Imagine navigating the complex world of caregiver services with ease, confidently answering client questions and having effective strategies at your fingertips. That's what we're unpacking in this richly insightful discussion. We delve into the nuances of 'meet and greet' requests, setting caregiver rates, and managing the intricacies of providing 24-hour home care. With valuable insights, we help you manage realistic client expectations, especially when multiple caregivers are involved in a case.
Ever wondered how to balance pricing in home care services and Medicare coverage? We've got you covered. Offering a clear roadmap, we explore ways to navigate complex situations when clients require advanced care. From conducting supervisory visits to providing discounts for long-term care, we share essential strategies for success. We also reveal how to spot-check caregivers and clients, secure permissions for unannounced visits, and set suitable rates for caregivers.
Finally, we guide you through effective home care marketing strategies and highlight the importance of quality assurance. We share tips on how to break into hospital networks, research Medicare and Medicaid percentages, and effectively compensate marketers. Wrapping up, we share practical planning tips for December and January, underscoring the necessity of being organized and having resources ready for the next meeting. Listen in, and equip yourself with the knowledge to navigate the caregiver service industry with confidence and expertise.
Imagine navigating the complex world of caregiver services with ease, confidently answering client questions and having effective strategies at your fingertips. That's what we're unpacking in this richly insightful discussion. We delve into the nuances of 'meet and greet' requests, setting caregiver rates, and managing the intricacies of providing 24-hour home care. With valuable insights, we help you manage realistic client expectations, especially when multiple caregivers are involved in a case.
Ever wondered how to balance pricing in home care services and Medicare coverage? We've got you covered. Offering a clear roadmap, we explore ways to navigate complex situations when clients require advanced care. From conducting supervisory visits to providing discounts for long-term care, we share essential strategies for success. We also reveal how to spot-check caregivers and clients, secure permissions for unannounced visits, and set suitable rates for caregivers.
Finally, we guide you through effective home care marketing strategies and highlight the importance of quality assurance. We share tips on how to break into hospital networks, research Medicare and Medicaid percentages, and effectively compensate marketers. Wrapping up, we share practical planning tips for December and January, underscoring the necessity of being organized and having resources ready for the next meeting. Listen in, and equip yourself with the knowledge to navigate the caregiver service industry with confidence and expertise.
So we are right, we're on time, let's go.
Speaker 2:Yeah, All right, Valerie you're up, all right rules of the road. If you're new here, we want you to share your successes. I would ask also that you mute your line. Mute yourself. Meet your line when you're not sharing so we don't listen to your background noise. Ask for help, tips and advice, please.
Speaker 2:We have the chat feature, which is I think somebody's already put something in chat and said hello, please use that and contribute to the conversation. We want to hear from you for sure. And then any card or scene and yeah, and then log into the private portal. I didn't get encouraged you to do this because every mastermind we've ever done not all of them from 2022, but a majority of them and everything we've done from this year is all inside that private portal. So if you're new here, you can come to our website. We have the email address. We have the healthcare marketing mastermindcom. Use your email address that we've been sending your reminders to and then whatever, if you don't know your password, just use the forgot my password feature that doesn't work, reach out to us at support, we'll help you.
Speaker 1:So question time. And it was such a big hit. Everybody loved it so much because I think that we have lots of questions and you know we're here and we're doing our thing every time, but maybe your question has nothing to do with what we're talking about, and so you have this question. That's been. You know you wanted an answer to, but it didn't make sense to ask it during mastermind, so we wanted to give you another opportunity and we didn't get to all the questions last time either. It's another reason we wanted to do this again. So we do want to take your questions live as well. So we're going to go through a couple of slides and then and Lisa help me remember to we will ask us anybody have any of their own questions, because you should get to ask them live to because you're here. So We'll go ahead and we'll get started and Lisa and I in Valerie to jump in. I'm sure she has the answers to these two. We will do our best to answer them as best as we can, and maybe both you know all of us chime in on some questions as well, because none of us know everything. Yeah, don't be shy. Don't be shy, so can meet this. So this is somebody who's getting asked these questions and they want to know how to respond, how to maybe not answer completely. So can we meet and interview the caregiver before they come to my house?
Speaker 1:And I used to hate that question because you go through the motions, right, if I'm the caregiver, and it's beautiful and they love her, and then she disappears. It doesn't happen all the time, but it can happen. So some of the things I can say about this is if they really want to do this, there's not going to be a lot you can do to say no, because there are other companies doing it. And if you're going to say no, there's there's a chance they're not going to go with you, so you have to do what you can to make this work. It's not I called it like a meet and greet and just to have to give them the caveat that and it depends on their hours and their days, right, if they're seven days a week, yeah, they're going to meet one of them, but this is not going to be the only caregiver, because a caregiver is not going to work seven days a week, so that. That's the first turtle. What are the hours?
Speaker 1:If it is hours that, if it's Monday, wednesday, friday, for a few hours and it could be the same caregiver, fine, so let them know. Yes, we can do this. You want to meet with them at the same. You want this caregiver to have the meet and greet at the same time as the shift, because we want this caregiver to be available at that time.
Speaker 1:What used to drive me crazy. They're like oh well, let's meet at 10 o'clock on a Tuesday, but services are on Monday, wednesday, friday at two o'clock. The caregiver is probably not going to be available 10 o'clock on Tuesday for the meet and greet, so the meet and greet needs to be at the same time. The shift would be that that's a big and it took me a bit to figure that out, but that that'll help you guys, save you some time. So I always preface with them. Our goal is for you to have the same caregiver, but that's not always the best case situation. We also like to introduce maybe one of our lead caregivers into the mix and maybe one other caregiver, so that there is a backup plan.
Speaker 1:We're always going to cover the shift with somebody, but wouldn't it be nice if you knew the somebody? And so, yes, you're going to do the meet and greet, you're going to meet this caregiver. She may not do all the days and she may, you know, she may be your one and only, but we would like to also introduce some other caregivers at some point so that you have someone that you know coming in as a backup plan. Lisa, you have anything to add? I mean, that's kind of how I handled. I hated the meet and greets, but yeah.
Speaker 3:I'm going to go ahead and say that those because, like you said, the caregiver wants to work now they're available right now they're not going to be available in a week when you make a decision on the caregiver, so you need to act quick on that and I would let the client know to. Another thing you have to be really careful is that you have to pay the caregiver for their time, and so the client needs to understand that too, and I did that. It was usually a higher end client who you know insisted on meeting first and making sure that there was a, you know, a spark or something that they connected. But I mean a lot of the times I had that failed, I would not make this common practice.
Speaker 1:I know home care companies that always do meet and greet. I would not make it a common because it doesn't usually work that well. I would say maybe 50% of the time. And Lisa, to Lisa's point, I did high end clients. I think that's where spending the time is kind of worth it, because they're big billing. But someone who's going to be like four hours once a week or something, I don't know, that I'd even. I don't know.
Speaker 1:You have to decide for yourself if you want to do that or not, but yeah, the caregiver should get on. And then the other piece of this is someone who wants to do a meet and greet. They're really wanting this deep, wonderful relationship with this person. They need to understand, and you need to set their expectations, that that's great and wonderful, but there's probably going to be more than one caregiver and they're going to have this person. It's one and done. It's going to go on for 10 years and it's always going to be the same person. So you do need to set their expectations that they're asking about this. Their expectation is probably that this is their one and only and that's not probably going to be the case.
Speaker 3:So that part the expectation setting is huge. Yes, we're the expert, not them. Let them give you a little bit, but you need to lead kind of lead that person into yeah, we don't need to meet, why do you want to meet them? They're not going to be available and I would always tell people I would definitely discourage that.
Speaker 1:Yeah, yeah. And and it's great and it helps to, and I would say, you know, the meet and greet is nice because if this is somebody you like.
Speaker 1:It gives us an idea of what kind of care you're looking for to. So if they insist on it, you're going to probably have to do it, but I would definitely not make this a part of my everyday business. I don't know how the companies that do that how, how they do it. I don't know how that works. Okay, how soon can services start? So we always started services within 48 hours and not everybody can do that and that's okay. I would say be honest with how soon you can do it. I promise don't say you can and then you can't. So you kind of to think about you know what is your caregiver pool look like? Do you have on call caregivers or lead caregivers that do your new starts for you? And that's a great way to get away from this. Meet and greet to is that we start our jobs with our lead caregivers because they're very best and we can't have her know she won't be your permanent, because everybody wants her to be their permanent caregiver you're gonna fall in love with her.
Speaker 2:I always would tell them you're in fall love with her. Everybody does.
Speaker 1:But we like, we like you to get off on a good start. We want them to run through your whole service with you the whole day so they can train, they can help to train those next one and get the the anybody details of what it is that you're needing, so that that's a good way to get out of that meet and greet to please say anything to add to that one.
Speaker 3:You know I think I would give. I gave about the same timeframe between 24 and 48 hours. However, there's always an exception to the rule because there is no cookie cutter and home care. So you know I've had where you know I had enough information in front of me from the intake and did the assessment actually right then and there and had a caregiver with me to be able to start in that caregiver. So, based on what I already knew about the client you know had definitely could have went to any client whatsoever, was very skilled and so starting, starting right then and there has happened to. But again, the expectation needs to be set and just be honest and truthful.
Speaker 1:Yeah, and you can do soon quicker starts in certain areas. Right, I mean here, mesa, arizona. We could do a quick start because start that night in Mesa, scottsdale, not so much that that took some time and the the that's for two reasons caregivers don't generally live in Scottsdale because they can't afford to. It's a longer drive for them so it's hard to find people, and people in Scottsdale can tend to be a little pickier about their caregiver.
Speaker 1:So that one might take a little bit longer or we put a lead on it. So it really just depends. I would say if you want to grow your business, you do need to be able to start quickly. If you're going to be trying to get clients out of SNF skill nursing facilities because they're discharging and they need help now and they a little bit of time to discharge a day or two before they were supposed to, and so you got to be ready for that. So if those kind of jobs they're bigger jobs usually that you want you're going to have to figure out a way to be able to start sooner, and that lead caregiver is a great way to do that.
Speaker 3:And we'll just a lot of times you have the information from the phone call and so you can actually start kind of putting your feelers out for a caregiver right then. And there I always did that Because I didn't want to be just like not knowing how do I move forward with this person.
Speaker 1:So that's a, that's a good point If you're on if this, if you've gotten a referral from a case manager or a social worker at a skill nursing facility and she's like I'm in trouble, like you're her, go to, I'm in trouble. The doctor told me it'd be Friday. It's tonight, please help me. You know, then you get to be the savior and you need to be that person for them. So then you get as much as you can, like Lisa said, as much detail as you can. So, and then, before you head over there, you tell your scheduling team this is what I know so far. It's what I know.
Speaker 3:I started. I even gone myself. Yes.
Speaker 1:Yeah, true, yeah. So multiple providers. Again, I tell them we start with the lead we want you to have. I mean, we don't want it to be a, you know, a spinning door of hundreds of people coming in to provide care, but we also don't want you to have just one person, because we want you to be comfortable with more than one person. People get sick, people have, you know, emergencies. Your caregiver you know they're gonna, they're gonna be sick, they're gonna call out it's, they're gonna have a flat tire, it's gonna happen. And so you know, we want you to be comfortable with more than just one caregiver. So that's, that's how I kind of address that issue.
Speaker 1:It was tough during COVID. People didn't want a lot of people coming in and out of their house probably still a bit of a problem, but they can wear masks and take precautions. Do you have caregivers available? So I always said yes, and we, we did generally, it's true, because we had lead caregivers and they were always available. It is hard to say that when you're just not sure and you're the person that it has to find the person. But yeah, I have, if you, if you him.
Speaker 3:And however, this question you're not going to get the referrals or the it's not going to feel confident. Yes, you are a staffing agency. That's the staffing agency, that is your job, you have.
Speaker 1:And when they say do you have caregivers available? You don't say well, where are you? You say yes.
Speaker 2:Yes.
Speaker 1:I do. But then when you're talking to them, if they say, you know, I'm in some remote you know, you know typically then.
Speaker 1:Then you can tell them oh, your area is going to be a little more challenging, but we do have people there. So I wouldn't start with the where though, because you want you don't want to place doubt in their mind about your services, and if you have caregivers available, do you have CNA? So some of you may. I think it depends on states too. Our lead caregivers were CNAs. We were a non-medical company. Cnas are not allowed then to practice any medical types of things when you're a non-medical company. But having CNAs on staff was nice. Because of their skill set. They seem to be a little bit more reliable, a little bit more professional. We could kind of put them anywhere and they would do well. So, yes, we did have CNAs. We didn't charge more for the CNAs, though, and so that can be hard. You know we. I guess I can take that back. If it was somebody who was going to be very particular and they were very high need, then of course you're going to charge more.
Speaker 1:And that's where we would put our CNAs. So high need being hands-on, high need and also high need being just fussy and demanding. Number four with sweet and spicy wings.
Speaker 3:Traditional, I want some.
Speaker 1:I think we got to mute some people.
Speaker 3:I'm a vegetarian.
Speaker 1:I know you and even so, with the CNA questions. So, as always, when you're working with a client and you're this is why we have to do the assessment you get there and you find out they're going to be really fussy, right, or they're very high, need very hands-on, you're going to, you need to charge them more than you would charge somebody else. You need to have that. That's why we give price ranges and not a straight, flat hourly rate, because you need to have that wiggle room when you sit in front of them, because I mean, someone could be lovely and just want someone to go to lunch with them and go do things with them, but they're also really fussy and they're going to expect that caregiver to take care of every little thing, so you need to charge more, so you can pay the caregiver more, and I would typically put CNAs on those jobs.
Speaker 1:Lisa, I can.
Speaker 3:So we just have a question here, because I can't raise my finger. Sharon, how much more would you charge, sorry, how much more would you charge for a CNA?
Speaker 1:So for me, I didn't charge more because they were seeing I would charge the client more because they required more. So my CNA lead caregivers they got paid more. They got paid like two or three dollars more an hour than my caregivers, but they were lead caregivers and they were available when we needed them and they would just have to run and go do whatever we needed them to do. A high need client, though, either physically or demanding. If I was charging $30 an hour, I might go up to 33. You know, I might go up a couple dollars more an hour so I can give my caregiver more. You have to think about, you know, if you're paying the caregiver 17, maybe I don't know, and now this client's going to be very fussy and very hands on and all of that, I might want to pay that caregiver 18, 19. And so I would do that and double it, you know. So, just, you just have to. You know, if I were the caregiver and I was in this home, what would it take.
Speaker 1:What would it take for me to be able to do this and stay and stick, because you want to, you want to stick. So, lisa, do you have anything to add?
Speaker 3:to that. Well, it's getting more. It's kind of getting a little more money if I add to it. But just a thing that I trick sorry, a trick that I learned is that sometimes in some regions of the country like things like the VA pay out a lot more and those type of things you can actually take that money and kind of balance everything out so that you don't have to change More rates and pay Sorry, my dumb dog, but yeah, so that's like a little more back in the weeds, but I always use that as a buffer as well. If I get one of them priced you know, priced up or have to worry about.
Speaker 1:You can average it out over several. I see what you're saying. Yeah, that's a good way to do it too. What is the cost of your services? So again, arrange. I would give them. You know, arrange like three, $4 range from this amount to this amount, so, you know, maybe 30 to 33 an hour, something like that, so that you have wiggle room when you are sitting in front of them, Cause you might get there and they might have 15 cats. I mean, you don't know, I love cats, I'm a cat. I would be great with 15 cats, but caregivers not so much. You have to get there, see that house and be ready to charge them the higher because of it.
Speaker 1:Do you provide 24 hour home care? I mean, I guess that just depends if you do or you don't. There's live in care and there's 24 hour home care. Live in care is a flat rate, usually 24 hour home care. We, you know, we charge hourly, around the clock, and the caregivers are awake, they don't sleep at night. So you know, we always, everywhere I've ever worked, we always provided 24 hour home care.
Speaker 1:I think it's good business. I think those overnights you get some caregivers. They want to work overnight, that's all they want to do and they tend to be steady. The overnight caregivers for me seem to be you know we could rely on them. I felt I don't know if Lisa will agree but I felt like they showed up more than your daytime people. I don't know why that is, but, yes, if you provide 24 hour home care, great.
Speaker 1:I do think that the SNFs like that. I think if they're going to refer to you, they're going to want for you to provide 24 hour home care, because a lot of their patients discharging need that. So I think that's the question. I think that that's the point of the question. Should you provide it? And if you do, then, yeah, explain how it works though, so they understand. Live in care, you have to be a little careful, just because of the labor laws I think here in Arizona it's something like they have to have their own room with the door that closes. They have to get at least five and in locks. Yes, they have to get at least five or six hours of straight sleep a night. They can't be interrupted, and if they do get interrupted, then that whole shift goes to hourly and they have to understand that.
Speaker 3:Yeah, yeah, that's exactly. And then, too, you have to look at. You know, are you doing 12s or are you doing three eighths, are you? How are you going to divide this?
Speaker 1:Yeah, that's a good point. Yeah, I have seen I always did 12s but yeah, three eighths three eighths was more.
Speaker 3:Sometimes the client doesn't want to pay that OT on the 12s and they're looking at you know.
Speaker 1:Three eighths is a great way to split that up. Sometimes the client doesn't like that because it's another person, another body, some caregivers or some kind of.
Speaker 1:This is what I tell them when I need them. You know, if I know they're not going to do the overtime and I don't want to pay the overtime I mean, we did on some cases, but I don't want to pay the overtime I'm going to try to convince them to do eights, like Lisa said. And if I'm going to convince them to do eights, I'm going to talk about the fact these people are with you for 12 hours. I get sick of my husband 12 straight hours.
Speaker 2:I get sick of him all the time.
Speaker 1:So having three people yeah, it's another person, but then it's only eight hours of you know of this person here so that might be a way to kind of gear them or get them to move over to the three eighths, because that's a good idea and it does help with the overtime.
Speaker 3:Great point, lisa, and also after I mentioned that, Jida mentioned it too, so we were on the same page, Jida.
Speaker 1:Yes, I see that that's great. Yep, the three eighths is a great idea. Did I get them all? I did. Okay, how do we avoid the fees question? So that's a tough one, and some people are just going to well, if you're not going to tell me your price, you know that's where they get with you on the phone. They just want to know and they're shopping around, and so you can't always avoid that question. But you can give them a range and you can tell them it's based on the services needed, and so I have to come to the home to see exactly what's going to be needed to be able to give you the exact rate.
Speaker 1:But our prices range from this to this, and so sometimes I mean at my first, the company that I worked with in the beginning we gave them a discounted rate if they did a 12 or a 24. And then their hourly was more per hour. Where I worked last, everybody paid the same, except if it was going to be challenging. We had the leeway the marketer was allowed to. You know we couldn't go under a certain amount, but we were allowed to go up, and so if you do give a discounted rate for 24s or 12s, include that in your range. So say you're doing $30 an hour for 12s, 24s and 32 for hourly your range, and 32, 33 for hourly you would do. 30 to 33 would be your range. Even though that low one is for a discounted 24, it's still a party of pricing structure, so I would include that. Lisa, do you have?
Speaker 3:anything. Yeah, the fees question, I would just give a range Because I mean, how many times have I had when I, you know, and we've all made the mistake of saying, okay, it's this, and then get there and oh yeah, I just need you to give my mom some food and maybe do this and this, and then you get there and she's like 25% weight bearing and you're actually having to help her move from her, you know, stand up recliner to her wheelchair and things like that, and that you know, not everyone is comfortable with doing that.
Speaker 3:And that now might require a CNA which, right exactly, I had a companion caregiver in mind. So now I have to rethink this whole thing, and you know. So, yeah, it's definitely better to give a range and then say, you know, let's look at it, let's talk about it.
Speaker 1:It looks like we have a question from. Let me see we've got a couple of questions. Do you build the clients for the nurse visits every 92 days? So is it. It must be private pay nursing. I mean Medicare, I know, pays for some of those visits. You know you're having to pay the nurse. I mean, in the private pay arena I have not done private pay nursing but I would say you're having to pay the nurse. So yeah, I probably would build for those visits. I mean you could always call around your competitors secret shop and find out if they're charging for that. You know, if the nurse is gonna come see my mom every 92 days, what is their cost involved?
Speaker 2:That's how.
Speaker 1:I, if I was unsure, I would just secret shop star six, seven, block your number and secret shop. You should be secret shopping them for how they pay their caregivers and how they charge their clients every quarter, anyway.
Speaker 3:So so on the private pay side non-medical private pay side we would, I mean, a supervisory visit was always a good thing to do and we kind of I think Rebecca and I talked about this the other day how to kind of try to, you know, do pop-ins basically, and so a 90 day visit and some state agencies require a 90 day, like on that day, like here in Arizona there's an ACOG and you have to have that visit on the 90th day or they'll accept 88, 89. So if you have 20 clients that need that all in the same timeframe, that's a beast to tackle. But you know, we just it was just part of the service. You know, making sure that caregivers, everything looks good, you know you're going over, you know you're making items make it more about the caregiver too, not the client, because how else am I going to supervise the caregiver and the client like that better than checking on them versus, you know, checking on the caregiver? So that was just a part of our process.
Speaker 1:Yeah, and it looks like another. Another person here said that they do charge the clients for the nurse visits and they are asking about private pay. And then I have someone asking what type of discounts? So what type of discounts did we offer when I worked before? If someone did a 12 or a 24, we would give them like a dollar off per hour if they did a 12 or 24. And then you're kind of working the math for them. So at eight hours, this is your total per day and this is your total per day because they're gonna save a dollar per hour for those discounts. It worked great for us. But the second company I worked for did not wanna do that and so we did it. So you know, you've gotta work your own numbers and decide if it makes sense or not.
Speaker 3:Well then, what about couples care? Has anyone ever had couples care where you have the husband and wife one caregiver, because there's really not a lot of hands-on care needed, but you do have to pay the caregiver more? And I think we upped it like by, I wanna say like $7 or something like that.
Speaker 1:Now we did three to six per hour for the couple, depending on. You have to picture yourself being there right, like is the husband in the shower, and the wife has to go to the bathroom.
Speaker 2:Are you?
Speaker 1:running back and forth. Is it crazy, or is it more? One just has Alzheimer's and just needs you, just need to kind of keep an eye, and the other one, who usually takes care of the one with Alzheimer's, is now hurt and needs help. That probably, unless the Alzheimer's one is wandering. And then it's gonna be a lot more but you kind of have to just think about what does this look like for the caregiver?
Speaker 1:What is there gonna be. So we charge three to $6 more an hour for couple care, always put yourself in their shoes.
Speaker 3:Could you do it?
Speaker 1:I'm going to take and the lady with the 15 cats right, you walk in if it doesn't smell bad, which it may, or may not and the caregiver doesn't have to feed them or do the cat box.
Speaker 1:But you need to ask those questions. So is the caregiver responsible for these cats? Are you needing help and Medicaid or Medicaid? You can't do cat boxes or do any of that. Private pay. You can, and that's another thing caregivers don't understand, but when I worked with this client, I didn't do the cat box. Why are they asking me to here? It's different between Medicaid and private pay.
Speaker 1:But either way you need to ask those questions. The caregiver is not doing cat box Nope. Okay, it doesn't smell bad in here. Maybe it'll be okay. Or maybe you need to charge $2 or $3 more an hour because of the cats.
Speaker 1:Or maybe you don't take it at all if you can't find someone who will do that. Usually, though, there's somebody that will, but I would go to 15 cats, I wouldn't have a problem if it didn't smell. Let's see. Does Medicare cover for home care service or do they just cover home health? As far as I know, home health I think that they're working on getting to. That is the whole movement right now is that they were trying to get Medicare to cover non-medical, as far as I know, no job, yet they only do home health services. Oh, Valerie knows, yay.
Speaker 2:Yay, okay. So right now, medicare, some Medicare Advantage plans. So if they have Medicare plus a Medicare Advantage plan like a Medicare HMO, those Advantage plans will pay for private care. But it's very limited. So, just like home health care is very limited. They may pay for six to eight weeks of private duty in home care for baths and companion care and stuff like that, and the determination is carrier by carrier. So you need to contract directly with the carrier. So, in other words, if United Health Care is the HMO in your area the big one, you wanna talk to United Health Care and find out if you can get contracted with them to provide private duty care services. If it's Aetna, if it's, you know, whatever Medicare HMOs are the biggest deal in your area. You wanna first of all check to see if they offer like just go to like any consumer, go to their website and see if they offer any private duty or non-medical home care services for a limited time. If they offer that benefit and if they do, then you want to try and figure out how to get contracted with them.
Speaker 2:It is going to be still few and far between. This is not gonna be a long-term case. Typically it might end up being a long-term case. There's always that possibility, right. But usually these are short-term, post-stop, post-hipp replacement post, maybe something about cancer, maybe it's not gonna be an Alzheimer's disease thing, it's not gonna be, you know. So it's usually post-hospitalization care or illness of some kind, and it's very limited in its nature.
Speaker 1:So Okay that's great good to know, we have someone answering the RN visits and we build a clients for the RN visit. That is required by law. We tell them at the assessment. However, we do additional quality check visits by our quality assurance manager, who is not an RN. Okay, so, all right, moving on. How and I love these questions Keep asking. This is the time to do it. You're here, live. You get to ask the questions too. How long do? How long to do? Why can't I think how long to do? Visit one location? How long do?
Speaker 1:you visit one location during the one you're here, okay, so if you're out, marketing it looks like.
Speaker 2:So if you're out, they'll keep you yeah, as many times as I'll let you come.
Speaker 1:You should go every eight to 10 days to see everyone. You get a face-to-face maybe once a month. In between you're dropping off, leave behinds. So I would go every eight to 10 days. So I don't know how many people can still do them out, how many times. That is a year. But, lisa, looks like you have a something. I just wanted.
Speaker 3:Yeah, I just want to add to that Make sure that you give yourself some buffer time before you have anything else to do, Because I've had so many times where I got to that place and someone actually wanted to talk to me and took me into their office and we sat down and never want to be in a rush, Cause this is like this is go time for you. This is what you've been doing this for is to get in front of this person and get them to see you for who you are and ask you back to, maybe for an in-service or something. So always be, have that buffer time. You never know what you're going to get and if you're not available right then and there and you're like, oh yeah, well, I got to be somewhere. So just make sure that you have that time if they ever want to talk to me. That's a really really good point.
Speaker 1:If you think you're going to pop in and out quickly, that'll be the time they go. Oh, I'm so glad you showed up.
Speaker 1:I'm so glad you're here right now I have someone down the hall, can you go see them? And you've got something in 15 minutes. It's the worst feeling to be. It's the worst corner to be in, because you are cornered Like you got to get here, but this is finally opened up for you at least. That's a great point. It's a great point. Yes, give yourself time, cause that will be when you think you're popping in quickly. That'll be the time they grab you and you better be ready for an assessment, whatever you're going to need to sign that client up. Better be in your car. Yep, let me pop out to my car real quick and then, if you do have enough time, you're hoping to God you can reach that person and move it back because you've got such a tight window. Don't do that to yourself. That's a good point.
Speaker 1:Should you visit during the holidays? Absolutely, yes, yes, yes. This is when everybody else stops, and in here, where I live in the summer, where Lisa and I are, they also stop in the summer because snowbirds aren't here. The seniors leave all summer and they think, oh, there's no business to be had. This is when. This is when you sneak under the radar during the holidays because nobody else wants to do it, or is doing it, or they feel like they're not gonna make any connections. And summer, and guess what, they're not as busy, so they have time to see you. So, yes, absolutely go during the holidays. And if you're, if it's snowing in your back east somewhere, go during the winter. Maybe it's, maybe it's the opposite. There Everybody has left to come to Arizona and so you're thinking, you know, there's no reason to be marketing so much. I actually increased my marketing in the summer and we had a big level one year in the summer because we were like nope, nope, no one else is doing it, we're gonna get everything that's out there and it works.
Speaker 1:So, yes, you should definitely do visiting during the holidays.
Speaker 3:Also just a touch on that too the weekends, don't forget. There's still people working on the weekends and clients need care just as much or more on the weekends, so you should definitely have someone dedicated to the weekends. I did that was my one. Of my jobs at one time was Friday, saturday, sunday, monday, and I killed it.
Speaker 1:You did. I got the ERs on the weekends. There's no social worker on staff in the ER on the weekend. You're lucky to find one, maybe even in the hospital on the weekend. They don't know what to do with this person who ended up in the ER and now has to go home. They fell and now they're gonna just send them home. They don't know what to do. If you've been there with the bucket of donuts and your cards and Guess who they're gonna call, and nobody stops you from going into the hospital on the weekends either I don't know about the floors but the.
Speaker 1:ER no one has ever you can't be here.
Speaker 3:You know, ever, ever, ever so also make sure that you're not setting yourself up for something you don't want to actually build on to, because once you become that weekend person, you're, you're that weekend person. So, yeah, that's about this yesterday dawn. Don't set yourself up for stuff you don't want to be known as, unless you really want to be known as that.
Speaker 1:That's true too. And the ER I started making I only would do, I only did one. I wasn't the weekend person, but I would. I had my own territory and I wanted my territory to grow, and the Owner of the home care company, you know, treat this like your own pocket of business. And so I thought, well, I want this pocket to get bigger. So, right, the hospital in that pocket and I would go faithfully every weekend to that ER and bring them donuts. And they started introducing me to the case managers in the hospital. For, you know, just for the day to day stuff. I was able to meet with them, so they liked it so much that I came by. They had used services a couple times, so they started introducing me to people in the hospital.
Speaker 1:So you just never know where it'll take you Okay, any tips on an efficient process for doing spot checks, quality checks on caregivers and clients? I'm undertaking this project in this moment and we were finding some challenges and also some wins. So, yeah, we had QA quality assurance people in the field and their sole job was sometimes they started a job, like with the caregiver. They would start the job, they would meet the caregiver at the client's home and Open the case with the caregiver. That was part of their job. The other part was they were the caregiver supervisor and so they did pop-in visits. They were never announced. Now you have to set this up properly, though. When you sign the client up, you have to ask them Are you okay with QA Just stopping over any old time to check in if they're not checking in on you? I mean, maybe they are a little bit, but they're checking in on the caregiver. We have to supervise them. They work in the field, they're by themselves and we need to make sure that they're doing right by you, by the company. You know they don't. Children love this. The seniors don't always love the QA visit without warning. So in the, in that assessment, I'm getting permission to pop in whenever we want to for QA. If they say no, then I say okay, we will call you, but we would appreciate you don't share with the caregiver that we're coming. And sometimes they did anyway because they're friends, right, they love their caregiver. But the idea is it's a pop-in and nobody knows it's happening. That is the idea.
Speaker 1:One pop-in that we went to one time this this still just in my head and it just it hurts my brain to think about it popped in clients, diabetic, and the adult daughters signed up. The services QA showed up and the caregiver and the Senior man, the gentleman patient client, they were on the couch eating Cheetos and chocolate pudding and watching adult movies. So you know, daughter was due to come there in two days as to surprise her dad. Happy birthday dad. And she would have walked into that had we not walked into the bath. So QA visits so so important. You should be doing these. If you can do pop-in surprise visits, that's the best thing. I'm quite sure if this person knew we were coming, we went to seeing what we saw. So Anyway, at least I know it's a horrible story. It's the worst one I have probably in that realm.
Speaker 3:There's lots of home care stories, but there's, I have, I could write a book and I really probably should write a book.
Speaker 1:There's probably a book that could be written.
Speaker 3:Um, yeah, I had. There was one place that I was at that they, I told you don't. They called me judge Judy because I would just uncover the most. And I was just like cheese Louise, what is your issue? Why can't you guys just be here and do what you're supposed to do? And you know, I didn't want to uncover those things, but once I did and started to unravel, I'm thinking, oh wow, I gotta do more. So I audited everything all the time and it was um, and when you catch, one.
Speaker 1:It makes your stomach turn because you think, okay, we have 400 clients and this is one. Stop, what's, what are they all doing? I mean, it just makes you start to what are they all doing? You know, you just start wondering they could all be doing this, like they're not. But you do just start to get very nervous about it.
Speaker 1:Some, um, rebecca says we have horrible stories too. Yeah, I'm sure we're all. Yeah, that's what we should do, valer. We should take them after mine group and write a book about horror stories. Now, yeah, horror stories in home care. It could be a halloween book.
Speaker 1:Okay, I have not yet opened, but I have, uh, direct contact information, phone numbers, email addresses for many that Social workers and court care coordinators that work at the same hospital I work at. That's fabulous. How should I go about marketing to them and what should? What should I say the first time reaching out to them? Okay, so, um, if they're your friends, that can be a little uncomfortable, possibly, and your co-workers, that could be uncomfortable, but it is wonderful that you have these connections. I don't know, I might start with like a, a lunch kind of thing. If they're allowed to do that, maybe meet them in a break room and tell them about your new business and share, if you're, if you have that kind of relationship with them, if they're kind of just pass or buy co-workers I'm thinking if you have their cell phone number, though Probably are closer than that I would probably set up a lunch in one of the break rooms and share everything about your company, how you're different.
Speaker 1:Always remember, don't tell them about home care. Tell them how you're different than all the other home care companies that are out there. That's probably what I would do. Um, I might talk to them about because you probably know what their their problems are. What solution can you provide for them? Are they hit with Friday discharges all the time and have nowhere to go? Um, I don't know. Whatever their problems are, be that solution for them and that's what I would share with them. Lisa, you have any and how? Tips on breaking in a hospital.
Speaker 3:No same same Thanks.
Speaker 1:Okay, so that definitely.
Speaker 3:And if we were friends? You're referring to me, no one else.
Speaker 1:Exactly. Yeah, if I have yourself a number, I am now your home care company. That is exactly how I would. But it depends on your relationship, don't you know? If you have yourself a number? So I would feel like you're close enough to be able to at least set up a time where you can sit with all of them and show what you do and how you're different.
Speaker 1:Tips on breaking into a hospital for me. I know it's gotten hard. When I first started we were allowed to just walk the halls. I mean it was just fabulous. You could just, and I had learned how hospitals work, like every floor has like their I don't want to say disease, but there's an ortho floor and then there's a heart floor and then there's a cancer floor and you could go to each floor with an article about ortho or about cancer. It was just a wonderful time. The day in the life of it was wonderful. It's not like that anymore and I can tell you one reason why there was a home care company here that was going by and getting the patient's name and room number and then they would go home and call them at the hospital while they're in the hospital and trying to get an appointment set, so you know they blew it for everybody.
Speaker 1:Either way, I would start with the ER, like I had said I would. I would start in those ERs on the weekends, get to know them. Lisa has another tactic that I should be shared with me, that we're not going to say you should do this is at your own risk, go ahead, lisa. Well, which one I know? Judge Judy has these back door. The back door tactic.
Speaker 3:Yeah, I did find other doors that just kind of weren't, they were just like another door to go into the hospital, and you know, I didn't know, I was just kind of exploring and I ended up finding, you know, that this one door happened to lead to the social workers and the discharge planners right into their office, basically. And so I would, you know, knock and have conversations. I would go with my, my hospice person and sometimes my home.
Speaker 1:That's a good way to do it. Yeah, so co-marketing is excellent Co-market with home health and hospice. They have the end of the hospital, absolutely, that is a great idea, but I mean that definitely worked.
Speaker 3:Another thing is I would follow my my clients through the hospital and I would be there often and I would even one time I remember I wasn't really allowed in a place until they like buzzed me in and they did. And when I got to the nurses desk you know that little station that they all said that I had the nurse call the social worker from her desk phone and she answered and I got started talking to the social worker about my client and let her know that she does have home care and how do we make this a better situation when she gets home and how do we help, you know, maintain the quality that they're going to send her home with, and things like that. And they really appreciated it. And I did get calls from them again and you know, just Making sure you just kind of get in where you fit in and talk to the right people.
Speaker 1:Yeah, anytime any of your clients land in the hospital, go see them in the hospital. It is a brilliant opportunity for you to meet the case manager and you have a right to be there. That's your, that's your client and you want to make sure that they're discharging safely and you want the hospital to know that they already have home care. You don't want them to discharge them to another home care company and I've had that happen and they will. Yeah, they will.
Speaker 3:They don't know who you are and your, your client, might not be in their right mind and they're like, yeah, yeah, home care, sure, sure you know. Yeah, they're thinking it's you, they don't.
Speaker 1:They don't know.
Speaker 3:Yeah, and they think they're thinking they have to re-sign up because they were admitted to a hospital and then to come out, they have to sign again or something. They're not really thinking about all of that and so you have to, you know, state claim on your on your territory.
Speaker 1:So you have to. We used to call it tag them. You have to tag them with you.
Speaker 2:Because when they leave, the hospital.
Speaker 1:Many times they go to a sniff. So if they leave the hospital and go to sniff, guess what you get? To go into that sniff now meet the social worker and tag your client and tell them all about your services. So yeah, follow your patients into the hospital, follow them into the snips. It's a great way for you to network while you're there too, and it also helps for them to see you caring about your client. We used to bring them blankets or a plant with our logo, you know, a sticker on the plant with our logo so that they that was another reminder they already have home care, but also just that we take good care of our clients and we care about them while they're in the hospital too.
Speaker 3:We talked about. We talked to sorry, just really quickly, we're in the hospital and there's the whiteboard. We actually talked about tagging with our logos like a sticker, tagging their markers and their their erasers, because I wanted them to know that this is my person. Yeah, yeah.
Speaker 1:And they put on their nurse and they put PT. I wanted to put home care and you have a social worker. Go well, let's go in there and put that on their board. And she wrote it on the board home care, you know. And then you're a company and my contact information, so they do that board. So that I mean, I don't know if you should go right at yourself, but you could certainly, you know, talk to the social worker and make sure they know that they already have home care. Okay, ways to qualify a SNF without having to call questions to ask. If you do call, should you let them know you're an agency home care owner when asking these questions? So there is a way to qualify. There is a website. It's a Medicaregov website. I don't know if I have it. Let me see if I can find it real quick and pull it up.
Speaker 3:Oh, I forget what, yeah, which side it is, can you?
Speaker 1:see if you can find it. While I yeah, it's a Medicaregov, I believe, but you can go in and you can we'll. We'll supply the link for you guys when we send this out. You can go in and you can kind of qualify them as far as knowing how many beds they have. What do they take Medicare? Do they take Medicaid? If they don't take Medicare, medicare that's probably not going to be a good private pay discharge for you. If they are straight Medicaid, that means all their patients are Medicaid patients and then they can't usually afford private pay care. Someone that has Medicare typically can afford private pay care.
Speaker 1:Now, this website is not going to tell you what percent they are. I can say if a SNF is over 80% Medicaid, probably not a great place for private pay. It doesn't mean don't go at all, it just means don't go every eight to 10 days, maybe go once a month, every other month, something like that, because you could get a good job out of there, but it's. It's going to be few and far between. If a SNF takes straight Medicare and that's all they take, that is a gold mine. We have about four of those in the East Side of town where I live and they send us 24 to 12 all the time, and we, they were like our best friends. They didn't take Medicaid at all, and so Medicare is is where it's at. Medicare is not going to pay you, but people with Medicare have the money to pay for private pay services.
Speaker 3:So Lisa, On that website you can do a compare. You can see their overall ratings. So yeah, it's.
Speaker 1:Another great thing about that website, too, is they get audited right. The state comes in and doesn't audit every once in a while and they grade them. They grade them on different categories. You can look at the staffing category. If they got dinged in staffing like they didn't have enough staff on the floor per person, that's a great place to offer bedside sitting. Maybe it's a great place to offer your caregivers as staff, like the staffing for them. You can go in and see which ones are not, don't have good staffing and they're not rated well for staffing. You can see that yourself and then and then you can you don't say that to them, of course, when you go in there, but you know they're struggling with staffing you can be a staffing company for them If that's something you want to do. That's another, another way. So we'll make sure to include that link where you can search. So that's one way.
Speaker 1:If you're going to call them I don't know. I typically did not tell them. I don't know how Lisa feels about this. I just pretended to be an adult daughter and blocked my number and just pretended to be an adult daughter and find out everything I can about them. You could call like you're an agency and ask them who the social worker is. If you want to get the names of the social workers ahead of time, it wouldn't make sense that an adult daughter would be asking that question, so you could call. The way I usually did that, though, is I didn't call.
Speaker 1:I would go in and want to meet with their admissions coordinator. That's their salesperson. Their admissions person is their salesperson and a sniff, and I would ask for a tour and she would tour me through the whole thing. Get to know her. She wants to meet you. She wants to see you because she wants you to refer your clients to them if they need to go to a sniff. Maybe one of your clients is in a hospital and they're going to discharge to a sniff, and you go in and you meet that case manager at the hospital. You could recommend the sniff, and the admissions coordinator is going to love that you're recommending them. So you do have some power there, and so you ask for a tour. Admissions take show on the tour. They're your best friend. They're never going to refer to you, but they can help get you in front of the social worker once that relationship is established. So that's another way of qualifying Hope that answers the question. Lisa, anything to add? Oh hi, that's great.
Speaker 1:It's great there's two of us, because our brains aren't exactly the same. We get lots of, lots of different answers. How many SOCs? That starts with care. Should a marketer sign up monthly? So it just it depends, I think, on the size of your company and what they're doing. If they're full time, they should be making 40 to 50 stops a week. That's about 40 to 60 contacts, because you're trying to see more than one person in each stop. You want to infiltrate the building, you want to go in a sniff and you want PT to know who you are. The director of nursing should know who you are and Mrs should know who you are, social workers should know who you are. So it's 40 to 50 stops, but it's, you know, 50 to 60 people because you're trying to see more than one person in each building. I would say, from those efforts you're probably going to get I don't know, maybe eight referrals a week. Lisa, you think eight referrals.
Speaker 3:That sounds, I mean that's. I think that's what is, and you'll probably sign.
Speaker 1:I mean, all referrals aren't always good, right? Sometimes you go in the client can't afford it or oh, my daughter's gonna be here the whole time, I don't need home care. You know they're not all. The referrals are not always good. You always thank them for the referral, whether they turn into a job or not. So out of those eight you'll probably sign six ish, depending five to six, depending on if they were good or not. You should be signing 90% of the assessments you go on. If they're qualified and they're good assessments and there's a real reason they really need the help, you should be signing 90%.
Speaker 3:Yeah, so that has to do a lot with educating who's sending you the referrals to. Yes, and if you can't, you know, sign them, at least have a resource for them, you know, to push them over to your office. Yeah, that's a great point.
Speaker 1:Yeah, and sometimes you do have to educate your referral sources because sometimes I mean I had someone send me in and they wanted nursing. We were non-medical. You have to make sure that your referral source really understands what it is you do and some of them will say well, what kind of clients are you looking for? It's been very rare, but I had a few ask that question and that kind of caught me off guard. You know I would of course answer them, but most of them aren't. You know, salesy. That's not their job, their role. But I would say you know five to six sign jobs a month, or SOCs a month, or a week, sorry, a week. If you're doing that and you're getting eight referrals, you have to get eight referrals first, right. So it takes time. This is not going to happen immediately. It can take six months to really get and it depends. If you're getting face-to-face meetings, you know, drop off, drop off, drop off. That's not building a relationship. It's good that you're doing it, it shows you're consistent, but you've got to get some face time with these people too. So if you're doing the 40 to 50 stops a week and you're seeing the same people eight to 10 times every eight to 10 days and you're getting a face-to-face every month. You should be getting about eight referrals a week and that should be five to six jobs. But it takes a long time to establish those relationships. It absolutely does.
Speaker 1:Is there a good incentive plan to give them if they're on salary? So I was always at the mindset for marketing people out in the field, not to just give them everything in the salary. Not that we paid low, but the salary was good. It was just kind of good. It wasn't excellent because they need to have some incentive to get this business in the door. I mean I did pay one hire just because she came from another company and she had proven results and she just was very complacent. She assured her salary was about 20 grand more than what I would have paid anybody else and she just was happy with the salary and that was just kind of it. She really didn't perform so well. So I really do like for their incentive to be a big chunk of their pay.
Speaker 1:And the way that we did it is we gave them three to 6% of their signings For the first year. The client was with us and so whatever the billing is was from that client and you need to look at your own numbers and figure out your own, whatever you're doing. But ours was three to 6% of the billing that they signed and they signed all their own jobs. So the referral came in, they went and signed it themselves and what's great about this is if it's a percentage of their billing the billing that they brought through the door they're gonna wanna keep that billing Because for us it was for the first school year they were with us. So 24 is bill hire, right. Well, that means their commission's also hire because it's a percentage right. And so I mean my marketers were taken.
Speaker 1:They're 24 hour clients plants. They would go see them and just sit and visit with them. They wanted them to stay on for and they actually did have a relationship with them. It wasn't just about the money. They liked them but they would, and if things got a little weird maybe a caregiver no show do we have two no shows in a row they would go out and make sure everything was okay. They were involved and that is how we kept them involved because that commission was coming in and it was bigger. The bigger the job, the bigger the commission was for them because it was a percentage. So this was a great way to keep them, because that's who they liked in the beginning. They signed because of this person. So when things start heading south, you pull them back in. They come right back into the situation. Sometimes they need to go out to the home and have a talk with the caregiver and the client. Sometimes they need to call the adult daughter and say what your mom is saying. That's not exactly what happened, but let's talk about it. They're keeping everybody happy and they'll do that if they're still getting some kind of incentive pay. So I hope that that answers that question.
Speaker 1:Do you pay the marketer the full three to 6% when they sign the client? Well, they get paid with the billing, I guess, when they sign the client. I guess I'm not understanding that. So they get three to 6% and that depends on how it was. It didn't range. We decided you're getting 3% or you're getting 4% or you're getting whatever. It didn't move around. So, yes, as soon as that client gets signed, their first, very first billing, the marketer gets 3% or 4% and 5%. They get that, and they get that for the first year. That's how we did it. That may not work for your structure, but it worked very well for us. Lisa, do you have anything you wanna add to the pay?
Speaker 3:So that three to 6% you could also, if you're a smaller agency or you're still growing, you could do like okay, if this person stayed this many hours or whatever, then a different type of bonus structure for that. So you could do something like that too.
Speaker 1:Yep, you could do that too and you could do in the very beginning. I've heard companies you get $100 every time you sign a client. I mean I've seen and heard all different kinds of things.
Speaker 3:We were Whatever makes sense for you.
Speaker 1:We were really big, a big well, we were big in Medicaid and then when I started, we started working in private pay, and so that's what we did. After the year, the percent goes down. I think it was to like one or 2%. They got to still. They still kept it. So each time the client paid a percentage, yes, yep, for the first year. That is how we did it and it worked great for us. But again, work your numbers. I don't want to tell anybody anything that doesn't work for your numbers. How to keep the marketers wanting to work for your company. I mean, I think, incentivizing them, helping them be effective and efficient. Marketing people we're getting close on time. Marketing people and I don't mean to insult anybody, I'm a marketing person, lisa's a marketing person they love the job of the running flying by, especially in this industry, flying by the seat of their pants. I used to call it controlled chaos. They love that. I love that. I do.
Speaker 2:I do a controlled chaos.
Speaker 1:Throw me in. Don't put me in coach. I love that, but the other side of that is they don't like the tedious, they don't like the note taking, they don't like that. Oh my gosh, I have to give you a report. They don't all of the and it slows them down. And they might love putting together the marketing stuff and all of the. They love the idea of it and handing it out, but do they have time to sit and do it all? Do we want them to sit and do it all? They need to be in the field, Keep them in the field.
Speaker 1:Get them a CRM that helps them stay organized, so they don't have to be taking notes in their car with the. We were talking about this the other day. Lisa and I had a post on left-handed, so I couldn't do any of this right now. Well, I'm driving, so I'm driving and I have a post that stuck to the steering wheel and I'm writing. You know, like you shouldn't have to work under that, it shouldn't be like that. So support them. Yeah, the phones go and you're slamming on the brakes.
Speaker 2:Terrible, terrible.
Speaker 1:It's just it's a hard thing to do to work out of your car. So make it easy for them. Have somebody else assemble their marketing stuff. Make it so they just run in, they grab and they go. That is going to pay. They're going to like that, but, more importantly, that's what's going to work for you, because the more they're out in the field, the more they're signing, the more referrals you're going to get. If you have them sitting in the office filling out a report, putting together their marketing stuff, making copies for the assessment intake forms, you're just paying somebody.
Speaker 1:Good Is their tool, for your company is bringing in the business, so don't put them in the office. I only let my people be in the office for an hour every week for a meeting, and then it was in and out, in and out. I don't want to see you in here. Go, go, go. I will support you, I'll help you, I'll do whatever you need, but you can't be in the office, and so that's kind of how we did that. We are just about out of time. I don't want to. We didn't get through all the questions again.
Speaker 3:And we'll stop on this one, and then we can get, we can do another one coming in.
Speaker 1:Yeah, we will have to do this again. Top ways to use. That's more of a Valerie question too. So, ok, I guess we're going to call it. We will save the other questions.
Speaker 1:We are going to be working on handouts for December and January for next time. I know that there are many of you out there that want to be ahead, need to be ahead, you want to have it done. You have multiple offices and you want to get your stuff, your plan things, ordered and in organized cast. It is better to be organized. So if you can have all those things done and be a quarter ahead, that's great. So we are going to try and help you get there in our next meeting. We will be working on handouts for the next December and January. So thank you guys for being here. I hope it was helpful. I hope everybody enjoyed the questions and answers. It was a big hit last time and I'm sorry we didn't get through all of them. Do we have a question here now? Oh, just a thank you. Ok, well, thank you everybody. You have a great weekend. Bye, bye. Have a good one. Bye, bye.