. “We have about 1,400 employees when you count 600 or so employed through the PACE program, and they’re the key to us living our mission each day.”

To work at PVM, a person must be mission-driven and motivated by the organization’s core purpose of allowing residents to age in the place they wish to call home, whether it’s a facility or a residence.

“We set a pretty ambitious BHAG—a big, hairy, audacious goal—a few years ago,” Carnaghi says. “We said we wanted to make Michigan the best place to age in the country. We want to transform senior living and senior services with high standards of ethics and integrity. That’s a huge goal, and you need to have people on board who believe in reaching that goal.”

To bring aboard team members who embrace that, PVM puts the goal and the mission at the center of the interviewing process.

“We’re competitive with pay, but we’re not the top of the marketplace,” Carnaghi says. “We do recognize that our people need to make a living, but at the same time, to work here, we want you to match with our beliefs and values first. We want our team to be a service-minded team.”

Alignment with the core mission and values of any organization must start at the top, Carnaghi says, and PVM’s leadership has been, and will continue to be, instrumental in setting that tone as the organization continues to grow and expand its services.

“The strength of the leadership is a big reason why I came here in 2003,” he says. “We have a great CEO in Roger Myers, we have a strong board, and all of that stability around our values filters down throughout the organization. Everything builds off that, and it’s why we have these tremendous opportunities in front of us.”
Presbyterian Villages of Michigan
(Photo by Tom McKenzie)

A change for the better

In 2005, Presbyterian Villages of Michigan was at a banking crossroads. Its bank was moving out of the senior living and health care field, and to continue growing, PVM needed a new bank—one that was not only interested in its assets but that was passionate about helping the nonprofit organization accomplish its mission of serving seniors.

PVM found that bank in Huntington.

“They wanted to learn about us, and that’s no small task,” says Brian Carnaghi, PVM’s vice president of finance and business development, CFO and treasurer. “We have a legal structure that’s kind of complicated, and a lot of different aspects to our business. Huntington brought their whole team in, with experts in a lot of different areas, and they worked to understand us.”

Huntington also brought other advantages.

“They were already well established in Michigan, and they had an entire group based out of Columbus that that works in affordable housing,” Carnaghi says. “They understand the legalities around affordable housing and construction loans, which is integral to the type of construction we do. It was a great fit.”

As PVM continues to grow, Carnaghi says its relationship with Huntington will grow as well.

“They’re developing a growing level of understanding with home- and community-based care right along with us,” he says. “They’re going to be right alongside us, working to find solutions for whatever the situation may call for.”

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