Ep:42: CNA to CEO: How to Recognize and Reward Your Caregivers Through 90-Day Reviews

Miriam Allred (00:08):

Welcome to Vision | The Care Leaders’ Podcast. I’m Miriam Allred with Activated Insights. My guest today is Gabby Hoing, the CEO of Kore Cares in Sioux Falls, South Dakota. Gabby, welcome to the show!

Gabby Hoing (00:19):

Hey, thanks so much for having me here. I’m excited.

New Speaker (00:22):

It’s been so great to meet you here for a few minutes, and I’m really excited to have this conversation. You have a unique experience, you know, you’ve been a CNA, you worked in long-term care for a number of a years. You’re young and you’ve started a business, you know, in the last five years. Kind of highlight for me where you’ve been and what you’ve done the last 10 to 15 years to get you here?

Gabby Hoing (00:41):

Yeah. So I actually started in healthcare as a CNA in a nursing home. My friends were working there, they needed help. And I said, you’re a caring person. You’d be a great fit. And I, I honestly didn’t know I was kinda nervous. But I started and they were right. I did love it. I loved caring for people. I thought from there I’d be a nurse kind of thought about that, but I also really fell in love with the business side of healthcare. So I ended up going to school at the university of South Dakota and got a degree in health services administration. And that’s when I discovered home care, I thought I was going to be a long-term care administrator. And then I discovered there was a whole different realm of healthcare called home care. One of my friends convinced me to apply at a local home care agency.

Gabby Hoing (01:30):

And I started working as a home care aid and I absolutely loved it. So I graduated college. I worked for the Good Samaritan Society, a large senior care organization and help them start one of their first home care agencies move to their corporate office, designed the business model for home care and then got to implement it throughout the country. I got to start agencies in Hawaii, Oregon, Arkansas, Colorado, Iowa, Illinois everywhere. It was an amazing experience. But I needed a break from corporate life a little bit and wanted a little less travel. So I ended up working for a very e-care and sold telemedicine to long-term care facilities. And that’s when I discovered that I really missed home care. And that was really where my passion lied. So I started Kore Cares about five years ago. And I guess the rest is history, as they say.

Miriam Allred (02:24):

I want to say, shout out to the friend, you know, back in high school to introduce you to home care. You know, we talk about the recruitment recruiting new caregivers right now. It’s hard, but look, even you came to home care from a friend who knew what it was and invited you. So just shout out to, to referrals, you know, bringing people to this industry. That’s so awesome.

Gabby Hoing (02:42):

Exactly. It’s so nice to hear from other people that actually do the job and can say, yeah, you’d be great at it. And it’s a really fun, rewarding work. So we definitely need more of that today. With our current staff recruiting other people and letting them know what a great industry this it really is.

Miriam Allred (03:03):

Absolutely! I can only imagine back when you were a CNA, when you were a caregiver, you know, you would have maybe not looked ahead and saw, wow, I’m going to open my own agency in 10 to 15 years as a caregiver. What were some of your short-term goals or short-term and long-term goals, you know, what did you envision yourself going into back when you were a CNA or a caregiver?

Gabby Hoing (03:24):

I really thought I was going to be in leadership in some sort of in healthcare that really attracted me. I wanted to be the leader that really knew and understood the frontline staff. But I thought I was gonna work in nursing home to be honest. I, at first I did not, like I said, did not know anything about home care and, and thought I, the only place you could get care was was a nursing home. And then I discovered this whole wonderful world of home care and I just really wanted a job that was meaningful. I really wanted a job where I can make a difference in people’s lives. So that was also very important to me.

Miriam Allred (04:02):

So let’s talk about that, you know, your current caregivers, having the firsthand experience, being a CNA, being a caregiver, I can only imagine you can really empathize with your current staff because you’ve been there and done that. So just tell me about how you relate to them. How do you understand them? How do you empathize with them on a regular ongoing basis?

Gabby Hoing (04:22):

Yeah, I think sometimes, you know, when I caregiver can’t get a client to take a bath or do their exercises or things like that, and they think they’re like failing themselves. Like I’m not doing my job. I can say no, it’s okay. I’ve been there. Like, let’s try a different approach or let’s let them have some space or here’s some different techniques to try and it’s okay if they don’t want to have a shower today, that’s their right. And maybe do these other things with them instead. So really being able to put myself in their shoes and use some of the things and techniques that I’ve used in the past and make recommendations for them. I think that makes them feel like, Oh gosh, supported like, Oh gosh, someone really understands what I’m going through. Really understands. The situation and pro can provide that, those recommendations that make their, make them feel fulfilled. Even though maybe they’re not checking off all the boxes on the care plan.

Miriam Allred (05:20):

Yeah. Let’s for our audience. Let’s talk a little bit about your size. You know, how many caregivers do you have? How many clients do you have? What is your office staff breakdown look like? Just so people can know.

Gabby Hoing (05:30):

So I also think it’s important to know how the population we serve here in Sioux falls. I want to say it’s about with the rural areas that are included in Sioux Falls. Like we’re looking at 300,000 people, not a ton of people in the area that we serve. And we have a lot of the, we talked a little bit about this. We have a lot of the big franchises here in town, and I’m one of the few independent agencies here. So we a team of just under 50, right around 50 employees, we serve a census of around a hundred clients and growing. And then my office staff, I have a manager of operations who takes care of a lot of our billing, payroll scheduling. I have a manager of community relations who takes the care a lot of our marketing and sales HR. And then I have a caregiver support specialist and she does a lot of the introductions to clients and caregivers, trains, new caregivers answers the phone when she’s in the office and really is kind of a good support and training person for our office.

Miriam Allred (06:33):

So pretty small office team, you know, 50 caregivers, but then there’s only four or five of you there in the office. So I’d imagine you’re pretty, hands-on, you’re pretty close to your office staff, but also to the caregivers, because there’s not very many of you, you know, how often are you talking to the caregivers themselves, you know, a weekly basis, a daily basis?

Gabby Hoing (06:52):

I would say a weekly basis. One of the things that we found really important at Kore Cares is to have reviews every 90-days. And I have told other home care operators that, and they’ve kind of looked at me like, you’re crazy. How do you make that happen? But it’s really important to us that we see our staff on a regular basis because once they get up and going, you know, and they see those clients day in and at the same clients day in and day out, there’s no reason for them to call office or come to the office. So we do reviews every 90 days. So at a minimum we see them face-to-face every 90 days.

Miriam Allred (07:26):

Yeah. Which is awesome, which is hard, especially. Yeah. Even with 50 employees, that’s a lot, but I’d imagine they want that, that, that connection, they want that personal relationship back to the agency. Are you conducting those virtually or in person now? And what are those kinds of things

Gabby Hoing (07:45):

Here in South Dakota, um you know, COVID affected us for sure, but we’re a lot more lax and I think the rest of the country and we love face-to-face interactions here. So we still conduct all our reviews face to face. There was a period of time where we tried to do them over the phone. We tried to do zoom, but it just, it just wasn’t the same. So we do all of our reviews in person in the office. And there’s just that, there’s just something about that personal connection and seeing people face to face and being able to give them really specific feedback and for them to give us feedback too, on how we’re doing in the office and maybe even feedback on how our clients are doing in the homes and shine some light on some things that we didn’t realize that was happening, or maybe help them work through some issues that we didn’t know that they were experiencing at home. So it’s really good to do those 90 day reviews.

Miriam Allred (08:42):

Yeah. Let’s talk a little bit about other ways that you recognize your caregivers. It seems so simple. Just, you know, recognizing them for everything that they’re doing, but I think some agencies are missing the Mark or not remaining with that recognition. So tell me a little bit about some of the ways that you keep that personal recognition at the forefront with your caregivers?

Gabby Hoing (09:04):

So we do this in a variety of different ways. One thing we started this year is I have thank you notes that each of my managers does and as well as the caregiver support specialist desk, and I want them every week to find a person to thank for something and write them a handwritten. Thank you. Note the other way we recognize people as you know, it’s been tough with COVID. Our caregivers have had to step up last minute. They’ll shifts have to be really flexible with their schedule. And so we’ve done gift cards and thank you notes. Anytime people really step up to the plate and maybe work a little bit more than they were anticipating. And then in those reviews. So we look at, are those caregivers providing good teamwork? Do they have good attendance? Do they have great job performance? Are their clients satisfied and making sure in those reviews that we give them great feedback on what their clients are saying about them and things that their clients like that they’re doing. Because I think sometimes when you’re working in the home, you’re like, I think I’m doing the right thing. I think my clients like the care I’m providing, but it’s nice to hear from the office staff and to hear that the clients are reporting back to the office, like, yeah, you are doing a great job. And these are the things we like when you come to the home.

Miriam Allred (10:21):

Yeah, even the thank you notes, it’s so simple, but I’m just thinking of, you know, we live in a digital age and we’re used to a lot of digital communication, texting emails, social media messages, DM, you know, but even just a handwritten know or a thank you in person goes a long way these days, you know, if you get something in the mail or you get a handwritten note, it feels really personal. And so I don’t think that can be overstated the simplicity of a really simple, but kind genuine gesture for your employees.

Gabby Hoing (10:54):

Right? Like someone took the time to write me hand written, thank you know, where they could have just texted me instead. I think that it does add really nice personal touch.

Miriam Allred (11:04):

Yeah. Let’s talk a little bit more about other compensation methods. You know, pay is always a hot topic and kind of what feels like a hangup in this industry. What are some ways that you’re addressing pay and also finding other ways that are meaningful to compensate your caregiver?

Gabby Hoing (11:23):

So on at least a yearly basis, we send out a compensation survey and we do that through a Google form and we just kind of get their feedback. What’s important to you. Is it dental? Is it health insurance? Is it bonuses? Is it hourly pay? Like what is important to our staff? Because we want to hear directly from them. We don’t want to make any assumptions. So what we do is we do ongoing bonuses. So our staff can get, if you’re a full-time employee up to hundred dollars a year in additional compensation through our bonus program. And that’s where we really reward people for going above and beyond the call of duty. And we just, we have clear parameters that we set at orientation and, and how you earn those bonuses. And then we give all those bonuses during those 90 day reviews. Okay.

Miriam Allred (12:15):

Yeah. Can you talk a little bit about how you award those bonuses? You know, what are some of the criteria or things that you do that you award?

Gabby Hoing (12:22):

So coming from a corporate setting, they’re always very nervous about bonuses because they want to make sure they were fair and that you could, you know, accurately document things. So we had that in the back of our mind as we develop this compensation or this bonus program, but we also wanted to get creative. And we wanted to really think about what is important to us as an agency. Like what do we need from our staff to operate a really great agency and make sure that our care our clients are well cared for? So we look at five categories, we look at attendance because it’s important that people are reliable and show up to work. And then we can count on them. We look at client satisfaction, so making sure our client’s needs are taken care of and we use ClearCare so we can easily tag any time a client calls in or another coworker calls in and says, Hey, this caregiver is doing a great job.

Gabby Hoing (13:15):

We can easily make a note in their profile and tag a compliment to it. We look at making sure they’re compliant with our policies and procedures. So have no corrective actions in the lookback period. We look at job performance. So we look at their last supervisor visit and how well they scored on that, but also look at whether or not they’ve completed their online learning in a timely fashion and gotten us important documents like driver’s license and car insurance and things like that in a timely manner. And then we’ve look at teamwork, you know, are they flexible with our schedule? Do they pick up shifts last minute? Do they help us out or help their team members out when other people need to need time off? So we look at all of that. A lot of it’s just tags and notes that we make in ClearCare to document that. And then if you work, you know, five hours a week, your bonus is going to be a little bit less than if maybe you work 40. So if you’re a 40 full-time caregiver, you meet all five categories. You’re going to get a $200 bonus every 90 days. Whereas if you work five hours and you meet all five categories your bonus might be $50. So we kind of tear it down based on number of hours and how many categories they need.

Miriam Allred (14:30):

Thanks for breaking that down in such detail. You know, I think like you said, people shy away from the legwork, that’s going to go into building it and then maintaining it. But like you’ve said, you know, you just rise to the occasion and figure it out, map it out with your office staff team and then hold people accountable and make sure it’s a part of that 90 day review. So that you’re maintaining that, that bonus recognition, any specific examples, I’m kind of putting you on the spot of a story or a time when you, you awarded a bonus and how it was received or the impact that it made on the individual caregiver.

Gabby Hoing (15:05):

Yeah. I think it’s just always really excited. I think first time they’re nervous. The first time they come in for their 90 day review, if they’re nervous, like, am I doing a good job? Like, what are they going to say to me? Am I going to get fired today? Cause I had to come to the office and then after we get through that, they’re like really excited. Like how did I do like, yeah, I’ve got a bonus. I can go buy tires for my car or I can their college student, you know, put that money towards their college education. And I think they really, they enjoy it. A lot of caregivers will tell you, they don’t want to be recognized. They don’t want appreciation. They don’t wanna be recognized. They do it because they care. But I will tell you that caregivers really do love the appreciation and the recognition and they need it from when I worked in a nursing home, there was very little recognition given out. And the morale there was low because of that. And I think to keep people excited about their job and keep them confident in their skills and abilities, you need some sort of system to show them that appreciation and recognition. Yeah,

Miriam Allred (16:11):

Absolutely. I want to kind of put you on the spot too. We’re talking about the caregivers, but are there other specific ways that you reward or give bonuses to your office staff? I know that’s always kind of a question of they’re doing so much for us, but how do we accurately reward them? Any examples or successes that you’ve had there?

Gabby Hoing (16:28):

So last year before COVID started, I set some really high goals and the CA and the office staff revenue, we looked at revenue for our goals because it’s an easy thing to measure. And so I said, if you guys, and we looked at billable hours, so if we meet this many billable hours, you’re going to get this amount of money. You meet this, your billable hours, you get this bonus. And so as the higher billable hours, you get the more bonus. And then I put a big bonus on, if we break this revenue goal, you’ll get this amount of money. And so they were a little nervous at the beginning of the year. Like you have some pretty yeah, you’ve got some goals that are girl and then COVID hit and things slowed down tremendously for us. And they’re like, there’s no way, no way we’re going to meet these goals.

Gabby Hoing (17:22):

And guess what? At the end of the year, they, they got all of their bonus money. They met all of their billable hour goals and they met the revenue goal and they just couldn’t believe it. They were so excited. I think sometimes in this business, it’s hard to grow and get excited about it at times because you need more staff. And it’s hard to find that staff sometimes when you’re in a big growth mode and this last fall, we had huge because people were like, you know what? We don’t want to go into a facility if we don’t have to, we want to be cared for at home or they’re moving out of facilities to home. And so we went through a huge growth spurt last fall. And it wears on you at times when you are adding that many clients and adding that many people to your team.

Gabby Hoing (18:09):

But it’s exciting to know that you’re going to get rewarded for it. Like, yep, I’m working my butt off now, but I’m going to get bonus for it. And we got to celebrate his team. Like I love giving bonuses. I’m probably one of those weird owners that like loves giving out money, but I’m like, mate, you’re doing a great job. That means like they have a lot to be excited for. So the office staff was super excited about their bonuses and they’re like, we’re going to go buy a Peloton end of the year. They’re like getting ready for their new year’s resolutions. Like I’m always like, that’s awesome to have something to be excited for. And like, we worked hard for this and it’s been a stressful year, but you know, it’s, it’s all worth it when you can make a difference in people’s lives. So,

Miriam Allred (18:50):

And it’s so good when it’s so clearly defined just like you said, revenue is so straightforward. You know, you have a pulse on it throughout the year or billable hours. It’s great to have really transparent, straightforward goals with bonuses directly attached to those. So there’s no question. There’s no debate it’s, this is what we’re trying to accomplish. And I love what you said. You know, there are lofty goals and your team was a little bit intimidated, but that’s how agencies grow in setting those lofty goals and working together as a team to make them happen. So, so I love what you said there before this conversation, we kind of talked about your community presence. This is straying a little bit from the topic, but I’d love to hear about how you personally had a really strong presence in the community as you started your agency and maybe the ripple effect that that’s had in finding higher quality caregivers or using your, your networking to be able to, to recruit right now. Cause I know that’s a really tough thing for most agencies.

Gabby Hoing (19:50):

Yeah. So, because I worked for Good Sam and Avera two big, large healthcare systems, I got to really connect with a lot of other healthcare executives through both of those positions and really get to know people in the community. And when I started core, I wanted to be even more involved in the community. So I joined the Sioux falls chamber, the Hartford chamber, local chambers to get to know people. I joined several different organizations like YPN young professionals, network sales and marketing executives and really just got involved in those groups and help them with whatever their initiatives were. Mission was and got to know people through those groups. And they have, because they know me and they know my heart and they know where I’m coming from. They have been great in sharing Facebook posts that helps a ton.

Gabby Hoing (20:46):

And, and, and people who are looking for meaningful work to say, Oh, go talk to Gabby or people going through college, like other parents in the area who might have college students. I say, you need to go talk to Gabby about healthcare and how you get experience. So that way you’re ready when you get your nursing degree or your business degree or whatever, to hit the ground running. We actually had a client call us recently a client’s son, I should say. And he said, I needed to talk to Gabby. And this, this client has been deceased for a while. And we’re like, I just need you to talk to Gabby. So I, I call him back. I’m like, Hey, how’s it going? He’s like, Hey, my daughter’s going to school she’s pre-med and she needs a summer job. Will you take care of her? I’m like, well, I’d love to have her apply. So it’s, it’s great to have those kinds of connections and even have clients think of you or think of their grandkids or their kids, you know, Hey, maybe this would be a great job for them.

Miriam Allred (21:43):

I’m just thinking the 2021 Benchmarking Study about to come out here in a couple of weeks. And I was just reviewing a draft of it and seeing the importance of word of mouth for both client and caregiver, referrals continues to just soar above all other referral sources, but you’re, you’re living and breathing that and having that community presence to where clients are referring you, other clients, or even other caregivers and caregivers to other caregivers, it that’s how you grow is having a community presence. So that word of mouth really becomes, you know, your lead recruitment source. And it sounds like that’s what’s happening for you.

Gabby Hoing (22:18):

Yes. And it’s the freest form of marketing, you know, it’s, it’s such a great form of marketing because people get to hear about you. But then it’s free. Like you don’t have to spend a thousand dollars on a Google ad. It’s, it’s, it’s free. It’s just out there. And so I think that’s super important. And one of the things we told our caregivers is like, we don’t mind paying you for referrals. Like if you send us a really great candidate, we’ll pay you $200 when they weren’t reached 90 days of employment. So I, and I tell him, I’d much rather pay you guys to bring great caregivers to us, then pay the big companies like the Facebooks and the Indeeds money, because usually the caregivers that recruit other caregivers, they stay longer than sometimes from those other recruitment sources. So I’d much, I’m very happy to pay caregivers, to recruit for us and, and they’re always excited to, and then they have then when they recruit somebody and they make a great caregiver and they, they get excited about too. So,

Miriam Allred (23:22):

And the data backs that up that their attention rate of caregivers that have been referred by another caregiver versus those that have come from a social media platform, not discrediting those, but, but the retention rate is so much higher because of that connection. And you experienced that, you know, when your friend mentioned in-home care to you, years and years ago, you know, look where you are today, just having that friendship or those relationships, that means something in your work

Gabby Hoing (23:46):

Is, you know, what brings that job satisfaction. And that’s what the caregivers experience. So early on. So just kind of one question in closing here, you know, you’ve been in business, started your agency about five years ago. This is just kind of recapping everything that we talked about, but what is one piece of advice that you give to agency owners to better connect with their caregivers today? If you don’t have experience as a caregiver, go work a shift it’s eyeopening. Even today, I still go work shifts every once in a group. I don’t work them as much as they used to, but every once in a while I’ll go out and I’ll work a shift and it just brings you a purse, just a different perspective on the situation. And I think it’s truly helpful. I know as agencies get bigger, it’s harder and harder to maybe work those shifts or connect with those caregivers.

Gabby Hoing (24:36):

But I think it’s so important. And one of the things I saw at a corporate level is sometimes I felt like we lost touch with what the frontline staff was really experiencing. And so I think it’s really important to either work alongside a caregiver every once in a while, maybe if they’re struggling and need some extra training or mentoring, or like I said, just go work a shift every once in a while and go listen to your clients and what they have to say about your caregivers and your team. And I just think it’s really, really good to get that perspective every once in a while. Yeah. To be on the front lines. And, and it’s true. They’re owners and operators or admin staff out there that haven’t, you know, worked a shift, but something as simple as you know, there are plenty of shifts to go around, to go and fill one for a couple of hours, just to get that firsthand experience like you’re saying to be on the frontline so that you can better support them and the clients.

Miriam Allred (25:26):

I love that. Yeah. Well, Gabby, it’s been a pleasure. It’s been a really quick, you know, a couple of minutes here, but appreciate everything that you’ve said. Appreciate, you know, just being on here and sharing your story and sharing kind of some insights about how you connect with your caregivers. It’s invaluable. You know, our CEO always says caregivers are invaluable assets, and it sounds like there at Kore Cares is you are, you know, living and breathing that every day and reaping the rewards.

Gabby Hoing (25:50):

Exactly. We’ve always felt that if we give our caregivers the training support tools, resources, they need to be successful. They’ll provide exceptional care to our clients and everyone will be happy. So your CEO’s right. You know, our, our caregivers are hands and feet of this business and we need to make sure there’s much cared for as well your clients are.

Miriam Allred (26:12):

Yeah, absolutely. Well, Gabby, it’s been a pleasure. Thanks so much for joining me today. Yeah. Thank you. Thanks for listening to this episode of Vision with Gabby Hoing. If you’ve enjoyed listening to this podcast or better yet learned and applied something you’ve heard to your own agency, feel free to drop us a review. Whether you’re listening on Apple podcast, Spotify, Google podcasts, or Pandora. We’d love to hear from you. Thanks again. And we’ll see you next time!