After eight years in the only job he'd had since college, Charles "Chip" Hill left it for an idea. His thought? He could do what he was currently doing, only better. Hill's first workplace — a large, well-established home health care provider that he prefers not to name — taught him about the industry's tight margins and nearly endless compliance issues. In his second job, as co-founder and COO of Open Systems Healthcare, he made sure to put compliance first — and let the margins take care of themselves. It worked.

In Open Systems' first year (2012), revenue was $350,000. In 2016 (the last year that they've gotten official reports for), revenue hit $46 million.

The company was named No. 1 large company for the second year in a row and also headed the list for Top Managers among large companies, based on a survey of employees. Open Systems has been among the Top Workplaces for four consecutive years.

The company's current workforce numbers over 2,000, with 14 branches that stretch from Philly to Reading to Washington, D.C., St. Louis and West Palm Beach. Open Systems, headquartered in Center City, has cared for thousands of people, most of whom, Hill said, were able remain in their homes solely because they received professional care there. Here, the COO explains the way he and CEO Mark Fiato did it, and what they'll need to do next to keep on top of their competitive, expanding industry. (This interview has been condensed and edited.)

Charles Hill has been president since 2014 at Center City’s Open Systems Healthcare. The company provides home health care service.
Tracie Van Auken
Charles Hill has been president since 2014 at Center City’s Open Systems Healthcare. The company provides home health care service.

The silver tsunami. Is it coming? Is it here?

It's here. In recent years, there have been 10,000 people turning 65 every day. The need for the type of care Open Systems provides is going only to increase over the next 10, 15 years.

Open Systems must face lots of competition.

In this market, particularly in Philadelphia, there are over 300 providers like us.

How do you set yourself apart?

Having the opportunity to start the company from the ground up, on a platform of compliance, has really given us an advantage over some of the older competitors, who've had to change as the years have gone on.

Those over 300 providers here are all vying for the same candidates we are. The recruitment process — just trying to find quality caregivers — is extremely competitive.

What jobs are you trying to fill?

When it comes to caregivers, we hire three levels of expertise. The first is a direct care worker, and that's someone we can train ourselves to do the job. That's 60 percent of our caregiver workforce. The next level, a home health aide, requires 75 hours of training, that's about 30 percent. The third level would be a certified nursing assistant, which requires state-issued license and training, so, 10 percent.

How does Open Systems recruit and retain caregivers?

We do a lot of posting on job boards like Indeed and CareerBuilder, but there's also a lot of word-of-mouth from our current roster, which is several hundred people in this market.

We offer competitive pay [for caregivers], starting in the $9-$10 range. We treat our employees well, recognizing individuals who go above and beyond, giving them gift cards and annual Christmas gifts. We do offer medical and dental benefits. About 60 percent of our caregiver workforce is eligible for benefits, based on the definition of a full-time employee, and about 30 percent participate. I know larger providers seem to have a lot less participation in their plans.

How do you match caregivers with clients?

Case by case. We spend a lot of time working with the family up front. Some of our clients are not accustomed to having someone new in the home, so each branch office will personally introduce them to a couple of caregivers at the beginning of a case. The adjustment certainly can be a challenge — not only for the consumer, but for their family as well.

How do you make sure the company is running smoothly as you expand?

I get out to the branches a few times a month. It's easy to sit here in the corporate office and lose sight of what we're doing every day. It's really important that the corporate office interact with the branch staff.

What about in your corporate office? What's the environment like?
Our internal workforce is about 135 people, including myself. The average age in our company is 27. (I wish I were closer to that average.) It's a young group, 70 percent female, an excellent and talented workforce that we're proud to work with.

What are you looking for in new hires?

We have really clearly defined career paths for individuals who want to take on the challenges of business. We seek out high-performing employees who want to open their own branch office or take on new roles. Ours is a vision of hiring people at entry level and creating opportunities for them.

Anything especially cool about your corporate-level work?

Over a year ago, we created an intranet on a platform called Yammer that has been really well-received by our population. It operates very similarly to Facebook, but only employees within the organization can access it.

If we have an employee who recently had a child, they'll post a picture. We celebrate work anniversaries on that platform, send out organizational announcements and encourage participation. It's been tremendous.

What does the future of home health care look like?

We are finally seeing a lot of introduction of technology, and that has certainly changed the landscape of this industry. It changes the way we interact with our consumers and the way our consumers interact with other professionals.

While we're a long way away from a single platform, in our West Palm Beach branch, each of our patients has a co-issued iPad in their house, where a nurse can clock in and clock out, and make notes. Our industry is very paperwork intensive. The introduction of technology will save time for consumers, family members and their caregivers.