Home Care U - How to Grow Your Home Care Agency Using What You Have Today (Michelle Cone Pt. 1)

Episode Date: April 25, 2023

Michelle Cone, SVP of HomeWell says you can turn one client into $1M in revenue over time. Here's how.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 Care Switch. Enjoy the session. Welcome to Home Care U is hosted by myself, Miriam Allred, and Connor Koons of CareSwitch. Enjoy the session. Welcome to Home Care U.

Our guest today is Michelle Cohn. She is joining from HomeWell, where she is the SVP. Michelle, thanks again for joining. Absolutely. Thank you so much for having me today. I have learned a lot from Michelle. She is a walking library of home care expertise. And today's topic is going to be pretty cool. So Michelle is a big proponent of growing your

agency with what you have today. That includes not just your financial resources or whatever connections, but also your clients, staff, and caregivers. And so we're going to dig into how to grow your agency using the connections you have with your clients, staff and caregivers and go into kind of some growth strategies that you may not have heard before. Just a couple housekeeping items as we get started here. First off, if you're joining us live, remember that we love to answer your questions both as we go and at the end. So throw those into the chat or the Q&A box in Zoom. And depending on the question, we'll either answer those as we go or we'll save some for the end and address them then. Just remember, this is both

a live class and a podcast. You can sign up for the live class free at HomeCareU. That's you as in university.careswitch.com. And then you can also find the HomeCareU podcast wherever you get your podcasts. We've had some just really stacked lineups of past presenters and some really awesome ones both today and in the future that I'm excited for. So give it a listen and join us live to ask your questions. One last thing, if you have joined us before or listened before, you've heard me make this joke. For those who have heard this 10 or 15 times now,

I apologize, but it's a good introduction. I do have a stutter. Sometimes it shows up, sometimes it doesn't. I just mentioned that because if there are random pauses or blips of silence on our call today, that is probably not Zoom buffering. That is probably not your internet buffering. That is me buffering. So just know that it's fine and we'll roll through it. So all that being said, let's dive into our conversation for today's episode. So Michelle, I mean, like when we were talking about this before, you talked especially about one concept that was really interesting to me, which was this opinion you have that you can get a million or more in annual revenue from one client over time, not directly billing them,

but as a result of marketing through that client. So let's kind of start there. Talk us through your thinking. Absolutely. Well, I know that may sound like a magic bullet, and I do hope to drop some great nuggets of knowledge that those on with us today, either live or will be joining us in the replay and utilize in the future. I think that you and I will take the time to kind of unpack that a little bit today. Those that know me know that I prefer an inch wide, mile deep approach. Right. I don't like to just cast a wide net and see what works. I'm all about working smarter, not harder. And I'm sure that several of those with us on the call today probably feel and think very similarly. So you're absolutely right. Whether you have three clients, 30 clients, 300 clients, this principle is going to work to take you to the next level. I think too often we are focused on the next great thing, the thank you now I need another, right? I feel that when we do

that, we don't oftentimes take advantage of what we already have, what is right in front of us. And I believe that this is especially true when it comes to both client and caregiver acquisition and retention. How can we leverage what we have to really close that gap from where we may be now and where we hope to be in the future, right? Totally makes sense. And I really like that because, I mean, especially especially for those listening like we all understand that home care is is the scrappy business to get into right especially when you first get started you're like hey how do I find my first client how do I get my first caregiver and it's a journey you know and you have you may have times where growth is easier but you never have a time where it doesn't require effort and problem solving and figuring things out.

And so I really love your approach. Well, thank you. I know that it's important to really understand our business and how as business owners or operators, how can we take what we have and make sure that we're maximizing the opportunity to grow our business and to retain our clients and retain our caregivers. They're very similar paths that we need to pursue for both. So, you know, let's say that you do have the three clients. Let's start at, you know, that critical ramp up phase, right? How can you leverage those three clients to gain future clients and grow your census. So, you know, you have those three, where do you go from here? So I think first, you want to identify what is your gross revenue goal? Where do you want to be from 12, you know, about 12 months from now? And how can you utilize your

current operational strategy to get you there? So, you know, ask yourself, how many clients am I going to need to get me there from point A to point B? And that second question, which I know we'll probably touch on later, is how many caregivers am I going to need to hire and retain to get me there? So let's tackle the first part of that first, right, the clients. So as owners and operators, take a look at your current census. Let's say that it's the three that you currently have. Even with those three, what is the average billing rate for those clients? And what is the average hours per week per client that those three clients are bringing to the table? So let's say with those three clients, you have an average billing rate of $31.25 an hour, right?

We know that rates have continued to increase exponentially in this post-pandemic landscape as the demand for our services has significantly increased, but we're having workforce challenges. So identify what your average current billing rate is and then identify what is your average hours per week per client. Let's say with those three clients, that average billing rate is $31.25 and you have an average hours per week per client of $32. So that's a great place to start. This means that you're sitting at probably 96 billable hours per week, hoping to probably reach that 100, 150, 200, and beyond. So if you do nothing more than just keep those three clients the same billing rate and the same hours per week that they're producing in terms of billable hours, no more, no less, you just keep those three, you're going to land at around $156,000 in gross

revenue by the end of a 12-month capture period. So that's great, but that's probably not where you would hope to be, right? So what we want to look at is using those same numbers, your average hourly billing rate, your average hours per week per client, you would need to acquire and retain 25 clients for 12 total months to capture 1.3 million in gross revenue. That's a great goal, right? 1.3 million tends to be that million dollar threshold is where owners want is what they want to achieve. They feel like they've made that first tier of success once they've they've captured and moved beyond that one million dollar number. I know we see that in our system as well. So, you know, that's that's pretty significant knowing, OK, well, I'm going to need the 25 clients to get me there. Now we know what census drives that revenue number based off of your KPIs. And these are very important KPIs to monitor to

identify where you are now, and then you can back in to where you want to be. So for larger agencies, maybe outside of the initial ramp up phase, let's say your goal is $3 million, right, or more. According to these same numbers, the 32 hours per week per client, the $31.25 average billing rate per hour, you would need 58 clients on service for a full year, a full 12 months, no more, no less, no variables, and that would land you at over $3 million in annual gross revenue. So now let's kind of back into your question a little bit of, okay, that's great, Michelle, but how are those three clients going to get me there? So what do you want to ask of those three clients? What do you want to find out? What data can we extract? What value can we

receive from these three clients? And how can we leverage that to help us get to the 1.3 million or the 3 million that we just spoke about? One of those is, you know, where do they come from? That's an obvious question, right? We should be tracking that. What was the referral source? How did they land in your lab? Was one of them a paid lead source? I know a lot of folks use paid sources like A Place for Mom or Care.com or Caring.com. There's quite a few of them out there. So you would want to follow up with that lead source. Communicate with them.

Treat them like a referral source partner, a community referral source partner. Give them the same love, communication, feedback, and nurturing that you would your home health agencies, your skilled nursing facilities, or your physicians that you may be calling on. You know, be sure and share with them what hours they're receiving, what benefit are they receiving beyond just ADL support, right? It's obvious that we're providing that personal care support, but what benefit, what program do you have that they may be utilizing and how is that driving a positive outcome? How are they doing on your services? The higher your lead to admission conversion from those paid sources, the better. So let's say you can acquire and admit 10 more clients in a 12 year period, which is not

a crazy number. That's less than one a month. 12 month period, you mean? Sorry. Yeah, 12 month period. Yes, that's less than one a month for 12 months. You just need 10, 10 from that source, that one client that came from that paid source. You just want 10 more. That's your goal to extract from that referral source over the next 12 months. Maybe one of the other three of your clients was from a community referral source partner like, you know, a skilled nursing facility or an inpatient rehab facility or a home health agency, maybe an assisted living community. All those that were out there building relationships with on a local, at the the local level you also want to follow

up with them right you want to share with them the successes the program the benefit everything that that client is receiving that positive outcome build that relationship with those community referral source partners and let's say one of them did come from a skilled nursing facility and you acquire over the next 12 months maybe 20 more clients from those types of sources, which, again, is not a crazy number. Let's kind of break that down for a minute here. I think that do to leverage the fact that you have a client from them who's doing great with your services? How would you use that to augment the marketing that you're doing with that skilled nursing facility or home health or whatever it may be? So they're going to want you to follow up. That is the main issue that many of these referral source partners

have with home care agency marketers, right? Is that they may show up sporadically every now and then. They'll send a referral and they may or may not hear back from you until you want another one, right? And then you show up and go, thank you so much for sending me that referral six weeks ago. Do you have another client that I may be able to provide value to similar to that one? And that just doesn't cut it. We have to be very intentional in our marketing efforts. And we have to be consistent, consistent with our touches and consistent with our value. So if it did come from a skilled nursing facility, you want to show up as soon as that assessment is complete.

Share with them. Thank you so much for sending Ms. Smith to us. You know, we noticed that she was a fall risk and a readmission risk. We were able to place her on a particular program that you may have. This is the hours that she's receiving. This is the value that we're providing to her, to him, to maybe their spouse or partner or partner or loved one, or the family member that, you know, according to statistics, most recently from AARP, the average adult child lives more than 280 miles away from their aging parent. So they're going to want that peace of mind as well. So being able to package that, deliver that back to that discharge planner or social worker at that skilled nursing facility and communicate with them the hours, the services, the value,

the benefit. They want to hear that. They're thirsty for that. They are asking for that from us. They know that we provide personal care support. They know that we bathe and we dress and we toilet and we ambulate and we feed and they know we do housekeeping and meal prep and transportation. We all do that, right? But it's the follow-up that's so very important. Paint a picture of what you're actually doing for this client. Make them feel really good and confident about the decision that

they made to place that referral for you. They know you're doing a great job. You have the feedback, you have the follow-up. Show up with client testimonials. That data is so important as well. Don't just take our word for it. Listen to what our clients are saying about this. Thank you so much for the insight to identify that this client needed the service we provide

and look at the value you were able to provide to them. It makes them feel good about the decisions that they made. Then they'll be thinking about more opportunities to send those types of clients your way because they know that you're in there on a weekly basis. Love it. How often, in your opinion, should you follow up with that facility specifically about that client? So I believe regardless of whether it's following up with this client or it's one of the referral sources that you're working on your plan, I highly encourage, particularly if it's a new referral source that you're in that first 90 days of relationship building, that you connect with them on a weekly basis. And it doesn't necessarily

mean that every Tuesday I'm in there, every Wednesday I'm in there, but let's say it's Tuesday of this week and Friday of next week, right? And then I may skip that next week and come in on Monday or Tuesday. Now, some referral source partners want to set a calendar, right? They want to know when you're coming. They look forward to it over time. But when you're in that relationship building stage, you need to be in there and you need to be in there often. But you also need to make sure that you're getting the greatest bang for your buck. You know, I'm not a fan of trying to build relationships with donut deliveries or cookies or Starbucks drinks. They haven't earned that yet from you. Right. And so it really does decrease our value in that referral sources eyes when we just show up unqualified and start showering them with gifts.

So we need to learn about them. We need to find out what their pain points are, start building a relationship, having conversations with them and identifying ways to plug their gaps with the services and value that you provide. So in those first 90 days, even up to four months, it's important that you have a regular cadence of probably every 10 days. And then over time, you may modify that as needed. But the goal is over time, these are gonna be repeatable. You're gonna see repeatable business come from these referral source partners.

They're gonna see you as a true partnership in their discharge planning. And they're going to see how valuable you are, not only to them and their operation, but also to the families, the patients that they support. And they're going to be looking forward to your visit and looking forward to sending more clients your way. Love it. And I think there's something you said that's really interesting in there too. So you mentioned that it's not only not always productive to be bringing donuts and stuff like that in the first visit or two when they haven't really done anything for you, but that it can actually be detrimental. I find that really interesting because A, I mean, like we've all seen how typical it is to do that.

You know, that's a very commonly practiced thing. And B, I think it's understandable how come just because it's an easy temptation when you have a referral source you want to build a relationship with. You're not completely sure how to proceed, especially if you've already done a visit or two. And, you know, it's OK, but there's, you know, you haven't received any referrals or anything. That's an easy thing to resort to. So I love the fact that you identify that saying, you know, that's not necessarily a good thing. You know, don't, don't make that the go-to. Is there anything else you want to say on that topic before we kind of zoom back out? Sure. So yeah, I think that it's again, we need to make sure that we're not entering our referral

sources with that arm of salesperson, right? And I know that we all get, I was guilty of that. I'll be the first one and our franchisees know in our training, I am very transparent about sharing my challenges when I entered this space 25 years ago. So I've done it all. If there was a mistake to be made, I can guarantee you that I made it and I learned from it. Back when I started in this industry, it was a brochure and a business card and they sent you on your way and said, make the magic happen. There was no sales process. There was no training. You just went out with a personality and donuts and tried to make it happen. And you know, 10, 15, 20 years ago, that may have worked and it just doesn't work anymore. I think we really have to do our homework. Never enter an account without

doing your homework. Let's say that I'm going to enter a facility, right, and I've never been there before. Understand what type of facility it is. Is it an inpatient rehab facility? Is it a skilled nursing facility? What does that look like? Go to medicare.gov, look at their data, look at their readmission rates, look at what they're really doing well, and also be aware of what those challenges are. Go to their website. Take a look at their leadership team. You know, their website is no different than mine. It's no different than yours. We put our best foot forward, right? It's those things that are differentiators or that we want to highlight that we do differently than the next guy. Well, that's very true with our referral source partner. So take a look and see what they're

highlighting as something that's a differentiator for them. Connect with their leadership team. Go in with names and with data and insights into who they are and what they're doing. Congratulate them on what they're doing well. And over time, offer value on the things that you can help support that they may be challenged with, maybe a low readmission number, maybe a low discharge to community number. Really know what that looks like and do your homework. Then when you walk in, even if it's your first time, you're so much more confident about the account you're walking into. You know who they are. You know how they operate. You know what they're highlighting as a

differentiator in their community. And you can leverage that with confidence and then you don't have to rely on Starbucks drinks and breakfast burritos to get you where you need to be. You know, all that being said, if I'm on the referral source side, I don't object to question here, which is, you know, you talked about how 10 or 15 years ago you could do the whole, you know, just get a brochure and a business card and walk in. Why doesn't that work anymore? Because I still hear agencies who were trying to do that. Why shouldn't we be doing that in 2023? I think it's because the post-pandemic landscape that we live in now has been a good thing, but it's also a challenging thing that we have to navigate. And it has, I think, really painted a picture of the value that we provide, but it also has elevated the expectation of what we're supposed to deliver and how we're supposed to deliver that information, which goes back to data, which I know our industry is very poor at capturing.

We don't have standardization in training. We don't have standardization in regulation. We don't have standardization in outcomes or data capture. So we need to, whether you're a single agency or you're part of a large franchisor, you need to bring them data and insights that they're used to, because that is the world they live in. When I was in skilled nursing, when I was in inpatient rehab, when I was in home health, we lived and died by the numbers. And so sharing those numbers, they're comfortable with understanding what that means. And also, you know also equating that to the quality of care that you deliver. They don't care how the cake is made necessarily, right? So when you show up with the data and the insights and the client satisfaction and the employee satisfaction, that's a world they live

in and they're very familiar with. They want that that so we need to speak that language and come to the table prepared to have those conversations as well love that and completely agree so let's kind of zoom out here and move on to the next part of this so we kind of talked about how to leverage a client if you got them from a referral source and i'm kind of using them to get more referrals from that source. Let's talk about how you might be able to get more referrals directly from that client. Agreed. And there's probably two ways that I'd like to hear your thoughts on this. The first one is like on an individual basis, you know, your relationship with that specific client. What do you do to get referrals? And then maybe the second part of this after that is, as you start to grow, how do you systematize a good process of getting client referrals?

Absolutely. So I think we need to have a very close relationship and be very intentional with a high touch communication and, you know, making sure that we're in that client's home and we're visiting with them on a regular cadence. So whether that's with your care manager, doing a supervisory visit, be in there and identify, you know, where they're at and what they need. Because I can guarantee you if you did an assessment, it was six months ago and you haven't seen that client, 100% chance that that need is different than it was six months ago and you haven't seen that client, 100% chance that that need is different than it was six months ago when you first did the assessment and admitted them to services, right? So we have to have high touch. What value are they receiving? If there's any issue with your services, you want to know right away, right? So you can go back to your team and identify ways that you can

improve that process because if it's happening with one client, it's probably happening with others as well. And there may be some efficiencies or some coaching or training or support with your internal team that you may need to have so that that client experience improves and other clients can capitalize on what you have learned with that client. Absolutely. So high touch. We also want to identify in our process as they are on service with us for a while, you know, those, those promoters, right? You've got your promoters, you've got your detractors, and you've got the ones in between. So we always want to be moving them up a level. But if they're a promoter, and they love your agency, and they love what you do, and they love the caregivers and the value you provide and the care managers and they're thankful to the referral source for referring

the, you know, them to you. You want to capture that and provide that information back to the referral source. Absolutely. That is extremely important. And, you know, every client that you bring on to service, those three that we're talking about in that ramp up phase, they have physicians, right? They at least have a primary care physician, at least most of them. But many also have chronic conditions and they may see physicians on a regular basis for, you know, they may see an endocrinologist for their diabetes. They may see a pulmonologist for COPD or cardiologist for CHF. So when a client has multiple chronic conditions, and we're aware that they have these multiple conditions, we need to ask if they are seeing a specialist, do they need

assistance with transportation or reminders? Or does a family need to be reminded to that this appointment is coming up, and then they need to attend these appointments. And then have conversations with those physicians just as if they were the ones that referred that client to you. If you look at the Home Care Pulse benchmarking study, in the top referral sources, physicians are not on there. But I believe it's because we don't know how to have a conversation with them. And we need to start with the clients we have what physicians are supporting those types of clients what conditions do they have and then have a conversation one client could have three four five six different physicians they're seeing so this goes back to now you've got multiple referral opportunities again based off of that one client that you have.

Okay. Interesting. Yeah. There's lots in there. I guess my follow-up question would be, you focused a lot on making sure that you have a top-notch client experience and that you have systems in place to track and make sure that it's a top-notch client experience. When it comes to the actual asking for referrals and collecting referrals, what are the specifics of that? How and when should you be asking that kind of thing? Yeah, absolutely. So I think it goes back to really identifying who, which clients are those promoters. We've all, if you've been in business long enough, and even if you've only been in business for a short time, you're going to have those clients that just love you, right?

That think you're the best thing. You know, what can i do i had no idea that um maybe your business existed and the value and benefit that you provided the peace of mind that sense of control over my situation is something that's very important to me and you know i as a client would like to help you what can i do well that's when you want to be able to have a conversation with them about and i'm plugging home care pulse a lot today but making sure that you have an incentive a referral incentive plan for those types of clients same thing for caregivers right for our masters um it's the top referral source is current satisfied clients, former clients, and family members. So it's important that we are able to identify those clients that love us, right?

And you're going to be more comfortable saying, hey, you know, if you really want to help us, we have this referral program. It can be whatever you set it to be, right? Maybe it's a percentage off their next invoice or a dollar amount also, not only the client that's referring, but the new referral that they're going to provide to you. Maybe it's a neighbor, church friend, their buddy at the senior center. It could be another family member, whatever that looks like. But just get in front of them and message that fairly often, either during supervisory visits or whenever that you have this in place and you would love to

be able to provide support and assistance to other clients just like them and give them the same experience and sense of control over their current surroundings and situation just like them. And if you have maybe 10 clients that you're communicating that to and three or four of them send you a family member or an associate that they know and could benefit from your service and you can convert them, that is a very low cost acquisition opportunity for sure. You talked a lot about Home Care Pulse. I want to get into that just a little bit here. So as you are probably familiar with, so I used to work at Home Care Pulse. For those who don't know what Home Care Pulse is, they do several things. But what's relevant here

is that they survey clients and caregivers and then track satisfaction scores and feedback. So my question for you, Michelle, is when you first kind of start your business, you know, maybe you have your four clients or whatever, it's very easy to keep your pulse, so to speak, on how everyone feels about your business and the care they're receiving. And then as your business grows, it gets more and more difficult for you as the owner to see everything that's happening in your business. And that's where it starts more and more difficult for you as the owner to see everything that's happening in your business. And that's where it starts to become more valuable to have something like that, a system that tracks who are your promoters and who needs some extra care and some

extra help and that kind of thing. So my question is, in your opinion, at what stage of growth, whether it's revenue or clients or whatever should agencies invest in something like home care pulse to be tracking that so i think that there's some variables there and of course every owner operator is a little different but i would say that you know keep it in-house right i think that um until maybe you get to a 10 client and or 25 caregiver census that you can probably internalize that. Right. It's easy to keep your pulse on five, six, you know, seven, eight clients. But then it becomes a little bit more difficult to do. And it's one of those things that you can easily dismiss because you have another fire that you may be putting out. Right. And we know that that does happen. So that's when I think it's a great time to look at a third party to do that for you.

And then as you continue to scale and expand is is delegate that to someone on your team to manage that. Right. And and whether that's your Monday morning meeting or whether that's, you know, twice a month or your once a month leadership meeting, whatever that looks like. Make sure that that person is bringing that information and that data to the table so that you can speak about it. And then when you you have that information, you know, Home Care Pulse has that dashboard. I know that there's other ways that you can do that as well. Whatever way you need to capture that, that you're having conversations about it. Who loves us? Who are the passives? Who are the detractors? What can we do to move them up? What can we do to make them a better experience? Give them a better experience? Are we speaking to them about the referral incentive plan that we may have? Both from, again, a caregiver and a client perspective, they're very, very similar. The goal and what I

really want to emphasize is that you have one and that you're messaging it often. And as a startup, you need to start with those best practices and those best behaviors early on and make it a habit. And as you scale, you can delegate to your team and set that expectation. That totally makes sense. Thanks for that. Let's go on to the hiring and recruitment side of this. So like you mentioned earlier, often the most difficult part of growing an agency is not on the client side, especially after your first few clients, I think. It's finding the employees to staff those cases. So let's talk about how you can apply these same principles on the caregiver side of that. You know, acquisition and retention, whether it is from a client acquisition and retention side or from the caregiver acquisition and retention side,

retentionality is key. It absolutely is key. You have to have intentional retention of these clients and of these caregivers. It's extremely important. So it is a marketing function and we need to treat it as such. I think, you know, we hear a lot of talk in the past, particularly about we're client centered, we're client focused. And in a post-pandemic landscape, we're hearing about we're caregiver first and we're caregiver focused. Well, I agree. I think, you know, there's arguments to be made for both. I think they're equally important. I think every agency needs to be just intentional, as intentional and focused on caregiver acquisition and retention as they are on the client side. I don't know that one is actually more important or

is takes a priority over the other i think you have to treat them both as a marketing function and you have to make sure that you're not only acquiring and capturing those caregivers but you're giving them the love the support that they need to feel that they're part of a team we know that one of the some of the top reasons that caregivers turn over in this space is they don't feel connected to the business owner, they're not getting proper training, they don't have a sense of the why of the organization, they don't feel that the agency is communicating with them at all, unless they're asking them to fill an emergency shift, there's no intentionality behind it.

So in the same way that you need to have a regular touch cadence with your clients, you need to do the same thing with your caregivers as well. Don't just send them a mass text and they only hear from you when you need emergency shift staff, right? You have to get to know them. Your team needs to get to know them. They need to build a relationship with your internal staff as well so that they know what these caregivers, you know, beyond just availability of when they can work. We need to know about them. What do they like? What do they dislike? How do they like to

be rewarded? How do they like to be recognized? And then we need to make sure we have a plan in place and that the team understands that, you know, the ability for them to retain their job is very important. And I know if you're a scheduler or you're a recruiter, like you probably hope to stay with that agency. But if you can't bring in the clients and you can't bring in the caregivers and you can't match them and retain them, we're all as an industry, we're going to suffer, right? As an agency, you're going to suffer. So you have to be really intentional about having a regular cadence of touch points, whether it's, you know, two major events per year, a quarterly activity per year, reaching out to them. We know they want, they typically ask to be texted versus emailed or phone called and, you know, invite them into the office, have these different events, make sure you're recognizing a caregiver of the month every month and you don't fall behind. You're pushing that, you're promoting that, you're pushing it to social. Your community

wants to see that. Your caregivers want to see that. They want to know that if they're working for you as an agency, that you care about them, you care about their needs, their challenges, you care about supporting them, they feel bought into the agency, the why of the owner or the administrator or the operator, and they feel connected to your team as well. You know, they oftentimes feel like an island unto themselves and we need to bring them into the fold and make them feel that they're part of the team and that honestly, your business can't exist without them. That totally makes sense. Yeah. We all hear things like that of, you know, how much we need to focus on retaining caregivers and valuing caregivers. I've seen a lot of agencies that do a great job of it, but it's still the importance of that can't be overstated. So when it comes to the asking and gathering, you know, side of referrals again, what should that look like on the caregiver side? Well, for those caregivers that you feel very connected to, and you know,

either in your, you know, again, if you're in that ramp up, and you're having that personal conversation with you, and they tell you that you're just different to work for, they really like you, they feel connected to your team. That's when you're going to want to reach out, much like you do promoters for your clients and say, listen, we would love to have other great caregivers just like you come on to the team, right? So caregivers know caregivers. It's a community. And if they feel that they are getting what they need from you in terms of, you know, the hours, the support, the encouragement, the recognition, the appreciation, they're going to reach out to their caregiver friends and say, you should come work for this agency. They're doing things differently. They really understand what we

bring to the table. They have, they're training us, they're supporting us, they're appreciating us, they're listening to us. They're going to want to send other people to you. And honestly, these caregivers that are sending other caregivers to you, they're not going to want to bring people to your agency that they know are going to call off or not show up or, you know, ghost you. We hear that quite a bit now as well, because they know that that's going to impact them, not only the reputation, because they brought this caregiver to you, but then they're the one that's going to get the call at 6 a.m. for an 8 a.m. call out, right? So they don't need that. They want people to come into the organization that is going to make their job easier as well. And if they can have a benefit, like a bonus plan of

some sort, that's going to motivate them even more. But you have to hit them over the head with it, just like you have to do our clients, right? Don't think that you just tell them once, hey, we have this great incentive plan for you to identify caregivers and bring them into our mix and you know if they stay with us x amount of time you'll get a bonus and this is what that looks like according to studies most caregivers are working for multiple agencies so you can't make the assumption that they're going to remember that that's you that's doing that so you have to communicate that often and frequently for them to really understand and start taking advantage of that. Do you have any suggestions tactically on what you should or should not do in constructing that program? What you need to do is figure out what makes

sense for you. I know as a ramp up, you're really looking at, you're looking at your numbers, right? And you're looking at the bank and you're looking at how much you're looking at your numbers, right? And you're looking at the bank and you're looking at how much you're investing in this company to get to your break even. So what that's gonna look like maybe as a ramp up is it may be significantly different than if you're pulling in three, five, $10 million a year and you have more availability to offer a higher incentive.

But my recommendation is to have one, figure out what makes sense for you, and modify it, reflect, review, take action on how you want to improve that process. Solicit that feedback back from your caregivers as well. What are they telling you? Do a competitive analysis. What is your community doing?

What are your competitors offering in terms of a bonus plan of some sort for those caregivers? Because you don't want to underprice yourself, but you also don't want to probably, well, you may, but you want to be, you want to make sure you're making an informed decision if you are offering them significantly more than what may be that competitive landscape in the caregiver acquisition side in your community looks like. So I think it's just making sure you have it, you take a look at it, you solicit feedback from your caregivers, you see if it's working, you review, and you take action if you need to modify and really dial it in to what makes sense for you. So have one and

communicate it often. And the thing you said at the very beginning of this that I would add to that is to be tracking how you get your clients and your caregivers, you know, each source and its success. And here that includes your employee referral program to see, you know, as we've made this change or as we've made this the bonus, you know, how is it working? Is it bringing in caregivers? Are they are they people we want to hire? Absolutely. Look at the acquisition costs, because it may seem like on the surface, let's say you have and I'm just using this as an example. Let's say you're giving them three hundred dollars. Right. And and that may be more or less. You know, that's similar to what a lot of agencies offer, you know, a certain amount provided to the to the current employee that referred that caregiver to you. Maybe when they successfully complete orientation and they receive the second amount, the full piece of that after they've been on service for so long. But I think it's looking at what is the acquisition cost?

How much am I paying out? And how does that compare with my other caregiver lead sources like Indeed or Social or all the other opportunities out there that you're more than likely putting dollars to? And if you step back and take a look at the data and what the numbers are showing, it takes the emotion out of it. I know I've been guilty of saying, I think that this is true. And then I look at it and go, well, that's not true. So let's go back and reflect and see what makes sense. But you're absolutely right. Capturing that information, being able to pull the cost,

retention. You also don't want to be bringing people into the organization that are falling out the bottom, right? This is a funnel we have to pay attention to. So you have to identify that sweet spot that makes sense for you and be very intentional about communicating that. But capturing that data so you can make informed business decisions based off of the data that your agency is providing to you is going to be very helpful, then you know that you actually have a plan that you can follow and then take a step back and make sure that that's making sense for you. You said something in there that I want to talk about for a minute here, which is retention. I think it's important for those listening to this to mention that part of the value in growing your employee base from your existing employees is that all of the stats that I've seen show that

retention is a lot higher when you recruited those employees from your current employees. That hiring source simply almost always has higher retention than hiring from Indeed or something like that. Not that you shouldn't be hiring from Indeed because I mean, like we all use as many employees we can get. Absolutely. You got to use, yeah, there are always tentacles out there, right? You can't come in and say, Connor, try this. And this is going to work a hundred percent of the time. You have to use multiple, you have to pursue multiple channels, both client and caregiver and see what works. Very rarely is just you want to invest all in the Indeed bucket or all in, you know, any other bucket of acquisition opportunities for caregivers. You want to make,

you want to cast a wide net and see what makes sense. For sure. I think my last question for you here is to kind of put myself in the shoes of an early stage agency owner who's listening to this and thinking this is great, but it sounds easier said than done. What would you say to that discouraged agency owner? Absolutely. Well, you know, Rome wasn't built in a day. You can't eat the elephant all in one bite, right? So sit back and really understand that, you know, you need to take it in small digestible pieces. So if you have those five clients and you have those 10 caregivers, take the time to get to know them, right? So again, it's much easier when they're small. So go back and make sure that you're optimizing your onboarding process for your

caregivers and you're optimizing your high touch frequency and supervision and oversight with your clients. And you're getting to know them beyond just that they're an employee or that they're a client. We have to be really focused on the retentionomics. And I know typically when we use that term, we're thinking about the consumer side of things. But I think we need to focus on retentionomics for the caregiver acquisition side of things as well to help maximize your profits and achieve those organizational goals that you have set for your business. So take it one step at a time. Make sure that your care managers, when they're going out and

do the assessment, that they're having a conversation. They're identifying who the physicians are that are supporting that client. Understand and document who the referral source is and start there. Having conversations with those that are connected to that client. There might be half a dozen a dozen opportunities based off of one client that you can leverage that isn't necessarily a cold call because you have information that you can share you're part of that client's wellness you're part of their preventative care you're part of their custodial care their

maintenance care and you can come in and communicate and And they're, you know, I've never known a doctor that would say, no, I'm not going to talk to Michelle because I don't care how my patient is doing. No, if I can come in and say, this is what they're receiving. This is how we're communicating with our home health partner that may be in the home. This is what our readmission rate is. Those physicians are going to say, yes, come in and tell me more about that. I may have more clients that I can send your way. And that's really what you want to focus on. Again, that repeatable, sustainable business. It's a lot of money, time and effort in the turnover of referral

sources. So, you know, we want to focus and give them the time and the insights that they need to send more business your way. Love it. Well, this has been great. We're almost at the end of our time here already. It goes by really quick. Thank you for sharing all your wisdom and experience with us. And for those listening, this is only part one of our time with Michelle. So a bit of a preview for next time. So we do this every Wednesday at 1 p.m. Eastern. As I said, you can join live or listen to it as a podcast afterward. And so next Wednesday, we're bringing Michelle back with a member of her team from Homewell, and they're going to talk about the pros and cons of joining a franchise. Now that can mean you're just starting and you haven't started your agency yet, and you take the franchisee route from the beginning, or you're an

established agency, but maybe you're looking at making some changes to your business. Maybe you need help to grow or additional support or something besides that. So they'll be talking through the scenarios where it might make sense to become a franchisee and exploring a side of that huge decision that's not really talked about a whole lot. So I am looking forward to that. Thanks to everyone who joined and thanks again to you, Michelle. Thank you so much, Connor. I appreciate it. Great time. That's a wrap. This episode was made by the team at CareSwitch, the first free home care agency management software. If you're tired of running your agency on an outdated

software that looks and works like Windows 98 and you want to save a little money for your bottom line, check us out at careswitch.com. Thanks for listening. See you next time.