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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)
Hey everyone, welcome back to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's great to be back with you this week. I hope everyone's having an awesome week and things are going well for you. Today in the lab, I'm sitting across from Gabby Hoing the founder and CEO of Kore Cares in Sioux Falls, South Dakota. Gabby, welcome to the lab.
Gabby (00:20)
Thanks for having me.
Miriam Allred (00:22)
I have always been in awe of you and every once in a while I'll send you a message on LinkedIn and I'll say, hey, how are things going or what are you up to? You want to join me on the podcast? I think I haven't interviewed you maybe since my first podcast, but again, you're always on my radar and have wanted to have you on my new show. So here we are.
Gabby (00:38)
and awe of you as well, so it's mutual.
Miriam Allred (00:41)
You're so sweet. ⁓ For those that don't know you, let's start with your background. You are a CNA by trade and have had an incredible journey getting to where you are today. But tell everyone a little bit about your background and starting Kore Cares
Gabby (00:55)
Yeah, my healthcare journey really started as a CNA in a nursing home. I wasn't really sure what I wanted to do for a career. was a...
think a junior in high school and one of my friends worked at the nursing home and said, you need to join me. You love, you'd be great at caring for people. You're going to love it. And so I started out as a CNA in a nursing home and I thought maybe I wanted to be a nurse, but I really became intrigued by the business side of healthcare and the leadership that goes with the business side of healthcare. And like, how do we become a better leader or how do we develop those skills to really lead a care team? And what does that look like? And so I went to business school and I have a business degree
and Health Services Administration and I put myself through school really being a CNA and a home care caregiver. I did both and I learned a lot from both of those experiences. I'm so grateful that I was able to start really from the ground up in those frontline hands-on positions and develop my leadership skills over time. So from there I worked for the Good Samaritan Society and I started one of their first private duty home care agencies in Sioux Falls and then moved to their
corporate office and design the business model for home care. And I think I got to start 11 different agencies in eight different states from Hawaii to Florida to Arkansas to Oregon, all over the country. It was a ton of fun. I learned a lot. I was a part of an acquisition and a part of a lot of new startups. But as the travel became more and more and I started a family, I wanted something more local and needed something different than the corporate life. So I went to work for a very eCare and sold Telemann.
to long-term care facilities. And also a great experience, I got to meet a lot of the healthcare leaders throughout the region, got to see inside of lot of nursing homes, assisted livings, and really feel the impact telemedicine can make every day in residents' lives. But I really missed home care. So in 2016, a friend of mine came to me and said, what are you doing? You are passionate about home care, like that's where your gifts and talents lie. I think God is calling us to start a home care agency.
Miriam Allred (02:54)
Yeah.
Gabby (03:02)
We want to do things differently. We want to really focus on our staff and empower staff to use their God-given gifts and talents to serve those in need and really find the ways to support and train and lift up our care team so they can take excellent care of our clients. And so in 2016, we started Kore Cares with just me and one other person. And fast forward almost 10 years later, we're a team of 200 people serving a pretty
large geographic area in South Dakota. We serve over 95 communities, over 38 counties, and so we cover a lot of territory. And for those people that don't know, South Dakota is pretty rural. There's under million people in the whole state, and so we have a lot of rural areas that we serve.
Miriam Allred (03:53)
a lot of rural areas and you told me some of the lowest unemployment rates in the country. so when we, the lowest, when we talk about the workforce shortage and the challenge that that entails for home care in general, you know, you maybe like roll your eyes, like you guys don't even know because we have the lowest unemployment in South Dakota. And I love your background, CNA to then kind of corporatizing and then the medical sales with Avera, like what a great background.
Gabby (03:59)
have the lowest unemployment rate. Be low.
Okay.
Miriam Allred (04:21)
I wanna ask how old were you in 2016 when you started the home care company? Cause I look at you and you're so young still.
Gabby (04:26)
So I never tell anyone my age. I don't know if I'm willing to go there. So I was in my, had to be in my early thirties. I don't, I don't really even know my age today. So yes, I'm still pretty, I'm still pretty young, but I had a great, in my twenties, I had a lot of great experiences that led me to be able to open this company. So yeah, I was really fortunate to be kind of on an expedited path in my career and have good Sam.
Miriam Allred (04:28)
Okay.
Okay, but so young.
Gabby (04:56)
I'm really... ⁓
look at my gifts and talents and give me the opportunity to design a business model, a new business model for their company. I don't think very many people in their early 20s get that opportunity and they basically said, here, write the training manuals, the user guides, the SOPs, figure out what our finances should look like, our HR practices, put the business in a box and then go implement it throughout the country. And I was like, you're gonna let this 20-something very new college grad go do
that and they did trust me and it worked out great it was an awesome experience for both of us so.
Miriam Allred (05:32)
I love it. I love it. I'm also young myself, but I just think, yeah, we're so capable and given the right opportunities at the right time and look where you are today and you look back at the last 10 years, the last 20 years, and it's like you were led along to do all of these things. And now you're right where you're supposed to be, which is amazing. So one of the things that you said ⁓ was about you being intrigued by the leadership position and leading a care team. And I think that's what's resonated with you in starting Kore Cares is
Gabby (05:47)
Yeah.
Miriam Allred (05:59)
how can you give back to the caregivers and put them at the heart and center of everything that you do? And so today we're gonna talk about some of the programs that you have built specifically to benefit and help these caregivers not just survive, but also thrive. And so we're gonna talk about wages, we're gonna talk about benefits. If we have time, we're gonna talk about ⁓ your specific benefits program and issuing bonuses and things like that. But you shared with me.
there's been kind of this like this evolution in your thinking as you've scaled this company, you've had more resources and abilities to be able to offer these sorts of things. Talk about just like your thinking and getting to where you are today of like what, what you started, how you started thinking about wages and bonuses and how that like, again, that mindset has evolved as you've gotten larger.
Gabby (06:46)
Yeah, I've... my really why?
for growing Kore Cares has been about our care team, our caregivers and our nurses and how we empower them to use our God-given gifts and talents, but also how do we support them to really provide excellent care and what do they need professionally and personally. And so, you know, as I look back at my CNA experience, we would sit in these all staff meetings and talk a lot about rules and regulations and compliance. And I never felt like the leadership team
stopped and took an account for our feedback and what we wanted and how we could improve operational systems and what some of our ideas were. And so that's one of the things I've always wanted to carry forward with me is make sure that I'm always talking to our frontline staff and figuring out what they want. so, and I always wanted a way to be able to recognize those that are going above and beyond the call of duty. Cause that was the other thing in a nursing home setting and even in a home care
care
setting, it can be hard to recognize that staff that are going above and beyond the call of duty. But I think it's really important and people.
people want bonus. mean, they'll tell you, ⁓ I don't need a bonus or I don't need to thank you, but people need that appreciation. So how do we really live that out at Kore Cares And so, ⁓ we have tried a variety of different things over time and we have tried a point system. when we started this company, we had very little benefits because we didn't have a lot of funds to work with, but it's always been important that we continue to seek feedback from our staff on what they want. And,
and then try different things and let it evolve over time.
Miriam Allred (08:31)
So
you're big on feedback. You meet with every caregiver more often than most home care operators that I have met. Tell us about how often you and your administrative team are meeting with every single care professional.
Gabby (08:47)
Yeah, so we have six different offices. So we have about 20 different admin staff to help with this process, just to kind of give people a picture. But ⁓ we meet with our care team, our caregivers every three months. So we have a very structured, formal performance evaluation at six months in a year. And then we have touch bases at three months and nine months. And we try to do those four touch bases in person because of
our rural nature sometimes we have to do it virtually or over the phone but we feel like it's really important to sit in front of our caregivers and nurses on a consistent basis to get feedback from them, understand what they need from us and then make sure we're setting clear expectations so they know what we expect from them.
Miriam Allred (09:36)
So you mentioned you have six offices about 20 admin staff. Does one single person own these interviews? And second question is like, how do you schedule all of these? Because we know scheduling is a pain just in general and these caregivers are busy and they're out in the homes. How do you make these in-person meetings happen quarterly?
Gabby (09:55)
So.
We use WellSky and there's dashboard tasks. And so we set up all these tasks to remind us that those meetings need to happen and they pop up on the dashboard. And that's what kind of reminds the team that that needs to happen. There is no one person that owns this. We have toyed with the idea, but each office gets so tight knit with their group, but their care team that I think it would lose some of the relationship building that needs to happen between the admin
that are running that location and the care team. So some of our offices really only have two or three people running a pretty big geographic area. And so it's really just up to that, those two or three people to make sure that those get scheduled and that they meet with the caregivers and nurses on a consistent basis.
Miriam Allred (10:45)
I think
some offices struggle just to meet with every care professional annually, but here you are doing it four times a year. Have you always done it four times a year or did you start out annually and then semi-annually? Like what was your process to getting to four times a year?
Gabby (11:02)
We always, I think at first it was really informal and kind of haphazard. We knew that it was important to like meet with people. And so we were trying to do it at, you know, every six months. And then we just really found the need like six months isn't enough. Really need to meet quarterly. Cause sometimes people don't want to bother you with things. And so they hold things and then you'd get six months into it and there's, they don't like their schedule or there's a problem in the home that's been going on for months. And it's like, Oh, we could really improve.
your job satisfaction faster if we knew about these things, but the nature of some of the caregivers and nurses, just don't want to bother anyone. They know the admin staff are busy, they just kind of deal with whatever is going on, and then either they quit because they don't feel like they have the voice or the platform to bring up the feedback, ⁓ or we get them at six months and they're super unhappy about whatever is transpiring. And so we want to catch those things a little sooner, and we find that if we don't
intentional conversations, people don't always lift up the little things that maybe are bothering them.
Miriam Allred (12:08)
And
there's this common misunderstanding in the office that like, we're texting them all the time. You know, we're communicating with them all the time. We know what they think and feel, but it's so transactional. Whereas these meetings are formal, personal and professional development, one-on-one dedicated time in the office. And it's a totally different vibe than just like texting those transactional messages about the client or about the schedule, about payroll, et cetera. Right.
Gabby (12:18)
Yep.
Yeah, and that was one of pieces of feedback we would see on our home care pulse surveys is the office only contacts me when they need something. And so we wanted to change that perception too. We wanted to contact them. We make intentional efforts to contact them, good or bad feedback, timely, as soon as we get it. So we're not just contacting them about, can you pick up the shift? And then having those intentional ⁓ performance touch base points four times a year gives us an
opportunity to gather feedback, build that relationship and not just be after something like, we need you to pick up this shift or ⁓ we need you to do this or that. We want, and we, you now that you say that, we have not seen that on our home care pulse surveys, the whole, the office only communicates me when they need something, comment.
Miriam Allred (13:23)
I was just going to ask that this is a ton of work. Like, you know how much work it takes you in the office to coordinate these meetings, but there's like ROI to it. Your turnover is lower. Your satisfaction is higher and you're not paying to replace people as often. Can you share, any other like outcomes that come to mind of just like the ROI of putting in all this effort to make these meetings happen?
Gabby (13:46)
I also think when people are unhappy, when your care team's unhappy, they start to talk to your clients about it sometimes because they build relationships with them. part of your ROI is kind of...
building a culture so there isn't this undercurrent. And so your clients aren't calling and being like, I'm really concerned about Susie. She's unhappy about X, Y, and Z, and I'm afraid she's gonna leave and she's my favorite caregiver. And so kind of nipping that and being proactive, having more strategic leadership so that that undercurrent doesn't happen. And that will improve your client satisfaction too. And your employees are happy and taking really good care of your clients. Your clients are gonna be happy.
Miriam Allred (14:31)
That's a really great point. Happy caregivers, happy clients, but also yeah, prioritizing caregiver satisfaction in turn really boosts client satisfaction. And then retention is up for both of those, which is where the real ROI is keeping your caregivers and keeping your clients. So let's talk about your wage and bonus program. And again, I've told you, let's just get right into it because you have like structured this like super intentionally. And again,
Gabby (14:53)
Okay.
Miriam Allred (15:00)
You said it yourself. think a lot of companies, it's haphazard. It's like, yeah, we have a wage system and a benefits program, but it's another thing to have it like spelled out and then to be living it day after day, week after week. And what you've sent me, I think is really impressive. And so I want to just talk through that. Let's start with wages and then we'll go to bonuses.
You have both professional caregivers and nurses and there are some nuances, I think, to both programs, but let's focus on the caregiver side and then we can talk a little bit about the nurse side. just overview your approach to wages. There's like six tiers and it's all kind of broken down, but just kind of overview it then we'll get into the tactics.
Gabby (15:43)
So if you were to look at our caregiver wage grid, there's five different levels and then there's steps on each level. So when someone applies at Kore Cares and we're trying to assign them a wage, the first thing we look at is their experience and that's kind of where they start.
their levels. So if you have very little experience, you might be a level one caregiver. If you have 10 plus years of caregiving experience, you might start at a level four at a higher level. But we wanted an opportunity for staff that maybe didn't have a ton of experience and started at one of those lower levels, but really shined as a caregiver and really took our one of our values is having a growth mindset and really practice that growth mindset and level
up their skills pretty quickly. We wanted them to be able on an annual basis to move up a level if they're really showing great potential. And so that was I wanted people to kind of have
some autonomy or a way to increase their wage or increase their earning potential based on their skills and ability to really enhance themselves personally and professionally. Because a lot of times with frontline staff, you kind of get assigned a level or maybe there's just one level to your wage grid. You start at 17 bucks an hour every year, you get a 2 % raise if you're lucky. So you move up 30 cents, you move up 30 cents for the rest of your life.
and that's just, that's it. And so I wanted to provide them more of an opportunity. If they really want to grow and level up their skills, then I wanted them to have an opportunity on an annual basis to be able to level up.
Miriam Allred (17:29)
So can you talk about the criteria, their specific criteria that helps them advance through the levels? Can you talk about what that criteria is?
Gabby (17:37)
Yeah.
The first thing we look at is their initial or annual online learning completed. Do they have any corrective actions or performance improvement plans and how is their job performance? we have a really specific job performance review. We actually use a one to four scale. The reason I don't use one to five is I think it brings you an opportunity to give people threes, which is a cop out in my mind. So I want to be really specific in how
Miriam Allred (18:04)
Okay.
Gabby (18:08)
all your performances, either you're really going above and beyond or there's opportunities for improvement and where do you fall in that leveling. So we look at job performance. We also track all of the compliments and complaints that come into our office. and we do call all of our clients on a pretty consistent basis to kind of get feedback on our staff and how they're doing and we track all of that. So we wanna make, cause we wanna make sure they're providing good customer
satisfaction rate. So to level up, those are the first initial things that we look at. And then we're looking at, they ⁓ participating in growth opportunities? So are they doing Teepa Snow training? We wanted to provide dementia training to all our staff. As we're seeing that.
as a huge need in our area. And so we provide like an eight hour course on Teepa Snow So do they have that completed? Do they have a CPR certification? CPR is not required in the state of South Dakota, but we felt like it was something our clients wanted our staff to have. And honestly, something our staff wanted just to feel competent, in an emergency situation that they could help someone that they care about. And so do they have those two things completed?
How
is their documentation in WellSky? We are a Medicaid provider and so we do have EVV compliance that we need to adhere to. So how is their EVV compliance, but also how is their documentation in the home? Are they giving us a clear picture of what's happening in the home so we can maybe identify changes in condition and act upon that and be preventative? Are they leaving us good notes? Are they documenting accurately? ⁓
Yeah, we're looking at those compliments and complaints. are they really utilizing the opportunities to level up their skills?
And are they meeting our operational needs and our client satisfaction needs? And then to get up to your higher levels, you do have to have a CNA certification. So we will pay for people to have a CNA, which is a certified nursing assistant. It is also not required in the state of South Dakota, but I feel like it's a really good program to enhance people's caregiving skills. And
If people want to do that and want to feel more confident in their skills, we want to be able to provide that opportunity. So we have partnered with a vendor in South Dakota that they can do that mostly online. And then there is obviously some hands on things that they need to do to get that CNA certification. But in order to move up to your higher levels, you would have to have that certification.
Miriam Allred (20:50)
Okay.
This is fantastic. I love this already. A couple of follow-up questions. The first one is around the corrective actions, behaviors. I don't feel like we actually talk a lot about that. And I feel like it's this unspoken thing, like, and it's like a mental note from someone in the office. Like, you know, your staff and you kind of know the behaviors, but you all are really intentional about like documenting and tracking those things. I guess my question is, was there an evolution to start tracking that? Or has that always been, been the process?
And do you track all of that in WellSky like in the caregiver profile?
Gabby (21:22)
Yes, we're tracking all of it WellSky in the caregiver profile. And really what it came down to is when we developed this program and how it's evolved over time is what does the office staff need to be able to operate efficiently? And one of the things we need is good communication between us and our care team, the admin staff and the care team. And when we have maybe even admin staff or care team caregivers,
that are maybe being passive aggressive or...
not really articulating their feelings well and just kind of being angry about things, that's not helpful to the company. So we've done a lot of training and development, honestly, on that and how we operate efficiently, how we ask for what we need. But as far as the evolution of documenting it, I did want to go off of feeling. I am one of those people that needs data. I need data. And yes, it's hard sometimes to quantify or...
track how well someone is communicating. That's why you need to document in WellSky. So if you have a really off interaction with a caregiver, we want it documented in WellSky. So when we go back to that review, we can be like, yeah, we asked her five times to put her own availability in. She wouldn't put it in. So we just made our best guess on what she wanted the schedule to be. And then she was super upset because she needed time off, but didn't communicate that. And so it was this whole thing and we talked to her about it. I also want to make sure that admin staff,
are being proactive in how we talk to our caregiving staff, you know, when there is an issue. Okay, did we just, were we passive aggressive about it and just mad that she didn't document her time off? Or did we, what action items did we take to correct the situation? And then what was the outcome? Did the person that we gave the feedback to, did they learn from it and were things improved in the future? Or do we still have this pattern of behavior that needs to be corrected? We can't, I can't, we can't go off feelings. Well, I think
or there was this one time and this kind of happened like let's document the situation, let's document the action items, let's document the follow-up and honestly I always tell a team if we give anyone feedback the biggest thing I want is people to learn from that and so did someone learn from that and correct their behavior because of it? If so that's a huge win for the whole entire company, for the person. I'm ecstatic. I don't care that you know maybe we had to give you this piece of feedback. If you can learn from it and improve like that that is the ultimate
optimal goal.
Miriam Allred (23:56)
love this because too much of what you just talked about lives in the head and the heart of the admin staff and then they're operating off of off of feeling which this is a very personal business we all know that and so it's like the natural instinct to make decisions off of heart off of emotion but you're right there's a reason to document all of this so thoroughly so that you're making decisions based off of like
Gabby (24:03)
Yeah.
You're in.
Miriam Allred (24:23)
fact and history and reason and not just those gut instincts.
Gabby (24:26)
And I'm just saying, she never turns in her unavailability, or she always talks to me like this. Is that true? Or did you have one really bad instance and it just sticks in your mind and you feel like it's always proved to me that this is always and there's a true pattern of behavior. You know, like let's quantify it and try to get some facts behind it and not just feel like it's always or feel like it's never.
Miriam Allred (24:29)
Yeah.
And look what you just did, like so hyperbolic, like the extremes, because that's, again, if we're operating off of our heart, we go to those extremes, but you're right. It could have been once or twice, not every single time. And that's why we need to quantify these things.
Let's go to the CNA.
you said there's a level in which they move up to the CNA tier and you offer that. know some people worry about paying for that because they might turn and burn, but at what level, at what point, I guess, can they come to you and get that CNA and then where, where in the tier system does the CNA fit?
Gabby (25:29)
We have really specific criteria and I now I'm trying to recall. I think you have to work for us for 90 days and have good, prove some good performance before we'll pay for it.
And you have to be working on a consistent basis. If you're a PRN staff, we might not allow you to go through the CNA course. We want people that aren't regularly scheduled to have that opportunity. those ⁓ are some of the things we look at. Their performance, how long they've been here and how consistently are they scheduled. And then in order to move up, I think it's to level five, you have to have five years of CNA.
experience and that CNA. even to move up to level four you might have to have that CNA, but it's those higher levels on the wage grid. And when I talk about levels I'm talking about the wage grid. To continue to progress on those levels on the wage grid you have to have that CNA.
Miriam Allred (26:19)
Mm-hmm.
And you
mentioned you all covering the cost of that. you, has it cost your mind? Do you worry about people getting that and then leaving? Has that been your experience or do they oftentimes stay?
Gabby (26:34)
You know, what we've seen with that program and our benefits, if people start participating and buying in, we have better retention. So no, I don't worry about it. And really, if you look at our turnover in the first 90 days, it's quite high. But honestly, I don't care about that because I want to make sure the right people are on the bus. And so I don't want anyone not,
terming an employee or having a crucial conversation with an employee about what we need from them in order for them to stay at Kore Cares and worrying about them leaving because it's going to hurt some 90 day retention stat. I'd rather have the right people on the bus than worry about some statistic, you know, like that. so ⁓ once we get, I've seen two things, if we can get people to pass that first 90 days, we have a higher retention rate. And if they start buying into programs, like really participating in
the bonus program looking at that criteria and asking about the CNA or start participating in our benefits even if it's small things like our wellable program and Dave Ramsey's Smart Dollar program they start participating in some way they feel more connected to the company and they feel like we value them and we have a stronger retention.
Miriam Allred (27:50)
And you have had employees stay in that level five, like ongoing. guess my question is what about people that stay with you for years and years and they're in that level five and earlier we were talking about, you know, like that 2 % year over year that that's traditional. What do you do for the, what are you doing for the employees that have stayed with you into level five and beyond?
Gabby (28:11)
So we have a bonus program as well. And so not only do we give people the opportunity to move up on the wage grid, but we're also bonusing them based on really specific criteria. And I don't know if you want to get into that, but that's one of the things that we do.
Miriam Allred (28:25)
Yeah, that's perfect. get right into
it. Yeah, explain kind of high level the bonus program and then again, we'll get into it.
Gabby (28:30)
So again, we kind of looked at what do we need to operate efficiently and what do we need to provide good client and employee satisfaction? What are the key behaviors around our values that we really want to incentivize people around? Because what gets rewarded will get repeated. And so what positive things do we want repeated on a consistent basis? So our values are reliability, excellence, a growth mindset, and making a difference. So we've identified key behaviors that we try
and we bonus around those four things. So if you look at reliability
What we're looking at there is your attendance and we have a attendance point system. So we're looking at the number of points you have in order to meet that criteria. We're also looking at, you turn in your availability timely? We want our availability turned in by the 15th of the month for the next month so we can start strategically scheduling. So are people meeting that expectation? And then are caregivers keeping their availability consistent? Cause one thing we found was people would turn in their availability, we'd do the schedule and then things would change and it would be like,
Oh, I know I said I wanted days, but now I want to work all night. like that's our schedule. So those are some of the key things we look in reliability. Our second value is excellence. So we're really looking at job performance. How are they scoring on our job performance reviews? How are they documenting? How is their EVV compliance? And then how is their communication? Are they responding timely to the office staff when the office staff reaches out? Are they kind and professional in their communication?
Do they contact the office at appropriate times for appropriate things, like calling at 10 o'clock at night for time off two weeks from now, or are they calling at 10 o'clock at night because there's a critical need with their client and they need someone to work through that. And we're big on positive intent, know, so in their communication, are they practicing positive intent? Is their verbal, nonverbal communication positive? And then also in the excellence category, we're looking at are their drivers licensed and car insurance up to date? So simple things.
The third value we have is growth mindset. So we're looking at are they doing the Teepa Snow, CPR training, are they graciously accepting feedback and learning and improving from it, and are they completing their annual online learning timely. And then our fourth category is making a difference. So again, we're looking at those compliments and complaints that we receive from clients and coworkers and their teamwork. Are they picking up shifts for their coworkers?
willing
to train new team members? Do they have good availability on the weekends and are they participating the weekend and holiday rotation consistently? Are they flexible with their schedule and are they treating their team members with kindness and respect? So those are kind of the key behaviors we look at in each category and then we give them each category's worth of percentage of their wage and so we base the bonus on their earnings for a designated time frame. So we do these bonuses every six
months with their structured formal performance review.
Miriam Allred (31:40)
my
goodness, fantastic. I don't think enough people are tying bonuses to core values. Again, we've got that mission statement, the vision statement, we've got the core values, but it all gets a little like fluffy and ambiguous as time goes on. But I love that you've tied bonuses to the core values because then it's just like baked in everywhere. First question is,
This is a lot to track and I'm wondering if all of this lives in WellSky or is this living in another system or a spreadsheet or how do you keep track of all of these details?
Gabby (32:10)
So we're tracking all of this in WellSky, either in those activity notes or we'll assign tags to caregivers. if they their CPR or Teepa Snow, we'll give them a tag so that indicates that they have those things completed. And then we have, I'm big on checklists. When I went through college, I went through the Lean Management. I don't know if you ever heard of Lean Management. They're big on checklists. So I have a checklist. So when you go through a performance review, there are certain things you have to do.
Miriam Allred (32:32)
Mm-hmm. Yeah.
Gabby (32:40)
then at the back end, there's just a really easy way to like score everyone in each section and identify where you find the documentation. Yeah, it does take a little bit of time and we've looked at different ways to automate this and we were about to move to a different platform that could maybe automatically track some of these things. But the thing is doesn't give us the whole picture. It could track EVV compliance and it could track
track.
your attendance, but that's just a small piece of what we need from our staff. We wanted to be able to see a really comprehensive picture of our employees performance. And we met as a management team and said, said, okay, we could, we could go to this point system, this, automated tracking system. Like this is just not going to get us where we want to be. And we were all very bought into this bonus program, even though it does cause some
I guess you could say some administrative burden or time. We feel like it's really important because we need a way, you really should be looking at these things anyways when you do a performance review. Why not tie some incentive around it and just take the time to evaluate it and give people ⁓ really measurable feedback on whether or not they're meeting your expectations or not.
Miriam Allred (34:00)
And
my mind goes to the meeting itself. When you mentioned like checklist, that's just kind of like the execution of the meeting. But I imagine it's very conversational. It's a lot more just like open-ended questions to these caregivers. Like, yes, you're checking the literal boxes, but it's more of a check-in and it's more, it's formal, but also like very personal in nature. Describe, I guess, how those meetings go and your own experience or what you're hearing from your team.
Gabby (34:27)
Yeah, one of the, mean, one of our questions in those meetings is how do you feel you're making a difference in coworkers or clients lives? You rate your reliability on a scale from one to 10. How reliable do you think you are? And why did you give yourself that rating? Because it helps people think about, ah, am I really meeting this expectation? Um, I, I scored myself a nine. Okay, that's interesting. Why did you score yourself a nine? Well, I feel like I show up all the time. Well, in the last six months you've been absent.
five times.
Do you feel like that's reasonable? And what do you think the impact is to your clients or your team members when you are consistently absent from work? It helps people, yeah, kind of think through those values. With the growth mindset, we ask, know, where are they at in their personal and professional development and how can we help them grow personally and professionally? Are there aspirations they have in their life that we can help them achieve? And so
as we're going through each category in the performance review and we're scoring them, we're asking them, do you feel like we've scored you appropriately and if not, let's have a conversation around that and here's why we gave you a four in this category but maybe a three in this one. Do you feel like that's accurate? We can have a conversation around that.
Miriam Allred (35:50)
And what feedback do you get from caregivers about all of this? Like about this program, about this structure, do they love it? Do they thrive in this amount of structure? Like I'd imagine it's going well, but what do you hear from caregivers about, again, like this program and this structure?
Gabby (36:04)
We care consistently on our home care pulse reviews. We consistently see that people love the bonus structure. they especially are high achievers, right? Because they're getting a bonus and they're being recognized for their hard work. And you know, when I was a CNA in a nursing home, we all got the same 2 % raise. It didn't matter if Susie took a smoke break every single hour and I was running my butt off to answer call lights. We got, we got paid the same. And so it,
Jin.
I felt like that was a little unfair, but how do you fairly compensate those that are going above and beyond the call of duty? I think we've really found that in this program and how we really lift up and reward those that are going above and beyond the call of duty. I think those that are underperforming don't like this program and get weeded out because of it, because they don't like the accountability. They don't want to take the constructive feedback and make improvements. And they have never been held
this accountable to expectations in their life and they're not used to it and it makes them uncomfortable and you either really you you step up to the challenge and you thrive and you become a awesome part of the Kore Cares team or you constantly try to resist and but up against the way we've structured this and aren't happy about it. And in that situation you should you probably shouldn't be part of the team. Like we want we want the best at Kore Cares. So we want the best.
caregivers, we want to reward them, we want to take care of them, and so those that are exceptional are thriving and love this and that's what we want.
Miriam Allred (37:39)
You make
a lot of really good points. was just talking to someone about this, high achievers thrive in an environment like this, but then the underperformers or those that aren't motivated by things like this, it doesn't really impact them. But I like what you're saying is like, you have this really high standard, really high expectation and a program like this actually weeds out those people that maybe aren't a right fit for this level of culture. I'd imagine it has weeded people out and those meetings are points in time.
maybe to let people go or maybe to put them on a pip or something like talk about, guess, I know we like to talk about all the good, but maybe some of the good that is actually weeding out the bad.
Gabby (38:24)
So, I always say, like, I'm not out to fire people. I do not, for the unemployment rate of zero percent.
Miriam Allred (38:34)
Yeah.
Gabby (38:34)
practically
in South Dakota. We need to really help people rise to their potential. So that is our job as an administrative team. How do we help these people rise to their potential? We are not trying to catch anyone do something bad. We're trying to catch people do the right things. And if we see an opportunity for improvement in their performance or an opportunity to give them feedback, let's give that to them right away and let's give them the support they need to rise and shine. And so how can we support
you to succeed. Okay, we need you to work it on time. You're consistently 15 minutes late, which disrupts your entire schedule. We do a lot of short visits at Kore Cares, so we have one two-hour visits. And so when you're late, it disrupts the client schedule, but then it disrupts all of your clients throughout the whole day. And so we need you to be on time. How can we help you succeed? Do I need to go buy you an alarm clock?
Do you have an alarm clock? Like what's going on? Help me understand the situation behind you being late. And let's talk about this. Maybe you just can't be at an eight o'clock shift because you have to get kids to school. And so we have set unreasonable expectations for you to be at work at eight o'clock. Maybe we should start.
make your start time 830 so you have time to get your kids to school and time to see your clients. And so we really want to understand what's behind the behavior that we're seeing that needs to be corrected and how we can help them succeed. And then if we need to see as much, if we're putting in the time and effort to help people rise their potential, we need to see that back, right? And when we don't start seeing people positively respond to the feedback,
That's when we see a consistent behavior that we're trying to address and people aren't making necessary improvements. That's when the PIP start. And I don't think anyone's very rarely people are surprised when they're put on the PIPs, like because we've given them enough coaching and counseling that, OK, this is the next step. Like we want you to be here, but we need you to meet these expectations. And if from this PIP, if X, Y and Z is not resolved, we'll have to go to a verbal
warning, a written warning, and termination. But we don't want to get there. We honestly don't want to do that. We don't want to terminate anyone. We want you to help you rise to your potential and be great team member. So how do we partner together to make that happen?
Miriam Allred (40:56)
really well said. You give them every chance to succeed and you give them all the support, all the tools, all the resources, but then it really comes down to they have to put in the effort. They have to want it as well. This isn't in our notes, but I want to ask you about bonuses for your administrative staff. And this might totally derail us, but I imagine if you have a structure this formal for your care professionals, you've also thought through and structured something for your administrative staff. So I'm curious about bonuses.
Gabby (41:07)
Yeah.
Miriam Allred (41:25)
specifically for your administrative staff. Can you talk about that?
Gabby (41:29)
Yeah, I will say every year it changes. The reason it changes is because our business has evolved so fast and we've grown so fast that I feel like every year we need something different from our administrative team. And so we tweak it a little bit all the time. And so this year we're really focused on key metrics that we want to see as an organization and our each agency meeting those metrics.
Miriam Allred (41:31)
Okay.
Gabby (41:54)
And then it's also we're big on giving people bonuses based on a percentage of their earnings. You know, we also did something unique this year that we haven't tried, and it was a brand challenge. We don't have a structured marketer that I I do a lot of the strategic partnerships. I help with some of the I guess you could call it business development, but we don't have like some agencies have a business development like person. We don't really
have a person doing that. So it kind takes all of us to get the Kore Care's name out there and work together. And so we did this brand challenge and they got points if they got Google reviews and if they hosted an event, they, we had a bunch of different things they could do to get points. And then they could get fun things like an office upgrade, a walking treadmill.
PTO like what you know, we just kind of had a separate bonus program based on that branding challenge because we just really felt like we needed to get the Kore Cares name out there more but we wanted to work collectively as a team to get that done. So we had that and then we had like the metrics that we look at. We have these goals meetings every single month. We look at the metrics on the goals meeting and then we bonus based on how each agency if the each agency is meeting those categories on the goal sheet.
year we really had a strong focus on financials and so meeting certain financial goals and so there was a lot of emphasis around that.
Miriam Allred (43:25)
Okay, awesome. I love that brand challenge that you mentioned. I think most companies have a dedicated marketer and sometimes early on that's the owner, but then oftentimes they hire that out. But interesting that you don't have one, but then every single person is a brand ambassador, but then you have to like quantify that. Like how are we actually out there making a name for ourselves and building our reputation and actually quantifying that? And then I love that you're bonusing off of that. What was the success of that? Like did you...
Gabby (43:39)
Why?
Miriam Allred (43:52)
Did you track like new clients, new referrals, like what came out of that? I'm just curious.
Gabby (43:56)
Yes.
We are tracking new clients, new referrals. We've had another great year. We've been pretty blessed to grow at least 20 % year over year. And so we've continued down that path this year, which is what we want. And I think it has opened up new relationships and new opportunities for us and helped everyone think about, how can I be a brand ambassador and how can I help? People understand home care because people just don't even understand home
care. You know, how can we articulate that and get our message out there and get our message out there how we do things a little bit differently at Kore Cares.
Miriam Allred (44:37)
want to, if you think it's right, let's dial through your benefits and in context of your size and shape. So you mentioned six offices, about 200 employees. You mentioned at the start, one of your goals and passions with Kore Cares was to get to the point where you could basically offer benefits and help these caregivers have a livelihood and be, again, thriving and not surviving. And so I love how far this benefits program has come. And you offer a lot today and you mentioned a couple of things.
Gabby (44:42)
Love you.
Miriam Allred (45:05)
Can you just dial through everything that you offer as it stands today?
Gabby (45:08)
Yes.
So when I started in home care, we paid caregivers federal minimum wage, $7.25. And this is when I worked for a different company. And we offered zero benefits. We offered them a paycheck and opportunity to make a difference in clients' lives. That was it. If you look at the Home Care Pulse Survey, I had to pull it up to see if...
Miriam Allred (45:27)
minimum.
Gabby (45:35)
offering benefits had increased. They increased a little bit, still 30 % of the industry does not offer affordable benefits, PTO, dental, and I just think that's crazy. I do understand that.
there are some financial ramifications, right? And it does cost a lot of money to be able to offer benefits. So you have to be in a good financial place. But that has really been my driver to growing Kore Cares is to be able to continually add to our benefit package over time. And as we've grown and had the revenue to do that. one thing when we survey staff to figure out what they want, again, I don't want to offer benefits and no one really wants them. And the top things that people want or least our employees want ⁓ are health insurance,
PTO, retirement plan, and bonuses, top four. They're coming pretty strong. And so we do offer a health insurance plan. We pay for the majority of the employees premiums each month.
When you start adding dependents, it gets a little harder to pay for those premiums because they get quite spendy, but we pay for the majority of our employees' premiums each month. And we have what I would say good health insurance. I've seen companies offer things with really high deductibles or that have really high copays. ⁓ we want to make sure that the health insurance we offer covers a lot of those essential things at an affordable rate.
And then we offer, you know, flexible spending accounts. We offer PTO to all of our staff, which again, when I tell other people that we offer this, some people are like, well, of course everyone offers PTO. You know, if I talk to people in other industries, I'm like, not home care. PTO is honestly not a standard benefit for caregiver staff.
Miriam Allred (47:22)
Can
you talk about how you structure the PTO because also there's a lot of people, there's like debate around PTO for home care.
Gabby (47:30)
Yeah, so we do it based on how long you've been with us. So you get a little bit less PTO when you start. And then after you get over four years, we add to your PTO package. don't look at, I know some people look at like how many hours people work and it's on a cruel basis based on hours. We just do kind of a lump sum per year. It's accruing each pay period at a very standard rate.
And then we do have life insurance for all of our staff or all of our full-time staff. We pay for a life insurance policy. I've had a few employees pass away. That's pretty traumatizing, especially when you get really close to your staff. And I always felt like I want to do something for them. So we do pay for a life insurance policy for our full-time staff. offer Aflac, so we have a lot of opportunities for them to purchase a supplemental
policies. We do not pay for the supplemental policies, but we do have the options there for them to participate in, you know, cancer, accident, hospital.
those type of things. We have a dental program. We also have a 401k with a 5 % match. And that's really important to me because I want people that are passionate about caregiving and about this industry to be able to retire someday and have something in the bank. And I do these little videos for staff and I send them out. like, who wants to be a millionaire? It was one of them. I'm like, I, even though you're a frontline staff being a caregiver, you can be a millionaire when you were
and here is how you do it. You participate in our 401k and you take our contribution because it's just...
It's just free money essentially that we're putting towards your retirement. So someday you can have a life with no work if you don't want it or if you want that. So I'm pretty passionate about making sure people save for the future. We have the bonus program and then we also do SmartDollar, which is Dave Ramsey's financial wellness tool. We feel like not enough people really understand, even people in general, no matter where you're at in your career, people in general just don't understand
the
how to manage their money and how to find financial peace in their life. And this program really offers them the education and opportunity to build a budget and meet their financial goals and find that financial piece that they need in their life. And then we have a wellable program that is basically gives people points for exercising, eating well, drinking, taking care of themselves. Cause we're big on like, you've to take care of yourself so you can take care of other people. Like you need to
put into you just as much as you're giving out to other people. so making sure that our team is doing what they can to be the best version of themselves. And so we have a wellness program. They get points and they get rewarded for those points if they choose to participate. It's optional to participate. And then we have the CNA program where we help pay for their CNA certification. We have CPR program and then we also have some chaplain support.
if they need some spiritual support, have that as well. So we're really trying to make sure we have a comprehensive benefit program that helps people, like the whole person. Their spiritual, their physical, their health, their overall well-being, not just giving them a paycheck.
Miriam Allred (51:04)
I love it. love it. know that seems like kind of, you know, simple to like break down, but it just gives owners ideas like what's out there, what's possible. This might be hard for you to quantify. I'm not sure, but if you had to quantify like how much of your staff is, is, is taking, taking part in how much of your benefits, like how would you kind of break that down or quantify that?
Gabby (51:24)
It's hard because I would say about 50 % of the full-time staff participate in the health insurance.
There's quite a few part-time staff that participate in the supplemental policies and our 401k we have a high adoption rate because we have a two we automatically enroll people at 2 % so They are enrolled in our 401k and they have to opt out of it. So there's a pretty high percentage of people that Elect to just continue, you know with that auto enroll in our 401k the people we see that don't you know
want to participate in 401k are typically the college students that maybe need the money to get through school and probably not going to be here, let's be honest, forever. And they realize that and don't want to have to deal with switching their 401k somewhere else. So we've got some of those younger ones that don't participate, but otherwise we have a pretty high participation rate in our 401k.
Miriam Allred (52:27)
What about
Smart Dollar and Wellable? What's the adoption right there?
Gabby (52:31)
So I just looked, we had about 90 participants out of 200 in Wellable in our last challenge. So we have a pretty good participation rate. And then Smart Dollar, we pay for about 60 seats, essentially, in Smart Dollar. And we are about at capacity there out of 200 people. So.
I pretty good. I understand some people already know how to manage their finances or don't have an interest in that. So we knew that not everyone was going to participate. So our guess was about 60 and we hover around that 50 ish mark, I'd say.
Miriam Allred (53:12)
But I personally think those are great numbers. ⁓ know, like 40 to 50 % participating in something like that, that's just totally optional. But the way that I look at it is like the value it adds to one life, like one care professional that's taking advantage of Wellable or Smart Dollar and the impact that it's having on their life. Like yes, as a business, you have to make decisions that are smart for the company and the drive ROI, but the impact that those programs have on these, their individual lives and on their families, like that impact could be massive. And you probably.
don't even know the extent to which that will impact them in their lives, but giving them that opportunity to learn and to progress themselves is just massive. And that's what this is all about, right? Like back to your why is you want to help them thrive and to be just better individuals as a, as a professional, but also in their personal lives. And this gives them the tools to be able to progress.
Gabby (53:50)
Right.
Exactly. One of our values is making a difference and so I want to make sure that we're making a positive impact from an administrative side on our care team. And so just got to find unique ways to be able to impact people's lives because everyone's on a different journey. So it's really hard to like, do one thing that will benefit everybody because everyone's in a different place. And so you kind of do a variety of things to be able to make a impact in as many lives as you can.
Miriam Allred (54:27)
Mm-hmm.
So think back to younger Gabby, maybe five or six years ago, knowing what you know now about wages, about bonuses, about benefits, what do you wish you would have done sooner or what do you wish you could go back and tell younger you about everything that you've done and everything that you know now?
Gabby (54:52)
You know, I don't know that I would have done a whole lot different just because there was financial constraints, to all of these things and being able to grow. But I think I would have told myself to be patient. It'll come because I think I always want things now. Like I want to grow faster now so I can afford to add this to our benefits package or afford to do that for our team or what have you. So I'm always just like, I want the growth
now faster so we can make a bigger impact in the world but
Honestly, a slow burn is sometimes better because then you have the opportunity to really garner the feedback and live in the moment and really be aware of your surroundings and what's going on. When you're on this high growth trajectory, sometimes you don't have the opportunity or you grow too fast to really, you do more harm than good. You're not making good decisions. You're just flying by the seat of your pants. So I think I would have told my younger self
just to be patient and I think we've done all the right things like to be able to just consistently keep in the back of our mind that our why why we're doing this why we're growing and then Remember like okay. How are we enriching the lives of our care team and what can we do? ⁓ Just kind of always keep that and hopefully we continue to keep that in mind as we continue to grow is like how are we enriching the lives of our care team so they can enrich the lives of our clients and how are we giving people the
support they need to live their best lives whether it be our clients or caregivers. So I think that's just really important for me to keep forefront as we continue to evolve.
Miriam Allred (56:40)
And what would you say to owners that do have the resources and the financials to offer benefits, but say our employees don't want it, our employees don't need it. Cause there are owners out there that still again have the resources and the finances, but don't think their employees need it or want it. What would you say to that?
Gabby (56:58)
Have you really asked? Have you sent out a survey and thought what's important to them? And what do you feel is your social responsibility to the world? A piece of this is I feel a little accountable to doing what I can to support the team. so can you sleep at night knowing that you have the ability to afford these things, but choose not to?
I know that a lot of people grow for a lot of different reasons, but if you're just growing to fill your bank account, is that really fulfilling to you? Is that
fulfilling a higher purpose? And I guess for me, I have some deep faith that guides me and I feel like we're all put on this earth to make it a little bit better and to make a difference. And this is just the way I feel called. And so maybe owners just need to understand their why, what are you doing? Why are you growing? What's your purpose and are you making a positive impact in the company or in the world? ⁓
putting a log on the fire that's going to help make your community and your state and your culture better? are you putting a log on a different fire? And where's your why and what kind of impact and what kind of legacy do you want to leave?
I just don't want my, I want my legacy to be that I did everything in my power to take care of those that care for our clients. So, I feel that strong desire and other people just may not feel that, but I just, I feel like we need to care for our care team because if we don't, this business isn't worth doing. So.
Miriam Allred (58:48)
Gabby,
so well said. Thank you so much for joining me in the lab today. There's a reason why I interview people like you. I want everyone to connect with you. You have so much to offer and you have learned so much and you're so gracious to share everything that we talked about today. Again, I appreciate you being willing to share the details of your programs. And that's my personal objective. My personal why is to help people like you tell their stories, share what's working so that we really can elevate home care because we all win when we're elevating each other.
Thank you for joining me and thank you for everything that you've shared today.
Gabby (59:16)
Exactly.
Yeah, it's been great. Thanks for having me.