Home Care U - Some Big Mistakes He Made—And What He’d Do Differently (Kunu Kaushal Pt. 1)

Episode Date: March 25, 2024

Ever wanted to hear a few vulnerable mistakes made by a wildly successful leader in home care? Well, here’s your chance. Kunu Kaushal, Founder and CEO of Senior Solutions in Tennessee, will share some distinct mistakes he’s made along the way and what he’d do differently if he could go back.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

Welcome, everyone, to Home Care U, a podcast by CareSwitch. I'm Miriam Allred, your host, head of partnerships here at CareSwitch. It's great to be back with everyone. Happy Wednesday. A couple of housekeeping items before we get started today. In recent weeks, I've had more and more listeners actually reach out to me about more information regarding CareSwitch. And so I just want to quick at the top here, mention that we are an AI powered agency management system that we've got a webinar coming up that will actually be showcasing some of the AI powered workflows in our software in real time and kind of a live environment. So that's coming up on April 9th.

If you want to learn more or attend that session, you can find the registration actually on our company LinkedIn page. So just search CareSwitch on LinkedIn and you'll find the registration page there. And we'll look forward to giving all of you more insight into CareSwitch and what we've been working on. So without further ado today, I am honored to be joined by one of my favorite guests. I don't know if I should say that as a host, but I've got Kanu Kaushal, founder and CEO of Senior Solutions joining me. He's also the founder of the Independent Home Care Alliance. So it's my pleasure to be joined by Kanu. Thanks for being here. Thank you so much. Kanu's been someone I've looked up to for years. You know, I've just been in home care for a handful of years and Kanu's

one that I've had an eye on that I've actually had the honor of sitting on a panel with. I remember feeling really nervous and anxious and inadequate, but Canoo's one of those people that's got maybe an intimidating resume, but when you get to know him, he's really down to earth and humble and apt to share his vast knowledge and experience. And so I think that's what I admire most about you, Canoo. So I'm excited to pick your brain today and let you kind of do some storytelling with our audience. So before we get into today's topic, I want to give you a few minutes to introduce yourself, share more about kind of your personal background, your personal why, share more about the business and the businesses that you run and just let you tell people more about yourself. Great. Thank you so much for the opportunity. And your introduction is far too kind.

I will tell you that the resume being intimidating, I liken that to the fact of, I think in my just ethos as a person, so this will kind of give you a little bit of the why. I'm a, you know, I was born in India, moved to the United States when I was seven years old. And pretty early on, you kind of get this knack for you just you can't be scared. Right. So you have to just go after it. And part of the problem of if you've got an entrepreneurial spirit is that your mind just says yes. So when somebody says, do you want this opportunity? Yeah, absolutely. And I'm going to try to crush it and do a great job with it.

I think, you know, maybe that's a good place to start is kind of the background of what makes a person who they are. And in my scenario, it would be my father is a physician. My mother is a nurse. And when we moved to the States, we were pretty disconnected, obviously, from family for the most part. And one of the interesting things for my dad as a physician, my mom as a nurse, is they really came in and said,

well, we want to do healthcare, obviously, but how does the healthcare system in the United States really work and differ in a lot of ways? Pretty early days, what they found out, my mother is working in a critical care nursing unit, and then my father in hospital management really became a big focus of his. They centered in around the idea of elderly and geriatric care as being such a focus area that in India, you have such a nuclear family. So you end up with the elderly end up living with families. So this idea of people being independent and somewhat dependent, really alone by themselves in their homes became a real issue. My father went down the home health route. So in his experience, he ended up with Medicare based home health and hospice. And my mother went down the road of assisted living.

And so she founded an assisted living center and really from her side felt that the facility type was a good branch from when she sees people in critical care in the hospital and kind of doing it in a step-down way. They both agreed nursing homes were obviously a place to avoid. And although nursing homes get a bad rap, I will say, I think the main challenge for the healthcare system today is that nursing homes are a place that tend to be a default and people are there far too long. It's not how they were meant to be perceived. So, you know, you take my father's background in home health, my mother's now background in assisted living, and I'm coming up through college and kind of decision is made of like, what am I going to do? I got into home health sales pretty quickly, really because the dinner table talk was about geriatrics. I felt really comfortable there. And in doing home health sales, there were one thing that became very obvious is

that everyone loves the idea of getting care in the home. It's where everyone wants to be. The one kind of challenge I found in home health specifically was that we weren't there long enough, right? So the skilled nurse does a visit, physical therapist, whoever might do a visit. And so although I bopped around, I found my way to private duty nursing. And this was really an interesting time for me being an administrator in private duty nursing, where all of a sudden we were dealing with pediatric patients who had mints and traits all the way to geriatric. We did a lot of skilled nursing in the way that it was also longer term. So we had clients for month on month and very acute patients and their care needs. I say that

all to tell you, I kind of, you know, beat around the bush of personal care, home care before I ever landed there and saw for the most part, every other kind of health care that surrounded it. And I have to tell you, private duty nursing is a really tough business emotionally, so on your heart. And I was about to be a young father. And I think the challenge of seeing some of these young kids and the situations they were and really caught up in the insurance and Medicaid world, making really tough decisions. I think the one that changed my view on things was a four-year-old little boy who had never seen the outside of the hospital and was getting to a point where when the nurse would take

blood or do anything, stick them with needles, he wouldn't cry anymore. I mean, he'd just gotten desensitized to the pain. And I think that is amazing work that's being done. I think for my side, it was, you know, pseudo, like I didn't feel like we were making a difference in the way that I guess I wanted to. And so I found the opportunity really in watching. So as I'm the private duty nursing administrator, I've got my grandparents. And my grandparents who just imagine their son and daughter-in-law who are healthcare professionals have the ability to service them either in home health or in a facility. And my grandparents are like, we don't want either one of those, right? And what they want is home care and personal care home care. So they

were actually using a competitor. And as kind of all of us as a healthcare professionals at the time, my mother, father, myself, we're all looking at this personal care company and seeing how, number one, how mismanaged their quality was. And then the other side is that they had turned it into essentially a staffing company, which I think we all can agree. It's not how maybe high quality and successful home care businesses build their business. And we got to a point where I think I thought, hey, this is a great opportunity for me to go and try this and do it well. And in my eyes, it was going to be really simple. You know, we dealt with insurance.

We dealt with skilled nurses. And, you know, these things were challenging. We couldn't find any skilled nurses at the time. And so as many of you can already predict, right, how wrong I was. But I really thought personal care, home care was so simple until I got into it. And oddly enough, my worst and most difficult clients I ever had were my grandparents. And, you know, it kind of like makes you realize that personal care, home care, it really is a standard in which the client drives exactly what they want. So

I've heard the word concierge care before. I mean, I definitely sympathize with a lot of those words because that's exactly what it is. They are in control. So as I was kind of going through that and we were building the businesses, it is a blessing that my grandparents were the ones, they were the most difficult client that got them early on because I really got a sense of how difficult this business was going to be, but more importantly, how that is just what the business is, right? Like it's hard for a reason. People are opinionated for a reason. You are in their home, so you don't have the control of the facility. You don't have the ability to say, we'll be there a couple of times a week. You're really trying to bring your services to a family in that way. So that was 14 years ago. And we have been blessed with the opportunity to serve so many people along the way. And I'm really looking forward to sharing a lot of my story and in a couple of stories that

you know I hope you all will find entertaining but as far as an introduction goes one thing I will just tell you as a caveat and I think this is where Miriam gets the humble part from I am one of the few people I think that will tell you that number one, I still have feel like I'm in startup mode, right? Our mentality is we are re-engineering our business every single day. And the second is the true definition of experience is that I can share with you about a thousand ways not to do it. And it's still up in the air. There's a handful of ways that you can successfully do it. So if you hear anything from me today and in the following episode, just know that's my experience and I'm sharing it with you, good or bad, and happy to share either way.

I love the honest disclaimers. I think those are perfect as we transition into these mistakes. Before we jump into the stories, I do want you to share kind of a quick snapshot of your business today, just to give people a taste of like what the state of the business is today. Yeah, absolutely. So the start of the business 14 years ago was a laptop, cell phone, two caregivers. And over time, so now as we progress forward, we now cover all 95 counties in Tennessee. We have a little over 1,200 clients on service on any given day under different payer programs and can speak to that. So we see everything from Medicaid, VA to private pay, obviously. And then we're doing a lot of pilot programs as well. Throughout the journey,

we also found kind of our mission, our ethos is to say we want to find solutions, so Senior Solutions being the name. And we didn't want to just provide personal care, hands-on care. So the ways that we think we can be beneficial doing things like a transportation company, a home-delivered meals organization, and then obviously technology where it makes sense to implement it into clients' homes. We've done that. And then in the first year of COVID, we were able to find a great, I would say, complementary organization that was in Atlanta, Georgia. And they were kind of, you know, their leadership was wanting to sunset their years and finding COVID to be almost unbearable. And I think they felt good about us. So I hate calling it an acquisition, but I would say it's a really good partnership. It was a good

baton pass for us. So now we also serve the Metro Atlanta area. And there we, oddly enough, full circle, we are doing some skilled nursing again. And we do it kind of in a different way, very much focused on the geriatric population. One thing that we found, and this is maybe just as a side shoot here, a few years ago, and this is pre-COVID, one of the things that I found happening a lot, you know, before Miriam and, you know, all this great education was online. I mean, you know, there was so much, there was a gap there. And you essentially, the home care industry, we saw each other either at conferences or we were in a total vacuum, right? And you almost didn't want to talk to anyone because they were the competition, that type of thing. And the world has gotten a lot smaller, I would say, in the way of the industry.

In a very good way, we're all sharing best practices as much as possible. One of the things we found was that the independent home care agencies were really, even with conferences and those types of things, the independents were still kind of off on their own. The franchises, and by the way, hats off to them, there are many good things that they do. So we're not anti-franchise. But the franchises, their way that their structure is set up, they get their own little ecosystem of companies to be able to share best practices with. And independent is truly independent. So they're out there trying to make the best of every day. I have obviously a bias. We're an independent agency. We're not part of any venture cap or private equity or anything else. And one thing that I will tell you pretty quickly is I'm a home care nerd. I mean, I am the person that goes to conferences and still to this day, I'm so curious about the agency that has 15 clients to the company that has 15,000 clients. It doesn't matter because we're all

solving essentially the same problems in really creative ways, some ways I certainly can't even think of yet. And the kind of motivation was that we should create some sense of connectivity for the independent agencies where we can. So we founded an informal group at the time called the Independent Home Care Alliance. And with IHCA, it's really just a meeting ground and hopefully a way to build standards or best practices for agencies that might need it. And our thought process is that there are some really good mid to large size companies out there who occasionally also need help. And then there are some folks that have been in business for all of five minutes. Right. And they don't know what to do yet, but they know they want to be an independent.

They've chosen not to go the franchise route. So we try to serve them as well. So I hope what you hear is, you know, at least from my state, what I knew very early on is that I wanted to be of service and make sure that we supported people. I think early days when you write that down on a piece of paper, it feels very mechanical. And you say, I want to serve elderly people. Right. And what you find out pretty quickly, and I think I found that about myself, is that it's and, right, becomes just a really good word to use. So elderly people and great employees or, you know, caregivers who are willing to serve those people and those families and the healthcare system. And I've been lucky enough to have, I think, enough home care owners and operators and even industry folks like you,

Miriam, who have given me the opportunity to just feel like my thoughts are valuable. And I'm so thankful for that. And for me, it's just a way of giving back, right? I think we have such a long road to go that still to this day, we can all think that in our own vacuum that we're highly successful, we're doing a great job, which is good. You still hear the stories of people. I can't go to one barbecue or social event in which someone goes, I wish we knew about your services when we were having this issue with mom or so on. And that honestly energizes me more than anything else.

You go, oh, my gosh, it's not just opportunity. There are so many people out there that do not know, one, that we exist, but two, we could truly be helping them through a really stressful and unnerving time in their lives. Yeah. What an incredible introduction, Canu, just from your personal story to kind of the state of Senior Solutions today to your why of starting the alliance. I think it's just a testament of, you know, who you are, how service-oriented you really are. And even you just talking about giving back, you give so freely, you know, of your time and of your resources and of your experience. And so I just really appreciate that. And I think the whole industry does. The industry has benefited from your wisdom. And so, you know, just appreciate how gracious you are with your time. I want to give a little bit of context before we get into these stories. A few weeks ago, I was thinking about, you know, just common

mistakes. There are a lot of mistakes that owners make along the way and whether you recognize them in the moment or recognize them, you know, years later, you know, everyone's making mistakes. And I was thinking about, you know, how do we, how do we do an episode with maybe, you know, a large name like yourself and talk about some of the, some of the bumpier times in your business? You know, it's great when we talk about best practices, things that are going well, but how do we also look back and learn to, you know, accelerate, innovate, improve for the future. And so today, I want to let you kind of just divulge some stories of some mistakes you made. And I'm sure you already mentioned it. You've made a lot of mistakes. We all make a lot of mistakes. But what were some impactful mistakes, some hard lessons learned, and how can those be pitfalls that other

owners can avoid in the future. So today, we're going to talk about a mistake you made maybe in your early years, then one in a mid-transitional period, and then we're going to talk about one that's more current, that's more top of mind. So I want you to start by taking us back to those early years of the business and talk about one of the mistakes that, you know, left an impact on you and on the business. Yeah, absolutely. So I'm going to ask for forgiveness early because I feel like I'm actually going to get more out of this than any of you. This feels like a potential therapy session for free and a bit cathartic. But yeah, so, you know, early days, I'll tell you. So the short version is just to tell you, I think

accepting help and realizing that you can't do it all is something that has to really smack you in the face. And that was the case for me. I think, remember, I had the lens that this business is simple and, you know, I'm a spreadsheet person, like I said, a bit of a nerd. So in my mind, I was going, oh, all we have to do is have 30 clients. And if we have 30 clients, they're getting at least 40 hours a week, you know, and I did all the math through and it just made sense to me, there'd be just a bunch of money left over. And this is going to be a great living. And this is a great investment of my time and energy, that type of thing. Well, truth be told, it's never worked that way. As soon as you get 30 clients, you're like, oh, we need 50 clients to make all this stuff work and so on.

So this is not the mistake, but a challenge in there is be very careful about just doing everything because it mathematically makes sense for you, right? So like if you just say, hey, if we can get to a thousand hours of service a week, then all our problems are solved. It doesn't quite work out that way. The first, maybe we're talking now about the second year in business. So forget about the year one and then the typical stuff, right, that you have challenges with. So imagine from my side, I've got this maybe overconfidence where I think that I understand healthcare. Oh, I did the hard stuff with private duty nursing. I already know home health

and we can build relationships. No big deal. Getting referrals certainly was not the challenge. I think going out of marketing, I felt comfortable with that. It was the backend of our business. And I think from my side, I needed the numbers to work so badly that I delayed having any additional person in the business administratively with me until it was too late and it hurt. So the story I'll tell you is that I was, you know, I was a new father. So our business was founded in May of 2010. My daughter was also born in May of 2010. So during my wife's pregnancy, right, it was like this, this better work and we're going to launch. And the reason that I can say it was founded in the same month is we got our brochures delivered

the day my, my wife was having our daughter at the hospital. I got the FedEx alert. And just pro tip, don't ever tell your wife who is delivering a baby any sense of excitement that you just got a FedEx alert and your brochures were delivered. That is not the time or the energy to give. So a couple of years in, my daughter is two years old at this time, we're at the zoo, and it's on a Saturday, the weather's really nice, my phone rings. And there's only one reason during that period of time that my phone would ring on the weekend. It is because someone's calling out of their shift, or there is somebody who hasn't shown up to their shift, or there's some staffing issue. And it was, I think this, on a personal level, here I was ready to enjoy a day with family.

My wife was like, hey, we need to spend family time together. My phone is now ringing and she can just see my shoulders flop. And I just kind of let out a sigh because I can see that it's, you know, one of the caregivers that's calling. So she grabbed the phone, my wife did, and says basically like, hello, you know, and this person's trying to call out of their shift. And my wife let them have it. And I'm not saying that's the way you do it, but I think my wife understood from my side, I'm always just, you need to go to your shift. You do this every weekend. You know, some of the conversations that tough love, I think that we've all learned to have with our staff, she was able to deliver it and kind of hung up the phone. And as she hung up the phone, she told me, she goes, you have to get somebody else in to support. Now, why is that such a major mistake? I'll tell you the problem was that once you accept help in that way and say, yes, I should hire someone, the mistake was really not understanding what this person is going to do. So that whether it's your first hire, third hire, it doesn't really matter. I would say the mistake is not building out a clear maybe workflow or what people are going to be assigned as their core

responsibilities. And I get it. In teamwork, right, we all work together. One of my challenges at that time was that I just kind of did like I would assume many of you have done too. If you say, well, what does everyone do here in the office? Everybody goes, well, we all just kind of do it all. Who answers the phone? Well, we all do. Who takes intake? We all do. Who does scheduling? We all do. I think that now as time has progressed a bit further, I've gotten to be much more conscious. I remember back then, had I leaned into my strengths and then tried to bring someone on to support that was actually my weakness. Someone who I will say is detail-oriented, enjoys compliance. Folks, I'll tell on myself, you should have seen our personnel

records back then. It was like a scan of a driver's license that avoided check, right? And it was like put in with a floppy application in a manila folder and it was not in order somewhere on my desk. And those are things you just kind of do it. I mean, someone will tell you, well, you just bootstrap it, right? You just kind of make it happen. I think with some sense of organization early on, and then also understanding today, like as you have a discussion with other owners, or I'm sure there's been many episodes here that we could find as well that talk about, well, what are some key roles and responsibilities in the business? When you're having to discover it, like I'll tell you from my side, I didn't

know exactly what does a scheduler do beyond just answer the phone and mess with the schedules. When the reality is in a small business, at least back then, they were a great good cop, bad cop type scenario, right? Like it was really good to be able to have two different voices to kind of go back and forth on. They were a really good retention person because they took the time. They weren't too busy to actually build a relationship with those caregivers. In a lot of ways, they were magical when it comes to relationships with some family members. Like a good person can de-escalate a family who's very upset about what's happening.

And so I think from my side, I was so busy thinking, you know, the mechanics of it is just going to work out. I really needed to spend some time. And that was the experience early on that the mistake was number one, not accepting that additional person early on, but two was probably not letting them into the business and having enough, maybe autonomy to handle the things that they needed to do. The combination of those two just made those early days, that second year really rocky. And some of you like, you know, I hate to leave cliffhangers. How did it work out? I think how it worked out is that I personally grew as a leader

to go, okay, how will I work with another person in this business? What does real trust and accountability feel like? And then ultimately, we found a really good workflow. We learned each other as far as what makes each other successful, what our strengths were. And we got to a point where it was really good teamwork. Now, you could say, who is responsible for exactly what things? We had some stuff that was core. And then we did have a pool of activity that we kind of shared. I think that rocky road with that first initial person made the second, third and fourth so much easier. And I think I personally, from a leadership side, you know, had I known more, and I would tell you, I was also really young at the time. I was naive. I was kind of like trying to figure out how it all worked.

I was also coming from corporate mentalities and trying to apply that to small business. That doesn't always is a good fit. I think each and every one of you, if I had to give you maybe a what could you do with that kind of thing, is have a lot of self-reflection. It doesn't matter where you are in the stage of the business. It's one of the things that I do personally as much as possible. Every self-help book or business book or when I see people with challenges, it always starts with you.

You know, you got to like stop and say, OK, am I the problem? Right. Not to quote Taylor Swift here, but am I the problem? Am I like, is there something I need to be doing differently? Is there a resource that maybe isn't available? And so in this whole scenario, kind of give you the hook here at the zoo, the problem was obviously me and my acceptance of having somebody else around. It wasn't the caregiver. I mean,

you know, those are dynamics. Guess what? We still have people call on Saturday who try to call out, right? So you can't force the caregivers or what home care is to change. This will continue to be the challenge that home care is. Yeah. What, what a great story that I think absolutely everyone can relate to. I have just a couple of questions, I think mainly out of curiosity. One is, you know, you're talking about year two is when you brought someone on, you know, we're talking 12 to 18, you know, 24 months where you were going in alone. I guess I'm just curious, how capable were you on your own? Meaning, you know, how many clients did you grow to? How much were you capable of doing on your own? Meaning, you know, how many, how many clients did you grow to? How much,

how much were you capable of doing on your own? Because I think that's, you know, we talk about like magic pill or silver bullet. Like if you get to, you know, a thousand hours, then I need to bring someone on. But I'm just curious for context, like how much were you capable of? And was there kind of like this threshold that you could tie it back to? Yeah, we were at the time when I brought somebody in, we were close to 1000 hours, which is a lot. Now, we also happen to have three, maybe four 24 seven clients, which I will say so a lot of those hours were in that cluster. And then we had a lot of short shift folks. The 24 seven clients, I think for us, my value proposition early on was me, right? So like when you're trying to go out and get business and you know you're competing against like

Home Instead and XYZ Home Care and whoever else is also and people are kicking tires. So 2010 was an era in which you could get as many caregivers as you wanted. And that caused a lot of competition. I could either discount our services to be less expensive because I had less overhead. Or second, I could really pour on the concierge part and do the dreaded thing of like, call me 24 seven, like you ever have any problems like this is all I do. You have all my focus. Well, I ended up doing both, right? So I squeezed my margins down. And then the second is I also made it concierge. So caregivers, families, everyone felt very comfortable. I was doing in-home visits. I was going from one end of town to the other. And with 24-7 clients, that's just a lot more that can go wrong at the same house.

You're there so often, that type of thing. Sustainability, I would say, if I had to do it over again and tell you a marker, I think it's more like once you cross 20 to 30 caregivers that are at least 20 hours a week, like really working, not just on the roster, I actually think they dictate your bandwidth much more than maybe the hours, the number of clients, that type of thing, because it's the relationships with that staff. One person, I think, can reasonably 20 to 30 caregivers. But if you're planning to grow beyond that and service more clients, you really need another person just so that you can, one, answer the phone. I mean, we know all the typical challenges in home care. You guys don't answer the phone. You didn't

communicate with me the, you know, the schedules. Nobody's meeting with me out in the home. You know, like, I feel like my supervisor's not listening to me. Nobody calls me for positive reinforcement. It's always, you know, some kind of negativity. So I think the bandwidth is actually how many relationships you can manage as a person. Now, for me, type A, outgoing, was in sales before, also a workaholic. And to me, I'm like, I don't care that I'm doing payroll at 11 o'clock at night. I think it's where you are. And also, you know, what you define work as some people really need a lot of balance in life. And I think we've been a lot more cognizant of that recently. But, you know, if you are the kind of person, I'm the kind of person I can do anything for a little

while. So also for those people who think like, oh, I'm good running a marathon every day. Like the fact, I think my wife and I were suffering in our own ways, right? Like she was taking care of the baby and I was doing this with the business. And we both knew that the other had very important jobs that we were doing at the time. Had my daughter been, or my daughters now, like they're older now. And so my level of input or time with them, you know, it's really tough. I mean, we just had this thing happen last week. I had to cut spring break short for my work schedule. And, you know, luckily we spend more time during the summers and that type of thing. And I try to be a bit more flexible. A few years ago, that kind of thing is puts me in the doghouse, you know? So

I think it's also your support system, your lifestyle, a lot of things have to go into it. Yeah. Great. I love how you're talking in terms of like that rate relationship ratio, you know, like me to how many caregivers, me to how many relationships can I successfully manage? We talk a lot about hours and about client numbers, but I, I love that kind of like

perspective shift of like how many relationships can you successfully, productively execute? And that's really like the underlying, you know, number to be focused on. I want to go down, before we move on, I want to go down this path of this first hire. You mentioned your strengths, your pride, what you were really good at, what you brought to this business, and then, you know, how important it is to hire to your weaknesses. And obviously, that's difficult. And you don't know what you don't know. And you have to bring on kind of this, you know, this perfect person probably early on. So talk to me about some of the decision making and who you brought in early, you know, was it someone cold that you didn't know? What is it? Was it someone that you did know? Was it someone that came from a home care

background? Talk about kind of that first hire and, and maybe even kind of twist it on like having a number one, you know, having someone that you can really depend on, you know, early stages, even up until today, just the value of having a really trustworthy number one per se? Yeah. Yeah, I would say so in during that time, my strengths were, you know, I was a technology type person. So like, I felt good with systems and being able to use the scheduling software. I felt good about my business acumen when it came to accounting and processing payroll and so on. So I think a lot of like the business office manager type of function I felt good with. Obviously, I had a background in sales, so I felt good with community type involvement.

At the time, the things I had prioritized basically on the list, and this is an exercise, by the way, anybody can do, is wherever you are in your journey, but let's say you don't yet have a number two or three or four or whatever, is write out a list of the things that you actually do and that take your time. And it's kind of like a time audit from yourself and go, okay, how much time does this take? Because it can be really important, but it takes five minutes. And those aren't necessarily the things that are going to give you the biggest relief. And during that time, my list consisted of, well, everything. But what really came down to is like answering the phone and being available, because I could be doing a lot of things. The relationships with the caregivers, interviewing and onboarding caregivers, doing infield training with caregivers.

So what immediately came up is that the skill set I was looking for was someone who was highly relational to a caregiver. And who I ended up finding was someone who was a very experienced CNA that was working in home health, who basically worked with nurses and physical therapists throughout the week, but was doing things like bed baths and ADLs and that type of thing. And she was looking for a change. And for me, I was like, okay, can you be good on the phone? Can you build a relationship with caregivers? Can you train people in the field? Can you go open a case? You know, I can do a lot of things. I will tell you, I can do a bed bath. Nobody wants one from me, right? Like that's not,

that is not one of my, you know, resume items that we need to put out there. But sometimes that happens. You have a family in crisis and they say, I really need care this weekend. Can you start on Saturday morning? You know, who could be that person that once again, my weakness could come in and do that. So that's who I kind of identified and kind of what could they do. Keep in mind, I had experience in home health and hospice, I had experience in private duty nursing, I was thinking through skill sets. So I was already thinking of how a home health office and private duty nursing office works. CNAs were a really big deal for us. They were certified. They knew what they were doing. Also knew I didn't want somebody that was a new graduate. Relationship wise, I think I knew somebody who would have more of a, from an age side, be respected was going to be a big deal because some of our caregivers are

going to see someone like, oh, you've been where I've been. You've walked in my shoes, that type of thing. Almost like a mentor style person. So she was the first hire and she did a great job. I mean, an incredible job for what we needed at the time. That summer, however, we started trying this like, oh, we can teach anybody to do home care, right? So there's maybe another lesson in there. So we got some, you know, young folks that were graduating high school and they wanted to be nurses and we're like, oh, you know, come try this out. And I think we very quickly realized we were not built to run a daycare, right? Like people very early

in their careers that need a lot of structure, a lot of time. And that was exactly an example of, well, it doesn't quite work, just warm body effect. And we were coming to the realization that how you're perceived by everyone, clients, caregivers, referral sources, that need for professionalism, compassion, also some life experience where you can really understand when somebody says, you know, my mom fell and broke her hip. You get, oh, I'm so sorry to hear that versus like, oh no, like, you know, what happened? Where is she? There is a natural kind of style that comes with that. And you have to pick that out of people. So yeah, those are kind of our focus areas.

I wish we had five hours to just let you just keep talking through, you know, year two to then, you know, we're going to get to kind of the middle stages of your business just to hear, you know, like the why and the how of each of these hires. I think, you know, one of maybe my favorite topics is like org charts and just who you bring on and when and how and why, because every business is different. I actually love like you talking about this, just the dynamic, like you came with this business acumen with also, you know, the healthcare piece, home health piece as well. Your first hire, like a really experienced home health CNA, that's pretty different than a lot of businesses. And I think that's just speaks

to, you know, your strengths, hiring to your weaknesses, and that looks different for every single owner that comes into this business. But like you said, that time audit, you know, finding like the high yield, low yield tasks, the best use of your time, and then hire to, you know, fill the gaps of those low yield efforts, you know, so that you can maximize all the high yields. So I think just really interesting and some good takeaways there. I do want to transition into this kind of second mistake. I think that one was so rich and interesting. So I'm excited to get to the second one, which you've said is kind of more mid-stage. So kind of, you know, maybe like a little recap, you know, summary to getting

leading up to this second point. Yeah. So early days are gone and let's kind of go into like year five and six, something into that mode. And we've got a good business. We've certainly added a lot more people administratively. We've got lots of caregivers. We've opened up some satellite offices. And at this phase in our business, we probably have three regional offices. So we've expanded to the east and west side of the state. And administratively, we're probably in the three or four schedulers, which would put us in the four, maybe $5 million mark in revenue annually. And that's Tennessee revenue, by the way. So for all the California folks in New York, I know that this seems like peanuts, maybe. But we were doing

a good job. And we came to this fork in the road. And I think some of you either have done it yourselves or you will. And you have to decide, like, do we keep going on this organic growth trail? Or do we try to do something which I call like real businesses do, which is they try the acquisition and try to acquire companies or, you know, do a deal, right? And it seems so sexy and interesting. And, you know, maybe we'll get SBA involved. Maybe there'll be some deal structure there. And I have to tell you, if you are an entrepreneur by its definition and you love risk, acquisitions seem like such an interesting thing. Right. Because it's complicated and you've got to get audits done and there's due diligence. And I was wrapped up in it.

We were at the fork in the road of doing this organic growth where I'm like, oh, you know, that's boring. By the way, boring is safe and boring is also tried and true. So there's a reason it's a mistake. The acquisition side just seemed like fun. And that's sadistic in some way. It seemed like fun. It was going to be painful and complex. So we did our first acquisition, at least walk down the road. And when I tell you,

I was learning on the fly. We had multiple accountants, the buyer side, the seller side. We had multiple due diligence folks. There were things I didn't even understand in tax law. I mean, somebody is telling me like, would you be okay with blah, blah, blah, deferment of this tax and that? And I'm like, yeah, we'd be okay with it. And I'm going home and like Googling, what are they talking about? And I think from my side, like just being open to being in that period of time saying, I don't know what that means. Like there's a reason you have experts around you. And this is certainly not something you do deal making on the back of an envelope, because it's very significant. The first few times I had to go Google things, I was like, Oh, hold on, this, this is going to get serious. And we're talking about, to me at that time of somebody who had self funded and didn't really have a lot of money, this is going to be serious and risky. And so we got a lot of experts around us and we started

asking them to be involved and give their thoughts and the way to do it. And what I will tell you is that deal making when it comes to acquisitions, there's so many different ways. The best deals are ones in which both sides are unhappy. And what I mean by that is that no one feels like they got the upper hand on it. And that's really a tough thing to accept, by the way, when you're wanting this acquisition. It's like buying a home. You want it to just feel like such a great event. And then you go, oh, closing costs. Oh, we're on the hook for something else.

What do you mean a warranty? And what do you mean there's some additional points? So the mysticism and romanticism over the whole thing, I would say was a mistake on my side. And I hadn't even dealt with the actual hard part. The actual hard part is the company and the business and the culture. This is going to loop back around to that relationships thing. So imagine here we are senior solution, early days and onwards. We know relationships are big. I've figured out my strengths and our team strengths and weaknesses and vice versa. We know how we work together. We've developed policies. There's a culture. Our culture is how we do things here. And so we have a way that we're doing that. This acquisition happened to be a tuck-in, meaning they were overlapping in our service area. They were really big in their area and we were small. And this felt like we would just bring them in. Obviously, we were the acquiring body, so we would rebrand them. And by the way, you know, I don't know if you've ever had this happen to you. But if your local sports team all of a sudden says, hey, we're changing our logo, our name, and how we like recruit and do certain things. It's a different business, right? It's a different sport team. And I call it culture warfare. There is very much a dominating team that's doing it.

And when you're buying the company, the nice stuff falls away after a few months because you just go, okay, guys, like we can't sugarcoat this anymore. Like we're not going to debate it. This is just how we're moving forward. This isn't a right or wrong situation. This is a vanilla or chocolate, and we have chosen vanilla, or whatever the situation is. So I think the mistake isn't doing the acquisition. It was

going into the acquisition in the mindset that I was in, which was one, I'm going to love the experience of due diligence and legal and all that. And second, everyone will love the brand of senior solutions and our culture. And both were not true. And by the way, there's no bad people in this whole mix. It's just the reality of how things go. And, you know, to tell you from like, what was the most challenging or what would we have done different to make it not such a big mistake? Well, we did that six months later. So, you know, glutton for punishment, I tell you a true entrepreneurial spirit, which is, hey, I know I just went through a ton of pain here six months later, but we learned a lot. And now we're going to do it again. The biggest differences between the first

and the second were first, we obviously didn't know we were playing with kid gloves. We were just trying to like make everybody be okay. And, and, you know, really worried about emotional emotions along the way. And the second one, we, the difference was we were just very, very honest up front as we were going into it so that no one was surprised about the process. And we basically shared, hey, here's what we learned six months ago. And for the best effect for the whole organization, it's better to rip that band-aid off and say, we'd rather just tell you how we do things and how it's going to work. And in the second scenario, we also did things like we didn't hide the fact that this was happening from the staff. So in the first one, it was like a Monday and somebody walked in and goes, here's a letter telling you about basically what we've been doing in the back office for the

last two months. And option B, we actually kind of interviewed and we met with everyone. We were very open and discussed the potential. The owner of the second one was talking about why were they even doing this, making sure everybody knew that they weren't in trouble, they didn't do anything wrong and so on. And the second one, we literally transitioned and put them into the system and kept their people for many years, by the way, in less than 30 days. And it was a testament to how strong our systems were. And it was same thing, strengths and weaknesses, where our strengths were, where their weaknesses were, that type of thing. And I would tell you just, if you are going down that

road, so if somebody were to say to me, like, hey, I've got this company that's on the other side of my state or city, and I think we can work out a deal and they seem like they're going to do everything which sounds pro you, like seller financing, they don't want a high paying one, they can lay it out on a silver platter. What I'm telling you is you need to be very, very cautious about do you and does your team have the backbone to say, this isn't going to be like a soft and easy experience. And you may actually have to be someone you're not, which is you have to be a little cutthroat in this moment. The moments in which you love to have a big table and we as a team make decisions together, in acquisitions, it just doesn't work that way because you'll have a hundred different opinions and you've just got to pick a lane and decide you're going to do it. I've seen them work. Acquisitions work. We've seen them work. I can tell you from our side that we did two in 2015, 2016, when the two happened.

We didn't do another one until 2020. And even then, the one in Atlanta had to be such a sense of we were being pulled to do it because there was a deeper reason there. The family was, you know, aligned with us culturally. They wanted to keep it independent. It was not a tuck in. So we were actually in the learning seat. We were going to have to go learn about Atlanta and Georgia and so on. And candidly, it's been a much better way to do it. If you're going to is go into an area that you don't know. Wow, if we had more time, I've got a lot of thoughts and questions, I guess, my just maybe quick synopsis for time's sake is oftentimes acquisitions are romanticized. You said that. I think that's such an interesting term. You know, as you scale your business, you get to this point and, you know, there's a few different

paths to go down and acquisitions is one of those that just kind of naturally comes about. And you talked about it from this lens of as an entrepreneur, you know, it's like, you know, I need some risks. I need to shake it up. I need, you know, maybe FOMO, you know, I need to go down this path to at least try it once. But I think there's just a lot of nuggets in here for owners to understand that it isn't the only path. You know, there's a lot of due diligence. I love what you just ended there with, you know, there might be kind of years of recovery

of, you know, after the implementation, after the execution, you know, it could be years before, you know, there's a, after the execution, you know, it could be years before, you know, there's a really smooth transition that you feel good about. And so I think just, yeah, lessons learned of, you know, it's don't, don't romanticize acquisition, make sure you know what you're getting into and make sure you're going about it for the right reasons and, you know, know what you're getting into. So I think that was fantastic, really interesting. A lot of takeaways for owners across the board at different stages. In our last few minutes here, let's get to the third. There's one more that you want to talk about that's more current,

into the pandemic, post-pandemic. I'm sure we all made a lot of mistakes in that stage. Talk to me about how that was for you all. You know, the third one's interesting because it's more, the mistake is the fact that it took us so long. We were being stubborn. And the thing that we were being stubborn about is that we viewed 2019, I don't even say early 2020, as we were on an absolute clip of maximizing our operations. I mean, we were bigger than ever. Our hours were rolling in.

Even though recruiting was still kind of hard, we had it dialed in. And at that time, so a snapshot into early 2020, we had 26 physical locations throughout Tennessee and Georgia, lots of brick and mortar. We felt at that time, if you physically exist in this market,

that's how you have home care in this area. We had lots of rent. We had lots of utility payments and furniture and all the good things that come with that. Then we felt like we had to have staff that was in those offices, even if it was one person. And so we were just very heavy. And I think the mistake here is that sometimes your, first of all, home care is not a brick and mortar business. And we know that now more than ever, but you got to go back to 2020, 2019, there were different strategies. People were like, oh, I'm going to open up a satellite here and a satellite there. And what does that look like and feel like? We are a business that in a lot of ways, our business and our operations are in the homes of our clients.

Hiring and recruiting certainly is a thing, but where your manager sits has evolved so much. The mistake we made is that we were stubborn based on the logistics and the footprint and kind of the architecture of the physical embodiment of our business. And I think for us, we looked back and said, gosh, it took us so long to build up to all these offices and get furniture in them and get the utilities figured out, right? And all the things. And we just, I mean, we renewed leases, folks. I mean, I was smart enough from a business acumen is that we don't sign anything for more than a year lease because we know, well, anything could happen. What we could not get rid of is that we were really stuck on the idea of saying it will come back, right? Like, I think

we all live this is like, hey, in six months, things will be totally back to how they were. After this new vaccine comes out, right? Like things will be back to how they were. After these entitlements end or these checks stop or, you know, something happens at the government or in your state, once the emergency order gets lifted, whatever, it'll all go back. The mistake, which we just recently, maybe eight to nine months ago, really kind of took to heart is like, it's not going back to how it was in 2019 or early 2020. And that's not a bad thing. We actually find that in an era in which wages are increasing, which by the way, caregivers deserve every dollar that you give them.

Affordability matters to clients. So you can't just keep increasing your costs, right? You do have to run a more efficient business, which by the way, is very possible now. Technology, our EMR friends and partners and HRS folks, all these technologies are trying to make things more efficient. The connection with staff is trying to be better. Relationships are easier to be had. Also expectations, like the clients no longer go, where's your office? I haven't heard anyone ask anybody where their office is in forever. We used to be so proud we were in some of these, our flag was flying in certain areas. And now we go, you know, we're talking to people on the other side of the state. And that used to matter.

We literally used to do training where we'd say, don't say where, how the weather is where you are, because you're talking to somebody on the other side of the state. And now no one cares. They're all very used to it. I think you never know. And there's some risk in that where, gosh, I could be giving you a totally different story had things gone back to exactly how they were. And we were somehow the smart ones that held on. I think sometimes mistakes have a measured risk. And for us, we were changing our organization, having some flex work, remote work, moving our recruitment activities to like a workforce development center, to libraries, that type of thing to be even closer to where we needed people. And we started in like, you know, some of our offices that were really rural, we started to close them. And then as that felt good, everybody understood that, we closed a few more. We realized we needed to buy more

company cars because our managers were going to have to be in the field more if we're really going to commit to this. In the net, where we sit today is that our entire business, same size, is now operating out of six regional offices, so down from 22, 23. We have 25 or 30 vehicles that are company cars that our managers and supervisors use to get out in the field. Our recruiting has not slowed down because our remote recruiting events are still on. And guess what? Our staff is now actually going into the field and they're seeing clients more. They're seeing caregivers more. And, you know, the mistake I think from my side was, one, you know, you always have regrets and you go, oh, we could have made that change like in three months or the first time that lease renewal

happened. I think the one thing I've learned out of the whole thing is to be more open-minded to the winds of change. And as the winds are changing, you just go, it's going to be okay. Because now sitting where I am today, I realize, well, gosh, knowing what we know, we could go open offices. I could open 20 offices because I know exactly how much furniture to put out. I know how to build that budget. You know, we're saving money. Like what were we saving on exactly? So I think some of this is making sure as we've all, I think many people have earned their COVID stripe of, you know, like that level of experience, you experience, went through that war. I hope we all don't forget a lot of the good

things that came out of that. It worries me to no end, those companies that are still in their mind somewhere, they're like, we're going to have a return to office thing soon. I'm like, gosh, you got to just lean into this flexibility thing because I got to tell you, there's a lot more productivity that's happening right now. If you give people the right tools, good expectations, and good sense of teamwork, things are on the up and up, you know, even though we made that big change to my size. And I'm okay with that. You mentioned the word stubbornness. We're all humans.

You know, it's so easy to get so stuck in our ways and change is really difficult. I'm curious how you mentioned, you referenced like eight or nine months ago, you know, coming out of this as a team, as a company. How do you how do you how did you do that with your people? How did you get people out of this mindset? How did you get people to, you know, like embrace the change and accept it? And did you lose people, you know, in this transition as well? That's a really good question. And I'll keep it brief for you. I was the stubborn one. It wasn't the team. I think some of this is also trusting your team, right? Like, I would ask them.

I mean, they were on this trend, let's call it two years ago. They're like, oh, you don't need the offices. And the leases would come up for renewal. And I'm the one that signs the leases. And they'd say, do you really want to renew this lease? And I'd go, yeah, let's do it for one more year. To me, it was a psychological, I don't want it to be perceived we're leaving that market. Because then it's that physical embodiment of we don't cover it to be perceived we're leaving that market because then it's that physical

embodiment of like, we don't cover this area anymore. Truth of the matter is, I mean, we're not Taco Bell, so it doesn't matter our physical offices there or not. We still show up on Google. We still go see our clients, right? And still have some relationship. I don't know how much business we got because people drove by our offices. I'm sure it helped to some degree.

So I think you put all those things together. The change management with the team was, in this scenario, they were already ahead of it and supportive of the idea because actually, they found it kind of a pain of logistically, you know, there were caregivers were just showing up to an office that didn't have somebody there that day. And then we're dealing with complaints. And the perception of us not being in the market was actually because our office was closed. And we had a sign out by the road, but nobody was actually there because we're busy in the field. In general, though, the one area that's helped us always with big changes like that,

I think it's been, it starts with how the solution is presented. I think the one danger some of us make is that we do a poor job explaining what done looks like. So I would say instead of our organization in this story, instead of me saying, hey, here's an action list, all right, just we need to terminate these leases, you hear somebody's responsible for getting rid of the utilities, and somebody else needs to, you know, do these things, we really went with a discussion around strategy. And so the conversation with our leadership was to say, hey, in 2024, let me just kind of give you a snapshot of what it might look like if we were down to six offices, we had more cars, we had partnerships in recruiting locations. And by

telling kind of that vision and being really clear, and then also them candidly being welcome to shoot holes in it and saying, hey, guys, I need to hear your concerns now, not six months later and go, I knew this wouldn't work. Right. Like that's not helpful. So go ahead and try to tell me where the challenges might be. We talked through a lot of that stuff and consensus was built. Candidly, like a lot of times there's fear that people typically have, but logic always tends to overcome. And the more logical you and the team can be when you make decisions, especially big ones like that, and play them out in your head a little bit early.

And the other is also dip your toe in the water, right? We didn't go gung ho. It was like, okay, the next lease that comes up, guys, I'm saying no. So let's all be prepared for it. And then that snowball really picked up. And other leaders were like, hey, I can talk to the landlord. So let's all be prepared for it. And then that snowball really picked up and other leaders were like, hey, I can talk to the landlord and we've been here for six years. Maybe we can get out six months early. Do you want me to try? I was like, sure. Let's make it happen. Yeah. Well, here we are in 2024. I think there's a lot of applications of what you

just shared. We're years out here. I think it was just, what, maybe this past week, four years, and we've still got a ways to go. You know, I think a lot of people are still adapting, accepting, you know, you talked about setting expectations, communicating expectations, defining what done looks like. I think those principles resonate and go such a long way, you know, at any stage of businesses, but especially right now, as we continue to adapt to, to what is the present reality. So this was fantastic. You are so dynamic and so interesting. I'm already just like so many mental notes of, of things that I want to follow up on. Um, but thank you for being here next week for everyone. We're going to dive, dive in again with canoe on some of the of the pivotal decisions that he's

made along the way that have had an outsized impact. So small decisions, big decisions that have just really shaped the business and what it has become today. So I'll keep you on the edge of your seats for round two with Canu. I'm really looking forward to it. And we'll see everyone back same day, same time next week. So Canu, thanks again for being here. We'll see you next week. Thank you so much. 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.