Home Care U - Common Threads Between the Most Successful Home Care Leaders (Miriam Allred)

Episode Date: November 12, 2023

Miriam Allred has spent five years interviewing hundreds of home care's top leaders. In 60 minutes, here's what she's learned from them—and what she says they're all doing similarly. Enjoying 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

Hey, welcome to Home Care U, a podcast made by the team at Care Switch. Nobody went to school to learn how to run a home care agency, so we're bringing the education to you. Join our live audience by going to careswitch.com slash homecareu or listen on your own time wherever you get your podcasts. Home Care U is hosted by myself, Miriam Allred, and Connor Koons of CareSwitch. Enjoy the session. Welcome to Home Care U. Today will be a really fun episode, I think.

We're doing things a little bit differently, and I'll explain that in a minute. But before we get started, let me just go through a couple of the housekeeping things for those who are joining us for the first time. So Home Care U is both a live class and a podcast. If you want to join live, be on the Zoom and ask questions through the chat, you can do so by registering at homecareu.careswitch.com. That's U as in university. And for those who are on with us live today,

we do encourage you to ask questions, drop those in the chat. We'll answer them as we go or at the end of the episode, depending on the nature of the question. And then if you prefer to listen on your own time, you can get the replays after the fact as podcast episodes, wherever you get your podcasts. That's again, just called Home Care U. So we definitely encourage you to listen in whatever way works best for you. So thanks for joining. Today's episode, our guest is our very own Miriam Allred, who, as those who have joined previously will know, is one of our hosts. She has gotten the chance over the last five years to spend lots of time with a ridiculous number of leaders within the home care industry and gotten to be very good friends, know lots

of them and watch how they operate, how they're running their businesses, how they lead their teams, how they motivate themselves and how they learn. And so today we're going to dig into the different things that she has observed that the best leaders in the home care space all seem to be doing, both in terms of operations and in terms of how they develop themselves as leaders. There's probably like six or seven, I think, different topics we'll hit in there. So Miriam, thanks for joining. Thanks, Connor. I said to you before, it doesn't matter how many times we do this, I get nervous every time I'm behind the mic. So thanks for that introduction.

Thanks everyone for being here. Like Connor mentioned, I've been co-hosting Home Care U with him over the last year. And it's been an honor. It's a ton of fun. It's going to be interesting to be across the table from Connor at this point. We've worked together for almost five years and I still don't know what's coming the next 60 minutes. So he's a on-the-fly type and I'm a misplanner type. And so even though we've worked together for a long time, I still don't know what's coming the next 60 minutes. So he's a on the fly type and I'm a misplanner type.

And so even though we've worked together for a long time, I still don't know what's coming. So I'm excited and anxious for the conversation, but I also want to add Connor's been urging me into this episode, into this concept. And I was really resistant at first. I, you know, didn't know what I wanted to say or what I wanted to share. And as he urged and encouraged, I started putting together some notes and I've discovered I do have some things to say on this topic. Like Connor mentioned, been in the industry for about five years, have interviewed a lot of business owners, have worked with a lot of business owners, have observed. I've been pretty involved the last five years.

And what I'm going to share today is mainly just that observations. Before we start, a couple of disclaimers. There's a difference between what I think is a thought leader and what I think is an expert. And all of you listening to this are the experts. You're in it day to day. You're the ones running these businesses, performing these operations. I may be, you know, what some would call a budding thought leader, but I haven't actually been in your shoes. And so what I want to share today is strictly observations, things

that I have very carefully watched, observed and learned. And I hope what I share today can can be influential and impactful. And if none else, you know, eye opening to some of the things that I have observed. Awesome. Thanks for sharing and explaining that. And yes, I have been pushing Miriam to do this episode for quite a long time. I should say too, like just kind of to give more context on where you're coming from with this, like some of the credentials here. So before working at CareSwitch, we both worked at Home Care Pulse, which those listening may have heard of from their benchmarking study or different other forms of content they publish. She started their podcast there and ran that for several years. And so, I mean, she spent like two

to three years there talking to leaders, at least on a weekly basis for that. And then as head of partnerships, both at HomeCare Pulse and then now at CareSwitch, her entire job was to build partnerships and relationships, not just with other different industry, like software vendors and people like that, but with people at agencies, you know, both like large franchises, large independents, much smaller agencies that were still very successful. And so she just gotten to talk to lots of them in all different kinds of settings. With that being said, without further ado, let's jump into it. What's the first common thread that you've noticed? Yeah. One more disclaimer before we jump into it, and I'm not stalling. I'm going to be doing a lot

of name dropping in this episode and know that it's intentional. Like I mentioned, a lot of what I've learned and a lot of what I'm going to share is based off of things that I've observed. So this is going to be a little unconventional in that I'm going to name drop a lot of owners, executives, people that I've worked with and in specific examples, citing what I'm sharing. And if you notice, I'm actually feverishly like going through the attendee list to see if anyone that I'm name dropping is here. And there are a couple of you here. So if I misspeak, call me out. Again, I'm not sharing like direct quotes, but more just like concepts, ideas, observations, but just want to call out. I'm doing a lot of name dropping. If I misspeak on any of your behalf, call me out, throw me down, whatever you got to do to make it right.

So that being said, thanks Connor for the additional context. I think that's really helpful for people to understand, you know, where I'm coming from and my background. Like Connor mentioned, there's probably six or seven topics we're going to get to today. To be honest, it's going to be a little free form and I'm just going to like start sharing and then Connor's going to dictate where we go from there. So bear with us. First thing I want to share, first observation is org chart structuring and taking a very fluid approach to how you structure your org chart. There's no playbook for who to bring on and when to bring people on. I see that all the time in Facebook groups and I hear it in conversations. Who do I bring on? When do I bring them on? How do I bring them on? I see that concept

popping up and I've heard it for years. And so the thing that I've observed that large successful owners lean into is there is no playbook. There is no right or wrong answer. Every owner comes into the business with a different set of strengths, with a different background. And they bring people on that fill different or complementary needs. So someone with a clinical background may not need to bring on a nurse out of the gate. Someone with a business or sales background or mindset may not need to bring on a sales rep out of the gate. So I want to articulate that successful businesses have a very fluid and organic approach to how they structure their org chart. And I don't know if this is any consolance to people or maybe people are itching for a playbook, but to be

honest, there is no right answer. And taking it one step further, it's not uncommon from what I've seen for office teams to shift, to evolve over time. You may put someone in a specific role at a specific time to fill a specific need. That may change in three months. That may change in six months. That may change in three months, that may change in six months, that may change in 18 months. And so prepare for and lean into that like fluid org chart and be prepared to adapt and make changes and let it evolve with your organization over time. It sounds like part of what you're saying is that the best leaders are extra perceptive of their own strengths and weaknesses. And that becomes the primary driver of how they structure it,

especially in the beginning, because it can be so easy to say, well, yeah, I like the owner always does the sales and marketing at the beginning. But for someone whose real strength is in the operational side, they're a really good scheduler or something. It's important to understand that and lean into that. Is that kind of an accurate restatement of what you're saying? Yeah, totally. And that's honestly one of the things that I appreciate about home care is all owners that I have talked to, which is like hundreds, probably upward of a thousand, come with very different backgrounds and skill sets. And I have talked to, which is like hundreds, probably upward of a thousand, come with very different backgrounds and skill sets. And I have seen successful businesses start from an owner

with a clinical background and successful businesses start with an owner that has a business background. There's no mold of an owner that makes a successful agency. And so I agree with how you regurgitated that information, which is every owner comes in with specific strengths and then hires counterparts that balance those strengths. And like I mentioned, those needs evolve over time. When you're just getting started, when you hit that million dollar mark, when you hit that $10 million mark, there's a lot of ebb and flow. And so lean into that change and always be analyzing, you know, who to bring on and when and what gaps need filling and what purpose new hires serve. There has to be a different word we can use for that than regurgitate. But yes, thank you. I guess my question is, are there examples of this that you've seen that you can cite, especially if it's like maybe someone who took a non-traditional approach as far as their role within their agency as the owner?

Or like you mentioned, like having to shift around roles sometimes and being flexible that way. If you've seen any examples of that, that would be useful to share. Yeah. One specific one comes to mind and this will probably resonate with people because I've heard this a lot. The example or the name that I'm going to throw out is Jessica Nobles, who owns and operates an agency and is also a consultant. Many of you have probably heard of her. It's really natural and in a lot of cases, a good idea to promote from within. And it's not uncommon to promote caregivers to office positions, but a good caregiver doesn't always equate to a good office administrator. A good caregiver doesn't always equate to a good scheduler. I've seen a lot of agencies that have promoted caregivers to schedulers and to other office roles as well, but to kind of that care coordinator schedule role specifically. And because they are a good caregiver doesn't translate into't mean that they're going to be that shining scheduler that you were looking for.

And so I want to just cite that specific example of promoting from within is always something to consider, but it's not always like a silver bullet of bringing one good employee into another position and assuming that they're going to be good at that other position. One thing I want to throw out next week, we're going to be good at that other position. One thing I want to throw out next week, we're going to interview Crystal Wilkinson that's in Arizona. And she, we're going to talk about this, how, who to bring on and how, and how to recruit administrators or office staff from other industries, from home care businesses, how to find people that are a good fit for these office roles. Because like everyone knows, your office team is so critical to the business.

And when you have the wrong people or the wrong people in the wrong seats, it can cause internal turmoil. You can lose clients and caregivers. And so it's really important to get this right. But I'm also here to say there is no one way to do it right. And there is no playbook. But just keep an open mindset and make sure it's always evolving. A couple of things to add here before we move on. So first we have somebody in the chat,

I think kind of giving us a good reminder that it's easy to fall into using like jargon and stuff while we're talking. So when we refer to the org chart, we're just talking about like, how are the roles within your office structured? You know, like what, what are the job titles and the responsibilities of the people in there as it grows, which roles do you hire for, or like which responsibilities just get absorbed into somebody else's role? That kind of thing. I was just going to add to, I think one more really good example of this is, so we were both kind of mentored by Aaron Markham. He founded Home Care Pulse and has founded or been involved in several other agencies. And an example that he always uses when he talks about this principle is that when they were kind of first starting to use like

satisfaction surveys, like the ones that eventually inspired him to start Home Care Pulse, watching the satisfaction survey feedback from caregivers about some of the different schedulers they realized that they didn't have everybody in like the right seats within the agency they had all these really good admin employees but it was like something was off something was wrong and he made this crazy internal shift i think he swapped roles where there was a scheduler and like a billing person that they just had like trade jobs and it actually worked great. And the satisfaction surveys after that from caregivers showed that they love this billing person in the scheduler role. And the scheduler actually kind of had more of a background in like billing. And so then like

they all were happier after that. And that's kind of an unusual example, but I think that's very in line with what you're saying. So just wanted to add that. Yeah, that's a good, yeah, just all transition, but that's a good example because that's not the first time. Aaron Markham isn't the only example of that that I've heard where it was literally like two people in your office doing two very distinct roles and you shifted them around.

And it was like the magic all of a sudden happened when someone that was doing scheduling is really good at like HR or billing. Like it's not uncommon. So I think the takeaway here is just like keep an open mind and continue to have open conversations about who's where and how satisfied or dissatisfied people are. Just let that be kind of an evolving thing in your organization. So if you really want a fun time, tell your billing person and your marketer that they're going to trade jobs and see how it goes. Yeah. And tell us how it goes. Awesome. Let's move on to this next topic. This one probably won't come as a surprise to any or many of you,

but I want to kind of share from a specific lens. The second thing that I've common thread that I've seen between really successful agencies is tracking outcomes. And that is something that we have been talking about heavily as an industry, more so for the last five years, maybe for the last 10 years. But successful agencies, it's like a mindset of how important data and metrics and the right data and metrics are. And so a couple of things, points that I want to make here is you need to hire, fire, review and reward based off of these metrics. It's one thing to think about data. It's one thing to have data between like, you know, your tech stack, but it's another thing to like kind of live and die by metrics and to hold them in such high regard and to be talking about them on a daily

basis and utilizing them on a daily basis. And that's kind of the differentiator here is it's one thing to think about and talk about data. It's another thing to like make decisions based off of the data. And so the way that I've seen that successfully executed is quite literally hiring, firing, reviewing, and rewarding by data and by metrics and by outcomes. Other point I want to make is balancing, and I'm going to reference this a couple of times a day, balancing qualitative and quantitative. That balance in home care, it's important in every industry, but it's really important in home care because you're quite literally dealing with people in their homes. And that is very much

a qualitative experience, a qualitative outcome. But then at the same time, you know, you're running and operating a business and there are finances and there are logistics and there are headaches. And you also have to keep in check the quantitative side of the business. And so it's important to put metrics in place that support both sides of the scale when we're talking about outcomes. And to kind of just, yeah, zoom out a little bit on this point, the most successful agencies I've seen are very focused on growth and on goals. They are not conceptual. They're not, you know, just like totally mission- driven. They have goals and milestones in place and they're actively working to kind of get to that next milestone, which is

another key element of outcomes. It's, it kind of gives you that guiding light. And I, I want to clarify, it's not bad to have a vision and to be vision oriented, but to accurately execute on a vision, you need milestones and outcomes and goals to get you there to then successfully execute on a vision. And so successful organizations are really good at balancing, okay, what is our vision? What do we want to accomplish as an organization? And then the outcomes or the milestones are how do we actually get there? And how do we accurately say at the end of the day, we're executing on our vision because we've achieved X, Y, Z. I really like how you drew the contrast between like having some metrics, using them, maybe even having some compensation or something tied to it and like actually kind of living and

breathing as much as it makes sense to do by those metrics. It sounds like part of the key skill in here is being able to understand, like to break down like the vision and goals into smaller chunks and be like, here is how the contribution from each role can be tracked and measured in a way that feeds into this larger set of goals. Let me share two examples that illustrate two different ways that this can be executed on. First example is Guy Tomasi. Some of you may know him, Lifetime Care at Home out in Connecticut. The way that he approached outcomes was through the lens of a high stakes referral partner. It was in order for me to get referrals from this very high stakes, important referral partner, what do I need to take to them? Like tangibly, what do I

need to take to them to get referrals from them? And it was very specific data and metrics and outcomes. And so the paradigm shift happened through the lens of a referral partner in order for me to go and get referrals from this huge source, I need to have these data and outcomes. I need to basically like rewrite my agency to focus on these outcomes so we can deliver those. So when we're talking about data and outcomes, we're not going to get into, you know, what are those data? What are those data points? What are those metrics? What are those outcomes? Think of it from the lens that you need to get referrals, caregivers,

like there's a lot of different lenses to think about outcomes through, but make sure there is like intention and purpose behind it. And an example that I shared was like from the referral lens. A different example I want to share, this is our friend Jesse Walters at Hill and Dell in California. He is very revenue oriented and he has very lofty revenue goals for his organization. And so from his perspective, it's, I want every one of my administrators to know what our revenue is and to have a metric attached to revenue so that we can grow our revenue. And so that lens is totally slightly different. Obviously, we're all thinking about revenue at the end of the day and growth. But from his lens, it's, we want to get to X revenue by X date. Everyone needs to A, know our revenue. His entire office staff, they could tell you right now what their revenue is as a company. Not saying that's

the right way to go about it, but this is just an example. But then every person, every administrator has a metric and in most cases have actually like an incentive or a reward or a bonus attached to that metric, but that influences revenue. So I share those two examples to illustrate there's no one right way of how to put your outcomes in place, but think of them through very specific lenses so that you put the right metrics in place. I love that. I think those are two really good examples to bring up. And I also appreciate the fact that you point out like there's no one right way to do it. Like it's going to depend, like, yes, like every agency's goal is to grow, but like how you're getting there can be different. And that'll mean different priorities. You have

different skill sets, which means you might take different approaches. And so those are two really good examples. I think guys, particularly like something that you didn't dig into quite as much is like, they're very focused on readmissions, like hospital readmissions, and are really religious about tracking that. And it has paid off so much, like you mentioned. In fact, we're actually trying to get him on this. So if you're listening and you know Guy, bug him, tell him to respond to my LinkedIn message. And if you're interested to learn what he's doing, there's case studies written on him.

Like just Google him and look him up. You can also reference like the quadruple aim concept. He is drawn on like CMS guidelines for home health to illustrate and like kind of shape his thinking around. So look up the quadruple aim concept. He has drawn on like CMS guidelines for home health to illustrate and like kind of shape his thinking around. So look up the quadruple aim concept if you're interested. The last thing I want to say on this topic is actually referencing someone else and something important to consider here, which is, this is something I've learned yet from Brett Ringgold, is involve your administrators when you're establishing

metrics and KPIs. Don't take this top-down approach as an owner and just like inflict your opinions and your perspectives on your team. Sit down with your team members and set goals and metrics and numbers with them. Don't do this above them. Make them at the forefront of these conversations from the get-go. Is it accurate to say, the best way that I've heard that explained to me that I felt like makes sense was typically you as the owner or the admin are probably the best person to choose the metrics, but then to set the goals, which is the actual number attached to it, that should be a conversation you have with them. Is that generally what you've seen being done that works? Or are you saying like,

they should be much more involved in choosing the metric itself too? Like a slightly more nuanced approach would probably be as the owner, like establishing like company-wide goals and metrics, probably department-wide goals. And then when you go to an individual, have a few in mind and run them by them. Like I personally, I wouldn't go to them and say, this is the metric, like get on board or get off. It's like, here are three to four that I think make the most sense for your role. What resonates with you? What worries you? And then like you said, set the goal together. What is the weekly, monthly, quarterly goal? Set that with them. But I personally would also involve them in the

metric conversation because most likely for every role, there are a few things that that person directly impacts. And so I would have even the metric conversation with them, but bring some to that conversation. Good advice. Thanks for that. Third concept I want to talk about is referral marketing, local marketing. The most successful agency that I have seen, the word I want to use is dominate. Absolutely dominate the local market when it comes to referral marketing. And this is a concept that has probably crystallized more in my mind over the last year or two, working with some of the top agencies. And it's just this observation of relationship building isn't optional. And it is

quite literally in my mind, the difference between what a million dollar agency and a $10 million agency in the same market, the agency that dominates the referral sources and the referral marketing network territory, that's the agency that's going to succeed. And so in order to, in my mind, be the most successful in a market is to dominate those conversations, to win those referrals, to quite literally win at that referral source game, for lack of a better term. A couple of points that I want to make around that is that I've heard as well that are really important to call out is make sure multiple people are involved in those relationships. I have seen and I have heard time and time again,

where you have a sales rep or you have a marketer that's responsible for those critical relationships that leaves. And quite literally leaves your business in a pinch because they own those relationships. So I want to throw out kind of the disclaimer, which is make sure multiple people are involved and own those relationships. And also make sure there's a concentrated, consistent effort with these sources. It's not a, you know, take them a coffee once a month and hope that they send you

15 referrals. Like that's just not how it works. And I'm not the expert here to tell you how to like market and sell, but know that, you know, multiple people need to own those relationships. You need to have a very specific plan and a concentrated effort to dominate the, that pool, because it's not like someone's just going to hand you those relationships. They really need to be developed and worked at to ultimately get them at the end of the day. One thing I was going to add to this for someone who's listening and they're like, okay, well, that's great. But like, how do I dominate? I want to hear your take on that too. But a few

like quick resources for those asking that question. I think our last episode with Lance A. Slatton from Enriched Life Home Care. They basically have inbound demand from their referral sources where they just like come to them and they're like, hey, we want to refer you people. And they've basically done that by instead of like being the agency who goes and bugs all the referral sources, not to say that that's not how it should often be done, but like, they've just embraced this role of being like the ultimate source of, of help and education on home care related topics within their market. And they just have established such a brand around, like, if you want to understand more, regardless of whether you're a referral source or a family caregiver. If you have questions

around home care, around caring for someone with dementia or something, you go to Enriched Life Home Care. And so that's one possible way to do it. That being said, though, are there more specifics you can give us beyond that of how the agencies that you've seen dominate these markets are doing so? Yeah, two things that are coming to mind. First is you have to have boots on the ground. That's something that I've challenged in my thinking in home care. We learned a lot during the pandemic and people were not sending their sales or marketing person out to visit these referral sources. And there was this concept where everyone was challenging, like, could we do this virtually? Can we, you know, send emails and make

phone calls instead of being there? And, and I have learned, and my personal take on this today is you have to have boots on the ground. And I back that up by also saying I've seen working with these large successful agencies that all of them have boots on the ground. I think I have maybe yet to see what I would classify as like a large successful business that doesn't have boots on the ground. And so if you're questioning that, you know, I've questioned it myself, but I think my take today is you have to have boots on the ground. The second thing I want to call out, and I'm going to today is you have to have boots on the ground. The second thing I want to call out, and I'm going to reference Gabby Pumpian, who is actually on here, who's going to be joining us on the show. She's articulated this concept to us recently, but it's something that is really important to consider. If you want to dominate at the local

level, you have to add value. You literally have to add value to these referral sources when we were citing guy they needed data like you mentioned to prove that they can reduce hospital readmissions that is tangibly adding value to say a hospital who wants to entrust a patient to you you you know it's like you have to add tangible value. There's a lot of different ways to do that. A specific example is providing rich information and education. These referral sources in many cases

don't know what home care is, don't know what you do, don't know how you do it. And the best place to start is information and education and being really honest and upfront. And that's probably the easiest and most natural way for you to provide value and add value. Again, there's a lot of different ways. And I would challenge all of you to get creative. How can you add value to these referral sources? Think about that and talk to your team about it and really try and get creative and think of ways to do that. But that is how you

truly dominate the local market is finding out what these referral sources need and want, and then creating solutions or value that they can believe in and get behind. And then that builds the trust and the credibility for them to ultimately refer you a new business. Love it. There's one more specific you mentioned earlier that I want to go back to maybe add a tiny bit of context and then see if there's anything else you want to add there. So you talked about having more than one person own the referral relationships. I think that can be kind of a tricky question of like, what's the best way to do that?

A kind of unusual way that we've seen it done that I thought was kind of cool is like, you mentioned Jesse Walters at Hill and Dale in California. And what they do is the marketers and the client care managers, they co-own like different referral relationships. And so they're both points of contact there for different like types of communications. And then there are actual, like that like represents a book of business that the client care person is like co-responsible for and is comped based on growing that book of business. And so they have like almost this kind of sales aspect to their role of ensuring that they extra reason to constantly be communicating with referral sources to update them on the progress of clients they've sent them. Because they know that if they continue to get more referrals from that source, then they get dollars from it. So just thought that was pretty cool. And also, having said that, is there anything else you want to add as far as how you've seen agencies make sure that there are multiple people attached, you know, building relationships with referral sources?

I'm glad you shared that specific example of co-ownership because that's really the concept here. I don't have like another specific to share. I just want to emphasize that it's really specific to your size in some cases. And in many cases early on, the owner is quite literally like owning that relationship, say with a salesperson out of necessity, there isn't another sales rep. There isn't someone else at the office that has the bandwidth to co-manage those relationships. So I would say it's very circumstantial, most likely based off size of your organization. But the finer point is encouraging and establishing that co-ownership, especially with high stakes referral partners.

Because anyone here that's been in business for five years or more or less time, you've had administrators leave and you've had sales reps leave and you know how much it impacts and potentially hurts your business. And so the most important part here is what we both articulated, which is that co-ownership and establishing that early on and prioritizing it heavily with high stakes referral partners. Love that. And I'll just kind of say too, like, I suspect that your perspective on this also comes not, not just from talking to people who have done this in a home care context, but by being head of partnerships for multiple companies, having your job be building partnerships and relationships and understanding how easy it is for those to fall by the wayside if it's not

an organizational effort, not just an individual one. Yeah. Yeah. I hadn't really thought about it from that angle, but to be honest, that's very accurate. It's knowing who to bring in and when. I know what partnerships are high stakes and I know who's referring as business. And so I know when to bring in another executive. I know when to bring in someone on my team or someone on a different team in a different department. There's judgment calls that have to be made periodically. And it just stems from that co-ownership, making sure the right people are involved at the right time with the right people. Let's go on. Let's go on. A couple of concepts I'm excited about here. I don't know if we mentioned at the beginning, these are in no particular order. So I know we're

kind of cranking through these, but know that there's no rhyme or reason to how we're approaching these. Just FYI to everyone. The next one that I'm thinking that I've thought a lot about is innovation. A lot of people tout they're innovative. A lot of people use that word innovative. And so I want to share some concrete examples, but I do want to call out that successful business owners have a degree of innovation, whether that's innate, whether that's part of their personality, whether it's part of their business style, I don't know. And I don't think there's a right answer there. But there does need to be this level of innovation inside of a business to keep it growing and to keep it thriving in what is a really challenging market. A couple things.

These owners that are innovative aren't complacent. They're willing to try new things. They're willing to test things. They're willing to question things. They're willing to fail and fail fast. Innovation is about not always taking the safe route, but being willing to try and test and experience things that they themselves may question. I referenced it a minute ago. This industry is not for the faint of heart. This labor market is not for the faint of heart. And in my, this is kind of Miriam's point of view,

in order for us to turn a corner on home care, everyone knows the stats of how many people are turning 65 every day. In order for us to truly start turning some corners as an industry, we need to get creative. We need to think innovative. We need to think differently about some of the inherent challenges that we're facing. And that comes from all of us. We need to start approaching problems differently. We've experienced a lot of challenges over the last few years as a home care industry. And if we continue to try and test the same solutions, the same models, we're going to

get the same outcome. And so the most successful agencies that I see are trying, testing, failing, thinking outside of the box. And it has led them to be more successful because they're not attached to any one mindset, any one model, but they're always pushing themselves and their business and their people to think differently. Do you have any specifics on either just in general, how they're able to make it be part of their organization and not just a buzzword, or just really innovative things that you've seen agencies do that kind of speak to this. Yeah, let me start by illustrating some concepts, and then I'll share some specific examples, because I think both are important. This may sound slightly self-serving, but from a technology

standpoint, not long ago in my lifetime, in my young lifetime, agencies were, and some still are operating on paper. That has to change. I'll share it. I don't know if that's a hot take or call me what you want, but that absolutely has to change. We can no longer operate on paper. Over the last 10 years, we have seen a transition from paper to software. And now look at the advancements we're making in AI. How do we bring that into home care and start eliminating some of the minutia of paperwork, of day-to-day operations using something like an AI tool? So technology is a pretty easy place to think about and conceptualize the possibilities of what innovation looks like. Let me illustrate two other concepts.

One is from a cultural standpoint, applicants and candidates are a different breed. I've heard that a lot over the last couple of years, especially since the pandemic. Applicants, candidates, employees are a different breed. And so we need to be more innovative of how we're talking about and thinking about applicants and employees. What do you mean breed? I'm not quite following there. A different breed in that how many people, like the term ghosting, ghosting didn't exist to a lot of people three years ago, but look what's happening today. Ghosting is quite literally

happening on a daily basis in home care. So when I say different breed, it's just things that we've never dealt with, with applicants and prospects and employees, like we're dealing with now. So just things have changed. And many of the people we're talking to are a different breed. Does that make sense? Yeah. The last concept I want to share before I share specific examples is like from an operation standpoint, there has been a lot of evolution in service lines and revenue streams for businesses. And so thinking creatively about how do I open up different revenue streams? How do I monetize in different ways? You know, home care is a great business and it's a great service line, but there are other complimentary services or government dollars that you can introduce to your business to unlock like new potential.

And so innovative owners, innovative businesses are thinking differently about service lines and revenue streams and how to like kind of give and take and mold their business. Let me share a couple of specific examples. One that came to mind is Kyle Bossing with Senior OneCare. Their business, their agency, they opened up and operate a CNA school. That is a very large undertaking. And I'm not advocating that that's what every home care business needs to do, but they saw a really critical need and took it upon themselves to start a CNA school and train up people that can work for them, but also like broader spectrum that can go and work for their competitors, for their, you know, their healthcare system at large. But they saw that need, took it upon themselves, started a CNA school. One step

further than just that concept, they're using virtual reality to train those employees in the CNA school. I don't know if any of, I don't know if you've seen this, Connor, anyone that I'm talking to has seen this, but they're quite literally using like VR headsets to imitate what it's like to see through a client who has dementia or Alzheimer's, like see through their eyes, put on a VR headset and learn and be trained like through that lens. So two innovative concepts to me there is seeing and starting a CNA school on top of running a home care business. And then one step further, bringing to modern technology into that learning environment and demonstrating like really strong, true value to the employees and the potential employees that are a part of that. Super cool examples. Thanks for that. Really quick.

We have somebody asking about ghosting. So ghosting just refers to like, it kind of started out with like the Tinder dating app scene where it's like you have a really good date with someone and then they like don't text you back ever again. And it's kind of like now translated into the job market where it's like you have an applicant or a candidate, like maybe they have an interview. It seems great. Maybe you give them an offer

and then you just don't ever hear back from them again. And that's the end of it. And that's seems like it's happening more and more often. So anyways, one other, one other example, let me throw out another one. This is kind of down the path of like introducing new service lines as a way to be innovative. I've talked to her to owners and operators recently. I'll cite them Catherine Vergara and Casey Robinson about care management. Hopefully many of you know about care management and what that means. I personally have learned a lot about it, but that is another very like innovative approach. You know, what is care management? What is home care? How do those two things fit together? How do you successfully

own and operate and manage like a care management business? And how does that feed your home care business? That's another way of just thinking differently about, you know, the much larger inherent question, which is like the care of clients, the care of like our aging population. How do we serve them from a home care lens? But maybe more importantly, or more holistically, how do we serve them as a person and meet all of their needs? Okay. You know, let's, let's go down the care management path and be able to serve all of the client needs and be able to monetize for that. So innovation takes a lot of different shape and form and is kind of nuanced, but I have seen successful businesses that are just pushing boundaries and

thinking differently and challenging the norm. And I encourage everyone to adopt this innovative mindset because this is really where, like I said before, I hope we can turn a corner in home care. That was a really good one. Let's go on. We have about 13 minutes. Let's see how much we can get through. Awesome. This one may sound slightly similar to innovation, but it's slightly different. This next one I want to bring up that I've observed is owners that are really good at optimization. And optimization, I will call out as kind of a buzzword. When I say owners or businesses that are good at optimization, it means a few different things to me. It means that they're not afraid of change.

They are willing to make intentional sacrifices. They're really good at seeing things from multiple angles. As leaders, as executives, it's easy to get pigeonholed and to see things from a specific lens. But in order to optimize and get good at optimizing, you need to see things from multiple angles. As an owner, as an administrator, you want to make sure to bring in a lot of perspectives to important decision-making. And that's a key part of getting good at optimizing. I want to reiterate what I brought up earlier, which was balancing quality and quantity. I think optimization, being good at optimization is striking the balance and knowing when to

give and take on both of those concepts. A couple of examples, I'll just get straight to them. Two people in my mind that are masters of optimization are Kanoe Koshel and Jeff Weiberg. Hopefully those are names that you've heard of. If you haven't, write them down, follow them on LinkedIn. These are, these are in my mind, some of the masters at optimization and home care. Let me share why I think that in examples of specifically things that they've done. Canoe Koshel owns and operates what I believe is the biggest agency in Tennessee. He, in my mind, is kind of a home care genius. He is incredible at learning from his mistakes

and optimizing based off decisions he's made, mistakes he's made, bringing in the right parties of his team intentionally, and analyzing and rethinking. An example that I've heard him speak to was a few years ago, they sat down and put in place core values. I might have this a little bit skewed. I think they had core values in place, but they either resurfaced their core values or updated their core values and totally had a mindset shift of the concept. We're going to hire, fire, review, and reward based off these core values. And to me, that was a good example of like optimizing something that is table stakes in a business vision, mission, core values. Like most of you probably have that, but it's another thing

to refactor that in and then find how it's influencing day-to-day operations. To me, that's optimizing. Canoe knows the top, the bottom, and the middle of his business more thoroughly than most owners, but that's where he can thrive in making optimizations is because he knows the layers so thoroughly and can see gaps, weaknesses, cracks, knows who's involved and can refactor those things properly and make optimizations that actually move the business forward. Well, those are good examples. Yeah. I was going to mention, so Jeff, who Miriam mentioned, at the time that we did the interview with him, he was president of the HCAOA board, and then he runs Family Resource Home Care in Washington State. But he's interesting because

it's a really large agency. He's a CEO, but he knows kind of what's going on, like you mentioned, at all levels of it. And so we, if you go back early on in our episodes, we have a pair of episodes with him that are titled something like the best caregiver hiring process we've ever seen, and something related to that. But they're a really good example of how to optimize every small little bit of your hiring and recruitment process over time based on data, based on observations. So yeah, definitely second to all that. Yeah. Let me add just a little bit of color on that because that's the exact example that I'm thinking of here. During the pandemic, what Jeff did was basically sat down and broke down his recruitment process as in-depth as possible. Literally every single step of the recruitment process, he just ripped it apart and then had to

put the pieces back together and optimize every single step. So that's another example of breaking things down, quite literally like breaking down processes, mindsets in your organization, and then very intentionally and very carefully building them back up. That to me is optimization. And hopefully I'm not scaring anyone out of this concept because I think it's so important. And that's back to innovation. You have to start thinking differently, pushing boundaries, challenging your own thinking. And then that's where like the secret sauce starts like working and making its way into your organization is when you're optimizing and making changes to some of the critical

functions in your business. We've got time for one more, I think. Let's do it. Last one that I want to talk about, avid learners. I am amazed at how receptive large owners and operators are to humbling themselves and taking this very hungry desire to learn, I think that is a symbol of a really good owner. And from those that are most successful is they're still willing to learn. They're still attending the same webinars that I'm attending. They're still going to the conferences that, you know, someone that

just opened their doors is attending. I personally love to see it, but I also think it's a part of their success is that they are very much avid learners and they're humble enough to take advice and learn from everyone in this industry. We're all trying to solve the same few challenges and we can learn from someone that opened their door, someone that's two years in business, someone that's 20 years in business. We're all kind of working through similar challenges. And I love that the large successful owners and businesses

are willing to learn alongside the rest of us. Do you have any specific recs on who they should follow, what content people can be listening to or reading or whatever, you know, what communities, just things like that, like where people can go to learn continuously about how to become more effective at managing home care agency. Yeah, I'm sure you and I both could put together a very long list for everyone. Self-serving, I'll just say you're in the right place here. You know, I feel like we are talking to some of the leaders that you want to be following. And so if you haven't gone through, go back through all of our episodes, obviously listen to them, but also connect with these people on LinkedIn, strike up conversations with these thought leaders and start picking their brain.

Because from what I've seen as well, they're very apt to share their knowledge. So don't hesitate to reach out. Just spewing a couple off the cuff, from a conference perspective, many of us just attended the HCAOA conference. In my mind, that is the best conference for any private duty home care agency to attend. It is home care specific. There's a huge network and pool there. And the education is outstanding.

So put that on your calendar for 2024. If it's not, it's going to be in Seattle. Can't recommend that conference enough. Beyond that, there's Decision Health actually coming up later this week in Las Vegas. That's another very home care private duty specific conference. I hear a lot of times that there's a lot of conferences, but it's not uncommon for them to cover home health, hospice, and home care in one event. And so the examples I'm sharing are home care specific. Third event I would recommend are state chapter meetings or state association conferences. A lot of the information that you need as an owner takes place at the state level.

So get involved at the state level, attend chapter meetings, state association conferences, events, some are virtual, some are in person, but look those up and attend those. As far as like digital communities, resources, just calling out a few, there are a lot of Facebook groups out there where there are other owners, operators conversing, asking questions, et cetera. And so if you're not on Facebook, get other owners, operators conversing, asking questions, etc. And so if you're not on Facebook, get on Facebook, find those communities, search home care, and you'll probably come up with 20 of them. So it's not that hard. And I'm not going to cite a bunch of examples. Home Healthcare News is a news outlet that covers home care. They also cover other industries, but I would say that's a good place to start for industry news. And then just

kind of a last one to cite, if some of you haven't heard of it, the Home Care CEO Forum. That's a business and basically mastermind groups run by Stephen Tweed and Jensen Jones. Those are for kind of the top tier of the industry. But I would also say seek out mastermind groups, communities, kind of build your own network or circle of home care providers, because that's where you can continue to like share ideas and foster information. So connect with people on LinkedIn, strike up these conversations. We all have a lot to learn from each other. I'll just kind of shamelessly add here, besides our podcast, we do also have what we call the

frequently asked questions of home care, where we kind of have these like mini blogs that we publish here and there that just respond to the questions that everybody asks when they're running an agency at some point. So you can go to faq.careswitch.com and there's some good content there. But I second all the other sources that Miriam said. Thanks for sharing all this with us. Any last words you want to leave everybody with? I just want to say thank you. I, as you can tell, I'm very young. I still have a lot to learn, but it's been kind of like the joy

of my life of these five years to learn alongside of all of you. I love learning and I love having conversations with like-minded people. And so I just want to thank all of you for what you're doing and the example and inspiration that you've shared with me. And I hope I've given back a little bit today of sharing some of what I've learned from all of you with more owners and operators. So keep up the great work. Let's continue to learn and progress

and grow together. Well said, thank you. And I second all that. So thanks again for sharing all this and for all that you do and are doing for the industry. We'll go ahead and close there. Everyone have a great rest of your day. Thanks again. Awesome. Thanks, everyone. 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.