Welcome to Vision | The Home Care Leaders podcast. I’m Miriam Allred with Home Care Pulse. Before we dive into today’s conversation, I want to say thank you to all those listening to Vision. We’ve already got hundreds of listeners, and we want to thank you for taking the time to consume this content brought to you by industry thought leaders. As a reminder, I’d invite you to visit our website homecarepulse.com/podcast. To subscribe on our website, you can find the full episode, the episode, transcript and episode related links and resources. When you subscribe to the podcast on our website, we’ll send you new episodes, right to your inbox. Take a minute and check it out. That’s homecarepulse.com/podcast.
All right, let’s dive in. I’m really excited to introduce today’s guest John Bradshaw. John’s the CEO of Georgetown Home Care, which serves seniors in the national Capitol region with offices in Maryland, DC and Virginia Georgetown Home Care made INC 5,000 fastest growing companies in the U.S. In 2019 and 2020. And as the fastest growing healthcare company in Washington, DC. John is a board member at Georgetown Village. He serves on the DC Healthcare Finance Advisory Task Force, and he’s well known for speaking on Hospital Readmission Prevention as Georgetown Home Care has developed several programs in conjunction with hospitals and skilled nursing facilities to help lower readmission rates. John currently lives in the district with his wife and three children.
Well, thanks for joining us today, John, I’m really excited for today’s conversation. We’re going to hear about how your agency has pivoted over the last couple of months. You’ve already built some really strong relationships with referral partners in your area, but I’d like to hear your story, what it’s been like over the last few months. So tell me a little bit about that realization point when you decided to pivot and take COVID positive patients from local hospitals.
Yeah, so we started, um, the DC Washington DC area started really getting hit hard in late March and going into early April. And we were hearing from some of our competitors and some other agencies around the country that they were all just kind of saying, yeah, we’re not, we’re not gonna be able to take any COVID positive patients. And we kind of looked at it and said, we just don’t feel like we’re ready either. Um, but we, we sat back and thought we want to get in this fight. And what would it take for that to happen? If, if everything was aligned, what would we need to get in a fight? And we figured we essentially needed three things that we didn’t have. We needed a lot of PPE. We just didn’t have the equipment we were at that time. You couldn’t even get masks and gloves, much less gowns.
And that sort of thing there, you couldn’t get gloves anywhere you remember back. It wasn’t that long ago you couldn’t get toilet paper. It was, it was really hard to, to get any kind of supplies. So that was the first thing we’re going to need is PPE. The second thing we’re going to need is good training on how to operate in a highly infectious environment, uh, in a home, which is different than working in a facility in a highly infectious environment that we knew going to be different. And then the third thing we need was willing AIDS. And, um, right about the time we were laying this out in kind of early April, uh, the DC department of health sent us a supply of PPE and just, it wasn’t a ton of stuff, but it was, it was a lot. And we suddenly realized, okay, we we’ve got one of the three things here.
And so I went out and started looking for someone who could help us train. And I knew through Georgetown hospital, that’s not affiliated with Georgetown home care, the hospital. I knew some doctors in the infectious disease department, and I was able to hire a nurse practitioner from their team to come in and train our AIDS. And I said, I don’t even know if I’m going to have any AIDS, but I think we will. And we’ll, uh, we’ll see if we can get some people in front of you, if you can build a training module. And we had a great nurse practitioner, he was fantastic. He built a training management module and committed to training our aides. So now the third thing was the hardest part was just finding AIDS, who were willing to do it. And they were as scared as anybody else was of this illness. And we’ve got about 450 caregivers on our bench. And we’re able to convince about 45 of ’em to start working with Corona patients. So about 10% said, yes, we’ll do that. Uh, and then once we started training them, then we reached out to the hospitals and they were thrilled to hear our call
So, yeah, we definitely paid them more. We said, we’re going to, we’re going to pay you hazard pay for this, but the, and the pay was helpful, but it wasn’t, it certainly wasn’t the most important thing. The most important thing for them was could we keep them safe and did they feel confident that we could keep them safe? And so a number of our AIDS already work at hospitals as well when they work for us on off days. And they were already working with Corona patients. So they said, we’re finally doing this, but you’ve got to convince me that you can keep me safe. Like the hospitals keeping me safe. And so we were able to show them the gear and our process for how to operate in an infectious environment. And they were convinced. And then as we got a few of those AIDS working with us, we started using them and little videos to our other age, two as a Testament to the quality of the gear we had and the quality of the training. And, uh, I mean, they were literally saying I’m getting better gear with Georgetown home care than I am with XYZ hospital that I work at and turning is excellent. And that convinced a number of other AIDS to step forward, who honestly, this was almost a, an appeal to, uh, to community and to patriotism that there were AIDS who wanted to get in this fight. Um, but didn’t know how, and didn’t know if we could keep him safe.
Yeah, that’s incredible. And as far as you know, the lifecycle of the client, so they’re coming out of the hospital positive, you know, you assign them to a caregiver for, you know, a certain length of time. What would happen as the client transition from positive to, you know, asymptomatic and aggressive as the, you know, as they would phase out, would you keep them with that preexisting caregiver or aid, or would you, you know, hand them off to another aid? What, what did that process look like?
Yeah, it’s a great question. And it opens up one other issue. One thing we didn’t understand what these cases was that we weren’t getting COVID cases, we’re getting Corona cases. So if somebody had tested positive in the hospital for, uh, for Corona and developed COVID-19, the hospital was keeping them their problem. The hospital’s problem was they needed to get rid of the people who were tested positive for Corona, but were asymptomatic. And it was a mill place. They just needed to free up the beds, uh, because they were filling up so fast with, uh, Corona patients and it couldn’t send them home. Cause the families didn’t feel that they could take care of them. And the assistant, the nursing homes around here weren’t taking them either. So the cases we got were actually fairly easy, um, they were, they had tested positive for Corona. They were still considered infectious, but none of them, none of the cases that we handled actually developed COVID. So we would work with them for a week to two weeks until they tested negative. And then we would, and we told them this ahead of time, we’re pulling our Corona team off and putting in other caregivers who are willing to work with non-infectious patients. Um, and then that team we considered to be the Corona team. Can we consider to be a special strike force that only works for Corona patients? Cause we had so few of them
And throughout that whole process, were you testing caregivers? I, you know, I know they’re asymptomatic and they weren’t as far, you know, severe, but did you have a process in place of testing your caregivers routinely to make sure they weren’t contracting
The virus? Yes, I’m in DC at the time DC had really, uh, jumped on testing and had opened up testing sites all over the city. They had probably about a Hasad half, a dozen in April and they and healthcare workers were pushed to the front of the line and got results within a day or two, which was great. So we were able to get our age tested fairly quickly after working with patients.
Okay. Yeah. Yeah. It’s incredible. How many, you know, pop-up testing centers have just accumulated it’s been a huge resource and a blessing, you know, for the healthcare industry, but you know, for just, you know, locals that need to get tested and need their results. It’s, it’s incredible. The, you know, just the push to pop those up as quickly as possible. So I’d like to take a step back, um, and talk about your preexisting relationships with hospitals. Um, I know that’s been a focus in your role in, in your, you know, your background, but how have you developed, you know, what have you done to build that trust with the hospital system so that when this happened, you know, you were able to go to them straight away and say, Hey, how can we help? What were some, you know, steps that you’ve taken to develop that sort of level of trust with these hospital providers in your area?
Um, yeah, so really early in the pandemic. Um, so we’ve got a sales team of, uh, community liaisons that call on the hospitals and we look at them as our single big, they are our single biggest referral source for new patients. We’re already working with them and had good relationships with them. And as the pandemic was starting to hit our region, we reached out to them before we could take Corona patients and said, we’re here to help. Um, let us help you clear your hospital beds as this pen w of the non Krone patients. So you have more capabilities, uh, and more, uh, resources for the Corona patients. And they were thankful for that. So we were getting non Corona patients out early, but then most of the hospitals around here were filling up primarily were Corona patients. So it was a matter of pivoting to being able to help him on that side as well.
Not at all. I mean, they were so thrilled that there were one or two other agencies that were in our area that were trying to get into it, but we’re really struggling with some of the same issues and probably their, their single biggest issue were AIDS that, um, said they would do it, but then backed out at the last second from fear. So they were saying to the hospitals that, um, you know, we’ll take this patient. And then at the last second they had to call the hospital back and say, we can’t take it, that we just don’t have any AIDS willing to do it. Um, and we ran into that a little bit, but really, really worked hard on our team, um, to follow through. And once we started saying, we’ll take them and we started taking patients, they were just so thrilled. Our biggest problem was we were capacities constrained. We could have, there were weeks where we could have taken a hundred patients and we, and we took six, um, just because we just didn’t have enough AIDS.
Wow. And, and diving into this nurse practitioner that provided the training. Can you highlight what that look like, you know, to find the nurse practitioner and then how they, you know, worked with your aides to provide this training? Ultimately?
Yeah, so it was a guy named, uh, Gusto parade is who, um, his nurse practitioner who worked at Georgetown hospital and, and had, and I had known through some other contacts at Georgetown hospital through their infectious disease department where he specifically worked and he had left and gone to work at a clinic and that clinic closed up during the pandemic. And so I reached out to him and asked him to come on board with us and, uh, work for us full time. Um, and he developed a really fantastic presentation that he did via zoom. Um, and we did him in small groups, four or five aides at a time, so they could ask plenty of questions. We showed them, he showed them how to Don and off the gear, um, safely. And one of the things was over March, April, may. The guidance from the CDC was changing constantly. And he was really, really good at staying on top of the guidance and adjusting our protocols almost on a, a weekly basis as to what CDC, as CDC learned more about this disease.
Okay. And before the pandemic, what was, what does your training look like? You know, were, are you already doing kind of a blended approach or do you do primarily e-learning online training or in person, or how did this very, you know, from your, your past, you know, training methods
Prior to the pandemic? We did, uh, we did all of our initial onboarding, um, in person and, uh, our initial orientation was, um, six or seven hours of in person training in our office, um, with a lot of additional e-learning, um, for, um, uh, as we develop more continuing education for the team, ongoing training. Now it’s all virtual, uh, everything we’re doing as well, virtual, and we’re trying to adjust that to make it as effective as possible as well. Okay.
Yeah. We’ve seen that, you know, as a shift in the industry, um, having that ongoing training for, you know, things that happen, you know, viruses or whatever it may be that come up, you know, we need that ongoing training to keep the caregivers up to date and, you know, up to speed on what’s happening. And I think a lot of agencies have learned from having, you know, a nurse on staff or, you know, someone that can train on hand for, for cases like this. So I think, you know, looking ahead a lot of are, you know, trying to keep people, nurses, or other medical professionals closer to their network so that they can provide ongoing training. So that’s definitely been a takeaway, uh, for the industry. Um, so what, what do you feel like have been some of your, as an agency owner, you know, have a large staff and a large clientele, what have been some of your biggest takeaways? You know, what have you felt, um, throughout this whole experience?
You know, I think, um, in any leadership role, um, you’re, you’re defined by the, uh, the challenges that are presented to you and not necessarily the good times, but you’re really going to be defined in the bad times. You think about who the greatest presidents of all time were and all of those were wartime presidents. And so if you’re running an organization like a home care agency, this is your leadership will be defined in this moment. And I’m not saying that we did the best job. I can think back on a lot of things we could have done better, but we realized fairly quickly that we needed to be pushing out messages and having conversations with our team regularly. Uh, just so they, they heard our voices as often as possible. And I think that was probably one of the most important things we did was to do small, um, periodic calls with all of our AIDS where we’d have four or five on at a time just for them to ask questions. Is there anything on your mind, anything we can be doing better. Um, and I think, uh, this is an opportunity to really step up. And I, I think ultimately if you do that effectively, and I hope we have, um, we will come out of this much, much stronger. And I think any agency that is doing it effectively and really taking a leadership role with their team will come out of this much stronger.
Definitely. And, you know, every agency is different in our, you know, network from home care pulse. We work with agency, you know, startup agencies, also all the way to, you know, what we call the industry masters or 5 million plus, you know, agencies. What would you say to maybe people in the beginning stages right now, maybe some of these startups or smaller agencies that may not be as large as yours, or have as many processes in place. What advice would you give them based off your experience right now?
Um, I think the, uh, I would say get in front of your people as often as possible and, and take a moment on a daily basis to think what members of your team are potentially hurting right now. Um, so, you know, I’ll give you an example. There was a period where I just felt like some of our staffing coordinators, they were working from home and, uh, it just felt like they were really under the gun and under a lot of pressure. And so we took a night where a couple of us in our leadership role, um, went and bought a bunch of frozen lasagna and drove around to their houses and dropped them off on their doorsteps and said, Hey, you know, this is for your family this weekend. And it was really, really appreciated that they, they, they felt very appreciated at that moment.
Um, we think about that with our caregivers also where, um, how many, we’ve got some caregivers who can’t work with Corona patients because they’ve got preexisting conditions. They’ve, you know, 65 year old diabetic, who’s a fantastic caregiver, but she’s really, really worried about getting sick and it’s, and she said, she’s in a high risk category and we’ve got a handful of those. And so we’re trying to think of ways to keep them working in the safest possible way. And if you, if you just keep putting yourself in the position of your team members, what they’re worried about, um, you’ll ultimately end up developing a much stronger team and a much stronger organization.
Our staffing coordinators and our director of HR, our, our, our frontline, cause they’re talking to them on a regular basis. So I keep reaching out to them and saying, what are you hearing? What are you, is there anybody out there hurting, you know, is there somebody out there who can’t take shifts and isn’t able to put food on the table? You know, we are running into those types of situations and they’ve been raising those things with me, but the conference calls we did with them, where we set up a, especially at the height of it’s gotten better now, but at the height of the pandemic, just putting out a series of conference calls where I took a two week period and every hour on the hour, I had a conference call where anybody could call in just to ask questions and we had people signing up for though. And, um, that helped a lot. And it honestly, it opened my eyes to some of the issues that they were dealing with also.
That’s awesome. Yeah. I had, you know, I, haven’t heard of that type of, you know, like a forum open forum with all your employees to say, Hey, reach out with questions. That’s really awesome. Um, and that’s great that they were willing to get on and participate.
We didn’t want to do that in a big session either. We didn’t want to say, um, let’s have all 450 on a call cause it would just be chaos. But if you did it in small batches of four and five at a time, they really got a chance to talk and you heard a lot more
[inaudible] and any of that feedback stand out to you. Anything you want to share, you know, from what your caregivers or even your staffing coordinators were saying, anything, stand out. Probably the single biggest time.
Biggest thing at the time of the pandemic was I didn’t realize how much fear there was in our workforce. That, that really stood out to me that, uh, that they were as scared as anybody was. And I thought being trained healthcare professionals, that they would be less fearful and that they had to understand that the training we provided would help to keep them safe. And they were as scared as anybody and in some cases more scared than many, it, it really frightened them and, um, uh, helping them deal with that fear, I think was a big part of it.
Definitely. And I think for a lot of us, it’s the fear of the unknown. You know, this virus is constantly changing and symptoms are constantly changing and there’s just still so much unknown. And the fear of the unknown, you know, I think we can all relate to whether we’re, you know, caregivers or, you know, just members of a family or, you know, wherever we are in our workforce. There’s just still a lot of unknown. And the fear of the unknown is, is pretty scary.
I wouldn’t say too to their benefit, they adhere to their training and their process. And none of our Corona team has contracted the virus. None of them have tested positive. We’ve had, I think four AIDS out of the 450 test positive, but, um, the best we could tell, none of them tested positive on the job. There was no, uh, based on the contract contact tracing that we did, there was no crossover between the job and their positive tests and none of our clients had tested positive from any of our age. So there was some community spread, but I think the healthcare professionals being trained at hand washing and wearing masks and being thoughtful about their environment ultimately ended up being safer. Knock on wood.
I would say it that way. Yeah. Another question that’s coming to mind, um, you know, we’ve talked a lot about clients coming directly from these hospitals as far as overall demand for your services, you know, have you seen, have you seen that gun go up or down or what has that looked like over the last few months, as far as just, you know, organically finding new clientele?
Uh, yeah. So late March, early April, we lost probably about a quarter of our clients and it was mostly clients who were saying, you know what, I, there were two categories you had, you had the, we’re taking care of mom, mom lives with her daughter. Her daughter goes to work every day and they’ve hired us to care for her. Well, now the daughter is working from home and she doesn’t really need us right now. So that’s fine. So we, we lose that client. We also lose the client who says I I’m in, I’m not in that bad of shape. I really liked the companionship. And I like having somebody to come over and, and help me, but I can get along without it. And I just don’t want to take the risk. So that combined those two things combined add up to bet about a quarter of our business. But once we started reaching out to the hospitals and saying, we were here to help, we replaced that really quickly. And then some, so we’re, we’re above where we were in February. Okay.
Um, we, no, we never had to lay anybody off. Um, we were, we were hopeful and we were capable of replacing them with, um, with patients coming out of hospitals and we were able to do it fairly quickly. So it was really a quick, almost like a V shaped, um, uh, downturn for us. And it popped back pretty quickly.
Okay. Okay. Yeah. That’s great. You know, that hasn’t been the case for some agencies, but that’s great that you had, like you said, you know, your sales reps out there ready to go talking to the hospitals to fill that demand so quickly. Um, so looking ahead, you know, what are you anticipating for the next couple of weeks and months?
Well, we’re still sourcing PPE. Um, the DC region is doing pretty well. Um, we’ve had, uh, it’s, we’ve flattened the curve pretty well in Maryland. Uh, we operate in Maryland, DC and Virginia and Maryland they’re testing. Um, the percentage of positive tests is down around 4% in DC. It’s down around 4% and in Virginia, it’s a little bit higher. It’s up closer to 7%, but a lot of that is in a part of Virginia that we don’t service. So really in and around the DC area, the positivity rate is down around 4%, which is good. Um, but we’re just going under the assumption that it’s going to start spiking again this fall, and we’ve got to be prepared and we’re telling the hospitals we’re prepared. So we’re, we’re trying to ramp up more PPE. We’re trying to talk to more caregivers about, um, uh, volunteering to work with Corona patients. And just assuming that this is going to be bad over the next six or eight months. And if we’re wrong, we’re going to be pleasantly surprised and, uh, that’s prepare for the worst and hope for the best.
Um, I think, can we convince enough caregivers to handle the, uh, the surge of patients that we’ll get from hospitals if it does spike back up? Um, because it was heartbreaking to say to a hospital, Oh, you’ve got 12 patients. She needed the discharge today. We can take one. Um, and they were thankful to get that one, but the, you know, it was just anguishing to know that their, all of their beds were filled and they had people who were not that sick that could go home. Uh, but they just had nowhere to send. And so really sick people were not that, that was the kind of thing that just kept me up at night thinking about how do I solve this problem? This is my community.
[inaudible]. Yeah. And yeah, I don’t, I don’t want to go too far off on this, you know, recruitment is its own beast that we could dive into, but I’m assuming you’re actively recruiting new caregivers all the time right now, correct?
Yeah, we, we recruit in two primary ways from our current staff, we’re constantly reaching out to them, asking them to bring friends and family members in who are licensed caregivers. Um, and we do a lot online in our region. Um, our website, we do a lot of work on, uh, SEO and SEM, um, search engine optimization, search engine marketing, and PR. And we get a lot of caregivers coming in off of our website. And then we do a lot of advertising on Craigslist and indeed, um, Craigslist has been fairly effective for us as well.
Great. Great. And, and are you hiring, you know, in these job posts or in this content, are you hiring specifically to take Corona patients or do you mention that in the, in the recruitment, you know, content,
We do have some ads out there saying that we’re a, it’s not all of our ads, but some of our ads talk about, uh, working with Corona patients and, you know, having an effect on the community and making a little bit more money and that sort of thing. And, uh, um, and we’ve gotten a few from those.
Yeah. Cause like you said earlier, you know, there are people with good hearts that want to be in the fight and they want to help. And you know, the more we can capitalize on those special people, you know, that just have good intentions the better off, you know, we are as an agency, as an agency and as an industry. So yeah, I really appreciate, honestly, everything that you’ve said today, I think it’s been valuable. Um, you know, you’re out in the East coast and we talked to, you know, people listening to this maybe, you know, on the West coast or Midwest or, you know, down in the South, but, but honestly everywhere is experiencing this, you know, pandemic in a different way. And like you said, a lot of people are anticipating researches in the fall. So a lot of what we’ve talked about today is applicable moving forward. Um, so just in closing, you know, is there anything else you want to mention or anything, you know, that we didn’t hit on or I didn’t ask that you feel prompted or inspired to share?
Uh, not, not in particular. I think I, I think I covered probably most of it. Um, I, I guess I would, the only other thing I would say is stock up on PPE now while if you can get it, get it. And, uh, the best case scenario is if you’ve got PPE that wastes away a storage room someplace, you know, that’s great news for all of us.
Yeah, definitely. Yeah. The importance of PP, honestly, right now can’t be understated and you know, right now we feel like we’re doing okay, but it’s just better to be prepared moving forward. So that’s, that’s a great piece of advice. Well, thanks for taking the time today, John, I really appreciate it. You know, Georgetown home care is lucky to have you. Um, the industry is lucky to have you you’ve accomplished so much. And you know, we really admire leaders like yourself that work so diligently to take care of your, your own staff, but also the clients that you care for and to, you know, light the load of the hospitals in your area. I know that they are grateful and know the impact that you are making. And so, you know, awesome job and we wish your team the best moving forward. You know, we’re all hopeful for the future. And honestly, like you said, we’re just all hoping to come out of this stronger. So best of luck moving forward and thanks again for taking the time.
As always, it’s been my treat to converse with John Bradshaw. We hope you’ve enjoyed today’s episode. Feel free to check out our website to view the episode transcript and related resources. We also want to invite you to share this episode on social media or with a colleague in the industry that could benefit from the content. But those of you interested in learning more about Home Care Pulse and what we do besides the podcast, blogs and industry data, visit our website. We work with thousands of home care agencies across the country, providing client and caregiver, experience surveys and caregiver training. Our solutions are customizable and designed to help you improve your client and caregiver experience. Learn more at home care, pulse.com. Thanks for listening and tune in next week.