Home Care U - The Best Caregiver Hiring Process We've Ever Heard Of (Jeff Wiberg Pt. 2)

Episode Date: March 28, 2023

As CEO of a rapidly-growing home care agency and president of the Home Care Association of America board, Jeff Wiberg has a unique combination of on-the-ground insights and high-level vision. His agency has been used as a case study of caregiver hiring/retention; here are his methods.Enjoying the show? Send me a text and let me know!Learn more about Careswitch at: careswitch.comConnect with the host on LinkedIn: Miriam Allred This episode was produced by parkerkane.co

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

I am really excited for today's episode. We have returning Jeff Weiberg from last week. Jeff is the CEO of Family Resource Home Care in Washington. He's also the president of the board for the Home Care Association of America. Super knowledgeable and also a very compelling and entertaining guest to have on here. One thing I talked about last week that I think Jeff brings a particular value in is the fact that given his two positions, he has kind of this unique mixture of very high level understanding what's going on in the industry from a 10,000 foot view.

And then also talking to caregivers on a daily basis, being on the very front lines of things on the ground in his agency. And so love his perspectives and his vision for the industry. So a couple housekeeping items to get into before we get started here. As a reminder, Home Care U is both a live event on Zoom and a podcast. You can sign up to join the live event on homecareu.careswitch.com or find the podcast wherever you get your podcasts. It is put on by the team at CareSwitch where I work. CareSwitch is an agency management system similar to some of the other systems you might have used like ClearCare. However, a couple things that make it different. First off,

it is freemium priced, meaning that you can use most of it for free for as long as you want. And then there are certain things you can choose to upgrade to, such as having us process your payroll for you. It is also extremely easy and user-friendly. It's designed to be learned in minutes rather than days. Our users typically say that they can basically intuitively tell what to do with it within a few minutes of when they log in versus having to have days and days of

training and things like that. So great system. Check it out at careswitch.com. And then also just in regards to this class and the podcast. So these are all free and will always be free. All we ask is that if you enjoy them, please share them. Send the link to someone in your network who could use it and would be interested. Share it to Facebook groups, share it with your team, things like that, whatever might be useful. Explore the library that we have and use it to run your business more effectively. So last thing, if you are joining us live, please drop whatever questions you have in the chat and Q&A. And as you listen, know that if you've listened to past episodes, you always hear me kind of like start off with this little joke at the beginning and introduce

this. But I do have a stutter. If you hear a random pause during today's episode, that is probably not Zoom buffering. It is probably not your internet buffering. That is me buffering. Just know that. Be ready for it. It happens occasionally. All that being said, we have a lot to talk about today and I want to jump into things with Jeff. So first of all, Jeff, thanks for being on again with us today. Yeah, my pleasure. Happy to be here again. So I'll just briefly recap what we went over last time and what we can look forward to today. A couple of years ago, we all know that especially the last several years have been tough for recruitment. Several years ago, Jeff and his team realized that they were hitting rock bottom as far as

recruitment goes and number of applicants specifically. So after months of trying to deal with this, Jeff called an emergency meeting for his leadership team. And they basically sat down and started from scratch and figured out what to do differently in their recruitment, hiring, and retention processes to attract and keep more caregivers. What they did worked. In a span of months, they went from, I think you said it was 20 applicants a month to 600 applicants a month? It's per week. Yes. Yeah. Week. Yeah. Amazing stats, amazing change. And so we talked about a lot of that last time in terms of how you cast your recruitment net. If you didn't join us, I encourage you to go listen to that one. Today, we're going to pick things up from

at the point that someone applies, what should your communication with them look like? What should that whole process of hiring look like? And what should their early steps with your agency and early kind of retention processes look like too? So lots of really good stuff. Let's get into it. So Jeff, at the point that someone applies to work with your agency, let's kind of frame like what might the typical process look like from there? What's the prevailing wisdom there? And what have you found to be more successful there? Yeah, I appreciate that. And I appreciate those who are maybe back. And for those who are watching maybe for the first time, maybe you like watching movies from halfway in.

And this is going to be a little bit one of those situations. So we're kind of done with the sourcing. Now we're going to be talking about the next phase of recruiting. And last week, we did have a great conversation around how some paradigms have got to shift in that we as employers, when we're recruiting, we want to know everything we could possibly know about this candidate before they step into our offices. Because that way, if they don't look good on paper, we don't have to waste our time. And I shared the stats from Harvard and Hireology's study that they did with 5,000 different employees and found that you only get about seven questions on your application. And then after that, every single question that you add, you're going to get an additional bounce of 5% to 7% of candidates who are no longer going

to continue on in the process. And the day is that average caregiver can have a ton of job opportunities when they sit down to look for a job. And I just want to say that when you have someone who is hitting that apply now button, that means that their willingness to transact with you is right then at that moment. And so we have a theme here at Family Resource Home Care that we call Stop the Shop. It means that we want them to continue an engaged conversation with us and make it feel normal and natural and do it as quickly as possible, preferably within minutes of them applying. And so what it would look like for us is a real person sending out a communication via text usually saying, hey, I understand that you're interested in working for us. Can I ask you a few additional questions as follow-up to your application that you submitted? And if they engage back, then there's

some automated processes that will ask them a couple of additional questions that are, yeah, they're screening questions. The one that I love the most is why do you want to be a caregiver for us? Because we get a lot more of a story in that regard than if you're just saying, what job are you interested in? And tell me about your last employer. That kind of a thing is just, that's all facts, but it's not necessarily what's in somebody's motivation. It's not speaking to the why they've decided to come to you. So key takeaways there is respond as quickly as you possibly can. Start to ask those follow-up questions that get into the reason why you would want to maybe hire this individual.

And make it feel conversational to where they'll stop their shopping process and really start to focus in on the conversation they're now having with you. The goal of that conversation would be to end with, I'd like to interview you and get that booked. If you're not using an application tracking system that allows for that kind of automation, you should look for one. And we chose one called Breezy. And it allows for some of these automated workflows to come through. But it also allows for, if we put out a calendar link, it'll allow for an individual to engage with the recruiter themselves and schedule an interview. And when somebody feels like, okay, I've got an interview, it's set up, it's booked, the likelihood that they will continue the energy required to shop ends.

They're like, okay, I've got an interview set for tomorrow. I'm done. I've accomplished my little goal here. I'm going to go watch TV or eat some pizza or whatever the case may be. Something much more interesting than applying for jobs at that point. That's part of the stop the shop concept. And our goal is to get that done within the first hour after application, and then to have them be interviewed within 24 hours. Love this. So I have a handful of questions here to break this down a little bit. I think first off, you mentioned repeatedly like speed, respond as fast as you can.

So what is your benchmark at Family Resource for how fast you should be replying to applicants? And can you speak to how that might need to look different at different sizes of agencies with different resources to put behind this? Yeah, sure, sure. The speed to hire is so critical. Folks will not wait on the shelves for very long anymore. And so we want somebody to be hired within five days. So that means within an hour, preferably, we're contacting them to acknowledge their application and do some follow-up questionnaire. We're reviewing that questionnaire and offering, if appropriate, an interview. We want that interview to take place within 24 hours. Of course, the candidate is the

one who drives that. And then within about an hour, I'll call it after the interview, we want the recruiter to make a hiring decision. Do we invite this person with a conditional offer to come into our office? And so most of our interviews today are taking place virtually. And I'll confess that that is one of the things that as an old HR guy, I had a real hard time with because I'm like, no, I want to see the whites of their eyes. And I want to see them in my my office and I want to be able to know that they exist. And I want to know that they can show up on time to an interview and such. But the world has changed and I had to change with it. And so we gave up that process, but I still piloted some differences. So, like we did some in-person interviews and we did some virtual interviews and the yield ratios were much better with the virtual interviews.

And we didn't screen out any higher of a percentage of candidates through the in-person interviews versus the virtual ones. That being said, before you go crazy with this idea, I want you to know that all of my staff went crazy. They all went, they were like, are you kidding me? And I said, look, we're going to invite them to orientation. The orientation itself is still, if you think about it, a little bit like a five-hour interview. You have them in your room. You're having interactions. You're seeing how they grasp concepts. You can see how well they follow instructions. You can see how well they pay attention. You can hear the kinds of questions they ask. You can see how they present. You can see how they dress. You can see a ton of stuff that you're interested in for the interview.

But you know what? You only turn away about 2%. So why would I want to create more barriers on the front end and yield less candidates coming in my door just for the sake of not wasting my time with that 2%? And oh, by the way, as long as you have a decent number of people come into the interview or the orientation, even if you dismissed a person out of the orientation saying, yeah, I'm not going to put that person in any of my clients' homes, you haven't wasted your time because you still have all the other people in the room. So if you think about it, you're actually saving time from that regard. And again, I'm trying to sell the sold because I admit that I

had to go through that paradigm shift and my staff had to go through that paradigm shift. But looking back on it, we would never change the way that we went because our yield ratios are so good. And I see a comment up here that everything seems so fast in the hiring process. And you're right. It is fast. From the point of interest where somebody says, yeah, I'd like to come to work for you to the point that they're getting a paycheck is now has to be measured in days. It cannot be measured in weeks. And so our current average length from application to hire is now 5.1 days and used to be greater than 14. And I know that there's still steps that you have to do.

There's prescreening checks and background checks and so on and so forth. That's why you do a contingent offer. But at the end of the day, there's just not enough people who fail those things to justify lengthening the process for 100% because you just lose good people that are otherwise ready to go to work. So you mentioned that it's five days in your agency from applying to hire. How are you measuring hiring? Is that when they've signed an offer? Is that when they go to orientation? Is that their first shift? Great question. So we measure it legally speaking, which means that their date of orientation, because we pay them for orientation, they've completed an I-9, they've completed a W-4 at that point. Those are all constitute legally hiring that individual because we're going to have to put them on payroll regardless.

And the failure rate of coming to orientation to failing to go to that first shift is minimal. Does it happen? Yes, it does. But it is minimal. Does it happen? Yes, it does. But it is minimal. It's not enough to not do this. It's, oh gosh, how could I, an analogy that would work here. Let's say that you said, I'm going to go, I don't know, target practice. And I were to tell you, well, you're only going to get a bullseye eight out of 10 times. So you might as well not play. Nobody would think that way, right? They're going to say, well, yeah, I'm getting eight out of 10. That's good. That's real good.

Why do we think differently with recruiting? Why do we think that we statistically need to get it better? I mean, even the best HR methodologies in existence, statistically, we're only able to predict job performance 63% of the time. So we need to tolerate a little bit more shrinkage, a little bit more leakage in our recruiting process in order to get the volume that we need to be able to grow our businesses. And if you're thinking that, well, Jeff, that means you're putting a warm body to these clients. I'm like, no, we haven't sacrificed nigh onto one iota of our screening questions, our process, our training, our background checks. Those kinds of things are still in place. We're just doing them very expeditiously,

and we're allowing for more people to make it to the end of the process than we used to before we screen them out. And that's because sometimes I'm wrong. Sometimes the best recruiter in the world is wrong about a candidate. They see somebody who comes from McDonald's and they say, well, why would you be a caregiver? Not realizing that they're actually phenomenally experienced, but just in the gray market. In that regard, that has made a world of difference. And by the way, this process, if you want to tighten that process, it does not have to be a huge team. In my case, we have a talent acquisition specialist or a recruiter, and everything lives within that one person.

It's not like there's a million handoffs. You can really run this with a single body or even half an FTE, depending upon the size of your agency. Lots to explore here. Before we kind of move on from this part of it, I want to break down a couple more things you've said. So going back here, I really liked the discussion on live versus virtual interviews. And I agree with you that, you know, that is being seen as a necessity by a lot of candidates, and we have to at least experiment with it. One question I have. So as you've talked about, a big challenge in hiring for home care agencies is to get them into an interview.

Yes. And there's tons of people who are lost from the step of applying to interview and getting them to show up for interviews that are scheduled. Yep. and getting them to show up for interviews that are scheduled. You mentioned that in comparing in-person to Zoom interviews in your agency, there was no meaningful difference between the number of people that your team decided to move on. Did you notice a difference in the number of applicants or people in the interview process who chose from their side to go forward between Zoom interviews and in-person interviews? Oh, it's much higher with the virtual. It's much, much higher with the virtual because you have the opportunity to stop the shop.

See, at the point of application, they really don't know much about you and you certainly don't have a relationship yet. So, let's say that you my candidate, and now we're having a conversation. I'm getting to know you. You're getting to know me. I can articulate our values. I can articulate our culture. You become increasingly interested. You're more attached at that point. Prior to that conversation, I'm just a name on a paper. I might be a text message in your phone. There's no emotional baggage associated with that. You could tell me no and not feel bad about it at all. But the deeper we go, the harder it is for you to say no and vice versa, by the way. I mean, that's the whole purpose of an interview is to

get on the inside, inter-view. You want to get an inside view of how they think and why they want to be a part of you and what's in it for them and what's in it for you and all those kinds of components creates a relationship. And the stronger the relationship, the more likely it is to succeed. So it's not so much the quality of the interview being the difference. It's about the ease of making that interview take place. Because people are busy. And if you're in a major metro, the prospect of having to maybe drive a long distance or whatever the case may be for an in-person interview is a barrier. And you just want to reduce barriers. And more importantly, if they say, boy, I can't dedicate four hours of my day until next Thursday, now you've lost time. And everything that happens to them,

every opportunity that comes their way, every phone call that comes their way between that moment and that availability for an in-person interview is an opportunity for someone else to form that relationship that I'm describing with the candidate. You want to limit the amount of time, which is why you want to have a wide availability for folks to be able to do a virtual interview. Plus, the world today, we're so used to this interaction that we're having right now. Just five years ago, there's no way I would want to do this kind of a conversation. It would have been foreign and weird. But now, today, it's like, this is what I do all day long. It's not a big deal. And the same is true of everybody.

So, adjusting to the new reality is okay. It's okay. I think that's a really good point to make is just how fast things can change, especially in regards to like how much we accept, you know, Zoom being a part of life. I sometimes joke that as a remote worker, my favorite part of my week is when I leave the house. But, you know, and there is truth to that in the sense of we are all way more used to Zoom and that being a part of the process than it used to be. Last week, you talked about how you found that it's way more effective to time your spend on Indeed in the evenings when the people you're trying to reach are more likely to be like surfing job postings. Are you also doing your initial outreach in the evenings for the same reason or do you wait till the next day? Oh, fantastic question. Well, if you're responding

to them almost in real time, the nice thing is you're responding to them in a moment in which they're available. So whether that application is coming in in the morning, afternoon, over the weekend, three o'clock in the morning, it doesn't matter. And again, this is where an ATS, a good ATS can really be helpful because that you can automate this. You can have the acknowledgement

of the application received and a couple of follow-up questions done over text easily. And if you use natural language, it will feel very conversational. I will say that one of the things that I feel is really powerful about our best recruiters is that they are willing to modify their schedule to match that of the caregiver. So if the caregiver can't meet with them until 7 p.m., their willingness to meet with them at 7 p.m. has been heaven sent. Now, I compensate our recruiters oftentimes based upon how many folks they can bring in. And that's, by the way, dual, not only just hiring, but also retention. They get the bonus after 90 days of retention.

So I'm not just running a sweatshop there. I just want to give that little caveat. But the point there is that if you have somebody who's really hungry and motivated to bring in good candidates, then they understand that maybe 8 a.m. start time is not going to be the best for them. And for us, we've determined that our best recruiters really need to be able to be self-managed from that standpoint. That, hey, if you had a late night interview, no problem. You do what you need to do, flex your time, whatever the case may be, in order to be able to get those candidates across the board. If you are dealing with individuals who are already working, that's one of the accommodations that you can make for them. And you sell on that point. They'll say, thank you so much for being willing to meet with me at 7pm. And you say, of course, we get it. You got a life during the middle of the day.

Our goal is to create an environment in which you have the flexibility that you need to live. And this is one way that we can prove our culture to you. So you could use it even as a selling point in the recruiting process to kind of help you stand out as being a much more attractive company than maybe some of the other experiences that they could be having at the same time. I really like the trust in there. And I agree that that's super key to establishing the kind of culture that you're talking about and you need to succeed here. So let me try to recap what you've described as being your process so far. Sure. And just kind of make sure we have this outline clearly. So when they apply, first thing is to text them as quickly as possible. This can be someone actually texting them or someone that has written

casual, personal sounding workflows through text or someone that has written a casual personal sounding workflows through text or email that are automated. That means saying something like, hey, we've received your application, glad to see you apply. And then also be asking them some follow-up questions. I think one of your favorites you mentioned being what interests you in caregiving and what interests you in this agency particularly. Part of that kind of response texting conversation is scheduling a Zoom interview as soon as possible. From the Zoom interview, that is when you're sending them a conditional offer, I think you mentioned, right? What is that offer conditional on? Background check and stuff? Yep. Background check, reference checks, drug screens, whatever you need to be in person for,

or the whole, I'm legally able to work in the United States. I'm over the age of 18. All those kinds of little things that we tend to clog up our pre-screen process with can all be done after a conditional offer. And then from that point, so as soon as they accept the offer, you're probably scheduling orientation with them. That is correct. I would assume that like whatever parts of those things can be done not in person, you're doing in that time period before orientation. yeah go on yeah so um i'm glad you hit this um we found that like so many agencies that i talk to and i hear from um around the country that getting a caregiver to show up for orientation it can be so difficult it could be so hit or miss and so we we had to think

through this and kind of get into the head. And we actually tried to interview people of like, hey, we know you didn't show up. No problem. Can I ask you a couple of questions as to what happened? Why didn't you show up? We tried all sorts of different approaches and kind of got into the head of caregivers to realize that if the relationship didn't get established, they don't feel an obligation to come. And so we've done a whole series of things. There's a couple of key ones that I want to share with the team today. One would be that we have a lot of post-offer engagement activities that we do. We send out a welcome letter from the person who's going to be their scheduler.

This could all be templated. Hey, I'm going to be your scheduler. I'm looking forward to meeting you. I was hoping to be able to get your availability. What days of the week do you want to work? What times of the day do you want to work? What kinds of clients? Could you fill out this little questionnaire for me?

Because I'm going to start working on your schedule. The moment you get somebody to feel like, oh my word, they're actually setting me up for real work here, there's an obligation that starts to build. There's a sense of responsibility that I've got someone doing something for me. Our orientations by statute have to be at least five hours in length. In Oregon, it's eight hours in length. And as a result, we know that they're going to be there at our offices for a little while. So I've decided to invest a little bit of money in feeding them. So one of the reach outs that we do is, hey, we're ordering lunch

for the orientation coming up on Thursday or Friday or whatever it is. We want to know, do you have any allergies or dietary restrictions? Now, A, they have an opportunity to be able to answer that question, but B, oh my gosh, these guys are going to feed me lunch. Not only is that a good thing because it produces endorphins for the individual, but it also helps them to feel like, hey, now they're spending money. If I don't show up, I need to tell somebody. I need to inform them ahead of time. And then we do give them outs.

We give them proactive outs. Hey, if you find life happens, if you find you need to reschedule your orientation, click here. And that's in all of our communications. And we have some of the pre-hire paperwork that we can do. Fortunately, we use an HRAS system that allows for us to kind of kick that out ahead of time so that they can fill out a lot of their paperwork ahead of time. And it just keeps them engaged. The longer the distance between offer and orientation, the more engagement you need to have. If it's greater than a week, because remember, my rule has to be within the week. But if it's greater than a week, we actually have the office staff call out to them. And instead of sending,

hey, I'm your scheduler and I'm going to be setting this up. Can you answer a couple questions? We'll say, call them and have that conversation. So there's more touches, more opportunities for them to form a relationship, one that imbues them with a sense of responsibility that, okay, now somebody is relying on me to be there. Somebody's relying on me for a schedule. I need to then show up. If they don't show up at that point, that's one of the best indicators of a swing and a miss that I could give you. And I know that it sounds like a lot of effort, but I have to tell you that our yield ratio went from at one point, we had like a 50% attendance ratio, and now it's like 90% or better. Actually, I think 92 was last month.

So getting people to show up is a matter of engagement. And those are some of the elements that we put into play. I want to draw some attention to the stats here real quick. So you mentioned, you know, you're at 92% attendance rate for your orientation now. To put that in perspective for those listening. So a few weeks ago, we had Rachel Gartner, CEO of CareWork on here. They're helping with recruitment across the nation for a bunch of different home care agencies. And they have a lot of benchmarks they've built up. She says that the average show up rate to interviews, so not quite apples to apples, but close, and the average show up rate to interviews is 25% nationally. So what you're talking about works. Something you haven't

mentioned explicitly here, but I'm kind of sensing as this theme that I want to dissect a little bit. So as background, I talk with the owners of home care agencies all the time. I'm in a lot of those conversations. I'm with them in person and in Facebook groups, things like that, listening to what's being said. And there's a lot of, I think, you know, justified frustration with, you know, people flaking out during the hiring process, things like that. At the same time, there's also a lot of times this tendency to get maybe overly negative or fated, dualistic with what people expect of applicants and in general of caregivers. What I'm hearing from you is a much more positive, a lot more like faith and willingness to assume good intent on the part of applicants. Can you speak to that a little bit? Yeah. I'm so glad that you're bringing up this topic because I think this

is probably one of the most fundamental mental shifts that the home care industry, those of us who are doing recruiting day in and day out, because it is a slog, has to go through. They have to be very comfortable with not every putt sinking. They have to be comfortable with that. The failure to do so results in cognitive dissonance, which is where you don't want to experience rejection. You don't want to experience disappointment. So you stop thinking of the other party as being valuable. And what inevitably results then is a commoditization of the caregiver. And I am absolutely as guilty as the next person of having thought that way. But I can tell you that the fundamental shift in our company's culture that has resulted in astounding results from a recruiting standpoint and astounding results from a retention standpoint has been all about stop thinking of these people as the thems, you know, the arm length, nameless, faceless, commodity, pull them off the shelf. If they don't work out, throw them away, kind of an interaction, kind of a relationship.

And instead, let them become the named, faced employees, team members, family members is what we call them, that they want to feel like and that actually produces a much better experience for all of us as well. We just prevent ourselves from doing it because we have been disappointed. We've been bit and we're shy. We're gun shy. We don't want to experience that disappointment again. But to become comfortable with, yeah, some people are going to reject this. Some people are going to disappoint me. Some people are going to be, as I call them, the knuckleheads. And at the end of the day, the knuckleheads are the minority. They should never be the tail that wags the dog.

The good things that come from good people doing good work in your agencies way outweighs the problems that come from the knuckleheadedness that exists out there. And it's all about where you put your focus. Are you going to focus in on the focus. Are you going to focus in on the positive? Are you going to focus in on the negative? Because it's easy to focus in on negative and commiserate and complain. And then I start to expect negative behavior from somebody. And guess what? They live up to my expectations. Whereas if I instead form a relationship of trust and treat them with the dignity that they truly do deserve. And I already treat them with the kind of expectancy that they're going to behave in the way that I want. Guess what?

They rise to that occasion too. It's so nuanced. It's like calling a candidate and saying, hey, so I was just wanting to reach out and confirm, are you showing up tomorrow to orientation? Which already comes with a negative assumption. Change it just slightly to say, hey, call him by name, Tammy, I'm looking forward to seeing you tomorrow at orientation. I just wanted to follow up. Is there anything else I can do for you to help you to be ready for tomorrow. Completely different assumption, completely different energy in the way that those two conversations happen. But at the end of the day, what you're really looking for is confirmation that they're coming. And that's okay. But it's just a positive approach versus a negative approach. And I really think that that is as germane to the success that we've had at Family Resource Home Care as any process changes, was the attitude change, the cultural change, the shifting the mindset to be less of a complainer

and more of a creator. And I think that if nothing else, that would be what I would want to proselytize in our conversation today. So I'm so glad you brought it up. Love that. And he was not cued for that in any way, shape, or form. We did not discuss that ahead of time. That's a conversation I've heard and had a lot. And I don't blame anyone for whatever level of frustration they may be and probably are feeling with recruitment and hiring and when people don't show up, super frustrating. At the same time, I 100% stand by what you've said about, yes, some of that is always going to happen, but there's so much to be said for

how you approach it, the expectations you set, the expectations you hold them to, things like that. So love that. We're already about two thirds of the way through our time here and I want to make, there's a bunch more I want to hit. So let's continue here. So then once you get them into orientation, that's also, I would assume where you're doing some of those kind of like final background check type things that have to be done in person. Then you immediately go into the orientation from there. They're being paid for that. Then you kind of have this like second gap here where you can lose people of like, of, of the orientation to their first shift. You're mitigating that somewhat

because they're already being paid for the orientation, which helps a ton, I'm sure. But there still is that gap. So what does that look like? What do you do during that time? And then what does the intro to their first shift look like? Yeah, yeah. Thank you.

Thank you so much for that. So my answer is going to be a little bit nuanced based upon location. So optimally, I'll start there. Optimally, they leave with a schedule. That's kind of the gold du jour for family resource home care is that you have engaged with them both pre-orientation and enough during orientation that you have a sense of the kinds of client assignments that they would be comfortable with, the kind of schedule that they would be good with, and you have already built a schedule ready to go for this individual. Even if it's not all the hours that they want to work, they are starting out with something. Rule of thumb for us is that if I can't deliver that

on day one, I deliver them a shadow shift, meaning that I place them to a company or do a ride along with another caregiver at an actual shift that yes, I do pay them for. And the reason why is because again, that goes back to that concept of people want to know that they've got money coming in. And so if they walk out of the interview or the orientation feeling like, okay, I've got my first shift, it's tomorrow or the next day or whenever it is, then they feel contented that they have started a job. And that is a psychological experience for people. And we've all been there. We all know what that feels like. So that's super important. I say that that's a little bit nuanced based upon location because in certain jurisdictions, there has to be certain background checks or whatever that have to come back. And sometimes the time lag is real. Well, it's awful. But that being said, if I can show them a clear pathway to the kind of paycheck that they want, that makes all the difference in their level of engagement. So we collect

on the front end, not only their availability, but we say, all right, optimally, think about how many hours you'd like to be able to work. And I'd like you to think about your bills. I want you to think about your monthly bills. How much money do you need to bring home in order to be able to make your world go round? And then let's equate that to hours, because that's what I want to put into our system as being the goal for your supervisor, who by the way, their performance is measured by how successful they are at getting you what you want. And that sounds really cool for the candidate to hear, but guess what? On the opposite side with the scheduler, my conversation with them is almost opposite. I say, okay, they're telling you how much they need to

make. So when you're making a shift offer, you don't have to say, hey, would you take this shift pretty please, pretty please, like we always do in home care. I'll bribe you with a gift card. You can instead say, honestly, hey, I've noticed that we don't have you quite at the level of hours that you told us that you need to be able to make your world go round. I'm thinking about that paycheck in a couple of weeks. I want to see if you're willing to take a shift tonight because that'll help you get there. That will take the candidate or the caregiver in this case and take them out of the mode of, I don't want to go to work tonight. I had plans for tonight. And then put them in the mode of thinking actually in advance and saying, oh, dang, you're right. If my paycheck

is short in two weeks, you know what they never do? They never say, you know what? I did decline a couple of shifts a couple of weeks ago. So this is completely my fault. And I should totally feel bad about my own choices and apologize to my employer. No, no, no. They say, family resource is not giving me enough hours. And they think, oh, I might need to quit or whatever the case may be. So by the scheduler knowing that information in advance, they're armed with a different kind of conversation to help the caregiver think holistically about themselves and to think about that paycheck. And so the quantity of acceptance to those shifts goes up. Even if the shifts are not optimal, it'll go up because people care about their monthly bills. If it's the second day of the month and your rent isn't due until the first

day of the next month, people don't think that way. They don't think about the next month's bills. They think about what's right in front of them. Do I want to go to work tonight? Do I want to take a shift that's maybe a little suboptimal to what I want? No, I don't. But if they can think about the longer-term perspective about their paycheck, then maybe they would. So we try to establish that kind of a relationship at orientation, that kind of expectancy, that kind of way that we like to work. And that speed to their first shift is something that we do measure and that we care about deeply because once they've started, it's a big deal. I went all over the place there, but-

No, I'm just absorbing. There's a lot in there. I really like that perspective, especially making sure that the applicant slash caregiver explicitly understands that you are thinking in terms of like their financial wellbeing. Yes. That needs to be focused on more and said more. When it comes to the preparation for their first shift in terms of like, here's how to be prepared for it. Here's what to expect. Here's the client introduction. What does your process look like for that? It differs from person to person. If somebody is coming to us with a lot of background in home care, they kind of know what it feels like to start a new client. They're going to need a near and dear family friend for maybe the rest of their life yet. Because the first meeting is always awkward.

I don't know where to put my stuff. I don't know where your stuff is. I have to ask you a million questions. I don't know what your preferences are. I don't know what towel I'm supposed to use to dry my hands after I wash my hands. I mean, there's so many little nuances of information that feel awkward. And so what we want to do is prepare them for that very first shift. You're going to feel this way. And it's totally normal. It is totally natural. It's going to require time. So you need to go to the same location about three times before you start to be like, okay, I kind of know the lay of the land. I kind of know this person.

I know how to kind of deal with them a little bit. I know how to redirect them or whatever the case may be. And that helps to set a little bit of expectation. So they're less likely to, after their first shift, like, oh, this is not for me. Or saying, oh, I didn't like this client. Could I get a different client? They're much less likely to have that experience if you're doing a good job of doing what we call job preview, of helping them to understand that. Best practice, in my opinion, not everybody's going to be able to do this, but putting together a video of a day in the life of

a caregiver, helping them to understand what a typical shift looks like, helping them to know what it looks like to clock in and out, how to greet a client, how to even do a door approach of walking up and knocking the door for the very first time. What do you say? If you can remove the mystique and the awkwardness of that experience, people feel so much more comfortable in just going about it and experiencing that, yeah, Jeff told me it was going to be a little awkward. It's okay that I feel a little awkward. And then our habit, our best practice is we always call the caregiver after the very first shift.

How did that go? How did that feel? And they will inevitably say, yeah, it was a little bit awkward, but you told me it was going to be okay. All right. Excellent. That's totally normal. I want to reassure you that that is normal.

Let's get you back in there. You'll find that the second, third rounds are going to be a little more comfortable and the success rate of people dropping out after the first couple of shifts goes way up. Okay. This is a great segue into kind of the last thing I want to touch on with our last 15 minutes or so. So to kind of frame this, like you've probably heard the stat from home care polls that 57% of caregivers who leave a job in a given year will do so in their first 90 days of employment. We often don't talk about the fact that that stat is from 2017 and it's probably a lot worse now. What do you do during the rest of those first 90 days beyond what you've already talked about to help ensure retention?

Yeah. So we touch base after the first shift, after the first week, after the first month. And we actually have a set of questions that we ask. For example, after the first month, I'll use that example because I already talked about this concept of preferred work hours and that being their optimal paycheck is what we call it. Actually, we call it the Paycheck Protection Program, a little bit of a rip on the COVID days. And on that one-month check-in call, which is what we call it,, will ask, hey, now that you've had a paycheck under your belt and so forth, is this still working out? I just want to make sure that 32 hours is exactly what you were hoping for. Is that mathematically working for you? And by having that conversation, you're doing a couple of things. You're double-checking to make sure your

data is correct. You can identify if there's additional capacity in a now a caregiver who's not brand spanking new. And you're showing them that you'd legitimately care about their outside of work welfare. And all of those are really, really reinforcing of the relationship. And I keep using the word relationship, and I really want that to be the case. So these little check-ins, these little nuances that we involve with are powerful ways to engage the caregivers. We have a monthly newsletter. we do an all staff meeting, we do various different ways to connect with these individuals and make them feel like they are part of a larger team. One of the things that Family Resource Home Care does is,

I'll tell you a little bit of our secret sauce. Let's say that we're gonna charge 30 and pay 15. What I'll do is I'll pay 14.50 and take the 50 cents that I normally would have paid. And this is not exact math, but I'll take the 50 cents that I normally would have paid and I'll set that aside for a bonus. And quarterly, we give out bonuses to all the caregivers based upon their achievement of branch goals, their overall success of the branch, as well as their ability to stay in compliance with anything that is required of them.

And as a result, we're using money that we were already planning on giving out anyway, but we're giving it out in the form of a bonus. And so we get to talk about that a lot in the prescreen process and so on and so forth, but it also drives the behavior that we're looking for out of them individually, but then it connects them as well to the collective goals. So if a branch is supposed to hit, say, 1,500 hours a week as a goal, then now they're paying attention to how well the branch is doing because their bonus is tied to that. And it's a cool way for them to feel connected to maybe coworkers that they don't ever see or even office staff people that they only know over the phone, that kind of a thing.

Okay. Follow-up question to that is besides that, do you have a formal caregiver recognition program that you're using? If so, what does that look like? recognize longevity after one year, three years, six year. And the reason why I chose those thresholds is because we did a study to just understand where turnover takes place. And that's kind of the itch moments for us. So their PTO goes up at one year, three year, six year, their bonus goes higher at one year, three year, six year, and so on and so forth. So we recognize those during our all staffstaff meetings, that here's the names of every single person who has joined the company. Here's the names of every single person who's hit one year. Here's everybody three, six. And then we do increments of 10, 15, 20, 25 after that.

So we've got that kind of recognition. We also do stories. So if a cool experience happens, we see it on a home care pulse survey that somebody is particularly satisfied about an instance, we'll socialize that using social media, using our newsletter. We'll talk about it during our all staff meeting. I personally like to send notes to caregivers that hey i heard about this situation because it helps them to feel like oh my gosh somebody's aware of me and aware of my performance um so sending out thank you notes um is a big part of our company culture we had a

program where we called take two and that basically was week, if every person in the office were to take two caregivers in the field and send them a note, do something personal for them. We collect information like, what's your favorite candy bar? If you were to do a home visit with them and you brought their favorite candy bar and just recognize that they're part of the team, it goes a long way. So our retention stats for the 90 days is over 75%. Are you using a caregiver mentor program? We do the shadow shifts at the beginning for individuals that are either waiting, staged, or that are not experienced caregivers. We've attempted to do a variety of different kinds of mentorship programs, but we've never

gotten a really solid, repeatable, scalable program in place despite those attempts. So an informal one through the shadow shifts is what we call them, but not a formal mentorship program per se. We do have lead caregivers who, if there's a challenged caregiver who's having a hard time, maybe doesn't know a skill, we'll assign them to do a shadow shift with that caregiver. And that's definitely mentorship, but it's not a huge program out there. We have kind of a side question on that. Someone's asking, have you had families or clients who aren't open to having people there for shadow shifts? Yeah. I mean, I can't think of off the top of my head, any specific instances where that became a challenging situation where,

oh my word, we can't get this person a shadow shift because families don't want it. It's oftentimes in how you present it. And this is true of even when you do supervisory visits with people in the office, people don't want to feel like they've got a big brother of who's this person in my home. So if you present it differently of saying, hey, we feel like that you've got a really great caregiver and every client wants to feel like they've got a really great caregiver. We'd like to be able to have that individual have another caregiver to accompany them so that they can kind of show them the ropes. This is going to do two things. One, it'll help this second person know what right looks like. And then second, we now will have somebody who's more or less trained on your case so that if your other carrier wants to go on a vacation,

which we hope that they do, we've got a second person who's already been in the home that might be able to fill in for that individual and you'll have already met them. It's all about the with them, what's in it for me of helping them to understand what's and how you frame it. I apologize that today it seems like I we're basically at the top of our time here. So I just kind of want to give you a chance. What are your last words of wisdom or your last rant that you want to leave us all with? Oh, my word. It goes so fast. I feel like we just started. I'd say the biggest takeaway that I would hope that people would walk away from this conversation with would be proactively shift your paradigms to be positive. Really focus in on the greatness of the people that we employ and treat them with the highest level of dignity, and they will rise to prove you right. The same is true on the other side, but I'm not going to talk about that. I would say that if I had anything that would be a nugget that you could really assess about

your company culture and that could make a world of difference in how you implement process, it's you got to do it with the right attitude. Love that. Thank you for that. Thank you for joining us again and sharing all of your experience that you've gained here. Just a couple final reminders to people who are listening. First off, if you enjoyed this, if you learned from this, please share it.

Spread the word about this. Send the link to someone who can use it. Share it in Facebook groups, whatever works. But please help us reach more people with this. Thanks for joining. And we have some great future guests lined up as well. So keep checking the HomeCareU page, homecareu.careswitch.com. And we will see you all next time.

Thank you, everyone. 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.