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Increasing Recruiting and Retention Success with Science and AI [Home Care and Adult Day Services]

This episode addresses the most critical concern in home care and day services - recruiting and retention of caregivers.  But as a bonus, it offers a way to improve it with science and artificial intelligence.  And... as if that isn't enough there's an offer to use this technology for free AND to get amazon gift cards for the caregivers who participate...  I'm excited already!

Today's special guests are John Penrose, the CEO of a company called Agile Brain, and one of his chief scientists Dr. JD Pincus.  Most surveys are long, boring and not very accurate. Participants typically respond without much thought or even understanding. AgileBrain is different. It's a 3-minute exercise where you select images that correspond to ways you feel. So, it's fun, fast and easy to do even for caregivers with limited English language skills. And because AgileBrain is grounded in science, the results are astounding...  AgileBrain can predict how long a caregiver candidate is likely to stay and give you early warning about existing caregivers' likelihood to quit. Armed with this information you can take actions to recruit and retain better.


If it sounds too good to be true, they'll let you try it for free AND 25 of the caregivers who complete the assessment will receive a $25 Amazon gift card every time they complete an assessment.  Why would they do this you might ask...  Whether you realize it or not, you are interacting with artificial intelligence (AI) every day. Two simple examples are when Amazon.com suggests "Customers who bought that item also purchased this one," or when Netflix proposes the next movie you might like to watch.  Their models are pretty good and the reason is that they're based on lots of data. Agile Brain is asking for home care agencies, Adult Day Service Providers, and disability server providers to use their technology for free so that they can expand their model to include a rich and diverse set of caregivers.

To participate in the survey go to https://agilebrain.com/homecare or scan this QR Code


Home Care Heroes and Day Service Stars is produced and sponsored by Ankota - If you provide services that enable older or disabled people to continue living at home , Ankota can provide you the software to successfully run your agency.. Visit us at https://www.ankota.com.


Today's episode has all your favorite topics rolled into one. We have recruiting, we have retention, and we have artificial intelligence. And on top of that, there's a great offer for you to participate and get the benefit of our guest's capability for free.
Welcome to the Home Care Heroes and Day Service Stars podcast. If you provide services to keep older or disabled people living at home, then this podcast is for you. Now here's your host, Ken Acardi. Well, hi everybody. Welcome to the latest installment of the Home Care Heroes and Day Service Stars podcast. So today we have two topics that are often asked about and they're coming together. So...
The most talked about thing on Home Care Heroes and Day Service Stars is caregiver recruiting and retention. So we're right in your wheelhouse, but something that gets asked more and more about, especially in 2023 with things like chat GPT out there is what's this stuff with artificial intelligence and science and that kind of thing. And this episode is going to bring all of that together because we have a great team here from a company called Agile Brain, and they're going to talk about what they're doing.
that is using science and artificial intelligence to help with recruiting and retention and employee satisfaction and a way that they're gonna make that work here in home care and adult day services. And I'm really, really excited about this episode and I've gotten to work with these guys, John and JD in preparation for this and there's an opportunity for you guys at the end. So I'll kind of lead with that. So working with small number of home care agencies, they built a model
for how recruiting and retention can be improved with their technology called Agile Brain. But if you've learned some things about artificial intelligence, then what makes these systems better is by having more data. So if you think about places where you see artificial intelligence in your everyday life, like amazon.com telling you something else you might wanna buy when you're putting things in your cart or Netflix telling you something else you might wanna watch, they're able to do those things because they have lots and lots and lots of data.
And so there will be an opportunity for you if you want to participate in getting better recruiting and retention through this science, that'll be offered as an opportunity to you later in this podcast. And it comes with some really nice benefits, like some free access to the service and what you'll be doing is helping build that artificial intelligence model. But usually I don't do such a long preamble when we jump into a podcast and I, um, I've been remiss in introducing our very special guests who are from a company called agile brain.
and they are Dr. JD Pinkus and John Penrose. So let me welcome you first, John. And so let me welcome John Penrose. And John, do you know anything about home care or adult day services? Let me ask you that question as you introduce yourself. Yeah, that sounds like a leading question, Ken. We had this conversation earlier. You know, my mother who just celebrated her 100th birthday.
lives at home, supported by a wonderful group of women who come in around the clock to care for her. And so I've been in that seat for a number of years now and really, really appreciate the value that those women and the home care industry deliver. So yeah, I know a little bit about it from one perspective. Yeah, perfect.
The very special thing about our industry here in home care and day services is that, you know, we all have parents and people who benefit from it. And it's helped all of our lives in a certain way. And it's great to have a guest who relates to that as well. And a quick hello from Dr. JD Pinkus. So what kind of doctor are you, Dr. Pinkus? And where are you coming from today? I could tell from those of you who are going to be watching this on YouTube, I see that Mr. Penrose is in.
some fancy high rise in Boston or something like that. But where are you? You look like you're in a more rustic place. Yeah, I'm out in Maine, between Freiburg and Bridgerton. So up in the lakes region. So here I can show you my view. Hopefully that will come through. Yeah, no, it's very, very beautiful. There's a lake and a mountain, yeah. And it's nice foliage. But yeah, so I'm not a medical doctor. So, you know, if you asked my kids, they'd say he's not a real doctor.
I'm a social psychologist by training. And I've been involved in kind of studying people's emotions and motivations for a really long time. So that's sort of the background that's gonna be relevant to this call. Very excellent. Okay, so I think we'll start questioning with John. And I know that Azulbrin is helping people not only in home care and day services, but in other industries as well.
Let me kind of start by asking the question. If I look across, let's say the US business market, what are people spending on employee development and employee satisfaction and those kinds of things? Is this a real industry that people are spending money on? Yeah, it's a really big industry. In fact, there are lots of market studies out there and data, but a reasonably reputable source that we look at suggests that
Yeah, US corporations spend over $160 billion on training and development each year. That's, I think, one of the more conservative numbers. I've seen much higher numbers, but I don't have quite as much faith in that. And so that's a lot of money spent trying to develop people's capabilities and engage them in the work. But there's another number that's important too, and it's a number that's grown from almost zero 10 years ago.
And that's 57 billion that corporations spend on wellbeing platform, wellbeing programs. This is above and beyond the traditional benefits package that employees get from their employer. These are all kinds of programs that are really in response to the wellbeing crisis among employees. It's trying to get employees to be well enough to engage in the work. And...
And so there's a huge number when you put those together, well over $200 billion spend each year. Well, that's a pretty big number. And based on all that money spent, is everybody just doing great and all the employees and all the companies in America are just super happy people? Other than maybe in home care? Yeah, you'd think so, wouldn't you? No, unfortunately, the ROI on that big spend is really terrible.
Gallup, I think most people know Gallup, they do an annual study of employee engagement and their latest data, which came out a couple of months ago, said that only about 30% of the US workforce, one of the most engaged workforces around the world, by the way, but only 30% of the US workforce is actively engaged at work. 50%...
of the workforce, half of the workforce is kind of neither engaged nor disengaged. And a further 20% are actively disengaged. These are people looking for the exit. We do a workforce listening study twice a year. And we've been doing that since the beginning of COVID. And the numbers we see completely confirm that.
we've seen the level of unmet emotional needs of employees grow study by study to the point where it's now at the highest level we've seen. And furthermore, that the level, those needs, the nature of those needs has declined dramatically in terms of their positivity. So employees are really emotionally wired and they're wired negatively right now. So.
the conditions are really not good for engaging and retaining employees. No, it's a tough picture. And so this is going to be talking straight to probably some data that a lot of our folks in home care know these stats inside and out. I'm actually going to share some slides. Most of you are probably listening to the podcast in your car as you're driving somewhere. So I'll try to be very visual in my descriptions. The first thing
which is talking about the decline in the available pool of caregivers. And actually it shows that around 2010, we started having a decline in eligible caregivers in the country. And at the same time, we all know that our number of, you know, Americans are living a whole lot longer and we have an aging population. The home care participant community is estimated around 12 million.
people today and that's expected to go up to $30 million. But the rest of these slides come from, you know, Mr. Penrose there talked about the reputable source in his industry. I think the most reputable source here in home care. And here I am leaning on the home care side, although I will say that I spent, I visited the National Adult Day Services Conference in Chicago just a couple of weeks ago. And that industry is now kind of starting to catch up with some good stats. But the first thing I'm showing here is
is profit margin in home care agencies. And really it comes down to, most home care agencies have single digit profit margins. If that on average, the profit margins are less than 5%. And that's pretty scary in any industry. We also are, I'm showing the next slide is the impact of the caregiver shortage. And basically if you add it up 97% of
of all home care agencies are talking about there being, you know, a measurable impact of the shortage of caregivers. And in the case of, you know, more than 60% or right around 60% are saying that it's either extremely negative impact on home care or a very negative impact. So we know we're all feeling that. And then this last slide I'll show is one that says that,
85% of home care agencies say they've turned down cases because of not being able to fill them with caregivers. And actually 59% of agencies say that that's a very regular thing is that they're just not able to, you know, kind of fill cases as a result of that. So I think, you know, unfortunately, Mr. Penrose from Azulbrain and myself have painted a pretty bleak picture of...
you know, kind of employee satisfaction and things like that. I guess the last slide, which I should have shown is probably the most important one, but I won't bring the slides back up. It's that we have about a 64% turnover in home care staff. So home care folks only stay in their job, you know, on average, I mean, two-thirds of the workforce in the home care industry is turning over on a yearly basis. And that's quite a big, you know, number and a big fact. And it's really the biggest problem that we face in,
in the home care industry. And I guess just another little plug here for the opportunity we're gonna offer in the end, just in the way that a lot of you are turning in information to home care polls, so they provide these great statistics. You're gonna have an opportunity to participate in a study here with AgileBrain to really get a better reading on what's going on in the home care industry in terms of recruiting and retention.
All right, so I've kind of talked too long. Let me kind of go back to the question. We've kind of painted this bleep picture. I'll go back to you one more time, John. It sounds like you guys at As a Brain think there's something that we could do about this that would be better than other people have been doing so far. And can you tell us what that idea is and how it works? Sure, thanks Ken. Yeah, I think as business people, we're all familiar with that adage, what gets measured gets managed. And part of the reason that
corporate America has such a terrible ROI for all of this huge spend in trying to recruit and engage and retain employees is because we fundamentally don't know how to measure what is really going on. We know from the neuroscience revolution that emotions drive human behavior to a large degree, much larger than we think. And yet we all grew up in
you know, maybe we went took a business degree, undergraduate or got an MBA, or have simply been in the work world for a long time. And we apply our brain power, our cognitive, you know, best thinking to solve problems. The problem is that doesn't do a very good job of explaining human behavior. And so one of the critical shortcomings is the ability to understand what motivates our employees.
So we use the words emotions and motivations, kind of interchangeably, they come from the same Latin root, but they basically mean making a change. And we want that change to be positive. So measuring those emotions and motivations is absolutely critical. And the good news is JD and the team at at agile brain have come up with a way to actually do that. Incredible.
So, I mean, is it like that thing I always see and like, you know, okay, answer this on a scale of one to five, you know, five if you're happy and one if you're not happy, is it that kind of thing or is it a little bit different? JD, you wanna take it away? Sure. So I guess I'd like to ask people, you know, to think about the last time that someone asked them to complete a survey and, you know, how excited did they get about that prospect? And when they were actually taking the survey, how closely were they paying attention to the items
and as opposed to clicking through it as quickly as possible. That is a perennial problem in the survey business. For some reason, through some unfortunate starting values, we ended up with a situation where almost all research that's done, social research, psychological research, is done with text and scales, which is a hyper-rational way of looking at things.
For the most part, we know don't pay attention. We know that when they do answer, they're concerned about who might see their answers. So that affects what they give. And as a result of all these various biases that go into that, we end up with results that are not particularly predictive of anything because everyone is either picking the central value, you know, a three and a five, or they're giving everything a five, or, you know, there's not enough variance and it's just really kind of a mess.
If you think about it, this is the situation that the psychology world faced when it came to the questions of bias, things about racial bias or sexism, homophobia. And when you ask people about those things, they wouldn't give you their honest answers. So what did they do? They had to come up with a workaround. They came up with the implicit associations test, which is a reaction time-based test, which looks at pairings of...
you know, qualities of people and people's sort of things that you associate with those types of people. And it's a thing that they couldn't game. And because of that, it was a way to reveal that people had these implicit biases. That's essentially what we're using in our technique is the same thing. It's a rapid exposure to images. The images complete a sentence. You basically select the images that complete that sentence for you and you don't select the ones that don't. So we'll say things like,
when I think about my work in home care, I wish I could feel a little bit more and you'd a bunch of positive images will come at you, about one every second, no time to think. You basically click on the ones that fill it, that complete it for you. You don't click on the ones that don't. Then we flip it around and do it on the negative side. The prevention motivation, which is negative images served up as, when I think about my work in home care, I wish I could feel a little bit less and you see these negative images.
And the whole thing happens in three minutes, which is crazy. It's so fast. People will go through, invariably they'll say, I just picked on a bunch of images. I'm not really sure why. There were some other images I wanted to pick on, but I didn't. I wish I could have slowed it down. I wanted to see that one again. That's the whole point of this is that you can't think. We're basically forcing this into this emotional response window where you have to respond with your gut. The beauty of this is, first of all, it's over very quickly.
is incredibly predictive. We're finding in our predictive models of things like retention that the vast majority of the predictive value is coming from this exercise. And we're able to explain, for instance, in one industry, 70% of the variance in whether or not people will stay or leave. And it kind of makes sense if you think about it. You're seeing a bunch of images of people in various kind of
know, motivationally negative states, you know, a person who feels like they're being stabbed in the back or a person who feels like they're overworked or that kind of thing. That's the sort of images that are depicted. It's a lot easier for somebody to pick an image like that in a split second than it is for them to rate that on the scale. I mean, there's a complete level of deniability associated with this in that they have no time to think. So what ends up happening is the truth is revealed.
So we end up very quickly coming up with a very accurate picture of the motivations and emotions that the person's having at the time toward their job or toward whatever the situation is. And that is very useful for identifying who is likely to stay and who's likely to leave. Very good. Well, thank you for explaining that. You did a couple of science words in there. You lost me a little bit. But if I kind of bubble it down and kind of the takeaways, I'm going to be essentially, if I'm participating in this as...
let's say a caregiver, I'm gonna be asked really two questions. It's, you know, I'd like to feel more this way and less that way. And those are gonna be my two questions. Then I'm just gonna react to images. And, you know, so maybe I'll see an image of, you know, a group of people and say, yeah, I'd like to feel more included or, you know, and that kind of thing. But it's not gonna be a big narrative and it's not gonna be on a scale of one to five. It's just gonna be like, yep, I'd like to feel more like this. I'd like to feel less like this. All right, well, this sounds pretty cool. And...
I mean, it sounds like from definitely from the participant perspective, like it's not going to be hard or arduous or take a whole lot of their time. So that's all very, very positive. So, you know, you talked about being in the industry for a while, but I mean, did you just make this stuff up yourself? Like when you started this company recently, or is like, you know, can you tell us a little bit more about the science here, Dr. JDP? Yeah, absolutely. So, yeah, I've been working on this for a really long time.
the original ideas I was playing with back, I don't know, around the year 2000 or so. So for about 25, 24 years or so, I've been playing with these ideas. And basically, this really came to fruition when I joined up with John and Bill and the other folks at Leading Indicator and kind of recreated it as AgileBrain.
human motivation that really, you know, human motivation, there's a million theories out there, these mini theories of motivation, like, you know, the fear of failure or the need for achievement or the need for affiliation or the need for safety or Maslow's hierarchy of needs. There was no meta theory to explain all of that. So that's essentially what we did is to create a meta theory that basically says, motivation is about two things, it's about change. It's about...
where do you wanna make a change in your life? And there's four answers to that question and what kind of change you wanna make. And there's three answers to that question. So it's essentially four domains of life within myself, within the social world, within the material world or within the spiritual world. And it's, you don't have to take my word for it. There's 12 different, you know, world philosophy systems, including all five major world religions that make that same supposition. And then the other question is what level of change do you want? And that comes from Aristotle's
modes of existence, sort of being, doing, and having, if you will. And when you cross those, a wonderful thing happens. Suddenly, we have a home for every single one of those mini theories of motivation. And that's our framework. So that's the first sort of scientific pillar. The next was to understand that images work much better than words in terms of listening emotions and measuring emotions. We actually can process an image at least 10,000 times faster than we can text.
Our bodies and brains are evolved to process visual stimuli. Text has only existed for a few thousand years. So by using images and then exposing them in this very rapid way that we're borrowing from neuroscience and Antonio DiMazio's lab, the godfather of neuroscience came up with this and basically showed that within a few milliseconds, you can understand what it is you're seeing within about a half a second, about 400 milliseconds.
That's the first time that your body sort of launches an emotional response. And then in about a full second, a thousand milliseconds, that's your first opportunity to kind of cognitively reprocess and think about how you're feeling and possibly bias your answer. So what we do is simply force you to respond in the emotional response window before you get to the intellectual cognitive thinking part. And that's sort of the secret sauce here that we're getting people to give their gut reactions
instead of a thoughtful, deliberate answer, which is prone to bias. Right. Okay. Well, again, a lot of sciency words in there, but I'm pretty much getting it and I'm definitely understanding that there's a lot of science behind this. And, you know, but what I really like is the simplicity of it. You know, I'm looking at pictures. It's something that I relate to. I liked how you talked about the different realms of life and this kind of thing. And
So I'm very, very excited about all of that. So actually in your first answer, Dr. Pinkus, he talked about some results like in one industry, he found, I think you mentioned a 70% correlation. Can you elaborate a little bit more on what that is? Cause you know, I'm really trying to get in. I mean, we're still building out this in home care and day services and things like that. But what have you seen in some other industries that's been very encouraging about this?
Yeah. I mean, so the correlation that we were seeing, if you think about it that way, was close to 0.9, like 90% correlation. To explain variance, this is probably more math than you need, but you multiply the two together, you take the square of it, and that ended up being around 70% of the variance was explained. Just for context, in social science, if you could explain 20% of the variance in a behavior or a phenomenon,
you could be in the running for a Nobel Prize, right? Because in social science, for all the reasons we've talked about, all the bias that comes in, the response styles, all that stuff, it's very hard to explain variance in real world behaviors. When we're able to explain 70% in something like intention to quit your job, I mean, it's unheard of. It's something that is sort of new to the world. So it really...
And this was in a particular industry, in the biotech industry, where they have a big problem of retention. You know, people kind of jump ship all the time and go to competitors and sort of look for opportunities. Knowing who is going to quit is really important and knowing what you can then do about it, what are their needs that are not being met is a pretty handy thing if you're responsible for retention. Yeah, fantastic. So, Mr. Penrose, John, I've been neglecting you for a while. Do you have any kind of anecdotes?
winds that you want to hear as well? Oh, I think you might have muted yourself there. I see your lips moving, but I don't hear you. I think I had a sneeze, so I muted myself. A couple of quick things. The fact that the images come so quickly and there's so little text involved here, it's really a gamified experience that happens on your cell phone. And with
you know, my mother's caregivers, you know, when they're not, you know, helping her, you know, I'm usually talking to her in the living room and they're in the other room on their cell phone, for better or worse, you know, people live on their cell phones now. And this is an application and exercise you can do right there in a couple of minutes, right on your phone. And because it's all images.
there's very little language barrier issue here. And so we can have a lot of confidence in the values, the responses we're getting. I think one other thing I'd mention is we talk about retention and oftentimes we think about retention as, you know, after the closing the barn door, you know.
after the fact, it's too late. But if we can do a good job of predicting retention, there are interventions we can put in place in a timely fashion. And I think as interestingly, we can predict the likelihood to stay for a candidate.
You know, imagine, and I have a buddy in my master, you know, mastermind group of other CEOs, and he runs a home care agency, and he's, you know, just flat out recruiting all the time. Imagine if he could have an indicator that would say, what's the likelihood that this person will stay three months, six months, you know, nine months.
That's important information to know in the hiring process. So I think there's a lot of excitement around this opportunity. Right, that sounds good. And speaking of the opportunity, so these guys from Azure Brain have put together a really nice opportunity for listeners of this Home for Heroes podcast, and we'll send it out to our community as well, and offer it up in a couple of different ways. But what they're actually offering is that at NoBestU,
asked to give, you know, essentially how to contact 10 of your staff and let them, you know, go through this three minute adlo brain assessment. And the one thing we're going to ask of you is, you know, for you to kind of bucketize them, Hey, this is one of my steady eddies. This is one of my rock stars and things like that. They'll basically by doing that, you will, you know, get
a number of things. First of all, the caregivers that you invite to the survey, they're going to get an Amazon gift card. And then you, as the agency, you're going to get results and you'll be contributing just like you've contributed to the home care pulse, statistics on the industry, you'll be contributing to making this model better and expanding the demographics to different places. And then you'll also get as an offer of this, you'll get three months
If you say, you know, if you, if it sounds appealing to you, that you could have something that you could use with your candidates that will tell you if they're more likely to like the industry and stay in the industry, and also with your employees to get more early warning signs where you might be able to intervene before they move on. I think you would find that really, really powerful. And this is something you'd contribute to. And you'll be getting, you know, a lot of these things. So, so bottom line is that's the offer that's coming from these guys in Agile Brain.
At this point, we're pretty much at the point of wrapping up on the podcast, but we'll put the details in the notes and how to participate in the program. What I'll tell you for now is that if you go to AgileBrain.com slash homecare, that's where you'll find out information about this. And I realized that we have not only home care heroes here, we have day service stars, but we wanted to keep the link short. So it's going to be AgileBrain.
dot com slash home care. And that's where you'll be able to go and sign up for this offer. We'll put links and QR codes on the places where you look at our content from Home Care Heroes and things like that and make it very easy for you to get signed up. And with that, let me say thank you very much to Dr. JD Pinkus and to Mr. John Penrose from AgileBrain. Thanks Ken, really appreciate it. Our pleasure. Thanks for having us.
All right, have a great day, guys. Thanks for joining us today on the Home Care Heroes and Day Service Stars podcast produced by Oncota. You can listen to back episodes by visiting forhomecareheroes.com. That's the number four, then the words homecareheroes.com.

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