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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 (00:00.95)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's great to be back with everyone here in the lab. Today I'm joined by Dana Charumbira, the Managing Director of the Home Care CPAs. Dana, thanks for being here in the lab.
Dana (00:16.437)
Yeah, thanks for having me, Miriam.
Miriam Allred (00:18.7)
We've talked a lot over the last few months and I have been thinking about this topic in the back of my mind of like breaking down a single hour of home care. And so you and I are about to nerd out on numbers and finances and data and home care. And I'm just really looking forward to this. I think a lot of people know you and have gotten to know you a little bit better over the last year or so you've been on stages, you've been on podcasts and webinars, but
I want to have you introduce yourself. Talk to us a little bit about your personal background, maybe life before you were a CPA, life before home care, and then the current firm and what you're up to.
Dana (00:56.543)
Yeah. Yeah. So it's great to be back. I'm excited to be on the podcast and impact some numbers. Financial analysis is something, especially in the home care industry for me, that's really exciting and just talking through numbers and how that impacts the agency. So I'm excited for today's topic. But before we jump in, yeah, so a little bit about my background. So we've been working with home care agencies for close to five years now has been our primary focus. So we do a lot of the back end support, billing, payroll, accounting, financial analysis, tax, and
I've been a CPA for 15 years, which is funny because when I first started working, I was like, I really want to say I've been doing this for a decade. And I feel like now that I can say that, I'm like, my gosh, that sounds so long. I, yeah, I've had a, I had a really interesting like corporate path. So I started out of school, an accounting firm. I was in risk consulting, which was interesting, like learning internal controls. I moved into a corporate headquartered in Chicago, which took me overseas. So I lived.
Miriam Allred (01:32.684)
Yeah.
Dana (01:56.361)
in South Africa for a number of years. And that was just a really transformative experience for me professionally, personally, in a lot of ways in life. And with that organization, it was a great way to learn the ins and outs of accounting and then also how that translates to a business and the performance. And I feel lucky that I can then translate that for home care agency owners and just have real conversations around like, are numbers doing what they're doing?
If you make this change, what does that do for your agency? And then for me, being able to layer in like the people aspect of it. So one of the biggest things that I've experienced is just the impact that opportunity and having a purpose in your work, that impact it can have on people's lives. So clients' lives, caregivers' lives, employees' lives, it just can touch so many people. And that's what I love about home care and I love about talking with home care owners.
They just really care. And the ones that really do care for me tend to be the ones that have some of the strongest financial performance. So yeah, it's been a great fit. We're consistently and constantly trying to evolve and improve what we're doing and really remain relevant and topical. So digging into industry trends and what's happening there for us is really exciting and keeping up with the pulse of what's going on.
Miriam Allred (03:19.144)
Awesome. Well, thank you for sharing all of that. As you were sharing, I was having this flashback to, think when we first maybe met or you emailed me, I think I was at Home Care Pulse and you were one of those just like obsessed with the benchmarking study. I picture you have it like by your nightstand and you're like reading at night. And you even just said to me while we were talking about this, like you're so excited for the new study to come out. You've just always been like in the trenches of the numbers of home care. And I think that is just reflective of you and what you're passionate about is
Dana (03:33.237)
Yeah.
Miriam Allred (03:49.142)
It's all about the care. It's all about the people. But behind the scenes, there's money, there's finances, there's legal, there's risk, there's all of these kind of mundane things. And I was just saying to you, we're about to like nerd out on this topic in a good way. Like we need to get into the nitty gritty. Every business needs to be thinking about where and what every single dollar means to them. And so I want to start by talking about like shift duration. And I want us to start with the
the standard kind of eight hour shift. You and I have talked about that as like maybe the gold standard is like that eight hour shift. And so let's talk about the gross margin for that standard eight hour shift. And then for context, we're going to talk about longer shift durations and shorter shift durations and by different payer types today. But let's start with this again, kind of gold standard eight hour shift. Why, why would you maybe consider that the gold standard and what does a gross margin typically look like for that eight hour shift?
Dana (04:44.117)
Yeah, yeah, so I think eight hours is a good base case. I think that for a lot of reasons, it's kind of what people gravitate towards as like a great case would be, you know, a standard 40 hours a week. It's, you know, for staffing purposes, it meets a caregiver need typically that wants full time. You're not going into overtime. It's kind of for me that, you know, eight hour shift to from a pricing perspective is somewhat.
will fit in like a client affordability metric. Because when you start to push into like a 12 or 24 hour, then you have different thoughts around other options. So I think eight hours can tend to be one that we sort of think of as like a standard case. So I'll unpack the numbers that I think through when I'm analyzing these cases in terms of like shift duration. And I do have a spreadsheet. I am an accountant. So I'm going to pop into that and just kind of talk through.
some of the assumptions and I think really pausing and unpacking why some of those are built in there and sometimes what agencies miss when they're thinking about it. So when I'm looking and thinking about an eight hour shift, a lot of times, so kind of backing up, we look a lot at gross margin as an industry and I do think that's important to measure. And that's where payer source comes into play because there's different, I think with different payer sources, you have different.
parameters or guidelines around what a gross margin should be or is achievable. And a lot of what I'm talking about right now is a private pay shift. These are private pay shift assumptions, because a lot of the times, if it's claim-based like Medicaid, VA, anything with like, you know, some of the triple A billings, those are typically going to be like a standard reimbursement rate. They're not going to necessarily vary by shift length. So lot of this will be like a private pay discussion for now.
So typically, if we want to in private pay achieve like a 40 % 45 % gross margin, that's what we target. And there's some variability there too if it's a franchise versus non-franchise, because franchises, typically have a royalty fee. We tend to include royalties in cost of sales. And there's different schools of thought around that. Our position on it is because you're paying that franchise.
Dana (07:01.313)
royalty fee when you're incurring revenue that it is truly a direct cost of the sale. Others put it in overhead. For the numbers I'm gonna talk through today, I'm not assuming that there's any royalties included just as sort of a baseline for everybody. Just in case you're not putting it there, you're not a franchise, we're all on the same page. So a lot of the times what agencies will do, and this typically does achieve that 40 to 45 % target, is they'll take their caregiver pay rate and then they'll double it and set that as their price per hour.
So the first example I'm gonna talk through on an eight hour shift, I've assumed that my price per hour is $36 and my pay rate's 18. This number varies geographically. We work through agencies all across the country. One of the things that we look at closely is their average pay rate and their average price per hour, especially when we're looking at gross margin fluctuation, because those are the two drivers that volume is one thing, but typically the driver is going to be the fluctuation in one of those two numbers.
Dana (08:01.227)
So that's a pretty standard sort of simple way to think about, okay, my price per hour, or sorry, my pay rate per hour, double that. And then what happens though sometimes is, and there's different people that interact with this number, right? So there's the agency owner, the leadership, if you have an executive director, director of operations, then you have like a recruiter and a scheduler. And so a lot of the times people take that $18 as like that cost for that hour.
and they sort of skip out on what else goes into that total like hour cost from an employment perspective. So we tend to layer in, and this is sort of what we've just developed is like our standard when we analyze everything. So that the employer tax on that $18 an hour, which is FICA standard. So that's the federal, like your social security and Medicare, that's 7.65%. And then usually there's a state unemployment tax, which
That varies based on your state, based on unemployment claims. For the numbers we're talking through today, I've assumed 3%. And again, that can vary. And then there's usually workers comp. It's pretty much required everywhere. And again, very much varies by the state as well as claim history for an agency or if it's a newer agency, sometimes there's a higher rate applied as they're working through things. I've assumed 2 % for this one.
So if you're in California, number is going to be higher tip most likely. If you're in New York, that number is going to be higher most likely. It really is a lot dependent on the state that influences that. So when I look at the total cost, I layer all those things in on that $18, we get to $20.28. So really, you're looking at that when you take a cost of care, you're looking at 1.25 or 1.3 times that.
price per hour, or pay rate per hour to get like to your total cost. And so when we do the numbers on that, if we're looking at a $36 price per hour, and we reduce that by our $28.28 in our total cost, we come out to a gross profit of $15.72, which is a gross margin of like 43.68%.
Dana (10:21.739)
So that's the gross margin aspect of it. And then if we look at like, what's the total dollar amount earned on that one shift. So if we just take our gross profit times our number of hours, that's $125 and 78 cents. Getting very specific in my accounting right now. And then the variable here that there's some assumptions built into which overhead will impact on it probably a little bit later more so, but I'll talk through.
Miriam Allred (10:36.685)
great.
Dana (10:48.961)
how I think about it when we're looking at assigning those costs to the shifts themselves. So if we're looking at an agency, and I use 4,000 hours a month on average at this $36, that's an agency that's like 1.7 million in revenue that I'm using to kind of set my overhead rate. So I'm gonna assume a 40 % gross margin and then,
Overhead of about 40 grand a month that gets me to a net income of two hundred and eleven thousand dollars, which is twelve percent return on sales Return on sales varies. The most recent benchmarking report had it around seven percent We see agencies typically between like five and twenty percent. So twelve is a fair number and I'm just kind of fact-checking like my my assumptions around what my overhead rate that I'm going to apply to the shift is
So what I take there is that assumed overhead number per month of 40,000 divided by the 4,000 hours of care. So that means that my overhead costs, which is my admin salaries, my rent, my recruitment, any technology fees that you're paying, that's about another $10 an hour that we need to layer in to that shift cost to get to like that true net profit for that shift. So if we reduce that 125,
If we're assuming it's an eight hour shift, we take that 10 times eight to get to $80. So our net profit is like $45.78 on that shift. Profit per hour is about $572. And then the total client bill on that one's gonna be like $288 for that eight hours of care.
So that's the unpacking of an eight hour shift and the metrics around that and sort of in line with what we're seeing, hitting some of the targets for gross margin and then the overhead spend.
Miriam Allred (12:50.826)
Okay, great. I'm taking notes and I've got a lot of follow up questions here. That was great. I know that was maybe a little hard for... Well, people can follow that. This is going to be a section where you re-listen to it several times, so write all that down. But no, so a couple of questions. First, starting with, I love what you said about the easiest...
Dana (12:53.249)
Bye.
Miriam Allred (13:10.442)
most like simple place where people start is like take their hourly wage, multiply it by two and that equals their rate. And so a lot of people listening to this have probably done that and that's okay, you know, but you're kind of falling into a trap where there's all these additional things that need to be layered in, which I like what you were talking about. I want you to just run through all of, there was maybe like four or five things that need to be layered into setting that hourly rate. Can you rattle those off again? It was like employer tax.
and workers comp. Can you just mention all of those layers one more time?
Dana (13:42.943)
Yeah, so like the broad, how I broadly think about it is there's employer tax and workers comp. And employer tax can be broken down into FICA, which is the federal part of it, which is Social Security and Medicare. That's pretty standard at 7.65%. It does stop at $176,000 of income, but we're probably not gonna hit that number with what we're thinking about from these economics. And then...
The SUTA, which is the state unemployment tax, that's the other part of those employer taxes. So combined, I like to say that the employer tax is around 10 % is my general assumption. And then your workers' comp, and that really varies. And your workers' comp policy will tell you what it is. It'll say like that caregiver wage category, what is your dollar per $100 of coverage or the actual rate. And that depends on how your workers' comp is structured.
You can look at your workers comp policy and pull that number. So I've assumed 2%. So typically if you add the two, that's like a 15, 10 to 15 % bump on that pay rate.
Miriam Allred (14:52.014)
Okay, and then you were talking about overhead. Do you factor overhead into the hourly rate or you do not?
Dana (14:59.341)
I typically don't. I typically think about overhead as something that we look at, like what's our gross margin or gross profit, and then we reduce our gross profit by our overhead spend. The trick with trying to load overhead into your price is there's a lot of assumption that goes into it. You could price yourself out of the market, especially if you're a smaller agency and you're trying to price like 20 grand across like 200 hours.
Miriam Allred (15:12.919)
Okay. Okay.
Dana (15:28.933)
or you could, know, it just, it moves too far away from me anyway, from the market rate to try to like build that in. And then I think it's already confusing enough if someone's not like super into the numbers to then say like, and then you multiply X by Y, and we're getting like into an algebra lesson for, know, someone that's just trying to fill a shift. So I don't load overhead into the gross profit or into the price.
Miriam Allred (15:54.796)
Okay, okay. This is super helpful. Again, I think you and I talked about this. think smaller agencies aren't quite thinking about this, but I like how you're simplifying this. It's like, okay, there's employer tax and there's workers comp. And here you're sharing kind of like general rates, but they can look at their policies. They can look at their state rates and calculate that exactly. And then literally tack that on to their rates. So it's scientific and it's formulaic, but it's based off real numbers and
just makes more sense as you scale the business. The other interesting thing that you were talking about is seeing this through the lens of different roles, the way an owner perceives these numbers versus the way that a scheduler perceive these numbers. Talk a little bit more about that. You've worked with lot of owners and a lot of agencies and you've probably talked to maybe schedulers, recruiters, salespeople, and you kind of see both angles of like how an owner sees these numbers versus how office team sees these numbers. What do you want to share on that?
Dana (16:51.521)
So typically, an owner, can talk, and depending on the owner, right? So each owner has their strength and each owner has their interests. So some owners will really talk through like the nitty gritty around like, okay, here's our price per hour, our pay rate per hour. And how do we get there and let's unpack it and what can we tweak? Whereas a scheduler, they're trying to fill a shift. So they need a range. They just wanna be laser focused on, okay, I can.
pay $18 to $19 or $18 to $18.50 for this shift. The big thing, I think, with the scheduler is a lot, not a lot of times, but sometimes they're kind of scoped out of like the measurement of that number in hindsight. So they're kind of given this number and then life happens, right? So they might have to fill a shift because there was a call out. So they had to go above that, or they have caregivers that are just starting. So they came in at a lower pay rate. They can take a shift.
The big thing there, I think, is feeding back to that scheduler at the end of the month, like, hey, here's what your average pay rate per hour was, and here was the target. And it's really helpful because it brings them into that conversation, and it's not so much of like, here's the plan. We want you to execute it, but we're not going to really share feedback on how you're doing against it. And then it helps them, and it helps the agency bring, start to correct, if things go in a different direction.
But if we're just like sitting on this information or we're not sharing it and not, you know, helping understand why it's going a certain way, you know, then we aren't able to like correct it or to improve on it or give that schedule or training or ideas and help them improve in their role.
Miriam Allred (18:26.944)
You and I both know there's a lot of fluctuation in home care. If you're not managing these margins and it starts to slip, you're six months in, it's like, my gosh, our gross margin has really started to slip. It's like, whoa, you have to be on top of that with say the scheduler month over month so that six months into it, your rates aren't outrageous or slipping and you're like, whoa, how did we get to this point? This is a separate conversation, but a lot of agencies are starting to bonus.
Dana (18:37.024)
Yeah.
Dana (18:56.161)
I was going to say that. That's a great incentive. Yeah.
Miriam Allred (18:56.608)
and compensate an incentive. Yeah, speak to that. Why that's working so well for a lot of businesses.
Dana (19:02.837)
Yeah, so, and this is a conversation we're starting to have more and we do have, we're working on an incentive guide for agencies to kind of share like different roles in the agency. Cause you know, there's traditionally been a compensation structure where the marketing or the leadership is bonused on certain numbers and there's different ways to structure these. But we have started to see more of an interest in agencies bonusing at different levels within the organization and bringing everybody into that compensation planner structure.
And it's a really, for me anyway, it's a great simple number, because sometimes they can get really complex. And then you say, OK, if you hit this for these three months, you get a quarterly bonus of $500 or whatever it is. So it doesn't have to be tied to like sales or anything overly complex. It's like, here's the number. If we hit it, here's the bonus. And so we've seen that be extremely effective with making someone's work.
It's always valued, right? But then when you're putting a number to it that they can work towards and that they can earn more, it just tends to lead to an outcome that's better for everybody.
Miriam Allred (20:06.762)
Exactly. And for the most part, people thrive in transparency. It's, you know, These schedulers, they see the rates, they see the wages, and they want to understand how these numbers and how this actual revenue like move the business forward. And so tying them to those numbers is really empowering and satisfying for them.
Dana (20:13.931)
Okay.
Miriam Allred (20:28.398)
So let's keep going and talk about longer shifts. So we kind of started with the eight hour golden standard because that's kind of what everyone strives for and everything kind of fits nicely around that, but let's go longer duration. So let's talk about those 12 hour shifts and those 24 hour shifts and how you think about correcting those rates for longer shifts. And then we'll go the other way and talk about shorter shifts. So what are your thoughts around setting rates and margins for longer 12 and maybe 24 hour cases?
Dana (20:56.979)
Yeah, So, the thing there is you're really trading off the duration of the shift in the gross margin. There's a play there. So it's really hard to achieve that 40 to 45 % gross margin. So your volume of billing is going to go up, but most likely your margin, the gross margin on that's going to go down. So how I looked at it, and I modeled all 12-hour shifts, is...
If we keep the same economics, so that $36 an hour, the pay rate of $18 we're achieving that 45 or 43 % gross margin. Our gross profit is $189 about. And then we layer on $10 per hour overhead at $12 an hour is $120, net profit of around $69. It's going to get us the same profit per hour. That client's bill in that month is going to be like $9,360.
So that's where it starts to like, you know, the affordability and that's where a lot of right now with private pay we're seeing and that's why there's these different shift durations that are becoming interesting is like, care is expensive and people are trying to find like what is most optimal for their family and their loved ones. And so when you start to get into those numbers, they might look at like, does assisted living make more sense or do we need to do something else? So that's where like that trade off.
comes into play where you might bring that price per hour down, we haven't seen a huge change in like the pay rate per hour with that. So I assume that that's constant in this scenario. But if we bring your price per hour down to 31, and I brought it down there because our gross margin is around 35 % on that, that brings that client spill down to like $8,000 a month. Still like probably a question around like, you know,
Is that something that we can afford? Can we keep mom or dad at home at that price? If you come down much lower though, I would say like 30 % maybe as a gross margin target.
Dana (23:10.293)
But those, and it depends on like the shift scheduling and how the schedule is because sometimes those can be a lot to schedule or they can be easy to schedule because you get a caregiver or two on there and then, you know, they're consistent. So there's not a lot of like overhead support or it can be something where you're constantly turning caregivers. You have to recruit more. And that's why I wouldn't take that gross margin down too low just because the variability of that aspect of it. You don't want to expose the agency to like just losing money on the case. If it does become something where there's like a lot of.
changing caregivers and recruiting and scheduling time spent on it. And at that point, you're still making, know, your profit per hour is quite low. You're like about a dollar an hour, but you're looking at the volume really at that point. And that's where those shift length, that's where it's kind of like a tricky one when you go higher to achieve some of those margins and then like, what's the true profit on it? So we like to keep like a close eye on those.
and really make sure that it's making sense for the agency.
Miriam Allred (24:11.566)
Okay, this is good. So to make sure I'm hearing this right, for the eight hour shift, we were talking like 40 to 45 % gross margin. You're saying for a 12 hour shift, you know, maybe strive for like at least a 35 % gross margin with the maybe bare minimum being maybe that 30 % gross margin.
Dana (24:29.877)
Yes, and I think one of the things here that if someone is like really gonna like pick this apart and this is what I think about too is like that overhead number is kind of high, right? Because we're assuming that it's $10 an hour across 12 hours. That's a hard like, unless you're really tracking time around like, okay, how much time was spent scheduling this 12 hour shift or we, you know, do like a true time study, which we say, okay, we assume that there's actually only four hours of overhead spent. That's where there's variability.
I just kept it as a standard one because it's already a lot to talk through and visualize. But if someone really wanted to pick it apart, that's where I would think from a 12-hour shift interrogating the profitability around it is that overhead piece of it.
Miriam Allred (25:11.918)
Okay. I think this is good though. Thinking, I don't know if a lot of businesses are doing this, but unpacking their gross margin per shift duration. Like this is reminding me of like breaking down referrals and revenues by different payers. This is like, now look at all your shift durations. And I don't know, every business is different. Some people have minimums, know, a six hour minimum and eight hour minimum. And so if that's the case, this looks a lot easier, but for some agencies they've got two hour, four hour, six hour, eight hour, 12 hour, 24 hour, like
Dana (25:20.289)
Yeah.
Miriam Allred (25:40.162)
That's a lot to unpack, but this is really good analysis, like looking at all of your shift durations and understanding what your gross margin looks like for each of those so that you can forecast so that you can understand like what your revenue looks like month over month and year over year. So, so this is really, really good and really interesting. Do you have more thoughts on like 24 hour or did we want to just stay at 12 hour?
Dana (26:01.537)
I'm all about 12 hour. We don't see a lot of 24 hour live in. There are some 24 7 cases. I would say.
the economics on it probably aren't too different than a 12 hour and that there will be some trade off. And that's, might be able to go like a little bit lower on the gross margin, like 30%. But again, that overhead part of it is where we see that could be like the burn or the spend on it.
Miriam Allred (26:33.262)
Okay. Okay. Yeah. I think that makes sense that it's similar to the 12, but you're right. This overhead is always the factor of like how much work does the office take to schedule and manage these longer, longer cases because oftentimes they do. Let's go the other way. Let's talk about four hour shifts because I think that's also a pretty common one. We're seeing a lot of that. And then we'll go to like the micro shifts, which is a whole nother topic, but I want to hit on that like 15, 15 minute cases, 20 minute cases because we see agencies doing that. But
Dana (26:42.049)
Mm-hmm.
Miriam Allred (27:01.346)
Let's start with the four hour shift. How do you think about the numbers and the margins for four hours?
Dana (27:06.699)
So I did a similar exercise where I applied the same economics that I would for...
the eight hour shift. So I did bring the pay rate per hour up on this one to $19 So typically, this is how I've seen it and think about it. On a shorter shift, depending on the caregiver, and this is where knowing your care staff and knowing their preferences, a shorter shift, typically they'll want to be paid slightly more than they would on an eight hour shift. But if someone just wants five days of four hour shifts because it works with their kid's schedule or something, then you know.
you might not have to do the pay rate adjustment. I'm assuming though that there's this trade off of like shorter shift, a little bit more pay. So that gross marginal, and then you, so you're just basically taking the same thing. You're doubling that $19 an hour. You're landing at 38. We're going to hit the same gross margin of 43.68%. This is where there's like a big shift because on that eight hour shift with the economics of doubling your pay rate, you're hitting a net profit of 40, about $46 an hour.
When we look at that on a four hour shift, you're basically hitting $26 an hour of net profit. And so this again kind of goes back to that variability around like the scheduling and the time consumption. There's the argument that they're harder to staff and sometimes, you know, they require more effort from the overheads, yeah, the office staff. And then, you know, there's that overhead burn. So what I think for agencies to really think about is
you know, we need to move away from just that taking that higher pay rate and doubling it. There's like a shift premium that would be applied to a four hour shift. And when you're looking at like the shift economics, for me, the four hour shift makes a lot of sense in a lot of ways. So if we bring that pay rate up to 19, which I think is a fair assumption of a dollar an hour or more. So our price, our pay rate per hour goes up like five and a half percent.
Dana (29:15.969)
I would say you want to bring your price per hour up around like 13 to 14%. So we're taking that up to $43 an hour. So our gross margin on that is higher. It's around 50%, but that helps with covering that overhead cost. So then we're hitting back that net profit that we were on an eight hour shift of 46. So.
It makes sense for the agency, it makes sense for the caregiver because they're getting paid a little bit more. And then I also believe it makes sense for the client. So if we look at the billing on that eight hour shift for the client, they were at $288. If we're looking at that billing for a client on the four hour shift at the $43 an hour, they're paying 172. So it's $116 a shift less than they would have paid for eight hours. So.
For me, this makes a lot of sense for everybody, because the agency is still hitting a profitability target, the caregiver is getting paid more, and then the client is still able to access care, but not at that almost $300 a day mark using those assumptions we had.
Miriam Allred (30:21.804)
What about changing it to a flat rate? Like you mentioned this premium rate. I don't know if we're like using those words synonymously, but talking about transitioning to a flat rate rather than an hourly rate for say these four hour shifts.
Dana (30:35.713)
Yeah, so like we'll see that especially if like a client's doing like a two hour, you know, they'll say like $100 or whatever for two hours and it's just like an easy you could you could do it that way this for me was helpful to do like the cost build up and like a per hour perspective so you would take that 43 and times it by four which is What 162 no 170 172 diary did that math? So you maybe say like four hours for 175 or something like that. Um, and that's where I would say
from like a marketing perspective to like what lands best with a client, you know, is the thought around it 175 and that's, your day visit versus 43 an hour, that might be an easier sort of phrasing of it. So yeah, that's definitely something that we've seen just help kind of market that piece of it, the four hour care.
Miriam Allred (31:30.21)
Yeah, pricing for any business is always like the hard question of like, how do we price this? And like you're saying, it's like, you know, there's always like numbers on the spreadsheet, but it's like another thing to go out and market this. And does a flat rate for a four hour shift sound appealing to people because that's just easy math and easy for them to like understand, or does the hourly rate make more sense? Like, I think that's interesting. I also see more flat rates for shorter shifts, but...
I think it's possible and could be interesting to experiment with that for even like a four hour shift and see if it lands with people. Explain to me, I think I'm not quite picking up like this, like you're using this word like premium and what that means like on the spreadsheet, but also even communicating that to people. Like when you say this, like charging that premium, what are you saying exactly?
Dana (32:20.737)
So what I'm saying is, I wouldn't say that to like a client, but internally thinking about we don't just want to take our pay rate power and double it. We need to charge a premium on that shorter shift because of the fact that basically like our kind of not like the clients buying access to a shorter like care shift, but there's this premium to achieve like profitability metrics that we would see on an eight hour shift.
Miriam Allred (32:50.958)
Okay, that makes sense. wanted to make sure I was just understanding like how you define that and that makes sense. And it also comes back to that higher wage. We charge a premium because we're paying a premium. I guess that like makes sense in my mind is like we have to pay the caregiver more. So we have to charge a premium to the client. Let's talk about the really short shifts. I don't know if you're working with anyone that does this, but again, it's, it's kind of maybe an up and coming topic a little bit. think just there's some businesses that specialize this in this. And so
Dana (33:00.543)
Good night.
Miriam Allred (33:20.876)
Talk about these maybe 15 minute cases or 20 minute cases and what that looks like.
Dana (33:29.259)
So yeah, we're starting to see like some of these shorter visits. And I do just think as the cost of care increases and agencies are looking for ways to meet client needs of access to care, these are ideas. And then the other thought is sort of like you build that client relationship and you expand care from there and there's additional time spent.
not the trap, but What sometimes will happen is to incentivize that caregiver to take the shift, you probably have to pay more than you would have to like on that four hour shift per hour. And then you're also potentially going to be paying, know, depending on the state, depending on how this is all structured, like potentially travel time and then also mileage.
And then the other thing that happens is, you we talked about a scheduler sees the price per hour that's being charged. They sometimes can think about being like generous with the pay rate then, and then they want to fill the shift. so it really fall, you know, agencies can fall into this trap of like, Hey, we're billing $50 an hour. You know, we're paying 22. That's sort of the example I have.
And at that point, you're actually losing. You're actually losing money. Just if you assume, you know, that there's mileage time spent, there's travel time spent, and then assuming overhead. And that's the really big one on this. The shorter shift. Before an agency does it, I really think they have to think through, like, how are they staffing these and like, how are they being structured so that your whole scheduling staff isn't consumed by trying to find someone care for 15 minutes or like an hour, whatever it is.
And so on this one, like, and I looked at sort of an hour of care, and we could break it down if we divided by four. If we think about that $50 an hour, at that point, you're you're losing money, I would say for an hour of care, like a very short like a one hour shift, you want to charge like 1.8 times what you're going to charge regularly. So that $50 would become 65. In this example.
Dana (35:50.113)
You could, I don't know about doubling it all the way, but yeah, 1.8. So like 65 for that hour of care. And that way you're still like your gross margin is assuming that there's 10 miles of mileage at the IRS rate of 70 cents. And then assuming that there's 30 minutes of travel time loaded in there. Cause if they're not like, if you have to drive to the client or like you're stacking them and you have to pay travel time, that's sort of a reality that we have to deal with. So your gross margin is closer to like that 12 hour shift of 34%.
Your profit per hour is pretty good though if you assume that your overhead is only $10 and that's kind of the the debatable part of it So you're hitting like 1222 an hour in profit So really the big takeaway for me on these micro shifts, there's two of them Anyway, there's making sure you're pricing it at a price point that is truly profitable for the agency Which is most likely higher than kind of what they're thinking about right now And then you're staffing it in a way that's strategic
So either you're stacking the shifts and so everybody's kind of in like close vicinity to each other, maybe like an assisted living facility where you're doing these like short visits or you're in an area that's populated in a way where you're kind of short time between clients and you're able to stack them. Or maybe you have somebody that splits time between the office and we'll do like care visits. you you're not having to like spend time scheduling that person. Like they're already kind of committed.
to those 40 hours in the weekend, like this is part of their responsibility. If the program is big enough and if an agency already has sort of like a floating caregiver that will fill in for call-offs, you could also make this part of their responsibilities where they'll do these shorter shifts. You don't want to fall into like, okay, I have an hour, I got to call like my whole roster and see who's going to fill this. So really just thinking through the structure of it and how you're going to staff it. I do think it.
if done in the right way, can be profitable. And the big thing I think in the home care industry is people want people to be able to access care. Like profitability and numbers are important, but at the end of the day, if someone needs care, we want to find a way to make that happen. So this is a great example of that. The balancing part, you know, when I think about that though,
Dana (38:10.187)
The reason it's important to keep the eye on the numbers is we want the agency to be sustainable and be able to grow and continue to do this. So we have to do this in like a very strategic way. And especially if an agency is already kind of profitable, they have their fixed costs covered. I would say getting into a program like this is great because you can figure it out and see how it works and like refine it. If it's something that you're going to like come out of the gate with and try to build your agency around, I think that could be a little bit of a challenge in my...
Take away from other things that you're trying to do as an agency when you're getting started.
Miriam Allred (38:45.43)
Yeah, I, this is so good. I love what you're saying here, cause I am hearing this more and more that agencies want to be able to serve everyone in their market. You know, as you grow that business, When you first start out, you have to kind of take everything and then you go through this period of like specializing, like this is our, you know, ICP, this is who we really want to focus on. But then as you get bigger, it's like, we want to be able to say yes to everyone from a payer perspective, from a duration perspective, from a needs perspective.
Dana (38:55.393)
Mm-hmm.
Miriam Allred (39:13.228)
And that's why this conversation is so relevant because you need to know your margins for every different type of shift duration. And we're just talking about private pay and we could get into VA and long-term care and Medicaid. That's, know, those, those numbers look different, but this is so important to know your margins for each pay or tie or for each shift duration, because it does vary. you know, every dollar does matter when we're breaking it down in the weeds like this. I want to shift gears a little bit. That was.
Amazing, Dana. I know you have your spreadsheet up in front of you. We might have to share something like that so people can conceptualize all of this. I'm over here taking notes, like writing all this down. But I want to ask just kind of a variety of other questions that are just like little factors and layers in this. You were just mentioning like travel time and mileage. What are some of the overlooked costs that agencies forget about or overlook when they're thinking about these margins and these numbers?
Dana (39:44.607)
Hahaha
Dana (40:09.301)
Yeah, travel time and mileage is a big one. Or if you've given your scheduler sort of the leeway to incentivize clients or caregivers to take shifts, like you'll pay a dollar or two an hour or more, they can, if not, then that's why I go back to the measurement of the pay rate per hour. Because if that's not like closely monitored.
they wanna fill those shifts and they can kind of go down that direction. Then it starts to set a standard for caregivers that that's like the real pay rate per hour. So I've seen that kind of go in a direction that has to be like reined in. And then it's just really, and This is a harder one to kind of quantify is just that internal time consumed by your staff trying to like schedule and fill these.
When you just think about all of the things, and This is something I was thinking about with the home care industry and drawing comparisons to the accounting industry, which they're so different, but the same in a lot of ways is we say like, we provide care, but what a lot of times we skip over is like, we're recruiting caregivers, we're doing background checks, we're going to visit your family in the home, we're making sure that the home is safe, like we're taking someone, your loved one here and there and everywhere.
There's all this stuff going on in the background that we sometimes just kind of forget about when we go to deliver an hour of care. And we're not undervaluing it or underselling it, but we're just, because it's so matter of fact, and we're just doing it to like, you know, serve our clients. All those things do come into play when we're looking at like, where are the dollars going at the end of the month?
Miriam Allred (41:47.342)
And there are, I'm just thinking of, This is a great conversation to have with your staff. Asking a scheduler, how long does it take you to schedule an eight hour shift? How long does it take you to configure a 24 hour shift? How long, you know, just like conversation starting. And I think the scheduler can probably ballpark these numbers, you know, you know, yesterday it took me, you know, three hours to schedule a 12 hour shift. Like,
I think just getting kind of these baseline numbers and having this conversation, I was thinking you can even get technical. There's software tools out there that help you like time track for different projects. I don't know, you know, not everyone loves that. And that can get really nitty gritty and really, you know, in the weeds really quickly. But I think just like you're saying one person in a home care office oftentimes is wearing multiple hats and doing so many tasks on a daily basis that it's really hard to
quantify overhead and time tracking for specific projects and scheduling, cetera. But that information is really valuable. And it's not like you have to do it for a long period of time. It's like, OK, for this week, let's think through this lens and track these metrics, like track these projects and tasks. And then we can factor those into our numbers.
Dana (43:03.583)
Yeah. And what's interesting, so this kind of goes back to like my experience prior to home care is when I worked for a manufacturing company and we broke down like the cost of manufacturer widget. did a talk, like we would do time studies. Like it takes this long to take this out of the package and this time to take this piece and put it here. And so you do that, you know, one time and you kind of have your standard around, okay, we know that this process takes this long. so having that information from.
schedulers perspective or like a recruiters perspective and that's where a lot of people or agencies kind of like focus is the cost to recruit a caregiver or like cost to hire and like, you know lost cost if they don't or lost the cost spent if they don't come into the agency like what is that lost there? But I don't think we right now there's not this firm grasp around what amount of time is spent like actually scheduling somebody once they've moved because there is just so many things that have to work for this person to get to that shift to provide care.
Miriam Allred (44:00.02)
Yeah, yeah, 100%. That was a really good comment. I totally agree. There's other areas where we're applying this thinking, but we have yet to really maybe apply it to that scheduler role. And I think a lot of good will come out of this. Even just like empowering that scheduler to like break down their time spent. Because again, we know how like fragile that role is and there's a lot of turnover in that seat and it's a really intense role, but helping them communicate how long
every task takes and then understanding like when it's time to hire another scheduler, how do we help them and how do we improve those numbers? You know, if it takes hours and hours to schedule these types of shifts, like what can we do to help them? Like I think just a lot of good will come out of that conversation. Another question I want to ask is around office salaries eating into margin. We talk and think about like that owner salary and we think about maybe the salary for some of these other roles, but I think another
pitfall and thing to be aware of is just how salaries are eating down margin. Is that part of overhead in your eyes or is that a separate component?
Dana (45:07.891)
It's part of overhead in my mind anyway. so it can, yes. then that's where we also, I think about agencies and like where they are in their sort of like their growth journey. So you'll find that, you know, an agency is just getting started and they have their, you know, their team in place and they're probably, they're probably losing money at that point because they don't have the hours maybe to cover all their fixed costs. But then if you think about
They've matured, they've hit a point where they're like, hey, we're growing, our office staff is at capacity, we need to add headcount. We are probably then going to take a step back from a profitability perspective because of the fact that we've this headcount. They're not totally utilized at this point. So yes, there's sort of this, until an agency is like steady state, which I've never met an owner that said like, I'm done growing, you know, like every owner is like, how do we grow? How do we improve?
There's sort of this constant checking in of like, okay, what is our overhead in relation to our revenue or what percentage is that of like our total overhead cost so that we're checking in and making sure. I would say the biggest area that's hard to kind of get a grasp around is like that marketing role and just.
You know, measuring the ROI on that, setting a target for like, what is the sales number that they have to bring in to like really cover their cost. And there's like some patience involved usually, because someone doesn't typically step into that role and perform right away. Like there's an adjustment period. I would say that's the one that tends to be like the most up and down from, you know, does it really, how is it contributing and does it make sense? And you know, what portion of our revenue is going towards that?
Miriam Allred (46:59.854)
Yeah, anything more specifically that you can share on that or things that you've seen done well by maybe some of your clients when it comes to that sales role, like thinking from a margin perspective.
Dana (47:11.169)
I really, for me, it's like having a grasp on, what is my gross margin? What is this person's salary and like their comp structure? And at what point are they truly paying for themselves? I mean, marketing people are tend to be like more expensive or like a salary perspective. So typically we're seeing like 750,000 to a million in revenue to really justify and keep the role.
The trade off though, and that's why it's like a hard one is like there's brand awareness. There's things that necessarily don't always translate directly to like a client or something that they've brought in. So for me, a big thing is like knowing that number and that's where your gross margin is important. Cause then you can say for the hours of care that they bring in, how much are we keeping of that? And then that gives you, the difference between that gross profit and their salary is, know, how much that's coming through to the bottom line and any associated marketing expenses that come along with it.
And then having a timeline. because it is typically higher spend and agencies are cost conscious, they're not huge margins in the industry, it's like, do you have a three month window? Do you have a six month window? Do you have a year? At what point are we really saying, is this working or not? And that for me is the harder part because if someone's not coming into the role with an existing referral source network and they're building that out, that's going to take time.
And then it's like, kind of made this investment in this person and they've made the investment in growing your brand. then, know, parting ways before they're starting to like really show the traction, you know, that could actually set it back. So it's a tricky one, but I do think six months, anything longer than a year is, you know, probably been more than enough time to demonstrate. And this really check in to see like, okay, are they starting to at least partially pay for themselves at that point?
Miriam Allred (49:05.726)
Yeah, this is really good because every business, Every new hire feels so weighted and so important. And again, it's knowing these numbers, it's knowing your margins and being able to tie everything together from like a margin perspective, including these new hires. I might be putting on the spot a little bit. We're talking in terms of private pay and that's kind of your wheelhouse and bread and butter. I don't
We can't break down like the durations for different payers. You we hadn't scoped that out, but just like high level, do you know kind of like healthy gross margins for different payer types? Because again, I think a lot of people listening to this are thinking about long-term care and VA and Medicaid. And again, not by shift duration, but just healthy gross profit margins for different payer types.
Dana (49:55.167)
Yeah, so that's interesting because, okay, so like long-term care, if you look at that one, and it depends on the policy, but a lot of times what happens is they come in at like a rate and they're typically longer duration clients, which is great from like annuity income and length of stay and all of those metrics. Sometimes agencies have a hard time bringing those rates up if the policy isn't written to like increase coverage, know, or like there's an inflation adjustment. So they,
And it's hard to cut back here, right? It's hard to be like, well, now we can only afford to visit you like six times or whatever it is, or six hours instead of eight hours. So that's where just like getting an understanding of how that relationship will evolve over time. But in general, we can typically see those set around a private pay rate. Again, depending on like the policy.
Sometimes what agencies will do is say like, okay, here's the reimbursement and we're gonna kind of back into like the hourly rate based on how much care we think this person needs. And then is that within the range of what, you know, we believe would be profitable or like taking a look at how we're gonna staff it. Long-term care is good because typically there's like reassurance that you'll get paid. That's not always the case. There's always, you know, potentially hiccups.
But from that perspective, we typically see rates kind of in line with private pay. It's just hard sometimes for them to keep up with the private pay rate evolution and growth over time. The VA, it depends on the state. But we typically see those rates on par or potentially more than what a private pay rate would be. So that's a great relationship to establish. And then some.
VA, depending on the state and the structure, have different rates depending on if it's a metro or a rural area. And those rural rates can tend to help clients really achieve a higher gross margin and then overall return on sales. And I think about all of those not in a similar way, really in that always volume in home care. home care, a lot of it's a function of volume and the price per hour.
Dana (52:04.897)
Though where I really think that there needs to be a focus, especially on volume, is when you get into some of the lower reimbursement rates with Medicaid. At that point, you're probably looking at a gross margin maybe. My cutoff anyway would be 30%. And so there are gonna be states that their reimbursement rates will not jive with that. And that's where you really wanna consider, does it make sense to do it? So we did an exercise at one point where we looked at reimbursement rates by the different states and then the...
minimum wage and like how that impacts the caregiver wage. Like you can go on Indeed and see, you know, what are people recruiting a caregiver for? And that was sort of our benchmark was like 30 % is the lowest he would want to go. And with that, you have to be really, really tight with your processes. You have to like make sure you're billing everything, you make sure that you're hitting your EVV. Like the operational aspect of that is extremely important. If it's lower than the 30%, I would say
You might want introduce it as like a payer source mix if you want like the volume and to show like the growth of it. But that's tricky then because an agency is probably getting pulled in different directions and it's sometimes hard to like focus on private pay as well as Medicaid. So those are my thoughts on like the different payer sources and some of the margins that we see and then like how the operations impact or like how kind of the operations that would match what the payer source needs are.
Miriam Allred (53:23.906)
That was great. And it's interesting to hear you say that like 30 % is your base. Like you wouldn't go below that. I think that's a really good thing for owners to hear, especially as they're entertaining new payer sources, because there are states where it's likely lower than that 30 % and where it does not make sense, but that's on you as the business to like figure that out. It's like, okay, how do we ensure we have at least that as our minimum? We have to...
Dana (53:45.76)
you
Miriam Allred (53:51.158)
you know, play with the wages to be able to make that work. And it's complicated, but it's possible. But I just, appreciate you saying that, like that 30 % because I think that's a really good like baseline for people to think about when they're introducing new payers.
Dana (54:07.317)
Yeah.
Miriam Allred (54:09.004)
And you're right, there's a lot of state factors. So we can't like get into this without going like state specific. But I think even just some of those concepts that you just shared are really useful. we haven't in our last few minutes, we haven't talked about like return on sales a whole lot. know that's something you talk a lot about and think a lot about. and we've been talking conceptually about this, single dollar in home care. And so if we take a single dollar of home care revenue, how does that dollar get allocated differently across agencies performing at different
percentages for return on sales, like an agency that's doing 25 % on return on sales versus maybe 10 % return on sales. Like what does that allocation look like?
Dana (54:48.001)
Yeah, so this was really interesting when I, so we use different softwares to like do our analysis. And one of the softwares we use, it's really helpful when we're looking at against the activated insights benchmark report. Cause it'll tell us like what percent of like revenue are all these different factors. And so when I was pulling together like a return on sales at 25 % first 10 % first break even, and like where does the money really go? The biggest factor, the difference is like what's going to caregiver costs.
Um, so what, like, what is that gross margin? That's why we like harp so much on that because an agency that's a 25 % return on sales, the biggest difference between like an agency at 10 % is they're hitting like that 50 % gross margin. It's interesting across all of these was like admin payroll was kind of that 17 % or like 17 cents of a dollar. So it's
A big factor there is like, you get that pay that price to where you need it to be? And then like, can you control your pay rates? And that's why we harp so much on it and as an industry. Because yeah, so admin payroll is like 17 cents of that, you know, you're keeping 25 cents of every dollar recruitment and retention is two cents, professional fees are three cents, insurance, tech and rent are all like one cent on the dollar. So they're not huge spend. It's really those those gross margin costs. And what's interesting is I did look at activated insights from 2024,
They had caregiver cost at 60 cents on the dollar, that the return on sales was seven cents. So there's a big difference there. So a big trade off going to the caregiver cost.
Miriam Allred (56:23.022)
Yeah, super, super interesting. I'm just curious when these businesses come to you, know, likely people are coming to you that need help in these areas. Are they tracking a lot of these things? Are they tracking 50 % of what we talked about, 20 % of what we talked about? Like how well do you think agencies are doing at tracking this?
Dana (56:44.427)
So they're tracking, like, people try to track things. think the biggest thing is the consistency of it. So like, they get pulled in a million directions, like things fall to that. the financials are always sort of like the last number until you have like a really robust team and like someone's able to like dedicate or the owner has freed up their time to focus on it. Cause you can pull like a report from your client management system. So if you're using like.
any of the bigger ones, they're gonna have a report that says, you know, here's your average, here's your revenue, here's the hours, you divide that, you get your average price per hour, same thing with pay rate. As long as you set that up correctly, you can usually get like an accurate gross margin. A lot of times, they haven't been configured to include like your employer tax and workers comp, although that's an option too. So they're like checking in on it here and there. I will say one of the biggest things is that,
The underlying financials to do these other like return on sales and those numbers just aren't there to like make it meaningful. And so we interrogate the cruel basis financial statements like quite aggressively whenever finalizing month and like we're tying out revenue to the client management system. We're checking gross profit, gross margin, doing variance analysis to make sure everything's in the right month. Like if you paid month, if you paid rent, you know, on the first of the month, you're missing a rent expense. So need to bring that into the right month.
So really interrogating those because if you're doing analysis on numbers that are like not correct, you're gonna start making decisions that just, you know, aren't maybe the most beneficial. But that's, I would say that's the biggest hurdle for a lot of owners is like spending the time to do it. And then, you know, having the underlying data set in a way that like return on sales is not gonna come from a client management system because they don't have visibility to overhead. So you have to get that into like an accounting software.
And then all the moving parts with the integrations and the bank feeds and like all of that can like one little thing can take you sideways. So that's people want to, and they understand the importance of it. It's just, you know, having the data to work with.
Miriam Allred (58:45.45)
Yeah, Which is why I wanted to have this conversation because I think so many owners are thinking about and talking about like revenue, like top line and bottom line, but there's like all this gray in the middle that they're not thinking about talking about spending the time on and then consistency. It's one thing to think about that like once a year, it's another thing to put process in place to track that like month over month. But it's so important and it's so good because again, there's all this fluctuation in home care and
things can turn on a dime. And so just having like the stability, the structure, the consistency is so impactful if you really want to like scale year over year. So I guess just like maybe two, last questions here as we wrap up for agencies that want to just improve margins. You know, some people may hear this conversation and be thinking like, wow, my margins are closer to that 30 % or below 30%. Like what are the first things that they should do? Like if they're, if someone's hearing this and their margins aren't great, like what
Dana (59:28.704)
Yeah.
Miriam Allred (59:45.206)
Or is your advice where they should start to like kind of audit their own margins?
Dana (59:49.627)
I would, if possible, sort of trend out like your, I would just first understand your pay rate and your price per hour. And then if you can look at those over like a six month look back or a 12 month look back and start to see if there's margin compression over time, because then you can identify is it movement in the price per hour and movement in the pay rate per hour that's causing margin compression. And you want to make sure, you know, within the market range for your
price per hour, if you're kind of making sure that other agencies and where you're at is consistent. Usually pay rate, you can kind of check on indeed and see if you're in line with that. The other thing is you want to check to see like once you identify the root cause of that, have you not brought your prices up? You know, are you kind of just letting these price per hours float? And then you want to have a plan to like communicate price increases and, you know, make everybody aware of why that's happening.
Those are really what's within the agency's control. Like workers comp is to a certain degree if you're managing your claims, but that's sort of like a once off every year. Like you do have to manage it throughout the year, but immediately the biggest thing you can impact and like change would be your price per hour and your pay rate per hour. And you need to identify which of the two are kind of the biggest pain point in that overall gross margin.
Miriam Allred (01:01:07.896)
That was great. This is exactly where people need to start. They listened to all of this information. They're probably like, my gosh, this is a lot, but you just said like, break it down. Do that six to 12 month look back, break down these numbers, look at them and then just like start to dig in. And I'm a big fan of yours. I think every business needs some support when it comes to the financials, you know, whether they're formally or informally working with a CPA.
Dana (01:01:12.649)
Hahaha
Miriam Allred (01:01:33.612)
or someone locally, like there's just so much value in getting a second set of eyes on your finances. So my last question is just who are you best suited to work with and who do you love working with and what are just some of the key like value adds that you can add to people really quickly in their business?
Dana (01:01:51.071)
You know, what are the biggest things? So we work with agencies of all size. I will say like at a certain point, you're probably phasing out and you need probably someone in house just to make sure everything is working. Like we do provide like analysis and industry feedback at that point, but you know, probably 10, 15 million you might, you probably need like some sort of financial director CFO. but within that revenue range, we really just like to interact with owners that care about their numbers and like want to talk about them. So.
It's interesting because you might think like a client that just signs up and we don't ever talk to them is like, okay, great. It's actually really hard. Like we want to talk to them. We want to check in with them. We want to understand like what's happening because the worst thing is like if someone's like, Hey, I'm losing all this money. Like we hired you and it's like, well, we need to talk to you. We need to understand the dynamics of your agency. So someone that's invested, someone that wants to talk and someone that's in it because they want to provide care and they just aren't going to like try to make a quick buck. and then
A big thing with home care is, you know, there's, this isn't just home care. People hire their family. have their bookkeeper that they've known for like however long. And so we have started evolving. So we do like full service and we do outsource if there's like the want to get that off their plate. But let's say you have someone like you really love and maybe the agency's grown to a point where they're not.
capturing all the accruals in the right way or there's certain things that month end that they should be thinking about or we need to just do like an analysis. So we started working more on like a do it with you type structure where we have, we understand the internal processes and identify like what that team member is doing and how do we support them. And we have a software that we go back and forth with them in so that there's a lot of transparency around what's happening. And we've built really successful relationships there.
because there's that comfort of somebody that's been with the agency for however long and they know like, okay, this goes here. And then there's us that can come in and say like, have you thought about doing it this way? Or here's some things we wanna think about at month end and know here's some numbers we might wanna pay attention to. So we add that layer on. So that's been really cool because we're also able to engage with clients in a different way.
Miriam Allred (01:04:01.196)
That's awesome to hear because like you said, you've been in home care for five or six years and look at how we just dissected shift duration. You know, maybe a local CPA isn't thinking from like the payer lens, the role in the office lens, the shift duration lens, and you will have that like area of expertise, that insight to be able to unpack things from a home care specific lens, which is so powerful.
Dana (01:04:23.339)
Yeah.
Miriam Allred (01:04:24.312)
Dana, this has been awesome. This was, this went by so fast. That first 30 minutes, I was like, my gosh, that was so fast, but so awesome. You were so spot on. And I have taken all these notes. We're definitely going to have to compile some sort of recess resource to go along with this because it's a lot of numbers and it's a lot of like concepts and formulas, but we can definitely kind of stub some of this out, in addition to the podcast, but
Dana (01:04:27.571)
I know.
Miriam Allred (01:04:46.69)
Thank you for joining me the lab. Really well done. Again, I'm a big fan and just have been so impressed with your growth personally and professionally over the last several years. And I think agencies are lucky to work with you from this financial perspective.
Dana (01:04:59.785)
Awesome. Thanks for having me in the lab, Miriam I'm so excited to like hear this go live. And I think it's just been awesome to hear all the guests you've had on and just continuing to add value to the industry. And I continue to point people back to the podcast just to learn more and like turn it on while you're driving. Cause there's so much to learn and a lot of great people in the industry. And I appreciate our relationship.
Miriam Allred (01:05:19.891)
Absolutely, we make a great team.
Dana (01:05:21.514)
Yeah.