Home Care U - A Framework for Landing High Value VIP Private Pay Clients (Justin Currie Pt. 1)

Episode Date: August 12, 2024

Looking to attract more high dollar VIP private pay clients? Justin Currie, Founder of WellSprings Home Care and Founder of Masters of Home Care is here to unpack key attributes, effective referral sources, and compelling messaging to attract VIP private pay clients. He’ll also share how to handle high pricing objections—come learn from a private pay expert.More resources from Justin:http://www.mastersofhomecare.com/—Home Care MBA Programshttp://www.homecaremba.com/—NewsletterEnjoying the show? Send me a text and let me know!Learn more about Careswitch at: careswitch.comConnect with the host on LinkedIn: Miriam Allred This episode was produced by parkerkane.co

All right. Welcome, everyone. This is Home Care U, a podcast by CareSwitch. I'm your host, Miriam Allred. It's great to be back with you week after week. Just telling today's guests how awesome the engagement, the listenership, just the network that this podcast is building. And it's really shout out, kudos to all of you. I love doing this. I love having these conversations. There's so many leaders, experts, incredible people in this industry. So it's my pleasure to interview them and to bring all this rich education to you.

This episode is gonna be nothing short of incredible. Just like the last few we've had, I have got Justin Curry, the owner at Wellsprings Home Care in Pennsylvania with me. He's also the founder of Masters of Home Care. Justin and I got acquainted just a handful of months ago, but have become, I would say, fast friends, a lot of mutual interests, home care being one of those. I'm really excited to bring Justin on the show today. We are going to be talking about high value VIP private pay

clients. So just throwing out the disclaimer right here at the start, if you're heavy Medicaid, heavy VA, know that this is really focused on private pay. So if you're getting into private pay or considering private pay, this is also a really important episode to you. So this is going to be valuable to just about everybody. But we're going to be talking about, yeah, how to land these high value VIP private pay clients. Justin has done this in his own business and now he's helping other business owners do this. So that's going to be the focus for today's conversation. Before we jump into it, Justin, I want to give you just a couple of minutes to tell our listenership about your background. How did you get into home care, started an agency, branching off, doing some consulting? Tell us about yourself kind of personally and professionally. Yeah, well, thanks, Miriam. And obviously excited to be here. As you know,

I'm a pretty big fan of CareSwitch. Miriam and I are kind of working on implementing that in my agency right now. So super excited about that. But but a little bit about myself. So kind of an interesting story. I grew up in a very small town, northern Saskatchewan, there was only about 500 people there. It was a farming community, oil and gas. So really had nothing to do with healthcare. So it was a long journey to get here. So what I did, I worked in the oil and gas for about 10 years. I moved out to Calgary, Alberta, still up in Canada.

And I started a consulting agency there where I consulted. I did inspections in the oil and gas. And that's kind of where I got my feet wet, I guess you could say, with running my first company. And it was just myself. So I didn't have any employees or anything like that. But what had happened was I offered a very specialized service. So the person I was working for, he was a really smart businessman and he owned a very large company. So he asked me if I wanted to partner in this company. So we started an inspection agency up in Calgary and that was my first kind of full-scale company that we ran. We were 50-50 partners in that. He was just an incredible mentor. I was young. I didn't

know a lot at the time about business. So I kind of got like a on the fly MBA from him and, you know, just learning through podcast courses, conferences, things like that. And that's kind of where my journey started. So I was in Calgary for about 10 years. And what happened after that, there was kind of multiple factors that brought me down to the US. And the first one is actually my grandmother. I know we all have a story like this.

I haven't met an owner yet that doesn't have a family story about a background, watching a family member decline or going through a really, really hard time. So I was living remotely at that time, but I was still very involved with finding care for my grandma, trying to learn a little bit about the healthcare system. And that was up in Canada. So we lived very rural as well. So it was really hard to get, you know, caregivers out there.

The closest caregiving company was, I believe it was two and a half hours away. So that wasn't really an option for us in the really, really rural area. So we eventually, we kept her at home for quite a while. And then we moved her into the skilled nursing facility. And she stayed there a couple of years. She was happy. It's a small town nursing facility. So she was with all her friends and everything aging in place. So that was kind of the trajectory of me learning about the industry. And then there was a couple more factors that came into play at the same time was I met my fiance down in a pool in Cancun, actually. And she lives in Pennsylvania here. She's from here

originally. So that's ultimately why I moved to this location. But the last factor was actually kind of the economy in Canada. When all this was going on, I was learning more about healthcare. I had met my fiance at the time. And the political economics of Canada just weren't very conducive to our inspection agency. There was a lot of ups and downs and a lot of negativity towards the industry. And I could just see where that trajectory was going. So ultimately, I decided to really start researching into home care. And I researched long and hard for a couple of years before I ever made the leap and actually got into it. So I did learn a lot about it. It wasn't kind of jump in and hope for the best.

And ultimately, it was a great decision because it combines, I have a great love for business. So it combines that with being able to help people out as well. So I was really, really able to help people out as well. So I was really, really excited to get into that. It's a lot more personally rewarding than my last business was. So I'm happy to be here. Awesome. Let's talk about the early days as we kind of make our way into the framework for high value VIP private pay clients. Let's talk about, take you back to your early days. I'm assuming in all of that research,

you looked into different payer sources, different business strategy structures, all of that. What was it, you know, that led you to private pay and to kind of the high value clients? Like, just walk us through kind of like your thinking as that teases up for the conversation today. Yeah, so interestingly enough, when I was doing the research, Like just walk us through kind of like your thinking as that teases up for the conversation today. Yeah. So interestingly enough, when I was doing the research, so I obviously I mentioned that

I did research for a couple of years and then I started the agency and I did. I started with Medicaid, with VA, with private pay, basically anyone that came in the door that fit our criteria. And as I learned a little bit more from what I learned in my research and from what I learned in my first year of my agency, I just realized that the industry's changed a lot. You can't really be everything to everyone anymore. And there's a ton of competitors. There's obviously the demand's always increasing. It's going to be increasing for a long time. But the tough part is, is that so are the competitors. There's obviously thousands and

thousands of competitors, even in my area, there's hundreds of competitors within a very small, small area. So what I looked at doing was I looked at finding a gap where there was really nobody being served. And what had happened was I really noticed a really large gap between a home care, a non-medical home care agency, and then a home health agency, which is obviously on the medical side. I know in some states, the terminology is a little different. But there was a massive gap there between somebody who's qualified as an RN coming out to do visits.

Sometimes they're doing private duty nursing. And then you're coming over here where, you know, somebody maybe has been put, you know, put through just a direct worker certification or, you know, just general caregiving certifications. Obviously, quite a wide range there between, you know, the experience level and the education level. And so what I thought is, okay, well, we need to drive our value up at our agency and we need to start hiring people that were a lot more closer to nurses than they were to just somebody who's just looking for a random job, right? So we're looking for very highly qualified people. And that's kind of how it evolved over time is that with the higher level of competition,

agencies, it's tough for them to be everything to everyone now. So what you have to do is really niche down. So I chose that niche because for one thing, I had a lot of issues with regulatory challenges and things like that in my business when I was in Canada. I saw that in the first year of business when I was working with Medicaid, just because I wasn't familiar with the billing and things like that. I believe I ended up having to forked at about 30 grand in unpaid invoices. And it was my fault for sure. But I realized that I didn't want to spend my time doing that. I don't want to deal with billing errors, hire and pay a company a lot of money

just because of billing complexities. So what I did was I got into just specifically private pay. And we still have one Medicaid client that was from about four years ago. So she's definitely not going anywhere. We want to take good care of her. But that's ultimately how we got into the private pay model is because we really wanted to find that niche. And there was a major gap there. And it's really where my experience slide as well. So that's kind of, yeah, the trajectory of where we went. Awesome. I love the honesty sprinkled in there too, of like some of the hard truth that you went through, you know, the mistakes you made in the first year. I think everyone

goes through that, you know, trying to be everyone to everything, taking on any client that's coming your way. But like you said, you've got to kind of niche down, figure out what you as the owner want, what your market needs, and then kind of build a framework around that. So let's talk about these clients. I'm glad you brought up like the caregiver side, and we'll talk about that later on in the conversation. But let's talk about who these clients are. You know, the term like persona or avatar comes to mind of figuring out, you know, who are these clients? So people can kind of look deeply at their own market. Like, is there a need for these types of clients based off who they are? So can you break down kind of that specific persona? Who are these high value, you know, VIP clients? What do they look

like? And who are they? And what are their needs? Yeah, sure. So yeah, so that is, you're absolutely right. That's one thing that we really dialed in on is, you know, who's our specific avatar and who are we going after? So we looked at a lot of industry data as well. We didn't pull all of this data, you know, but we were basically looking at people who were 60% were professional females. They're typically the eldest daughter of the client in need. So typically, they were looking for care for mom or dad, they were typically 45 to 65 range. And I know most people listening have heard all this before. But I'll dive into a little bit of more detailed specifics of who we look for. They were over $100,000 per year in salaries.

They were educated. Typically, they had like a university degree, typically married with children. So those are kind of some of the standard statistics with home care. And I don't want anybody listening to really overlook the fact that of how simple this is. If you're looking in your area, you're looking for those pockets of more affluent people. So you can go online easily. You can find medium household incomes. So it's a lot simpler than people think. So you're basically looking at an affluent area and if there's a lower income area, not that far away, and there's skilled nursing facilities in both, I mean, it's generally pretty obvious on

which facility they're going to be going to or assisted living, you know, or anything like that. So basically, the geographical aspect was probably the biggest game changer for us. So we really looked into median incomes, we made a map and we made a spreadsheet of all our territories and all the different locations. There's little pockets of affluent areas pretty much everywhere you go. We're just outside of Philadelphia. So we're a little luckier. It gets a little harder as you go more rural. But basically, that's what we did. And we'd spend, I told the marketers to spend about 80% of their time marketing in those specific areas. So they were spending about 20% spreading it around, you know, just kind of doing community

liaison stuff in different areas. But the vast majority, 80% plus, was in those more affluent areas where those clients tend to exist. And then once you have a good solid roster of those clients, they tend to start referring their friends. They're all in the same groups. And so yeah, it's a lot simpler than you think. It's just really targeting those specific areas. Let's talk about that marketing element. You referenced a couple of things. You referenced these skilled nursing facilities. You just talked about your marketers doing a lot of community work. What has been successful for you all in marketing to this demographic? Are you doing a lot online,

a lot of digital? Is it heavily in the community? And then who are like those referral partners that can refer you this business? Yeah, so reputation is a huge thing. So before you kind of start up your VIP private pay program, there's a few things that you need to have. And that's having your rates in the top percentile. So it's really tough to go from, you know, just specifically a Medicaid provider, because you have a different type of caregiver with that, and then just jumping straight into VIP rates. So the foundations would be being in the top percentile of rates, having a really good reputation, and then also your service quality. So what I did with my team is I took the quality of our service as a major marketing aspect. I don't know if you've seen like the new benchmarking study, but there's a kind of the overwhelming majority of the higher end referrals

comes from client referrals. So we dedicated a lot of time. I actually had my marketers doing client visits instead of the care managers just to really promote our services, because obviously they're very good at building relationships. We want to build those relationships with our clients. doing client visits instead of the care managers just to really promote our services because obviously they're very good at building relationships. We want to build those relationships with our clients. And ultimately I kind of had all hands on deck. I had all of my team basically contributing to the quality. And that is probably 50% of the marketing that we did

is ensuring that we were actually, you know, if we're going to charge these higher rates, we have to add the value, right? So that was one thing that we really, really focused on. And aside from that, we did a few different things like offer creation. We did some pretty advanced methods of that. So basically, I have a kind of a quote that I always tell my team when we're creating the offers, but it's everybody I'm sure has heard of it by now. But by Warren Buffett, it's not about how hard you row, it's about the boat you're in. And essentially, there's a lot of other agencies out there. And they're offering, you know, the standard hourly services, there's

not a lot to differentiate each other. So what we've done is with our offer creation, we basically created different packages that they can purchase. And instead of having, you know, like a morning wake up package and a good evening tuck in package or anything like that, it's actually packages that are a different level of value. So it's not just your hourly care. So we have a basic package that's still a little bit higher rate than even the highest competitor that we have, because that's how we kind of differentiate ourselves. But then there's multiple other packages where they can increase the value. So we have different things that we've added on, things like prioritized

coverage. We have a care concierge, we have increased level of care management. So we've really kind of came in, I guess, and given clients another option, right? So typically, we have another, one of our sales representatives, she came in from a franchise company, I won't say who it is or anything. And they were doing about $30 million. They had been around for a very long time in the industry. I think like three decades or something like that. So very, very established company.

And when I asked her, I said, you know, how many visits are your care managers doing? And she said, maybe, you know, there's usually one care manager to about 50 clients. And the only time they'll go out is in case of an emergency. And I said, well, that's definitely not, you know, that's not going to do it, right? So that's something that we've really dialed in. So in our packages, even in our base package, we have a high level of care management. So they're there for the start of care. They're calling after the first visit. They do another first week visit. And then we have, depending on the package,

they're either weekly, biweekly, or monthly visits that the care managers are doing. So we've kind of differentiated ourselves in that aspect as well. Okay. I'm taking notes. You're seeing me looking down. I'm like, okay, so much here. And I want to go back a little bit and then come back to service creation. This is awesome. I want to talk a little bit about reputation first. Reputation's tricky, especially as a young, new business owner. You can't just stand up this stalwart reputation really quickly, easily. So what would you say has been the key to your success developing a reputation in the community? You know, does that look like it's online or testimonials or just like how would you say you've built like a reputable company pretty quickly?

Yeah, so I would say there's kind of two aspects to that. There is obviously an online portion to that because I believe like 90% of people that are referred, they're going to check you out online. And with the reputation, it's really personal relationships. I mean, I was out there hustling, I was making relationships. And when you have a really strong relationship with somebody, you'd be amazed at how forgiving they can be, right? Because I mean, you've just started your agency, you're honest with them, but they like you, you have a good relationship, you're going out for coffee with them, you're meeting with them on a regular basis, they're going to refer you. And if you're just upfront,

like brutally honest with them, and you let them know if you have a service failure, which you are, you know, when you start your agency, you're not going to go without service failures. And even if you're a large agency, you're not going to. So if you're just open and honest about them and you're really proactive with your communication, they really appreciate that. So that's one of the things I noticed when I came in the industry is the communication was really, really lacking. If a caregiver didn't show up or they were going to show up late, there was no communication with the clients or with the referral sources. So we really have, like, I guess, kind of a structure in place to make sure that communication happens. So personal relationships. And then obviously, yes, you do need a little bit of exposure online.

You need some testimonials. And I know off the very start, those are very, very tough to get. So you do. I mean, at the start, you just have to hustle and trust on those personal relationships. Yeah. And I love the honesty, you know, being honest about service failures, you know, like things are going to happen. It's going to be a little bit of a bumpy road, but people will trust you, respect you, come back to you. If you're honest and transparent throughout the process, I think, I think that's great. I was just going to say one more thing, Miriam, is what I teach my team that if the client or the referral source has to get in touch with us about a problem, then that's an error. Like we fail.

So that's what I always teach them is to try and make sure that they're proactive on that. And that makes a real big difference in the community. It doesn't always happen. Obviously, it's not as easy as I make it sound. We have our issues too. But in general, yeah, trying to be really proactive with that is very helpful. Yeah.

Getting out in front of them, getting ahead, being proactive. Like you said, not always possible. Things happen in real time, but doing your best to be on like the offensive when it comes to these relationships and managing them. I think it's really interesting and awesome that you're sending the sales reps out to visit clients. I think that might be a semi like more novel concept. It's natural to send out, like you said, the care managers to kind of do those follow-up visits and to be talking to the client regularly. But

I think what you're getting to here is with these high value clients, there's benefit to sending your sales reps out to them to be getting referrals. So is there, is there a, like a structure to those visits? I don't know if you've like trained your sales reps up on what that visit is supposed to look like. Any insight you can share there on just like how that conversation goes? Cause you can't just, you know, walk in and ask for a referral, even though that's what a sales rep may want to do. But what are those visits actually like entail? What do they look like? Yeah. So we actually kind of, I guess you could say gamify it a little bit. So I call them like client marketing visits. And so when they go out there, we've trained them to do a few different things.

And they don't do the exact same structure every time. So we've given them multiple different things to try and work on when they're there. And obviously, client feedback is one, right? There is an aspect of care management there as well. We want to make sure that the client's taken care of. So that's first and foremost. But then we also have, we have additional pay actually for if they can get us a Google review, they get an increase. If they can get a video testimonial, they can get an increase. And then also there's incentive if there's a client referral from that specific client.

So they're going to be out there. They're going to obviously do the care management portion, but then they're going to be promoting our client referral program. They're going to be working on trying to get video testimonials with our clients that are very happy with the services. So it's really, they were excited about that when I kind of brought that up and it's been a fun game. We actually just got a Google review today again. So that was, so I guess I'll be paying up for that one, but it was that up. And it's been a fun game. We actually just got a Google review today again. So I guess I'll be paying up for that one. But no, it's really good

because it's really hard to get that feedback from clients. So to have somebody out there promoting that is really helpful. Yeah, that's fantastic. Even the video reviews. Everyone's got a smartphone, give them a little tripod, get set up. There's so much value to those interactions in the home and really good learning and insights for the sales reps. But like you're saying, gamify it, you know, get them out there, compensate them. And it's a touch point with the client. You know, I think like you mentioned, like the one care manager to the 50 clients only going out for emergencies, like any touch point, especially in the home with the client from the

office, from the sales reps, it's just like another opportunity to have like a strong, meaningful connection with them. So I think this is awesome. To be honest, I haven't heard of a whole lot of companies doing this where they send the sales reps out regularly. But again, I think it makes a lot of sense, especially in this case. And we all know the numbers like, you know, getting an online lead versus getting a referral from a client, like you said, is not only like a higher conversion rate, but a much higher retention rate, which is where the value, the long-term value from these clients comes in. It's not just getting them, but also retaining them if they've got a friend or kind of a meaningful connection with the agency. So I'm sure you've seen that, like longer retention with client referrals

rather than maybe online leads or something of that nature. Absolutely. Yeah. And I mean, it all goes as well to client satisfaction. I mean, so somebody referred them originally, right? So when we do a good job and we have somebody in there really supporting them and working hard at that, and they're getting a lot of face-to-face time as well, that information is making it back to that referral source as well. So it's not it's not just we want them to refer clients, we want them to basically promote us to their referral sources and everything as well. So it's kind of Yeah, there's there's a few different aspects to it. Let's let's talk about the the service creation, the offer creation. So you were talking about how this is kind of like a big part of the puzzle is like structuring your services and your

offers to the needs of these clients. I think you mentioned like different tiers. Let's go into that a little bit more, if you don't mind, kind of like each tier and what that looks like. You mentioned you've been using the term like care management. So there is this like higher kind of concierge type care that's a part of that. Any other kind of nuances or specifics in any of the tiers that are kind of moving the needle for you or helping you get more of these clients? Yeah, definitely caregiver experience. So we have a minimum for our lowest package. We have a minimum of three-year experience requirement for our caregivers. We have a very extensive screening process. And I think I told you, Miriam, that we're just rebuilding our whole onboarding retention system right now. So we're looking

to improve that. We just had all our caregivers come in for another extra orientation on top of the one they had when they were hired. So we're constantly working on training them. And so being able to tell a client that, know somebody coming whoever's coming in to help you we don't know who it is going to be yet but we know they meet these minimum requirements and so we also talk about the criteria that we're using when we're hiring so we're talking not just about experience level we're talking about character as well right like how did they present themselves when they came in into the interview? And one other thing we do that I don't think a lot of, maybe a lot of agencies do this, but I don't think a lot of them promote it is we do social media checks when we're hiring.

We've had a few clients that have checked their social media when they're out in the field and they say, well, you know what? We can't have this person out here. You know, it's nothing illegal or anything like that, but just they didn't like the look of their character. So we, we do check into that and make sure there's nothing, nothing, nothing could scare a client away. You know, we always look at it in the, in the way of, you know, would we like this person caring for, for our grandparent? And that's always a good criteria to go by. So we, we talk about the caregiver experience and screening. That's a huge, huge kind of, kind of buzzword, I guess you could say. We did a little bit of an analysis with what clients and referral sources were most receptive to.

And both of them, the number one was the background of the caregivers and the screening process and exactly who they are. And, you know, it might sound simple, but there's a lot of people that don't go, you know, super into detail when explaining. So that was one of the big things was caregiver experience. Another way we differentiate is we have a care responder program. And that's, you know, kind of a whole episode in itself probably, but we kind of found a way to structure it. So we have on-call caregivers. We did an analysis. We looked at exactly when the most call-offs happen, how many we're averaging per week,

per weekend. And so we put a care responder in place for all of those times. And essentially, we found a way to pay a daily rate. And then we also pay them additionally per visit. And sorry, I'm going on a little bit about this care responder program. But no, with that, most of it is paid for, right? Because they're getting called out to clients' homes. So you're obviously charging the clients the rates for that. So the majority of the care responders' wage is paid for. But what I was getting at is what that allows us to do is charge

a little bit extra for prioritized coverage. So that's where the priority coverage comes in is, okay, we are paying these caregivers, you know, X amount of dollars to be on call. So if coverage is extremely important to you, then, you know, this is probably the best package to go with. So we're giving them the option. It's not mandatory by any means. So those are a couple of things. And then the other one is just increased care management, you know, being a lot of face-to-face time. We, especially during the first week, we have a care manager in there,

multiple times throughout the week, start of care, follow-up calls. We have another visit the first week and just increasing that face-to-face time because that doesn't always happen in this industry. Yeah, really, really good. I want to talk about a couple of things there. Did I hear right that your lowest package is minimum three years caregiving experience? Did I hear that right? Yes, correct. Do you have,

does that mean you're hiring anyone that's lower than that experience or no? No, we don't have anyone on staff that's lower than three years. Okay. So that's a, that's a huge differentiator here as well. You know, finding high quality, highly trained caregivers. I think a key factor here is like rates. Like you said, you're charging, you know, premium rates. And so you're also, I'm assuming like paying premium rates so you can find people and attract people that are looking for higher pay. Is that all accurate? Exactly. Exactly. And it's a, it's a process, right? It's not like, Hey, let's just implement all of this at once and everything's fixed. It's evolved over time because obviously we were doing Medicaid before, we were doing VAA when their rate was a little bit lower. So we had a lot of caregivers that only had six months experience

or a year's experience. So it took a while to kind of work through the system and get to where we are today. So it is a process. You have to kind of look at your agency and see exactly where you're at. And then you decide kind of in a phase, step-by-step system of exactly how you're going to implement this program. So that's kind of- Yeah, makes a lot of, a lot of sense and retention. Can I ask like retention numbers? You know, this model is pretty unique. Have you been able to retain caregivers longer than maybe like industry averages? Yeah, we do pretty good with that because we're, we're paying them more. And, and to be honest with you, with this model, we're, we're operating on a lower volume,

but a higher margin, right? So it takes a lot less clients to get the revenue where we need to be. So it's also a way of controlling growth. Historically, I mean, there's a ton of home care agencies out there that probably have a ton of shifts on the schedule that they can't staff, right? So that's obviously not providing a lot of value to the client, but also there's just, I mean, it's, it's a flywheel of trying to get caregivers in, right. You're constantly trying to get caregivers in and we're, we're really never rushing to do that. We always keep a bench of five to 10 caregivers. If it gets down to five, we, we hire a few more and that basically,

you know, obviously from time to time, we have to let a caregiver go. And then when new cases come on board, we want to make sure that we have people there to staff those. So we really haven't had any trouble with that because we are paying those higher rates. So it's been really helpful to increase the quality. And I want to be transparent. I don't want anybody thinking like we have absolutely everything figured out and we never have a problem with a caregiver. That's not true. But we have a lot less than we used to and a lot less, I think, than a lot of other agencies that are struggling with that. Yeah. Like you mentioned to me and here publicly is like you're even like overhauling some processes right now. And that's just business. That's just life. You know, things work and work for a time

and a season and you bring in new people, you bring in new minds, new variables. That's just life. You know, things work and work for a time and a season. And you bring in new people, you bring in new minds, new variables. It's like things are, things are evolving and you are no, you're not exempt to that. You figured a lot of this out over the years. The other thing that stood out to me, I know you mentioned like not going totally into the care responder program, but I think that's a, probably a big factor here is that, that priority coverage that may be top priority or high priority for these clients. And so you've kind of built a model that supports that. Can you talk a little bit more about how that priority coverage works? So you have these on-call

caregivers, if someone calls out, like you basically have a backup or just a little bit more of like the specifics of how that works. Yeah. And first of all, maybe just get into why we did that. And the main reason we did that is because we really like created a robust hiring system. We're paying our caregivers more. And what we were finding is just inherently when you have, you know, a large number of caregivers out there, inherently there's going to be like legitimate reasons for call-offs, right? So we found out that we corrected the bad behavior and, you know, we removed the people that shouldn't be there. And then we found out, okay, well, we're still having, you know, X amount of call-offs. So when we looked at that, we really dove into, okay, what's the reason for these? Every single one was providing proof of call off and they were all totally legitimate reasons. So I'm like, okay, this is something that,

you know, we looked at what we can control and what we can't control. And with caregivers, no matter how much you train them, when you have a hundred, 150 caregivers out there, no matter how much training you do, you are absolutely going to have caregivers calling off. So that's something that if you know are absolutely going to have caregivers calling off. So that's something that if you know it's going to happen and you can't control it, then you have to put a control measure in place that is going to help that out. So that's basically why we built out that program. So when we did the analysis of the call-offs, we were finding out that pretty much all of them, I mean, the vast lion's share,

the vast majority were from 8 a.m. to 4 p.m. So that made it actually pretty easy for us, right? Because we just needed to find a care responder for that timeframe. We're not super heavy on the overnights. We have a lot of daytime stuff. So we don't actually have right now a care responder overnight. So we have multiple during the week. And so that's Monday to Friday, 8 a.m. to 4 p.m. And then we have a care responder on the weekend, Saturday and Sunday, same thing from 8 a.m. to 4 p.m. And we do have requirements. I mean, when we call, they have to go or else they obviously don't get their rate because we are paying them to be on standby. But what we're doing is we're

paying a specific rate for the weekdays and then a different rate, a little bit higher rate on the weekends. And so that's a day rate that's measurable to what their actual rate is. So obviously, everybody's at a little bit different rate, but even just from being on call, they can almost make as much as caregiving because it wasn't enticing enough when we, you know, we made it $10 an hour or something like that to be on call. It just didn't register that that was just kind of money they got for waiting there. So what we did was we increased that and then we also pay per visit. So if they see three clients in a day, they get an extra 50 per day for that.

So an extra 150 per day. So there is opportunity there for them to make a lot of money with the care responder program. And the good thing for us is that we cover shifts, we get that client satisfaction, and then we have clients promoting us, right? So that's the ultimate goal is to take control of that uncontrollable aspect. I love that you've shared that why, because so often in Home Carrots, how do we solve the call-out issue? But there's a lot of legitimacy to call-outs.

And I'm not saying every call-out is legitimate, but there's a portion of them, and maybe a large portion of them that are valid reasons. And rather than maybe reprimanding the caregiver, you wanna understand them, support them, and then also have that backup plan in place for those legitimate call-outs and for the illegitimate ones, but also the uncontrollables, like you're saying. These caregivers, are they kind of like their own tier of caregivers, meaning all of your care responders are only care responders? Are they caregiving some weeks, some days, and then care responders some days? Or are they kind of like their own kind of bucket of caregivers, their own bench? No.

So they are still a caregiver. So we typically just take some of our higher level caregivers that are interested in the program. We'll put them in place. And you know, a lot of them, a lot of the caregivers, they love hours. You know, they're always wanting more and more hours. So it works out good. I mean, if we have a call off overnight or something, sometimes they'll jump in and help out. So they're open, they're welcome to take other shifts. If it's outside of that 8 to 4 p.m., then we're paying them extra for those hours. We're paying them just like a regular caregiver. So there's a lot of incentives there. And we tried that program a few different ways and we just weren't getting the interest. I don't

think a lot of caregivers saw the value in that guaranteed wage every two weeks. They just wanted to be working, wanted hours. And so we just had to increase the rates. And yes, it does come at a little bit of a cost, but also a lot of that is subsidized by the client call-outs that they're going to. So you are going to end up paying a little bit with the program, but I mean, it's your agency. You can lower the cost a little bit, lower the price to have them there, and then potentially break even or even make a little bit off of them as well. So you can always control those variables. But the main goal is to make sure that the clients are taken care of in an economical way. Next week, we're going to talk more about like margins and cash flow and like kind of the

financial elements of this. But I guess the question that I want to ask maybe right now when we're talking about it is like overtime. you mentioned a lot of your schedule is during the day and you've kind of mapped that and that's working for you. Do you encounter a lot of overtime and do you try and stay away from it? Or is it very kind of client by client visit by visit basis? Yeah, it's visit by visit. So we have, we definitely have caregivers that are doing overtime. It's not the end of the world. We try and avoid it overtime when we can, but there is a little bit of, I guess, room there, like in the margins to account for that. So we know, you know, anywhere from, I think we're running like four to 6% overtime. I'm sure some agencies are way lower and some are probably a lot higher than that. We're about four to 6%. So we know roughly what that overage is.

So when we built out our packages and everything, we built them knowing that, right? So that we knew that there was inherently going to be some overtime. If there's a client that requests the specific caregiver more than 40 hours, we will charge them overtime. But that doesn't happen very often, especially at our higher rates. Okay. That's great. Let's talk about the question I want to ask is about rebuttals. Like you mentioned, you're in a pretty competitive market. And so as you're talking to these clients, they may be talking to several other agencies and you may be shooting out a price that's significantly or somewhat higher than

others. Are you getting a lot of that? And what does that kind of like price handling conversation look like? And what have you all learned through being able to refute the qualms of high price? Yeah, definitely. That's a good question because we get that question a lot. And to be honest with you, we don't get it a lot more than we did before we increased our rates. So that's really surprising. But I should say, before I tell you kind of how we handle those rebuttals is that we charge higher rates. But one of the other things I don't think I've mentioned yet is we also charge a pretty hefty startup fee. So anywhere from $2,000 to $3,000, depending on the package that they choose, we charge that for a startup fee. And then we pay it out through a loyalty program.

So it's paid out at 10% per week. And then if they stop services before that, if it's a passing, then obviously we give leniency and stuff for for that um but we do pay it back over time but if they stop services before that then they forfeit the rest of that startup fee so there's a few different things that we're doing there so i wanted to mention that as well because that's that's usually a question that we get as well that we have to handle but like a deposit a deposit but then you pay it back to them and like subsidize the service that it's kind of I don't like to call it a deposit, because we're not essentially giving it back. It's a loyalty, they will, if they stay with us for at least 10

weeks, they will get it back. But they will forfeit if you know, we've had people sign up for for a week of services. And obviously, it takes a lot of resources to set that up right at the start. And they had no problem paying $2,000 startup fee just to get that week of services. And then it actually made it worthwhile for us, right? Because I'm sure every agency owner knows you need X amount of hours to break even on a client, right? Because you're spending time and money to get a client case started. You're spending time marketing for them. And so when you bring a client on, whether it's 80 or 100 hours or anything like that, you have to protect yourself from that. So that's kind of why we had that startup fee is because we're spending a lot of time

and we're spending a lot more time and resources than the average home care agency to get them started. And that's what we help explain to them. So we talk about the resources that it takes. We talk about our screening process and how we're proactive with it. We do it ahead of time because a lot of times they're coming to us in an emergency situation, right? So we have to have people ready for them. So we talk about how we're doing that extensive screening process, but proactively. So yeah, I love this. No, I love this.

And I'm asking, I'm not questioning you. I'm asking, I had a CPA on just a couple of weeks ago and we talked about deposits specifically, but I love your loyalty element, which is, you know what you need to break even on a client. And sometimes, you know, they back away after a week or two weeks and you lose money. So I love the concept, but I actually, I was asking her if people pay it back or subsidize the service, then she says she doesn't see that a lot, but I love that you've worked in the loyalty element to where it covers you, you as the provider, but then it also is like beneficial

to them. And it's kind of like a mutual guarantee for both parties. So I love that. Yeah. And I think I got off track a little bit there, but with that startup fee, there's a lot of things that we've prevented with that as well. And we found out that the people that are really complaining about it are generally people that aren't serious about getting care. So it's really acted as a pre-qualifier for us. So it's acted as a pre-qualifier for our clients, and it's also protected us financially in the short term. So there's multiple aspects to that. sticker shock of people thinking like, oh, I have to give you $2,000 before we even start service. But like you said, it's a qualifier. You're looking for a certain avatar persona of people. And if they're not willing to kind of make that commitment or make that investment,

they might not be a right fit for you. So I love that it's also a qualifier for your right fit client. Definitely, definitely. No, that's, that's been really helpful. And you know, one, one other thing I'll mention on that is we, we retain about 37% of that. So it's actually, you know, where we're actually getting paid for all the services that we're doing upfront, you know, having our care managers go out. So it's, so it's worked out really well for that. So the question before the rabbit hole there was handling like rebuttals. You know, when people talk about price, I'm sure you've trained your sales rep to know how to sell your services, sell your price. Any kind of insights or things you'd share there about just managing those conversations?

Yeah, definitely. So we kind of went through all the things, you know, we talked about the offer creation and what was different in the offers. And so it's very similar, if not identical, to what I had went over there with talking about our caregiver experience. You got to remember that these are things that they're not hearing from other home care agencies. How many are saying that they have a minimum experience requirement and they're actually abiding by that? We also talk about our screening process, but we also talk about something called a caregiver acceptance rate, which we actually do in the agency. We're only hiring less than 5% of applicants, actually.

And then after a month, we turn over another 10% just because they're not up to our quality standards. So they really love to hear that of exactly what our acceptance rate is and how detailed and extensive our screening process is. And I'm sure you can tell by now that we hit really hard on the caregiver experience and the caregiver education and who we're bringing in the agency, because that seems to be a really big restriction for bringing on new clients. So we talk about that. We talk about, as I had mentioned before, the higher level of care management. And usually, I guess it might sound simple to some agency owners, but you'd be amazed at how many people just kind of breeze over this. They say, okay, we offer care management. Yeah, they'll be out. If there's an emergency or anything, they'll come out. Where we're if there's an emergency or anything, they'll come out where we're, where we're specifically telling them we're really

intentional about what we're telling them. We're saying that our care manager will be out, depending on the package, we'll be out there monthly. They're going to do a monthly reassessment of your needs and they're going to adjust the care plan in case any needs change. And all that information is going to be relayed to you. We're going to do a follow-up call with you. So that sounds a lot more, you know, just organized and professional than, yeah, no, we do have a care manager. I'm not sure who it's going to be, but we'll send somebody out, you know, and a lot of agencies are doing that. So being intentional about what you're saying and being a little more specific about exactly what you're going to be doing, it goes a really long ways. And I imagine the result of this is spelling it out in an agreement. I'd imagine you have pretty extensive agreements that outline all of this. Because like

you said, it's one thing for an agency to kind of like blow a little bit of smoke and say they do all these things. It's another to hold yourself accountable to it, to include it in an agreement. Have you refined your agreements over the years? Anything you've learned as far as like how these agreements work or any mistakes maybe that you've made when it comes to the agreements and like mapping all this out to hold yourselves accountable?

Yeah, we've definitely adjusted the agreement over time. And that usually happens when we're caring for a family that has a lawyer for a family member. It's because they like to bring that to our attention. We've never had any major issues with it. We did have one client that came to us and he was absolutely correct. Our team, they kind of dropped the ball. We didn't do our visit when we were supposed to do it. He was absolutely right. He wrote me a letter. So I refunded his invoice. I didn't make him pay anything for that invoice because we didn't follow through on it. But in the few years we've been doing this program,

I think the little, maybe two and a half years now. And since we started doing that is that was the only client that has had an issue with that. So we've been, we've been doing a good job, but like I said, you know, we, we drop the ball sometimes as well, but it's, it's best to, it's best to keep your promises for sure. Absolutely. Well, indirectly throughout this conversation, I know we're already almost at time. Isn't that crazy how fast this goes? We've been talking about like messaging and positioning throughout this conversation. That was kind of the area that I wanted to end on of just like structuring your messaging to sell to these VIP rates. Is there any other messaging channels or like methods that you utilize to clients or even to caregivers to just really position yourself as this kind of like

premium provider that you found success with, whether that's online or in the office or just any other kind of channels of, or types of communication that position you all as this premium provider? Yeah. So on the front end, for sure, we try and be kind of the experts in our industry. I hire people that are very well-trained. They know a lot of stuff that I don't know. We have one that's a dementia practitioner. She's very, very intelligent. So she goes and she does events and speaks or does like dementia trainings and things like that for other communities. So we try and be the leader as far as expertise, but also on the front end, it's confidence as well, right? It's, you know, knowing your value. It's not like you're going in there arrogantly,

right? Confidence is when you know the value and you can relay that and you can confidently speak to it. And that's a learned skill as well, because the same gal that I was just talking about, she's our sales director now. And she came in and she came from a franchise. And the first thing she said was, there is no way that I can sell a $2,000 startup fee and X and X rate. And I said, but we're actually, we're adding more value Like it's a different service than what you've been pitching before. Right. And she went out there and that was that same day. And she came back and she says, I can't believe it. I, you know, I got the $2,000 startup fee and we signed the client for this rate. And I'm like, okay, great. Now the real work starts. So I think

breaking that mindset and breaking that barrier on what people think is possible is definitely the majority of it on the front end, but on the back end, it's following through on everything you're saying. Like I mentioned, we're not charging higher rates and offering the same value. We're offering more value. So you have to make sure 100% that your team is on it and that you are actually following through on that value or else it's going to fall apart pretty quickly. So there's a little bit of a front end and back end to that. I love that. Believing in what you're selling and then delivering on what you're selling. That's kind of like a rule of thumb of just not over-promising under-delivering, but holding your value, believing in your values to be able to sell it effectively and then delivering. And you've talked about that throughout this conversation of

how much time and energy you put into the caregiver experience. Because almost ultimately at the end of the day, it's up to the caregivers to deliver this rich experience to these clients that you're promising on the front end. So you have to do so much for your employees. And you've talked about training. We could just talk as we wrap up here. Training sounds like a pretty big part of your business. You mentioned these caregivers come in with a lot of experience already, which is probably varied. You probably, you know, they may have three years experience, but that probably looks different from different agencies. How do you all approach training? Does

it look maybe different than other agencies or what's kind of your approach when it comes to caregiver training? Yeah. So ours is quite a hybrid. So we do obviously orientation in, in office. So we have a pretty extensive interview process and we even do like writing samples and things like that for them for care notes, because that can really explain a lot. But what we do is we do the extensive interview and then we take them through our orientation process. And that's basically everything about how, what our expectations are and a little bit about the company and our communication channels and everything that's super helpful. So they're, they're very well prepared. And then what we do is we don't do any online training yet, but I think we're actually going

to start doing that. But what we do is we do a lot of in the field training and basically assessment, right? So we have a care manager out there for the start of care for every client. So they're going through the care plan. They're watching our caregiver do a transfer. So we get to see kind of firsthand exactly, you know, what's going on out in the field. So it's really kind of there, there's multiple variables to it. It seems to be working really well for us because a lot of, a lot of the really skilled caregivers, you know, they don't want to sit through a 10-minute YouTube video on fall prevention or whatever, right? But they know what they're doing. And so we test them in-house and then we're actually looking at them in the field and

assessing them in the field. Yeah. I think that just speaks to the premium value here. Not to speak badly about the online training. There's value there and there's caregivers that prefer that. But I think, you know, the hands-on approach out in the field, in the home is really valuable if you have the time and resources to be able to do that. One other thing that stood out to me a minute ago, you mentioned maybe about 10% of the caregivers turn over in that first month. It sounded like you almost like turn them over. You know, it's almost not like the caregiver is opting themselves out or leaving like happens in the first 30, 60, 90 days, but you all identify people that aren't a right fit. Is that ring true that you all actually decide, you know, who's not a right fit and you maybe let them go? Or is there some sort of structure there? You know,

they're on kind of like a trial period for those first 30 days or what does that look like? Yeah. So basically with that, it's a little bit of both. So we do turn people over because of termination, obviously. So there is a percentage of that, but then there is also just people that aren't up to our standards. So what my team does, I'm not involved in that meeting, but they'll actually meet on a regular basis. I believe it's bi-weekly now. They will meet bi-weekly and they'll go through all of the caregivers and we do the RAISE review at the same time. So we're looking at the RAISE review, but we're also looking at, are they up to standard? We have our specific criteria that we're looking for, obviously like character and attitude,

communication play big, big roles in that that's what that's what they're looking at and if they find that people can't be trained we'll always give somebody the chance but if we've already spoken to them and you know we're still getting this this feedback then that's somebody that we're gonna you know probably opt out and just make sure that they're not moving forward with us so and then some do slip through the cracks as, as always, but we do have a pretty good screening process. So. Yes. And it all comes back to that being proactive. You know, if you want to deliver the highest quality service, you need to have, you know, the highest quality caregivers. And so there's this trade-off that we've talked about. Justin, this has been so awesome. I told

you to put on your owner cap and you've done phenomenal. I know you are living and breathing all of this. And so it's so fun to hear you just kind of talk through your learnings in real time. At the start, I mentioned you are the founder and I love you're wearing the shirt, Masters of Home Care. You have learned so much over the years running your business that you're actually helping and providing these resources and these frameworks to other businesses. Can you talk a little bit about kind of your service offering through Masters of Home Care? Absolutely. So just like you said, Miriam, is basically what we're doing is we're through mentorship, through courses, through community. We're helping other owners implement exactly the strategies and the systems and everything that I'm using in my agency. And we're basically just

moving it over to their agency and helping them implement that along the way. So there's, there's three different programs. There's the kickstart that's for typically for owners under 500,000 in revenue. And that's really designed to get some traction, right? Get you off your butt, get you moving. And then the next program is for those over 500K in revenue. And that's going to be, that's going to be the same thing. It's going to give you all the foundational elements, but it's also going to teach you the profitable client pipeline. So the GROW program is where we're going to teach you how to go after those VIP private pay clients.

And the third program is the partnership program. And we only take two people on per year in this program because it is a lot higher value, but there is an equity stake as well. That's a full partnership and that looks different with each agency, but there is a yearly amount and then there's a equity stake as well.

So that's kind of the three different programs that we offer. You're in the course for a year and the reason we do that is because people have questions, right? We don't want to give you the course and say, hey, you know, you guys can hope for the best. We want to mentor you all the way there. And it's really important that, you know, we make sure that the people that are trying to implement this program are successful. Amazing. One part of the package, I've been referring to it as like a resource hub.

One part of the package is a platform. What do you call the platform that has all of these resources? Yeah, the platform. So it's on Circle. So Circle is basically, yeah, it's just a platform where you can host courses and things like that. So we just call it the Circle community, but it's actually the Masters of Home Care community, but it's all hosted on Circle. Awesome. Yeah. So I guess, sorry, I didn't need like the name of Home Care community, but it's all hosted on Circle. Awesome. Yeah. So I guess, sorry, I didn't need like the name of the platform, but more this concept. So Justin has built this community where all of these resources are hosted. And I want to speak to this because he let me get access to it. And the first thing I said was, I want all of this because Justin and his team have mapped

out all of these very specific pipelines, frameworks, resources. I was blown away. I've seen a lot of resources in home care in my day, but the library of resources that he has built is phenomenal. And so as part of working with him, you get access to this library of everything you could think of and need as a business owner, it's there. And so I just wanted to mention that that's part of this offering of working with you is getting access to that community and that resource library. And again, it's one of the best that I've seen. I'm a little bit envious of it, but that's why we're here working together.

Justin, thank you so much. This has been fantastic. Like I mentioned, next week, we'll be back same day, same time with Justin. We're going to go like one step further and talk about the finances, the financial elements of managing private pay, high value clients, because the margins, like we've talked about today, are different. Some of the structure, some of the strategy when it comes to the finances are different. So we're going to talk about all of that same day, same time next week. Justin, thank you again. And we'll look forward to seeing you again next week. Thank you so much. I appreciate it.

Awesome. Thanks everyone for joining us live. This has been another great session of Home Care U. We'll look forward to seeing you back again next week. Goodbye for now. That's a wrap. This podcast was made by the team at CareSwitch, the first AI powered management software for home care agencies. If you want to automate away the menial of your day-to-day with AI so that you and your team can focus on giving great care, check us out at careswitch.com.