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Caregiver Retention and Why it Matters (with Steve the Hurricane and Nancy Muckle)

Steve "the Hurricane" Weiss shares great tips on caregiver retention. He starts with some very basic and actionable suggestions like adjusting your attitude to love your caregivers, speaking in the language of "shifts" and making sure that new caregivers get a lot of supervision. But then the magic comes where Steve shares some great ideas regarding career paths and puts important metrics around the benefits of retention.

Steve's team is offering a top-notch program on caregiver recruiting and retention called Momentum. You can learn more and sign up at https://homecaremarketing.net/momentum and get a $500 Discount with the code ANKOTA500.

As an added bonus, a friend of Ankota named Nancy Muckle tells us about her mom's caregiver and the impact she's had on their family. Nancy says that "home care heroes" doesn't go far enough and that in her case, the caregivers are Angels.

Steve runs Hurricane Marketing Enterprises (https://homecaremarketing.net). Steve and his team run boot camps and provide consulting services to help agencies to blow away their competition. To engage further with Steve, he recommends first that you check out all the free content that they've put on YouTube (search for "Steve the Hurricane.") If you like what you see and want to learn more, please send email to info@homecaremarketing.net. They'll give you a free initial consultation if you mention the podcast.

Nancy Muckle is a serial entrepreneur and a contracted sales executive who has helped many companies with sales, funding, strategy and more. Her latest venture is called "Problems Solved" (https://probssolved.com/) where solving elder care issues is one of her specialties. We'll invite her back to talk more about problem solving for seniors and their families.

Home Care Heroes is produced and sponsored by Ankota - the Software for the Heroes of Home Care. We truly embrace the notion that caregivers and home care companies are heroes. Our top priorities simplicity, caregiver retention and outstanding service. Visit us at https://www.ankota.com.

Ken Accardi: (00:00)
Today on home care heroes, we have an Encore visit from Steve the hurricane. Who's going to talk about how to retain caregivers and a bonus from my friend, Nancy Muckle. Who's going to talk about how important her family's caregiver is to them. Enjoy

Announcer: (00:15)
Welcome to the home care heroes podcast, featuring trending topics and practical wisdom for success in home care. Here's your host, Ken Accardi.

Ken Accardi: (00:28)
Hey everybody. Welcome this podcast. I'm here with one of our favorite guests Steve "the hurricane" Weiss. It's reat to see you again today, Steve. So listen, you've been on the podcast before, but, one topic that's on all of our minds, is caregivers. When we're a small agency, we're focused on "I 've got to get that 1st client. Then, I got to get two clients. Then three clients", but when you really want to grow, it's all about getting and keeping the good caregivers. And it's a battle out there. Do you think this is a good topic to go through today?

Steve "The Hurricane": (00:54)
Absolutely. It's the number one problem facing agencies these days.

Ken Accardi: (00:57)
Let's jump right in. You've put a lot of thought into this and what are... I sometimes get the impression that some agencies, they don't even love their caregivers. And it seems like a mindset change that that really needs to happen. With that as an intro, what would you say are a couple of the things that are maybe even easy things that the agencies can do better retain their caregivers and especially the good ones.

Steve "The Hurricane": (01:25)
Yeah. it's funny, you mentioned mindset because I feel that every part of our business... Attitude can make... Good or bad... Like if my attitude is in the wrong place, the business is going to go down. If my attitude is in the right place, the business is going to go up. And when I think about caregivers, I know that there is this mindset and attitude out there of, I can't stand caregivers and any person that tells me that they can't stand caregivers or caregivers always call out, or they they're constantly complaining about caregivers. I always put it in perspective and say, listen, you do realize that this is the business of people. If you don't like caregivers, if you don't like people, sell your business, go open up a McDonald's or a Dunkin donuts or sell tires or something else because this is the business. So the very first thing is to have a mindset of, I love caregivers and taking care of my caregivers is my highest priority. If you change your mindset to that, you will attract caregivers and you will retain them for the long haul. That's the beginning. But it all starts with what's between your ears.

Ken Accardi: (02:34)
That's something I definitely witnessed, but it is a subset of our, of our owners who are "Oh my gosh, my caregivers, they're such a nightmare". But let's shift to the majority who say "I started this business because I'm into, caring for people and I love my caregivers," but I'm just not winning in the retention war. And so what are a couple of things that people should be thinking about right off the bat about, Hey, What can I be doing to better retain my caregivers?

Steve "The Hurricane": (03:04)
So it's two part. The first thing is looking at, well, actually it's two part with, with the same starting point. The sttarting point is look at the home care pulse report for the last two or three years, they have put out the section with the top 10 complaints of caregivers. And when you look at the top 10 complaints of caregivers, this is where it's two part. Number one, you have to realize that the biggest complaint caregivers have is inconsistent hours and schedule. So even though we can't get enough caregivers, we really run into the problem of giving caregivers a full-time or part-time schedule. So, I always talk about a 20 hour minimum and maybe we'll get into that in a little bit, but we really have to understand that as a caregiver, caregivers make a certain amount of money, right?

Steve "The Hurricane": (03:51)
So what are all the jobs that exist that a caregiver could do to make the same amount of money, social economics? Right? When I look at every other position that a caregiver could do to make the same amount of income, the biggest difference between home care and all the other ones, including other parts of health care. So not just being in home care, every other job offers shift work. So if I'm Amazon, if I'm Walmart, if I'm McDonald's, I'm hiring entry-level position, I'm going to give you shifts that you have to work. We, as the owners of home care companies, we don't do that instead. It's like, Oh, you need care. I need care. Two days a week, three hours a shift. Oh, okay. Let me find somebody to do that. That is where the problem that, that disconnect change the way you run your business operationally by offering shifts.

Steve "The Hurricane": (04:43)
And then when people come in to recruit you, you add them, find out what shifts that you offer, that they're willing to work, match shifts to patients, and you'll be successful there. That's the first thing, the second thing is taking a look at the top 10 complaints and realizing that six of the top 10 complaints all have to do with communication breakdown and some form of it. And the reason why this is such an issue industry wide is because this is our practice for onboarding a caregiver. They come in for an interview, they come into orientation and go through training. You start a case. And then the next time you see that caregiver is that 60 to 90 days. When you have to do a reassessment required by law, depending on what your state's law is. That's why there's such a problem. Because when you think about the home care industry and the caregivers, like 80%, something like that, it says it in home care.

Steve "The Hurricane": (05:39)
Paul's I don't know the exact number, but something like 80% of caregivers when they work for home care, it's their first job, which means that they just came out of school, where they were showed over the course of two to four weeks, what to do with the patient. But they've never actually done it with a patient. They come into our office, we interview them, they go to orientation, reminding them of what they learned in school. Then we send them in the house, start the case up, and then we expect them to be able to manage it without us seeing them and checking on them again for 60 days to 90 days, no wonder the majority of caregivers quit their job within that first 90 days, because they go in the house, they start working with the patient. They don't know what to do, and there's nobody there to mentor them, to show them and work with them. So the other side of it is have a layer of management and field oversight, where you're literally checking on your patients and clients and caregivers together, once every seven to 10 days, this way, over the course of a month, you're physically there in a house with that caregiver. And that patient three times you do that, that will help you retain three times, which you're currently retaining with your caregivers.

Ken Accardi: (06:48)
Yeah. From that. And so tell me about the field supervisor concept. Is there a ratio of one field supervisor to a certain number, and are those field supervisors maybe more seasoned caregivers themselves that are also doing shifts, but also, I mean, what, what's the perfect makeup for that?

Steve "The Hurricane": (07:06)
So the perfect makeup of that is definitely take like a senior caregiver because what this allows you to do, and this is what I talk with all of my clients and train them on is you create a career path for a caregiver. So it's not just coming and be a caregiver forever. It's come in, be a caregiver and grow within my organization that also helps with retention, right? So if you have your best caregivers and they've proven themselves a year, 18 months, two years, and they can grow into like this leadership role where they're now a liaison between the office and the caregiver that's promotion that helps with retention is tremendous. So who knows a caregiver's job better than a seasoned caregiver? Makes sense. Now, the other aspect of what you were asking there and saying makes sense from the sense of how many caregivers slash clients can one care manager or care coordinator or this mentor person manage.

Steve "The Hurricane": (07:59)
Ironically, I always say about 35, make sense. And when you look at home care pulse, the very, very, very few percentage of agencies, we're talking less than 20% of all agencies in the United States and around the world who were surveyed, have this level of care. So that's how, it's an industry. It's, it's common. Everybody's going to eventually do it, but the ones who are doing it, their average is also around 35 to 40 people. Some people have people managing like 70 in the field. And I feel that that's way too much because if you want to get that frequency, when you're visiting that caregiver three times a month on average, we'll say, you really can't have more than 30, 35, maybe 40, because there's only 40 hours in a week. You want to visit about 20 caregivers plus drive time and documentation. That's a full schedule, 20 to 25 people a week. So I say 35 to 40 in a month is realistic.

Ken Accardi: (08:53)
Yeah. Okay. That's a great ratio. Just think like fifth. So think about what's going on in the market, train and mentor and above all communicate. I've definitely heard the story of, I don't ever see my, I do my in and my out. I couldn't tell you what anybody looks like it though. I don't care. You didn't see that sort of thing talking about us for a second. But one thing we have in our beta of our mobile app right now is we actually have like a chat that's like WhatsApp and like FaceTime, ? So you could do like a secure HIPAA compliant, video chat. So even as we're, hopefully coming out of COVID, but you, if you want to do not quite as many actual in the home face to face, but you want to talk to people and see their face and see the client and have them see your face.

Ken Accardi: (09:32)
we've put that right into the right into the app and then really, really important point about career paths, right? I mean, if you want people to say, you got to give them a reason to stick around in a way that they can grow and and get where they want to get in your life. I mean, there's some people, actually some of the best caregivers, are not the youngest people and they have a heart for caring and they're fantastic. But other people, like you said, a high percentage are coming right out of school and they want to go and get in this job and then they want to go somewhere in their lives. And so really, really great advice.

Ken Accardi: (10:05)
Okay. So listen Steve, what do you have that might be able to help people who want to dig deeper into this topic? Let's say that they're thinking about this, but don't know how to put a structure around it. What could you offer at hurricane marketing enterprises offer to these folks?

Steve "The Hurricane": (10:23)
We have a course that I've partnered up with Annaliese gear from gear consulting associates called momentum. And what momentum is, it's a six week certification for our home care business owners and recruiters to become a certified recruiting specialist. That's the position. You get a certification and a certificate in the mail. You get direct access to six modules. Each module is a video that's between 30 minutes to 45 minutes long and instructs you on how to recruit and retain your caregivers and improve your efficiencies within your organizations. On top of that, you're going to get six live classes with me and Ann Elise, to help you with the latest updates from whatever took place from the time we filmed it to what's taking place in current present market time. And then lastly, at the end, you take a final exam. Once you pass the final exam, and it's not hard as 25 questions, and all the answers are in the class is take your classes.

Steve "The Hurricane": (11:20)
You'll know how to pass it. Then we send you a certification you're on your way to go. And when we came up with this, we came up with this over the last 12 to 18 months, by helping our clients improve their turnover ratio. Many of our clients who have gone through the program now their turnover ratio went from an industry average 67%, meaning I hire a hundred caregivers today, a year from now, 67 of them quit. And I'm left with 33, right? That's the industry average to as low as 15% turnover, meaning I hire a hundred caregivers a year from now. I still have 85 of those hundred working for me. That is ridiculous how good this is. And the best part is, it, it, it doesn't cost you much more than getting like two caregivers to work for you to be able to get certified

Ken Accardi: (12:07)
Couple follow on. So one is, you mentioned Annalise gear. I, I have I've heard her name, but just tell us a little bit about Annalise and like how to her strengths compliment what you do

Steve "The Hurricane": (12:15)
In the program. She is an HR background by trade. So she was an HR specialist for many years outside of our industry, and then started doing work with folks who started an HR consulting firm and home care companies started to reach out to her. So she went specialty niche working within the home care industry. And what I love about her is she, she does two different things on the recruiting side. She really talks about the importance of interviewing properly training your interview. Chad, the person who's doing the interviewing on what are the questions that separate you from your competitors to get people to want to worry it's that whole attraction and then selection of the caregiver. The more difficult it is to get the job, the better quality candidates you're going to bring in and the higher the longevity that they have within the organization.

Steve "The Hurricane": (13:05)
So that was amazing. That's just, I didn't even get into any details. That's just part of what she does. And then the other side of it was creating this retention, toolbox and going through the seven different things within our organization that we can do not increasing salary, but improving operationally to support our caregivers better, which is what leads people to be able to retain two to three times more caregivers versus the industry. Average is absolutely amazing. She's she is, there's a reason why I brought her in to be my partner on this project because she there's no one else on the planet who can do what she does for our industry. Fantastic.

Ken Accardi: (13:45)
Yeah. That's so exciting. And it really sounds like a great program. We talked briefly on this podcast and actually you and I did an earlier podcast where you told people to get your year started right. If you're going to focus on one metric, it's on having a long enough hours per client per week, right? And if you're looking at getting these clients who say, "I think I want three hours or I think I want five hours." Those are the ones that are going to cause you churn in this revolving door. So I guess, I mean, it's all kind of coming full circle that all these concepts play together. But my question in all, this is when you go from having a retention rate of 30% to a retention rate of 80% in the year, how does that impact your business from an economic perspective?

Steve "The Hurricane": (14:29)
It's a HUGE impact! When you go, when you retain 80% of your caregivers versus retaining 30%, you actually have a working relationship with your frontline workers. So when you get new clients coming in and you have people coming off of shifts, their skillsets, the kind of clients they like to work with you in a clinic clients they don't like to work with. And that you can trust that this caregiver will work well with this client, which will reduce service failures. That's one of the most important parts of what we do now to get to that point. In the last time we spoke, I mentioned a 20 hour minimum, and I talk about it all the time. I learned this the hard way, recruiting caregivers and keeping caregivers is not a new thing.

Steve "The Hurricane": (15:16)
This isn't a problem that just overnight happened. Remember I owned a home care business 15 years ago and I did it for seven years before starting hurricane marketing enterprises. So this was a problem 15 years ago, and the problem didn't get easier until we went from our minimum hours to 20. Once we had 20, then it was easy to sell the shifts. People who didn't need the shifts. We could tell them to go somewhere else. We can refer them to other agencies and nowadays caring.com and other aid and other things like that exists really. That's what those programs are set up. Or when you think about somebody who needs less than 20 hours, do they need help every week? Probably not. Do they need the same hours every week? We try to set it up that way to make it easier. But then those are the people that aren't happy with the services.

Steve "The Hurricane": (16:05)
And then they discontinue the reason why is because they don't have this great need is almost without, I don't want to call it babysitting, but it's like a babysitter. I call a babysitter when I need a babysitter. So I have a lady that I reach out to. If I can't get ahold of her, I got a couple of other people and I go back and forth and I use them as needed. Now on the flip side where my children were younger because I was working, my wife was working. We had to put our kids in daycare. We hired a daycare because they knew we needed a schedule. We needed more hours than a babysitter could do. That's when we, as an agency, same thing, somebody has a great need go with an agency because we can fulfill that need every single day, somebody calls out and we have shifts. We have people back up that we can put in to that place. That's somebody who doesn't need a sitter service and somebody doesn't go carry that, come. They go with an agency. So as soon as you start to understand difference between agency and as needed care and you offer that, that will make your life 10 times easier because caregivers want shift work. It's as simple as that,

Ken Accardi: (17:12)
There we go. All right, Steve, listen, we're going to bring this segment to a close and keep the podcast short and sweet for everybody here. Guests who want to learn more can just Google "Steve the Hurricane." But we talked a little bit about the program called Momentum,.What do listeners need to do to follow up and get on board with Momentum,

Steve "The Hurricane": (17:39)
Easiest way to do it would be to email us at info at home care, marketing.net, again, info@homecaremarketing.net. We can get you into the next live class with us. As soon as you say, yes, I want to do this. You'll get instant access to all of those modular courses. And you can start right away, turning around and solving the biggest problem you're facing every day.

Ken Accardi: (18:01)
All right, well with that, we're going to close this segment of the home care heroes podcast. Thank you so much for being our guest!

Ken Accardi: (18:05)
Steve. The hurricane is always fantastic, but stay tuned for a story from my friend, Nancy. She's going to tell us about the caregiving experience that her family had. And if you anyway are doubting how important your frontline caregivers are? You better listen to this segment...

Nancy Muckle: (18:26)
Hi, my name is Nancy Muckle. I live in Massachusetts and about 18 months ago, my mother, her name is Hilda, came to live in the home with my husband and myself. My mom had been in an independent living apartment in Ohio and wanted to come and stay with us. So we moved her Thanksgiving a couple of years ago, and it was just a delightful experience. One of the key things was making sure that my mother had everything she needed, including personal attention and ways to get to various appointments. And so I began to interview caregivers and I really hadn't done this before. So it was a very interesting experience, but I interviewed a lot of different individuals. They were all women because I felt that was best served for my mother. And my mother is very independent and opinionated. So finding the right individual with the right personality was was critical.

Nancy Muckle: (19:42)
And I interviewed many, many folks on the phone, some in person, and usually I wouldn't meet them until I kind of found somebody that I felt had the right qualities. And then the key was bringing that individual to meet my mother because in the end, those two people were going to be connected and together daily. And so it was critical for my mom to like that individual, I wound up choosing two individuals, one who was at our home in the day as well as taking my mom to appointments. And one that was there in the evening till about 10 o'clock at night, every night. And all I can say is that in my estimation, the two women that I worked with for a year and a half with my mother were my heroes, my mother's heroes. And I even referred to those people as angels because they made my mother's daily living so enjoyable, special.

Nancy Muckle: (20:53)
And I like to use the word loving my mother developed a real love relationship, which is pretty unique for Hilda because she is, I said was always a very independent woman and always extremely opinionated about everything, which I think a lot of us are. So the first woman's name was Margo that worked with my mom and Margo went beyond the call of duty. She did everything from taking my mom to get her hair done, to take her to doctor's appointments, to do the grocery, shopping, to do the cooking, to even help straighten up my mother's room to help my mom. My mom liked to always like to look very put together. She put on makeup every morning at night, she would put on her creams and things I don't even do just to stay looking good. And my mom, I failed to mention when she came to live with my husband and myself, she was 96.

Nancy Muckle: (21:59)
So she was 96 going on 70. She looked amazing. People were like couldn't believe her age. And she at the beginning was starting to lose her short-term memory, but had a great long-term memory, like many people that become more mature. So she didn't have Alzheimer's, but clearly stages early stages of dementia. But Margo and my mother became an amazing like sisters and amazing team together. And my mother just looked forward every day to Margo's arrival to going out with Margo. Some days they would go have lunch. Some days they'd go drive down by the ocean and just sit and look at the pretty water and the surroundings. But to this day, my mother passed away this past April. And the bottom line is Margo still remains part of our family because that's what she became part of our family. So more than just a hero Margo to me and my mom was an angel and she remains close to us. We see her every couple of weeks. I talked to her and email her and she's like a sister to me. She's part of it. She's not a, an employee. She's a family member. So that's the importance to me.

Announcer: (23:28)
Thanks for joining us today on the home care heroes podcast, home care heroes is produced by Ankota, the software for the heroes of home care. You can listen to back episodes by visiting 4 home care heroes.com. That's the number four. Then the words, home care heroes.com.
Home Care Heroes is produced and sponsored by Ankota - the Software for the Heroes of Home Care. We truly embrace the notion that caregivers and home care companies are heroes. Our top priorities simplicity, caregiver retention and outstanding service. Visit us at https://www.ankota.com.

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