How One Franchise Model Increased Caregiver Applications by 300%

How One Franchise Model Increased Caregiver Applications by 300%

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Welcome to CareSmartz360 On Air, a Home Care Podcast. I’m Erin Cahill, Sales Account Executive at CareSmartz360. Today we’re joined by Joshua Stess, paid media manager with a sharp focus on accurate attribution, strategic thinking, and smart campaign deployment. Using a core versus exploratory model and the paro principle, Joshua has helped scale recruitment and provider relations in seniors focused home care. As a manager of 100 plus providers at seniors helping seniors, he boosted applicant acquisition by 300%. Joshua

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will share how one franchise model even increased caregiver applications by 300%. So stay tuned. Welcome to the podcast, Joshua. >> Oh, thank you, Erin. Thanks for having me. Excited to be here. Yeah, it’s great to have you. So, I’ll jump right in. Um, our first question here, what principles helped you identify and fix the root cause of caregiver turnover? >> Uh, so I would say it wasn’t exactly principles, it was more of a thought exercise. I took a look at uh a lot of the components in

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play um and kind of took stock of each of them and then looked at that holistically. So, I’ll go through some. Uh so I looked at the recruiting status quo when I got to this company, the company I work at, seniors helping seniors. Uh and uh I saw that and this seems to be the case with other home care agencies also is that they’re hiring caregivers non-stop and it’s continuous um regardless of demand or the business conditions. So I saw that I I thought to myself like let me make a

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note of that. That seems off to me. Um, and then, uh, I, uh, I took the perspective of the caregiver. Um, I thought about the economic reality, what job they’re accepting, uh, what the job looks like. Uh, for example, within that, I finally put my finger on this, but basically what’s happening in the homecare industry, one reason that there’s a dysfunction in recruiting is because it’s really project- based work. You work with clients, they pass away, then there’s like feast or famine,

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droughts. Um, so it’s project based work, but in order to buy the model is um normal employment. So you’re hired as a normal employee. So there’s a mismatch there and that’s what has created this dysfunction in this industry in terms of recruiting and turnover. That’s kind of the core piece that created it. So I looked at the perspective of the caregiver. I thought about the economic sustainability of being a caregiver working in that role.

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Um then I took a look at the business practices. So, we’re doing the continuous hiring process that led to I mean the industry benchmarks from activated insights is like 80% turnover uh for caregivers uh within I think it’s like the first six months, three to six months. Um and that’s you’re paying for training like 10 hours of training for each new caregiver. Um you’re paying for all those hiring costs, all the marketing costs to uh put up ads to bring in caregivers. um and then they’re

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turning over immediately like they’re go they’re just gone they don’t say goodbye they’re gone in 30 days so I saw how wasteful that was so the business practices I see this is wasteful I looked at the operational timing of this premise business-wise which is that >> um as new big clients come in you have a new batch of caregivers at all times so that’s the the premise why the hiring is done continuously in such a wasteful way uh but but the timing of that matching up is

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actually not that viable. Like a lot of the times it’s the timing of the caregivers and the big new client. They’re mismatched and it’s just a bunch of waste. Um so I saw that piece as well, the operational timing. And then I thought about the human ethics of it in terms of how that happens for the caregiver because that’s their livelihood. They’re waiting for hours. If they’re uninformed about this industry, they’re going to be pulled into this situation that we’re

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perpetuating as the recruiter. Uh, so I thought about this as our livelihood. They have big fixed bills to pay every month and we’re giving them we’re promising the hours that will be here in one week once they’re onboarded and ready to go. But those hours may or may not exist. And from the past predictability, I could tell I could look at patterns and see like, okay, what I’m promising is unlikely, it’s a low probability that those hours will be there. So the ethics um and humanity of

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that piece um it didn’t sit right with me either. Uh so uh those were the main pieces that I looked at and you know in some ways it was a thought exercise once I had all that kind of in my field of vision. Um and in some ways it was a complex puzzle to solve but in other ways it was some pieces were really easy to see the dysfunction but some pieces were more complicated. So uh that is that’s the system that I went through in order to improve retention. Basically flip it on its head. So like the last

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six months since I made some changes I found a model within that that works well. Um, I went from 80% new hire uh turnover, 80 or 90% for like six months while I was like learning the business and just doing the status quo down to the last six months it’s been like 15% 15% turn up >> over and I track 30 60 90 days and like past that. So that’s how I achieved it. That’s where I started in terms of thinking patterns. >> That’s amazing. And what framework did you use to turn early caregiver churn

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into that long-term retention? >> Uh, so the framework I can’t share fully like the answer that I found for my company, but I can share the framework for other home care agencies that they could use to start exploring different solutions. Like I tested a lot of things and then I found one that was a success. So I have one caregiver model that works really well and is actually extremely transformational for the whole business. Um but I that and I’ll say this later um that one model is not enough to sustain

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The staffing needs that we need to power this full business. So there needs to be other models to other demographics that I attract in terms of caregivers. So, um, I identified the one that was successful and I explain I can explain how I the framework I used to find that answer, but it’s not the full answer to all staffing for this agency. >> Um, uh, but yeah, so let me talk about that. So, you know, when I got here, and this may be the case with other homecare agencies, there’s a one-size-fits-all

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role for caregivers. Just the general caregiver role. We have the same terms, the same benefits, everything for those caregivers. So when I started looking at it, I said, “Okay, let me see what are our main benefits that we offer for our all one-size-fits-all caregiver role. Um because of the obvious issues, dysfunction, I see all those things. So I’m looking at a lot of things I can tweak and play with.” Uh so I look and I see that our main benefit is a 401k and then health insurance. Uh

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For my company, we’re called Seniors Helping Seniors. So we try to attract 60 plus caregivers uh for who we hire because we find they can relate to our clients uh better and there’s better rapport, better relationship and also that they you know have some better professional habits as well. Uh so a 401k and health insurance for 65 60 plus people neither of those benefits even hit. They completely missed our demographic. those are the those are the job benefits we’re offering for this

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role. So I said, “Okay, well that’s one of our major demographics. Um that’s we’re not going to be successful doing that. Obviously, that should be obvious.” So I started taking that one all-encompassing role apart into custom terms, custom uh custom benefits, custom terms, custom conditions for our main different demographics that we wanted to hire as our caregivers. and then that allows me to make a much more compelling offer and allows me to retain them better. So that was kind of the highest

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level thinking. Um but within the framework there’s a bit more. Um so one sizefits-all role I know is not going to get me there. Start breaking it out speaking to each major demographic specifically. Um and then I thought about the economic reality like the plight of the caregiver. What’s their economic reality? Uh, and how good is this deal for them? So, I think I mentioned before that like math, basic math actually gave me a lot of the answers to at least one model. I think it’ll give me the answers to the

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others as well. Um, so I feel like there is a resistance in this industry to to look at math and do basic math both like we’re not. I don’t think this industry is a very math forward industry and I’m just talking about arithmetic like basic math. um you know the caregivers the caregivers that I’m interviewing every day they kind of shy away from looking at math so I’m like doing math on behavior on their behalf um and that’s a piece of the perspective taking is doing some basic math to think about their finances

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and what’s viable what’s economically sustainable for them so I looked at the economic reality and I could tell that it’s just it’s not a reasonable deal for them when you offer anyone a job um you’re making you you’re making a deal with that person they get these things they offer these So, I could tell it wasn’t a good enough deal. I think the overnight caregiving is like maybe a little too sweet of a deal for the caregiver, but I think the day shifts, the like little pieces of, you know,

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variable work, that’s not a good enough deal. Uh so what I did is I thought about my agency and the demographic that I want to attract for my agency. So seniors and I thought about our core values. How do I tap into a demographic uh that fits that well and I finesse those conditions that are not fair enough. Um finesse them in different ways so that way I can have more customized roles um with custom terms, custom benefits um to find the right demographic. And then I you know I played with some things and I found I

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found one of the answers. So which has been hugely transformational for the company so far I believe. So yeah. >> Yeah. No, that’s incredible. And how did you balance recruitment versus retention and decide where to invest? >> Yeah. Um, let me take a look here. So, like I said, I found one model that I feel is an answer. It’s been proven out super successful. Um, but I knew, let’s see, I knew that that model, the people, the demographic I’ve identified

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has a finite number of people that are located within. So, if you match that demographic, you’re finite. Um, that’s located within the proximity to the territories that my company serves. So, there’s only so many out there and there’s only so many that I have the budget to actually reach. But, I think the bigger problem is the finite number that exists. Uh, so I know that scaling up my numbers, um, I don’t have as much agency to turn that dial in terms of a business dial to turn. So,

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opening up the funnel more and more to my ideal demographic, um, that’s pretty limited in what I can do. But I did see, you know, as I was working through these processes, this was over many months, etc. Uh, I saw that, you know, retention being so bad industrywide, um, that that was a dial that I could play with and have much more agency to influence. I’m pretty locked in terms of the finite number of existing people that meet the demographic where I win, where so I’m slowly ticking them in um,

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at all times, but there’s a cap on what I can do with that. So that’s how I knew to focus on retention like where where am I going to have big impact with without having to solve like the Da Vinci code basically >> right that makes sense and what core systems must agencies build to sustainably improve retention. >> Okay. So, well, I’ll have to start by saying that in this industry, what I found and many industries, the most impactful way to improve retention is through

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intelligent recruiting. So, that’s the biggest move that’s going to have that’s going to change your outcomes the most. Um, basically in terms of retention, I found a model where it’s not required that they need all of this handholding with matching to shifts and stuff as they’re getting started. Um, so I found that it’s actually not required for that demographic that I’ve liked. It’s like whatever I hit a home run on. Um, but that again that’s not going to

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power our full business. I need to hit like the professional caregivers um which have even higher turnover. So it’s even more challenging. Um, so for that we do have some there are some course core systems that you would want for retention to have in place. Um, but I do think recruiting them in a way that’s going to be economically sustainable for those professional caregivers is a lot of the answer upfront. um they may not really realize or be motivated in good faith effort to address the economic

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sustainability when they’re in the hiring when they’re in the interview hiring seat. Um but what I do is like I go like four months ahead of where they’re going to be and I’m almost like their financial advisor in terms of if they can accept the role. So even for the professional caregivers that’s part of the answer. Um but the core systems um I feel like on these podcasts uh in terms of the core systems I feel like on the podcast people talk about best practices a lot and core systems

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you know there there are some best practices in the retention core systems um I want to bring value so I don’t I try to like stay away from best practices and just generally my business style is um the best practices are not where I live at all like in terms of uh marketing to get new applicants in terms of uh recruiting like the way I the way I do any of my like my style is away from all of that. Um nothing by the book. So >> okay >> um in order to bring value I’ll talk about a couple that are less obvious. Um

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but I don’t have all the answers on this one >> or on any of them really but I have I have a couple of the answers and some >> framework. >> Yeah. So um okay so let’s see uh with new hires um we want to reduce silos between our different departments. So that would be transferring the information about the new hires across departments. So if I hire a caregiver that um is afraid of dogs that are not well train well trained let’s just say I want to transfer that to

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scheduling so then when they’re getting them started they’re very aware that they don’t make a mistake there. Um there’s a bunch of different examples like let’s say that they’re not as comfortable with helping clients with toileting. I want to make sure that you know for nine months or so that they’re just getting acclimated. They’re not put into any pressure situations. You know a major thing with keeping people that you recruit is uh this is all focused in this like

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from recruiting to scheduling as they get started. Um, but another major thing is, uh, scheduling has the tendency to want to fill shifts with whoever’s available, um, because that’s like a stressful event for them. Um, and that’s one of their metrics. Uh, but with new hires, they really need to be protected from fill-ins or else they’re going to turn over right away. So, I have a big thing trying to protect my new hires. Like, we’ve invested so much in them. Like, we need to protect our investment.

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If you put them on fill-in shifts, that’s going to be the most. That’s going to be every new shift is the most difficult shift possible. Every first shift with the new client. So fill-in shifts, the client’s already kind of disappointed. So I think that’s a way to lose a bunch of caregivers, letting them do the fill-in. So operationally, we have to make up for not using that as a crutch, basically. And that allows us to help with retention, too. So those are a couple of the less obvious ones. I don’t have a

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ton that are like the most insightful in this area. >> No, that’s really helpful. Um, and what you said about the fill-ins, I think it is very actionable. So, that’s great. >> Fillins like you have to protect them from the fill-ins. Yeah. >> Yeah. >> And like if there’s desperation of like they’re in orientation and a schedule come scheduler comes over and introduces themselves and like they’re trying to cherrypick the people to start on like a fill-in that’s for tomorrow and it’s

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like that person there’s a natural process they need to go through. So, we have to insulate the new hires from the fill-ins, from the desperation of needing to staff things. Um, if you do things in the right order, then you’re going to create the optimal onboarding experience for for caregivers and then you’re going to have a lot more they’ll have a lot a lot more longevity with your business. >> Absolutely. And what’s the biggest caregiver retention challenge this year

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and how should agencies respond? >> Okay. Uh so I think I don’t exactly look at uh retent or let’s say recruiting and retention issues or challenges on a year-to-year basis in this industry. I feel like there are hard problems that were left behind that have been systemic um in the industry for many years. Uh so uh I think it’s you know the easy problems were solved immediately by the home care agencies and then the stuff that we’re still dealing with like the turnover these things they’re the very diff

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they’re the hard problems and those got left behind. So um I will share uh the the challenge that I’m just arriving to now um which is like my challenge for 2026 which is uh uh I am working to find a way to make hiring professional caregivers economically sustainable for the caregivers. >> Uh and and you know I’m trying different things. Uh it could be encouraging them to work with multiple agencies. uh and we respect each other’s boundaries because it’s really project based work

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but they’re >> set as an employee so we can supervise them. So that mismatch creates so many problems. Uh but that’s the way it works in this industry. So um I’m testing ways to make this work but I have not found the solution to the retention fix and making it not so wasteful and the efficiency fix for hiring professional caregivers. So that’s my challenge for 2026. But it’s been here for many years. I don’t think anyone’s tackled it and and found

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a solution. So, I guess that’s my next piece. I need this model too and this is it’s got to be the professional caregivers because a 247 comes in. How are you going to staff that? I can’t give them um within the other model. It doesn’t really support a 247 just coming in instantly. So, right. >> Yeah. >> Okay. Sure. Yeah. I know that’s helpful. And then the last question for you. How are you using AI or data to predict churn and improve retention outcomes?

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>> Okay, so um in terms well I’ll say this uh so we’re not we’re not predicting uh churn within clients or caregivers. uh we are I mean I collect data on 30 60 90 days on all my hires and their retention data and then I look at patterns and that the pattern recognition and analysis is predictive. Um but in terms of clients uh we’re not predicting it. Um we have just launched a care intelligence platform that uh across the company that allows us to help prevent churn instead

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of predicting. So we’re doing prevention instead of predicting. Um but uh basically we don’t lose clients to uh other other care agencies. That never happens. um we lose them to health problems, passing away, going to the hospital, going to rehab. So in terms of our you know prevention approach it is around um you know care intelligence uh solution that helps uh it it collects data that allows us to predict different uh health declines, areas of health decline in our clients. Um and from that uh we can use that data

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to empower our caregivers to help slow that decline when they go to their next shift. And we can also basically prevent the health churn instead of the um like being taken by other clients. So that’s our newest approach that we’re launching. Uh seniors helping seniors for at least our locations because we’re part of a bigger franchise. >> No, that’s great. Um well, thank you so much Josh. I really appreciate this. Um and to everyone listening at home, thank

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you so much for tuning in to CareSmartz360 On Air. We will see you next time.