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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 (00:01.35)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. Today in the lab, I'm joined by Jonah Francis, the president at Pansy Home Care Services in Hartford, Connecticut. Jonah, thanks for being here in the lab.
Jonah Francis (00:16.937)
man, I've been looking forward to this. I can't wait. Thanks for having me.
Miriam Allred (00:20.858)
The feeling is mutual. was just telling you, I see you at conferences, I hear your name in different rooms and I was like, I'm reaching out to him, I want him on the show, let's do this. So sorry this is long overdue, but I'm glad we're connecting today.
Jonah Francis (00:24.046)
Thank
Jonah Francis (00:33.944)
Same, same.
Miriam Allred (00:35.686)
Awesome. Well, let's let's jump into it. People may or may not know a whole lot about you, but I want to start with kind of the background of the business. Your mom is Pansy and she started the home care business and you've been involved basically since the beginning. So tell us a little bit about her background and starting the business and then how and when you got involved.
Jonah Francis (00:55.084)
Yeah, so Pansy is a flower. So I go with the seed analogy. So the seed was planted back in 1966. My mom was a CNA when she immigrated up to the United States. Well, well before that as well. And eventually what took place was she's always been kind of what you see from caregivers overall, right? A hustler, a grinder, somebody that puts passion in their heart into everything they do. So starting a business was from the inception what she always wanted to do.
The business though was officially launched in 2013. And in terms of like my role with the company, I always like to tell people I was like, volatile to be a part of the business, whether I to or not. My mom was gonna get me to help and support in some sort of way. But I officially started full time with supporting my mom in 2017.
Miriam Allred (01:46.692)
Okay, and you're young now, so you were probably pretty young back then, right?
Jonah Francis (01:51.946)
Yeah, yeah, believe I was 26 years old.
Miriam Allred (01:54.904)
Okay. And what was your background coming into it? Were you working? Were you in school? Like what were you up to until you got kind of all untold to get into the family business?
Jonah Francis (02:02.702)
Yeah, I was climbing the corporate ladder. I was an analyst with Cigna, a healthcare organization, and at night I was a sports multimedia journalist with a local TV station here. So I was running the beat at night and, you know, crunching the numbers during the daytime. That was my background.
Miriam Allred (02:21.246)
What in the world? I did not know either of those things. That's amazing. And this was all in Hartford. So the business is in Hartford. You mentioned to me, you guys are from Jamaica originally, is that right? And then moved to Connecticut.
Jonah Francis (02:34.028)
That is correct. So specifically we're in Hartford County. West Hartford is the town that we're in, but we cover all of Hartford County. In terms of our background, yep, I was born in Jamaica, as was my mom. My mom migrated up when I was relatively young and struggled and eventually found a way and made a way to be able to file for myself to come up as well. And then eventually my father. So again, hustler, hard worker.
doing exactly what a lot of our caregivers do today, which is sending their funds back home to support their family as well.
Miriam Allred (03:08.036)
Yes, I love that Pansy. I love all the photos of you and her and her on the website. Just so many great photos. She just seems like the most incredible woman and you get to work with her every day. And you were just telling me how involved she still is in training the caregivers. You know, it's her name on the business, her name on the door and she loves caregivers and she can relate to them. And so she's very involved from the training standpoint. So you all are a dementia first dementia focused home care business.
Jonah Francis (03:24.162)
Hahaha.
Miriam Allred (03:37.18)
Has that always been the case, you know, from day one? Was that kind of the thinking or what was the kind of the strategy early on and when did you all decide to focus on dementia?
Jonah Francis (03:47.212)
Yeah, well, great question. It was not the strategy from the beginning, especially when I started. We were kind of like most small businesses, most entrepreneurs, just trying to do anything that you possibly could to kind of make it, to survive, to create a name for yourself. It really wasn't until a few years after, as we just kept finding ourselves caring for people living with dementia, we looked at our census as well and our
heart started to go in that direction and our senses was also telling us at the same time, it's always great when those two things align, right? Our census started telling us the same time that that is the direction that we should go in. So what kind of I kind of summarize it is it started it started as like again doing anything we could to survive, then it became a specialty, right? Because we started to put some a lot more effort behind it and then it became our focus, which is where we're at today.
Miriam Allred (04:41.694)
And when you talk about it becoming your focus about how many years ago was that that you were like, we're really going to lean into this and make it our identity basically.
Jonah Francis (04:51.352)
Yeah, about three years ago, we said, you know what, everyone is talking about this dementia specialty. And my theory is that everyone likes to theorize or whatever the right word might be, dementia care and dementia support. And everyone does a pretty good job of just kind of talking about it. We didn't want to just talk about it and be like everyone else. We wanted to lean in because during situations, our families are looking for us to be the experts.
And what we do today, our team talks about it all the time, is we lean in those situations and try our best to make sure that we're supporting them in the ways that they need, including our caregivers, of course.
Miriam Allred (05:34.238)
Yeah, I love that. So I want to talk about today what that looks like, you know, from the client side, the caregiver side, training operations, partners, technology, like what it looks like and what it means to be a dementia first or dementia focus agency, because I've heard you say you all want to be the service provider, the preferred kind of dementia service provider in Connecticut. And that's what you're working towards. And so I just want to like unpack what that means to you. So
Let's start with the client side. What are the specific marketing strategies that you all have deployed to target dementia clients in your market?
Jonah Francis (06:13.836)
Great question. Starting right off from that side of things. I would say what was very apparent was when we were going out into the marketplace looking for like marketing training programs, everything was pretty like open. It was all of home care and how do you sell all of home care? Nothing was really focused. So what we ended up having to do was we took all of the Steve, the hurricanes, the Sarahs,
the Melanie Stovers, we took all of them and just kind of comprise them into what fit who we are and what our messaging had to be on a consistent basis. So we do some of the same things and we're going to a lot of the same areas, but we found success in flipping the message from what other home care agencies usually goes out to sell, right? Other home care agencies are going out to talk about, we do everything. yes, and we have this specialty program.
Well, what we did was we flipped it. We have, this is our focus and we built it around ASA, approach, skill and ability. And yes, we can also help with some of those other individuals that you have, but this is our focus and having such a targeted message when you're going out and speaking to people at least makes people from what we've experienced go, hmm, what does that mean? How does that look like? We're listening and that's kind of all you want.
you're starting off a relationship anyways, it's just for them to listen.
Miriam Allred (07:44.506)
Yeah. And when you think about like referral partners and the people that you're going out and, you know, cross selling with, have you found that there's any specific referral partners that are best suited to refer you dementia clients?
Jonah Francis (08:00.13)
Great question. Yes, for us, our GCMs out in the area, we don't have many in Connecticut. I think if you go like over into Boston, Boston has a whole field of them, right? But right now in Connecticut, I want to say there's less than 15 throughout the entire state of Connecticut. But we've developed really, really great relationships with them, including one that has been growing throughout the state of Connecticut. And so in terms of referrals, that's been a great partnership.
They love our concierge program that we bring to the table that helps families start off low and scale up to what they need. In terms of other referral sources, we go to memory care communities a whole bunch. And what we're telling our assisted living communities, we're not looking for your entire organization, right? We're not looking for every resident under. We're coming in at your assisted, we're coming in for your memory care.
And then what usually happens is again, that tight focus then starts to expand out. And so we started Memory Care and then we ended up providing support for other residents in their community as well.
Miriam Allred (09:08.048)
Nice. Would you say those are your two primary referral partners, those GCMs and then this memory care?
Jonah Francis (09:14.286)
Specifically, yes. Memory care is overall, but specifically coming to the top of my mind, those are the two places that we receive referrals from the most. We partner with some specialty hospitals as well. However, what we found is that's more along the Medicaid waivers line. So again, having to refine our marketing approach has been something that we've learned over time.
Miriam Allred (09:38.258)
And what about your online presence? You you think of like SEO and being able to like really lean into like keywords and that specialty. Have you all made like online marketing a big focus and have found success there or not as much as these referral partners?
Jonah Francis (09:47.256)
Yeah.
Jonah Francis (09:53.342)
Not as much. That's something that we are really like honing into. Just got Alex Hormozzi's book for the $1 million lead, so I can't wait to start digging through that. However, we decided not to go in the SEO direction because when we attempted with Google, Google started off as a small number and before we knew it, we were spending every last dollar that we had. So we pivoted to the social media.
and through social media, it's been some growing pains. However, we found like a really nice little niche. We call it, Let's Talk About It. That's like our segment. And then, you know, so from our Let's Talk About It, we're like putting people in real life situations and role playing it through. And that has actually turned into a really good niche for us. And we've been gaining a lot of support from it as well.
Miriam Allred (10:45.246)
That's great to hear. What platform is that on? Is it on Facebook or LinkedIn or Instagram or where is that gaining the most traction?
Jonah Francis (10:52.468)
Most traction is on Facebook. But yes, it's all it's on our LinkedIn. It's on our Instagram as well. And again, like, you know, it just came from continuing to search and refine what we're trying to do, and the message that we're trying to get across and how best it's going to be received by people. And so far, as of right now, anyways, that has been the best messaging that we've been able to put out for social media.
Miriam Allred (11:19.934)
Yeah, I love that. I love the transparency too around like you're paying an arm and a leg for Google and not getting great results. But then you pivoted and thought like, let's lean into social. with any kind of online education, you have to put a lot into it to get a lot out of it. And you're already learning that is like, we've got to put a lot of work into that segment, really kind of build an audience before we gain traction. But like you said, a niche, know, like find your people, find what's interesting to them, and then lean into that as a strategy. That's awesome.
Jonah Francis (11:49.912)
Thank you.
Miriam Allred (11:50.238)
Connecticut is crowded. think you, I remember hearing the statistics when you guys started back in 2013, there was maybe 300 agencies today, there's upwards of 1200. So you're in a competitive market, which means you really have to stand out, right?
Jonah Francis (12:05.026)
Yeah.
Correct, correct. It's been pretty awesome though, to be honest with you. I always hear, because I'm also the vice chairman here for the HCAOA Connecticut chapter, and I always hear before my time how competitive it was with only like 300 agencies and how agency owners never would talk, never would share, but that was never my experience. When I started, those are the agency owners I'm thinking about right now, a couple that comes off the top of my head.
I go and have lunch with them regularly. You know, we talk about best practices. We talk about how we can continue to improve home care in Connecticut overall. So it's been a really different, I guess, generational difference because what I hear from the older folks in our industry is not what my experience and a lot of other home care owners' experience has been.
Miriam Allred (12:59.172)
Isn't that so interesting? know, just each every few years in home care, it feels like a different a different beast. But I love that you can relate to the older generation, you know, like the previous decade and, you know, talk the talk of like this upcoming generation and this upcoming wave in home care. And it's going to be interesting to see how it all shakes out. A couple of minutes ago, you mentioned like Medicaid waiver. And tell me about your all's payer sources.
and how dementia maybe influences your payers or doesn't influence your payers.
Jonah Francis (13:32.11)
Great question. As of right now, I don't believe that it influences our payer mix at all. Right now we're about 12 % in terms of like long term care. We are looking to start building up our VA presence so we don't have much of a presence in the VA. And then 10 % of our senses are our clients that are on the Medicaid waivers program. And for us, what we have done when we started in 2013 and coming in,
Almost 90 % of our clientele were on the Medicaid waivers program versus today, again, that's only 10%. So what we had to do was again, pivot as best as possible to be able to sustain growth. The waivers program here in Connecticut at least is at least $10 to $12 less than what our average hourly bill rate is.
Miriam Allred (14:23.87)
I was just going to ask that how are the VA rates and the Medicaid rates in Connecticut?
Jonah Francis (14:29.518)
VA rates are wonderful. VA rates is equal to what we charge for part time home care services. And the Medicaid rate, I want to say it's about $43 an hour here in Connecticut, $42, $43. And in terms of the Medicaid waivers, it's $24. We were pitching so hard to get it up. And I believe as of June or July, the rates going to increase by $1. So you know, it's that
We're fighting with Connecticut to do a lot better on the rates, especially considering we're such a high cost to live in state.
Miriam Allred (15:04.35)
It sounds like mostly out of necessity, the payer mix of your business has totally shifted. Basically, just based off rates alone, it sounds like the dementia piece hasn't really been a factor in the payers. It's just purely out of margins and needs.
Jonah Francis (15:19.438)
Not at all, but we look forward to the future because the program that we have here, especially being a dementia specific agency, that's one of the needs that someone has to show to be able to get expedited onto the Medicaid waivers program. So we do believe if what we're doing as an organization for the Home Care Association is successful and we start to get Connecticut to accept what we're proposing, which is a 10 % increase year over year, as
wage will continue to year over year here in Connecticut as well due to legislation. Pansy Home Care will get more back into the Medicaid waivers program, but unless that's happening, unless those rates continue to increase, we stick to what our calling card is, which is for our clients. We guarantee them that if they start with us private pay and if they then transition onto the waivers program, we don't drop them. They stay with them and we stay with them for the rest of their lives.
Miriam Allred (16:17.982)
That's great. That's really great. Let's talk about your ideal customer profile, your ideal client. When you think of a dementia first client, what is the persona of this person? What do they look like? What's their demographic? When it comes to the dementia piece, who are you looking for? Who's your ideal client?
Jonah Francis (16:38.146)
Yeah, so our ideal client is usually over 70 years old and is mid to late stage dementia. Typically, they do have a child that's for us what people keep on telling us is that typically they're far away. But what we've been noticing is majority of those cases and clientele that we've been working with are actually pretty close. And a lot of times they live with the person that we're caring for as well. So our ideal client usually again is 70 plus.
mid to late stage dementia and usually has at least one other person that's supporting them somehow,
Miriam Allred (17:15.014)
Okay, but not from a caregiving perspective, right? Not a family caregiver, just essentially someone in the family's living with them. Am I understanding that right?
Jonah Francis (17:23.438)
Whether they're living with or not, it's just been our experience that we're not seeing a bunch of kind of empty nesters, if you will, just if you will. A lot of the times we are seeing people that have family members closer to them. I don't know if that's just because it's a Connecticut thing. But again, I home care post reports show that typically those family members are farther away, but that's just not been our experience.
Miriam Allred (17:45.564)
Yeah, that's interesting. I'm glad you kind of call that out because that is different than what we hear a lot of the time. Talk about your assessment process. You're referencing, they're usually mid to late stage dementia. Is there any maybe different approach you take to that assessment or kind of initial interactions with the client that help you identify whether or not they're a right fit for your business?
Jonah Francis (18:08.352)
Yeah, majority of the time, it's not actually the client themselves that we're doing the assessment with. It's some it's a responsible party. And within that, we do understand that we're only going to get so much information. It's usually not until we usually start where we're going to start discovering more things. So our assessments are actually layered, because we understand that's what's going to happen. Right. So starting off, we have one of our sales representatives, they also are learning everything that we do internally as well.
So they go out and they do the assessment on the assessment. We're checking for goals We're creating 30-day plans. We're not creating an assessment that's supposed to be forever It's literally just a 30-day plan and we're trying to understand what this dementia is whether it's diagnosed or it's not what are the brain changes that this you've been noticing as a family member that you can tell us about what are some of the triggers that you found What is the story of why we're here in the first place?
And oftentimes that story gets shifted once we go in for our start of care, which we go through our MOU process, which is also a 90 minute process. So both of them are 90 minute processes, typically speaking, but both are goal oriented, trying to understand the person as much as we can from someone else talking to us about them or even the things that we might be seeing when we're with that person. for typically speaking, once again,
during the assessment, that's what we're looking for. We're looking for what type of dementia or brain changes are you noticing triggers? What are this person likes? Have they ever had home care services before? If not, we have a whole thing that we do to try and get them caught up to speed. Those are usually the things that we're looking for. And of course, what are the other needs, diagnoses outside of dementia as well?
Miriam Allred (19:58.716)
You mentioned this MOU process. What is that? I'm not familiar with that terminology.
Jonah Francis (20:04.492)
sure. So our MOU just stands for Memorandum of Understanding. And it's just something that we picked up. It's not something that's required here in Connecticut, but it's something that we picked up along the way in terms of best practices. We had a lot of families earlier on sign a contract and not always know our processes and procedures and, you know, and things like that. So during that MOU process, when we go on our first shift, our branch manager goes out there.
and goes through, it's just a one pager that everyone is initialing as we're continuing to conversate about things. And then they shift over to the seven quality of life indicators. That's what now the branch manager comes in and does. They shift over to the seven quality of life indicators, finds out what might be lacking for this person in terms of their quality of life, as well as the caregiver stress test. Those are the things that, again, that's why our assessments are two parts.
It starts off with the sales team gathering that and then it goes over to the branch manager that picks up some more things on the start of care.
Miriam Allred (21:07.048)
Okay, this is great. I'm leaning in here because this is new to me. So I want to keep kind of picking your brain on this. The seven qualities of life. Is that something that you all have developed internally and use?
Jonah Francis (21:18.246)
Nope. So it's not something that we've developed. Miriam, I like to tell people like we're growing so much so fast sometimes that we feel as though we're living five quarters in the span of a year instead of four. So the quality of life indicator we actually got from a dementia consultant as we bring in consultants all the time to look over the things that we do, our practices and stuff like that.
And one of the things that she said was, you know, maybe you should think about like integrating this into your business. And that was at the start of last quarter, right? So, so now it's embedded into our business and those quality of life indicators, anyone could type it in. You'll, you'll see a test on Google that will go and they're formatted so differently for each of them. But long story short, they're basically helping you to grade what
part of life that person is having good quality in and what part of life that person might not so that you can improve that and put a game plan in to start building that up for that person.
Miriam Allred (22:25.5)
Okay, I love this. I'm writing this down in my notes and I love your transparency here of like, we all kind of like steal bits and pieces from different consultants and industry people and books we read and mentors. like, that's how you build your businesses, like just stealing and taking all these different parts. So I'm writing those down because maybe we could share that with the audience of this seven qualities of life. Cause that's the first time I've heard of it, but it seems like a really nice layer to your assessment. You think of, you know, like IADLs and goal setting and even
Jonah Francis (22:55.256)
Yeah.
Miriam Allred (22:55.814)
like socialization metrics, but it sounds like this is kind of a really nice like formatted approach for dementia specifically.
Jonah Francis (23:04.338)
Most, most definitely. mean, honestly, so the way that we also do it is the first time is just the first time. And that's usually during when we go on and do our MOU. But when we continue to do it, so every 30 to 60 days, as we're doing our real, our 60 day reports, what we continue to do is we go through it with everyone on that person's team on that client's team, so that we're not it's not
I guess we're trying to let go of as much bias as possible to just one person's experience as they're narrating this person's potential quality of life indicators. And we also like to make sure that the family members is one of those stakeholders that we're talking to as well.
Miriam Allred (23:47.39)
Tell me exactly the stakeholders or the involved parties from the business. You mentioned the branch manager is the one doing that MOU process. I'm assuming with the caregiver there on the first shift. there anyone else that's involved like a nurse or someone from clinical or anyone else from the administrative side that's involved in those early processes?
Jonah Francis (23:54.286)
Mm-hmm.
Jonah Francis (23:59.438)
Correct.
Jonah Francis (24:07.564)
Nope. usually it's the branch manager owns their branch and all the successes of their clients, their caregivers, as well as their referral partners. And we've divided our company into two. So we have our corporate umbrella and then the corporate basically takes off all of when I started, we didn't have a corporate, we were everything. So what I just kind of figured, what did I need to be successful during those times to keep me
driven by the things that I had to do on my purposes, which was my clients, my caregivers, and my you know, the community that I was building a relationship with. So our branch managers do truly own that, that experience, they, we do have a coordinator that assist the branch managers as well. And so our coordinators afterwards, if the branch manager can't make it out, they can go out themselves or they can
do these phone calls because of course they're not going to go out every single shift to meet if there's four caregivers on an assignment to meet to talk to every single caregiver they're going to call them and try and figure those things out. So that's usually what our hierarchy is. Each branch has two people in it, a branch manager and that coordinator and then our corporate takes care of everything else under the sun, billing, payroll, marketing, sales, all those other things so that they can continue to live in their purpose.
Miriam Allred (25:27.942)
Okay, yeah, this is great. Every business is structured a little bit differently, so this is interesting to hear. I'm assuming you have the state of Connecticut all broken down into different branches about how many branches, they're not office locations, right? That's more of just like territories for your different branch managers. Is that right? How many branches would you say you have?
Jonah Francis (25:48.502)
Miriam, you catching the wave. Yes, that is exactly how it is for us. Initially, we were thinking acquisition, acquisition, acquisition. However, we're corporate led, but branch supported, like locally supported by people that are from that area. Now, with that being said, Miriam, we're literally right into getting our second branch established. So, you know, what we were doing is we're thinking about our future in terms of how we've been hiring.
and just brought on a director of care service that will be the intermediary between each of these branches. So we'll have our second branch up and running officially as of June, I believe is June 15th is the lease, when the lease breaks. And we're currently recruiting for our second branch manager. So I'm talking to you about, I guess I'm talking as if it's already there, but we're moving in, that's the direction that we've been moving in.
Miriam Allred (26:43.272)
This is great. So you're telling me to check back when the branches are all established and y'all are hitting the gas. That's great. But it's, it's awesome. It's top of mind for you right now. You're thinking about establishing these branches and what the business is going to look like. so this is great. One, one question on your website. And I've heard you and your mom refer to, your approach and this terminology around like memory damage. I wanted to ask about that. Is that something that you've heard?
Jonah Francis (26:48.726)
Yeah, right,
Miriam Allred (27:11.102)
or the community use or where does that term come from or is that something that you all have kind of taken on that that verbiage and found that it resonates?
Jonah Francis (27:21.164)
Yeah, thank you. That just goes back to small businesses, right? You take your eye off the ball and you forget to do some things. That's language that we're changing. We were playing around with a bunch of different languages to kind of articulate dementia, support care as much as possible. Why? Because I don't know how much you kind of remember about the time in Connecticut when they were trying to take away our ability to talk about care and call our caregivers, you know, caregivers.
Miriam Allred (27:45.062)
Mm. Yeah.
Jonah Francis (27:48.654)
So during those times, they were also taking away other rights as well, which was to talk about dementia support care. They stated at that time, if you weren't a hospital or a nurse or medical organization, those were not things that we were able to talk about. And not just dementia care, like even like respiratory support services that we provide or any type of clientele that are living with some sort of diagnosis, we weren't able to kind of talk about it or market towards it.
So we were throwing around different things. But right now, we don't utilize that word memory damage. So thanks for giving me the reminder on updating the website. We talk about brain change more than anything else because it's much more positive. It's a much more human experience than talking about memory damage.
Miriam Allred (28:36.892)
Okay. Yeah. I just thought it was interesting. It's interesting to hear you explain the context there because I was like, maybe they know something that I don't know or a lot of people don't know and that terminology is resonating. I think a couple of minutes ago you said, you know, part of the assessment process is dementia diagnosed or not diagnosed or self-diagnosed. I think there's a lot of people that it's not like maybe an official diagnosis yet. And so brain change or memory damage or other terms
Jonah Francis (29:01.08)
Mm-hmm.
Miriam Allred (29:06.466)
may be less like diagnosis focused or less of a label when you're talking to these families. And so I was curious if that was more of the approach of just different ways of talking about like brain change. I think that's a great, great phrase that maybe feels a little like less invasive or less intense when you're talking to the family if it's not diagnosed yet. Are you following me?
Jonah Francis (29:20.29)
Yeah.
Jonah Francis (29:28.462)
100%. And that's truly what we believe. Like we keep on morphing, right? And that morph has now led us into this particular phase of our journey. And for us, and that's also another way that our company has changed so much is because the dementia is a very human experience minus the brain failures, right? All of us have brain change. We're not the same person we are at five o'clock in the morning.
as we are at, two o'clock in the afternoon as we are at 12 o'clock when we probably should have been in bed two hours ago. We're not the same. Our brains, our capacity, all of those things are different. And so we're all experiencing brain change. The difference is our brains aren't actually failing, right? And so again, it humanizes the experience of someone living with dementia. And that's what we try to do and also educate our caregivers like here in Pansy Home Care. All right.
Miriam Allred (30:22.686)
Let's talk about the caregiver side. So when dementia became your focus a few years ago, you probably needed to kind of rethink about people that you're hiring. You know, do they have dementia experience or do they not and what your training looks like? So talk about that from the employee side. Did you, Were you hiring people without dementia experience and then training them? And now are you just hiring people with dementia experience?
Jonah Francis (30:51.672)
Yeah, I want to say we're still we're still like 50 50 there, right? Yes, we were still hiring people back then without dementia experience. And Today, we still do hire people without dementia experience. What I've realized more than anything else is oftentimes as long as we have our baseline right, right, we have the right fit caregiver that we believe aligns with us. As long as they have those things that we can't teach like empathy,
heart, right they genuinely care. As long as those things are all kind of baseline which is what we've always been looking for. We believe that 30 of the 30 % which is the dementia insights that we have we believe that we can teach that and what I also believe is that a lot of times clients they might say that they want a particular type of caregiver. But I believe more than anything they're looking for a particular set of skills
And again, when it comes to supporting our clientele and getting our caregivers prepared to support our clientele, I believe we do that really well. So they don't have to have dementia care. It doesn't mean they'll be placed on a client that might be more challenging and have some more challenging expressions than others, but that there's still space for them to learn and grow within our organization and grow within the clients that they're supporting as well.
Miriam Allred (32:12.958)
That's great. Tell us about your onboarding and training tools and resources from the dementia lens. Like what are you all doing? Who are you working with? And what is that dementia training focus look like?
Jonah Francis (32:24.898)
Yeah, great. Once again, mean, we're probably, I don't want to say we're a thief of anything, but we get inspired all the time. We're consistently looking at other people and what they're doing. And we're taking trainings from everywhere. I was also on the board for the Alzheimer's Association. So we've taken some of the Alzheimer's Association's training.
Three of our members in our office has gone through the Teepa Snow Training and I'm also proud to say I'm a mentor under Teepa Snow's umbrella. So we've taken some of Teepa's trainings and established some great foundations and we've kind of taken all of those things that we have. We also have a mental health organization too. we've even taken some of the mental health experiences and trainings and kind of combined it into what works for Pansy Home Care.
Miriam Allred (33:15.176)
Can you tell us in kind of next layer is what does that look like? So caregiver gets hired. What does the initial training look like? And is that in person or online or videos like give us kind of the next layer deeper of what it looks like for a new hire.
Jonah Francis (33:30.392)
Yeah, great. even so before we even hire them, they everyone goes through that one hour long dementia experience from Second Wind That's where we're putting the glasses over their eyes. We're compromising their all of their senses basically, right. And that experience itself is only eight minutes. But it's the communication and all of that stuff that shows us the things that we can't train. So that's that's kind of where it starts. Overall.
That's within the orientation. Our orientation here is only three hours because what we explain to our caregivers during that state of time is that we're looking to make a decision as to whether you're right for us, just like you are, you know? So at any point in time, they can get up and they can leave. And Aaron, who was on your podcast not that long ago, we actually got to go see him in his office in March and gave us a a great tool that we're using to this day now.
We were uncomfortable with dismissing people in real time when we noticed that they didn't fit, or at least our team members were uncomfortable with doing that. And one of the things and tools that he gave us was by offering a voucher, whether it's a gas card or a meal ticket or even just a $10 credit card, $20 credit card, that kind of eases the blow, thanks them for their time and the opportunity. And it's not now.
not forever, you know what I'm saying? So that's how we've been able to a little bit easier usher in or usher out people that might not fit us at this moment in time in their lives. But that's the start right there. It's that orientation out of the three hours, one of those hours is spent literally going through that dementia experience and in group conversation, again, so that we can make a right decision and they can make that decision for themselves. Now fast forward to our training. So before they start,
They then have to go through training with Pansy and that's a eight hour training course. She does it in one of two ways. She either splits it up into four and four or she does a full, she does a full day. And with that, she, we call it Pansy's care Academy She's going through everything that it takes for a, for ADLs specifically through the lens of caring for someone living with dementia. And then she's going through what we like to call
Jonah Francis (35:54.04)
from our PCA, so personal care assistant, to our memory partner training, and then that's another four hours. The difference between our trainings and most other home care agency trainings is that, especially that second tier, is really hands-on. It's really situational-based. It's things that they're gonna be seeing, and they're role-playing those things through. I'm a big sports fan, so what we always talk about is the way that people grow.
is from actually doing and watching the film and watching others. So during those trainings, they're able to get all three of those layers tied in. And I think that's what starts off our caregivers, you know, to be able to represent Pansy in the way that we feel is the right baseline for a caregiver starting with us.
Miriam Allred (36:40.808)
Jonah, that was awesome. That was the juice I was looking for and you just delivered. Something that stood out to me, tell our listeners about Second Wind. I bet people aren't actually familiar with that, so explain what exactly that is.
Jonah Francis (36:43.896)
Yeah
Jonah Francis (36:56.738)
Yeah, so Second Wind is the organization that we chose to go with for the dementia experience. The dementia experience is that experience, again, that one hour long training experience that gives people, at least to the best that I've seen so far, an ability to relate to the experience of someone who might be living with dementia and other forms of brain changes.
I guess that's in a nutshell, that's the best that I can explain it. They give you the resources, the tools, the trainings to be able to replicate their experience in real time as often as you'd like.
Miriam Allred (37:38.984)
But essentially you actually put on a headset, right? There's like the tech, explain the technology piece.
Jonah Francis (37:42.165)
Yeah, yeah.
Yep, so the glasses is impaired and so even if you had like, you know, light coming in from outside, we dimmed the rooms at least, but at least you can't see exactly how you could see and plus there's things inside of it that also throws off your vision. You do put on some headset. The headset has random sounds, random noises as well that's triggering at random times. So it's pretty...
It's pretty disorienting to be honest with you. We put some things inside of there. We put like a soul inside of their shoe so that, you know, to replicate the neuropathy. We put some gloves on to their hands as teacher as Teepa teaches are these three fingers are our skill fingers and they're one of at least two of them are usually compromised throughout the experience as well. That's that arthritis side of things.
Plus the things that we do to the room and the lights that are getting triggered on and off consistently to again continue to kind of disorient people's senses or the way that they take in information from the world around them. And that's what the Second Wind technology is doing.
Miriam Allred (38:58.856)
And the concept is to get the caregivers to walk in the shoes of these dementia clients. And it's probably so humbling. I bet that's why your mom, Pansy, loves that experience so much because it's so humbling to see these caregivers experience it firsthand. So they really do have that deeper empathy to go out and care for someone that their day-to-day life looks like that and feels like that, right?
Jonah Francis (39:04.012)
Yeah.
Jonah Francis (39:23.746)
Yeah, you're 100 % right. I've never had someone that has gone through it and walked out the other side the same that they did when they went through the experience. Everyone feels a type of way. We've had people that after like two minutes stood up against the wall and cried for the remaining eight minutes of the experience. We don't stop it because if you're just experiencing this for eight minutes, know, live in that shoes for the rest of your life.
So we don't stop. It sounds cruel, you know, it's an experience and we don't want to take away from the experience, especially because it's so short of an experience. And it's the conversation afterwards. So it's the questions that are asked, it's how they are answering the questions, how they are communicating with the person next to them that's also answering these questions. That kind of gives us the sense as to whether or not, again, they have those things that we just can't teach.
they have that empathy in the heart to truly care for the people that are living with dementia and other forms of memory impairment.
Miriam Allred (40:27.964)
Yeah, thank you for sharing that. You referenced finding in this orientation onboarding process that you find people that aren't a right fit. You can tell they can probably sense and you just kind of mutually agree that like this isn't a right fit. Are you finding that that's where you're identifying a lot of the drop-off is early on or do you also see 30, 60, 90 days in there's an additional layer of drop-off because caring for these dementia clients is really hard and some people just
Jonah Francis (40:30.691)
That was my part.
Jonah Francis (40:40.504)
Yeah.
Miriam Allred (40:58.19)
aren't, you know, a right fit. Like where are the drop off points maybe even after care starts?
Jonah Francis (41:03.638)
Yeah, sure. So we don't have too many people that we're dismissing, even with the vouchers that we've established. And to be very frank with you, too, because we do a pretty good job of estimating where that person lies and getting very good transparency from the people in terms of where they align their comfortability as well and what their needs are from us for training and support.
we do a decent job of making sure that they're aligned with clients that matches their current skill sets, right? So where we kind of find the drop off is exactly that. It's when they start on with a client, if we get it wrong for some reason and put them in a client, that's just to advance for where they are. And sometimes we might not get that second or third chance because that experience was just so traumatic for them and so hard for them.
So we might not even get a chance to make it back for them. But generally speaking, we've had a 70 % retention rate year over year going back to 2021. So again, we don't really lose too many caregivers. And when we do, it's usually because of, again, a traumatic situation.
Miriam Allred (42:12.414)
70 % retention. That's really impressive. Congratulations on that. That's phenomenal, especially with dementia clients. Like I'm honestly surprised to hear that, but it sounds like you guys have really honed in on finding the right fit, matching and preparing them as best as you possibly can for these tough dementia situations.
Jonah Francis (42:16.43)
Appreciate you.
Jonah Francis (42:35.348)
I'm sorry, one moment.
Miriam Allred (42:37.619)
You're okay.
Jonah Francis (42:41.78)
I just had a spider like jump on me. I'm so sorry, Mario. Yeah, I'm good. I'm mad scared of spiders and stuff, so I apologize.
Miriam Allred (42:45.47)
No, that's okay. You're good.
Miriam Allred (42:51.97)
shoot. Sorry. That's okay. That's okay. Let's keep going. A few more minutes here. I want to pivot and talk a little bit about operations, just the behind the scenes. You were talking about kind of the corporate structure and the branch structure. Is there any other layers to the operational side, the administrative side that are catering to your dementia focus? Just any other approaches in the office that you all take for supporting your dementia clients?
Jonah Francis (43:19.458)
Good question. Good question. It's a Jim Kinsey that owns another dementia specific organization. I forget his name, but I was on a meeting with him one time. It was with a group of home care owners. And one thing that he said to me was, you know, how do you show up for the people that are showing up for your clients? And he wasn't just talking, at least I took it as he wasn't just talking about, you know, what are you doing for your office team in terms of rewards and stuff?
He was talking about how are you, I believe he was talking about how are you giving them the tools to be able to support these people. So for us, it's not just like a, it's not just, you know, a one stop shop. Everybody goes through these trainings and on a quarterly basis, every single person in our operations team. Doesn't matter if you're HR, doesn't matter if you're the CEO, every single person comes together.
on every quarter, one Saturday a month for four to six hours for continued education and learning. And every month for one hour, every single month, we're again watching the film. So we're going and everyone has to be a part of it, including our sales team. We're watching the film and we're probably taking one or two different films, which is usually a caregiver interaction with some with a client or our interaction with a caregiver. And we're going through it.
role playing, practicing it out for how we could improve and be a little bit better, support our caregivers, validate, don't rush to solve a little bit better than we did during those situations. So everyone starts to build competent confidence, as we like to call it.
Miriam Allred (44:58.504)
That's amazing. I love to hear that, that continuing education for the entire office team from that dementia lens, because it affects everyone. know, everyone in the office talking to clients, talking to caregivers, it's just, it's again, your identity as a business and you want the office to be as comfortable and competent and confident as even those caregivers out in the field. So I absolutely love that. Any, any other operational areas you think of?
Jonah Francis (45:07.885)
Yeah.
Miriam Allred (45:23.792)
scheduling or billing or HR. Are there any other kind of nuances of in those functions that you have different strategies or decisions from the dementia lens?
Jonah Francis (45:35.178)
Yeah, the scheduling for sure. We actually came up with our own from the conference. Someone talked about identifying their caregivers and clients into four different groups. So we decided to establish that ourselves. We utilized and we built it from the ground up. We utilized the Myers Briggs and a bunch of different other personality profile tools to create our specific own one.
And what we actually found was we have them built into four different animal types. And what we found was the majority of our caregivers fell into the same category, which was owls. Very patient. A lion, a turtle, an owl. And man, I'm striking on that last one.
Miriam Allred (46:12.156)
What are the four? Share what the four animals are.
Jonah Francis (46:23.854)
It'll come back to me. It'll come back to me. But yeah, but nonetheless, majority of our caregivers are identifying as that owl profile. Not that they're nocturnal and don't sleep, but because they're just a bit more patient, observant, you know, and so they, a lot of them falls into that. And a lot of our clients are actually what we were surprised about falls into the lion category.
Miriam Allred (46:24.092)
Sure.
Jonah Francis (46:48.48)
and it might be because of the demographic that we're used to servicing. I'm not really sure exactly what it is, but a lot of our clients fall into that. When we started, especially from a scheduling standpoint, what we thought was that we would be matching a lion with a lion, but what we found, especially because one of the main tools that is needed, the best ability sometimes, as we like to talk about in sports, is availability.
We're not really using it anymore to try and pair like-minded personality traits together. We're utilizing it more to say, hey, this is who you are, and this is the profile of the person that you're going to support. And these are the commonalities that we found for you to just kind of be ready for and to try and work in and massage a little bit. You do 80 % of these things that are required already.
These 20 % is the tweaks that you might have to make on this shift here and this client that you're going to be supporting.
Miriam Allred (47:51.42)
Okay. This is super interesting. So you mentioned basically you've taken a bunch of different personality tests and resources and created your own. How formal is that? Do the caregivers actually fill out that assessment and then they know which animal they identify with, or is it more kind of behind the scenes than that?
Jonah Francis (48:08.662)
Yeah, that's on the orientation side. So right in the orientation, they're also that three hours, there's also filling that out as well. And then they
Miriam Allred (48:15.472)
Okay, interesting. then on the client side, same thing. It's like kind of a transparent part of the process.
Jonah Francis (48:22.122)
As best as possible, especially once again, because we're targeting people mid to late stages. So not all the time are they able to contribute. However, again, the family members is usually who's filling it out. And Tamika, at least our branch manager for the West Hartford location, during that MOU process, that's something that she's helping to get established as well.
Miriam Allred (48:41.926)
Okay. I love the imagery of the animals. I'm thinking of star ratings and tiers and all the different traditional approaches that home care agencies take, but I'm picturing in your scheduling software or in your documentation, there's these different animals. I think that's really interesting and I love the way that you just described it. It was an aha moment for you all. You thought you were going to be pairing lions with lions or owls with owls, but that's not actually the case. That just comes with experience of
You you said like there's that 80 % and there's that 20 % availability. There's all these, you know, pieces of the pie and how do you fit those together? But I just love the imagery of the animals.
Jonah Francis (49:21.614)
Yeah, well, and the golden retriever. That was the last one. Thank but yeah, thank you so much. And we wanted to make sure that we weren't doing anything that felt felt wrong. Right? We want to put like animals that you might someone might feel embarrassed about or something like that. So we're really we're really open to making sure that everything was okay and comfortable, no matter which one someone might land on, but still like did a good job of like even if I just said, ow.
right off the top of your head or golden retriever, right off the top of your head, there are specific traits that comes to mind about both of those that are different for each. And so we were really trying to be mindful of how we were coming across when we were choosing and selecting and telling people about what profile they might fall into.
Miriam Allred (50:05.758)
Thank you.
Yeah, the thing that I'm loving from this conversation, Jonah, is how you all have absorbed so much information, so many resources, so many tools, and then created your own version. You sometimes read that out of the box. You can just pull something off the shelf and apply it to your business. But I love that you all don't take that approach. Maybe early on you did, and maybe all early stage businesses do, but you all have absorbed so much information and then repurposed it.
and created your own set of tools and training specific to your people and to your dementia focus. I think that's phenomenal. And to be honest, I want a copy of all of these resources so I can see them, but maybe I'll pick your brain on a couple of them. Like even this animal personality test like, I think it's just different and interesting, but speaks to the nuances of home care, know, like Myers-Briggs, like maybe it's great and it works for a lot of businesses, but how do you apply that to your own business and your own people and make it your own?
Jonah Francis (51:04.642)
Yeah, thank you. And it wasn't just like out of my brain. So again, the idea sparked when Greg, our COO, went to that specific training or training at the conference back in November and brought the idea. And I took the idea and I ran with it. But I did say earlier on too, like, you know, we're probably living five quarters in the course of four. And that's just because of just how much we're committed to growing and improving overall.
And that can be fatiguing for our team. So we also had to develop, like we call it, clears. Did we clear the idea yet? Before we start to bring it to the table so that we're not, we're honoring our team and we're not burning them out with, you know, how many changes and the right, it's the right change at the right time, as we like to call it. So we, we find a lot of ideas. We want to implement a lot of things, but we want to also make sure that we're doing it at the right time.
right scale and we're not having, you know, diminishing returns.
Miriam Allred (52:07.966)
Nobody likes whiplash when it's just change after change after change. You got to do it strategically and one step at a time. Just a couple other topics I want to hit on. know we're going through here. Partners, you mentioned a couple of minutes ago that you all have started, I think it's called A Better Way, a mental health organization for seniors. Talk a little bit about that. Then you've referenced Teepa Snow, you've referenced a variety of Second Wind. Any other partners
Jonah Francis (52:17.624)
Yes ma'am.
Jonah Francis (52:34.318)
Yeah.
Miriam Allred (52:36.488)
that are just really foundational to your business today.
Jonah Francis (52:40.238)
Great question. Great question. So Partners Foundation, I guess I'll start with that one. Foundational to our business. It's the home care CEO form. I talk to somebody every single week at least within our group. And they've helped me to answer so many questions. You know, they've also helped me to kind of grow out of the scarcity mindset. I think when we were
When we were younger, in terms of a business life, what was very hard was as you started to make money, make income, make profit, you go through so many years and stages of not doing that. So then you get scared about spending it. So you start to do kind of what we see with our clients. Sometimes they're living with dementia and you start hoarding it. But, you know, again, speaking to a lot of these professionals, experts, getting expert coaching and counseling.
Miriam Allred (53:30.907)
No.
Jonah Francis (53:38.238)
from Jensen. Again, just to throw out some other names too, because we just as you said, we've taken so much from so many different places and just internalized it and applied it to who we are. But the Home Care CEO Forum, it's been revolutionary for us in our business.
Miriam Allred (53:54.558)
I love that you're also saying Jensen, the structure, but also you go out and visit the other businesses and you talk to them on the phone and you're probably texting them. It's a really great built-in community for you to be able to have that sounding board with other owners.
Jonah Francis (54:07.747)
Yeah.
straight up and you know we're not the only ones in the group that has taken this purpose, this mission, this passion on. My friends up in Boston has as well, Ryan with Minute Women and we've kind of been on this journey for somewhere around the same amount of time so we're able to talk about best practices and be transparent and share certain things with one another and not feel threatened or judged.
when we just need to kind of, know, somebody to our sounding board, if you will, expert impact, that's the E for our clear decision making hierarchy. So we're able to talk to people like Ryan and his team and, you know, get some really great insights and feedback. So it's been invaluable for us and the growth of our organization.
Miriam Allred (54:59.39)
I love that. Any other resources, partners that come to mind?
Jonah Francis (55:05.11)
Yeah, so of course you know of Teepa and that team and that's been monumental in our philosophies and our foundational philosophies when it comes to dementia support. One of the things that we are looking to start getting going as of Q3 is also Sensei AI. Jensen always teaches ROI isn't just income. So, you know,
One of the big learning things for us was impact or income. Of course, just like caregivers, we want a good caregiver and a good employee. We want both. We want impact and we want income. But not every decision that is made is going to result to income. And we had to understand what decisions we're making, it amounts to ROI. know, Sensi AI is one of those things that it's not a decision driven income thing that we're.
going forward with the program for, it's because we want that impact. So that's something that's on the horizon for us. I don't talk about it like I might be doing it. We literally are in the contracting negotiation phases right now. But that's something that we are full force moving forward with because of the impact that it's going to help to provide for our clients.
Miriam Allred (56:24.254)
Super exciting. And I like the way you and Jensen think about that, that ROI impact and income. You know, there's two different kinds of buckets there to think about when you're bringing on resources and partners, talk a little bit about a better way. So that's another side business that you or your mom have started or what's kind of the background there.
Jonah Francis (56:43.466)
boy, that's all three of us. So my sister who was a branch manager for us for three years is a licensed therapist and has been the entire time. And that's what her passion has always been. So what we were able to do is figure out a way to utilize her passion to also support back to, excuse me, utilize her passion to support, you know, our passions as well. And
I think the one thing that we've realized with dementia overall, again, it's a human experience and being that it's a human experience, people need therapy. Whether you're the person that's going through it or you're the person going through it. And that's, feel like the biggest difference between A Better Way and most other organizations is we do go after family members of people living with dementia because we understand that journey a little bit better and a little differently than most other therapists.
Miriam Allred (57:37.822)
That's amazing. You entrepreneurs, you, your mom, your sister, and tying it all into this purpose that you have as a family, which is to support these seniors, especially with dementia. think that's so powerful. So thank you for sharing a little bit about that initiative as well. Jonah, one more big question here. Your five-year goal is to become the most well-known dementia-first home care provider across the state of Connecticut.
This is a big question, but how are you going to achieve this? What are you setting your sights on the next few years to achieve that lofty goal?
Jonah Francis (58:11.438)
Well, first by cutting five years down to two. Well, and the way we're going to do that, seriously speaking, is with people, operational excellence and expansion. Number one, as I told you, one of the big things that we wanted to do was start to bring in experts. And that's exactly what we're doing with this director of care service as well as the director of sales. We're hiring for where we want to be, not just where we are. We keep a 70 % return.
Miriam Allred (58:14.14)
Okay, great.
Jonah Francis (58:39.82)
retained earnings year over year because we want to continue to be aggressive in our growth. Now you get those individuals, right? You get the right people sending the right seats You have to grow to be able to continue to afford them, which is where the expansion kicks in for us. In order to also deliver on our mission of being the best dementia care agency, non-medical, non-medical in Connecticut, supporting all of Connecticut, we can't do it from just this one branch. So we will be at, we're adding two more branches within the next year. So
One that starts up within the next two months. And then one after that, about six to 12 months after, depending on how that's going. All of which are about 45 minutes away from one another so we can continue to expand and not compromise quality as we're continuing to grow. And last but not least, operational excellence. We're bringing in these great people and locally led branch managers to help to deliver upon our message.
We want to continue to improve and to grow year by year, quarter by quarter. I think if you ask anyone on our team if we're the same as we were three years ago, no, way better. And if you ask them if we're the same as we were in January, no, way better. So we don't want to compromise on that either, operational excellence.
Miriam Allred (59:56.978)
Jonah, so, so, so good. This has been so fun, both fun and casual conversation, but also really insightful. You have delivered. I am so glad we had this conversation. Thank you for sharing so openly and honestly, and for also just leading this charge on dementia first businesses. There's just such an opportunity in the country and in the world for businesses to focus. And I think you all have done it so eloquently and are leading the charge on this. So thank you for sharing. Thank you for joining me in the lab.
and fantastic job today.
Jonah Francis (01:00:28.822)
I appreciate you homie. Thank you so much for having me. Thanks for the opportunity.