Ep:43: How Home Care 1 Went From 0-850 Billable Hours in 5 Months

Miriam Allred (00:08):

Welcome to Vision | The Care Leaders’ Podcast. I’m Miriam Allred from Activated Insights. My guest today is Dawn Blackman, the CEO of Home Care 1 in Cleveland, Ohio, Dawn, welcome to the show.

Dawn Blackman (00:20):

Ooh. Yes. Thank you. Thank you. I’m super happy to be here. Very excited and honored. Thank you for having me.

Miriam Allred (00:26):

Yeah, absolutely. We just met and got connected, but you have had some unbelievable success being in business for just over five months, right?

Dawn Blackman (00:35):

Yes, that’s correct. It’ll be six months the end of June.

Miriam Allred (00:39):

Oh, so exciting. Well, introduce yourself. Tell us a little bit about yourself, your background and how you came to home care just a few months.

Dawn Blackman (00:47):

Sure. So my background is very colorful. I’ve done lots and lots of things. I was in the army for three years straight out of high school. I went to college. My main background lies within proprietary educational sales and that’s like a fancy suit up bell title for someone who recruits for post-secondary for-profits educational institutions. So I did really well in that field and I excelled and I worked my way up the ladder from the bottom up and became in an administrative role as the director of admissions. My most recent proprietary admissions role was that med tech college in Atlanta. I’d lived there for some time. And then I came back here. I worked for the department of labor’s Bab or program for about five years. And in that role, I wore many, many hats that I think like to, to this very day play a key part in how I conduct my day to day activities.

Dawn Blackman (01:48):

I had to create my own book of business. I had to plan, I had to implement, I had to do orientations. I had to do community outreach. I had to research why we do outreach. I had to recruit, I had to just, I wore many hats and I absolutely loved that role. I then moved back to Atlanta and resumed working as an admissions director. And then my dad fell ill to congestive heart failure, who was coincidentally also receiving home care services. And I moved back here permanently. And so someone there in all of that, I ended up getting married to my husband and became a housewife. And that totally was awful for me. I did not want to be a housewife. I thought I could do it, but I’m a worker bee. And so it didn’t work out. So I decided to apply to a local position that was just right around the corner from my home as an administrator for a home health care agency.

Dawn Blackman (02:48):

So I got that position and quite frankly, it was only supposed to be part-time, but I found myself being there eight hours a day by choice. I’m not charging them for the extra hours. And I pretty much ran that whole from scheduling through recruiting, to budgeting, planning, to revamping their policies and procedures. And just when I started there they had only had 14 clients and they had been in business for three years and they were Weaver certified. And even myself having no knowledge of waiver certifications, things of that sort. And I knew that that was extremely low for someone who’d been in business for three years. And so in the short amount of time that I was there, which was 70 months before I decided to go into business for myself I had basically taken them from the 14 that they had to over 40 clients and over 30 staff in seven months.

Dawn Blackman (03:45):

So they were extremely grateful for that. There they were floored they’re miles, Fritz, and floor. I had approached them for a business proposition to see if they wanted to expand and open up another location of being business partners. Of course, and they were not for it. It said home care is a headache. They didn’t want to do it. And so they were all for supporting me. You know, obviously without a non-compete to open up my own agency. And so that’s how home care one came to be. I, in that role though, I have to say, and I hope I’m not being too wordy is that I was a cleanup crew. I saw a lot of problems with, with no known as last minute from staffing issues to scheduling issues, to staff retention issues, to client issues. And we all know we get those calls from clients every day. And so I decided, Hey, I can do this for my own agency. You know, I, I can put all this effort into my own agency. And so that’s how home care one came to be. Sounds

Miriam Allred (04:47):

Like the perfect background to start your own agency. I I’ve said it once. I’ll say it again. But having that background in recruiting, also working as an administrator at an agency that really needed you, those two things, you know, led you to, to incredible success and, you know, having been in the military, like you said, and being a housewife, but all those things have culminated to all of your success today. So wow. To give our audience a little bit of some context here, like we’ve mentioned, you’ve only been in business for five going on six months, you’re nearing a thousand billable hours.

Dawn Blackman (05:21):

Oh yeah. Oh yeah. As of, actually as of this morning, I just took on another client for 40 hours. So we are now at 894 billable hours and we will be in month six at the end of June. So

Miriam Allred (05:37):

Exciting. So clearly you’re doing something right. And that’s what we’re going to talk about today. I’ve asked you to kind of break down three strategies that have led you to this rapid success. So I’m going to kind of turn it over to you to introduce the first strategy, and then we’ll kind of dissect how and why it’s working.

Dawn Blackman (05:56):

So it, it’s, it’s really hard to kind of narrow it down to this three, but I have a lot of different key ingredients that leads to, you know, what I would think to be home care. One’s current success with the 894 billable hours in less than six months of operation. The first key ingredient, in my opinion, based on my experience should be staff retention. So retention should always come first above all, even before the clients, you know, and Alex I’ll get into that in a second, but I like to think of my staff as my most valued gem. That’s what I refer to them as my most valued gems. Now our clients are our most precious asset or, you know, but your, your staff all ultimately should come before your clients. If you really want to think about it in hindsight, because without staff, you don’t have any clients, you can’t work the clients because you don’t have staff to work.

Dawn Blackman (06:50):

So you need to establish a permanent mindset that your staff is your most valued gem, not your clients. You must understand me that home care one is like pretty much like a well-oiled machine and you need every single little part in order for it to function and that begins and ends with your staff and their attention and what is motivating them and keeping them working for your agency. So so yeah, one of the things that I did was in my strategizing was I placed my office, this location in downtown Cleveland, which is a centralized location in Cleveland. We have, what’s considered the west side and the east side. And honestly, a lot of people think that live on the east side, that traveling to the west side is too far and vice versa. So you have agency owners. I have a couple of colleagues in the field where their offices are located far east and some that are located far west, but then they don’t want to get clients on the west side because they’re far east and vice versa.

Dawn Blackman (07:51):

And then they don’t get staff to come to them because of that fact as well. So I placed my office strategically here on in downtown Cleveland. It is literally right smack dab in the middle of both my front door sits in front of the bus stop that I decided, you know, in case they, you know, immediately catch the bus and things like that, which a lot of agency owners do hire people that catch the bus. I for the past four months after month, one has stopped doing that. And strategically only hire staff that have we’re being vehicles as a screening question. And I asked them before I even scheduled them for an interview before they’re even considered for employment, extra typically needs to know because they have their own working gig because a lot of clients require errands, things of that sort. And plus one, it here in Cleveland, we’re in the snowbelt, it rains, it pours it snows.

Dawn Blackman (08:44):

We get lizards. I don’t want to hear anything about Paul offs at that time. So you have a vehicle anywhere in Cleveland, from Eastern Washington, take you more than 20, 25 minutes to get to if you have your own car. So that was also a strategic. I also pay my staff again. You always want to have your staff in mind and you are strategizing, everything begins and ends with your staff, because that seems to be the biggest problem that agency owners are facing now in healthcare across the country. So I also pay my staff and paper checks. Is it all fashion? Yes. Does everybody have direct deposit or some type of time card or whatever nowadays? Yes. However, in order to be compliant, and this is more state specific here in Ohio, we, our staff have to do things called in-services and they need 12 hours each year.

Dawn Blackman (09:35):

Now in a facility, you can just grab everyone in a room for a couple hours and feed them a course and boom, that’s their hours for the year. That was our staff working remotely. It’s kind of hard to get everybody in the same place at the same time. So when they come pick up their checks, there’s things that they have to do in the office. They have to do in serve as quizzes. Each one is worth one hour and they need 12 hours each year. So every time they pick up their check, they’re doing two. So by month six of employment, everybody is compliant with their 12 hours. They also have to turn in, I still do paper time sheets, even though we are EBV compliant and they electronically clock in and out, it’s just an added it portrayal, which includes the client’s signature, which is another strategy on my part or signature stating what time the staff got there, what time they left, what they did while they were there all that.

Dawn Blackman (10:26):

So that’s just a client signature that I have in hand. It’s a wet signature that I get every payday from my staff. So I mean, a lot of things, you know, you have to strategize, you have to be strategic. You always have to think about what you’re doing and possible things that could go wrong before they go wrong and solve problems before they are problems. So you have to be used preventative measures. And one of the biggest preventative measures is to adequately strategize. And I have other points too, but I don’t want to take up too much time talking about that. I want to add

Miriam Allred (11:01):

Here that you don’t have any office staff. I don’t, it’s just you, everything that you’ve just mentioned. You’re a one man band right now, and you’re doing every single process start to finish. How does that not get just too overwhelming and too stressful for you? How are you making that happen?

Dawn Blackman (11:19):

I will admit in the beginning it was stressful. I mean, I made it work and everything was, you know, I got the job done, but it was just, it was stressful. I had no idea how much work I had cut out for me. But I have learned that stress maintaining healthy stress levels is also a key factor that you should put before. Anything else, even that is the one thing I would say that goes above staff retention is maintaining a healthy mental health and, and a healthy stress level because I mean, you guys know, and, and home care, you can get out just like that. And so me being the only one in the office, I don’t even go to work every day. To be honest, I don’t have to, I do not have to, to find, fill ins people. I don’t get call offs.

Dawn Blackman (12:08):

I don’t get client complaints every day. The things that I’ve done to, to set up home care one, the way it is now are working out perfectly. And I don’t mind patting myself on the back for that. I pay my staff at least three to $4 more per hour than the agencies in the local market. My goal was to be the highest paying home care agency in greater Cleveland and the state of Ohio. And we are on our way. I mean, you guys should know, I don’t know how it is in other areas, but just in Metro Cleveland alone, there might be in a 20 mile radius. There might be 20 home care agencies in that 20 mile radius. So, so yeah, we, we definitely pay our staff well, and with that comes higher higher standards, main issue that keeps people at their desk everyday.

Dawn Blackman (12:57):

Instead of being a true boss, is that they are trying to, to do staffing and scheduling all day every day. And they’re just kind of fitting everything else in and around. So once I got a grip on that and it’s like, okay, I don’t even have to go into the office today. You know, I can take my kids to the zoo or, you know, I can do something else. I always have my cell phone on, but, you know, it’s, it’s usually a pretty dry I’m very proud of my staff. So yeah, I’m, I’m the one here that’s doing billing and billing administrative stuff, keeping up with guidelines and compliance and all of that

Miriam Allred (13:31):

And no call offs that is basically unheard of at most agencies. So just hearing that, that that’s what you’re accomplishing is, is amazing. And you’ve hit on a couple of things that you’re doing differently. That’s kind of where I wanted to take this next. Do you, you mentioned that your staff have to have cars that you’re paying higher rates. Are there any other specific strategies that you’re doing that set you apart? Or how are you know, that you’re getting your caregivers to show up to every single shift? Anything else that you can pinpoint that relates to just getting them to show up every single day?

Dawn Blackman (14:06):

Oh yeah. There’s a lack, but I’ll narrow it down. One of the things that I do is once a month, I capitalize again on the fact that I give out paper packs. Nobody wants to come to the office for anything, unless they’re picking up some money. So I capitalize on that. I’ve already expounded on a couple of ways that I capitalize on that. Another way that I capitalize on that is I do what I refer to as well, checking meetings once a month. I’ll check meetings are exactly what they sound like and the staff really appreciate it. It not only helps them, but it helps me to if the time for them to come in and, you know, because I have so many staff, I break it up into three different groups. And so staff, so group a may come at this time, group B may come at that time, et cetera, et cetera on different days, but we do it once a month and it’s a time for them to really just come in and be themselves, be all the way themselves.

Dawn Blackman (15:00):

Like if they want to shoot out it can do that at the, at the well-check meeting, we eat good food. We talk about you know, how our personal lives are going. And sometimes it’s really hard to get up and go to work everyday, you know, and, and, you know, especially when you have a lot of staff that are in their twenties and they have these really, you know, going south, which I’m sure other agency owners have heard it. I have a lot going on in my life is the main excuse that they say when they’re called, trying to call off. Right? So when Nick pumped into these well-check meetings, it gets events and they get to discuss amongst ourselves each other, how they are handling, being a single mom and, and being able to get up and go to work every day.

Dawn Blackman (15:45):

And, and what is working for this staff person, this staff person may be going through the same thing as the person sitting next to her, but the person sitting next door had no clue on how to handle that. And so the person that is handling that same exact situation, well now the person sitting next to her, they didn’t have a clue now knows how to handle that situation. And so they bounce ideas off each other and we vent and we laugh and we cry and they get to see that I’m a real person. You get to see that I actually really do care about, you know, the fact that they’re going to work every day and how hard it may be for some, and that they’re pushing through. Whereas when they’re with their clients, they’re in those all blue or all weighed scrubs representing home care one and they’re professional.

Dawn Blackman (16:31):

And so if you don’t get to have that emotion that they need to express, I believe wholeheartedly that the mental health and having someone here about that is just as important as physical health, especially in terms of your staff, because they need that in order to go to work, especially in this field. I, another thing that I do is that I give out employee of the month strategically, there’s that strategizing again in front of everybody. And with that comes cash. I’m not a believer in the gas cards. I’m not a believer in the gift cards. I am a believer that money talks, I cash is, is a big deal. And it doesn’t even have to be a lot of cash, you know, but the fact that you’re giving them cash, you know, says a lot Nate, our employee of the month, they get recognized in front of everybody.

Dawn Blackman (17:21):

They get their award and they get an envelope with Ash on it. And then I get to tell a whole spiel about their permission, of course, their background and, and, and maybe even some trials that they’re dealing with. Like, so-and-so has three kids. She’s a single mom. She, she gets to work every day. She’s never once called offered late. You know, give examples like that. And it kind of helps motivate the staff. Hey, I want to be like, I want employee of the month when I come in. Also another thing that I use at that you know, with strategizing is I, I give them a sense of accomplishment when they get hired here, a lot of agencies make the mistakes that, you know, if you have a car, you have open availability and you know, you have the credentials and you’re automatically hired.

Dawn Blackman (18:12):

Like they’re telling them on the phone, but to bring in, bring your ID, bring your social security card, bring this, bring your certificate. Even before they even meet, you know, or even have a full conversation. So the person already believes that they have the job before they even get there. So they know that they can get this job at this agency anytime they want. Right. So they have no real motivation to Excel in that role if they even follow through hiring process, because anyone knows if they’re going to get the job regardless. Whereas me, you know, I ask reading questions upfront before I even give them an interview. And then I never ever tell them to bring in their IDs or their socials or anything like that. I’ve even had staff ask or, you know, potential applicants as, what do I need to bring in because they’re so used to being pulled up front, you know, basically that they have got before, even an interview and I’ll tell them nothing, just bring yourself and your questions and we’ll sit and we’ll talk and we’ll get to know we’ve other to find out if this is going to be a good fit.

Dawn Blackman (19:08):

And my interviews take about an hour or longer, I take as much time as I need to in that interview to get to know that person and peel that onion down to the core and vice versa.

Miriam Allred (19:19):

I’ll ask a follow-up question to that. A lot of agencies are so desperate to hire right now, and they may be jeopardizing or sacrificing the quality to meet the quantity demands. It sounds like you’re not too flexible on leeway of who you hire you, you have in mind, correct. And what you need. And you’re not really willing to budge on that, but, but maybe speak to that. You know, how flexible are you, what are you willing to work with? What are you not willing to work with and how do you make some of those judgment calls early on?

Dawn Blackman (19:51):

Right. So I’m not willing to supply on them having a car. Just in my experience, like I said, it snows here when it snows, they don’t want to go sit at a bus stop and a blizzard. They don’t want to get wet when it rains. Other people that rely on Uber or rides, well, Uber’s not running today or my ride can’t take me. So we’re just going to, again, use that preventative measure at, at strategy. And we’re going to prevent that problem before it even comes up. And we’re, you just have to have a vehicle I’m not willing to budge on that. And I’ve never had an issue with it, to be honest. Everybody that works here has a vehicle and it works. Another thing that I’m not willing to budge on is that they have to have open availability. They have to have open availability between the hours of 8:00 AM and 6:00 PM, which is another strategy of mine.

Dawn Blackman (20:41):

I told you I have a little hot Miriam. So I, you wanted me to narrow it to three it’s it’s so hard to do, but another strategy is that I don’t, my staff don’t work in the evenings and they don’t work on weekends. So neither do I, right? Because, you know, as an agency owner, that if you work, if your staff works in the evening, so to you, your phone is on, you know, for potential Colloff in the evenings, weekends, whatever, when your staff are working. So are you, and if you’re really not in front of a computer, your brain is working, your anxiety is going, just waiting on someone to call you to call off or, or whatever, or the clients call you to say, so-and-so, didn’t show up. So I, I never do evenings. I never do weekends. I always, I never take a total out of clients.

Dawn Blackman (21:28):

I do have two out of the clients that I have. And I have a lot of clients well, not, not allowed depending on what you think is a lot. So right now I have 40 clients. So out of the 40, I only have two that are at our bedbound total care clients, but that’s because the gear givers actually Acme and beg me and beg me to have them because they come with the most hours, whereas they don’t have to do multiple clients to get the number of hours. They want me to just go to one. So yeah, I do not budge on weekends or evenings when I get the referrals from the caseworkers or the case managers, if they tell me that this person for instance, gets a split shift, three hours in the morning, three hours in the evening and ends in the morning, I will tell them I can staff this client in two days with reliable care, yada, yada, yada.

Dawn Blackman (22:19):

If you adjust their hours to be from 10:00 AM to 3:00 PM, Monday through Friday, for instance, something like at or 10 to four mornings, you’re fighting, I’ve never had any issues with that. It’s just the confidence that you exude in your emails and in your phone calls. And they work with me because my staff shows up again. You want to bear, you want to keep in mind that you always want to go into anything you do in this industry. Any decision you make, any move you make having staff retention in mind because it pays off in the end. And again, we want to always solve problems before they’re problems. We want to use preventative measures. You mentioned

Miriam Allred (22:56):

Referrals, you know, talk to me about your community presence. Like you said before, they’re in Cleveland, there are 20 other agencies, right? They’re competing book of business. So, so just talk to me a little bit about, you know, any specific strategies to stand out in the community. And also, how have you worked with referral partners and what are you doing to kind of stand out from those competitors that are competing for those same referrals?

Dawn Blackman (23:22):

So my response time with the social workers is immediately, as soon as I get that email or the, obviously the phone call I’m answering it, or as soon as I get the email, I am responding whether or not I’m responding to ASL, I can take it or no, I can’t is a different story, but they are hearing from me immediately in response to that referral. I want to first, as an agency owner, acknowledge that they sent it to me, that they actually took the time out to think of home care. One, for instance, as a potential servicing agency for their member, when there are so many other agencies that they could have reached out to in, in a lot of cases, they’ve reached out to many at once, and I’m just the one that responded first. I’m the one that’s being interacted with them.

Dawn Blackman (24:10):

Also. with that I home care one, I think stands out with the referral sources and in the community because we are actually reliable. And I know it sounds redundant, but my staff, they, they show up to work, which is sort of unheard of, you know, it’s like every other day is hit or miss with agencies and whether or not their staff are reliable. My staff, they actually show up and I don’t mean that, but they show up in uniform, they show up with out scars or, or things like that on their heads, their improper attire. They’re not on their phones. They’re actually doing that. I even have some of my staff that will, that will contact me and say, Hey I was done with my shift an hour ago and I just wanted to let you know that I’m, I’m just sitting here with her and we’re just talking and I’m like, great, cool, perfect. You know, and, and so that’s really sort of unheard of at least in greater Cleveland where they’re just fighting, trying to get people to, to, to remain and, and show up for their shifts. So we stand out in the, in the fact that we are very reliable. And so the case workers will look to the home care one as one of the first, if not the first agency that they reached out to locally for staffing, one of their members. One follow

Miriam Allred (25:29):

Up question to that. This might be kind of a dumb question, but obviously it’s your word, you know, to them saying these specific things, is there any way that you can almost prove that, you know, you’re a new agency and they may think, you know, home care one is new. We don’t necessarily know them yet. And she’s just telling us all these things, but I don’t know. Is there any way that you can prove that, you know, as a new agency to someone early on, or how are you doing that other than your word? Just, just curious.

Dawn Blackman (25:59):

Well, well they know they believe me, the caseworkers because like I said, we are never certified. So we have to be Evie compliant, which EBV is an electronic visit verification system where they, the staff have to clock in and out. And the way that they do that here at home, Caroline is they can only do it utilizing the client’s phone to clock in and out. So, you know, Medicaid uses GPS tracking and monitoring systems to see that the staff actually there at the times, that, that we bill and submit claims for. So the caseworkers are held accountable with Medicaid. For any visits that have been missed in the system, for instance, they have to answer as to why, or provide an explanation to their superiors, who then provide an explanation to Medicaid as to why a visit was missed and not clocked in or out for a particular Medicaid member, for instance, where they know they see in the system that, that home care one, their staff and they clock out they’re there.

Dawn Blackman (27:05):

Also they do their own site visits with clients. So the caseworkers have to go out and they have to actually visit the client’s homes. I think once every 60 days as we do that too, but they also have to do it to follow up, to see how their level of care is going, things like that. How has his staff showing up for your service, things of that sort. And so they actually fill out a report and the client speaks for themselves will. Yes, so-and-so does show up every day, she’s here. So they actually hear it from the horse’s mouth. It’s not just me telling them and they can actually see it as verification, appreciate

Miriam Allred (27:41):

The clarification there. And it goes back to what you said earlier about confidence being a hundred percent confident in your staff, so that when those visits come up for them to tag along, you know, you aren’t anxious or waiting to hear how it goes, but you are confident that they’re going to deliver. And then that referral source is going to keep coming back. They’ve seen it and they believe it because they’ve seen it firsthand. And so, you know, just doing everything that you can to be confident in your staff so that everything does go right, and they deliver on what you promise.

Dawn Blackman (28:09):

Sure, absolutely. Yes, I do come back again, agency owners out there that have a healthy referral source, but maybe they’re not getting to you first, second, or maybe even third to send the referrals too, because you’re having staffing issues or you’re inconsistent, just make sure that you’re doing something to stand out in your agency. The well-check meetings, they do work when you, when you show your staff that you care about them. Sometimes it goes a longer way than even money or hourly pet. They just want to know that they’re nice and that they’re appreciated. And then this becomes a domino effect. It trickles down. And so when they feel appreciated, when they are you know, treated with respect and a certain standard, they will give that back tenfold and it shows in their work and they will be reliable. It won’t show up for you. So it all is like definitely a trickle down effect. It’s like part of the oil machine is helping to make the other one work more effectively.

Miriam Allred (29:13):

It starts with that valuable gem and how you take care of that gem. The time is just flying here, Don. I can’t even believe you shared so many great insights and strategies. You know, just here in closing, we’ve talked about so many different things, but just maybe one more piece of advice that you have for, for agency owners that are stressed, that are struggling and don’t know if they could make it out. What words of advice or hope would you offer up?

Dawn Blackman (29:38):

Well again, like I said, you always want to maintain healthy stress levels. That pause first and foremost, quick example is a lot of a lot of agency owners will get referrals from referral sources and they’ll get maybe a 24 hour a day, 70 a week client. And so all they hear is coaching, you know, and they will say yes to the referral source before they even think as to whether or not they have adequate staffing for instance. And so they’ll just say, yes, I don’t recommend that. I recommend that you make sure you always have staffing and check with your staff before you take, say yes to that referral and commit to it, to always get the commitment from the staff first, before you commit to that client from the referral source. So press me distrust the process, make informed decisions,

Miriam Allred (30:28):

The process, and make informed decisions. I love that Don. We’re so excited to follow your journey over the next few months and years, you’re already off to such incredible success and we can’t wait to see what more you accomplish. So thanks for sharing all of this good insight. It’s been a pleasure. And we’ll talk again soon.

Dawn Blackman (30:46):

Thank you, Miriam. It’s been a pleasure and I hope to talk to you soon.

Miriam Allred (30:51):

Thanks for listening to this episode of Vision with Dawn Blackman. In case you didn’t hear, we recently released the 2021 Home Care Benchmarking Study. If you’re looking for a roadmap to take your agency to new heights with over 175 industry benchmarks and trends, all in one Study, head over to benchmarking.home carepulse.com to purchase your copy today. Thanks again and we’ll see you next time!