Ep:07 JEVS CEO Explains How to Create a Culture With 99% Caregiver Satisfaction

Miriam Allred (00:05):

Welcome to Vision |The Home Care Leaders podcast. This is Miriam Allred with Home Care Pulse. While you might be familiar with us from the Home Care Benchmarking Study, our weekly blog or this podcast, our day job is actually helping agencies improve their quality of care using monthly client and caregiver surveys and caregiver training. Learn more about us at homecarepulse.com.

Today I’d like to welcome Michael Ferraina to the show. Mike brings an abundance of expertise and experience having served as a division director for an international home health care organization, where he ensured that the best caregivers were hired and retained to serve clients. Michael holds an MBA in healthcare administration from Wilmington University and a bachelor’s in business management, marketing and leadership from Eckerd College today. Mike is currently the CEO of JEVS Care at Home in Pennsylvania. Welcome to the show, Michael, really excited to have you, before we jump in, I’d like to ask a couple of, get to know you questions, so you’re not prepped for this, but hopefully that’s okay. Who was your celebrity crush in middle school?

Michael Ferraina (01:12):

That’s a tough question to start with. Well, let me start with saying thanks for having me. My celebrity crush in middle school. I don’t remember what shows I watched the middle school. I think I watched Saved By The Bell saved by the bell. I may have to go with Kelly Kapowski.

Miriam Allred (01:33):

Hey, nice. Yeah, that’s a great one. Shows your age a little bit, but that’s okay. One more question. This one might be a little bit easier, but what restaurant have you missed most since quarantine started?

Michael Ferraina (01:48):

So restaurants in general I’ve missed it’s probably one of the things I like to do most with my family gets a salad. I have young kids, so it’s the probably the safest place for us to go as a family. But there was an Italian place near me. It’s like traditional South Philly, Italian food. It’s called the Kitchen Consiglieri and South Jersey and yeah, we used to go there at least monthly and we had all of our big events there, like, you know, bridal showers and things like that. So I would have to say Kitchen Consigliere.

Miriam Allred (02:28):

Awesome. Yes. I’m sure everyone listening to, they also misses restaurants, especially. Yeah. You’re in Philadelphia area, so things are still pretty shut down so I can only imagine, well, yeah, thanks again for joining us. We’re really excited to have you today. I want to dive into company culture, you know, just at a high level, Michael, tell us how you’ve built a strong company culture there at your agency.

Michael Ferraina (02:53):

Yeah. Starting at JEVS. Yeah. The first thing I noticed was JEVS is a, it’s a more regional company. We, we service all of Pennsylvania you know, stronger pockets in the Philadelphia and Pittsburgh markets. And we have a aspiration to grow throughout the state and to start branching out a little more regionally. We also want to diversify. And so the, those were some of the things as I was beginning you know, through my interview process to even getting this job that was always my vision for jabs. And I, I realized that JEVS originally was run as one large office in Philadelphia where most of the businesses run out of, and we had a small satellite office out in Pittsburgh. There was some connection, but it wasn’t deeply rooted in how we did things. So my big concern always was around consistency, you know, how can our brand grow consistently?

Michael Ferraina (03:56):

And then how competitive home care is in general, like how will you grow? So there’s agencies popping up, you don’t have to, especially in Pennsylvania, you don’t have to have you know, like this well-built company in order to be established here, you could be you know, a small player and with minimal employees and get it off the ground. So I wanted to make sure that when we went to a new market or even in our current markets, we start to brand ourselves around a common purpose. So JEVS is a nonprofit. So the common purpose has always traditionally been, you know, connecting people to resources in their community creating opportunities for employees you know, really big aspirations, but they were very general and we were really starting to hone in on who we were going to become as when we grow up. And I just felt like it was really, really important to start establishing a set of fundamentals or guiding principles that we all we, as in employees can connect to so that our language becomes stronger and more consistent so that the people we serve can start to feel more connected in very individualized ways.

Miriam Allred (05:16):

Yeah. I love the way that you’ve broken that down. I want to even specify in a lot of people in a lot of industries, not just home care can fuse culture and, you know, benefits or perks. And I think you’ve done a really good job of, you know, using some strong words, community consistency, connections that really define culture. So taking a little bit further, how are you as a CEO, as an executive setting that example, or setting the tone for the whole company?

Michael Ferraina (05:47):

Very upbeat and very positive. And one of my passions and where I get a lot of job satisfaction is helping him watching others grow. I always had opportunities early in my career to, to lead to run offices, run teams, run regions, things like that. And I was very fortunate, but when I, I looked back and I try, I do it all the time now, like what helped me put myself in that position? It was always because I was trying to help the next person get better. And when the team is as strong through, you know, each person helping the next one it leads to a positive environment. And whenever I think about growth, I think about like the largest growth jumps that an office that I was in or running happened around a group of people that were well connected.

Michael Ferraina (06:46):

Like we would do anything for each other. Yeah. You could usually tell an office settings when you go out and, you know, maybe get drinks after work or, you know, you have it volunteer opportunity and, and you throw it out to the team when the whole team comes, you know, your culture is tight and you know that you, you have a connection, you know? So I, I always looked at that and I said like I, I enjoyed that. Like that, that’s, that’s the other part that money can’t buy, like, you know, watching people grow and helping them grow, like always mattered to me. So when I, when stepping in the JEVS, the like culture is it’s infectious and like people you think of JEVS like, I always break culture down. I try to look at Orange Theory or CrossFit, like people go to those places and spend the amounts of money they do cause they want to be part of something. So starting at JEVS and like really throughout my whole career, I’ve always tried to have people want to be a part of something with me. And through that comes personal growth, you know, operational growth, you know, just general business success. And everybody tends to win when that happens.

Miriam Allred (08:03):

Yeah. That’s huge. Everything involved with personal and professional development, you know, setting that tone and being that leader that, you know, not only exemplifies that, but also encourages that behavior with the employees and the people in the company. That’s awesome. So how, how would you, how do you define the communication or the implementation of the culture? You know, what does it actually look like?

Michael Ferraina (08:29):

This was a, like a really large project or, or a commitment that I made early on. Like I, I literally the first day I started at JEVS, I started talking about culture, you know, that it was going to be the most important thing that we do. You know, we can have a strategic plan and we can have sales plans and recruiting plans and all that stuff. But if we didn’t invest enough time in our, and our people, you know, none of that matters because it was never going to become as great as we wrote it down. So the communication started early articulating it and defining it in a way that people can understand. It took a lot of time. So I I’ve been there a little, little over a year and a half, and I feel like we’re really now are just starting to catch momentum on what this actually means and really what it looks like.

Michael Ferraina (09:22):

I mean, people tend to understand things in pictures. So what we ended up doing was I, you know, I was reaching some milestones in this, but I was also faced with a lot of barriers. And I started, I joined a networking group and they recommended us book culture by design. And after reading it culture by design is all about culture and how you set up a rich culture internally, and it’s really a workflow. So you can actually work through the book and actually implement things as you’re reading it. But I realized the author was from South Jersey and I reached out to him and we connected. And in that meeting, he told me there was this app that he was developing called culture wise. And this all happened, I would say January of 2020. So it was pre COVID. So I was all in, when I saw it, it was exactly what we, we needed.

Michael Ferraina (10:24):

It was a consistent message that connected everybody, whether you’ve lived in Pittsburgh or you lived in Philly, everybody had this opportunity to be on the same platform and communicate the, the culture that we’re trying to implement. And what came out of all of that was a commitment to 28 fundamentals. Other words, you know, another way of saying that is 28 behaviors that we are going to agree to, and those behaviors are the makeup of who we are going to be day in and day out when we’re working at Joe’s. So right now we’re in the midst of rolling out these 28 fundamentals and on Monday morning at 8:00 AM. I, well, prior to that, I write a two to four paragraph a write up about the fundamental of the week and when that gets pushed out to the whole company they read the write up, you know, why it’s important you know, looking at that fundamental inaction.

Michael Ferraina (11:22):

And then every meeting that we have that week whoever’s leading the meetings spends three to five minutes, just talking about the fundamental the week. So it’s, it’s like a way to connect back to purpose, and we’re starting to see there’s a lot of momentum and just shared stories around things that we commit to. You know, the first thing is do the right thing, always, you know, so we, there was just a lot of great discussion about that and it, I think it’s going to evolve in time, if this is foreshadowing of what’s to come the excitement and the connected connectedness to the vocabulary we’re starting to use is starting to, I think, brand us in a way that is consistent with our actions. It’s our word. It’s not just what we say is we’re actually doing it now. So it’s, it’s been exciting. It’s early. It definitely helped us with COVID and being remote there, there’s a kudos section on there where the group can give shout outs, you know, this was a, you know, a fundamental inaction and they give a shout out to somebody and for somebody that’s not in the day to day, I know exactly what’s happening and when recognition is, is needed, because people are recognizing each other and it’s just really helped with the morale as well as you know, just having a line of sight on what’s actually happening.

Miriam Allred (12:50):

Wow. Yeah, lots of right down there. Wow. I could ask a ton of questions. As far as those 28 fundamentals, I’m not sure if they’re broken up into categories, but could you give us maybe a little bit of a deeper look at what those entail? You’ve mentioned a couple, you know, recognition, kudos. You know, you mentioned a couple, but maybe at a higher level, but also deeper level, you know, maybe talk about what those fundamentals look like.

Michael Ferraina (13:19):

The hardest thing in the service business is like, we have our metrics and they’re concrete. They’re very objective, but then you have behaviors. You know, service is led by behaviors. There’s, there’s a reason why, you know, certain companies are just known for their service, know, you think of Disney, you think of Ritz Carlton. Like there’s a reason for it because they’re consistent in their actions. So how do you coach the actions? And that that’s always been, that’s a big leadership challenge. And I always looked at the fundamentals as a way to objectify the action. For example, if somebody, you know, doesn’t call a client back timely or say somebody applies to a job and nobody responds within 24 hours, we can take phrases out of our 28 fundamentals and those 28 fundamentals or 28 ones that we selected. So they’re not the same for everybody.

Michael Ferraina (14:24):

But you know, we, we decided that like make quality personal, you know, like what does that mean? Well, you know, we want to make sure that we have a healthy dislike for mediocracy, you know, so are we good? Are we great? You know, so good is the enemy of great. If we can’t say that we’re, we’re doing a great job on something, we call out that fundamental and it becomes a little more, but it also ties back to a operational metric of quality, right? So there’s a connection and it kind of bridged the gap around behavioral leadership. And it also, like you can picture, like, what does assume positive intent mean? I mean, it’s pretty self explanatory. Like don’t go in with a preconceive thought on how somebody is going to respond to you or why they’re responding to you that way.

Michael Ferraina (15:21):

You know, it just, it gives you a trigger to say, am I following my fundamentals? You know, or not? And if I’m not, what do I need to do to get realigned back to it? Because if I have a one on one with my supervisor, or if I’m with a team member, how are they going to perceive, you know, my way of having this conversation, if I have already assumed assuming negative intent. So it’s done a lot to connect us create pictures of what things mean. You know, one of our, our final one that we chose was to celebrate we, we want to be you know, a company that recognizes and sell celebrates and to keep things fun. And we want work to be as fun as possible, even though it’s hard.

Miriam Allred (16:11):

Yeah. Well, I love everything that’s been said. I love what you said about the difference between metrics, because I think a lot, you know, most agencies, they’ve got metrics, they’ve got numbers, they’ve got data that they’re going by, but you’ve broken it down by behaviors. You know, like you said, this is a service based industry and, you know, the data is important, but at the end of the day, the behavior and, you know, sticking to those fundamentals is what’s really important. So I love everything that you’ve said there. I know you guys are just starting to implement you know, this plan or these fundamentals, but what, how are you going to be flexible with it? You know, how are you going to adjust as you know, the needs of your company or the needs of your individual employees changes

Michael Ferraina (16:57):

So great in regards to the fundamentals? I believe that is our foundation and we can always add to it at 28. It’s a lot, you know, but it, it tells a story. We didn’t want to go over 30. We didn’t want to stay under 20. So there’s a lot of other good ones we can choose and we can swap out and things like that. So the evolution of this business could also evolve through the fundamentals that we’re selecting now that said I think that like the industry as a whole is changing I think operationally we’re going to change. But the way that, you know, like putting your best foot forward, when we’re talking to referral sources, clients, payers you know, employees, I think that the fundamentals are there basic. So, and it’s really, it’s like your best practice.

Michael Ferraina (17:58):

Like when you say, how should a great company operate or, you know, act, I think a lot of these things would fall under any company. And the key though, is, are they being followed? And I, I think that’s the challenge that I see is in our industry, you know, our metrics track a lot of growth and satisfaction and things like that. We, we talk a lot about doing the right thing for clients, but the actions don’t always show that. And that’s the one thing that bothers me the most with home care is, you know, we are in the service industry. I want to make sure that our company is known for doing what we say we’re going to do. So that it’s not, Oh, like, yeah, I see, want to grow. We want to grow the right way. And that’s what these fundamentals are doing for us. And I don’t think they’re ever really going to change completely in time whether we’re working remotely or, you know, for telehealth services, whatever it is. I think that the personal side of what we do will always have relevance to these 28 fundamentals

Miriam Allred (19:11):

Yeah. In those kind of a perfect bridge to our next topic. As you focused on culture internally, you know, the communication, the implementation of it, how has that affected your output? You know, the services that you’re actually providing that your caregivers are providing, how is, you know, focusing on internal culture, going to segue to better, you know, service provided

Michael Ferraina (19:34):

Well, consistency in service is a seller. I mean that, that’s it. We can put money into marketing or we can put money into our people. You know, so my approach was I want to put money into my people because my people ultimately get the outcome. I can pump a bunch of leads if I don’t call timely. If we don’t take quality personal through the call you know, if we’re not doing the right thing, always we can mess a lot of things up. So I put a lot of dollars into my people through this process and the commitment to this process moving forward, because this is a direct correlation back to culture or back to service. The culture that we’re establishing is going to impact how we talk to people, how we treat people, what we’re willing to do above and beyond, you know, whether an authorization says, like, if somebody is out of food, are we just going to let them starve or are we going to help them now, are we going to try to connect them to another community provider that might be able to deliver food for the longterm?

Michael Ferraina (20:42):

You know, maybe, maybe we’re you know, an, a private pay client, for example they need to get to the doctor and we order a Lyft or Uber or something like that. You know, I think those are the behavioral things that impact service. And then going back to what I said about operational metrics, when you hire somebody new, or, you know, you have somebody, you know, that staffing or recruiting, and you say, you know, we need X amount of people or, you know, your margin needs to be Y being able to explain that, and then not just saying, well, you know, we have to keep the lights on, you know, of course we do, but how does that impact the future? You know, and I, I go back to the personal experience and personal growth, you know, people want stability, people want confidence, you know, in, in the company that they’re working for. So how do you connect the operational metrics back to if we do these things right? You further support the operational metrics that we need in order to be healthy. So I, that, that correlation between being able to describe the metric, but then create the, the path on how to accomplish it, I think creates an, a tremendous amount of clarity for people.

Miriam Allred (22:04):

Yeah. Yeah. I love how you’ve broken that down. I wanted to talk a little bit, I know you use you know, client and caregiver surveys to keep track of, you know, that polls on their feedback, what they’re saying, what they’re thinking, how has obtaining, you know, getting those, that feedback, how has that helped you identify maybe these fundamentals or how has it pointed you in this direction to focus on culture as it relates to internal and external services?

Michael Ferraina (22:38):

Yeah. I mean, it’s the voice of, you know, our, our clients, you know, and then that includes the employees because our employees are just as much of a client to us as, as the people getting or receiving the services. I mean, when you hear it from them, you can really break it down. If there’s a complaint, you know, we can identify what fundamental is not being met. And that situation when, when you get a, a, you know, a score of a 10, and then there’s a nice little writeup and maybe a testimonial in there, we can correlate it back to the fundamental, you know, and it just further supports that these work or these, you know, we didn’t do it and it didn’t work. So it, it definitely tells a story. And we, one of the things that we try to do is call everybody.

Michael Ferraina (23:29):

So we get the survey we’ll check the interviews the morning after we’ll call everybody, you know, thank them for taking the survey if they scored us well. If, if we didn’t, if it, if it wasn’t a 10, like, you know, we want to better understand, and then we can tie not only their written results, which sometimes can be vague, but we can dive a little bit deeper and get a little bit more perspective on what they meant by, you know, an eight versus, you know, a 10, like what maybe some people just don’t give tens. Okay. You know that now we know, but is it anything in particular that we need to be doing you know, that that could lead to better behaviors internally to get a consistent you know, nine or 10.

Miriam Allred (24:18):

I just want to throw out there that, you know, JEVS has achieved a 99% caregiver satisfaction rating, you know, so as you’re saying these things, it’s not just, you’re not preaching to the choir, you know, you’re actually living up to the scores. Anything you want to say to that, you know, having achieved such a high caregiver satisfaction rate, what, you know, what does that mean to you?

Michael Ferraina (24:42):

Well, I, I mean, it’s, it’s great to, to get those scores. I think what keeps me up at night is how to keep them there. You know, it’s, it’s a moving target. You know, one or two bad conversations can really turn the tide or if he’d get, you know, a bad Apple in the mix of your operation. You know, it’s really important that we’re talking about this all the time. I mean, it’s, like I said, in the beginning, it’s every day it’s, it’s Mondays to, you know, to introduce it and whatever that fundamental is, but it’s constantly in our face. It’s the questions that I asked first are more around how people are feeling about us rather than how we’re doing, because that is the, like, that’s a lead measure. I mean, you know, we, if we can impact how people feel about us, then, you know, we’re not going to get the results that we budgeted for. You know? So I, I think that you know, it’s, it’s great. It’s a, it’s a great feeling, but you know, this is a journey. So that’s, that’s a snapshot in time, you know, tomorrow’s a different day and we have to continue to be consistent.

Miriam Allred (25:54):

One question I want to ask along those lines is sometimes it’s tough to find someone or to know in the interview, the hiring onboarding process, if somebody really fits a company culture, are there, I don’t know, identifiers or things that you could speak to that help you find, you know, good cultural fits for your company?

Michael Ferraina (26:19):

Well, I wish I had the magic bullet, but I think interviewing and hiring is I guess, more often than not, but we do pull these fundamentals into the interview process, which I think has helped us as far as creating excitement and consistency prior to somebody starting with us. So just speaking to like the onboarding process, you meet with multiple people, especially as, you know, a regional size national company you know, there’s going to be a lot of people that you’re talking to throughout the process. One of the things that I get concerned about is, are we dropping the ball or like is one person providing excellent service and the process and the next person isn’t, you know, if, if you have a language, a common language throughout it, it starts to build connections with people where when they get to the end of the interview process or the hiring process, they feel pretty good.

Michael Ferraina (27:18):

Like this company is on it, they’re consistent. I know what I’m walking into. So I, I, I feel like we get a good we start off on the right foot when people begin with us. And I think that’s really important, especially from a retention standpoint. You know, we want to, especially caregivers, we want to keep them at least the first 30 days. I mean, if you was in the first 30 you’re in trouble you want to keep them beyond 90, you know, and, you know, and then beyond a year is like the next target. So we have to be consistent upfront, otherwise they have a lot of other options. So I think, I think from the perspective of onboarding it’s, it’s helped us tremendously. I can’t say that we’ve unlocked all the secrets of interviewing and how to tie this stuff in. But we do use it. I mean, we definitely, you know, talk to me about, you know, what going the extra mile means to you. You know, I’d say it’s a behavioral, you know, tell me a story when, you know, you took an intelligent risk and there’s another fundamental. So if the answer is tie back to some of the descriptions and what we believe is are the greatest way of doing our work you know, we, we can start to navigate or break down the interview a little bit deeper.

Miriam Allred (28:38):

Yeah. Yeah. Great, great response. If you had the silver bullet, I’m sure the whole industry would know cause we’re all looking for it. So, so no pressure there, but great response. Honestly, I love what you’ve said about how these behavioral fundamentals, you know, really are talked about from day one, you know, before day one on the job, but really in the interviewing process. And it’s helped you, you know, identify and establish that relationship and that, that transparency from the beginning. So I love that. As we kind of wrap up here a little bit, I want to kind of bring it back to services and how your culture benefits and really changes the outcome of your services. I want to talk a little bit about client referrals, you know, when you’re focusing on, on company culture and then that in turn reflects your service, that is how have you seen that turn into more referrals and reviews from your current clients?

Michael Ferraina (29:33):

Well, we started a couple of different service lines since I’ve been here. So for example, we were primarily a Medicaid organization, like from the beginning, I mentioned that Philadelphia is like the main hub that’s for a lot of our clients live. So as we diversified over the past 12 months, and this was starting to be rolled out we’ve saw a tremendous uptick and private pay business. We started with nothing this year we’re estimated to do almost 2.5 million. So we had, you know, massive growth over the first year. We finished the first year with over 45 or 50 clients. There was just that we were consistent. I mean that, that’s, consistency’s everything. We, we have the same personnel internally, and I know that’s important with retaining staff and things like that. So I feel like people are happy to work here.

Michael Ferraina (30:39):

They’re delivering on the fundamentals and the community is feeling it, you know, we’re at a point where like a lot of providers, you know, we can’t hire fast enough to keep up with the growth opportunities. So that’s really exciting that gave us the confidence to build our next layer of growth opening to two more offices and diversifying a little bit further into a third service line this current fiscal year that we’re on. So we’re, we’re definitely seeing volume come in as far as requests, you know, needs requests for more clients. And then, you know, just the, the recruitment piece I wish there were more applying, you know, it’s, it’s one of those things. It’s, it’s like a Seesaw, the minute you have too many referrals, you don’t have enough clients and or you don’t have enough caregivers.

Michael Ferraina (31:34):

And you know, when you have too many caregivers, you, you know, you’re scraping to get the next client. You know, we’ve been on that, that other turn though for, for a little bit of time now where the referrals are there, we just have to staff it. So we want to do it the right way, you know, so I think that the, the word’s getting out that it’s a great place to work. I, it’s the first time in my career where I actually had people calling me to want to work internally for me which you know, it’s, it’s it’s just a great feeling. I, you know, you kind of have a bench of people that want to join you. I just hired somebody that I been talking to for a year. And we finally had an opportunity and that person just joined us and you know, it’s just it’s been great in that way. It’s by far perfected though, you know, we have a long way to go. But it’s just really exciting. I mean, this, the journey of building culture is so rewarding when you start to see the service results.

Speaker 4 (32:35):

Yeah. Wow, great summary of everything that we’ve talked about. I love it.

Miriam Allred (32:40):

Anything else that we haven’t hit on today that you want to speak to or elaborate on?

Michael Ferraina (32:45):

No, just the our hypothesis, I guess you could say is culture drives everything and we’re going all in on our culture. If people are not spending any time on their culture, I, I would just question that and, and say, think twice about it. It’s just as important as your business line because you need your people to get there.

Miriam Allred (33:09):

Definitely. I love it. Well, thanks for taking the time today, Michael, I really appreciate it. Everything you’ve shared today has been insightful. And, and even just that question, you pose it at the end and, you know, we want to get agency owners thinking about their culture and, you know, looking to drive that change. So appreciate it. Thanks for taking the time.

Michael Ferraina (33:28):

Thanks a lot. Thanks for having me.

Miriam Allred (33:32):

There’s more where this came from. If you want to get the latest episodes of Vision, head over to our website, homecarepulse.com/podcast to subscribe today. We’ll see you next time.