Ep.6: How to Build the Right Environment for Client Referral Growth

Melissa Mendez (00:12):

Welcome to vision the home care leaders podcast. My name is Melissa Mendez, and today I’d like to welcome to the show. Melanie Stover owner of home care sales. Melanie has previously been on several webinars with us here at HCP and I’m honored to have you on today before we jump into our discussion today, Melanie, can you give our listeners a little snippet about yourself and home care sales?

Melanie Stover (00:35):

Sure. Thanks for having me. I’m so excited to be here. I love speaking with your audience. You know, my background actually in home care begins before I was even born with my grandfather. He would find out that he was diagnosed with polio on the same day that my grandmother was found out she was pregnant with her third child within one year, he would become a quadriplegic and they you know, they told my grandmother to put him in a home in a PO home, of course, back then, nobody really, you know, they didn’t really know what to do with somebody who was a quad and, and could they even take care of him at home? And my, he, my, my grandmother Helen was a feisty lady and she said, well, I don’t think him home. And for the next 19 years, she kept him home in a hospital bed in a wheelchair in her dining room, along with the help of course of my brother or my mom and her brothers, my uncles and private duty nursing.

Melanie Stover (01:34):

So I grew up hearing stories about their ingenuity. They kept him alive and well, and without pressure ulcers or skin tears for 19 years in my grandmother’s home. So he was able to be a husband and a father to no wonder that I became an occupational therapist from all those stories. And I entered home health pretty quickly as a young therapist and realized, oh my gosh, what a magnificent line of service that was really as best kept secret in the Medicare world. And I also realized that, well, as a therapist, I could impact one patient’s life or one family’s life at a time. And that was awesome. I also recognize that if I could market back in the day, if I become a liaison, I could impact more families lives by bringing more families onto service. And so through that experience, I really realized that we, as a profession of marketers, didn’t have a framework of, of how do you market, how do you market to docs and, and get those referrals? And so I went on a quest to find a framework and created one and in 2001 opened up home care sales. And my intention of opening up home care sales was to get more patients the care that they deserved, which is all of your care, all of your listeners care. And so today at home care sales, along with my business partner share with LTE, who’s an RN. We focus on home health hospice and in-home care, giving them solutions and frameworks for them to grow their business and coach their sales reps.

Melissa Mendez (03:17):

That is amazing. It’s I, I love hearing the story of how you came into this industry and what uniqueness you have to it, you know, it’s very different from, from some other folks and I love it. You bring such great insight and I’m super excited to discuss more in depth about how agency owners can build that right environment for client referral growth. So we’re gonna just jump right into it with that first question and it’s, how can an agency communicate with refer referral sources to help promote in-home care as, as a good option for patients?

Melanie Stover (03:56):

Oh, that’s great question. Thank you for asking it. So here’s the scoop. What I wanna share with you is as an occupational therapist in the clinic, in the hospital, inpatient rehab, and as a home health therapist, I never once referred in home care. Not one time it breaks my heart. Now I think about it that I didn’t understand in home care as a medical professional, I got one paragraph in one book in my third year of OT school about how I might be able to come become a home health therapist, but nothing about in home care. And my mentors didn’t refer in home care. And so I didn’t refer in home care. I didn’t know how to do it. It wasn’t until I was actually managing, I do a lot of coaching and managing, I, I was managing a a multiple service line agency in method Tennessee.

Melanie Stover (04:55):

Whereas I was responsible for the marketers and home health, hospice and HME. And in came the DLN of the in in-home care division. And she says, why aren’t you promoting us? And I said, oh my God, I don’t even know who you are. Tell me, you know, tell me a little bit about who you are and what you do. And here she was, she was in our own building and I had no idea what, who she was, what she represents and nor did we go out and communicate that. But she educated me really quickly. <Laugh> and we were able to think about what, what does it mean for in-home care? And for, for me, and, and specifically Cheryl and I have created a paradigm we’ve coin to term total patient care model. And what we mean about that is you can visualize a rainbow.

Melanie Stover (05:45):

The, the, our band of that rainbow that goes from horizon to horizon, we, we turn that in home care, in home care can span from horizon to horizon. And then if you think underneath that, there’s Medicare certified home health, palliative, and hospice, that really kind of sits in the home. And what we wanna make sure that every referral source knows and that every in-home care person marketing person can go out and communicate is that in-home care deserves to be a referral at every level of care in the home, because it’s not mutually exclusive. You don’t have to have criteria for in home care. Other than some payer source, you know, I recognize that I I’m on a mission really to get seniors the care that they deserve in home care specifically, because I recognize as medical professionals, we don’t off, we don’t get educated on it.

Melanie Stover (06:46):

So our idea is not only to educate and be care advocates for our clients or potential clients, but also understand that it’s reciprocal referrals and reciprocal referrals. Just meaning that if I’m an in-home care marketer, and I’m going to share with you about my caregivers and here in, in, at home care pulse, you guys do this so lovely with your caregiver career ladders and your certifications for those caregivers. If I am a therapist at now, if I put myself in the shoes of being a therapist back in the day, have Medicare certified home health, no one came to me and said, Hey, if you were able to refer your patients to in-home care, they could help with your home exercise program. And then that’s, I would have better outcomes. Yay. And everybody wants that, right? So not only is, is it about referring to the in-home care, but it’s also about in-home care, referring back to Medicare certified home health or hospice when it’s appropriate, depending on the level of care.

Melanie Stover (07:55):

And, and the biggest challenge with that is that in-home care needs to elevate their conversations with their marketers. That’s where the disconnect happens. And you know, you’ll see you’ve seen us many times talk about selling my diagnosis. We trademarked it, we back in 2010, we wrote in a book about it because we believe so deeply that we can engage our medical referral sources by sharing with them and selling by diagnosis so that they can see that connection between the diagnosis and how you, as an in-home care provider would support the medical treatment plan in a non-medical web. And we all know the social determinants of health impact our outcomes in Medicare certified home health significantly and in home care is amazing at that.

Melissa Mendez (08:51):

Yeah, that’s so great. I mean, you talk about it, it being under the rainbow, and I love that analogy under the, the horizons, and it’s so important that everyone receives a referral and, and that communication needs to go both ways. So I, I really love that. Something I had noted is, you know, the, why the why is it important that we give everyone the equal chance for great care?

Melanie Stover (09:18):

I believe that this is a care access issue, no matter where you sit in this continuum, if it is Medicare certified home health or in-home care or hospice we are really talking about limiting access to care when folks don’t make those referrals. And I know that all the medical professionals that I went to school with, that I had the luxury of working with, they have not thought about that in that way. Why wouldn’t you make an in-home care referral and the most obvious reason, I’m sure you’ve heard this is money. Like our patients can’t afford it, but is that true?

Melissa Mendez (09:55):

Well, and something you had brought up in one of our earlier discussions is that it’s not really our part to make that judgment call, whether they can afford it or, or not, they need to be given the opportunity to receive that, that care

Melanie Stover (10:10):

Agreed. Yeah. And day story. Right? My grandmother who took care of my grandfather for the 19 years and the dining, when she became older, we she needed care and we learned that she was making 900 and $72 a month in social security. And if anyone would look at her, they would say no way it could help and get care. But between the VA benefits from my grandfather, my mom and her brothers, they were able to come together and give her the care that she needed. So I tell that story, if, if you just made a judgment on what you saw on paper, my grandmother would never give a referral, but luckily she had us.

Melissa Mendez (10:54):

Yeah. And you really, when you, when you make those judgment calls, you’re limiting yourself and your, your agency’s potential and your caregivers, right. You’re, you’re limiting it there. So you’re really selling yourself short by making inaccurate judgment calls. Definitely. So my next question for you is define the role of a marketer in an agency and what it might look like for, for your agency to have that position, and maybe for those who don’t have that official marketer, what can they do in their current role that would help fill that gap?

Melanie Stover (11:34):

Sure. So across all three business lines in home care, hospice and Medicare certified home health, the primary goal of a marketer is to drive revenue, right? We all hire marketers or sales people to do that. And that’s through gaining referrals. I would submit to you that our industry specifically our marketers in our industry have a professional identity crisis they’re seen as muffin marketers, or even just this morning, I was on a coaching call with one of our management clients. And the marketer said to me, so and so hospital said, oh yeah, you can come in, but you know, bring some treats and you, it just drives me crazy, cuz there’s nowhere else in the other, in the world that someone would say, Hey, yeah, come on over. Let’s have some professional conversation and please bring pizza. That doesn’t happen. Right. You don’t do that with your financial planner.

Melanie Stover (12:33):

You, you don’t do that with your dentist. Come on. So let’s figure this out. How can we elevate the conversation so that we are seen as a postacute care expert, which is what you are. And I always say to the reps that we work with and coach and the owners that we help, man, I didn’t go to seven years of school so that I could be a caterer. My, my value is not in the things that I bring you, my value is in my knowledge and how I can help connect you with resources in the community, even if it isn’t mine. So I would share with you that your marketer is the face of your agency, and we wanna make sure that marketer has a professional identity. And the way that we can do that is following a consistent sales process. I find, I find that that is the number one thing that I can do as a coach or mentor to marketers out in the field is to show them a protocol similar to a protocol that you follow for nursing, or for me for therapy, you know, when you’re a young therapist, you’re like, man, I don’t really know how to treat this disease process, but luckily I have this clinical protocol that’s gonna help bring me through the great things to do with this patient.

Melanie Stover (13:51):

It still means I get to be me. I get to infuse my personality. I get to have encourage them the way that I wanna have them, but at least I have a framework and a structure that’s res gonna get me a repeatable result or an outcome. That’s what I like about sales process. Sure. When I have created an industry specific sales process for home health hospice and in home care called high performance sales academy. And then we took it one step further. Because what we know is as, as Cheryl likes to say, that sales reps don’t like to go out and be naked. And what she means by that is, is that they like to have something to hold like handout. And if you don’t give them an educational piece of material, what we find is then they start bringing in trinkets and bets and the, you know, and the cookies and the muffins and all that kinda stuff, because they want to be seen as somebody who is helpful.

Melanie Stover (14:47):

So what we did is we created 52 weeks of sales messages so that every week a sales rep can wake up and go, okay, we’re gonna target CHF. All right, this week, we’re gonna target C O P D. And we do this across all business lines, by the way, we have different planners for different for different service lines. And if anybody wants to see the one that we use for our own clients, you’re welcome to, you can have it as a gift. And we have it right on our [email protected] slash planner, like a marketing planner, P a and N E R. And you can see it right there. It’ll be like week one, we’re targeting Alzheimer’s week two, we’re targeting Parkinson’s. And what we found by doing that is that sales reps would be consistent in their message. They’re going to deliver you high value referrals.

Melanie Stover (15:43):

And they’re going to give you what you want, which is revenue, right? You’re go you at the end of the day, you ask me what, what is a marketer? What is their role? Their first primary role is to deliver you patients or clients in the form of referrals. And you know, the second thing that they do probably better than anyone else or, or is that they’re change agents. So they bring you what’s happening in the industry, or at least in your territory right now, good or bad and sharing with the market expectations as agencies up their game and up their customer service level. And I’m sure you’ve seen this right. Even with your products, if, if, if I don’t have your training program, but another marketer agency does, and he or she is out there presenting that they’re certified or they got, they went through this training program on Alzheimer’s, they’re going to have a competitive advantage over me.

Melanie Stover (16:41):

And so it’s my job as a marketer to bring it back to my owner and say, Hey, do you know about home care pulse? Because, so and so over here says, all their caregivers are trained in that and she’s getting some play of that. And so folks are referring to her, right? So changes. And the third one really just came in the last couple years during the pandemic is recruiting and retention. We didn’t really involve them in the past in this, but for sure because people are our product and if you don’t have caregivers or nurses or therapists you can’t sell, you can’t go out there and get referrals. So we, and just, you know, intuitively brought them into that process, cuz marketers are so creative in this way that they can do that. And then to answer the second part of your question, which is what if I am an owner who doesn’t have a marketer yet, basically we say halftime it. So, you know, you’re gonna have half the time out in the field, for example as opposed to a full-time rep, you’re gonna have those expectations. You can do this. Many owners have started off their agencies as way where they’ll market one day a week, maybe two. And they, until they can get enough revenue to hire a marketer,

Melissa Mendez (17:54):

Having the right, you talked about having the right value of deliverables, right? The right material that, that can help you that is more than just pizza and, and muffins and donuts. So I, I think that that’s super important and for those agencies that are smaller and don’t have one dedicated person, I love your tip of start small one day, two day and, and see how it can really change what you do.

Melanie Stover (18:25):

Bears. Don’t go in the office,

Melanie Stover (18:28):

You’re an owner. And you’re like, man, Tuesday’s my day. I’m going to go out on Tuesday and market and see my, you know, five referral sources or eight referral sources, whatever you’ve identified, don’t go in the office. It’ll suck yet. You’ll never get out. So, you know, I, I just tell the owners we coach or work with say, okay guys, look, I’m going out Tuesdays my day, just please. Unless the agency’s on fire, no scratch that call the fire department. I’ll be back at, you know, two or I’ll be back at three, whatever it is, y’all handle it until three. And then I’ll be in here and we’ll fix whatever is broken, but don’t get sucked in the office cause you’ll never leave. There’s always something to do there.

Melissa Mendez (19:10):

Yeah. And if you never leave, then you, you never get to build those relationships. Yeah, absolutely. So how can you engage and empower marketers into a more recruitment and retention mindset? You had brought that up that, you know, retention is a big thing and, and bringing in that into the picture. So how, how do you shift that mindset?

Melanie Stover (19:33):

So we talked a lot about this on our group coaching calls with our teams that we coach and the, they were lamenting really that they didn’t, they couldn’t sell, they couldn’t they didn’t have availability. And so they weren’t either able to start care for the Medicare certified home health folks or hospice folks, or be able to go out and even do an assessment for the in-home care folks. So what we talked about is how could we be part of this solution? And, you know, marketers are so creative in the very first thing we did was empower them with a recruiting message. What do we need specifically? What do we need? Not more, but do we need to start a care nurses? Do we need a PT in this area? Do we need a caregiver in this area? Or do we need six caregivers in this area?

Melanie Stover (20:29):

What is it that we need then the second? And we have weekly recruiting calls that they’re on. Usually the ops team was responsible for that, but over the last, you know, few years we had the, had the marketers attend those recruiting meetings too, because they needed to be in the know. The second thing is, is that we asked them to post it on their own social media, not just our, you know, company media, but would they be willing to post and say, Hey, you know, our company’s amazing and we’re looking for a few good caregivers. The third thing that we did was empower them to our referral sources. Now this gets sticky, wicked, cuz you can’t go in and say like, Hey, please gimme all your CNAs. That would be amazing. That won’t work. Right. You’re gonna get booted out cuz you’re poaching, their staff, the, it, it isn’t like that.

Melanie Stover (21:18):

What we wanted to say was, Hey, we have some openings. If you know of anyone who is desiring to be a caregiver to be, you know, if you have a friend who’s a nurse we, we have some openings or if you wanna do some per visit stuff. So in the home health world, in the hospice world, we’ll take on one or two patients and do some per visit activity. And that doesn’t, that’s how I got started in home health. I needed some extra Christmas money and I was already working in a rehab. I took on patients on my way home from the rehab. And I, you know, took on a couple patients at a time and it wasn’t a big commitment, but now I understand on the, on the op side, you know, every little bit helps. So the fact that, you know, someone will take on one or two patients after work, they will get extra money and you can, you know, obviously get folks seen.

Melissa Mendez (22:15):

Yeah. A win-win situation is, is how that sounds. I like that. So the, the last question that I have is do you have two to three techniques that you like to use that you can offer to help keep referral sources warm and keep your agency at the top of mind when you, when you have to say no. How do you keep that open communication and promote transparency during those harder conversations?

Melanie Stover (22:46):

That’s a great question. I feel like we’re better now, but boy, how did we have to say no a lot. Previously, and I think this is similar to, you know, even when we engage with somebody and we get in a high growth pace, they’re struggling to keep up with caregivers. So I don’t think this ever really stops. You can go, you know, you, you you’re always gonna have to be prepared with these with these tactics because there are gonna be times when folks are out on vacation, given an unexpected leave or maybe maternity leave that may leave you a little bit of a pickle. So what we learned I just did a big survey with a bunch of case managers because one of the teams that we worked with was struggling with some availability. And so we went out to the referral source.

Melanie Stover (23:42):

We went out to the case managers in the territory, in this larger city and ask the question, you know we are, we’re struggling with availability right now. How do you want us to communicate with you? And it was insightful, right? You think, you know the answer until you actually ask it and then you have you get it straight from them. And often the response was, we know you guys are understaffed, we’re understaffed, we’re running with a skeleton crew. We know you guys are trying to do the same thing. It’s okay. You say, no, just say it quickly. Don’t drag it out. Don’t try and find a 18 things and then throw it back on our laps. Another technique that we we used and you have to identify your referral sources and make sure that that’s okay with them is that when you don’t have staff for the patient or client depending on what line of business you have having a network, having a good partner that you can refer to in every territory, there’s at least one or two worthy partners, worthy competitors that probably are pulling from the same caregiver pool that you are.

Melanie Stover (24:56):

So you know, oftentimes one of our greatest recommendations is to make sure that the administrators or owners are reaching out to competitors, but really partners, folks that they trust folks that have same values or integrity as, as you do. So that when that happens, you can either ask to refer. And I always ask, oh, say, you know, right now we, we’re not able to get to that patient or client today or wherever, however long it is. And then I would say we will, like an example would be home health would be like, Hey, we’re not able to if PTs out three days or five days, we know that’s not what we want. Is it okay if we refer it to our partner agency of X, Y, Z, and then they have the choice? Yes or no. Do they wanna take that referral back and then give it to the other agency?

Melanie Stover (25:53):

Or do they say, yeah, Mel, you know what, I already gave you all the demographics, go ahead and refer it right. Or maybe they’re allowing to do nursing ahead of time and say, Hey, can we put a nurse there? Let’s do medication. Reconciliation’s, let’s, let’s take a look at them from a nursing and, and condition or diagnosis, education piece. And by that time, two days later, the PT will be in there. Is that okay? And so giving them some options allowing them to still be in control, however you know, getting the patient, the care that they need as soon as possible. Cause at the end of the day, we wanna make sure that the patients are cared for cuz that’s our priority.

Melissa Mendez (26:35):

Yeah, it’s it sounds, I mean, we’re all in it together, even though you may be an agency and a community and there may be five others in your community, it’s still a village and we need to work together. And I think that this, that level of partnership really goes a long way. I love it. Well, thank you, Melanie. This was so great. And for those who want to reach out to you, what’s the best way for them to get in touch with you to, to maybe chat more with you and about what home care sales offers.

Melanie Stover (27:04):

Sure. You can go straight away to our [email protected]. You’ll find all of our contact information there, including Cheryl’s and I’s email and our telephone numbers. So either way, whatever way you wanna reach out, we welcome you.

Melissa Mendez (27:19):

Perfect. Thank you. I hope we all have taken some notes and can implement them into your business as always thank you for listening and supporting us and we’ll see you next time. Thank you.