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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 (00:01.288)
Welcome to the Home Care Strategy Lab. I'm your host Miriam Allred. In the lab today I'm joined by the one and only Laura Coyle, the CEO of Home Well Care Services of New Jersey. Laura, welcome to the show.
Laura Coyle (00:16.735)
Thank you, Miriam. Pleasure to be here.
Miriam Allred (00:19.294)
You are an avid listener and you and I have spent a lot of time together over the past year, but this is our first formal interview and I have been looking forward to it. So thank you so much for making the time in your busy schedule.
Laura Coyle (00:32.063)
You're welcome. I've been looking forward to this too. And I've been missing your podcast. I am an avid listener. So I'm super excited to tune in again. I'll be listening to every episode except for this one because I don't like listening to myself.
Miriam Allred (00:47.558)
You are going to listen to it because you're going to get so much feedback. You're going to want to hear it back for yourself. As I was preparing for this, I was thinking you turned me down last year, but getting some no's occasionally I think is good for me, but that left me wanting more, which is why I reached out to you and had to have you on early. So I am just so excited. I have learned so much from you and think the world of you and your journey.
Laura Coyle (00:51.551)
We'll see.
Miriam Allred (01:13.908)
is so interesting. I've interviewed maybe a couple of nurses to CEOs, but your journey is unlike any other. And you stepped into the role of CEO just over a year ago. And so I wanted to just pick your brain on how everything's going and what you're up to. So let's start with a couple of things. I want you to share a little bit more about the origin story of Homewell in New Jersey. Again, you're the CEO, not necessarily the owner, but you have been involved for a long time. And so
Let's start with that and then we'll talk a little bit about the business model and then we'll get right into your background and what you're up to. So could you start with the origin story?
Laura Coyle (01:51.167)
Sure, sounds good. So Lou Romano, our owner, he was young, like 24 years old, and he was out there working in the corporate world and pharmaceutical marketing, and he just identified he did not enjoy working for anyone else, wanted to do his own business. around that time, I think he had a grandmother that...
was not doing well, had some health issues. So he was looking for some home care for her. So I think he was the one, if I remember correctly, he was making phone calls to home care agencies to shop around and find out how do we set this up. And he was shocked by the lack of customer service and just people weren't calling him back. And when they did, he was like, I don't know about this.
place. So he quickly identified there was a need for, you know, a business like this. And his family was supportive of him, you know, joining like a franchise system. He liked having the support. And so he joined Homewell in 2005. When he joined, he was the seventh franchisee in the system. And I joined Homewell in 2012.
So I've been here almost 13 years now.
Miriam Allred (03:20.576)
Amazing. was just going to ask that. So when did you join and talk a little bit about your early days? well, let's talk about your background. Let's start. Give us a little precursor of your background pre-Homewell and then yeah, what drew you there and kind of your early days in the business.
Laura Coyle (03:36.213)
So my background, I've been a nurse for 31 years now. And early on, one of my first jobs actually was in home care. When I graduated and was licensed, it was during a time, at least in my area in New Jersey, where it was very competitive and it was difficult to get a job in a hospital. You either had to know someone or...
have graduated from a very prestigious school, neither of which I did. So I did a home care job initially, one-on-one private duty care with a patient who had cancer, taking care of them in their home. So that was a brave undertaking for a brand new nurse. And luckily, she was a very sweet woman. And she taught me. She taught me things that I needed to know about nursing and home care.
After that, then I did work in a hospital for a few years and then ultimately moved to Hackensack University Medical Center. It's now Hackensack Meridian. And that was my, the job I loved. I was there for 13, 14 years. I worked in oncology, stem cell transplant unit. So it was a very intense, you know, unit to work on. Difficult.
You know, obviously working with oncology patients, have to really, your heart has to be in it. And it's a privilege to be involved in those people's lives. That's such a fragile population. And it's something I loved doing for many years. While I was working there full-time, and then I started having my children 25, 26 years ago, I went from full-time to part-time down to per diem.
Then when my kids were getting a little older and they were getting into school, I had some days during the week free. So I decided to sign up with a few home care agencies and do more home care, like skilled nursing visits. And I enjoyed that for a while. I can appreciate the caregiver grind of working for two or three agencies at the same time, going with who gives you the shift you're looking for, the most money.
Laura Coyle (05:59.975)
you know, what works for you. And so I did like maybe a year at each agency and jumped around a little bit. so that kind of gave me a taste for home care while I was still working at the hospital. I think I, I think I thought that was going to be my, my ultimate career. That's what I was working towards and going for my master's degree in nursing education while I was working and you know, life, life throws, throws you some curve balls sometimes. So
My dad ended up getting cancer. He ended up passing away from cancer while I was working at the hospital. So he was treated by my oncologist there. He was, you know, given chemo by nurses I worked with and had trained. So it was difficult after he passed. It was very difficult for me to have that same passion. And the job I once loved just changed.
changed for me. So I stayed, I stayed about four years afterward because I'm super stubborn. And I thought I'll get through this, it'll get better and you know, time, time heals everything and it didn't. So I ended up leaving there mostly because I didn't like the nurse I turned into. I think I was, I was guarding myself more and more and I, I was not
you know, meshing with my patients' families and bonding with them like I once did and supporting them. I just wasn't the same nurse and I didn't respect it in myself. I didn't like it or respect it. So I figured I need to remove myself from this. So I left there, took some time, a little bit of time off, trying to reevaluate. I don't want to go work in a hospital again. Do I want to work in an office?
just wasn't sure where I wanted to land. And there's something exciting about that to have options and not know what direction you're going in yet. So then I ended up seeing an ad in Craigslist for Homewell. And I thought, seems like an easy job because that's what I was looking for. At the time, I was looking for something easier and I liked home care.
Miriam Allred (08:17.976)
Thanks
Laura Coyle (08:26.473)
you know, that there was something where I had that experience before and keeping people in their home and allowing them to age in place. So that appealed to me. So that's where I came to Homewell. And I came with the mindset that this was my cruise to retirement job. We see how well that worked out for me.
Miriam Allred (08:47.056)
my gosh, there's some nuggets in there that I didn't know. So thank you so much for sharing that and being vulnerable. And just, that's so interesting to be honest, to hear you say how your love and respect for your career changed. And that's just interesting and vulnerable. So I appreciate you sharing that. So you come to Homewell, tell us what role you started in and what was kind of the size and shape of the business at that point in time.
Laura Coyle (09:14.869)
So at that time, I came here as a nursing supervisor. So there was two other nurses at the time. I honestly don't remember how many clients we had. know revenue wise, like 6.7 million in revenue. To give you a reference, we're at like 23 now. We were in a very small office. There was...
under 10 people working in the office. And so my role was to go out and see clients, do initial assessments and write care plans, supervise the home health aides, and just an entry level nursing job. And that didn't last very long.
Miriam Allred (10:06.446)
But at the time, you probably weren't thinking this is going to become a track to become CEO. Was there conversations? Was that crossing your mind? Did you think that you were going to be a nursing supervisor, director of nursing forever, right?
Laura Coyle (10:16.033)
no.
Laura Coyle (10:22.803)
Yeah, yeah. You know, initially, honestly, there was definitely, it was very different then. Very, very different. And anyone who's been here, like more than 10 years, we talk about the old days and we joke about them. We're so glad they're over. Very different crowd here, different people. A lack of processes, just a lack of organization. So my early days were...
kind of full of what am I doing here? know, am I, if I'm going to stay here, which I wanted to, I did, I wanted to, it wasn't like it was this big struggle, I immediately identified that Lou was someone I wanted to work for. You know, he is great, as you know, right? He is generous, he is kind, his heart is in the right place.
He does this for the right reasons and he just needed help. He just didn't, he didn't have people around him that were looking to help him, quite the opposite. So I knew I wanted to stick it out, but if I was going to do that, I needed to be part of the solution.
Miriam Allred (11:39.054)
Did you have a lot of experience organizing processes and managing people? Like you said, you came into this kind of messy, scrappy business, which is hard and frustrating, but you didn't even have a lot of experience to that point coming into an organization like this, let alone turning it around.
Laura Coyle (11:46.026)
done.
Laura Coyle (11:50.741)
Mm-hmm.
Laura Coyle (11:59.175)
Mm-hmm, none whatsoever.
Miriam Allred (12:02.21)
But you're determined and ambitious and smart. so obviously Lou recognized that in you. And so you played a big part in this transition. You just talked about it, like joking about the old days versus the new days. You are definitely a key role in this transition. So just kind of talk about that. What were you thinking then and how have you helped facilitate this makeover of the company?
Laura Coyle (12:26.569)
Right. I think it helped that even though I don't have that, you know, the business background and the even working in an office, really not, you know, no significant background there. But my level of expectation for myself and for the people around me, you know, the unit that I worked on and where I came from was
very, the nurses were very autonomous. So we were allowed to really function very independently and a lot of pressure, but there was a very high expectation, professionalism, empathy, you know, to be really well-rounded. And, you know, those are like world-renowned oncologists that we worked with and worked for. So the bar was set really high.
So I think I, you know, coming from that, I took that here and still maintain that for myself. I still had that expectation for me and for the people around me. So that kind of drove me to want to help fix things because pretty early on, I think I identified that, you know, this was some of the lack of process and like lack of communication. was affecting clients.
It was starting to affect their care and aides whether they're showing up or not showing up and scheduling mishaps. So I knew I needed to help. And Lou, I would come to him with my list. Sometimes I would write it on a sticky note and have a long list. And I'd be like, listen, you have a lot of problems here. And I would list off all the issues and this and this and this.
Miriam Allred (14:14.286)
you
Laura Coyle (14:20.135)
And I would, you know, slide it, you know, across his desk and give it to him. And it'd be like, I'm going to, I'm to go now. I'm going to go visit my people in the field. And maybe a handful of times I did that. And he was like, no, he's like, if you're going to keep coming to me with all these issues, you need to help me. You need to come with solutions. And initially I was like, I don't know about that. I don't, I don't think I'm the person for it. You know, I think I just need to go stick in.
Miriam Allred (14:21.774)
you
Laura Coyle (14:49.023)
stick with nursing and he's like, no, he's like, I need the help. And you you can't do both. You can't come to me without coming with solutions. So that kind of annoyed me initially, but, and then I got over it pretty quickly and I was like, he's right. He's right. And what, he needs the help and let me figure this out. Let me come up with solutions and working together with him, I would throw ideas at him. And of course,
early on, not fully understanding this business and this industry, there were things where he'd be like, we can't do that and this is why. So I definitely learned a lot from him in those early days. But that's how we just started organically working together. one problem at a time, one department at a time, just looking for solutions.
Miriam Allred (15:41.87)
I love the word that you use a couple minutes ago, autonomous, like your role as a nurse was very autonomous and the expectations were high. And now you embody that at Homewell. You want everyone in the office to be as autonomous as possible and high expectations. You you want to elevate people and you want to set high expectations and then everyone's achieving, you know, high expectations, which is incredible. Can you elaborate on your
Laura Coyle (15:49.704)
Mm-hmm.
Miriam Allred (16:11.278)
career path then. So you came in as nursing supervisor. Can you kind of dial through all of your different titles and roles to get you to where you are today? As best as you can.
Laura Coyle (16:19.323)
if I remember them. Yeah, so I stayed within nursing for a few years. I would say probably a good five, six years before I branched out of nursing into a different role. I was the assistant director of nursing. We joke I was the silent director of nursing. The person who was here at the time had been here for years and a family friend of Lou's. So
It was not the kind of thing where we were going to take her title away and I didn't need it. just want, know, as long as the right thing is getting done, I'm good. So, nursing, you know, was the assistant director of nursing. I think my next jump was to VP of like clinical affairs, something still in clinical, but I was starting to branch more into the staffing and HR.
like the whole caregiver kind of spectrum and how that relates to our clients and ultimately quality care. And after that, VP of Operations, so there's probably like a few years in between each VP of Operations and then maybe 2019 Executive Vice President. So that's kind of where I thought that would be it, you know?
Lou at that point was the CEO. So that was, he was the number one, I was the number two. And then we had all of our, you know, directors of each department. So that was the structure until a little over a year ago.
Miriam Allred (18:04.322)
And let's talk about that. A little over a year ago, you become the CEO of this franchise that is owned and operated by Lou and his family, essentially. And so you stepping into the role of CEO is a huge ordeal for you and for them. There's so much we could talk about, but what has, can you share a little bit about this past year? It hasn't been easy and you've...
Laura Coyle (18:14.42)
Mm-hmm.
Laura Coyle (18:30.325)
Yeah.
Miriam Allred (18:31.234)
done a lot of work and done maybe even some hard things, but can you give us just a little inkling into like what this last year has entailed for you and what you stepped in to do?
Laura Coyle (18:41.653)
Yes, so stepping into the role, you know, it's interesting. When you ask like, did I ever envision myself being here, it's such a hard no from the beginning, right? I'm not a person who's, like I don't go somewhere and I think I need this title and I need to get to this point.
I'm really not that ambitious. Maybe that might be a bad thing to say, but I'm really, it's not what drives me. It's more about making an impact, having the right thing done for the right reasons. And that kind of just organically brought me to this point. I understand the structure, organizational structure, and why titles are important, but it's just not something that's ever
been super important to me. So Lou, you know, Lou had come to me over a year ago about becoming the CEO, you know, and my initial first reaction was, do we have to do that? Like, we're fine. We're fine the way we are. Exactly. Do I have an option here? You know, I felt like things were working and we're good. And I, yeah.
Miriam Allred (19:53.518)
Do I have options?
Laura Coyle (20:06.771)
I think I said no, actually the first time and then he came back to me again. And so I said, all right, I need to, I need to be open and listen and let's talk about this. What does that mean? Structure wise, because I felt like things were working well and they still are. So it was for him, just, he felt like it was important that he, you know, kind of take a little bit of a step back and let me really be in the forefront.
He felt that would be better for me, for the company. So I went with it. I can't argue it. So it definitely, I would say it worked well. Coming into the role, I know I've worked really hard. I don't have any self doubt. I don't feel like I haven't earned it or it makes sense. It makes sense for the company.
Um, so initially I, you know, people's reactions were amazing to it here. Amazing because this team is incredible. So he actually announced it at our company party in December of 2024. And you know, the response was great. I, it got me choked up. It was just incredible. So, um, I just felt great coming into it and I would tell everyone, you know,
They were asking me, how do you feel? Like, what are you gonna do now? Like, what's your plans? And I'm like, I don't really have any plans. Like, we're just a status quo. I like even, like consistency. So things are the same. I've kind of been doing this role so you can expect the same. And that was like my message to people. And then, I don't know what happened in my head. Something happened in my head where then at some point I was like,
All right, so I need to make a list. I need to like start making more changes and come up with new strategy. And so I started making this long list for myself. And then I realized, like, okay, so I'm already at my max. I can't work any more than I do. I'm already working too much. And I have this, these goals and things that I do want to implement, but
Laura Coyle (22:29.791)
How do I get there when I need three of me to do that? So that kind of, I'd say that would be the struggle for me in the last year to get myself out of the weeds, to have more work-life balance, and also give more, when I'm spread so thin, I'm not giving anything.
the time and quality that it deserves, any one or anything. So I knew I couldn't, that list that I made, that's beautiful list of things I want to accomplish, that had to go to the side. I needed to quiet my very busy mind of those things and focus on the company structure. And that led me to start this year long kind of company reorganization.
Miriam Allred (23:09.038)
Bye.
Laura Coyle (23:27.213)
of how I needed to change some things. If I'm doing too much, how do I get myself help? Which Lou and I have talked about for a long time, but it's like when I'm so buried in the weeds, like what does help even look like for me? And I struggled with it. I struggled with what kind of role is that in my spending a year of my life training someone else to do things the way I want them done. That person could be a question mark, you know?
new people always are. So then it's who do we have here? And we have this amazing team. So my choice, instead of bringing someone in from the outside, was to build up the people we have and, you know, get some, make some new hires that support them in ways that then they can support me more. So that ultimately is what this last year has been about. Just a company overhaul, reorganization.
Not quite done yet. I'm almost. I'm close. I'm close, but it's been a lot.
Miriam Allred (24:28.782)
Thank
Miriam Allred (24:32.502)
Laura, thank you for sharing all of that. I love your humility and your nonchalance. know, like, I'll just be the CEO. Like, I think that's what draws me to you. I think that's what draws so many people to you is just you're so humble in nature and you're so easy, but also so like strong and powerful and intelligent. And that mix is just like so special and has made you this incredible CEO. And I love you sharing about that list. It's like you had all these
Laura Coyle (24:40.585)
you
Miriam Allred (25:01.602)
You felt the need to have the list, have the strategies, to have like the game plan. But I like your transparency and just put that aside and kind of ride it out. then like organically, you knew that things needed to give for yourself and for the organization. And then that kind of dictated like what your past year has been. One of the things that stood out to me, you said you are very impact driven.
Laura Coyle (25:20.255)
Mm-hmm.
Laura Coyle (25:26.035)
Yeah.
Miriam Allred (25:30.892)
which is incredible. And I think a lot of owners and CEOs in home care are impact driven. They would say the same thing, but as the CEO, you have to balance the numbers, the KPIs, the revenue, the deliverables with that impact driven mentality. How are you balancing that?
Laura Coyle (25:49.523)
to say because of the team that we have here, think that lets me have a really nice balance of that. You know, we have a CFO. We have these really strong directors in place that they don't need to be led. They don't need to be, you know, inspired and they come to work inspired. They come to work ready, you know.
to make positive changes and they are all part of the solution. So I think that makes it easier for me because I don't feel alone in it. I don't feel like this is just me. And Lou is, I'd say he took a half a step back in this last year. He's very much still present. Everyone here loves him. So, you know.
Being in the same boat with these great people, I just feel like we're all rowing in the same direction. We're all in it together. So we want the same things. that makes it really, to me, that makes it easy. It's just quality, you know, quality service and customer service and all the things that we are, what we're here for. It falls into place organically. It doesn't feel like you have to try.
Miriam Allred (27:14.126)
Which I mean we could totally try and unpack that because you said everyone comes to work inspired That's there's a lot there, you know, you're inspiring them They are inspired by the clients and the caregivers but to maintain that to retain that inspiration You know year over year in a home care business is really hard and I'm sure you've seen that and had to had to inspire people But I don't know anything that comes to mind
that you have done or seen to maintain that inspired team.
Laura Coyle (27:49.471)
I think that we, a big thing is consistency. So for me, I think being a presence, you know, being, and we have three locations. So I make sure I get to those other locations. I make sure that everyone in the company knows their importance and their part. And I am very consistent. So it's not like I'm up and down and.
You know, there's rules here, but there's not rules here. Complete consistency, showing up and making this a really safe place for people. It's just a basic fundamental thing. And then how we communicate our why, how we communicate our success stories. We do these, we call them all hands meetings where we do it twice a year.
And our CFO came up with the idea for it and we have a theme. We talk about each director of each department gets to present like the past six months, everything they've accomplished. But they also get to present their struggles, their challenges, what their goals are for the next six months. So there's this feeling, there's this constant feeling of you're a part of this.
That's the constant, consistent message that no one department is more important than the other. This isn't like sales is everything and operations is just here to serve. That's not this world here. Everyone here has an equal part in our success. And you see it, you see it in people. That's, you know, every role, big, small, medium.
they bring their best foot forward because they know their worth. They know how important it is. And I do think, you know, the success stories that we share, like the testimonials and the client pictures that come to us, you know, the 100th birthday celebration. And so people who aren't in the field, they're not, you know, talking to clients in person, but they get to see them. They get to get that warm and fuzzy feel.
Laura Coyle (30:13.91)
It's just a great reminder of why we're here, what we're doing, why it's important. And we're just lucky with this team. They're really great.
Miriam Allred (30:17.678)
and
Miriam Allred (30:24.558)
Yeah, I love everything that you said. the two words that stand out to me is like consistency and equality. And your team is very large, you know, but I think how important those two principles are, even with a small team, you know, those listening to this that maybe have a team of six or 10. I think these principles ring as true with a small team as they do with a large team, because to retain these people, you've got to make sure they feel valued, they feel heard, they feel seen and
Laura Coyle (30:39.573)
Mm-hmm.
Miriam Allred (30:50.626)
Consistency and equality go such a long way. Again, from small teams to big teams, those principles are universal. I want to transition a little bit. Something that you've shared with me, as a CEO, you still think like a nurse. You are trained like, you are a nurse at heart, I think, through all of this, and you still approach leadership from this nursing lens.
Laura Coyle (31:13.077)
Yeah.
Miriam Allred (31:18.216)
And I am not a nurse, but you shared with me the nursing process that maybe you learned in school or maybe you learned throughout your years. But I want you to talk about, you know, the steps of that nursing process and how you've translated that into essentially like your style and approach as a CEO. So let's just kind of talk through each of these steps. The first one in the nursing process is that assessment. You know, and I think everyone listening to this is familiar with home care and understands kind of what that assessment piece is, but
Talk a little bit about that from the nursing lens and then share how you see that in your CEO role.
Laura Coyle (31:55.431)
Yeah. So the nursing process, just to give like a little background on it, I believe it was like 1950, late 1950s is when it first evolved. nursing theorists came up with these steps in this process. And it was the, the goal was to make nursing like a more, you know, recognizable profession and formalized, you know, process. And then in 1970,
Somewhere in the 70s, it was adopted by the ANA, American Nursing Association. So now this is like the standard for all nursing. Doesn't matter where you work, what background, what specialty. You learn this in nursing school. It's drilled in in nursing school and everything you do, this is the foundation for. So yeah, there's five steps to the process. Assessment is the first one. That's where we collect patient data.
Diagnosis, where we're defining health issues. Planning, everyone knows about care plans. That's where we develop the plan of care. We also develop goals in that planning phase. Short term, long term, they just have to be measurable, realistic goals. Next step is implementation. And that's where you're executing these interventions that you came up with. And the last one is evaluation. So
during the evaluation period, you're looking back, you're assessing, okay, did what I just carried out work? If it kind of worked, okay, that's still good. Go back to the planning. You can always jump back in the stages. You may have to jump back all the way to assessment, to the start, and just start reassessing and then go down the line. this kind of, it is how my brain is wired.
and it is very much my logical, you know, organized thinking and working in nursing for so many years, it's natural for me. So it's easy. It's easy for me to think this way. think it's not, maybe if people are just a little more impulsive or emotional, it may not be the easiest thing, you know, but I would say, you know, we'll talk about how it.
Laura Coyle (34:21.627)
how I correlate it to like leadership and some of the strategies. But you do not have to be a nurse to think this way and to implement this at all, right? I didn't go to business school, but I'm able to run a business. someone has their MBA and their college background is in business, you can implement these pieces.
You don't have to be a nurse. You don't have to be clinical. It correlates to business very easily. And I'm excited to share it. I feel like it's very unique and different. And it works. It works here. So.
Miriam Allred (35:02.604)
When you shared it with me, it was like a light bulb. I was like, my gosh, this is incredible. For me looking in, I was like, wow, this is really good. And I'll put a quick plug in, you and I have collaborated on this resource where we basically spelled all of this out in a document. So that'll be available in the show notes for people to download because you organize it so well. was like, wow, we've got to get this out to different people. so thank you, first of all, for organizing your thoughts.
Laura Coyle (35:13.236)
Yeah.
Miriam Allred (35:30.338)
So let's dial through it. Let's kind of dive into each one and you share just kind of your thinking about each step in this process.
Laura Coyle (35:35.293)
Mm-hmm. Sure. So, and just to note too, I used this, I've used this very much so in the last year for this company reorg. So some of the how I applied it and some of the examples I'll use are related to that reorg and how I executed it and what the steps were. So starting with that first phase of the process, assessment. For a leadership principle, that translates to gathering data.
Sometimes this step is probably the longest, maybe the most painful and the most tedious, know, depending on what you're trying to address. This could be from a small operational issue that you're looking to solve or a humongous company reorganization that you decide to take on. So some of the things that you do in that phase, you're gathering real data. This can be subjective.
objective, should be, probably should be both. You're identifying inefficiencies. You're looking at compliance. Are there risks? Are we in compliance? Is everyone here understanding whatever your accreditor is, your state guidelines? That's super important. Everybody has an understanding of that and that you're following it. I'm very much a believer of doing things the right way every day.
not just when you're coming, you have your surveyor, whatever it is, annual, you know, and you're cleaning things up before that. No, no thank you. I'd rather operate, you know, the way we're supposed to operate all the time, let them come in any day of the week, we're ready for you. So that's a big one to be always looking at that. You can manage inefficiencies. Also management.
ineffectiveness. So looking at your people that are in management roles, how effective are they? That for me in this reorganization and in the assessment phase was important because that kind of dictates how then the rest of the people under them are operating. So some people feel like management, you know, any level of management
Laura Coyle (38:01.129)
beyond the basics is micromanagement, but yet if there's problems and there's issues and mistakes happening and processes not being followed, then you need to dive in there. You can't ignore those. So you really have to look at your managers in that assessment phase and how effective are they. Looking for performance gaps. So in that assessment phase, like I was able to identify pain points, roadblocks.
And also financial burdens, like financial, you know, where are we, where are we not being smart financially? I like to operate lean as lean as we can. So, you know, that that's something I looked at too. So for, you know, assessment, that was, that was part of that phase for me. And that it took a while. That was a time consuming phase. Then when I moved to the next phase,
In the nursing process, it's diagnosis for operations. We identify it as defining root causes. So what is the problem?
Miriam Allred (39:10.254)
Can I interject with one question on assessment? The thought that I'm having is how you keep your brain organized because as a CEO, you're constantly assessing. You're looking out, you're seeing, you're observing, you're noticing. Part of burnout is just the volume of thoughts in your mind and your team lives in, WellSky, that's where all the clients and the caregivers live, but where does your brain live? How are you staying sane and keeping
Laura Coyle (39:12.746)
Of
Laura Coyle (39:22.186)
Yeah.
Laura Coyle (39:29.692)
You
Miriam Allred (39:39.862)
all of this information, all of that assessment data organized? Is that on paper? Is it in a note? Like, how do you keep your brain organized?
Laura Coyle (39:45.407)
Such a good question. Yeah, because there's a lot. It could be overwhelming. It really can, because you're so right. Like, because of how my brain is wired, I am constantly assessing. And I'm quiet. I'm an observer. I'm never going to be the most talkative or loudest person in a room. So I am constantly just taking in information. And it can. It can definitely feel overwhelming. So I have...
You know, I have a good planner that I use daily. go at night, I go home as I'm thinking after dinner, I'm thinking of something, I have to write it down. I also use monday.com. It's like an online project management platform. And I feel like that's super helpful. I feel like we, as a company, we use it.
And we use it for project management. We use it every Monday morning and we go over things. So I can go in there and make notes and make updates at any point. And then everyone else can see it. So those are kind of the two ways I do keep myself organized. My Outlook calendar, very heavy in Outlook calendar of just reminding myself, I have a list for tomorrow, things I don't want to forget to accomplish and check off the list. So.
Yeah, those are three ways.
Miriam Allred (41:11.5)
Yeah, that's good to hear. was just curious because I know you as an observer and that can just get really burdensome really quickly. And I'm the same, write everything down, you know, just like get it out of my head onto paper. And then when I go to bed at night, it's like, okay, I've got the list ready to go tomorrow. And it's just cyclical. It's like, just get it out of the brain, write it down. So, and it was just curious. Yeah. If you use, sounds like monday.com, which is great because you can document and then the team also can have eyes on certain things inside of there, which is great.
Laura Coyle (41:27.925)
Yes.
Laura Coyle (41:33.973)
Mm-hmm.
Laura Coyle (41:40.989)
Mm-hmm, yeah, we do, we find that helpful.
Miriam Allred (41:43.635)
So let's keep going. So second stage in the process is diagnosis. So keep going on that one.
Laura Coyle (41:48.477)
Right. So we're defining the root causes and coming up with like where where did you identify the issues? The pain points are always you know what what is the root cause of the problem? You have to take your time here too right? Don't think just scratching the surface and you find like one or two things wrong. You have to keep digging. Just just find it all. Get it all.
find everything before you move to the next phase. I think that's a mistake. I've done it myself and I've learned from it to jump and think instinctually, okay, that is the problem, let's fix it. And then it turns out I should have asked a lot more questions. I should have really dug in more. So just some examples of things that I found and things under this category like workload imbalances, leadership gaps.
operational inefficiencies, wrong person in the wrong seat, noncompliance in a role, and lack of accountability. So those were kind of big things that I had identified. so now you move from that, the defining the root causes. Next phase is planning. So developing solutions and setting goals. Here examples are like
Developing structured solutions and creating organizational strategies to address these inefficiencies, to address compliance. How do we educate everyone and then get them in full compliance? And then that needs to be watched. You can't just assume, set it and forget it, and then everyone's going to do it because you said so. Audits need to be in place.
you know, people need to be managed and things need to be watched. And I've learned more and more over the years, not everyone's comfortable with that on both sides. As a manager, some people aren't comfortable with that. And as just an employee being managed, they consider that micromanaging and there has to be good communication and explanation. This is why we have to look at it. This is how it affects us in the long run if we don't look at it. So
Laura Coyle (44:11.357)
A lot of just a good communication, I think, avoid those issues. But as I said, know, wrong person, wrong seat. If you have someone who's really fighting against that and can't get on board, you probably have the wrong person. And, you know, no one likes that, but that's, you can't avoid that. You can't dance around that. We've learned that the hard way too. So.
Miriam Allred (44:37.56)
Which is a big part of the role as the CEO is identifying that. Maybe it's obvious to some people, but you have to be the one to vocalize it and to take those matters into your own hand, which is actually the question I wanted to ask around like diagnosis is as the CEO, you may feel this weight to be the one to identify all the root causes. Has that been your experience that you are the one
Laura Coyle (44:46.133)
Yeah.
Miriam Allred (45:07.166)
identifying those root causes or is your team feel empowered and open enough to come to you with what they may think is the root cause? Is that happening as well?
Laura Coyle (45:17.215)
That's totally happening, yes. I would say early days, it was me. I had to identify everything and there was a pushback and there was a denial of things being wrong. Fast forward now for quite a few years now with the right people surrounding, you know, both Lou and I, those people are bringing the problems to us. We don't have to look, we don't have to ask too many questions, you know, they're totally on board.
So they want the same level of expectation that we have. So they'll bring it to us and they come with solutions. Like I did not early on.
Miriam Allred (45:57.208)
Mm.
Which I'm glad you're calling attention to this because I think this is like a cultural thing is empowering your team to dig deeper, to find root causes because in a business, there's a lot of issues. There's a lot of miscommunication. There's a lot of challenges happening all day, every day, but challenging your team to dig deeper and look for the root causes and as a team, let's find these root causes and then, you
Laura Coyle (46:08.959)
Okay.
Miriam Allred (46:25.142)
surface them and then work together to resolve them. And then that's where the planning comes in is, okay, we've got all these root causes. How do we work together to create a plan that works well for all of us?
Laura Coyle (46:34.741)
Absolutely, Yeah. And it's, think it really is what you said, like they're, they're empowered to, speak up and bring it forward. And, you know, they've learned, they've learned with all of us. I'm, I learned something every year I learned by our, you know, our people, I learned by our past mistakes. And I'm an avid learner. I learned from your podcast. I learned from so many different avenues. So
We all have that shared mindset. We want to keep getting better individually as professionals, but as a team, we just keep getting better. it becomes easy at a certain point when you do have the right people in those positions. And it's not a struggle anymore. Yeah.
Miriam Allred (47:23.95)
Could you share one of these root causes? Can you think back to maybe a time when you thought it was something else or when it wasn't obvious what it was and then you did have to do that deep dive diagnosis and you found out, okay, this was the root cause? Does anything come to mind that you've experienced?
Laura Coyle (47:44.767)
would say, I can give actually a recent example of something, and this was only like in the last year. So we were getting like some client complaints that they weren't aware of like a schedule change, you know.
didn't know this aide was coming. They didn't know her name. Like just this like seemed like a breakdown in communication. And so we, you know, at first glance, we kind of attributed it to, all right, maybe we had turnover in the staffing department. We call them staffers here. I know some companies say schedulers, but so we had some turnover. So we attributed it to that. And like maybe making an assumption of
You know, it's going to quiet down. And it didn't. And then as the pattern, as it was just going on and on and getting bigger, I decided like this, need to investigate this. So I start from the assessment phase and just asking questions and what is our process? And we also had like a few like mishaps with caregiver schedules too, them.
showing up for a shift that they weren't confirmed for and just weird things happening that, in my opinion, at this point, in this stage of the game, shouldn't be happening. when I looked at all the different processes and asked, how are we confirming AIDS? And let me see. I always want to see it, even though we're talking through it. Show me. And I got pretty deep into it.
And, you know, it wasn't, you know, it wasn't the turnover. wasn't new employees and got to the point where then it was this final stage where our staffers use a staffing coordination sheet. It's this beautifully created spreadsheet where they're plugging in every shift that they staff and it's a workflow for them. So they're putting in that the nurse gave the orientation that the client was,
Laura Coyle (50:01.321)
I'm sorry, the caregiver was confirmed. They have to text through WellSky a confirmation. They're given the name and the address. They confirm. And, you know, is this a facility? Do they need documents sent? And then was the client notified? And who did you speak to? You have to identify who you spoke to. So when we, I popped into one spreadsheet after another, after another for the schedulers.
they're just not filling out. They just stopped halfway through filling it out. So it was like, this is different. Okay, that was my root cause. That was my, you know, the issue. Clear as day. Then there's more questions. Why? When did this stop? Why did this stop? you know, so that was an interesting one. I didn't expect it.
That was not the answer I expected. I mean, easy fix, you know, easy fix, that just then you dive into who's ownership is this and who's managing it and who's now watching it and this needs to be audited. This has to be audited weekly because we're not gonna go backwards. We can't say this for three months and have full compliance and then we fall off again because you can see the direct.
correlation with these mistakes and communication lapses by not completing the spreadsheet, just going halfway through a process. So that was an interesting one.
Miriam Allred (51:43.402)
So you're kind of getting into it, but keep going into the planning phase. So obviously there was a lot of digging, a lot of research, a lot of questioning, what questioning sounds like interrogative, but just asking why, you know, why has this broken down over time? so then how do you go up to the director and then work down or how, how do you then like execute the planning phase here?
Laura Coyle (52:02.773)
Yeah, yeah, so the planning phase, so that's like, go to the director. I'm always asking questions. I don't want to assume, right? I think in my head, I know this isn't, you know, being managed properly, but then I'll ask, you know, how often are you looking at this? Do you know if this is being done? Is it being done a different way outside of this spreadsheet, you know, that we're not aware of? So...
That's kind of the approach. And then when you get your answer, know, okay, I know what the problem is. No one's looking. No one's checking this because it goes back to the management, levels of management, right? I don't think I should have to look at that. It turns out we do. So that's where the workflows come in and the organization of just like weekly audits. What's important to look at? There's weekly.
There's monthly, some things are daily, but I think we have to then, and that's part of that implementing stage of what is that plan? That plan is identifying audits, identifying level of management and executing it, putting it into place. So.
Miriam Allred (53:19.95)
I like the word that you're using audit. The next stage in the process is this implementation. And I actually think audit's like kind of a good synonym to that is essentially you create the plan, you're executing on the plan. And then during the implementation, you're refining, fine tuning, auditing the process as you go. So continue to share kind of your thoughts on the implementation. What are the thoughts that come to mind with that phase?
Laura Coyle (53:44.969)
Yeah, so this is executing the plan, tracking progress. So you're rolling out, it could be you rolled out new processes, you could have updated old processes. For us during the reorg, I'm referring to we created some new roles, we made some promotions, maybe two new hires.
And so this is that implementation phase where you are rolling out new roles. You are mentoring these people and acclimating them to the company. Even if it's an internal promotion, okay, there's a training. There's still training that needs to be done there. Structured training, what does that look like? And implementing that. Always with a timeframe because we're, you know, everyone's so busy.
So if you don't commit to a time and you don't put a goal, a measurable goal with a time, we will kick it down the road. know, I, and, I'm, yes. And unfortunately that list that I had to put to the side, you know, there's things on there that I've been talking about for a while and I've been wanting to do. And it's like, stop talking about it and just do it. But so that's, you know, that's kicked down the road.
Miriam Allred (54:50.446)
Next quarter.
Laura Coyle (55:08.773)
So it really needs to be, hold yourself accountable to that timeframe and okay, you have a month, it has to get done. And I like to check in with people, I like to check their progress, like, you know, even if they gave themselves a month or two to accomplish something, how are you doing? Holding accountable before that, you know, very last day, up to the last minute, because if I can support and help in some way, I will, I'm happy to.
So yeah, so implementation and also, you know, are there new KPIs to set? We're all big on KPIs. We all have them. We have them for everything. So new process, new role. Maybe there's something new that we need to attach to it that holds that person accountable and we could see the results. Last.
Miriam Allred (56:00.014)
I was going to say a topic for another day. Your KPI spreadsheet is intimidating, but if it works for your business, that's amazing. You have it really dialed in by role, by department, by company, but that's a huge part. Like you just mentioned, sometimes it's abstract to have these big looming projects or changes. You really have to break it down. Then I love what you're saying about checking in with people. It's like, okay, even if it's a three-month project, it's like,
Laura Coyle (56:08.437)
Mm-hmm.
Laura Coyle (56:22.197)
Mm-hmm.
Miriam Allred (56:28.878)
checking in every other week to make sure we're on track to meet that, you longer term process essentially. So yeah, cover the last one. Then I want to ask a few questions. So the last one is evaluation, correct?
Laura Coyle (56:32.895)
Mm-hmm.
Laura Coyle (56:41.365)
evaluation. Yes. So you're measuring your results. You are looking at mostly I would say it's a combination subjective objective. So looking at those KPIs, checking processes by audits, is everyone following it? Does anything need to be tweaked? This is that evaluation phase where you can identify what worked, what didn't, what kind of worked and then you're you're back to
re-planning, know, adjusting some things. And then you're just always looking for continuous improvement. That's just part of that evaluation phase. For me, I think a lot too in that last phase is staff feedback and how do they feel. And again, going back to being like the observer, aside from asking questions and, you know, getting to know just by talking to people where they're at and...
how they're feeling, I listen. I observe and I listen. And you could tell the difference. You can always see a shift when someone is feeling overwhelmed, when they're not so happy to be here. And I really like pay attention to those people. And I want to know, is everything okay? Could be outside of here. Could have nothing to do with this place. But I want to make sure you're okay. And I think it's really important. People appreciate that.
And if it's a workload, you know, a new someone who just took on a new role or was promoted and now they're feeling overwhelmed, let's talk about that because we don't want that. We, so let's shift, shift priorities and you know, what can we take off your plate and always supporting people. It's really, it's vital.
Miriam Allred (58:31.322)
I love all of this. Let me just dial back through it really quickly. So assessment, diagnosis, planning, implementation, and evaluation. You've been kind of talking in terms of restructure this past year, but the beauty of this, and you said it at the beginning, is just this can be repurposed in any aspect of the business. Small operational issues, large strategic overhauls, this process can be valuable and repeatable in every instance.
And that's what I love about this. And the question I want to ask, is this a company wide framework? Is this just kind of like live in your head and this is your mode of operation? Or is this more of like a company wide framework that other people think through?
Laura Coyle (59:14.303)
So it's definitely my foundation. I would say no one here really understands this, like how we just mapped it out. So, but this, this has kind of brought that to my, to my attention that I should share this. I should share this with everyone. I'm sharing it with you guys now. So, you know, aside from me, our former director of nursing, now our chief nursing officer.
Jen Kelly, is, you know, one of my main go-to people. Definitely, you know, one of the strongest people here. She probably does this without even realizing it. You know, we call it having a nurse brain and we have like labels for it, but I will guarantee you this is, she'll read this and say, that's why I do what I do. Yeah.
Miriam Allred (01:00:07.438)
Because we're talking about it really rigidly. It's like, here are the five steps, but you and Jen and others are likely implementing it so seamlessly. Like it's just how your brain works. But I do see it as like a framework. It's like this process again can be used in finance, can be used in HR, can be used in scheduling. Just it's a way of thinking and like problem solving is how I see it.
Laura Coyle (01:00:19.721)
Yes. Yeah.
Laura Coyle (01:00:27.797)
Mm-hmm.
Laura Coyle (01:00:33.447)
Exactly. It's critical thinking. That's really what it is. It's critical thinking. And even though I don't share this, you know, this table and this talk about these faces with people, everyone here who they observe how I work, right, and how I lead and the people that have been here for a while will say, you know, I've learned from you, I learned, you know, not to make emotional decisions. You have to base it on facts and
whether it's data and you know, or someone's word for it, caregiver, no call, no show, know, years ago, we were ready to fire someone. Nope, they could be laying in a ditch. You don't know what happened to them. Call them, ask them, are they okay? You know, so it definitely has created that expectation here that that's how we want everyone to operate and think, really think through and use critical thinking.
and be autonomous, problem solve, and it makes for such a better company culture here. It's made a world of a difference. Yeah.
Miriam Allred (01:01:42.198)
Yeah. I mean, I almost want to challenge you. I do think you should share it with your team and with your company because, again, they observe you, they're watching you, you're implementing this every single day seamlessly with multiple different tasks and strategies. But again, I just keep looking at it and reading over it I just think, wow, what a beautiful structured framework for businesses to operate under. So I just think it's the most incredible thing. And that's what I
Laura Coyle (01:02:04.821)
Mm-hmm.
Miriam Allred (01:02:11.436)
want to bring to this podcast is like formulas, frameworks. Again, people listening to this will probably think, we're doing that or we're doing this. But it's like, wow, I never thought of it kind of holistically. take what you like, take what you don't. Implement it personally as a CEO or company-wide. Take what works for your business. But I think this is just such a strong framework for problem solving and for critical thinking. Laura.
Laura Coyle (01:02:35.794)
Absolutely.
Miriam Allred (01:02:37.086)
I want to end with you talking a little bit about what's ahead of you. I know we've talked a lot about, you know, kind of this past year and what you've been through, but I'm sure you're excited and looking forward to things this year and the coming years. What are you up to and what's on the horizon for Homewell?
Laura Coyle (01:02:50.559)
Mm-hmm.
Laura Coyle (01:02:53.909)
Yeah, I definitely am up to getting to that to-do list that I have pushed to the side. So I'm really looking forward to that. And I've been looking forward to it. This whole reorg, I would say I am 80 % there and then we'll be done. I'm hoping by the end of the second quarter. So it's soon. I'm looking forward to tackling my to-do list, some new challenges for me and...
For us as a company, I would say in the next year, another location is on the horizon and that will be our fourth, our fourth office, fourth location. So we have that to look forward to and just continued, you know, growth. We just had 16 % growth last year as a company, which is impressive. I think at our size, our scale is, you know, something to be really proud of. And I know our whole team is.
So I just want to keep that going. And this reorg really helps us sustain that growth with less pain points, less drama, more work-life balance for me, and continue growing.
Miriam Allred (01:04:06.56)
Incredible! Laura, this has been such a pleasure to interview you. You're such a natural. And I just want to say thank you for joining me in the lab. Thank you for thinking through all of this to prepare for this conversation, because I think you've really, really delivered. And there's a reason why you and the team there are so successful is because you're, you're such an avid thinker and you're such an avid observer. And it really shows in the conversation today. So thank you so much.
Laura Coyle (01:04:18.677)
Thank you.
Laura Coyle (01:04:31.743)
You're very welcome. Thank you. This was awesome.
Miriam Allred (01:04:35.296)
Awesome. I'm gonna hit.