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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.
Wayne Morgan (00:00)
if your social worker is doing this and has three admissions and five discharges the same day, like, how do I fit in? Because my ultimate goal wasn't just to get referrals, but like, how do I get the senior director to one day say, how do we make this gentleman and his colleagues and his company part of our everyday conversation and process?
Miriam Allred (00:31)
Welcome back to the Home Care Strategy Lab. A little love from me, your host, Miriam Allred, before we get into it. I just want to say thank you again for tuning in. I'm glad you're listening, but I also hope that you're learning and doing. This information is good, but it only is best when it's applied in your businesses. So I hope you're taking what you're hearing week after week and turning it into tactics and adaptations for your business.
Today I'm super excited to be doing something that I've been wanting to do for a while and I have really high hopes. So I have a feeling that we're going to start doing more of this. But today I'm joined by two people. I've got Wayne Morgan, presently the co-owner and COO of Amada of Central New Jersey, formerly on my past podcasts. So some of you may know him, but he was formerly a case manager. ⁓
served in business development representative roles, and was also a VP of corporate development. So as a really vast background, then I'm also joined by a special guest. I have Breanne Muchmore, currently the regional director of referral operations at a nationally recognized skilled nursing facility group. She was formerly the senior director of care management at Spaulding Rehabilitation Hospital, one of the most prestigious high-end rehab hospitals
in the area, Boston region, but also probably in the nation. So Breanne is a special guest. I haven't had someone like her, let alone her on the show before. So I'm super excited to have this conversation about both of you working together kind of in a past life and a past role. And we're going to dig into that relationship and that experience and Wayne, how you got your foot in the door and how you started winning referrals from Breanne at that prestigious rehab hospital. So thank you so much, both of you for being here.
Breanne Muchemore (02:20)
Thank you.
Wayne Morgan (02:20)
Thank you, appreciate it.
Miriam Allred (02:21)
Let's have you both, I just kind of quickly overviewed your backgrounds, but I want you to share a little bit more depth, ⁓ paint a little bit of color into your background, your work experience, and then also share a little bit more detail on your point of view that you're bringing to this conversation. So Wayne, let's start with you and then Breanne over to you.
Wayne Morgan (02:41)
Yeah, no, I appreciate it. And thanks for the opportunity. Thanks, Breanne, for being a guest and joining me. And thanks to the listeners, right? This is what it's about. So ⁓ like you said, I am the co-owner of Amada senior care of central New Jersey ⁓ COO as well. You know, titles are titles. But we've been in business for about this will be our second full year. So about a little over two years. We're doing extremely well. We're within two full years. looking at most likely trending right now.
million dollars. So I'm really excited. We're growing a great team. We're helping great clients, helping really good families, hiring amazing caregivers, which is the most important thing. But the backtrack, ⁓ I grew up in a restaurant setting, hospitality background. As you mentioned, I was a case manager working for a care management organization helping ⁓ adolescents that were at risk. My caseload at that time were children that were detained in detention centers. And my job actually was working for the
of Bergen County, New Jersey to actually reduce the length of stay for children in detention and to work with the stakeholders, the attorneys, ⁓ find the resources for them to rehabilitate them, which in a weird way I did correlate now with senior care. And then from that time, just building a little bit of my resume and my experience working with families, working with kids, strategically trying to figure out how to help them. ⁓ I was then presented an amazing opportunity to be part of another home care agency.
in New Jersey called Home Well Care Services in New Jersey. At that time in 2000, I think 17 they were expanding and ⁓ the owner needed another business development representative to expand into a new territory and ⁓ I was grateful to be part of that team. ⁓
We expanded. did really good. was with them, I'd say five, six years. ⁓ If anyone's listening, know, home care years are like dog years, but really good dog years. You work hard, you learn a lot. ⁓ That team there taught me everything I knew. I was very spoiled. Just, I was put in front of a lot of mentors that you've had, ⁓ you know, currently on your previous shows with consultants and coaches. And, ⁓ you know, that leadership from that company gave me every tool to be successful. And lucky enough, my field nurse became the,
You know the
nursing director and a COO and now currently the CEO. So I learned from really good people,
but they also gave me the tools. I also, you know, I studied from there. ⁓ I wanted to kind of like go more and like not just consulting, but like more of a national role just because working within Homewell, we had a lot of other Homewell owners reach out a lot of other, you know, marketers, salespeople. I don't like the word sales, but business development representatives like come to us and ⁓ shadowed me. And that was like one of my favorite things to do. So I was actually presented an amazing opportunity to do corporate development.
for another home care agency who is in six states, 20 plus locations called Caring People, amazing company. The owner, his grandma started the company in New York, really great teams. ⁓ It gave me an opportunity to go into other states, other markets and learn, but ultimately streamlined processes, helped with sales training, ⁓ actually utilized a lot of operational experience that I knew I had, but I actually didn't realize I knew so much. ⁓
But that's why I was successful in that business development role was understanding operations and procedures and systems. I was with that company for a little over a year. ⁓ We did very well. Part of that job was to actually expand into Boston. ⁓ So within one year, we developed that team and developed that office where we did just about $1 million in one year. From there, I really thought about consulting and kind of do my own thing. And thankfully, I had ⁓ a really good relationship with the owner of a
of
Senior Care in Bergen, Bisset County, New Jersey where we decided to be co-owners and join forces and Amada Senior Care is a fantastic franchise nationally as well and I have good back end support and here we are.
Miriam Allred (06:40)
I love it. Thank you so much for sharing that Wayne. We were talking before this. I like to have you dial through your career history because there are administrators and directors and GMs maybe listening to this podcast and you almost don't know what you don't know about like a career path in home care. It's a little bit ambiguous. And so I like to hear like your progression because again, I think even that's useful for people to understand like different pivots and roles are possible.
inside of home care. excited to hear more from you today. Breanne, why don't you jump in and talk a little bit about your background and your point of view.
Breanne Muchemore (07:12)
Absolutely. Well, first of all, thank you guys for having me. This is so exciting and really a great opportunity to be a part of this. So my name is Breanne Muchmore. I am a clinical social worker by background and a certified case manager. I received my bachelor's degree at Baylor University in Texas and have my master's degree in social work from Boston College. So my career I knew from truly probably the age of five that I wanted to go into the field of social work. Just wasn't sure.
exactly what social work was at that point, but I knew I wanted to help people and I knew I wanted to make a difference and ⁓ my career path has really led me to the place that I'm at today. So I started working in Boston after graduating from Baylor and I spent a lot of time in the city of Boston working with patients with mental health disorders, helping them with ⁓ jobs, finding jobs, obtaining employment, doing some job coaching and it was a really great entry to the
career and the profession that I'm in currently. Then I transitioned to working into inpatient psychiatric hospital as a clinical social worker, which really laid the foundation for all of the work that I've done throughout my career as a clinician and also as a leader and administrator. And ⁓ more recently, I was the senior director of care management for Spaulding Rehabilitation Hospital. Spaulding is an amazing hospital, model systems,
⁓ and they are currently number two hospital in the nation, is really exciting. I oversaw a team of about 60 clinicians, including social workers, care managers, inpatient teams, outpatient teams, utilization management, and some very unique donor-funded programs as well. So after almost 12 years at Spaulding, ⁓ I made the decision to transition my career to another side of the post-acute world, and so I'm currently working for a large
skilled nursing facility company that's nationally recognized and I'm a regional director of referral operations where I have the opportunity to really build relationships and work with our hospital partners and hospital leaders on ⁓ the throughput from the hospitals and getting them into our skilled nursing facilities here in the state of Massachusetts. a ⁓ little bit about my career. In addition, I am super passionate about the field of social work and case management. ⁓
to be elected to the board of American Case Management Association, the Massachusetts chapter, and recently president-elect for that organization. that's a little bit about my background and excited to share more about how I've interacted with the home care agencies, particularly Wayne, and how we can continue to do great work together as hospital and community partners.
Miriam Allred (10:06)
Fantastic, Breanne. We are lucky to have you. Honestly, this is my honor to interview someone like you. And I know you're nervous, but that just made me nervous. we're the real deal. But that's why we wanted to have this conversation, is you see home care from your angle, and that's what we want to talk about today. So just kind of a quick overview of how this conversation is going to run. In home care, we talk a lot about the low-hanging fruit.
Breanne Muchemore (10:14)
Thank you.
Miriam Allred (10:31)
the referrals that are pretty easy to go out and capture and you know, next week you're getting that first referral and you're already moving. This is the opposite spectrum. This is the long-term relationships that are hard to get in a market that take weeks, months, even years to build a relationship like this to get that first referral because you said it yourself, Spaulding is number two in the nation.
You will talk about this, but home care agencies are walking in left and right and you're turning away. don't know. 98 % of them and only working with a handful. So what we're going to talk about is Wayne getting your foot in the door with Spaulding with Breanne. Then we're going to talk in depth about the discovery phase, like building that relationship, building that trust, getting that first referral, like all of the legwork that goes into that.
Wayne Morgan (11:05)
All right.
Miriam Allred (11:17)
Um, and then we're to talk about like getting creative together, building up programs and initiatives and value adds to support each other. Um, and then we're to talk about the continuum brand. Obviously you have all of these other partners and Wayne needed to tap into those. We're going to talk about like building the continuum around each other to make you essential and irreplaceable and to drive really that long-term growth. So we're also going to talk a lot of stories, a lot of mistakes, a lot of lessons learned. Like I want you guys to sprinkle all of that into this conversation. So.
Wayne, let's start with you and let's go back to kind of the beginning. How did you first come across Spaulding and then how did you find Breanne at the organization and what was your initial approach? Like literally like that first meeting or the first couple of meetings, like what was your approach to meeting her?
Wayne Morgan (11:53)
Sure.
.
Where do I start? ⁓ So when I joined the previous home care agency and ⁓
we were building up really good systems in place on a national scale. And that was one of the things I was always taught is like, you have to follow these specific processes and we have to make sure our operations are set up for success and the business development team, you're not just going out and bringing coffees and saying what's on your brochure. And it's about like being passionate about the work, but also like, you gotta walk the walk too. ⁓
when I was, given the opportunity to build up a team and an office and put the, not just the brand out there, but also hire really good caregivers and give them opportunities to work. ⁓ It was exciting. So let's just go back to like the initial discovery phase and anyone who's ever listened to our previous podcasts, like I'm a big research data guy. ⁓ I didn't really know much about Boston. I really just went to Boston to visit friends and
find reasons to eat at the North End and just do my own thing. ⁓ But really it was, where do we go, right? Because Boston city proper has a lot of work opportunity, but also outside the actual city itself, there's a lot of those, let's say, long-hanging fruit referral sources. And it's a big territory. So where I'm going with this, I did so much research. Who are the key players? ⁓ Which hospitals are in the city? ⁓
if they had any referrals to subacute rehabs or assisted livings or Geriatric care managers or obviously every discharge is probably going to a home health company or hospice company like.
who's who because there it was a lot and it was it was new for me but we were a startup essentially there was one office maybe like five clients a few caregivers those start from scratch which I was like so excited for so anyway Spaulding came up and ⁓ in New Jersey I had a really good rapport and experience with referral sources that were very similar to Spaulding and for me I'm not a nurse or a clinician but like I love the clinical aspect of our job maybe it's because I was groomed by nurses at my
at my other home care agency, but like that just drew me in. And I always felt like if, where can I get, where can I go? Or what's the most challenging place, but also like.
What can I learn, right? So ⁓ I was that business development rep that went to like directors of therapy and would ask what their progress notes meant. And they would look at me like sideways. I'm like, I need to know why you're referring 12 hours of care. And I know you should be talking to my nurse because clinical to clinical, you'll both get it. But I'm kind of interested, like what are all these acronyms? Anyway, I Spaulding was like a really, you know, let's just say like it would be difficult to get business there.
But I also looked at it as like this would be a great opportunity if I could somehow become part of their process, help their patients, but also like
in a way, utilized as business development. If they needed a step down sub-acute, if they needed senior living, if I could partner up with the power partners in the community and help them too, what do I do? So let's fast forward. Like Breanne says, she's part of the American Case Management Association. We held a table there at a conference. It was about November of 2022. you're giving out chavskis and flyers and
there are speakers there. And what's great about those conferences on nationally scale is they have great speakers about education and industry trends and maybe what local hospitals are doing within the Boston market in terms of bettering their systems, bettering the experience of their patients to what resources are out there if you run into X, Y, and Z challenges. So I sat in those sessions, which always blew my mind. There was not really many home care there. And, you know, at the end of the day, I busy development. So my head's on a swivel. I'm saying, OK, who's there? Who could be good for business?
And maybe one of the places on my list is there, right? So, Breanne Spaulding is there and lo and behold, I had like a couple fun games on my table, a raffle, and I guess she's into games. So. ⁓
Secretly I knew who she was, full disclosure, but I pretended I didn't. ⁓ we're just talking and at that time we were building up specialized programs that were really focused on preventing falls,
and reducing hospital readmissions and social engagement. We're really building something up different. So anyway, it led to ⁓ really talking about our specialized programs.
Talking about our data or KPIs and what we do well to recruiting, to retention, to the specific type of clients or patients that we can service and service really well. Staying within a lane and not what I always say in previous conversations, like we weren't taking a shotgun approach with this. We need to really specialize in something and stick to it. ⁓ And I guess whatever I said at the time.
you know, kind of ⁓ We exchanged cards. ⁓ I sent a few emails. Obviously she was very busy. I didn't expect her to jump to her email and answer me right away. So I kind of thought, so I, you know, I kind of just thought like, you know.
Breanne Muchemore (17:12)
I didn't respond.
Miriam Allred (17:15)
Thank
Wayne Morgan (17:19)
That was that, but at end of the day it was like, how do I book a meeting from a meeting? And my first meeting was that conference. So just again, fast forward, ⁓ we had, at that time I did have another director of business development who accompanied me to one of the campuses and we had a one-to-one meeting and ⁓ we shared more of what we spoke about about the conference, but then I really dove into like.
discovery questions. ⁓ I always say when you first go into a referral source you meet someone like awkwardly it's like kind of dating somebody. ⁓ If you just go in and just dump a ton of information it's like a turnoff right so
Miriam Allred (17:56)
Let's
pause here though. Don't get into the discovery questions just yet. I want to plug here because I want to get into that in a second. But Breanne, I want to give you a chance to kind of like rebuttal and talk about ACMA. I think you said it, Wayne, not a lot of home care companies are participating in this association, let alone at these events. I think that's a differentiator and an opportunity for the home care owners, operators listening to this Breanne, You're
Wayne Morgan (17:59)
Yeah.
Breanne Muchemore (18:19)
Thank
Miriam Allred (18:21)
heavily involved, can you share a little bit more about what that was? And then also that initial like table meeting like from your perspective, what were your thoughts? How did you feel like Wayne handled himself in that moment?
Breanne Muchemore (18:32)
Well, first of all, I want to know why I didn't win the raffle prize, Wayne. It would have been fun to walk away with a prize. ⁓ No, I think that our meeting was great. It stood out. ⁓
There's a lot, ACMA has conferences, they have national conferences and then they have local state conferences. But often there are 50, at the state conference, 50 to 100 different community partners or exhibitors, vendors, whichever name we want to use. I like to use community partners. But we have community partners that are there and it can be a little overwhelming because you're walking around and people are saying, you're meeting so many different people, you're meeting home care agencies, you're meeting skilled nursing facility groups, DME suppliers, and trying to
out what stood out and I think that our conversation with Wayne stood out because I could feel and sense his passion. ⁓ I am an incredibly passionate person in like everything I do. For better or for worse, I am very passionate. so feeling his passion and his interest in ACMA and showing ACMA is a professional organization for case managers and majority of the case managers or many of them are hospital case managers, leaders,
directors
and the fact that he was taking his it's a Saturday typically spending his Saturday spending the time they're investing in organization was the first thing that stood out but then also that he really seemed to understand what the role of case management in hospitals was it wasn't like hey I have a know a brochure like let me tell you what we can do it was like wow like you guys really care for really challenging patients you really take care of like patients that are you know suffering catastrophic injuries or
incredibly sick and really took the time to note that patient population. And then I think again, this is building beyond the table, but that he noticed.
the work that we did and how hard it was and recognize the work of my team and kind of spoke like hospital language, case management lingo about throughput and readmissions and length of stay, all those buzzwords that are so important for us to hear. And quite frankly, many organizations, business development, leaders don't focus on that. They focus on what their company can sell. And so think that's what really, really stood out.
Wayne Morgan (20:35)
Thanks.
Breanne Muchemore (20:51)
I'll pause there and I have so much to say, but we'll pause there.
Miriam Allred (20:55)
That was perfect.
That was perfect. And that speaks to what Wayne did well. And Wayne, you said it before, you did your homework, you do the research, you put in the work. So when you're at that table, you're using the jargon that Breanne and team uses. And that was like a connection point, because Breanne, you could say the same about a lot of other home care companies that likely have approached you over the years that weren't speaking that language
that aren't, using those buzzwords and those people are quick to write off because they don't necessarily know, what you all do. And Spaulding is even like another layer deeper with the severity of the cases. Can you share just so people understand like who Spaulding is dealing with? It's not even just kind of typical.
Breanne Muchemore (21:38)
Yeah, yeah, absolutely. So spalding has several different levels of care, skilled nursing, LTCH, long-term acute care, and inpatient rehab, IRF. But majority of the patients are coming after, as I said, a catastrophic injury. So an accident that resulted in a traumatic brain injury, an accident that may have resulted in a spinal cord injury, meaning that that patient may be paralyzed. the majority of our patients are learning to do all those
things that we take for granted on a daily basis, learning to do those things again. So it is a very special population that we work with. And not to mention, in addition, our LTCH ⁓ was able to manage patients on ventilators, tracheostomies, status post transplant. So very sick patients that really needed that care. And I felt so ⁓ protective of the patient population that Spaulding
has and wanted to ensure that any partner that we refer our patients to that we can really trust them and know that they will care for the patients like we care for them at Spaulding.
Miriam Allred (22:51)
Yes, 100%. A minute ago, we were joking, like, did Breanne respond to Wayne's email? I actually want to dig into that because, anybody's email is just like chaos and our people responding to email are not. So Wayne, after that table meeting, did you send her an email or what were your like literal touch points to then get to that one-on-one meeting? Text, email, what was it?
Wayne Morgan (23:15)
Yeah.
So no texting. I was not there yet. I think I sent just like maybe two or three emails. One of the things I do, it's a little salesy. I hate the word, but it is. In the subject bar, I actually put like who I was.
Like, because you always get like an email like, oh, pleasure speaking to you or appointment request, you know, and it's like, how many does she get? Right. How many spams, newsletters, plus three campuses, 60 plus staff members. Like you just heard the type of patients she was managing on a day to day basis. So it's like, all right, well, I know like I can just show up. So I think I even tried to show up twice to the front door and it's like, you know, there's a gatekeeper and
Miriam Allred (23:39)
you
Wayne Morgan (24:01)
You build a relationship with them, but again, you hear the, like any place, they're protecting their patients. But most importantly, there's three campuses. I probably went to one a day and tried to catch it, right? ⁓ No, but seriously, I put great conversation at the ACMA conference in the subject bar. It was very specific.
And it took a couple of attempts and it took a couple of drop-bys, like physically. And then from there, we scheduled a formal one-to-one meeting in her office with, now from that time, once speaking with her and understanding more of the Boston actual market, we brought in a...
team of registered nurses to oversee the home health aides. Then I needed a director of business development once I realized you could spend a full week in just north of the city. So it was a big territory. So we started building out the operation. But I also knew I needed the actual main director of nursing on board. Because just with the regulations and the criteria with doing home care in that specific city,
I knew we needed to approach this at a first, like a clinical approach, right? So there's some states where you don't need like certain clinical requirements for home care. I said, no matter what referral we receive.
we need to be like clinically first. And we need to see this through the scope of our nursing team. So if my nurse had hesitations or concerns or questions, like that's priority first. Like we're not doing anything until the nurse says so. Again, that just goes back to my training. I needed a nurse's approval for everything. ⁓ But again, it was, yeah.
Miriam Allred (25:41)
That's good context though, because
with someone like Spaulding, with someone like Breanne, you only have one shot. If you blow it with a referral, with that first referral, like you're done. So I like what you're saying though, is you knew the level of expertise, the level of care that Spaulding was going to require of you. So you said, while I'm trying to get my foot in there and build that relationship, we're also going to build out our clinical function so that when we get that first referral, we are going to nail it because we have the people in place and the operations in place.
Wayne Morgan (26:08)
Perfect.
Miriam Allred (26:11)
to be able to take on a patient that Spaulding could refer. So I like that context because again, of course you want a referral from Spaulding, but had you gotten one and not been prepared, would have been game over right then and there.
Wayne Morgan (26:16)
Correct.
Breanne Muchemore (26:18)
Thank
Wayne Morgan (26:26)
Yeah, honestly, the time works in favor, right? Like as much as you want to build a business up, like time's actually the best thing you could have with our business. And I'll get more into that later in the episode. But again, it to a formal and then it led to in services with her team. Right. I did get to know them. There's 60 plus of them. So, you know, that takes time. I mean, it was like a solid six to eight week timeline. Most hospitals and, referral sources such as
hers or Spaulding, like sometimes can take you a year.
Nationally and statistically, it's probably 8 to 12 months. A traditional resource, 8 to 12 consistent weeks, that's no guarantee. Like we said prior, me knowing the lingo and the language, it wasn't me just throwing it out there. I had so much experience, but it takes so much homework and so much studying and so much to actually comprehend all this. So me probably asking the questions to previous referral sources, me going to DONs and social workers
and actually sitting down with them saying, can you please explain me this progress note? Or previous nurses or my current director of nursing, can you walk me through this care plan or why you're hesitant on this? That made me just get a better understanding of not just the clinical scope, but the importance of why we might be recommending specific hours or why their team might have hesitations with just PTO team speech in the home and why they're referring private duty home care. ⁓
So it took a lot of meetings, a lot of education to myself, a lot of education to her and her team, ⁓ consistency. And then on the back end, I was building up the operation because I was involved with the operations as well. So I had to relay all the information that I was getting from their team back to my operational team to a point then introducing them to her team. So everybody's on the same page. So it was almost like a two-month-long project of
a Spaulding project and then everything else. Because like you said, if we got a referral, we had to execute it. We had to do it right because those types of referrals were very unique. And you had to essentially have your own in a way, like program within your program just for those patients. Which we were really passionate about. Like I had a whiteboard that literally just had Spaulding with like a thousand notes. And how do we work our way through the maze of that?
Miriam Allred (28:55)
So, Breanne, I want to hear about these early meetings, this discovery phase from your point of view. that first meeting that you had, I don't know if you can think back to literally how that meeting went. Were you, Breanne, doing most of the talking and Wayne was doing a lot of the listening? Or was Wayne doing more of the talking and you were doing the listening? What was the back and forth in that initial meeting and what worked well? And maybe where's room for improvement in that first meeting?
Breanne Muchemore (29:12)
I think that's
Yeah, absolutely. think that exactly what you said is key. Because when I reflect, he was doing most of the listening and I was doing most of the talking. What woman doesn't like to talk? But no, besides that, I think that it showed that he was really invested in the type of patients that we had and that we were caring for as opposed to what he was selling or what product he could offer. And going back to the email, because I'm not going to lie, I feel a little guilty that I didn't respond to two or maybe three of your emails.
Miriam Allred (29:31)
you
Breanne Muchemore (29:50)
But it's so interesting and technology and social media is such a great tool. But as a director of care management, it can be very overwhelming because there are so many emails and LinkedIn messages and business cards and brochures at the front desk. And sometimes they sneak past the front desk and they're at your office and there's so much pressure in the hospital, especially at this in this day and age with the way our healthcare system is operating.
And so ⁓ it can be overwhelming. I know, my 12 years at Spaulding, ⁓ the first year, I never missed an email. would always respond. Then I learned that I wasn't going to be able to be effective at my job as the director of case management if I was consistently meeting with different home care agencies and partners. So they really had to stand out and make an impact for us to be able to ⁓ give the time and to be able to have
them come in. And I know it's hard for me to say that because I'm such a person of relationship building and networking. And, you know, I love that. And that is so key. But, looking at the lens as a case management director and understanding the pressures that they're under and that they're guiding their teams with, it makes sense as to why, they can't, we can't, always give that time. So, yeah. ⁓
Miriam Allred (31:11)
So the million dollar question is though,
what stands out to you? The coffees and the lunches are nice, but of all of those people that have reached out to you over all of those years, like what is the subject line that they use or what is it that they do that really like makes your ears perk up and makes you say like, okay, I'll give you a one-on-one meeting. Like what did they do to get that, to deserve that?
Breanne Muchemore (31:34)
Yeah.
I know, I could probably summarize it in like maybe three points. Let's see if I can do it in three. But I think the first would be ⁓ just the, as I mentioned before, like passion and like that relationship and that connection for like the work that they do. You can tell people who are just selling a product ⁓ versus someone who really believes in the product that they're selling using sales terms. But you know, that passion and that initial like relationship. ⁓ The second piece is, you know, yes, aside from the cost,
that most hospitals truthfully aren't even allowed to accept. So then it kind of gets this awkward thing. You know, was that the personal connections and really understanding, you know, hey, I saw Spaulding on the news the other day and they were ranked number two in US news world report. Like those things like that really stand out. It's like, wow, they're paying attention to Spaulding, not just talking about their agency or their organization. ⁓ You know, I think attention to personal detail is always so key to know that people are listening.
like ⁓ mentioning something about like, how was the weekend with your kids? I know your daughter had a birthday. Like those little things that go and say like, wow, they were really listening to what I was saying. It wasn't just coming in to do a sales call. All right, so those are my two points. And I think my third is...
really treating it as a relationship and being transparent about what you can and can't do. One of our most challenging populations at Spaulding in a variety of discharge planning perspectives were patients with spinal cord injury, or Spaulding's model system for patients with spinal cord injury and...
Wayne Morgan (33:12)
Thank
Breanne Muchemore (33:14)
home care agencies, skilled nursing, there's groups that cannot, are not trained or equipped and do not have the resources to provide care for those patients. And I want to hear that upfront. And I want to hear that transparency of like, no, we actually haven't worked with a patient who has a spinal cord injury, but we're willing to learn or like being transparent, honest and open rather than saying, yeah, we do that. We do that. Cause I'm like, really? It's a unique, a unique area. So those are my three, probably big points of why I was interested
Wayne Morgan (33:36)
No. ⁓
Breanne Muchemore (33:43)
in pursuing the relationships, I really thought that they would not only be able to care for our traditional ortho patients, know, or patients that recently had a minor stroke, like our patients were so much more complex and wanting to know that they could do that. Because quite frankly, anyone can care for a straightforward ortho patient. And there's a lot more to that.
Miriam Allred (34:07)
think that last point is key because in home care, we want to say yes to everything. We want to be able to staff everything and excel at everything. But you're right. Be honest and upfront and transparent in what you are equipped to handle well and what you're not able to handle well and being honest and upfront. And I think some people may see that as a weakness, like, they're not going to work with me because I can't take on, you know, maybe 25 % of their clients. But you respect that. You want that honesty and that trust upfront.
Breanne Muchemore (34:16)
Yeah.
Absolutely. Yes.
And I think any case manager, any case management leader would say that they're more okay with hearing no right away than waiting days and days and kind of putting all those eggs in that basket and not being able to get that outcome or not being able, more importantly, not being able to provide the care that that patient needs. So sometimes it's okay to say no.
Miriam Allred (34:54)
Yes. Yes. Yes,
I agree. I think that's ⁓ an important lesson that everyone has to learn, maybe the hard way at some point or another. Before we talk about the in-services and bringing the team in and starting the more collaboration, Wayne, you shared with me a list of, I think, eight or 10 questions that you knew some of going into your relationship with Breanne but also Breanne probably influenced some of those questions.
These questions that you put together are so key that every home care company that is going to attempt to approach someone like Spaulding needs to know. So can you just walk through what those questions are and then at the end share why those are so important to understand to win business like this?
Wayne Morgan (35:30)
Yeah.
Yeah, absolutely. So again, like, let's just go to the dating metaphor, right? Like you're going in, you don't know this person, you know this building, you don't know this referral source. As much research as you really do, you don't know.
You don't know what happens on a day to day between those walls. You really don't, right? So ⁓ to get into it, like, you know, kind of like an old school home care guy, you have three campuses, right? Like one, what does that even mean? what's the distance between them? What determines campus A to campus B? Is it just bed capacity? So with that said, like, what is your bed capacity with this campus or total? ⁓ on a like estimate, like how many discharges are you seeing that are going home or, you
going to another home type setting to, you if you have three campuses, like how many admissions is that? And for me, like when I started really diving into like my direct little like personal niche, like what are those admissions, right? Like there's so many moving parts with like insurances now and ACOs and patients under bundle payments and managed care and traditional Medicare. But then today it's like,
Are those all traditional Medicare admissions? Are they managed care where a length of stay is determined by the diagnosis or the skill of the patient, where you have a case manager of the insurance calling you, basically determining next steps in a discharge plan before you even see the patient? Are they part of an ACO? So that way, can we update that group and understand what that looks like? There's so many ins and outs of just the admission process alone. So for me, though, I knew like,
If, let's just say hypothetically, 95 % of all admissions were managed care. then I would transition and say, what's your average length of stay goals? What are your outcome goals? These are little more higher clinical complex patients, but you have goals. Insurance can only pay for so long. So what does that look like? Is it every managed care patient was a
10 to 14 day window. OK, so if I got a referral who's managed care, because when I did, I would say, well, is it traditional? I would ask. Because then that would, a way, raise the priority if I knew.
know, patient who was managed care was there for four days and they averaged 10 to 14 days, I probably only had five days to get things going. And what we presented was, complimentary nursing assessments. I did a home assessment for every single patient that I saw. So now even to today's my business now, we don't take on a new client until we see the home. Like there's no ifs, ifs or buts. Like we're communicating that back to the team. We're communicating that back to home health. We're working with the DME companies. Like if I knew we
Let's say five days versus 30 days like that's going up the priority board not to say like anyone else is being bumped down But my goal was to help their outcomes and their length of stay goals because then me and let's say another representative from Spaulding we could go into these other hospitals and say hey when you refer Spaulding and X company you're gonna get more of like a higher or better outcome report for your team Makes the hospital happy they're saving money the physicians are happy which ultimately not to be business developing
But like that's going to lead to more admissions. It's going to filter out and in a way kind of like handle the overflow of emergency rooms and free up beds and ultimately provide more beds and opportunities for people who need the actual care. So everything was connected. So, what type of admissions were you receiving? Understanding that. then I would ask I would ask her like, what does that look like for you? Like, how are you handling those discharges when by the time you get an admission, you're discharging them? Or if it's someone with an X, Y and Z
need, why are they in your building for maybe six months? What does that even look like to, who do you use for home health? Who do you use for your DMA? Who do you use for your hospice? Who are your primary feeders in terms of the hospitals and the physicians? What resources do you have out there? Because if I were to get a referral tomorrow and I'm bedside with my nurse, they're going to, when you meet with families, they pretty much unload everything on you. And it's fine. I want you to. But if they do ask like,
Hey, I don't have a POA from a mom. Do you know an elder well attorney or hey, I don't really know this company. Like what's this about? Or hey, why are you private pay when my dad's got Medicare and the best insurance because he was a stay employee. It's like, a way you have to educate him on a lot of things, but you also have to speak the same language and work within the same playing field as the referral source, but also be part of the team. So my job is to now then build those relationships outside of Spaulding on who Spaulding works with.
So that way if I ever got a referral, I know who the players are. ⁓
And most importantly, how can we help you? Not just with your day to day, but your patients. Are you seeing more falls? Are they more readmissions? Is there a lack of social engagement? Are there certain, not to be hospital-y, but social determinants that are a factor right now in the city of Boston? Maybe it's funding resources. Maybe it's VA benefits. Maybe most of the patients have long-term care insurance, and they don't have support with someone like me to go in and review them for them and guide them through that process as well. ⁓
When are your utilization review or care plan meetings? I'm not going to come to your building when you're in a meeting all day. Or maybe I could sponsor one. Maybe I can educate your team. Maybe I can give you some of my data or KPIs on a quarterly or biannual or annually basis. So I had to know every single thing about this building.
And you can imagine, this is way more than 10 questions. This is like a science. And I didn't say one thing about my company, because then I would say, well, if you UR every day, well, I'm like the kid who always asks why in class, although I wasn't the greatest student. So why was I asking why so many times? But I would say, well, if you have a care planning meeting every day from, let's say, 9 to 11, how do you get your work done? Or if your social worker is doing this and has three admissions and five discharges the same day, like,
how do I fit in? Because my ultimate goal wasn't just to get referrals, but like, how do I get 60 people plus the senior director to one day say, how do we make this gentleman and his colleagues and his company part of our everyday conversation and process? So while I was sending those emails, I still was building the relationships with the community partners that I knew they were referring. So even if Spaulding wasn't referring me, maybe that home health company would refer me where then home health could say like, hey,
give this company a chance, you're really doing a good job. That was long-term goal. Maybe she would say, wow, this guy sent me 15 emails, maybe I'll finally answer them. But I wanted to create a word of mouth and a presence in a brand in the community while I was establishing that rapport with Spaulding. But these questions are so key.
Miriam Allred (42:25)
That was, Wayne, this was so good. And I'm thinking in my head, like, we have to publish this list of questions that you put together because you probably said words in there and people listening to this are like, wow, I don't even know what some of those words and questions are. like you said, it's like a science, like you had to understand the science of Breanne's world in order to develop that trust, in order to even get that first referral. Breanne, the question I have for you in home care, we talk a lot about
fall prevention, socialization or social determinants of health, and re-hospitalizations. Like home care is approaching the acute space and trying to articulate that that is what home care can do. My question to you is, are those the three most important things that you care about? Or from all of those questions and things that Wayne just talked about, are there other things that are higher priority for you that home care needs to be aware of?
Breanne Muchemore (43:22)
that's a great question. ⁓ I think those are great, great points, absolutely. We've talked a lot about like yes and no and saying yes and saying no but I think one thing that I would really focus on is if we have to say no for safety.
Wayne Morgan (43:35)
Thank
Breanne Muchemore (43:39)
make sense, but how can we get to a yes? You mentioned social determinants of health and that is of those three really what stands out to me. if you look at different reports from hospital associations of the reasons why patients are stuck, for lack of better words, we use the word stuck, but stuck in hospitals, often it is those social determinants of health. And it's not necessarily medical. The medical team has done what they needed to do, but you know, that patient
isn't able to go back home because maybe there isn't a home, maybe the home isn't accessible. So being able to think creatively, think innovatively, think outside of the box, I think my team learned very quickly when I worked with them that I...
don't often just say no. I ask a lot of questions to get to that yes and to understand what we need in that particular situation. So of those three points that you highlighted, Miriam literally what stands out most is those patients. Patients, as we are seeing with our family members, as we see in our communities, as we see in our hospitals, there's so many social complexities that come along with that patient. It's not just the stroke that they have.
much
more and so being able to highlight and recognize and I like what Wayne said about the home because that is so important and there's often you know whether the patient isn't able or doesn't want to share the challenges that they may be facing in their home there's so much that we learn when we go into someone's home about their safety which will in turn one of your other points was readmissions and so working alongside with home care providers amazing.
hospitals can't go to the homes like we used to be able to. We have great partners, have great home accessibility questionnaires, we have great resources and tools and we use pictures and we use family, you know, all those things, but can't go to the homes and so being able to have partners that will do that to ensure that it is a safe discharge plan. ⁓ I think also another piece I want to highlight is just, along with the social term and to help in social issues, it's just like understanding the emotional, ⁓
the health, the toll that these injuries or illnesses or, just aging can place on a person themselves and a family member. And really thinking back to the root of the relationship, like we're all in this together. Like we're all ⁓ after the same mission and the same goal is really to be able to provide that best care and the most safe care for the patient throughout the continuum. Regardless of whether we're working in an acute hospital and a rehab
hospital a SNF or a home care of that continuum of care we're all at have that same mission so if we can continue to partner together we're going to be continue to do great things and even better things.
Miriam Allred (46:35)
OK, so
I want a great response. And I actually, think it's interesting to hear your perspective on this about of those three, like social determinants of health is the one that you are thinking about and focused on the most. I think home care has talked about that and is thinking about that. But I think we ⁓ currently are putting a lot of emphasis on fall prevention and readmissions. I think that those two actually come together with the social determinants of health. Like you said, the social complexities of a client and of a family.
Wayne Morgan (46:44)
Thank you.
Breanne Muchemore (46:59)
I do.
Miriam Allred (47:02)
We have to address those and then the fall prevention can be reduced. Then the hospital readmissions will be reduced. Like the social complexity is what we have to focus on. I want to take this in two directions, Breanne, with you. I want to talk about like the partners. You said like community partners or like power partners. I want you to think of like your table of power partners that are most important to you. And Wayne like got a seat at that table. Paint the picture though of who else is at that table in your mind. Like Spaulding.
Breanne Muchemore (47:06)
Great.
Mm-hmm.
Mm-hmm.
Mm-hmm. ⁓
Miriam Allred (47:32)
is like the head of the table because everybody wants to work with you, who are the other partners at that table that are the most important and valuable to you?
Breanne Muchemore (47:40)
in my head, I will always want to be able to name like our top three partners for every different different area of care. Like so when case managers are setting up a discharge plan, they're setting up everything from ensuring that the patient has medication to ensure that they have the appropriate durable medical equipment, that their home is accessible or safe or you know, if there's installations needed, making sure the patient has a primary care provider. Do they need a higher or lower level of care, assisted living?
⁓ hospice. So I, know, in my network, in the field of case management, always want to have three because we want to give patients choice, of course. It's important for them to be able to have that autonomy and make that decision on their own ⁓ from a variety of those practices. others that we don't often think about, but that have been really great resources are ⁓ med flight partners, obviously visiting nurse agencies.
companies that can provide oxygen. There are times where there are limited resources in the community, whether it's a shortage of speech therapy or home health aids. So being able to have those different referral partners. But I mean, I could probably write a list of like 25 different providers. But when you think about that patient really being at the center and all of the people around them and things around them that they need in order for a successful discharge home. ⁓
Miriam Allred (49:05)
And did I understand
right that you have kind of three per category?
Breanne Muchemore (49:09)
Yeah, mean,
on my list, there could be 20, but I think in my head, I wanna know that I have three people and agencies that I've worked with that I really trust that I could call right now and say, hey, Wayne, I have a patient who, and that I could make that referral right away. I think three is just like my go-to number to ensure that there's patient choice and that there are always, a provider, available.
Miriam Allred (49:34)
The reason why I specify is it's good to hear you quantify those numbers because again, a home care agency approaching someone like Spaulding, it's like, okay, Breanne has a list of 20 to 25. How do I make the top three? Like that is my goal is yes, I need to make the top 20, 25 and that's a challenge in and of itself, but I also need to be in her top three and how do I get to her top three? Like that's why I'm asking because that's an important differentiation.
Breanne Muchemore (49:36)
Yeah.
Yeah, yeah.
You know, one thing that I think about now that you say that is, there's everyone can have their first case, right? We can always have that first successful referral, that first time that we work together and that's great. And it's usually like really exciting and there's lots of celebrations if it goes well, but what about the second and the third and the fourth? And those are equally as important. And I think being able to show follow through and consistency that, the second referral was just as good as the first, if not better.
But also being able to share client testimonials or outcomes. Case managers love outcomes. We want to know, especially for discharging a patient, and they've worked so hard in PT, and they've gotten to this point of, you know, ambulating 200 feet with just a walker. We want to know that when they get home that they're continuing to progress to that level. So client testimonials and outcomes are always huge. The follow-up of not saying like,
I have, you do you, are you interested in referring another patient? But hey, let me, let me talk to you about, you know, Mr. Smith and what we did with Mr. Smith and look what Mr. Smith had to say.
So those always really stand out to me as hearing directly from that patient and family, ⁓ which is huge. And families want to hear that too. They want to know like, they're overwhelmed. How can I pick a home care provider? You just gave me a list of all these agencies that really mean nothing to me. some people truthfully will start with, ⁓ what's the, what's their rate? What's the most affordable? ⁓ In the grand scheme of things, we all know it's, I don't, I'm not even a home care operator, but we all know that they're all, it's all relatively similar. So really focusing on.
Wayne Morgan (51:30)
Mm-hmm.
Breanne Muchemore (51:38)
the person that you really built that relationship with, that person that you connected with, and being able to have those positive client testimonials and outcomes.
Wayne Morgan (51:47)
That was great.
Miriam Allred (51:48)
And Wayne, that probably became your cadence for going back to Breanne is you get a referral, you have success, you have those outcomes, you go back to her and report on those things. And then naturally more referrals come. Talk a little bit about Wayne about like the maintenance of the relationship. Like you get those first few referrals and then what does it just like the evolution of that relationship look like?
Wayne Morgan (51:56)
Yeah.
Yeah.
Yeah.
Yeah, so Breanne, I feel like I was just in the meeting for the first time. That was great. I'm ready to end this podcast and go business development. ⁓ No, I'm just kidding. Honestly, I actually sat here and just reflected back on my work, because what was discussed is everything I did for children. Putting patient-centered focus, like a wraparound approach, is what I learned through care management organizations. And ⁓ that was really refreshing to hear.
Breanne Muchemore (52:18)
You
Wayne Morgan (52:37)
Thankfully, I did go in with a lot of that in my tool belt with my previous job. I worked for a very successful company in New Jersey. I knew all this, but I learned it all from other hospitals. I tell now my business development team and colleagues and just people all over.
you have to talk about every single thing first before you start talking about a certified home health aide. That's what you're an expert in. Like talk about transportation, PCP. maybe they didn't meet therapy goals, or they're going home with a new medication, new DME equipment. Like check off every single box first, and then be like, okay, and this is how my certified home health aide is gonna help. Because guess what? With all that checked off, you're actually helping out your certified home health aide at the same time. So to go with that said, like a little bit of this
secret sauce, but it's not rocket science. Like in 2017, I went to every social work and was like, how do I become your top three? Like, I know I'm at the bottom. Like, what do I do? I mean, I was showing up to places on the 4th of July, like skeleton crew just to be like, here I am, like happy 4th of July. But like every single person till this day. And it's like, if you've, if you listened and not to plug it in, but like my previous podcasts, you can have a trillion relationships. That's great.
But this is like everything that Breanne literally said is like back to what I said in our original podcast, like you have to maintain this and you have to like really work hard for this. Like it is, it's really hard to like build systems and then it's even harder to follow them and then have a team to follow them because if there's one slip up in the system, the quality of the care dilutes, things are just.
not going the way it should be. with that said, like, listen, first referral, right? It's great celebration. My first referral was not easy, but to me it was easy because of everything that we built on the back end operationally, plus my experience, but plus the expectations that we knew from Spaulding. So
It's communicating, right? So I'm very big on quality assurance. What are we doing within the first 24 hours? What are we doing with the first week? What are we doing within the first two weeks to the 30 days? I'm not a guy who's going to be like, hey, by law, every 60 days we have to do a reassessment. No, this is a high risk client. What are we doing from now to 60 days? What's the communication back to home health, to DME, to the physician, to the ACA group, to the hospital? The hospital might not even know me. Guess what? You're getting an update regardless.
But like she said, let's celebrate the win, right? And then on top of that, what are the outcomes? What are the goals? Maybe this person was in the hospital six times in 30 days. Now they surpassed 30 days, right? So now to this day, I build a beautiful certificate for every patient that graduates my readmission program. And it gets funneled to every single person on the team, even a crossing guard if they're involved with the patient's care. So
Breanne Muchemore (55:11)
That's all I to
Wayne Morgan (55:25)
One, the data. Data always tells you a story. Follow it. Be passionate about it. Let it sometimes make decisions for you. Communicate back to the partners and continue just.
what you do really well, your assessments, your process, your communication, your follow-up, track your data. If there's a challenge, go back to the team who referred you and ask if they have a resource. Be transparent. Because all this at the end of day two, as an operator the more you do all this on the front end and throughout the process, guess what you're doing? You're attracting better caregivers. You're retaining them. You're setting clear expectations for them to accept the position, which is going to keep your longevity in place and lower your turnover.
You're going to pay them the right rate based on their skills and their strengths. And then that client's going have an amazing experience with your company, as will your caregiver. Now you're increasing your client length of stay. This is all being funneled back to Spaulding. And now that one referral turned to two. And then it turned into four. And then it turned into eight. But during the eight, there was one or two saying, you know what? At this point, I don't think this is home care appropriate. So now what do we do? Because I knew if I said yes to everything, the quality of care of my process
says
would be diluted. Like we stayed in our lane. We never turned our cheek the other way. It was like, hey, have you ever thought if home's not the right answer, what the next step would be? Like that's what we're saying to families. And maybe Breanne's team is like, hey, we've been trying to encourage the family to consider another option. Or hey, if you go home, maybe you don't have the right funding or the right home environment. Like what do do now? Like we're not just going to take you home. Like it's not just client caregiver revenue. It's beyond that.
I would say everything that she said is what we did plus more. And then I would come in with testimonial certificates and data and say, hey, we got eight referrals in the first six months. This is our readmission rate for those six specific patients. Here are the outcomes. Here are the success stories. Here are even our failures.
And the data spoke for itself. The testimonies spoke for itself. But like Breanne said, there's 20 companies. That team can literally say, hey, they have, let's say, 2 % readmission rate. All their clients are staying home. They have a great experience. We have great feedback from the families. Their caregivers are coming in and training with their teams. They're communicating back to us. They don't steer families in any direction. And I'm talking just general.
For me, if I was a family and I heard all this, would say, wow, I would want my mom to have a great experience like the rest of those families did. And for us and for me, that's what it's about. Positive experiences for every family, every person who calls his office, and every caregiver that walks through the door. You might need home care. You call us. We're going to figure it out. And I think with that model, the business part just falls into place.
Miriam Allred (58:14)
That was fantastic, Wayne. Breanne, I want to ask you two quick follow up questions because Wayne is talking about like all of the data and information and the outcomes. I want to ask you, is there such thing as over communication? do you want to know every single thing about every single referral all the time? Is there such thing as over communication? And then how do you want to receive those updates, receive that information? Is it an email in real time when things are happening? Is it a weekly email? Is it an in-person every month? what's your
preferred method of receiving that information.
Breanne Muchemore (58:46)
That's a great question. mean, typically I would say that there's usually no...
think such thing as over communication. However, ⁓ I as the case management director, truthfully can't take all the information in as far as what's happening. I think that ultimately I want to know that that patient is safe, is being well cared for, and that things are going well. And certainly if things, there's hiccups or if there's issues that come up along the way, how can myself or my team help support to solve those issues? But I think the biggest thing is being able to trust when you're discharging,
50 plus patients a week and you really need to be able to discharge them and know that they're in good hands.
And then as far as communication goes, I've had different organizations do it different ways. Some want to have monthly meetings. That's too much. Some want to have quarterly meetings. I welcome emails with updates. I welcome, I think the more volume that you do, there is a possibility that it would make sense to do, you know, quarterly meetings to really talk about the volume and talk about outcomes. But ultimately, think email is a really great form of communication. It allows us to then disseminate the information
to the doctor that cared for the patient, to the PT that cared for the patient, and be able to say like, here's a quick blurb on how Mr. Smith is doing at home, and they're doing really well, and grateful for that partnership.
Miriam Allred (1:00:15)
Okay. Yeah, that's good to hear because like you, you alluded to earlier, like you're so busy and you can't know everything about everyone all the time. And so that's why I was curious, like what's your preferred way? Because when we talk about volume, like this is a lot of clients and a lot of families, like you personally can't facilitate and be in the know on everything.
Wayne Morgan (1:00:21)
Right.
Breanne Muchemore (1:00:23)
Yeah.
Wayne Morgan (1:00:24)
Yes.
Breanne Muchemore (1:00:34)
Yeah, absolutely. But typically, my answer would always be, there is no such thing as over communication, you know? But I think just knowing like, ⁓ that this patient now is, the details make it harder to follow. But just knowing that we can trust is the biggest thing.
Miriam Allred (1:00:49)
Yeah.
Okay, wow. So many good moments and information inside of this session. Just one last question for each of you. Wayne, you've talked about a lot of the good things, the things that you've done right, the things that you've learned just over time accumulating all of your experience. I want you to just look back and think of maybe some of the mistakes that you've made so that everyone listening to this can learn from some of the things that you did wrong.
So in just a couple of minutes, one or two mistakes that you made along the way that can be pitfalls for other people to avoid in your experience.
Wayne Morgan (1:01:22)
So I've made a lot. One or two, mean, it really goes into like a quick, like just, I have like a six bullet like formula in my head. I was impatient. A lot of times you have to be patient. ⁓ You know, don't rush your processes. I've done that so many times and.
Then you lose sight and you create gray areas within your process and that leads to service failures. ⁓
I think also like composure and humility. there were times I wasn't composed because you know this business is tough as an owner, as an operator, as a business development person. Like I'm just telling the listeners now like yeah I own a business. I'm literally on the streets pounding the pavement still every day. Like that's the only way you're going to learn. So like I just stayed composed. Like there were times where I felt isolated and alone and didn't go to the last meeting or
went home earlier than I should have. I think just remain calm. Don't react with emotion in any scenario, literally. ⁓ Take a second to think. Call somebody. Go with your team just to remind yourself the business you're in. I did a lot. went and saw my operations team, not just to thank them, but to bring myself down to earth. ⁓ Stay consistent with your goals. Don't try to tweak them up every month or every quarter. If you have a yearly goal, stick to it.
Because if you start to flip-flopping, it's just going to be chaos. So stick to your goals. Have weekly meetings. Just stick to the course. I think there were times I just maybe didn't speak up. I wasn't composed. I wasn't patient. ⁓
I lost my motivation, and I also didn't accept humility. Honestly, if you can factor in education, consistency, humility, composure, and patience in any role in this space, you're going to be completely fine. And now at the point in my next year of my life or career, you've got to look for people that are better than you in certain aspects of your job. You've got to lean on people that are.
more experts in certain areas and you got to learn from it and you got to work before and after hours. But I always say like, there were times where I just felt like isolated and I didn't really like focus. ⁓ And till this day, I mean, what was our call an hour ago? I probably made two mistakes. You know, honestly, I probably did, but ⁓ I think it's just grounding. So I have this on a whiteboard in my office and it's a great model just to go by.
Miriam Allred (1:03:44)
Thank
Wayne Morgan (1:03:54)
personally and professionally and if you stay on that course you're going to be really really successful and so that equals growth so it's not just money it's growth so whatever your role is you're going to see growth if you stick to that so and it's okay to make mistakes it is just learn from them.
Miriam Allred (1:04:09)
I love it. Thanks for sharing, Wayne. You said it earlier. You really do walk the walk. You and I have a phone call like every couple of months. And every time you call me, the first part of the conversation is you telling me what you're doing in that moment. You're driving to a client, you're driving to a hospital, you're talking to a referral partner like, like Breanne shared earlier, like she could sense your passion for this business. And every time I talk to you, like I feel that passion as well, because you're doing it. Like right now we're recording this podcast, but you're going to walk out the door and 20 minutes after this and you're going to be
pounding the pavement, knocking on someone's door, walking into a hospital, like you're so in it, day in and day out, and that energy and that passion radiates. So I love the formula that you put together because you have years of experience doing this, but you're still like so in it, which I love. Breanne, last question for you. This is an audience of home care leaders listening to this podcast, and you come again from this point of view, and you've shared so many great insights today. I just want to give you one more opportunity.
If you had a room full of home care owners in front of you right now, which you do, what would you say to them? What's a piece of advice that you want to instill in them of building relationships with leaders like yourself? What do you want to tell them about how it's possible, about what they should do, and what they should leave this conversation and go and do in their business?
Breanne Muchemore (1:05:26)
Thank you and thank you for the opportunity, passion, persistence.
Remembering that the people that you're working with, most are social workers, nurses that are case managers and they're in this field because they want to help and they want to make a difference. They may not remember your sales pitch. They may not remember your rates or how many hours you can, service a patient, but they will remember how you cared for their patients. And I think that that really is just such a takeaway is like they will remember
and it will be a natural relationship, a natural evolvement, and they will think of you. ⁓
Show an investment in who they are and what's important to them and their organization and their hospital. Understanding what their pain points are, speaking their language and listening is key. And then, back to the data and the outcomes. Show up with data and patient stories, a picture with a patient of what they're doing in the community. Like, amazing.
goes a long way. So data, not coffee, and just really continue to forge that relationship and show how genuine you are in the work that you're doing.
Miriam Allred (1:06:44)
So good. This has been a fantastic conversation. Breanne, Wayne, thank you so much for joining me in the lab. Everyone listening to this, connect with these guys. They're on LinkedIn, they're out on the web. Connect with them. My advice is find the Breanne's in your market. I think we all want to spend more time with Breanne because we've learned so much from her, but find the Breanne's out in your market. Find these Spaulding's, find these partners.
Wayne Morgan (1:06:44)
It's good. Ready to run through a wall.
Miriam Allred (1:07:09)
and get your foot in the door and build these relationships and learn from Wayne. It's not easy, but break down the science of what it takes to get into these offices and put in the work and you will reap the rewards. So fantastic conversation. Thank you both for joining me in the lab and we'll look forward to more again soon.
Wayne Morgan (1:07:23)
Thank you.
Awesome. Thank you.
Breanne Muchemore (1:07:26)
Thanks so much. ⁓