Where Did the Money Go: Fix Your Home Care Marketing Leak

Where Did the Money Go: Fix Your Home Care Marketing Leak

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Welcome to CareSmartz360 On Air, a Home Care Podcast. I’m Carolina Gonzaga, Sales Executive at Caresmartz and I’m going to be your host today. We are talking to the amazing Dana Charumbira, who is the Managing Director of the HomeCare CPAs. She founded this company after years of working in corporate and deciding that she wanted to start a venture in an industry that meant something at her heart. And so home care was where she went. She’s been building her company

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for the last 5 years. And today they’re helping agencies of all types and sizes all around the United States to help them with wasted spend, helping them amplify their ROI and steering their goals and financial precision. >> Hey, I’m so excited today to welcome Dana Charumbira. It’s so nice to have you on the podcast. Thank you for coming. >> Yeah, thank you for having me. >> So, today we’re going to talk about a topic that Oh, it kind of scares me, which probably means that it’s good that

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we’re having you on because I’m going to assume that it probably scares a lot of agencies, especially the ones that might just be getting their feet wet and might be a little afraid of the financial side of what we do. So, uh I’m going to try not to make this all about me and my tax questions, but This is for the agencies after all. But we’re so thankful that you’re here. So excited to have you. So you are the managing director of the home care CPAs. And what I’d like to find out is how you

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got into this industry specifically in home care with your CPA background. Yeah. Yeah. So I’ve been supporting homeare agency owners going on five years now. And I was really looking for a way to marry my skill set of like financial analysis, accounting, you know, all the good things that go along with that and finding an industry that has a lot of passion and purpose. And so when I was evaluating, you know, next steps after leaving the corporate world and moving back to the US, um, is looking at either

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education or home care. I think both of those industries just touch a lot of lives. and with the US population aging and just some opportunities that came my way, home care was the industry that I decided to really jump into. Um, so yeah, it’s really for me a space where you can work closely with passionate owners, the clients that they serve, the caregivers that they employ, and then from our side too, just our team members being able to empower the group that I’m leading that support those agency

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owners. So you mentioned when we talked earlier that you started the company about five years ago. Is that correct? >> Yes. >> So since those five years, how where is the agency, not the agency, your company at in terms of uh how big you are now? How many team members do you work with? And what is your kind of span, the area that you’re able to serve? Yeah. So, we serve agency owners nationwide and we have a 15 people on our team, 12 full-time equivalent, I would say. Um, just to yeah, support the

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agency owners across billing, payroll, accounting, financial analysis, and tax. So, we do have quite a bit going on. >> Yeah. So that’s um so so you’ve had quite a bit of growth in the last um five years and you uh work all over and so would you say that that there’s certain areas of the country that are you know more challenging or you find that you get more clients based on kind of the you know requirements of of that specific state or states. So yes, so we do have sort of pockets of the United

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States where we have a larger client set and part of that also aligns with warmer climates, places for retirement. So a couple of those being California um and Florida. California, you know, there’s a lot of regulation, a lot of requirements, especially on your payroll side. So we’ve seen agencies in that geography needing a lot of support and also just from like a talent and recruitment perspective it could be pretty competitive and expensive. So having us as a solution works well for a

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lot of agencies. Um Florida is another market where we’re starting to see more interest you know I think as more retirees migrate to that space um and it just becomes another market for us you know as agencies find us there. >> Yeah for sure. And I come from the senior living background. So when I think of Florida, I’m like, that’s the place to go. >> I mean, there’s just like villages and the villages of places there that have like so much need for home care. And I know that

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those spaces end up being more competitive as well because of the amount of business. And so, you know, the ability to have somebody help with the revenue growth must be just so valuable to to those in those states. Um I guess uh one of the questions I have is you know working with myself um selling into agencies I’m talking to small agencies large agencies um when do you find agencies begin to come to you engage with you and do you find that those conversations are different depending on kind of the size

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of that agency? >> Yes. So we we hear from agency owners from like pre-revenue when they’re really just trying to gather knowledge and figure out the foundation of their business. So a lot of that is around entity structure systems, you know, workflows, taxes tend to be something that’s top of mind. I mean, at all levels, but I think when you’re first getting started, that can feel a little bit scary. And then, you know, as agencies grow and they have, you know, an evolution of their business from a

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size perspective, maybe payer sources shift, sometimes that agency needs more support than the team that’s in house can provide. Um, and typically at that point, you’re just evaluating a lot more on your financials than you might have when you were just really trying to figure out what clients are coming in the door and what caregivers are going on those shifts. >> Yeah. Yeah, for sure. And you know that you mentioned the payer sources. Question for you. Do you find that your clients are quite diverse or is there a

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certain type of payer where you’re finding that more agencies are asking for your help in terms of private pay, Medicaid, VA insurance? I would say as the market gets more competitive, you know, there’s more entrance, there’s more, you know, options from a senior care perspective. And as care becomes more expensive, agencies are evaluating more payer sources than they might have historically. So maybe an agency that was traditionally, you know, private payheavy is looking for growth in a

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contract source, whether that’s VA, maybe there’s a regional opportunity for them. Medicaid sometimes, but we find that a lot of times a Medicaid agency is like a Medicaid agency, and that’s just what they do well. And it’s sometimes tricky from them from a strategy and a staffing perspective to do both. Um but yeah so as the market is evolving those are some of the conversations we’re having are you know evaluating the reimbursement rates what is the pay rate that you have to pay you know what is

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your true gross margin on some of those contracts and you know that’s where you start to think about like the strategy and the goal of the business not just you know numbers on a paper on a contract. >> Yeah. Yeah. I honestly don’t know how you do it. It just sounds also like you’ve had to wrap your head around so so many different differences between the state and all of the complex challenges that each unique agency provides. So, and I’m just right now honestly I love talking to you, but I’m

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also reminded that I need to do my taxes. I’m going to keep you on on the call after. I have a little fitness business. Don’t call me government. I will get my taxes done. All right. So, we talked about, you know, pre-revenue. some of those initial conversations um that that you were having. Could you talk a little bit about maybe and at any stage, any size of agency, you know, any major common blind spots that you that you find um with with the clientele that you’ve served so far? In general, I would say a lot of the

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times owners don’t have a true understanding of their bottom line at the end of the month. That’s sort of like across the board what we see. They’re typically relying on like a bank balance or there are some of the client management systems. So when I say that word I’m referring or that term, I’m referring more to like you know your well sky or access care whatever system you’re using to manage your agency typically have like a gross profit report. But a lot of the times there’s

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just not this clear understanding of you know what is my bottom line? What is my return on sales? Um, and that’s just really hard when you’re trying to like make decisions about spend and like where is your money going and what’s your next step. So, that’s for me one of the first things is we just really want to make sure everything’s in the month that it was either earned or the expense was incurred so that we can really start to see trends and start to get into some of the analysis that we do.

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>> Yeah. Oh, this is so hitting home because I think especially when agencies are, you know, it’s it often begins as a project of the heart. >> And like for me, like I have a unrelated to home care, like a fitness business, and I’m really great at teaching fitness, but I’m not great at tracking it. And so even just you saying, you know, to be able to track and really see what your bottom line truly is, you really need to get honest and get organized about when things are

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happening, the months that they fall within. And for a new agency, I think that it could be really overwhelming, especially if you’re coming from, you know, the perspective of somebody that has started the agency because they’ve been a caregiver for 15 years >> and like they’re used to being, you know, on a payroll and now they’re running running, you know, their own business. And I wonder if with these agencies um that you’re kind of helping them sort out where they at and where

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and where they want to go um whether they ask you for advice on when or if they’re in a financial situation when they can be where they can begin to invest in tools that might help grow their business. I mean now if they’re talking to you, they’ve obviously invested in the idea that your organization can help them become more financially literate if they’re already literate, more financially successful, prepared. Um, but as a technology solution myself from Cares 360, I’m wondering if you are advising folks on

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these tech technological decisions and investments, is this the right time? Does this fit into my growth uh strategy, etc. Yeah, that’s a conversation we have often. I think now especially just with technology and there’s this industry I feel like sort of phase we’re in where we’re trying to figure out like how does technology fit into like a client experience, a caregiver experience, the owner experience, like operationally and there’s so many options right now. And so for us, well, we as much as we do the

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numbers and we’re financial analysis, a lot of what happens in the P&L and the balance sheet tells a story of what’s going on with the business. A lot of our conversations with owners aren’t about like a number. They’re about, you know, how did that number become what it is? What what decision did you make to get there? And so part of that is like technology investment, like streamlining operations. And so that’s when you look at a profit and loss and you see like, oh, my recruitment expenses up, you

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know, 20% month-on-month. Um, and we want to understand like what’s driving that? Is it because you spent more on Indeed? Is it because you had to hire somebody? Is it because you had turnover? Is there a technology solution we can bring in that would maybe offset some of that or streamline it or make your staff more efficient so you don’t have to add another headcount? So, it’s all those things that seem really fuzzy that you can start to put numbers to and make a more educated decision around

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than just like, okay, we’re going to try it and see what happens. Um, but until you can like hone in on like what’s that pain point you’re trying to solve with the technology, it’s really just feels like there’s so many things that you could bring in. Well, and I, you know, you mentioned a couple of the other vendors in the space and then Caresmarts 360 also being one that is like an operational platform and then talking to you like more than anything I’m also thinking about being

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able to track those expenses, making sure that there’s like less lost revenue. And so perhaps, you know, there is often, you know, a good case for why this would actually help um in in investing in certain technologies to help in kind of what you’re trying to help them achieve. I wonder if you ever advise or when you might advise that it is not the time to invest in a technology. Would that usually just be based on, you know, what their bottom line earnings are? Um, it’s not always bottom line earnings. So, there will be

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like well- capitalized agencies that have, you know, capital to invest. I think what I would recommend an agency avoid doing is just investing in something because it sounds like a good solution. You really want to understand like how does that fit into my operations? You know, how does it support my team? And then is there a financial use case? And there isn’t always a financial use case. It might just be like, hey, we’re going to try this out, but we know we’re making that investment and here’s the expense

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associated with it. So, we can assume that’s what it’s going to have is an impact on the financial statements. >> Yeah. And we talked a little bit earlier about how part of your business and you know the way that you’ve connected with uh your clients today is often through you know partnerships in the industry. So coming from you know being a CPA and then moving into our industry of home care. Do you find that this industry maybe more than others that you’ve touched is very much partner

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industrydriven? Um, what are your kind of thoughts about the industry of home care as a whole coming from your former more generalized experience? >> I do think that there’s a lot of trust that’s built with the vendors and the partners in the industry. And so for me, the relationship piece of it is also very attractive because there’s a huge difference when we’re delivering financials to an agency owner that we have, you know, a trusted partnership with versus one that, you

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know, is, and this is really rare, but would have found us and is just looking for someone to report their books. They probably aren’t working with us anyway. Um I do think that the fact that it’s a close-knit industry and the vendors that are in it are really all from the ones that we work with and that we have great relationships are all doing it for the you know greater mission of the industry and supporting the agencies that are doing a lot of the work. So, you know, that also helps us make informed

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decisions and provide recommendations to our client around like, hey, you might really want to consider this vendor or this technology because we know that this is what they’re working on or you know, they have this really cool thing going on right now. >> Yeah. I you know it’s interesting because like meeting with you you’re definitely the first of you know what your business does that I’ve podcasted with but I mentioned to you in our earlier conversation I met with kind of

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a le a a a legal team that focuses on you know employment in the space and it does feel like to be successful in the industry because it’s so intricate that it almost requires you to be super focused in a way if would you agree >> I would say So, and I think that’s sometimes when especially when you’re a new agency owner when it can feel really overwhelming because it’s hard to focus on one thing because it feels like everything is happening, right? Like you’re getting a license, you’re getting

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insurance, you’re trying to find an office space. Okay, you have those things. Now, you have to market and recruit. And depending on your budget, that might be you doing a lot of those things. Um, but as you grow, then you can really start to hire and you can focus in on like, okay, here’s my skill set that I really bring to this agency and what is my best contribution to making it, you know, move that needle. >> Yeah, it’s come up a couple times a little bit in our talk already about

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like when to hire, when to invest. I’m sure that that’s something that comes up quite a bit and I would imagine that sometimes maybe the reason why an agency might reach out to you say is, >> you know, maybe they’re super successful, they’ve got a big census of clients, they’ve got lots of caregivers, they’ve got revenue coming in, but it might not make sense for them to say hire and recruit like a chief financial officer. Well, I would say, would you agree that your offering can kind of

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like fit that gap and give them that expertise without needing to maybe hire that extra executive person if maybe they’re not in a position where that’s going to make sense for their business? >> Definitely. Yeah. So, we provide that solution and it is for in my mind there’s there’s different ways to frame it, right? But, you know, you’re bringing in someone that understands the industry and understands the vendors and the, you know, the financial terms of the industry cuz that

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can trip up a lot of, you know, non-industry specific accounting firms. Um, so there’s just a less of a learning curve and more of a value ad right away. Then there’s also the cost savings. And one of the things that I think about often is, you know, when we’re recruiting and hiring and building out our team, the cost of somebody that is really stellar is so high that you, you know, you’re trying to compete. And so when you’re hiring someone at an agency level, you probably don’t have the

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budget for the level of talent that your agency would really benefit from. And when you’re buying it fractionally, it’s more affordable and you probably don’t need someone full-time. And then also the other thing I think about is I mentioned we have you know 15 people on our team that are across these different verticals. Typically when you have one person in the home care agency doing that they have to be an expert in billing and payroll in accounting and financial analysis maybe tax. So to ask

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one person to come in with that skill set at the price point that agencies can afford is really to me probably not there maybe there’s like a unicorn out there that is a at the price point and has that skill set but for the most part that person >> probably can’t do all of those things or do them well. I mean, even from like an experience standpoint, right? Because you said you’ve grown to about 15 and then all of the all of the agencies and the clients and the cases that they’ve

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touched bring with it so much value. And so, you know, even if you’re like a midsize agency, whoever you hire is going to be working within your four walls, then they’re not going to have all that experience. So, a shout out if you’re thinking about maybe hiring someone. Um, this is you. These are the CPAs that you need to call. So re uh revenue leak, we talked about that a little bit already, but I want to like sit on it a little bit more. Can we talk about it a little bit more? So when

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you’re, you know, getting to know an agency, finding out, you know, reviewing the information they provided with you, can you name just off a few areas of revenue leak that you think that comes up kind of often um with agencies and things that maybe they might not think about right away or >> So when we think about revenue leak, is that more um like missed opportunity for billing overtime or would you also say just like missed bottom line like expenses that might not be like truly capture.

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>> Yeah. Let’s talk about expenses. And you know what is actually on my mind? Like I’m almost thinking about marketing. I’m from a sales and marketing background. And I know oftent times um I haven’t sold home care, but I used to sell senior living. And I just remember everyone had such a tight budget, but when it came to sales and marketing, it was like, hey, you know, do what you whatever you need to do, we trust you. So almost like revenue leak like spend that maybe is out of control and but

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maybe it’s hard for the agency owner to really identify it. >> Yeah. So marketing is sort of this like fuzzy area really and there’s this I feel like sometimes owners sit with this fear of like if I don’t have a marketing resource I’m going to fail and that might you know there’s this and I come from like a space that’s pretty critical of marketing spend just because I do think that it’s an area where I’ve seen a lot of funds being allocated and not always the return on that. Um, and

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so for me, a big part of that marketing spend is usually like if you have a marketing resource like a a salaried individual and just really keeping tabs on like what they’re doing and like the progress and the relationships that they’re building because >> yeah, >> it’s so easy for that person to like share, oh, I did these 10 things today and it’s like, okay, where what is that? Where is that really getting us and where is that taking us? And I’ve always said that, you know, you really want

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three to six months with that person on your in your agency on your roster to really kind of see their performance. I’ve heard industry guidance as long as 18 months. >> Yeah. >> So that’s a big investment and and I don’t disagree with that. I think it’s just more, you know, when you’re thinking about that, like that’s a lot of spend um depending on your budget. I don’t think that’s something that always needs to happen. But that goes back to knowing the owner strengths and like

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what do they want to hire versus what do they want to keep and do themselves. Um, but I don’t think it always has to be that way. I think that developing like strategic relationships, looking at digital marketing, that’s a big one right now. Like there’s other ways to do that without having this big headcount and spend around in a marketing um resource. >> Yeah. And I guess the reason why marketing, it’s funny when you’re like, oh, you know, we’re always the industry

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that I’m in is kind of critical of marketing. There’s so many memes about that. I’m like every every accountant’s worst nightmare because I’m like out there. I I totally get it. But I think that marketing can seem so intangible, but there is ways of of you know keeping it kind of under wraps. So I guess it’s also about recognizing that everything is tangible to an extent, but of course giving that individual enough time to make the most out of the relationships that they’re building, etc. But I think

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that it’s a good cautionary tale to yes, make the investment, but proceed with some intention and then maybe like have a plan of like when do we reassess to see if it’s working. >> Yes. Okay. Amazing. Okay. So, uh, one of the things I liked about the conversation we had prior to this podcast, and I’d like you to talk about it a little bit, is you had made a statement of one of the things that you do, if you could put it in a nutshell, was financial analysis, but really explaining to like an agency the story

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of their financial situation in the way that they can understand it. So, can you just talk about that and kind of how whether it’s an example of how it’s worked really well or just a breakdown of what that really means? So, the reason why I’m attracted to that statement is as I mentioned like I’m very overwhelmed and undereducated on financial jargon and so to put it in a way into a story that I can understand seems like something that would be well business changing it would really

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empower me. So can you talk a little bit about that as almost like a mission or or how you’ve done that for agencies and what that looks like? >> Yeah. So so when I look at you know financial performance and do like financial analysis right on an agency we we put together what we call our client compass which is basically like a one-page overview of the agency performance for the month. And that isn’t limited just to like a profit and loss and balance sheet. It’s actually a very abbreviated

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P&L, year-to- date, monthly. We do look a lot at like revenue by payer source. We look a lot at performance by hours. So, what are you paying per hour? What’s your um price per hour? And so, what that does is it makes it less of this like here’s a list of numbers and here’s what the number is at the bottom. It’s like, okay, your revenue went up 10%. Why did that happen? Well, let’s look. Was it because there was a volume change in your number of hours? Was it because you started charging your clients more?

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you know what what was a lever that you pulled to do that? Maybe you brought in a new payer source and so that’s the reason for the bump in the hours. So it’s starting to connect those dots for an agency owner and then it starts to sort of like validate decisions that they might have made like a month or two like they purs ago like they pursued a contract or they decided to raise their rates. Okay, so now we’re seeing the improvement in their gross margin because of that. >> The other example that I give a lot is

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um average pay rate per hour. So, especially as an agency grows and usually one of the first roles that someone would hire for maybe is like that scheduler recruiter. And so maybe you tell your scheduler, hey, we or your recruiter that if it’s one or two people, okay, we pay on, you know, 20 bucks an hour. So in that owner’s mind, they’re paying $20 an hour. And then when we look at the numbers at the end of the month, it’s like, okay, your average pay rate was $23 an hour. And they tell me, no, that’s not true. We

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pay 20. And I said, okay, let’s pull some reports. So, we start to pull it like look at the reports. It’s because they’re getting into overtime because they brought on this new client which was the reason for the bump in the hours and they didn’t have the caregiver bench, which is okay. It’s just understanding like, okay, this was a temporary change or was it is there a reason for it? Other times, it’s like, hey, we had this client that was so far away we had to pay $2 an hour or more

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for someone to drive there. Okay, that’s fine. You know, do we build that into the pricing? Do we need to do like a mileage reimbursement charge for this client? So starting to like dig into some of the numbers that are correlating your income or your cost of sales with your number of hours to like bring that to life because that’s a lot of the times what agency owners are operating on are like what how many hours did I bill this week? Did I go into overtime? You know that sort of thing. And so then

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you can also bring that back to your scheduling team and say like okay you know we did this but did we talk to marketing about it or your recruiting team? Hey, we actually need to get like 10 more, you know, caregivers in because we have this bump. And so you start to connect the dots for the business rather than just everybody like sitting in these silos doing what they think is right. >> Yeah. And you know, when an agency is growing to a certain point, I’m sure that you’ve seen it, like at a certain

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point, these decisions that are made that might be like, let’s get this new client and get through this might lead to bad habits or not recognizing like the impact that it’s making um in the in the long run. >> Yes. Yeah. Exactly. So, it’s like >> we just want to get these hours on the board. Okay, that’s fine. Um we you know that’s like there that’s a whole different conversation around like what’s your positioning and what’s your strategy and do you you know

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>> get away from that for certain exceptions or you like tried and true like this is my strategy and this is my price you know that’s where that’s like the business documented strategy behind it but 100% like they start to want to put hours on the board especially a marketing resource you know when the owner is like what are you bringing in what am I paying you for okay here’s a client oh but they’re $5 an hour below market oh it’s fine like you know whatever. So yeah, 100% it recognizes

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habits and corrects them hopefully before they become a habit. >> That’s great. And I see so much value in that. And like one of the things that I find agencies are most excited about like when I’m doing a demo is how our platform will like you can build in blocks to be like hey like this is what is happening when you’re booking this. And now really connecting it to kind of the conversations that you’re having. And I understand why like the light lifts in their eyes of like you can do

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that like you can warn me before a schedule is going to do this or even prohibit it from happening. And so it really is telling a story of what’s happening. What will continue to happen if those changes aren’t made and then now yeah that crucial decision of well is this the cost of doing business or is this a costly decision bringing in these new lives into our census when we’re just not ready for it. It’s going to cost us more than it than than it serves our kind of mission. >> Yeah. Well, I love that. I’ve learned a

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lot. You’ve definitely inspired me, by the way, to probably do my taxes soon. I don’t know. I don’t know. Maybe. Um, so that’ll be uh that’ll be I’ll I’ll report back to you and let you know what happens with that. Um, so >> we’ve seen a lot. >> Oh, I’m sure. That’s the thing. It’s like when you’re scared to do your taxes, people like you are like, “We’ve seen it all.” So, >> so that’s always good to know. I guess

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I’d love to end by just finding out, you know, starting this business five years ago, coming from the corporate, deciding to do something that connected more on a meaningful level. What do you think your favorite thing is just about working in this industry? And um with all of your experience that you’ve had, all the people that you’ve worked with, what would you say is the highlight of being a part of this small but big home care industry? >> Oh, easily it’s the calls we do at the

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end of the month with owners to go over their results. like it just you see owners light up when things go a certain way. You see them have like aha aha moments and then when they pull other team members in it becomes this like strategy session. So it’s just such this rewarding feeling to see what we’re doing help them feel better and help them serve more people and have a more impact on like their caregivers. And it’s just a really special feeling to know that like numbers can actually make

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a difference as much as that sounds like pie in the sky. Um so yeah. Yeah, >> meeting with the owners every month is just like such a a treat for me. >> I love that. And I also think that people as we started this, you know, podcast with a bit of vulnerability for my part, like I’m totally intimidated by these terms. Again, daughter of a a a retired tax auditor. Couldn’t be more opposite. I’m vibes. So, when I think about an agency owner that has started an agency from the heart and maybe has

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avoided these conversations or looking or not even being able to have the tools to look and see what’s happening and then to realize that that investment that they’ve made in your company is actually feeding their ability to be a business owner, have that autonomy and then do what they started to do in the first place, I think is more than the ROI that our listeners would be looking for. So, I want to thank you for your time today. Thank you for simplifying it to language that even I could

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understand. And for everyone, we’re going to drop all of the information where you can reach Dana and her team. And um last quick question, uh small agencies, large agencies, the more they need, the less they need. Is there flexibility in how agencies can work with you depending on where they are? >> There is. Yes. I mean we do have somewhat of um you know we try to really provide like a wraparound outsource solution. So that’s you know for us works well with our clients and it also takes you know a lot

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of the burden off of them. Sometimes it you know more mature agencies will say like I’ve had this accountant in house and they know everything about the business. They’re like okay if they’re doing what they need to do and you just need someone to come in at a higher level and help you with some of the reporting and month end and acral no problem we can do that. So we do try to recognize agency skill sets and help them in the way that makes most sense for them. Um just because it is yeah

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there’s a lot of different structures people have that make sense. We just want to support them in the way that makes most sense for everybody. >> That’s amazing. So to the listeners finally whether you have somebody on your team who is you know managing most of your finances or whether this is going to be the first time that you’re reaching out for help there’s lots of flexibility and Dan and her team would be happy to speak to you. Thank you so much for your time and for for for the

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conversation. >> Awesome. Thank you.