Ep. 71: How to Build Power Partnerships Across the Continuum

Miriam Allred (00:08):

I’m really excited to be joined today by Michelle Cone, the SVP of Training and Brand Programs at HomeWell corporate and also Lou Ramono, who’s the CEO of the h HomeWell of in Hackensack, New Jersey. Michelle, Lou, welcome to the show!

Michelle Cone (00:26):

Thank you so much, Miriam. It’s fabulous to be here with everyone today and I just wanna say thank you not only to yourself, but to the home care pulse team for having both Lou and I have this conversation with you today. Thank you

Miriam Allred (00:41):

Happy to have you joining us before we jump in, I want you both to introduce yourself briefly. I know I read your names and titles, but Michelle, why don’t you start, give us a little bit more detail on your background and where you’re at now.

Michelle Cone (00:56):

Absolutely. So you may wonder what does SVP of training and brand programs mean? So basically I’m responsible for the development of all of our brand programs and our surface offerings here at HomeWell corporate, I also manage our openings and trainings department and support our franchise HomeWell’s franchise system in, in any way possible. I have over 23 years of experience in the postacute care space. I’ve worn many hats within the healthcare continuum. I found my name tag the other day from my very first job in the mid to late nineties with the first home care healthcare and hospice organization I worked for. And it was a staffing coordinator of private duty. So that was quite some time ago. I have almost equally experience in both the facility setting as well as in the home care space, both with skilled home health and, and home care. I operate out of the corporate office here in north Texas, and I’m very excited to be here today.

Miriam Allred (02:01):

Wonderful. Thank you, Michelle. Lou, why don’t you tell us a little bit about yourself?

Lou Romano (02:07):

Hi, I’m Lou Ram Romano. I’m the CEO and owner of HomeWell in New Jersey. I’m currently in the Hackensack office. We have another location in union, New Jersey about maybe 20, 25 minutes from here down, down south. I started this, I was the seventh franchisee. I was the seventh HomWell franchisee and that was in 2005. So we are in our 17th year and we, you know, I started this with my mom and I just working hard and an office that is, that was tiny. I don’t even know how it, we, we made it, but we did. And and now we are providing over 9,000 hours of service per week to seniors. We have close to 350 caregivers, every, every payroll I guess, and 40 administrator staff. And and we’re also moving we’re gonna, we’re not moving. We’re opening up another location down in central New Jersey this year. So things are still moving 17 years later, we’re still growing.

Miriam Allred (03:14):

Awesome. We are lucky to have you, Lou, there’s a lot happening, you know, this is the start of the year. I’m sure all of you have priorities in a lot of different directions, but something that Michelle and Lou are passionate about is, is building power partnerships. As you can imagine, Lou’s growth over the last 17 years has been a lot of relationship building and he probably wouldn’t be where he is today without a lot of those relationships. So, so let’s start there. You know, I wanna start with you Lou talking about how you have and are determining the right referral partners in your area and how you’ve really just ignited some of those relationships.

Lou Romano (03:53):

I think when we talk about power partners, they are probably the single most important piece when it comes to, to growing your business and marketing. I don’t think we give them enough credit and a power partner, what a power partner is and how we determine them. It’s just, it’s simply a partner or a referral source that provides care in the same place as we do, which is the home. So, and the other P to determining who is the right one, is that they, they have to call on the same referral sources that we do. So who is a power partner, it’s home health, hospice geriatric care managers DME, even elder care attorneys, Michelle and I, we talked the other day about even liaisons for, for sniffs or, or admissions directors for assisted living. So these are people that, that are, are, are doing the same thing we are doing.

Lou Romano (04:58):

I think the key to six success with a power partner or figuring out who you want to connect with the most is they have to already be getting business from the account or, or referral source you are calling on. So if, if you’re gonna partner with a home health company, you wanna make sure that they are doing business in that and that referral source that you’re targeting to, to get referrals, that’s sniff that you’re you’re targeting. I think that is super, super important when we’re trying to determine who the right local partner is. It’s just much, much easier for, for marketing success.

Miriam Allred (05:38):

Thanks, Lou. I, I would add, you know, you’re in a metropolitan area, so there’s probably dozens, if not, you know, even hundreds of, of options for referral partners, how do you determine kind of the right fit? If there are a plethora of option? I think

Michelle Cone (05:55):

It’s important to understand your ideal client who can most benefit from the service your agency provides and where are these clients located within the healthcare continuum? And much to what Lou said. You have to identify accounts that have a need to refer those referral partners that that get it, it want to advocate for the patient and the family or the resident, if it’s an Al or an IL because they recognize the value that you bring to the table. You, they recognize the benefit that you’re bringing to their patients, to their residents, to the, the families that, that you serve. And you guys do a great job up in your benchmarking study. You always identify the top marketing sources that are out there, and you’re absolutely right. There’s, there’s hundreds of them and you don’t have to be in New Jersey to see the volume of referral source partner opportunities that are available go to medicare.gov/care, or pull up nursing homes or inpatient rehab facilities or home health agencies within your zip codes.

Michelle Cone (07:03):

And there’s dozens if not hundreds within a particular territory. So I think that what you really need to look at is culture. Those that really do want to advocate and, and align themselves with other like-minded organizations that have the, the, the best understanding of the client journey and the client need and how we all operate and work together towards shared outcomes. We all have the same goals for our clients, whether that’s a client that’s discharging out of a facility or someone that’s on services with us, but is also on services with skilled home health. We just own a particular piece, a little different than our skilled partners, but the value that we provide and the benefit to support our clients and our referral partners are it it’s undeniable.

Miriam Allred (07:57):

That’s great. Let’s transition to now we know, you know, who the right fit could be and what to do, you know, to, to get started there. Lou, you’ve engaged with a lot of these people in your local market. What have you done to stand out? You know, when you’re about to go and approach someone for the first time, what does that look like and what are you doing to stand out from potentially other home care agencies? Yeah,

Lou Romano (08:19):

I, I mean, there’s, there is quite a bit of things that agencies have done over the years. I think we are a little different in our market anyway. And I think one of the ways that I guess we, we stand out is by providing outcomes. We want to show our referral sources that this it’s not a popularity contest. You know, we’re not trying to, we’re trying to relationship market of course, but we want them, we wanna give them a reason why they should refer us. We measure a variety of, of outcomes. I think one of them that is probably the, the most important is our, our go home well program, which measures readmission rates. So this is something that we, we hone in on. We focus very seriously clinically from a clinical perspective of, and we do it really, really well.

Lou Romano (09:17):

That is a, it’s a program that we have been working very hard on and we have significant results. For example, the industry average, I think they’re, you know, around 19 or 20% for readmissions where our office is last year we are at 7% readmission rate for our go home program. So what that shows is that we are a quality agency. We take quality care very seriously. There’s other things that I could talk about as far as fall statistics, hospitalizations you know, we have to measure all of these and, and stand out in a different way than, okay, we’re the, we’re the entertainment for the week or we’re here. We’re the fun, we’re the fun agency for the week. I think that’s important. You want to establish a relationship, but at the end of the day, why are they gonna refer us? They’re gonna refer us because we have quality measures, quality outcomes.

Miriam Allred (10:15):

I wanna dig in a little bit, and both of you can address this. I, I was just reviewing, you know, we’re about to release the 20 to 22 benchmarking report and less than 30% of agencies are tracking readmissions. So it’s a significant amount of providers that aren’t tracking it. And I think people get hung up on how, you know, how do I even go about starting to track? So, so Michelle or Lou, you know, where, how are you doing that, you know, as get as detailed as you can. And when did you start that and how did you start and what are the results that have come from tracking those readmissions?

Michelle Cone (10:50):

Absolutely. So to speak more to what Lou just ended on is hope is not a strategy. It really is not you know, the days of, of cookie trays and breakfast burritos and Starbucks drinks, while that’s a great value add once the relationship is established, the way that we have to market and connect with our referral sources now is very different than a decade ago when Lou first entered this industry years and years ago, it’s a different animal now than when he first entered this space. So we it’s all about the value. It’s all the outcomes. It’s all, it’s EV it’s about the data, right? Show me the data. So when it comes to outcome based data and how do we track it and where do we track it? Most operational platforms, whether whether using clear care or someone else, they will typically track that data, if you enter the information correctly, you might have to, to create some particular tags or work with your operational system, your customer service rep, in order to to get that information to where it can be input into the system.

Michelle Cone (11:55):

And then you can run analytics or reports to be able to pull that information we’ve developed and, and found some work arounds within the clear care platform particularly with their, their quality of care option that they created a few years back that does allow us to go in and interchange range of condition and pull readmission rates. So most operational platforms will allow that you and, and support that you just might have to find some work arounds in order to actually capture that data. But you have to make sure that at the agency level, that information is being placed into your operational system correctly, or the, or the data that you will be incorrect

Miriam Allred (12:36):

And it’s worth it. Lou, you’re probably a Testament to, yes, there’s probably some manual processes that you have to set up to get those reports, but, you know, then you can print ’em out and take ’em to that referral source on this topic of outcome based data. Lou, you mentioned a couple of other metrics that, you know, they’re asking for, or you’re telling them, could you run through, you know, maybe in more depth, the other outcomes that, that they’re often asking or that you’re usually willing to share?

Lou Romano (13:01):

Sure. I mean the one thing that comes to mind, that’s really simple to share to me is our, our home care pulse satisfaction surveys as well as online reviews. So, I mean, we can get it into more clinical, but I think, I think that’s really important. Consumers are placing a huge value on online reviews and, and, and testimonials, I guess you can say. So we’re showing our referral sources, our power partners, our clients, their families we are performing, and it’s also really important for us administratively to look at ourselves and say, how can we improve here? So if our clients are taking surveys and maybe we’re dipping, there’s a little trend for a few months in communication. You know, we pay attention to that. And we look at that and we figure out how can we get better? Is it our phone?

Lou Romano (13:55):

Is it are our nurses calling enough, our staffing team communicating enough? There’s all these things that we look at. And we, we just, you just have to constantly like question, are we providing an excellent customer service experience? And through that, the, your, your survey results will increase. Your online reviews will be better and you could showcase that and you can show that you’re, you’re a a quality provider and not only do referral sources, you know, believe in that and refer you more, but families will hire you more to take care of their loved ones. So it’s, it’s it. I think that’s an important measure that I see that that’s a huge trend more than ever,

Miriam Allred (14:41):

And the satisfaction piece, it compliments the data, you know, there’s qualitative and quantitative and they go so well together. And the satisfaction surveys that feedback should supplement your numbers. You know, if your readmission rate’s really high and your satisfaction’s really low, you know, there there’s just an imbalance there, but they do really well to, to supplement each other right. Anything that you would add there, Michelle.

Michelle Cone (15:06):

So it, it, Lou hit the nail on the head. It’s not just about capturing the data, but it’s also so making sure that you analyze the data to recognize any trends. Like he said, he wants to make informed business decisions. Every business owner should, and by capturing data and really taking, taking the time to, to peel back the layers and unpack what the data is telling you, it will paint you a beautiful story of gaps or de or opportunities within your agency for you to move the needle in your favor, based off of what the numbers are telling you. It removes the emotion from it. And when it in, when it goes to the you know, the satisfaction surveys, both from a client and a caregiver perspective, that’s important information that your referral sources definitely do want to know. You know, we’re all in there selling ADLs, right?

Michelle Cone (15:57):

Bathing, dressing, toileting, transferring, feeding, ambulating, we all do the same thing. What’s really gonna set you apart is things like data. It’s the, it’s your outcomes? It’s your fall rates? It’s your readmission rates, it’s disease specific data. Take the time to capture that. It, it really helps say, don’t take just my word for it. Look at what the data shows. It’s that proof of value. And also look what our clients and caregivers are saying about us. Most of us in across all brands and all lines of service in care are doing a really good job, but does your data support that? Do the, a outcome support that your, your referral source partners want that information so they can make informed partnership decisions. So they’re, they’re hungry for it. They’re thirsty for it. We just need to provide that to them.

Miriam Allred (16:48):

And something that home well is doing, you know, you all have kind of programed you’re offering. I think you mentioned it, Lou is, is this go home well program? Let, let’s start with you, Lou, why don’t you talk a little bit about what that looks like and how it’s benefited these partnerships?

Lou Romano (17:06):

It’s it’s the simple explanation is just, it’s, it’s a, a goal of, to reduce readmission rates within the first 30 days of a hospital stay, or if they even go to the hospital and then go to rehab and then come home to us. Our goal is to keep them home. The reason that it’s so powerful for us, it’s, it’s a quality care measure, you know, first and foremost. But then it also, you, the, the sniffs and the doctors and hospitals are getting dinged, you know, they’re getting penalized for early readmissions, early hospital readmissions. So we use that as a, a marketing tool to say, here’s, here’s what we can do to support you in that battle against Medicare, who, you know, so that battle against quality care, I guess. It’s a really good system that they have in place, cuz it forces hospitals and sniffs to, to provide better care and, and think about maybe early discharges or holding on to patients too long.

Lou Romano (18:16):

We get to show our power partners, that home health that’s really important that they are supporting their hospitals and their, their sniffs. And that speaks on a different level. So sometimes maybe the case managers, social workers, they’re interested in that they want to hear from it, but we get to go to administrators of these facilities and talk to them on a higher level about our go home well program about what our goal is to reduce readmissions. And that helps them directly from a business perspective. So it allows us to really, you know, you can talk about quite care, which are, I feel like social workers care about that more than the business side of things. But the administrators are gonna, they want to hear both of that. Both of those things I just mentioned. So it’s, I think it’s really powerful program. I’m surprised that I just did a competitive analysis 25 agencies in my area. We do it twice a year, not one of them measures readmission rates shocked. I shouldn’t say that out loud, but anybody from New Jersey, but there’s such an opportunity there it is. You know, and it does help us stand out.

Michelle Cone (19:25):

Yeah. But I think Lou hit the nail on the head. We have to understand the pain points of our partners have to understand value based care. We need to understand that their reimbursement and their payments are are completely affected by both efficiency and effectiveness. And you can see all this information, it’s public knowledge. We are a great advocate for, and a Compli to the care that they provide. We get to be a non-weightbearing or non-risk bearing partner. And when eight, when our referral source partners get that and understand that we recognize that this is, you know, the microscope that they’re under. And we know that there’s financial implications and penalties, and we know that you’re being judged on particular outcomes and quality measures. The more informed we are about the partners that we work with and we align with the more that we can speak their language and we need to speak their language. We need to get comfortable with looking at data and speaking data and speaking outcomes. This is their comfort zone for our referral sort. And in order to really you know, earn our place at the table as a non-weight bearing or non-risk bearing partner, we need to be able to show the numbers and let data tell our story

Miriam Allred (20:47):

A hundred percent well said, Michelle,

Speaker 4 (20:49):

Hey, Louis, it’s Ronnie down in Austin.

Lou Romano (20:52):

Ronnie, how you doing? Hey,

Speaker 4 (20:54):

Ronnie, I’m doing great. Hey, just real quick on readmissions. I know that in clear care, the, the software that most of us, all of us use, how much are y’all using that to track your readmissions? Maybe I missed it. If you said it,

Lou Romano (21:08):

We use it to an extent you could use tags in a way to help track the I guess, diagnosis. Who’s on the program, but really I think where our, where our CR, where we crunch our numbers, it’s on a separate Excel file. So we take that information and, and translate it over. You could use clear care in a way that like, if you want to, if you want to document or record the activity of your phone calls and the tracking of what you’re doing for each client each week, I think what’s you can also do that in Excel, but I think when it comes to number crunching and, and how we, how we monitor our statistics, it’s a, it’s a separate Excel spreadsheet. Very, very easy, very simple to use.

Speaker 4 (21:57):

Right.

Miriam Allred (21:58):

Good question, Ronnie. Thanks for that.

Speaker 4 (22:00):

Yeah. Well, this is Jason, you may not have this issue having been doing what you’re doing for 17 years and as large as, as you are and all the relationships you have, but for someone like myself who hasn’t even opened yet. So I’m at zero right now when I try to take in data and kind of be outcome driven, one, developing these referral sources, other than those third party surveys. I mean, do you ever have anybody just bow up to you and go, how do you get those numbers? You know, how do you get 6%? I don’t, I don’t necessarily believe, believe what you’re telling me. I mean, does that, how would you handle that? I mean, cuz I could see that happen for, so like us is just kind of getting started in the area.

Lou Romano (22:54):

Well, I think there’s a couple pieces to your question. It’s a great point. You know, it’s a great question. You know, you gotta remember I was a 24 year old kid, no idea what I was doing. So I was in the same boat, you know, the same boat probably worse, you know, so

Lou Romano (23:14):

And I think, you know, the first thing you have to do is commit to that type of program, commit to that program. And what we have done successfully is shown our referral sources, exactly how we are this program through our process. So we’re talking about you know, taking the referral, taking the admission, putting them in the program. We explain to them how our nurses are involved with each patient. We have the nurses, we have the the, the, I guess the sales reps following up with the social worker, letting them know, keeping them informed throughout that 30 day process each week. Right? So they get to, they get to feel and see the program. So, and, and eventually you have 10 cases, 15 cases, right? 20 cases, a hundred cases under this program. So you have to grow it by, you know, showing them, making them a part of the program too.

Lou Romano (24:19):

Don’t just say, okay, we do, we do the go home well program and we’re gonna take your client and then your client comes on and they’re just, they don’t know what happened to the client, show them. And that may be one client a month, whatever it is, but show them that this is what you have done. And sometimes that client becomes readmitted and you can talk about the why or what we could have done better, or maybe they needed more care or sometimes it just happens. So I think that’s the first bit of advice I want to give you just starting out. The second question is, you know, yeah, I guess people can lie and make things up. That’s a bad thing to do in our industry. It’s a small, small world. You know, we don’t I don’t even want to entertain that, but I think sometimes people ask for maybe it hasn’t happened yet, but they’ll ask like each disease state, what is the, or diagnosis?

Lou Romano (25:16):

What is the statistics? We have all that at the, you can just email it very quickly. So I’ve never run into that. I don’t think, I mean, we’ve asked people, people have asked us like the numbers for each diagnosis as far as readmissions, but I’ve never had someone say, well, you just making these numbers up. You know, we kind of, we kind of post our information out there and you know, they all, all the numbers match up. I wouldn’t be concerned of that. I think, I think as you go on, as you develop up a reputation, we have a very strong reputation in our area, but as you make them part of your program and part of your team and they feel like they’re doing something with you, they’re not gonna doubt you. They’re not gonna doubt what you’re doing. I don’t think they’ll be a problem with that at all.

Michelle Cone (26:04):

Yeah, I think Lou’s absolutely right. I mean, we are in a trust industry, we really are in order to be successful in this industry, no matter whether it’s attracting and retaining caregivers attracting and retaining clients, establishing community presence, creating brand awareness establishing, nurturing, maintaining relationships with your referral source partners. It all come down to relationships, reputation, and reliability, which is all under the umbrella of trust, people are trusting their reputation to refer to you. They wanna make sure that you’re reliable. You know, it’s all about the relationships. This is a very emotional buy. It’s a very hyper local relationship. And that’s one of the reasons that Lou has been so successful is people have seen him. And his business grow year after year. They, they know that he’s around for the long haul. They know that he does a great job taking care of his, his caregivers, his clients.

Michelle Cone (27:04):

So obviously the data more than likely is going to reflect that. And they really do their due diligence. Making sure that they capture that information and just like any partnership, right? Typically any breakdown is going to be due to lack of communication or lack of trust. So we have to really open the lines of communication and we have to continue to foster trust. And if you don’t know the particular answer to a question, that’s okay, tell ’em, you’re going to go figure that out and you’ll come back next time and you’ll share that information with them. So just being very transparent and knowing that that relationship starts with that first handshake, that first conversation, and it’s, it’s not just a one off. This should be the goal is that this is going to be a very long term, sustainable partnership.

Lou Romano (27:52):

Good luck, Jason.

Speaker 4 (27:54):

Hey, thanks. I really I really, the part you talked about, which I think Michelle had brought up in a different meeting I was in, but using the opportunity on that first client that you get referred to really communicate everything back yeah. To the per that, that that’s where you could really build a lot, a lot of trust. Yeah.

Lou Romano (28:18):

That’s how, that’s how I started my business. I was, I, I, I was not begging, but I would really ask referral sources, give me a chance. Give me your hardest client. Give me something Friday at four. O’clock just gimme an opportunity to show you that you know, what, what we can do and how we can make your job easier. Your client’s life easier, their family life easier. Just gimme that opportunity. So once you get that one, that first referral sure. You take care of them really, really well.

Speaker 4 (28:52):

No doubt.

Miriam Allred (28:53):

I was just gonna add, this is one of the reasons I love this call. You know, we’ve got Lou that’s been around for 17 years. Jason, who’s just starting out. I’m sure all of you on this call right now could share a piece of advice with Jason as he’s just getting started out.

Speaker 4 (29:05):

No doubt about that. There’s

Miriam Allred (29:08):

This, this sense of community that Michelle’s talking about. This is such a human to human business where trust is at the heart and center of everything that we do. And that speaks volume, you know, to this topic that we’re talking about, building these power partnerships, it all hinges on trust and follow up and loyalty and delivering on, on what promise. So, so great insights. There’s a really good question here in the chat from Carolyn. She’s asking, where are you getting your definitions for readmissions? So they are the same across the board. Are you differentiating between ER visits and readmissions? You know, are you using medicare.gov for that Michelle or Lou? What, what would you say to that?

Michelle Cone (29:49):

So Lou may do it a little different, but to me, a readmission is a readmission. Whether it’s a hospital or a facility, if we’re going to assume the responsibility of taking on that client, we should also a responsibility to do all that we can to prevent a readmission or a, a rehospitalization from occurring. So for us, it’s, when they’re discharged from that facility, be it a hospital, a sniffer, an earth. We are going to capture all the information for 30 days and provide a 30 day snapshot back to our referral sources. What did we see? What did we, what did we identify? Was it a success? Was it not a success which maybe a readmission was a scheduled hospitalization, right? So it’s not an unsuccessful readmission. And if, if we start to see commonalities, we’re communicating with referral sources, they make, may I recognize that not just us, but maybe other folks they’re working with.

Michelle Cone (30:45):

They’re seeing an increased readmission from a particular doctor or a particular facility, or after a particular surgical procedure, or maybe it’s a particular diagnosis. So this information is very helpful to them because they can look at everything holistically and see if they see any commonalities based on some of these readmissions or hospital bounce backs. So for me, long story, long, 30 days after a facility discharge, be it hospital sniff or earth, we take on that client. We are going to project out 30 days from the discharge date and, and, and provide that, that quality of care and collect that data.

Miriam Allred (31:26):

Lou, anything you’d add to that?

Lou Romano (31:28):

I, I, Michelle handled it perfectly. I think that we back in the day, you know, I believe it or not, I’ve been doing this since 2013. So we were always toying with, well, if, if the person came from the hospital and then went to the rehab and then they spent 15 days at the rehab, then they, them home, well, all we need to keep ’em home for 15 days. We stopped doing that early on, just because 30 it’s, 30 days, you know, and especially with the sniffs, cuz they’re, they’re, they’re in it. They have skin in the game now, too. So it’s just an easy, just 30 days. And it, it’s not only just we’re not gaming the system, you know, we’re not only just doing the right thing for our partners, but we’re challenging ourselves from whenever they come home just 30 days, just stick to that number. That’s our, that’s our program, that’s our readmission goal. And it’s, it’s, it’s, it’s working. It’s a more powerful story. I think.

Michelle Cone (32:24):

Well that as an industry, if we’re going to accept the claw client from a facility, we should assume the responsibility to do all we can to allow them to continue to recover and age in place at home. If not, we probably shouldn’t accept that client.

Miriam Allred (32:39):

That’s great. Something that we haven’t touched on really yet is, is the staff piece, you know, we’ve touched on it briefly, but right now there’s this challenge of maybe not having enough staff to staff, the referrals that are coming in Lou, have you experienced, and what’s your approach to a partner, a referral partner, you know, if you don’t have the staff, are you experiencing that in some volume and how would you handle that?

Lou Romano (33:07):

It, it, it we’ve had a, a, we had a great bounce back here. 2020 was tough. 2020 was we went from I think we were averaging about 22 new hires per month, right. In, in 2019, say then the pandemic hit and it went down to about eight new hires. So it was really very, very challenging, but but you adjust, you know, you figure out what is what’s the market need it’s. And really what we had to do is, you know, you take the, and this is why I’ll mention it again, that home care, pulse satisfaction survey, you know, we take that information, we see what’s important or where we’re lacking and we we figure it out and we increase it. So maybe it’s pay it’s benefits, it’s caregiver recognition. It is communication it’s, it’s making the caregiver feel appreciated.

Lou Romano (34:09):

So we took that. We, we focused on those goals and we also did a major pay increase and, and made sure our benefits program has been great. So the, you know, I think what’s happening in this industry are that caregivers are still underpaid. They don’t have real benefits and that’s something that we were able to do. It’s a simple formula to me. I think it should be just pay, pay the right caregivers higher treat them better, appreciate them more, give them support and they will come give them real benefits, you know, real health insurance as time and someone like Jason, he, he needs to grow into that, but it needs to be something that he thinks about as time goes on such as health insurance, 401k even not even voluntary benefits that don’t really come across the agency, anything dental, vision, PTO these are things that you add on as year goes years, go on because what you’re doing is you’re attracting caregivers that at this time, now they know their value more than ever, and they will on our work for agencies that recognize that.

Lou Romano (35:28):

So not only are we doing that with higher pay and benefits, but we’re listening to their surveys, we’re listening to what they want. They want better communication. They want to be matched better on their cases. They want caregiver recognition. I think that’s probably like to me right now, that’s that’s number two, if not number one for some caregivers, but I feel like that’s number two on the list. They want to be recognized. They wanna feel good. They wanna be appreciated. So we have, we’ve changed that the pandemic has really helped us change our approach to caregivers. And today we’re, we’re back at hiring in, in the high teens or twenties at the end of the year, last year, we were averaging maybe 23 new hires. And I think it’s a, a real result of evolving with, with the caregiver demands and, and the, the, the, the industry. And I think we do that better than, than almost all of our competitors

Miriam Allred (36:24):

And everything you just mentioned are differentiators, you know, tying it back to what you communicate to a referral partner. They wanna know the, these things. They wanna know how you treat your staff, how you train your staff, how you recognize your staff, because happy caregivers equals happy client. And all of those can be used as differentiators to take to a referral partner and say, Hey, this is what we’re doing to recognize our caregivers. And you know, the other 10 agencies that are approaching them, probably aren’t doing that. And so using the way you treat and train your staff as differentiators to communicate to a partner is essential.

Lou Romano (36:57):

It, it is. And I just wanna add like one more thing, I’ll brag a little bit, but you know, through, through that satisfaction survey, you know, we are, we were able to we were awarded the employer of choice for 2020 and 2021, which is, you know, I know you guys, you know, home care pulse gives out, you know, I don’t think they give out too many. If you think about it throughout the country how many agency easier are, but we’re in that group. So to be able to, I was very proud of that, but be able to tell our referral partners, this, to tell them that we use home care pulses in the no training and, and, and how we try to customize the training and give them some webinars or e-learning, you know, that things that we do you and talk about to our referral partners, to me, that I feel like they’re interested in that they, you know, I don’t think, I think they’re tired of hearing the same thing over and over again.

Lou Romano (37:49):

Hi, I’m I’m Lou from home. Well, I have coffee for you. Like they want to hear, they want to hear what are you doing to be a better person? What are you doing to be a better agency? How are you taking care of your P people? That’s what we’re doing out there. That’s the message we’re we’re talking about. And all it all circles back to quality care, treat your caregivers with quality, treat your clients with quality and talk about it and, and back it up. And you will see strong results and, and trust that’s built.

Michelle Cone (38:19):

Don’t be shy, cuz you can tell Lou is very, very shy about him and his team messaging that information to his community and referral source partners and, and anyone that that will listen, right? So, but you have to advocate for your own agency. You have to advocate for your own brand. You need to do what’s right by your staff, by your caregivers, just like Lou said. And by default, they’re gonna do what’s right by your clients. This in increases your, your length of stay and your retention with your caregivers in turn, that’s going to increase your length of stay and your retention with your, your clients. It helps support at that interconnectedness between those caregivers and clients. We want those wonderful matches, right? We never leave a client and a caregiver to where we just set it and forget it. Right? We’ve got supervisory visits and support and oversight engagement, and all these touch points that are built into to our process. But you need to do what’s right by your staff. If you happy, happy, supported caregivers, a happy, supported, engaged team, they’re going to go out and do quality work

Miriam Allred (39:25):

Well said. We’ve, we’ve got two very similar questions that have come into chat from Carolyn and Sophia. What do you bring to the very first meeting, a brand new facility exec to sell them on the program? And then is, you know, how are you starting that initial conversation? We touched on pieces of that Lou, but what would you say? What do you or your staff bring to that very first meeting?

Lou Romano (39:50):

Well, I guess, I mean the very first meeting is, is typically it’s an inservice. You know, we’re trying to, I mean, there’s always a little bit of a buffer before that inservice, but our goal is to schedule an inservice. And what are we bringing? So it, it really depends on the facilities policies or what, what people like. It could just be simple as it just could be you and, and a conversation and a group of people. You can bring coffee, you can have a, a little, you know, coffee meeting. You could do a lunch and learn. You could do a breakfast things that are, I don’t think you want to, you know, go crazy. And I think you want to have something that is you know, reasonably, reasonably priced that’s ice presentation, but you know, people love food. And but I think what’s most important is, you know, you bring your materials, you bring your, your, your business cards and your brochures and you don’t need to bring, you know, they don’t want a PowerPoint presentation.

Lou Romano (40:55):

They don’t want anything special. They want something they can give to of the families, which is your business card and your brochure make sure that’s sharp and and you want to be able to like, they want you, they want to know about you. They want to connect with you. So bring yourself, but like, you know, but you want to, you want be yourself, you wanna be professional and you want to have, you want to be of like a subject matter expert on, on your company and your business and how you can provide them with a easier job. I guess you can say how you could help, help them do their job better for their clients. Does that answer your question? Is that help?

Michelle Cone (41:37):

I think that that’s, that’s blue. I think you did a fabulous job. I think you need to know it’s important to understand the referral source partners that you’re calling on and understand what their pain points are. Whether you are looking@medicare.gov care compare or you in that you should back up with researching their website, looking at their Facebook page, looking at their leadership team on LinkedIn, finding some things that are common ground that you can use as a conversation. I, I never, I don’t recommend ever walking into a referral source with stuff and trying to sell them based off of brochures and business cards. That’s not the very first touch it’s like Lou said, it’s gonna take a buffer, probably three, four touches with an account before you’ll actually qualify them and be able to sit down and have a conversation about the benefit of your program based off of their particular needs.

Michelle Cone (42:27):

So I think you need to understand and become that subject matter expert on home health and hospice instilled nursing facilities, been patient rehab facilities and, and hospitals. What is their challenge of the moment? Do you know what that is? Is there an industry article or something you read about recently that you can go in and help use that information to facilitate a conversation? It shows you care about them. You care about what’s going on in their world. You care about what’s impacting their industry. And it, it really allows for that collaborative communication and will elevate you from the donut delivers and the Starbucks coffee drink drop off folks that they’re used to, it’s going to really paint a picture of what you do differently versus other folks that may be coming in and asking for their business, do your homework.

Miriam Allred (43:17):

Yeah, I’m just, I’m just seeing here, you know, Carolyn said, she’s speaking specifically about the one on one with the leaders. I think you touched on that, Michelle. I think we were, you know, first of all, talking about that initial contact, you know, that looks different, but then, you know, after the third or fourth, that’s probably where you have, you know, maybe a, a data, one sheet, you know, these are our outcomes. How can we help solve those pain points, you know, by doing X, Y, and Z. So, so hopefully that was helpful, helpful, Carolyn you know, really good responses there. This has been a really insightful conversation. Michelle Lou, thank you so much for being willing to share so much, like you were just saying Lou, the competition and is stiff in your area, but there are opportunities for us to help each other. You know, I think the end goal is for all of us to deliver the best care possible. And there are plenty of seniors and people that need care out there. And so it’s up to us to work together, to, to elevate the industry at large. So thank you both for being a Testament of that.

Lou Romano (44:16):

You’re very welcome.

Michelle Cone (44:18):

It’s been a pleasure. Thank you so much, Miriam. Thank you, Lou. It was wonderful to see everyone today.