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Is there a single right way to run a home care agency? We sure don’t think so. That’s why we’re interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Join host Miriam Allred, veteran home care podcaster known for Home Care U and Vision: The Home Care Leaders’ Podcast, as she puts high-growth home care agencies under the microscope to see what works, what doesn’t, and why. Get ready to listen, learn, and build the winning formula for your own success. In the Home Care Strategy Lab, you are the scientist.
Miriam Allred (00:16)
Welcome to the Home CareFor Strategy Lab. I'm your host, Miriam Allred. Is there a single right way to run a home care business? I sure don't think so. So that's why I'll be interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Through this podcast, you'll be able to listen, learn, and build the winning formula for your own success. In the lab, you are the scientist.
Today in the lab, I'm joined by Catherine Vergara, the CEO of CareFor based in Austin, Texas. Catherine, thank you for joining me today.
Catherine Vergara (00:52)
Yeah, thanks for having me. Always a big fan of yours and honored to be here.
Miriam Allred (00:57)
So people are about to hear for themselves why you were a top pick as an early guest for the show. I've only known you for less than two years, which is kind of crazy, but I've been so impressed with you and I've already learned so much from you. So I want to start with the origin story of CareFor 4. Can you go ahead and share that with us and then be sure to weave in your own personal highlights and your own personal journey into the origin story itself.
Catherine Vergara (01:22)
Sure, yeah, thanks so much. So CareFor is 25 years old this year. So we began back in 2000 under a different name. We practiced under Nurses Case Management. We were founded by Debbie Pearson, who is a nurse, and really through caring for her mother, dealing with Alzheimer's and her career history in home care and home health and in the acute care setting, really became integral in her mother's care as she aged at home with her dad.
kind of looked up and out and realized that there were a lot of people having the same types of challenges, figuring out how to age in place and navigate the complexities of the healthcare system. And she birthed Nurses Case Management, which was a care management firm. And she ran that as a solo practice out of her home for the first 13 years. And along the way, acquired quite a large pool of private caregivers that would work directly for the families. And she would help manage them and process their payroll.
And I joined in 2013. I was a pediatric oncology nurse. And as she was looking for her succession plan, she partnered with a private equity firm that recruited me to help grow and scale the business. So I've been a part of the organization now for almost 12 years. And during that time, we've obviously rebranded to care for. In 2015, we became a home care company and all of the caregivers began to work for us.
And we've really grown and scaled the footprint of the business. We have nine care managers that work for us now, and we serve north of Austin to south of San Antonio. And we have about 150 caregivers that work for us. And the business has also grown into the guardianship space, and we serve the medical power of attorney space as well. I would say the heartbeat of our business is care management.
that has a home care component as a part of it to care well for our patients. And we're growing into the hospice space this year, which is really exciting, but really the desire of the business is to provide peace of mind for the aging, injured, and mentally ill. And that's probably just like 30,000 foot view of how we started and who we are.
Miriam Allred (03:38)
That was perfect. Can I ask how old you were when you joined CareFor?
Catherine Vergara (03:42)
Yeah, so I'm 42 and we're approaching 12 years here. So I was just on the, just had turned 30, you know, was turning 30 right when I joined.
Miriam Allred (03:55)
The reason I ask is you were so young and so you have grown up in this business. And I think I've said to you before, I wish I knew you 10 years ago because that's right around the age that I am today. And I just think, I think so highly of you. And I'm like, wow, what were you 10 years ago? And look who you are today. And we're going to talk about leadership today. And I just think of like your personal journey.
Catherine Vergara (04:11)
Yeah, you know, I...
Yeah, I was young and they certainly took a shot on a 30 year old pediatric oncology nurse who had some conviction or fire in her belly that we could build a really, know, scale the foundation that was solid into a really meaningful business. But I've grown a lot personally and professionally. I mean, I was single. I'm now married with two children.
So a lot of life has happened in that time on the personal front, but very much this business has grown up sort of with me and there's like my nuclear family doesn't know me apart from CARE4 either. So that's kind of interesting as well, but there are some OG folks. There's a nurse that works with us that has been with us from the very beginning. My executive team has been with me from the very beginning.
They've been so gracious because the 30-year-old Catherine had whole lot to learn.
Miriam Allred (05:19)
your journey is so interesting. And I've interviewed you before and we've gone into the elements of care management and also the elements of private equity because like you mentioned, there was this, you know, this owner with a care management business, but then was ready to grow and expand and you came in with private equity. So we're not going to get into that today, but that is a huge part of your journey and a huge part of your success. But like we're already alluding to is this leadership.
component and building leaders and building an unmatched office team that stayed with you for years and years and years. So, before we get into that, I want to hear you, you already kind of talking about your business model and the pieces of your business. Can you articulate that a little bit more so people can understand like end to end your business model and how everything fits together?
Catherine Vergara (06:06)
Sure, so we have two core service lines. We have the care management service line and then the home care service line. We consider our guardianship work and our medical power of attorney work as an extension of our care management. So very simplistically, we bill for two different things. Our care managers bill in 15 minute increments and then our home care is billed traditionally sort of hour over hour for the shifts.
It all flows out onto one invoice. So I like to say that we are able to administer a very integrated model. And the only place where you see our service lines differently is on the invoice because it is a very cohesive team. our operations staff, HR, scheduling, even care management, they all have a primary role with an expectation that they're integrated well with the other service line. So on paper, it's very,
simplistic, but the operations of integrating that I think are where it becomes challenging because it is two very different service lines that are achieving different goals.
Miriam Allred (07:15)
And just high level, you're expanding into hospice this year, which is a very large commitment and jump for the business. Explain just your thinking there, why the move now.
Catherine Vergara (07:27)
Yeah, so, you know, we've spent the last decade building infrastructure and capacity to scale and home care has changed a lot, especially since COVID as far as just the cost of wages and the cost of care. And when you think about diversifying, we have chosen not to go the acquisition route. And so when you think about organic growth and opportunity for the business, we've grown organically into a new market down in San Antonio, but we were really thinking sort of like,
not Blue Ocean in the sense that it's never been done before, but what's Blue Ocean for care for? What's something, what's a new service line that we could offer that's integrated seamlessly within what we already provide? And we care for folks, really, we discontinue care either because they've improved and healed through an injury or because we've carried them all the way through the end of their life. And in that final season,
CareFor is still very much involved on the care management home care side, but we're bringing in a new entity. And we have for a long time wanted to be able to extend that continuum of care for CareFor to be able to provide that hospice service to our patients. And candidly, we're in the private pay business. And when you think about meeting the needs of a larger population, tapping into the Medicare funded space, thinking about expanding
our quality of service, the way in which we approach patient care and meeting the needs of clients in that realm to a population that hasn't always been able to take advantage of CareFor's core business. That's also exciting as well. So those were kind of the things that we thought about from the patient side and how to serve them well from an opportunistic side and when is the right time. We just felt like we'd built enough capacity that we could take on something new and
step into a new sort of territory and service line for us.
Miriam Allred (09:25)
Super, super exciting. Well, to be continued, this conversation, we'll have to circle back in a year from now and hear how the journey has been.
Catherine Vergara (09:33)
Yeah, there'll be a lot to say.
sure we'll have most, I mean, we could have a whole podcast on all of our learns. So we have a lot to learn, but we are excited about it.
Miriam Allred (09:43)
And you're so good at articulating the journey of the progression of just how things have gone. So I'll be excited to hear how, how all that shakes out. So let's get to the topic at hand, which is building this rock solid leadership team, this rock solid office team, because all of your growth over the last decade has really stemmed from you building up these leaders to then provide service to the clients and to the caregivers and to their families. So, a couple of rapid fire questions. I know you were kind of sharing some numbers at the beginning, but I want to do kind of
a few rapid fire questions to set the context before we really get into it. How many office staff do you have? then can you do kind of a quick breakdown of your org chart? Again, because your business is structured slightly different, I like to hear how your org chart is structured so people can kind of understand the lay of the land in the office.
Catherine Vergara (10:31)
Sure, so I'll talk about how we're structured and then I'll get into how many people we have. So my title is Chief Executive Officer, myself with the COO and our Chief Strategy Officer. The three of us make up our executive team. We then have three directors who the six of us collectively are the leadership team. And that's, have a Director of CareFor Management, a Director of HR and a Director of Finance. And then the ops team, the scheduling team.
they flow up into the chief operating officers as does finance. I have kept the care management side, the director of care management reports to me. Our care managers are mostly nurses, the director of care management is a nurse, I am a nurse. And so just the clinical arm has always kind of flowed up into someone that's clinical. And that's generally the makeup. Our ops folks,
mostly it's kind of a division between the chief operating officer and the HR. We tend to stay very lean and then add leadership or layers in once we've sort of built that capacity. And so you could probably argue that we could make a good case for some other director level folks or some, even some managers in those spaces, but we have chosen to stay lean for multiple reasons, but
It seems to also keep us pretty nimble and allow us to adjust with the needs of the business as things change or we think we see opportunity. And candidly, we're pretty particular about the type of leader that we believe is appropriate to lead at CareFor. And so that has been most effective with a really intentional smaller group of people.
Miriam Allred (12:25)
And just to add to that, the team that you just outlined is managing about 140, 150 caregivers. Is that accurate? Awesome. And talk a little bit about your retention numbers, because that's one of the things that drew both of us to this topic is your team and your numbers speak for themselves. Like you just mentioned your leadership team, the three of you have been together for 10 years, which is incredible and unheard of. But beyond that,
Catherine Vergara (12:35)
Correct.
Miriam Allred (12:54)
Has most of your office team been with you for several years or what are some of the other retention numbers that you can share?
Catherine Vergara (13:00)
Yeah, so, you know, our overall workforce, caregivers included, which that is in its own, has its own sort of like turnover churn. We have 31 % of our team that's been with us for over five years. And, you know, the largest retention space is in those nurses that we've retained to be care managers. Over 45 % of those have been with us for over five years. And five years for us is kind of the mark just.
from when I joined, like the business is 25 years old, but for 13 years it existed with one person. And so when we think about the growth, the other four care managers, it's not that there's been all this turnover within those roles, it's just the positions have been added as the business grows. So I would say care management is where we've seen the highest percentage of retention outside of the executive team.
And then the lowest retention where we've seen more turnover, I don't think anyone will be surprised, is in that scheduling role. And we'll talk about it later, but we've done some things, I think, to think differently about how to increase that retention. But that's kind of how we sit right now. And most of the new, most of the numbers are,
where they're lower is because of expansion of the business and there just have been newer positions that we've added.
Miriam Allred (14:29)
Let's get into that right away because again, I think that's not uncommon for anyone listening to this is that that scheduler role probably second to the caregivers themselves has the highest churn and there's a lot of reasons to unpack there. But I did want to ask you is, is that, or are there any other structural changes that you have made to the office team that have helped improve retention?
Catherine Vergara (14:51)
Yeah, so really kudos to our Chief Operating Officer Meg Lohan. She's worked really hard at thinking just strategically and differently about creative solutions to solving for the pain points within staffing. And when you think about a scheduler sort of having a life cycle of about two years, that's really discouraging when
we pride ourselves on having a business where people wanna come and really stay. sort of instead of accepting that as sort of like that's, well, we're just gonna get like, we're gonna maximize the two years. What can we do to differently to think different, to create a job that would not only recruit folks that we believe with align, that align with our core values, but really retain them and give them a really interesting career path. So the more recently, you know,
we expanded our work day from five in the morning to 10 at night, seven days a week. We've been a seven day a week operation for quite some time, but expanding those hours and staggering their shifts to, you know, we have the traditional sort of nine to five Monday through Friday, who, as we all would expect, is the most tenured, you know, scheduler who's been with us for a very long time. But.
plugging those holes with other very qualified, competent individuals who are eager to serve in the scheduling space and are comfortable with a more alternative schedule. I came from the hospital space and so I worked with a lot of people that liked working weekends or liked working nights and sort of that like shift work mentality. And if you can expand their shift and give them fewer days or shorten their shift and give them more days.
You can come up with something that's more customized. We say a lot at CareFor that if the job, if you're working more than 20 % of the time to make the job work for your life, that it's not a long-term sustainable fit. And when we talk about scheduling, that role just has such a high burnout through what the expectations are and the demands and the challenges and the availability and the on-call.
that if we can create a schedule for them that more naturally fits with their personal life based on preference of schedule and needs of the business, you can keep them longer and they're more content and it meets their needs and the needs of the business. So that's what we've been doing on the scheduling side and so far it has been successful. It gives you lot of opportunity to think about how you're gonna handle communication and handoff and.
to really allow them to be on when they're on and off when they're off. You need to be disciplined about that. But so far, it has been well implemented and well received.
Miriam Allred (17:49)
know we're getting into this topic specifically, but I think it's pretty interesting. Can you share a little bit more about the, because you said 5 a.m. to 10 p.m. So there's the 5 a.m. to 9 a.m. and then there's the 5 p.m. to 10 p.m. Are those two like independent shifts or how are you managing and who's on call for those two periods of time?
Catherine Vergara (18:11)
Yeah, so they don't cover just, I mean, we've got one person that works traditionally the nine to five, but then there's someone else that's working like two to 10 and someone else that's working like five to one-ish. Yeah, 12 one. So there's this overlap where there's really only this sort of middle section in the middle of the day where there's just one person, but there's two primary morning people and two primary afternoon people. And then in those sort of.
Miriam Allred (18:26)
12 or 1, yeah.
Catherine Vergara (18:38)
You need someone available, but maybe the call volume isn't as high or the call, it's not, not the stuff you're receiving is more sort of the ad hoc stuff is just one individual, I believe. And then we've got this weekend rotation where they work. Meg really should be here, the one talking about this, cause this is her baby. But you know, the concept that they're, it doesn't matter what hours you're working. This is a, you're not on call, you're working. And so they also have,
regular job duties during that time in addition to whatever calls they may be receiving. And our patients are high acuity. Our caregivers are used to being able to access someone always. So we've always had a 24-7 nurse and scheduler on call that is with CareFor. But this has expanded the bandwidth so that kind of Monday morning at nine, it's not just like this waterfall of all this stuff you got to pick up on.
you can even get to the names of the week.
Miriam Allred (19:40)
Okay. I know this might seem menial to you, but this is like, these are the juicy nuggets that like people want to hear. It's like, okay, how are you? Who and how are people answering the phone from 5 a.m. to 9 p.m.? Like that alone is like interesting. so it's good to hear you break this down and the evolution of your business. Like you said, you've expanded the hours, you kind of create new timelines and schedules for different roles. It's like it's an evolution. It's a process. And that's what we like to hear you just like kind of talk through how that all came to be.
Catherine Vergara (19:45)
Yeah, no, it's helpful.
Yeah, and
two of our folks are not local. they do, you know, we've got one in New York and one in Florida, and they've been with us for a couple of years now. And when the team meets, they, you know, join virtually and they've come into Austin and done some stuff here as well. And, you know, that was also, may sound pretty like, well, yeah, but for us, that was sort of innovative and different a couple of years ago when we started exploring kind of, you know, what makes them have to
be here, you know, if we're utilizing the system and we believe that we can build scalable processes, there's absolute value to being in person, but if we're look, if we really want to recruit and retain qualified folks, can we look a little bit beyond the geographical confines of Austin and San Antonio and think a little bit differently about it.
Miriam Allred (21:01)
And like you said at the beginning, it's all about the individual. It's about the right fit person. And so yeah, when you're restricted to geography, it doesn't mean there's not a huge talent pool where you're located, but it just opens up opportunities elsewhere. And, you know, they're on the East coast, so maybe it's beneficial to have people in different time zones covering different hours. So there's a lot of just like opportunities when you think differently and structure things differently. So I wanna talk about your pillars.
for building up this office team. And it really stems from three things that you've shared with me, which is respect, trust, and communication. And those may seem like rudimentary, like, obviously, of course, but I've heard you talk about these in a way that goes so much deeper and again, lends itself to your numbers and your retention. And so I want to basically kind of break down what each of those looks like.
for you with specific examples of them done right or them done wrong and things again, like that have evolved in your business. So I want to start with respect. And again, may seem like an obvious one, but I think all of us have been the recipient of like disrespect in the workplace. and so, you know, what does a respectful workplace actually look, look like? And so the first question I want to start with is around onboarding.
How do you set the tone and foster that respect from day one? what are you doing in the actual hiring and onboarding process that helps this team understand that respect is of the highest priority to you and the team.
Catherine Vergara (22:36)
Yeah, so, you know, I think to your point, when people hear those words, like, well, you know, this is all kind of like woo-woo. And but the reality is I do believe when there's ever a conflict of any kind, there's an erosion of one of those three. And something has gone wrong where either someone the trust has been broken, the communication has been unclear or the communication was unkind.
or respect has been eroded or you don't respect them, therefore you don't trust them, therefore they're not worth your communication. So this whole cycle, we call it the three-legged stool at CareFor because you can't really have one standing strong without the other two implementing that. And I do believe it starts in day one. There's just, as we all know, the volume of applications that you go through to get to the qualified, capable people.
is just exponential. But really having folks that are in those recruiting roles absolutely aligning with your core values and really being clear on what we expect and what we believe to be a successful employee at CareFor has been really important to us. And so that individual, while they don't necessarily report to C-suite staff,
they are very clear and have a relationship with both myself and my chief operating officer around the types of employees we want, the pillars that are important, the way we carry ourselves they care for, so that when they're recruiting, I care like not as much as people would think about someone's resume. Like there are jobs and skill sets that we need to have. Obviously, if we're going to hire nurses, you need to be a nurse.
But, and there's different things that I look for around the types of jobs nurses have had to sort of help me think that they're going to be solid in the care management role. But I'm way more interested in who they are as people. This is not a business of rocket science. We're looking for the people that align with core values, people that are going to be good cultural fits for the business. so,
having those types of screening questions, those types of conversations have been really helpful in building out sort of what that recruiter role is and who they are. And I know I'm talking, I haven't even gotten to like the onboarding experience, but I think it starts with who's recruiting those people. Because I, know, 10 years ago, that was me. Like boots on the ground, talking to people, finding the right people and...
My team used to joke that I would strike a conversation with anybody and then sort of have this bench of people that I would call when we were thinking about opportunities for the business to grow. Because I was looking for the type of person more than I was looking for necessarily a resume per se. But I would say one of the ways we demonstrate respect when people are onboarded is the environment that they walk into when they come in to care for. The expectation is like,
Matters not if you know who that person is or not. You're going to make direct eye contact. You're going to pause and say hello. You're going to introduce yourself and take a time to thank them for being here and express to them that you're grateful that they're here. And it sounds like very elementary, but like there's plenty of times you can walk into an office building and make a whole lap and no one will really acknowledge your presence. Becca who does our recruiting is very great at
follow up emails that are timely and responsive and address them by name and speak to them directly about what she appreciated about the interview. And they're leaving with shifts and they're getting out into the workplace. And then for the caregivers, we don't do it as, we certainly welcome them amongst the team, non-caregiver staff that comes on. There's an email that goes out and people respond and welcome them. And then I...
make a point to go to lunch with all of those operations and finance and care management staff that come to join us as a business. I think if you just slow down and take the time, people want to be known. People want to be, they want to be a name, they don't want to be a number, they want to feel a part of something, they want to feel like someone, they showed up and someone appreciated that they were there. And I think just infusing that virtue of hospitality.
into our interactions with people when we first meet them really matter.
Miriam Allred (27:22)
I was just going to reiterate what you just said, which is respect is really a sum of all the parts of every interaction. Every interaction has the opportunity to build or hinder that trust. It's a lot of just small interactions that lead to a culture of respect. One of the words that stood out to me was earlier in your comment, erosion, erosion of respect. That really happens when those interactions start to break down and that leads to this erosion.
What are some behaviors or things that you've seen in the business when that respect starts to break down? The way people talk to each other, the way people dress, or how have you seen, or what are the indicators that respect might be breaking down?
Catherine Vergara (28:08)
I used this analogy at an all-team meeting a couple weeks ago and I just said like, I want you to think about like the safest place that you can think of and how you carry yourself when you walk into that place and the assumptions you have about that environment, the assumptions you have about the people in that environment and when you feel safe in an environment, you trust
everything that goes on in that environment, you're more apt to trust. And when that trust is lacking, and I know we're talking about respect, but the point I'm getting at is when that there's an erosion of respect, there's typically an erosion of trust, and the way people carry themselves in that environment, we talk a lot about assuming the best, you're not assuming the best. You are largely critical, and you can be very
protective, self-protective, which the opposite of that would be vulnerable and be willing to have the courageous conversations. And when you don't respect someone, they're not really worth your time. You can be very dismissive. You don't appreciate their feedback or their comments. And just think about, you feel very disrespected when someone cuts you off on the highway. And you just.
have no patience and no tolerance for that individual and if they were to get out their car and start talking to you, you probably wouldn't really care a whole lot of what they have to say. And the same thing happens in the workplace. We spend more time here largely than we do anywhere else. And all of these micro interactions, know, the way you interpret or misinterpret an email or interpret or misinterpret a text, if my team has heard me say it one time, they've heard me say it 50,000 times, just pick up the phone.
So much of our interaction is written in text or email that we don't take up the time to pick up the phone and actually have that conversation. And I think when people start to feel disrespected, we'll get into this, it absolutely impacts their discretionary energy and effort and what they're willing to put forth to do their job with excellence. they're...
you're going to be stuck in what we call position leadership where they follow you because they have to because you have a title and not what we would call permission leadership where they follow you because they want to. And I don't believe that home care is the type of industry where you can be effective unless people are following you because they want to because this business is hard and the work is hard and it requires no one's
We're not selling widgets and we're stepping into challenges and intimate spaces and dysfunctions of families and infrastructures breaking down and physical bodies breaking down and minds deteriorating. people don't typically want to follow you and stay in those environments unless they respect you and trust what you're doing.
Miriam Allred (31:19)
This is a perfect segue into trust because what you're getting at is this is such a human to human business and trust can be a tricky thing because trust oftentimes feels very personal and there's a lot of personal interaction in this business. I want to hear you describe what healthy trust looks like in a very personal environment that has to maintain professionalism.
What is the balance? What is the blend there? How do you maintain trust when there's like push and pull from personal and professional?
Catherine Vergara (31:52)
Yeah, so it is a personal business and my leadership style is extremely relational and I also believe the business we are in is relational. I would say I like what you're saying about trust is feels personal and it is. What I would say about the professional boundaries is there's a difference between what's personal and what's intimate. And intimate isn't just romanticized intimacy. There is a
There's a trust that I have with my team that's very personal, but there's a boundary there that I don't share with my coworkers or my team because we are in the professional space. And so there's not an intimacy and trust the way that I would have with my deep friendships and family members and other relationships I have outside of the workplace because this is a place of business. It frustrates me when people talk about their
work cultures like a family. I'm like, you're not a family. You don't fire your family. We don't get to fire our family. But I think it blurs the lines and sort of.
Miriam Allred (32:57)
Yeah.
Catherine Vergara (33:01)
misuses trust and in a way that it can feel like That's too that's too close but this business is personal and I think to manage people effectively and to lead people well You do have to know them
on a personal level and therefore they have to know you. And you can't expect something out of someone that you're not willing to do yourself. And so modeling that vulnerability around, here's where I didn't get it right. It's not like you're sharing vulnerable, inappropriate things. It's like, gosh, here's where I made a mistake. And I trust you enough that I'm going to share this with you and you're not going to hold it against me and we're going to figure out a solution together.
But I can't expect my team to be vulnerable in sharing mistakes if they don't ever see me share my mistakes or admit my own faults or apologize. That sounds so basic, but good gravy, there's so many people that have never apologized in the workplace. And if someone says, how do I do that? I'm like, I'm sorry. Admitting that you have done something different than maybe
that's true to your core values. And I don't even remember the question you asked me, but this is how I think, know, trust is personal and it requires you to be known and it requires you to get to know others. And all of that takes time.
Miriam Allred (34:26)
you
There's three different things that I want to address. The first
maybe is this controversial topic that people label their business, their office as their family. I appreciate you pushing on that because we see a lot of that, not just in home care, but across the board in the business world that it's like, my company is my family. I like to hear you contradict that because you're right, there's boundaries in the workplace.
that are different than our actual personal relationships. And I think there's just a lot of pitfalls there, especially in home care, because like we're talking about, it's so relationship driven, it's so trust driven, that if those boundaries aren't clearly defined, it's just a landmine of personal and professionalism mixed together and it can get really hairy. So any additional kind of thoughts on just...
I don't know if you've crossed any boundaries and made those mistakes or if it's always been top of mind for you and that's what's led to this culture that you've built in your own office team.
Catherine Vergara (35:45)
Yeah, so, you know, my one comment about the family thing is like, I don't care how great your family is, everyone has dysfunction in their family. And we don't have to tolerate dysfunction in the workplace. Like we have an opportunity to build a very healthy, functional culture because we hold people accountable and we have the courage to have the...
hard conversations and we hold at the top priority. know, CareForce leading core value is patient first and we cannot do that if we don't function cohesively as a team. And I care so much about us delivering excellent service that I will get up the courage to have that hard conversation. And there's just, there's boundaries and expectations that you can put in a workplace that you can't necessarily put in a family.
to your position or your place or, you know, a myriad of other things. But the connection between like family around work and personal is a hill I often die on or when I hear it I like kind of cringe. And sometimes people will reply like an office email like, Emily, welcome to CareFor and someone will reply like, so glad you're a part of the family. And I'm like, know, like I don't take it, you know, it's not all bad.
Miriam Allred (37:05)
you
Catherine Vergara (37:08)
You know, don't take it like, I gotta talk to that person. But the general philosophy of you should create a work culture that's like your family, I do not subscribe to.
Miriam Allred (37:17)
Yeah, I honestly, I'm, to be honest, I'm neutral here. Like I have experienced both. And again, just like the opposition that you're bringing to this, to be honest, I wish I could see and I wish I could just see and hear everyone's reaction to this because obviously we don't have an audience. A lot of people are going to listen to this. But again, I think this is pretty controversial, especially in home care. so, you know, let, let Catherine and I know if you feel strongly,
Catherine Vergara (37:28)
You're gonna get a lot of comments.
Yeah.
Miriam Allred (37:46)
on the flip side of this, like we want to hear from you because again, I think there's, look what I said at the start of the podcast, there's no one right way, but that's why we're here is to discuss these opposing ideas and take it or leave it, take what works for you, take what doesn't work for you and build upon that. I just want to keep going on trust a little bit longer around
Is there anything unconventional that you do when it comes to trust building? Like we know how easy trust is to break, but building it up, again, it's probably those micro interactions, but is there anything else that you've done with your leadership or with your office team that you feel like has been like a trust building exercise?
Catherine Vergara (38:25)
Yeah, I was thinking about this question. I don't know that I do anything necessarily unconventional, but I would say that the things that we do to build trust are, you know, at times on paper unproductive and just require spending a lot of time. So as I mentioned, I like to take folks out to lunch and spend time with them. And, you know, at the beginning when they're new, I think it can be a little intimidating. You know, I got to go to lunch with the CEO.
And I think they're sort of like, what's the hidden agenda here? And it really is just to get to know them and for them to hear from me, the mission and vision of the business and our goals for this year and how I believe they can participate in that and be a part of it. And, you know, an opportunity just to get to know each other as people. But when you think about, like, opportunities within a business and to really get to know people, the part that, you know, you cannot manufacture speed up is time.
and relationships are built over time. doing reps together and spending time, would, again, not unconventional, but the concept of managing by walking around. And it can look like Catherine's just kind of cruising around the office. And the goal is to touch base and to have conversations. And in those micro pieces is where you get to know each other.
and on a personal level, but also kind of like, what are they working on and what are their pain points and how can they be helpful? And so I wouldn't say that we've done anything truly daring. Our leadership team does get away for a couple of days every year on our leadership retreat. And we have a focused time of leadership development and reflections and reviews on the business part of the business. But we also build in time just to be together.
and to have fun. And I think a lot of organizations do that in a lot of different ways. But I do think in the type of business that we're in, we can get very caught up in talking shop and not make spending time together a priority in a meaningful way. talked to another business leader and asked her like, when was the last time you just like went to lunch with your other C-suite folks? And she was kind of like, we don't do that. And I think it's important.
And you don't have to be best friends outside of work, but I do think you need to spend time together to build trust.
Miriam Allred (40:51)
Yeah. Let's get into the third pillar here, which is communication. And again, on paper, this seems like so elementary. But like you said, it's like this trifecta of respect plus trust plus communication. I want to hear from your opinion. You were just asking your conversations with other business leaders. You're exposed to a lot of home care people and other leaders in general. What are some of the biggest communication mistakes that leaders are making that you've seen?
Catherine Vergara (41:21)
I think people are sometimes afraid to give quote too much information. Like if I tell them, if I show them too much of the financials, they're gonna have too many questions. Or if I pull the veil back a little bit and give them more insight into the process of how we got here, maybe they're gonna not trust that we always know what we're doing. And I think that's a mistake because,
It's a facade. It's okay to be vulnerable and for them to see you as humans and for them to see, we call it sculpting the fog. How did you get here? There's a humanity they bring. I think it increases trust when you're willing to share the financials to a degree for them to understand how their work contributes to the growth and the success of the business should give them some confidence and surety that this business is stable and solid and doing good things in the marketplace.
So I think just not sharing enough, I think is a communication pitfall that leaders can run into. And I think leaving out the why. We want people to do it because we said so or do it because they should just trust that I know what's best. I have always been a curious person. And so my curiosity is no judgment upon
I truly just want to know. I want to know why. I want to know what you thought about. I want to know what the implications are. And I think the more we can explain the why, we're going to get more buy-in and they're going to understand the impact of their actions, whether it's on another team or another department. And we talked to our care managers a lot about their billing.
and their timeliness of their documentation, their accuracy in their billing against the system, and to explain to them how that impacts accounting, how that impacts our trusted referral sources, how that impacts our operations staff and even our HR department, they're sort of like, okay, so if my portion of the process, if there's a breakdown, like gosh, there's this huge ripple, and it really impacts these other people, and it really impacts these other people I care about. So now I have
meaning and reason and purpose behind what I'm being asked to do. It's not just because Catherine wants to give me more work. And so if someone can understand why they're doing it, they're more apt to find purpose in it and to see how it like funnels into the goals and the vision for the business. And so whether you're sharing goals or financials or, you know, process mapping or how we got to this decision,
I think all of that is a really empowering thing for an employee and the more we can communicate and the more transparent we can be, I think it only enhances trust and I think a lot of folks don't make the time for it and don't see the value in it.
Miriam Allred (44:29)
I really like what you were saying about curiosity and breeding curiosity. You want people to be inquisitive. want, because like you just said, you like to ask questions and you like to know. And so if you're inquiring of them and what might look like probing, it's like, no, we're breeding curiosity. We should all be curious. We should all be asking questions and it's not probing. It's just better understanding. And I think it's really easy for leaders to shut that down or to get defensive or
to put up walls there, but you really want to break that down and let everyone have this curiosity about the business. And then it just breeds open communication and transparency across the board. There's something here in our notes about who gets what information when. As your team scales, that becomes an issue. If you tell someone something to someone and then it trickles down to the telephone like,
How do you handle those issues of how do you try to inform the right people at the right time in the right way?
Catherine Vergara (45:33)
Yeah, I think it requires a lot of thoughtfulness because no one likes to be caught off guard and no one likes to be out of the loop. It doesn't matter who you are or what position you're in or what your situation is in. No one likes any of those feelings. And just quickly on the curiosity thing, we had a leadership team meeting this morning and one of our leadership team members asked another one. She prefaced it with, this is a curiosity question. Why da da da da da?
And it was like, because of X, Y, Z, and this is how I'm thinking about it. And I think if you create a culture where curiosity is encouraged, people don't get defensive when someone's asking you a question because they really, they're trying to understand. And with understanding, you make better decisions and you have more purpose. But back to the question you asked me, which was...
Miriam Allred (46:26)
around thoughtfulness of who to tell what to when.
Catherine Vergara (46:28)
Okay,
so you this is something I haven't always gotten right because you can get moving and there's a lot of moving parts and you assume someone's heard or knew and that can bite you in the tail when someone feels flat-footed because they didn't have the information or they feel left out because they were the last to hear. So we had a conversation today with our team.
about communicating some information. And it's just, in my opinion, it's gotta be very forefront of your mind. Who is communicating it? How is it being communicated? And what is the messaging around that? And I think being very intentional in equipping your leadership team so that they are clear on those parts and then how are we responding? And then if there's questions you don't have the answer to, who are you gonna go to? So.
I think also when you're making systematic changes, like we changed a pricing piece of how we bill for our medical power of attorney clients. Well, that touches a lot of departments and it touches sales and marketing and how they sell it. It touches care management and how they bill it. It touches accounting and how they document it and, you know, finance and how we budget for it. And,
You know, can have these conversations in silos, you know, and just make a decision in one department. And I think, you know, not just communicating the final product, but making sure you're communicating amongst these teams. Like, yeah, this sounds really great for sales and marketing. It'd be a whole lot easier to sell. But like, let's talk to accounting on how that would be entered and then how do you track it? And then does, is care management clear on like how they would document that? And we need to talk to them too.
So I think really understanding the stakeholders in each decision and it can feel like, gosh, this is clunky. I got to talk to all these people. But if you'll run a lean and mean and efficient team, you can have these quick conversations, follow up action items from the leadership meeting, have a 30 minute zoom, and then move forward with the people that you need to talk to to make those decisions. But I think you've got to be very intentional about that and then be quick.
to fix it when you get it wrong. And to admit that you didn't handle it in hindsight, or I dropped the ball, or I got busy, or I've totally forgot. And that's the piece about just owning our mistakes and being clear that this is not consistent with how we would handle it. And given the opportunity to do it again, we do it differently.
Miriam Allred (49:12)
Really quickly, think what's so important with communication is structure and clearly defined rules, essentially. It's like, how do we communicate certain things and in what way? When do we hold meetings and what do those meetings turn into? It sounds like you all have that really clearly defined. Earlier, you made an interesting comment about picking up the phone more. I'd imagine you have
I don't know, daily stand-ups, weekly stand-ups and quarterly meetings, like kind of the traditional setup. But it was interesting to hear you say, maybe we're relying too much on written communication and not having enough FaceTime or phone time. just reading into that. Like, do you think people have gotten used to the way things are and you need to like kind of break out of that or what's at the root of needing more FaceTime and more phone calls and...
what does that look like?
Catherine Vergara (50:09)
So we do all of that. Our teams meet weekly, our leadership team meets weekly, our executive team meets every other week. Most of those are virtual though. Our care management team meets every other week in person. On the off weeks it's virtual. I think it's more like the micro, the day to day, the text, the email, the back and forth. And I think you have to have a pretty good gut check on would this be better in a phone call? Or like gosh, this seems like it's maybe
Maybe that response I'm interpreting is that they didn't read my email as I intended it. So I'm gonna pick up the phone and just clarify and just double check that we're on the same page. And just pausing and going that extra step to either pick up the phone call. I had someone reach out to me and just was like, I feel like we're talking a lot recently on some hard stuff and we haven't spent much time together, can we go to lunch? And.
Just taking that extra step to have the FaceTime to sort of just get aligned and get on the same page. And aligned doesn't mean you'd necessarily agree on everything. It's just we're aligned on the direction that we're headed and we're gonna row in the same direction on this. But I do think, we all very much learned how to operate our businesses in a virtual environment. And then sort of the back to office was like, well then do we even really need to come back at all?
But there's so much value and productivity that can happen in more of a virtual hybrid space. So we've really landed on this hybrid model with a strong commitment to FaceTime and talking on the phone when necessary. And even on a Zoom, like let's just hop on a Zoom, like you don't have the micro small talk in ways. And so I just really...
It's important to me that our business just holds that intention and we don't lose the flexibility and productivity that happens in a virtual space, but also value the face-to-face connection and make time to do that. entire staff gathers, our entire office and operations and care management staff gathers in person once a month. And we have a meeting and we share a meal together.
They always hear me say like, we don't do back rows or we don't do second rows. Everyone's got to sit in the same row. It's ends up being like a really big circle. And then as they break for lunch, I always kind of give like sit next to someone you haven't talked to this week. Just to encourage them to get face time with people that they inevitably they would have serious pain points if that person wasn't a part of the business because the role that they play, but they don't necessarily touch them every day.
Miriam Allred (52:50)
Just to bring this full circle, a couple of thoughts that I'm having back to trust and respect. think it's in this very virtual heavy world. It's so easy to hide behind the keyboard. It's so easy to shoot a text. It's so easy to shoot an email. It's just convenient. I'm just thinking through this. Maybe when that trust or that respect is not totally eroding, but it's just
convenient and easy to send a message and it feels outside of your comfort zone to like strike up a hard conversation or you know, FaceTime or call when it's when it's a difficult conversation to have or it's a personal conversation to have. think it's just easy to hide behind messages in this very virtual world. And so I like what you're saying about this hybrid of like, there's a lot of communication documentation that needs to happen and can happen really seamlessly virtually, but don't let that
go too far and take away from the really meaningful, important conversations that need to happen over the phone or over FaceTime or around a table. that balance, you you think of just the world and the media and big companies today, like everyone's trying to figure that out, but it's a really worthwhile pursuit to figure that out for your business of what can be done well and done right virtually versus what needs to happen in person in real time, in a, in a live setting.
Catherine Vergara (54:09)
Yeah,
and I think, you know, developmental conversations need to happen in person. And if every time I'm reaching out for someone to meet me for coffee or lunch or meet me at the office, they're like, gosh, what's Catherine got to say? Like that doesn't feel right either. The only time I make time to be with you in person is when I'm going to give you. Hard feedback. Like that's that's inconsistent with how I want to be treated. And so, you know.
Miriam Allred (54:29)
Thank
Catherine Vergara (54:38)
I tell people in their annual reviews and in their semi-annual reviews, nothing should be a surprise. The positive things where we see you excelling, the opportunities where we see you growing. If I've waited six months to celebrate you or tell you you're doing great, I haven't done my job at the same time if I've let you make a pattern of mistakes. But I don't have the trust and respect to come to you and talk to you about these things and they be a productive conversation. If I haven't invested the time to develop the relationship.
that you care what I have to say about it. So I do think, you know, if you don't ever touch people in person, setting aside that time to have those conversations can be a little awkward because you haven't done that consistently.
Miriam Allred (55:23)
Yeah, I think the question that I want to end with that's coming to mind is different than what we have planned, but I'm just thinking of respect, trust, communication. You as the CEO have this weight to bear of, on paper, you need to be this model of these things to then, reflect that across the board. Do you feel this weight of needing to be perfect in these areas to model that to your team or have you learned to kind of mitigate?
the weight of the CEO role and what that entails.
Catherine Vergara (55:55)
I absolutely feel the weight. I used to feel the need to...
Let me give an example. I absolutely feel the weight. At the beginning of every leadership meeting, we have something called an executive perspective, where myself or another C-suite member provides some leadership principle or comment or business perspective or something, and we have a discussion about it. And in February, we focused on elements of management. And I opened it up, and I talked a lot.
And I'm a more natural leader than manager, so I can often focus more on leadership. And I felt like we needed to tick and tie some management pieces. so later that day, I was talking to our chief strategy officer, who's also a mentor of mine and has been a tremendous influence in my leadership growth. And I asked for feedback. I said, how do you think it went? And he's like, well, it's kind of a lot of lecturing. And I was kind of like,
Dang it, I was like, tell me more. So we talk about it and we talk about opportunities and he's like, you know, I think going forward, it would be helpful to hear more from the team and here's how you could position it. And I said, you I said, I've been looking at a couple of articles. And so we just, we sort of landed on, send them this stuff to read and we're gonna have more of a book club type discussion in the coming weeks as we dissect all of this together. Catherine 10 years ago, given that feedback would have felt the need to talk to my team members, apologize.
and just feel guilty and like I had failed them. Catherine today is like, gosh, not my finest moment, but no real damage is done. I have the opportunity to course correct. Nothing I said was untrue. Did they sign up for a management class today? Not really, but they got one.
And we're just gonna course correct and we're gonna keep going and I'm learning and they're learning and we're all gonna be better for it. And so I hope that demonstrates, like I still think about it. And I have a very unreasonable expectation for myself in a lot of areas. But I have learned to be more compassionate with myself and to give myself grace and to demonstrate to them that they...
that I know that I'm human and I know that they're human. And in that humanity, I think you only enhance these principles we've talked about. And the rest of the month, we had a really great discussion and I listened a whole lot more than I talked. But I think that's an example of how I absolutely feel it and I feel a tremendous responsibility.
Miriam Allred (58:45)
you
Catherine Vergara (58:57)
in the way in which I lead my team, but I've also learned that I'm not gonna be perfect and that's okay.
Miriam Allred (59:06)
Thank you for showing that. That was really, really well said. And the two words that come to mind when I see you and perceive you is just like humble and authentic. Authentic is such a buzzword, but I really like what you were just saying is you're human and you need and want your team to know that you're human, that you make mistakes, that you're learning and growing. And, everybody wants that in leadership. They want people that are humble and that are authentic and that are willing to own up to their mistakes and that are transparent.
that just comes with the territory. You feel the weight, but you're trying your best and you're letting people know that you're trying your best and you're on your own journey to get there. So that was really well said and a good example of all leaders, all CEOs listening to this are just doing their best and they're learning and growing and becoming better with each meeting, with each day. The very last thing I want to ask you, know we're running a little bit long here, but
You're still young and so you have a lot of mentors and I've read a of books and I'm just curious like what inspiration you have drawn on to shape your thinking around this. You just mentioned one of your mentors, Gary, I think you said, but can you just kind of dial through a few books or resources or people that you, that have helped shape your thinking around what we've talked about today?
Catherine Vergara (1:00:20)
Yeah, so Gary Loudamy certainly has shaped my view on leadership and how to implement it in a meaningful way. A couple of the books that are sort of our care for leadership academy that he built was built upon is The Leadership Challenge by Kuzises Posner and then Maxwell's Levels of Leadership and those two integrate. If I had to pick one, I would choose The Leadership Challenge because it gives you very practical principles to
to lead and then what it looks like under each one of those principles to operationalize those. I'm a big Brene Brown fan, so Dare to Lead, we talk a lot about clear as kind, and that is a Brene Brown thing as far as how to have courageous conversations and how to rumble and be vulnerable. She's obviously written a lot about vulnerability, but what I like about Dare to Lead is she brings a lot of these principles into the workplace, and so it sort of handles that boundary issue that you were talking about,
How do you do this professionally without it feeling like Kumbaya summer camp? But really have an authentic environment that people feel is real when they walk in the door. The Trust Edge is a phenomenal book all about trust. I would suggest the audiobook. It's something that I listen to every year. And then a Lindsay Oni book, Five Dysfunctions of a Team.
I think is a great book to read as a leadership team. It has a really cool assessment tool that team members can take as far as assessing their team that they're a part of. We did that for our retreat last year and have implemented a lot of those practical pieces into the way our directors are leading their teams and collective conversations we're having during our team meetings. And then,
On socials, I like to follow Simon Sinek and Adam Grant. I think they have good inspirational pieces. And that would probably round out my tops.
Miriam Allred (1:02:29)
That was a
great list. I'll make sure to include those in the show notes so people have those. Because again, I just think the world of you and I'm like, how have you learned and grown so much? But it's helpful to know the inspiration that you've drawn on and being able to share that with other leaders will be really helpful to them. So Catherine, this has been amazing. Thank you for joining me in the lab.
Catherine Vergara (1:02:50)
Thank you.
Miriam Allred (1:02:51)
For all of those listening, Catherine is my first guest on this new podcast. So just feels really special to have this conversation with you today. And I'm just so proud of both of us. We're on this journey. Home Care has brought us all together. I just honestly thank God, like every day, like we're just doing this awesome thing together and it just lifts me up and I feel so grateful. thank you for all that you've shared today. Fantastic conversation.
just dialing into respect and trust and communication. And what that results in is this rock solid, retained office team that is with you for years and years. And I think that's every home care business owner's dream is how do I build that and how do I maintain that? And you're living proof that it's doable through really these simple principles, well executed. So thank you for joining me. Thank you for being here. Thanks for entertaining me here in the lab and we'll look forward to more in the future.
Catherine Vergara (1:03:45)
Yeah, thanks so much. It's been great.