How Home Care Agencies Build A Bulletproof Backup Plan

One uncovered shift can undo months of relationship-building with a client, their adult children, and your referral sources. We’ve seen it happen: a single call-off turns into lost billable hours, a stressed scheduling team, and a family that starts Googling other home care agencies. So we get specific about the fix, not the frustration, and we map out a staffing backup system designed to keep care covered fast and keep trust intact. 

We walk through the lead caregiver model: how to choose your most reliable field pros, how to structure guaranteed hours (instead of vague “on-call”), and how to define coverage windows around your real risk points like Monday mornings, Fridays, weekends, and holidays. We also share what makes someone true lead caregiver material, why many agencies lean toward CNA-level experience, and how to keep these high performers busy with pop-in visits, training support, and care plan updates when they aren’t dispatched. 

Then we tackle the silent revenue leak most agencies don’t notice until it’s too late: the words your schedulers use on the phone. If your team says, “Do you want a replacement?” you’re handing clients an easy way to say no and quietly reduce service. We offer clearer scripts that communicate confidence, protect client safety, and preserve billable hours, plus practical guidance on mileage, travel time, and setting expectations so clients understand a lead caregiver is there to stabilize coverage, not become the permanent match. If this helps, subscribe, share it with an agency owner or scheduler, and leave a review so more home care teams can stop missing shifts.

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Transcript

Introductions, Chat, And Giveaway

SPEAKER_01 0:10

We can do just quick introductions. I'm Don Fiella. I have been in home care for close to 20 years. I've been in a proof senior network for almost four years now. I think it's four years in May. I love meeting with you guys and working with you. We have lots and lots of home care clients as well. They're home care agency owners. I met with two wonderful people this morning, and I think you guys are just fabulous people. I'm so happy to be on this journey with you. Go ahead, Matt. Okay.

SPEAKER_00 0:36

Hi, everybody. For those of you that don't know me, I am Annette Ziggler. I will be with ASN two years this month. Wow, did time fly when you're having fun. I love it. I teach the sales training classes. I see a lot of my class members here, and I love what I do. I too have 20 years' experience in home care. So welcome. Dawn has a great class today.

SPEAKER_02 0:57

Hey, I am Lisa Marcella. I know all of you. So a little over three years now, and just love again being part of your journey on this side and helping you guys get where you need to be.

Why Coverage Fails And Costs

SPEAKER_01 1:10

All right. And I don't know if Valley's Valerie has joined, but she is co-owner and founder of Approved Senior Network, and she does all of the magical online things for us. She's the brain behind all of this. And the three of us are more the feet on the ground piece of this company, although we also did get into the online stuff too. So please keep your lines muted and less speaking. Share stories, experiences, and tips. You can ask questions by unmuting yourself or putting it in the chat. It looks like the chat is lit up now. Lisa's probably typed something in there. Make recommendations. We'd love to know if you have an idea or want to know something about home care that maybe we haven't covered or covered it a different way. So please tell us what you'd like to hear. We are providing a free giveaway. You have to be here for that to happen. And all of you are here. So one attendee will receive a set of customized leave behinds for May with their logo, colors, and contact information. So if you promise that if we give you this free giveaway, we're going to give you all the leave behinds with your colors and logo, colors, content information on it. You promise to send us pictures and you want to send us pictures when you go out with these items. Please comment yes. I see lots of people doing that already in the chat. And we will put you in the drawing and we'll reach out to you. Do we reach out the same day, you guys? Yeah, we do. Okay. We'll reach out to you later today to let you know that you won. Let's see, lots and lots of yeses there. Um today we are going to talk about never missing a shift. I know that sounds crazy and impossible in here, especially as you grow and get bigger. But I've used this myself, so I know that it works. So we're going to talk about building a bulletproof backup system for your home care agency. So we know that call-offs are inevitable. Sh no-shows inevitable. What happens when that happens, though, is you lose billiable hours and client trust, and it doesn't have to be that way. So we're going to show you today how to build a lead caregiver backup system and communicate with confidence with coverage challenges when they arise. So our agenda today is to stop the revenue leak, the true cost of unplanned call-offs, build your bulletproof backup, the lead caregiver system, and master the conversation so you can keep client-pressed during coverage shifts. So the whoops, the real cost of an unplanned call-off, I know that you guys know this, it's common sense, but when you really think about it, there's a lot going on. When you don't have a plan with a caregiver call-off and no backup system in place, your scheduling team is burning time calling down a list. Clients are left waiting and wondering is it going to get covered? Family members, especially the adult children, start to lose confidence in your agency. So one uncovered shift can trigger a family meeting about switching agencies. It really is as much work as we put into it and as much energy and how much we care. It really one shift can blow the whole thing. So the ripple effect of that is lost billable hours that can't be recovered. Once that shift goes uncovered, it's over. If you've lost the billable hours, there's no way to gain those back. Erosion of client and family trust, increased stress on your scheduling team, it really stresses them out. And they might also try and be staffed for tomorrow or the next day. And in the midst of all of this, they're dealing with a call-off. So that stress really sets the scheduling team back. Risk of client discharge or transferring to a competitor. There's a potential safety issue for clients that are maybe bedbound or vulnerable and they're not being served. And then damage to your agency's reputation in the community. Those adult children will run right to Google, right, girls? Lanies right to Google and leave them out with you. It takes hardly anything for them to do that. And what happens when your ratings go down, it affects your SEO, it's a big deal. So there's a lot that can be gained from having a backup plan. So we're going to talk about that today. So those two scenarios that demand a backup plan, call-offs or no shows, and then quick starts. Quick starts are fabulous for building your referral source confidence. When they know that if they call Annette on Friday at 10 o'clock and she can start Friday at 5 p.m. with a caregiver, when they know that Annette can do that over and over again, that builds their confidence in Annette in your company and they're going to start referring more often. And I will tell you, most referral sources send that kind of test ahead of time. Annette, Lisa, can you comment to that?

SPEAKER_00 5:45

I definitely. When anybody called me at five o'clock or on a Friday, I made it my business to get that shift covered because just like Don says, if you can cover it, they're gonna you're gonna be on speed dial next time they need you because they know that you're reliable and you could get it covered. There were times where maybe we couldn't start right at five, but we sent somebody from the office for a couple hours until the caregiver got there. We made it work.

SPEAKER_01 6:11

Lisa, what about the testing, the social workers testing with this?

SPEAKER_02 6:15

Oh like it's I okay. So what this is what I have two hours. And yeah, I try to make all of it happen all always just to build that trust. But of course, setting that expectation is a good idea from the get. But yeah, I would take them.

Call-Offs And Quick Starts Defined

Lead Caregivers And Guaranteed Hours

SPEAKER_01 6:31

Yes, yes, you take them. And I think a new social worker, like you're trying to build this new relationship with a social worker, they will throw something like this to you first. Can you really do it? You say you can. It's like a test, like they will test you. And if you follow through, then you become their person. So a call-off or no show where a caregiver calls out sick, a family emergency, or they just simply don't show, you need a qualified replacement in that client's home fast without disrupting the client's routine or alarming their family. And a quick start is when a new client needs services that start right away. Sometimes they're the social workers using another home care agency and they fell through. It fell through. They couldn't do it, or they didn't get back to the social worker and now they're stuck. Or the doctor just walked in and said, guess what? They're not going home Friday, they're going home today. So, regardless of how that happens, when you can fill a quick start, that makes that does it put you on speed dial, like Annette said. So we want to be able to do those as well. So both of these situations require the same thing a caregiver who's ready right now, who's knowledgeable, adaptable, and already vetted. This can't be someone who just responded to an ad from Indeed, right? It's got to be someone seasoned and someone that can get there quickly and who's ready to go. They've been vetted. So that's why we're talking about the lead caregiver model. So introducing this model. So who is a lead caregiver? It's your agency's highest reliability field member. It's someone who's been tried, true, been out there, has shown up time and time again. Maybe they've covered an appinage for you. Everyone loves them. I always my lead caregivers were always CNAs because I wanted them to be able to walk into any situation. I didn't want to have an issue because there's a Hoyer lift in the home, or it's a heavier transfer, or something that was a little wonky about the transfer. I a CNA is just, they're just more capable. It's not like they're being medical, they're not doing medical things. They just have a higher experience. It's a higher experience level. And then just someone who demonstrates exceptional professionalism, some clinical confidence, and dependency or dependability over time. So they're not on call in the casual sense. This with the linked caregiver program that I'm talking to you about, they are guaranteed ours. They're guaranteed ours employees. So they're compensated whether they are dispatched out or they're not dispatched out. They're going to get paid either way. So it's very different. It's not on call where just try to be available for us on Fridays at this time. They're going to get paid whether they get called out or not. And I know that sounds crazy, but you can set it up for however you want. It might be 20 hours a week, it might be 10 hours a week. It might be 40 hours a week, depending on where your vulnerability is. Where are the holes? Where are most of the call? I can tell you it's probably Monday and Friday morning. But where is all of that happening? What time of the day? What days of the week? And it's guaranteed hours. So it might be that they work from, I don't know, maybe you need them all day Friday. Let's say from 8 a.m. to 8 p.m. on Friday. They're guaranteed 12 hours. They're guaranteed their rate, whether they go out or they don't go out. What I can tell you is I've never had a lead caregiver not work. They've always worked the guaranteed, because we're going to use them first because we're already paying them. So if there is a call-up, if there is a no-show, if there is a quick start, guess who's going? The lead caregivers are going to go. And they're going to be able to walk into any situation because they had that experience. Maybe they're a CNA. And so that's who I'm going to use. That's who I'm going to call. I've never had a lead caregiver not work the hours that we guaranteed them. It never happened. Their commitment is that they need to be available during agreed-upon coverage windows. Whatever you've told them, they have to answer their phone live every time. They need to be ready to leave within a minute of call. It's not, I've got to take my kid to daycare. Their kids should be in daycare because they are technically working. They're getting paid right now and they need to be able to leave at a minute's notice. There can be no personal obstacles that prevent immediate departure, prevent them from leaving immediately. They need to be capable of stepping into any client situation and represent the agency really well in every case. They should be able to walk in because get this the client might be mad. Their caregiver knows. Their caregiver didn't come in. Again, we have no idea what this lead caregiver is walking into when you hire them. We don't know all the scenarios. A lot of times they're going in there and they're standing tall for the company. That's why they have me. They've put in a backup plan just in case this happens. So they're able to walk into a situation like that and iron it out where everybody's still happy with the company. So what makes them lead caregiver material? Clinical competence. I think it's important. Um, if you're allowed to do Hawyers in your area, I don't know, but there are so many different kinds of hoyers. They're sitting, standing, they all operate differently. They need to be able to walk in and be able to handle that and know what is the risk involved and how do I do this safely. All of that should be a given. They're always reachable. So when your office calls, they are available. They have no issues stopping them from coming, going out right now to that client's home. They have professional adaptability. Every client is different, so they can walk in and smooth things over right away. And your office could warn them the adult daughter is probably there by now, and she's probably human mad by now because the caregiver is late again or isn't coming again. So please make sure you make nice of that adult daughter right when you walk in the door, like giving them a heads up about that. But that's it's somebody that's able to do that smoothly. They're steady under pressure. Call-offs, quick starts, come with stress and upset clients and anxious family members. So that lead caregiver needs to remain composed, communicate professionally, and keep the agency's reputation intact. So this is a lot. It's a lot. Like it would be hard to walk in and everybody's mad, but they still need the care. That's not easy. So you do need to make sure that you're vetting these people really well and that you've had experience and time with them. You know that they're capable of doing these things. They've proven themselves to already. The structure in this agreement, the way that we did it was they were guaranteed a minimum number of hours each week. We picked the days, we picked the times ahead of time, and we paid them two to three dollars more an hour above a standard caregiver pay. And for us, it was worth it because they're saving the day many times. They're saving the day, they're keeping the clients, they're keeping the referral source, whatever it is, it was worth it to us to pay them two to three dollars more an hour. When we looked for this person, we made this, it was a promotion. It was everyone wanted to be a lead caregiver. Will they ever let me be a lead caregiver? We really made a lot of noise about this. We elevated this position in everyone's eyes. Everyone wanted to be a lead caregiver because they got paid more. You had to be cream of the crop to be able to qualify for this position. Priority scheduling for any available ongoing case, they're gonna go first. They're gonna be the one to go. Of course, you want a caregiver that's gonna stay there and be ongoing with a call-off, a no-show, that you just can't whip that together usually that quickly. With a new start, you can't always do that either, where this is your caregiver. So they should the client should be told ahead of time, this is a quick start, the caregiver coming in, especially if it's a lead caregiver. I've always been very clear. This is not going to be your ongoing caregiver. The only issue with this is you're going to love her and you can't have her. She is a lead caregiver, she's the cream of the crop, she's the best of the best. You're going to want her, and that's not going to happen. So they do need to be, they need to understand that. They definitely, because they will fall in love with them. Clear written expectations in an updated job description. So the caregiver commits to being available and reachable during designated coverage hours. They respond to calls within minutes, not hours. They depart for the four appliance home immediately when you call them. They accept any case assigned, familiar or new. They maintain all required certifications and compliance. They uphold agency standards in every visit. One thing I can tell you is they can get a little burnt out because they're running. So we didn't use them if on their off days. Like we didn't bug them with, hey, I had a call off like on a Thursday. I didn't bother them with that. I didn't want them to feel like they had to. If it was someone who needed a lot of money and was very clear, hey, I want to work, I want to work, maybe I would. But we tried to take that pressure off the rest of the week if we felt like we really strung them out. So keep just keep that in mind. So this arrangement must be formalized in writing and signed. Both parties must thoroughly understand the expectation before the role begins. We have any questions? I know there's a lot of chats in there, but that's probably about the leaf behinds. Everything is a good idea. Yeah, I don't see any questions right now.

SPEAKER_00 15:32

Okay. I'm gonna, I wanted to add, John, for our lead caregiver. So we always had them pretty busy too, but once in a great while, there was a day maybe that they weren't doing anything. We didn't so we would have them either come in the office and do some things or go do client visits, stop at clients, check in with caregivers, go to a new client's home with a caregiver and do some training. So that's how we used to use up the hours if we they weren't going anywhere.

SPEAKER_01 16:00

But we they usually that's a great idea, and that definitely, yeah, that's a great idea having them go there on the first shift with the new caregiver, new client, or just do the client visits that need to get done. That's those pop-in visits are great.

SPEAKER_02 16:14

The pop-ins, yeah. We had a similar model. Yeah, love lead caregivers.

Staffing The Roster By Risk

SPEAKER_01 16:19

Yes, they really do, and you can grow faster with lead caregivers. That's what I got. Our billable hours went up very quickly because of the new starts and not missing those shifts. And we're gonna talk about why that is too here in just a minute. So, how many lead caregivers do you need? So it depends on your census. Like what is your average daily number of clients? And then find your windows of risk. Is it early mornings, weekends, holidays? We did have weekend caregivers that worked all day Saturday, all day Sunday. We we didn't really have any that did an overnight because usually overnights were always really easy for us to cover. I'm not sure why that is. We had a lot of overnight caregivers. They love that awake overnight shift, so many of them. So we didn't have issues with those. We could always find someone to cover those. So that wasn't a risk window for us, but that could be different for you. And then you want to assign leads one lead shift per zone. So if it's all early mornings every day of the week or Monday through Friday, that might be one lead. It might be that you need we had four leads just on Fridays alone. Four that were available on Fridays. Some were doing quick starts because of the discharges, some were doing call-offs, no shows. And again, if we have four, we don't need them all. Like Annette said, they can go do client visits, they can do trainings. We're gonna keep them busy because we're paying them anyway. So we're gonna keep them busy. So most small to mid-sized agencies benefit from having two to four designated lead caregivers who cover different shifts or geographic zones. As your census grows, your lead caregiver roster should grow with it. So think of it as an investment. One coverage shift pays for hours of guaranteed coverage. So communicating with the client. So this is where this is where I found a ton of our billable hours going away. I would look on Monday morning at my billable hours for the week and it would be, and I'm just gonna say 2,000 hours for the week. And then I would look on Wednesday and it would be like 1,600 hours. So I'm like, how did we lose that many hours? What is happening? And then I went in and spent some time with my scheduling team, just in the room where they were. And when there was a call off, the they were calling the client and saying, Your caregiver called off today. Do you want someone us to send someone else? Do you want a replacement? Those are the words of death. You don't ever want to say that. And I had no idea the option. There's never an option for them to say no. We never want to give them that option. You can lose so many billable hours with that language. I can't tell you. We release billable hours hand over fist. And I understand for the scheduling person, it's scary to say your caregiver isn't feeling well, but we'll have replacements on the way. You can expect them within an hour. That's a scary thing to say, but you have no idea who's going. But if you have a lead caregiver, you do have an idea and you have a name because they're going to ask, what's your name? You have all of that when you call. And if the Monday mornings, I think we had four or five lead caregivers starting at 7 a.m. ready to go because we had four method clients. So we had four or five call-offs every Monday morning. Easy for sure. That happened every single time. It was just expected, it was anticipated. We all knew you have to have a backup plan because you know it's going to happen. So the things to say are good morning. This is so-and-so. Your caregiver isn't feeling well today, but we have a replacement on the way. You can expect them within the hour. Or Mary's already on her way, she'll be there by nine. Or we want to make sure your care continues without an eruption. Our team has this covered for you. Never say your caregiver called off. Do you want someone else? We're trying to find someone. We'll call you back if we can. Would you like a replacement or are you okay on your own today? Lots of things happen with that. One adult child is furious because what's this thing you're going to say? No, I'm good. I don't need anything. I'm fine. And so then that happens two, three days in a row. And guess what? They think they're doing okay. We know they're at risk, but they managed to get through three days without their caregiver. What do you think's coming next? They're going to reduce their hours or quit. It's a gamble, guys. So it's really important that you have somebody go out there and that the language we're using over the phone is about the person who's on their way already. They're all, and if you know it's a client that's been, I like Susie. That's my caregiver. I don't want anyone else. I'm sorry, Leanne's already on her way. That's what you say. That they're already on their way. We're not asking for permission. They're already on their way.

unknown 20:51

Yeah.

SPEAKER_02 20:52

We do have a question. Did you pay the lead caregivers for mileage?

SPEAKER_01 20:57

If they were driving, let's see, there was some kind of rule. If it was like if the shifts were within an hour of each other, we paid mileage. Does that sound familiar to me, Lisa?

SPEAKER_02 21:07

Yeah, so we paid mileage. Yeah, so if they you have to pay travel time too if they're driving from one shift to another and it's within an hour, you're right. Yes. So that is definitely we did pay travel time for their car, unless they had a fleet vehicle. Some of our caregivers, we had, I think two had we had multiple cars. And so two, I think two or three of them had a fleet vehicle. So of course we didn't have to pay mileage then. But yeah, if they use their own vehicle, we did have to. But I it might depend on your state too. I'm not sure.

SPEAKER_01 21:36

Yeah. So to restate that if it was within the hour, one shift ended and the next shift happened within an hour, we paid mileage. And of course, if they're driving the client around, which they could be because that's what caregivers do, then the caregiver paid the mileage. And that did you have something to add? Or that's paying mileage mileage.

SPEAKER_00 21:53

We are paying mileage, but I was also going to add, you might have this in another slide. But when there's holidays, we would call, and the scheduler would never say, Okay, Christmas is on Thursday, so do you are you do you still want our caregiver? We used to try and fill in. Another day because you lose a lot of hours during those holidays too. Oh, my family's here. So I understand your family's gonna be there on Thursday. So we can send somebody on Monday. We can do another day this week. Which day works.

SPEAKER_01 22:21

That's a really important way. Because some of them don't want to pay time and a half. Some of them have account. And when I would sign, even sign a client up, and they were like when I read about the holidays, they're like, I'm not, I don't want to pay time and a half. So I would never have their schedule be on a Monday because we have a lot of Monday model. So I think about that when signing them up. But yes, if Christmas was coming, we would call and we actually the marketing team did it because it was more of a sales thing. And we would say to them, Christmas is on a Thursday, so we're gonna send your caregiver Tuesday instead. How does that? So it wasn't even what day do you want to replace? Because then they're gonna say, Oh, I don't need anything. I'm good. So it was just like we're gonna send them Monday or Tuesday. Which day do you prefer? And the sales team's pretty good about making sure that happens. But that's a really good point, Annette, for the billable hours and keeping them.

SPEAKER_02 23:07

We would also do that during the assessment as well. If I was assessing someone and they say, We don't want to pay any overtime for holidays. I'd say, okay, so when there's a holiday on this day, can we just go ahead and move it to this day? We would still call them to remind them, but we would already have that kind of in place. So smart about losing that those hours. Super smart.

Scripts That Prevent Lost Hours

SPEAKER_01 23:26

Yeah. You have to, the more you can plan ahead, the easier I think this all becomes. So why do you want a replacement as a day, or do you want a replacement is a dangerous question because they're almost always gonna say no. They're they don't want to be a burden, they don't really think they need the care, most of them. I'll be fine. They see it as a luxury, not a necessity, most of them. These people grew up in the depression and had one pair of socks their whole childhood. So they don't see this care as something that has to happen anyway. So they're gonna say no. And that adult child is going to be livid because they feel like mom's got this caregiver. I can go to work, I don't have to think about her, she's doing good. So our job is to inform and deploy, not present options that invite a no. So just that's a really good one-liner with your scheduling team. Our job is to inform and deploy, not present options that invite a no. We don't want to use that. And that's what's best for the senior anyway. They're signed up for care for a reason. Their pink carriers aren't just there visiting and hanging out. Like it's a it's needed, it's a necessity. So we want to keep them safe too.

SPEAKER_02 24:38

So we have another question, Sherry. Oh, okay. We have another question. It's a follow-up to the mileage. But if you have a large territory, I guess we would have to define large territory, but did you give them a travel allowance? This is for the clients that are maybe far from their home. So I think if they're traveling, if the leave caregivers traveling from their home to the client and it's super far, a large territory, was there a travel?

SPEAKER_01 25:03

I mean, we did think about that. It was on a case by case. Elite caregivers, some of them could get whiny after some time, or it's gonna take me 45 minutes to get there, and I'm only there for two hours or whatever. We might throw in a$10 bonus, or we had gas cards too, lots and lots of gas cards that we would give them gas cards or Walmart gift card or something like that. You they do need to feel appreciated and not taken advantage of. So if it was a long drive and they just got done with another long drive, I might throw in a$10 bonus or something like that. I wouldn't probably say you drove 45 minutes, so we're gonna give you a, I wouldn't let say we really appreciate you. We want to give you a$10 bonus this week or the for today. I would never probably tie it to the actual miles because then they're gonna expect it every single time. And you may not do that every single time. So anytime I would throw in that kind of, it wasn't for anything specific. It's like you are just killing it this week. We really appreciate you. We want to give you an extra bonus today. It was more worded that way because I don't want them to come back every single time. I'm doing that 45-minute drive with them, they have to do it every day for a week because we can't find a caregiver, they're steady eddy caregivers. So I don't want to tie it to that specifically. I hope that answers it.

SPEAKER_00 26:24

Yeah, I think it does. I wanted to add there's another question, but I wanted to add one other thing. When I used to do an assessment and sign up a client and they specifically wanted this one person, maybe it was five or six days. I always tried to have a couple caregivers because that would alleviate the problem too. If the caregiver calls off, then Susie can come. Or so I never really I used to get into trouble when we just used to we'd get used to that one caregiver. I always said there's gonna be times when maybe they can't come. It's good for you to get to know two different people and they'll work together. I just wanted to add that in.

SPEAKER_01 26:59

When they say that I just want one caregiver that I have a really good that hairs in the back of your neck should stand because when Susie doesn't show up on time and you say she's been like three days in a row, we're upset with Susie right now, so we're going to introduce another person. But when they quit it because Susie was late three days in a row. So I know that we would always tell them we're going to you're going to see a few different caregivers the first couple of weeks. One that helps us to find somebody because maybe we could only cover Wednesday and not Thursday, Friday. And it also forces them to get used to different caregivers. Say this is a team approach. It's not like you're not a different person every day for the rest of your life, but the first couple of weeks we want we're just filling it out. Who do you like? How does this look? And we want me to have more than one because they need to back up. So that's an excellent point.

SPEAKER_02 27:55

Yeah. And for us on this end, it's I don't want one caregiver owning the job. I just can happen.

SPEAKER_01 28:02

They become control freaks after a while. They're calling the shot.

SPEAKER_02 28:05

Yes. Exactly. And just beyond, they can go out overstep and all of those things. So you can't just have one caregiver. They start running the household sometimes. It can go unnoticed, right? Even if you do pop-ins, everyone's on their best behavior when you're there. So it's uh never have just one caregiver, I would say, if you can help it. Totally. The question is if you guarantee, say, 20 hours, are you expecting for the lead caregiver to work 20 hours only, or are you slash them expecting to work 30 or 40 hours?

SPEAKER_01 28:36

So they can work 20 hours as a lead caregiver, and I would keep an eye on that. And they can have a couple of other clients as a regular caregiver if they want more than 20 hours, but they have to understand though they can't call out on the lead caregiver position because they're exhausted from working the other 10 hours that they did this week. Their lead caregiver work is always going to trump the other work that they're doing. Not that those lines don't matter, but they're not a lead caregiver in that situation. So there are some that want more than 20 hours a week. And if they're that good, then but they're not going to get paid the$3 more working with their ongoing client. They get lead caregiver pay and they get their regular caregiver pay. And eventually, if you have more room and need for lead caregiver, you start increasing their hours from 20 to 30, whatever you need. You also need to make sure they're going to show up and that they're dependable.

SPEAKER_02 29:31

Yeah, we actually did have our lead caregivers at the full time.

Mileage, Holidays, And Client Expectations

SPEAKER_01 29:37

Like 40 hours. We did too, but if you're a newer agency, you may not have that need. The weekend caregivers weren't always working 40 hours. Some of them did, but not always. So we had lots of different options because we had some caregivers that were fabulous. We loved them. We knew they'd be great at this, but they could only give us 15 hours a week. Whatever reason they have kids or whatever, their life just didn't allow them to work more than that. So we had all kinds of different agreements running around. Right. Definitely. Yeah. So the right script, word-for-word templates. So you're going to get a copy of these slides. I don't know that we need to read through all of them, but we have a script for call-off coverage. We have a script for the lead caregiver is in route and the quick start introduction. So I would print these, I would hang them up in front of your people, your schedulers, so that they it just roll or role play with them. So it just rolls off their tongue. Because it can be difficult to just like they've been saying, would you like a replacement? Do you want us to come later in the day or whatever they've been saying? It'll take a bit for them to get used to saying it this way. So role-playing with them would be good. Hanging these up would be good. And it's really important when your person signs these clients up that they explain the lead caregiver role and what it is. From time to time, if your caregiver is out, we have lead caregivers that will come and cover the shit. It's automatic. There's nothing for you to do. We don't charge you more. It's just what we do. Just know she's not going to be your ongoing caregiver. And if it's a quick start, the salesperson, whoever is signing up, needs to explain this is not your ongoing caregiver. I can't stress that enough because they do fall in love. They do the lead caregiver. And when their caregiver calls out sick and you call them, they're like, oh, is Mary the lead caregiver coming? Or is it Kim the lead caregiver? I love them both. I don't care which one, but which one is it? Like they're excited. That's how much they love them. So you it's really important that you set the precedent that they will never, because they've had them. We'll pay you more if we can have her. We'll pay you more. And like, no, yeah, she's not available. I'm so sorry.

SPEAKER_02 31:43

So we have another question. This one is if you had to guess out of the 2,000 hours a week, let's say how many were covered by a lead caregiver? And out of X total caregivers, how many were lead caregivers? Oh God.

SPEAKER_01 31:59

We had lots of caregivers, but they weren't all on payroll. Everybody knows what that looks like actually on payroll. I mean, we probably had about 400 caregivers on payroll. I would say 350 to 400 covering 400 clients. They weren't all full time though. Like I said, we had some doing 15 hours, some doing 30, some full time. But as far as the 2,000 hours, what percent was covered? God, I have no idea. I really don't. Maybe 10, 15. I don't know. Yeah, I think that sounds right. Yeah, something about probably 10%. Yeah, I would say probably. Good questions, though. I love very good questions. Very good questions.

SPEAKER_00 32:41

We love when you ask questions.

SPEAKER_01 32:43

So, what to tell the lead caregiver before dispatch? Of course, I'm sure all of you are using scheduling software and they can see the client's whole profile and all the things. If you want to make sure they know the client's name, address, the story, like a quick this is their care. They want to know why I am being called out. If I were a lead caregiver, how mad are we gonna be? That's what I would want to know. Give me the skinny, tell me what the story is. Like, is this the fifth day the caregiver is called out? Is it a quick start? What is the story? Don't send me in blind. I need to know. If there's gate codes or if they're going into an assisted living community and they have to sign in and do all this stuff, let them know that ahead of time so they get there early and they're not also late. It's gonna be even more important that the lead caregiver is never late, right? Because somebody already has called out. So these lead caregivers need really good instructions, really good everything. They need the skinny, they need to know what's going on. A quick care plan summary, little warning. If you open the front door or leave it unlocked, he's gonna wander off. Like little, those little caveats that are in the care plan somewhere should be vocally told to this lead caregiver before they go. Any emergency contacts that should also be in the profile. They need to be able to reach somebody from the office. I would have an open door. Lead caregivers get through to the scheduling team. I don't care what's going on, they get through to them. We don't play with the, oh, she's on the phone. Like they have direct access to the scheduling team. So if that lead caregiver calls, we do whatever we can to get them to the scheduling team because they are going into a client's home who is maybe upset already, has already been upset. Maybe it's a or it's a new quick start, which is a brand new client. So the lead caregivers always get through. So I can't stress that enough. That's really important. And then documentation expectation. They're lead caregiver, they've got to do everything a regular caregiver do. They're documenting everything they've done. If they're checking off tasks in their app, they have to make sure that they do that. Any notes that we need to know about? What I can tell you is those lead caregivers find out a lot of things going on in that house that the regular caregivers have not told us yet. Or they notice that the care plan doesn't match what's happening because that same caregiver's been going for a year, six months, the lead caregiver goes in there, and the situation is nothing like the care plan because things change, but no one has told us. So that that lead caregiver that might be an expectation that they might be told ahead of time if things are going on in the home that don't match the care plan, let us know so we can update it. And I can say that happened quite a bit. Would you guys agree that they noticed things were different than the care plan?

SPEAKER_00 35:21

Yes, yes. Absolutely. That's why we like almost every time they haven't taken that medicine in this long, or that's why we used to try. We had a care coordinator that we used to try to go every few months and update the care plans on a perfect world that we would do it, but so many times we weren't on top of it. So the lead caregiver would say, Hey, do you realize this is going on or that's going on important stuff?

SPEAKER_01 35:46

Or she's not in the offer anymore. She doesn't use it. She uses a cane. Where why didn't you tell me this? Oh, we didn't know. So, as much as we don't want to not know, we're trying to meet that same caregiver's been there and it's just gradually changed over time, and she hasn't told us. So they are going to run into some of that, and the scheduling team needs to be ready for that as well.

SPEAKER_02 36:08

And that's another reason why lead caregivers are so important because your client care can only do so many pop-ins because they're outside assessments, they're doing all those other things. And so having that lead caregiver, I know when I would go out to pop-ins and then I would get a little that little what is it, spidey senses or a little twitch in my nose. I come back here and watch a little bit more and see what's going on. And I would uncover so much. Yeah, just it's just crazy. So it's so good to have a lead caregiver system, really.

Dispatch Prep And System Rollout

Revenue Math And Training Offer

SPEAKER_01 36:38

And that's another reason why our lead caregivers were CNAs, because I felt like they're just quicker, at least with the safety clinical stuff, they can walk in right away and notice those things. I we just always hired CNAs for that. Okay, building the system step-by-step implementation. So identify your candidates. Who are those top caregiver people? Part of this that can be difficult for your scheduling team is they don't want to pull that caregiver off a client. Right. That can be painful. Leslie's fabulous. Everybody that she sees loves her, but she's got a steady client that's three hours every other day or something. I can't pull her off. And if you think it's going to break the client relationship, maybe she keeps that client and starts gradually moving into the lead caregiver role. You'll have to think about that. But that can be one pain point for the scheduling team and for the client that she's on. Sometimes, if you have a really great caregiver and their client dies or cancels or quits or what gets better or whatever, that's a good time to implement them into the lead caregiver role too, because they're not tied to a client. Have a conversation with them, discuss the role, the expectations, and the pay, update their job description and their agreements, do some staff training. So dispatch, teach them the dispatch, the scripts, the language, what they can expect when they go out to the home, and then launch it. Do a 30-day pilot and coverage review and see, see how it goes. So building the system takes focus and effort up front. But once it's running, your team will handle call-offs and thick starts with confidence and speed. So start with one or two lead caregiver candidates and expand your senses as you grow. So overcoming common objections from the caregivers. I can't always drop everything. The whole role of a lead caregiver is that you are dropping everything. That is the role. So it's important they understand this. If they can't give you an open window of when they're going to be available, then they're not good lead caregiver material. Why should I be on standby? Why am I just sitting at home waiting for you to call? They're not. They're getting paid to sit there and wait. How lucky are you? You're getting paid and you're doing nothing but sitting there. So it's, and I don't mean to sound so callous, but you get frustrated with these questions sometimes. They are getting paid, they're on standby. Most of them will be working. So selecting the right person matters more than anything else, more than the training, more than anything. You cannot train reliability or urgency into someone who doesn't naturally operate that way. If they're not that person already, they're never going to be that person.$3 an hour is not going to make them be that person. The title is not going to make them be that person. They have to already be that person. So look for caregivers who already show up early. They already respond quickly. They handle change without complaining. Promote the behavior you already see. Don't hope to develop it after they're assigned. It won't happen. Your lead caregivers should be people your office genuinely trusts to walk into any home, any situation, and represent your agency with excellence with zero notice. Create the role. So formalize your lead caregiver position. You should have a job description for this. Make sure in that it's got that specific caregivers' hours, days, times, availability, all of that should be, they're all going to be different if they're doing different hours. So they need to have their own. Select your candidates carefully, train your scripts and protect your billable hours. So if you start today with your top two, have that conversation. Your agency and your clients can afford, can afford to wait as you look for these people. It's an important role and they need to fit the role for sure. The role doesn't fit around them. They need to fit the role. So we're going to go through some revenue scenarios. So we're going to take a practical look at how lead caregivers protect and generate revenue across three real-world staffing solutions. So the first one is same-day quick start. So you have a new client, they need to start today. What do you do? Scenario two, you have a full 12-hour call-off coverage. So your 12-hour shift, the caregiver called off, and you have no one to cover it. Scenario three, a partial shift recovery. Your caregiver halfway through the shift has to leave. What are you going to do? So we're going to look at how this affects revenue and billable hours. So same day, quick start. The scenario is the referral was received at 10 a.m. The lead caregiver starts care at one and a three hour with a three-hour turnaround and turns a prospective client into an active billable case. So without a lead caregiver, you've got zero billable hours, zero revenue, and your referral source isn't thinking you're so hot because you couldn't do a quick start when you said that you could. So that's all, and you can't even put a dollar amount on that. It's bad. With a lead caregiver, they went from one to six. The case secured immediately, relationship established, ongoing billing initiated. So referral source is thrilled. You're now on their speed dial. We can't put a cost of money on that, but it's big. So maybe you bill$33 an hour at five hours. Your revenue for that shift is$165. The lead caregiver is five hours at$3 an hour. They cost you$15 out of that$165. You ended up at$150 revenue that day for being able to pick up this quick shift, this quick start. And the case is secured, and you're going to have ongoing weekly billing now because this is not a one-day thing. This is an ongoing client with ongoing shifts. So a single lost referral can represent thousands in long-term revenue that you're you would lose. The call off coverage. So a 12-hour shift, caregiver calls out. It's an 8 a.m. to 8 p.m. Without rapid response, without a lead caregiver, the client goes uncovered and revenue disappears entirely. So without a lead caregiver, the ship goes uncovered. Client care is disrupted. Satisfaction declined and a full days of billing is forfeited. And your scheduling team is frustrated and calling down the list of people trying to find someone to cover the shift. So you've lost$396 in revenue. The client is upset. The adult children are upset. A 12-hour client is usually more dependent on you. So there may be some safety issues involved here because they are left alone. With a lead caregiver at$33 an hour, your gross revenue is$396. Your leave, you pay$3 more in hours. So they took 36 of the$396. Your net revenue is$360. And again, this is just one shift. There maybe they don't quit now, right? And so you get to continue to do 12 hours and 12 hours. So the$36 leave premium is a 9% cost to save 91% of what you would have lost otherwise. Right. So this is a big saving. Partial shift recovery. 12-hour shift is in progress. The scheduled caregiver must leave at 2 o'clock, leaving six hours uncovered through the end of the shift. So without a lead caregiver, the remaining six hours go unbilled. Client is left without care for the second half of the day, risking safety and satisfaction. You've lost$198 in revenue. But if you have sent a lead caregiver in from two to eight, that's six hours at 33 an hour. So you get your whole 198 lead premium, the caregiver, the lead caregiver is costing you$18 out of the$198, your net revenue is$190. So even half of the ship saved delivers meaningful results and prevents a client complaint or an incident report. So if we look at all of these added together, just from these three shifts, it's just three shifts, your weekly total in net revenue is 690. That's just three shifts. That would be$22,760 a month in projected revenue, just from three common scenarios that happen every week in home care. So I just wanted to give you an idea of what's really happening in dollars, right? But it's also affecting client satisfaction and referral source satisfaction and getting ongoing referrals, and you're losing the billable hours that could have been also because they might quit. So that is the lead care right thing. That's it. And now we are on to, I think Annette looks like she I'm so glad you did that because that's really cool.

SPEAKER_02 45:14

That's really puts it into perspective.

SPEAKER_01 45:16

It really does. Yeah. But I started putting this together, I'm like, wow, this is definitely really valuable. And if you look at just the 2760 a month, and that that's over 24,000 a year, and this is just both these ships and a given week. That's it. So that is great. To talk about our GoCare Pro Sales Training Program, we have some openings on left, I think second part of April. Oh, April 14th. Oh, we have we, I think we have a couple openings there. So these are the next four classes that are open. We will teach you how to increase your private paid revenue. We teach you referral source by referral source, how to get in, what to say, what to bring with you, all the things that you need to know about every referral source type. We spend two weeks on skill nursing facilities. Hands down, the best place to get private pay revenue and private pay clients. So you will be able to increase your referrals, growth, your revenue, build strong referral relationships. By week six, it is a 12-week course. By week six, people are getting referrals from SNFs. So it is a great program. We've had over 100 people take it and it's going really well. If you're interested in this, let us know in the chat. We can have Annette reach out to you. She is the trainer, she does a boundary stuff. I think how many reviews has Annette gotten lately, Lisa? Like no one ever reviews me, but boy, Annette's there's gotta be like 10 or so.

SPEAKER_02 46:34

Are there came in?

SPEAKER_01 46:35

Yeah, just recently. Like Annette was my person. One of them's like, she's my best friend because they text her, they get stuck and they text her like you were in this class for 12 weeks, but you're able to text and get one on one. And uh thank you, everyone. Have a great rest of your day.

SPEAKER_03 46:53

Thank you guys.