Ep:01 Fascinating Operational Takeaways from Family Resource Home Care in the Ongoing Crisis

Miriam Allred (00:04):

Welcome to elevate the home care leaders podcast. I’m Miriam Allred with Home Care Pulse, and I’ll be, today’s host. I’m excited to chat with Jeff Wiberg, CEO, Family Resource Home Care. Jeff’s been the CEO for over eight years now and oversees their 10 locations in Washington and Northern Idaho. Jeff also currently serves on the HCAOA national board and is the liaison for the Washington chapter of the HCAOA. He’s a well known provider, speaker, and industry thought leader and it’s my pleasure to welcome him onto today’s show.

Miriam Allred (00:37):

So, Jeff how’s everything going?

Jeff Wiberg (00:46):

Well, under the circumstances, Miriam, I would say that we’re doing very, very well.

Miriam Allred (00:50):

Awesome. Glad to hear it. Well, we’re really glad to have you on today. You know, we’ve got a lot to dissect and a lot to talk about today, so let’s get right to it. Today we’ll be talking about what operations and protocols your agency has adopted as a result of COVID. Then we’ll talk about which of those adopts shins has been most influential and why. And then to wrap it up, we’ll talk about which adoptions we’re making as an industry in which you believe will become mainstream post-crisis. So to get us started, Jeff, what has your agency done or been doing to cut costs during and throughout this crisis?

Jeff Wiberg (01:27):

Sure. Well, you know, as, as you probably are well aware Washington state was very early in, in the whole evolution of, of the COVID-19 crisis here in the United States. And we had some of the first official cases within the U S right in our own backyard. And just down the street, literally from some of our offices in the Puget sound. And so I it’s, it’s almost like one of those scenarios where I remember where I was when, and I remember being in an executive team meeting and having my chief marketing officer who came from us came to us from a health system in the Puget sound region who had been communicating with some of her friends saying that boy, they’re seeing this, this coronavirus pop up and it’s starting to kind of catch some, some attention there at the hospital system.

Jeff Wiberg (02:25):

And thought boy we ought to, we ought to do some preparatory work and I have to confess Miriam that I was a little bit like Matt. It may become a thing, but I don’t know about that. And but feel free to work on it. So I had her and our CMO, our chief human resource officers kind of work on some communication pieces and little did. I know that boy, that that was going to become a very real concern very, very quickly. And so I was very grateful and this is a lesson learned for me, very grateful that we were, that we had some cool heads on our team, even though I was not necessarily one of them. We had some cool heads on the team who was, Hey, you know, this could become something let’s get prepared. And the way that we prepared started with communication pieces out to our clients and our caregivers.

Jeff Wiberg (03:21):

And in fact, the documents that Sasha or CMO drafted ended up becoming a template for what, the way released to all of, all of the entire industry. So we were definitely early on the process. We, when this really started to take hold, which is less than a week later, we met as a team and we came out with a cost cutting protocol that we called a level one level two level three. And we decided that we don’t know how long this is going to be. We don’t know how deep it will be. We don’t know how how we’re going to be financially impacted at this point. I mean, actually we were meeting

Speaker 4 (04:05):

At that

Jeff Wiberg (04:06):

Point we had only one client go on hold. And so at this, at this juncture, we’re talking an impact of two hours to our schedule. And so not, not very much impact, but nonetheless, we didn’t know where this was going to go. And we had a lot of talking heads out there saying that, you know, ranging from this is nothing all the way to this is the end of the world. And there was very little, truly good data available to us as an organization or frankly, us as a country. And so as a team, we said, okay, if this goes six months and we take a 40% debt, what are we going to do? And we knocked out all of the possible cost cutting measures that we could engage in as a company and categorize them based upon their impact to our ability to function, as well as the difficulty in which they, they would be implemented.

Jeff Wiberg (05:13):

And all of our response level one, as we called it were easy to implement and low impact. And so that was the, that was the first stage that we would, we would begin with and say, okay, we’re going to, we’re going to tighten a few things up, but it’ll, it’ll be the low impact to our ability to sustain our culture or model, et cetera. But it would be easily to implement. And then it would move up from there. You know, phase two would have involved a potential furloughs or a reduction of, of hours for staff. And, and that, that begins to have a true impact upon people, as well as the business and being able to operate. But we were willing to go there if necessary, we kind of are, are organized by thresholds. And I I’m giving you a little bit more background than you probably were looking for Mary, but, but I think it was, it was a really good lesson learned for us because you don’t necessarily know what the beginning of a crisis, how bad it could end up being.

Jeff Wiberg (06:12):

And if you’re prepared mentally to go there and you have it organized in a kind of a trigger format, we know if we get here, we’re going to, we’re going to do this. And if we get here and we’re going to do this, then you have your countermeasures ready to go. So that the examples that I give you in our, in our case, our organization, where we’re widespread, we have 10 physical offices within our organization. And so for us to be able to manage day to day, we do a lot of travel. So all the travel just kind of came to a screeching halt. We have a number of business development staff who spend their time, like in most hooker agencies out there visiting with little referral sources. So, you know, building that relationship, which involves sometimes taking them to lunch or bringing them a goodie or you know, the kinds of things that we do.

Jeff Wiberg (07:03):

And all of that was going to come to a screeching halt. And so there was some natural cost cutting that kind of took place. But in addition, we kind of backed off on, on some of our marketing, which actually sounds maybe a little counter intuitive, but we felt like, you know, the, the nervousness that was going to take hold of the population and certainly ended up being this way that consumer marketing was not going to be the best investment for us at the moment. So we, we chose to back off on some of our STM spend and and kind of tighten up a little bit on that front. We also saw just

Jeff Wiberg (07:49):

Subscription type services, programs, projects that we were undergoing. We had a couple of positions that we had a hire and we, we we put those off. And so there was some natural cost savings from our budget from that standpoint know, in our case the cost savings that we had identified in level one was going to be roughly about $30,000 a month. And that would make up for up to 10% drop in our hours when you factor the contribution margin from, from hours and so forth. And along with our, our kind of natural cost savings. So for us, and I want to put, I want to speak in relative terms because every agency’s a different size and has, has different budgets and so forth. So we, we were looking to offset up to 10% drop in our, on our hours from a cost standpoint and be able to maintain ourselves without having to go into bread for example on the, on the budget side.

Jeff Wiberg (09:08):

And it worked you know, the, the, the next threshold, the level to which we never got to would have made up for up to a 20% drop and a level three, it was a 30% drop. And at that point we would be, you know, we could create additional levels as well as necessary along the way. But in our case, we, we never did drop below 8% drop, which is fantastic. I mean, would love to be able to speak to how I think that that came about, but ultimately the, the advice that I give myself and that I would share with others is plant early and have triggering mechanisms. And then, and then the key to all of it was communicated to everyone so that nobody has to sit around wondering, and being distracted by the fear of, Oh, my word, what is my organization going to do? But instead, getting it out there completely transparent of, okay, this is what we’re going to face, this, the decisions that we’re going to make, no one loses their job or gets affected in any way until a phase two. So our goal we’re going to stay in phase one. And that’s what we did. We accomplished that during the course of the are navigating COVID-19 and I’m proud of the organization for doing that, but I can honestly say that the feedback that we got from our staff about how transparent we were was extremely good.

Miriam Allred (10:36):

Yeah, wow. Loaded answer, but I love it. And fantastic advice about transparency and communication. Those are, you know, simple but necessary in, in this time. So I want to, you mentioned a couple of ways that you’ve scaled back and consolidated of those, you know, few things that you mentioned, even in just your phase one plan, which of those, you know, methods or tactics do you feel like will carry over long term? You know, you mentioned your sales reps, aren’t out there, you know, visiting face to face, you’ve cut back marketing, just a couple of those things, which have you found, you know, what have been your takeaways and which ones do you think will kind of take with you?

Jeff Wiberg (11:21):

Yeah, I think that the paradigm shift that I’ve had is around first of all, travel you know, we’ve w like many have relied on electronics and telecommuting and what, you know, we’ve been utilizing zoom meetings and so forth. And I, I I’ve always felt that, and it’s just so impersonal and you need to be able to be in the same location and yada yada, yada. But at the same time, I gotta admit that our, our staff, some of them, you know worse are saying, boy, I’m so much more productive. I’m I think this is the way to go. And as a result, we were change, we’ve changed our paradigm to where I think our, our travel expense is going to be significantly down. And for me personally, that is very meaningful because you know, I, I spend a lot of time on the road and my family has really enjoyed seeing me for the last three months.

Jeff Wiberg (12:19):

And that’s, that’s a, that’s a good thing. I think that we will actually never go back to as much travel as we had been doing it instead rely upon the fact that, Hey, you know, we can still have a relationship and build a relationship, are communicating over, over a camera. I don’t think that it means it will never travel, but that’s something that will be probably permanent. The second thing is the, the necessity of real estate. So I spent a half, a million dollars a year on a real estate. We had, like I said, a lot of offices and how’s the operations. And I’m thinking about that in a very different way going forward. And I’m looking at, you know I think we could have more of a remote worker type of set up here.

Jeff Wiberg (13:05):

It doesn’t work for every position in home care, but it does for several. And that means that the footprint that we may need could be a smaller office and therefore we could have some real estate savings. And it poses an opportunity for us to maybe increase some productivity. And you know, the staff were very eager to know whether or not that that’s something that we’re going to consider going forward. And so we we’ve announced that we are and we’ve developed our telecommuting policies and so forth around that. That’s going to result in some legitimate savings. I will say Miriam that we have gone back to a lot of the marketing spending that that we had previously planned. Cause we certainly believe in, in in, in still having an outreach to consumers, especially right now, because the, the, the mind has shifted for folks that are interested in home care.

Jeff Wiberg (14:01):

A lot of individuals have been distracted from maybe going into the concrete living, which has been so badly impacted by, by COVID-19. And they’re looking for alternatives and becoming more aware of home care. And so I think right now is w we’ve, we’ve actually moved towards double down on the marketing front and making sure that we are telling our story and developing the right kinds of relationships and such. So we’re actually going to come out of this, increasing our spending in the marketing realm rather than maintaining any sort of cuts which is another lesson learned, I suppose.

Miriam Allred (14:39):

Yeah. That’s fantastic. And diving into maybe more of the day to day operations and training of your employees, what’s been the shift. Are there, you know, you’ve talked about communication, but what are some of other maybe training or protocols that you’ve implemented with your staff and even directly with the clients themselves?

Jeff Wiberg (14:57):

Yeah. So in addition to communicating that we were we were gonna use this phase one phase two phase three kind of approach, and we communicated the component parts into it. One of the other things that we did, I, I feel a really good job with is that we also communicate a lot more education on actually the backend of the business, how it actually functions and helping every position understand that if they in engage with the activities that they can, how they can make an impact. And we, we, we didn’t just say, Hey, you know, there’s this magic that’s happening behind the curtain. And, you know, don’t worry, we’ve, we’re, we’ve got all the decision making power. Instead we decided to go very grassroots and did a ton of education on how the budget operates and how, how overall the financial the flow of, of when you sell an hour, how much goes into the cost of, of providing that care or the field labor costs, and then what are the administrative costs and how those are calculated.

Jeff Wiberg (16:04):

And then what’s the ultimate margin at the end. And we, we educated everyone very carefully, very specifically, and then came up with ideas not just the executive team, but we grassroot sourced ideas from everyone in the organization on what is it that I, if I’m a scheduler, what can I do if I’m what we call client care supervisors? What can I do if I’m in business development? What can I do if I’m in a county, what can I do? And everyone had an idea of how they could contribute to the overall solution. And we communicated those ideas literally on a daily basis. I put out a daily update every single day, and here’s the metrics here’s, what’s on the schedule. And here’s some good news. I felt like that that was an incredibly important component for overall morale.

Jeff Wiberg (17:02):

And there’s so much negative news out there about everything during this whole time. And so I said, here’s good news. So I shared every little victory. I could possibly get my hands on of, of every good thing that was happening in any location. And then we had ideas of what we could do. We call the grassroots ideas. And I, it was simple ways to be able to move the needle and ways that people could engage within their goals in order to be able to make it like a rank. And we, we, we saw from the beginning of the crisis, which was the end of February down to our low, which was four weeks later that was the week of March ending March 28th. I’m looking at my data point that we actually put together for tracking during this entire time. And since that day we’ve been growing and growing every single week without fail. On some over since we’re, we’re now 17% over where we entered COVID-19 as a company. And we’re talking 3,000 hours a week. It’s it’s significant the kind of change that we’ve seen as an organization and the, the kind of ownership and the kind of empowerment that is resulted is something that will be sustained beyond COVID-19.

Miriam Allred (18:26):

Definitely. Wow, great response. You’re headed in that direction. So, I want to talk about metrics and data. You’ve mentioned it a couple of times on that last point. What, you know, additionally, what have you been tracking during this time, but what have you found to be, you know, the most important metrics, you know, maybe before, and how has that shifted as we’ve gone through this crisis?

Jeff Wiberg (18:48):

Oh boy. How do I actually used to think of myself as a bit of a data geek and that I would track a lot of key, key performance indicators since COVID-19 changed my paradigm there too. I started, like I mentioned, putting out a daily updated that would show here’s how, you know, we were yesterday, here’s where we are against the goal. Here’s where we are against where we entered this crisis. And, you know, just really had a strong comparison with a lot of percentages and so forth that was easy to digest for folks, a quick snapshot every single day. And I w I have this huge spreadsheet in front of me that that I used during the COVID-19 crisis. And then I have since continued using, but no more on a weekly basis. I was using this on a daily basis and I was tracking every hour.

Jeff Wiberg (19:37):

I was tracking every client. I was tracking every character I was tracking who was on leave which clients canceled hours that represented how many shifts that represented. And then as we started to recover, I started tracking things like hours per visit hours per caregiver, hours per client, based on the actual schedule, not, not who’s actively employed, but who’s actually on the schedule. I attract the number of leads that we had come in or referrals. And then the number of starts of care or admissions. And as I trended that data over on a daily basis, over a long period of time patterns started to emerge, and we were able to become much more responsive to the ideas that were actually working because I could see it happening in one office. I could call and talk with that office and say, okay, what’s been going on this week.

Jeff Wiberg (20:35):

What do you attribute that to? And they would share, and that we would share that information with the whole organization. And then as that was implemented, that it became a snowball effect. Every good thing ended up being replicated and everyone was hungry to be able to hear those good things. And so it got it, it got implemented very quickly. And as a result, our organization turn around very quickly. And that’s, that’s, that’s honestly, I feel like that’s because I kept my eye on the data of just looking at it every single day. And it’s even, color-coded, you know, with the conditional formatting in Excel, to be able to show, you know, really pop out those outliers and help me understand, okay, what’s, what’s going on in the organization. And then ever since we’ve been doing a lot of reflection on, okay, what did we learn from this? And, and what, what does this represent to us and how are we going to manage the business differently going forward? And it’s honestly a new day. It’s a new normal as a, as people sometimes call it.

Miriam Allred (21:40):

And just to clarify for our audience, that is just an Excel spreadsheet that you’ve created, it’s not in your scheduling software or hosted anywhere, correct?

Jeff Wiberg (21:49):

Certainly the data comes out of my Axxess Care, which is what we use. But but to be able to manipulate it and to be able to trend it I’ve been utilizing some of our little, little reports.

Miriam Allred (22:01):

Very cool. Well, yeah, moving into the next topic. How do you think the referral landscape is changing now? And looking ahead.

Jeff Wiberg (22:12):

Yeah, I love the question. We have been carefully tracking that because especially my CFO is interested to know, all right, how does this change our overall strategy? The days of home care being seen as a commodity and hey, whoever brought me a box of donuts last is going to get me an extra referral which is just a reality of, of some of our industry. And I don’t think that that’s a hundred percent change, so I don’t want to necessarily mislead anybody listening. But I would say that the evolution that we have been seeing slowly enter our industry over the past, especially five years where the conversations are a little more high level, they’re a little more strategic. We’ve, we, I think COVID-19 pushed us down that road by a good three years. So it was like this massive nitro boost on that, on that racetrack.

Jeff Wiberg (23:13):

And I think that it’s changing the kind of conversation that we have the opportunity to have with our traditional referral sources. For example, the hospitals have really taken a beating during this time and a felt the liability bug big time. Having, having felt like, OK I don’t want to necessarily discharge my patient to a skilled nursing facility that happens to be on lockdown and where there’s been a real localize outbreak what are my options? And we’ve seen a nice search of home as the alternative location of care that has accompanied an increase in acuity for, for the care that’s being provided. And that means to me that we have to be prepared for the increasingly acuity and to be able to talk more clinically cause I, I hate the fact that our industry still says we’re nonmedical non-skilled and utility of these CNAs that are non-skilled and nonmedical.

Jeff Wiberg (24:34):

They, they, they will be offended. I recognize that there is a scope of, or limitation to what it is that we can do, but what we do do is very much medical and clinical nature and the general public certainly seasoned that way. And so if we embrace that as our message and talk to the value proposition we’re getting listened to in a different way. And I think that that can continue as long as we really grab a hold of that narrative and run with it. And I’m not trying to throw our brethren of the skilled nursing facilities or the assisted living facilities on the last year, because they are continuing to be a huge component of our rural partners, but even the conversation with them can be different and they can see us as more of a solution than maybe they have in the past as being just, Oh, well, you’re going to go in there and help them bathe and clean their house.

Jeff Wiberg (25:30):

You know, we’re less, less of a commodity now. And I think that changes the conversation. It also changes the conversation from a consumer standpoint. I think consumers are a little more sensitive about saying, sending mom into a a congregate facility now because that’s where all of that process has been. I don’t know, honestly, Miriam, I don’t think that that will last. I think that we have an increased sensitivity that is significant today, but ultimately COVID-19 will become a memory and folks will get back into some patterns. So I liked the idea of seizing the moment and increasing awareness and increasing maybe planning amongst families that are saying, hey, you know, 70% of us are going to inquire longterm here, where do I want to consume that care? And let’s keep me prepared for that. And so trying to get out there and communicate that to the community, I think, is a good play for the long term.

Miriam Allred (26:29):

Definitely you, yeah. A great response and you’re exactly right. Just bringing awareness to our importance and vitality in the continuum. You know, we talk a lot about the continuum of care and home care is really making its stance at this time and just bringing awareness to who we are and what we do is so important. So I appreciate that to kind of wrap up the conversation. I want to hear, you know, from a personal and professional level, looking ahead for the industry, what would be your biggest concern or fear, and then to counter that, what would be maybe your biggest hope or anticipation for the industry?

Jeff Wiberg (27:07):

Yeah. my, honestly my biggest fear right now is, is that we have another resurgence in the fall. You know, there’s a lot of models that are going around now right now because I can’t deny that it, it, it didn’t have an impact upon upon business. And it was so selfish. It was distracting from where, what we wanted to be focused in on. That being said, I do believe that we’ve come out stronger than we went in, and that those are the lessons. Those lessons are gonna carry us forward and, and pay huge dividends in the future. But I, I really, I don’t want us to face this again. I don’t want to shut down our economy. I don’t want to have to cope with that. I fear the sort of crowd mentality that a company’s had and to get really specific, you know, like toilet paper.

Jeff Wiberg (28:01):

I mean, why, why, why in the world, why was there a rush on toilet paper that it was a self inflicted wound? And I’m wondering, okay, are we going to have more self inflicted wounds that really make life potentially difficult for an agency like ours to, to exist and, you know, could we get a little more extreme and say, Hey, nobody gets to go anywhere. That, that would really hamper our ability to provide care. I also fear we didn’t have it thank heavens, but I fear if there’s a transmission of COVID-19 to a client or from a client to a caregiver. You know, that, that is, that is, that would be just a nightmare scenario. And I worry about that for sure. But I, I do remain largely optimistic though. I think that as you pointed out, it’s, it’s, it’s a different time and that home care is an industry.

Jeff Wiberg (29:00):

Especially as the association, we are really seizing the moment to help people understand our value prop within the healthcare continuum and how we can impact things like the social determinants of health and, and folks are listening, and we need to take advantage of this moment for that. And so I’m more optimistic than I am pessimistic for sure. But my hope is, is that we don’t let our guard down and that we do get ourselves involved in being part of that voice. And if, if you’re a small agency in a small community in st volt, I, I’m not going to have a impact on the national scene. I think that’s the wrong thinking. I think that I think that you can say, well, I can do some community based presentations or press release to the local newspaper television station or whatever, and do some education, do some, I’ll call it public interest stories about how home care really made an impact upon the individuals to be able to stay safe in their own home.

Jeff Wiberg (30:01):

I know we’re probably on a reflection basis about the crisis. And, and I think that those kinds of stories could get some traction and you can do education within your own community and with community organizations or churches or whatever. And people are to listen in a different way because folks became aware that, Hey, there’s a vulnerable population in our elderly and boy, one day I’m going to be there. And so I need to pay attention to this. I need to not ignore it. And if we don’t grab the mic and start speaking, then even if people are ready to listen, there’s nothing to listen to. And so that would be my greatest hope that we, we do grab this moment and we take advantage of the opportunity to be able to educate it to the goodness that is home care.

Miriam Allred (30:46):

Fantastic. Jeff, thank you so much. I appreciate your words. And I know our audience does as well for instilling that hope moving forward. You know, we’ve all got to remain optimistic and, you know, really hold onto our hopes and anticipations for the industry. So thank you so much for taking the time today. We appreciate it. And on behalf of Home Care Pulse, we’re grateful for your friendship and your partnership and appreciate you and your team all the best moving forward.

Jeff Wiberg (31:18):

Well, thank you Miriam. I really appreciate it. I love what you stand for and what you do for the industry.