Miriam Allred (00:10)
Hey everyone, welcome back to the Home Care Strategy Lab. I'm your host, Miriam Allred. Hope everyone's having a great week. It's great to be back with you. I'm super excited for today's episode. We've got Nick Provost, the Director of Client and Community Relations at Gratitude Home Care located in New Jersey. Nick, welcome to the lab.

Nick Provost (00:28)
Big fan. Thank you for having me. Big fan.

Miriam Allred (00:30)
Big fan, time to get

you in the hot seat. You and I have just recently connected and I've been super impressed with you and love the passion and excitement that I've just gauged from you in a short period of time and also your story's incredible and what you're doing is awesome and so naturally wanted to have you on the show. So let's start with a good old fashioned introduction. I think most people listening probably don't know you. You're maybe a new face and a new voice to a lot of people.

But tell your story, talk about your background. How did you get into home care?

Nick Provost (01:01)
So ⁓ I was actually, home care was a family business. My grandmother in the 80s, part time she taught a home health aid class. And over the years, the classes got bigger and bigger and bigger. And my mother who was also a nurse recognized this and my father quit his job.

being a CPA and my mom left the local hospital and they created a home care company in 1984. Fast forward, my first job in home care was I was 17 years old. I just got my license and I was transporting home health aids from their home to the homes of our patients.

This was before Uber and Lyft. I don't miss those days at all, but you learn a lot. You learn a lot. And I grew up in a home with home health aides caring for my grandmother, my great grandmother. And after I graduated college, it was only natural to go into the family business. at 23 years old, I...

joined on and I was mostly in marketing and social media, which was getting really big. you know, I did a good amount of private pay business development. And then I kind of had to just get into operations. You know, I, were a Medicaid mostly agency, six locations throughout the state of New Jersey and.

We needed all hands on deck. at 25, I was managing the six locations and we were doing great. Then ⁓ my father got sick and we got a great offer. And I said, dad, everything's gonna be fine. You enjoy your retirement down the Jersey shore and trust me, he is. ⁓ So I've been navigating.

Miriam Allred (03:04)
Thank

Nick Provost (03:13)
my way through the home care industry since then and ⁓ COVID hit, ⁓ fell out of love with the industry and I was managing a small home care company, not far from here. And a little over two years ago, I met the owner of Gratitude Home Care. Her name is Yela Maretik and

She had a smaller operation, family, homegrown business. was everything that I was used to. ⁓ you know, Yella is a visionary. She works hard. She does not cut corners. And we connected instantly. And I loved everything that she was doing and I loved her vision.

And when she asked me to come on to be basically, so it's director of client and community relations, it's business development. So when she asked me, had been a long time. I was used to speaking with families. did intakes, loved it. But, the networking aspect and, the daily grind was something that was unfamiliar.

She asked me to come on, she thought I'd be perfect for the role. And I loved what she was doing and I never had a chance. It was a match. when I signed on, we spent two months in a conference room, going over accounts, going over the business.

where we can find the clientele that we're looking for. And she did like a soft introduction to this world of home care that I never really knew. And then when she knew I was ready, she just said, you know, Nick, go be yourself and this is all gonna pay off. So fast forward to now.

I can't thank her enough for saying what she saw in me and here we are, Miriam. Yeah.

Miriam Allred (05:29)
Great, great story. When you say

she showed you a side of home care that you didn't know, what are you referring to exactly?

Nick Provost (05:36)
Well, you know, lot of our patients are in assisted living. You know, they need that extra one-on-one care. Before I sign on with gratitude, if someone mentioned assisted living, I'd be like, you your loved one's not in the home? That's terrible. How could you pull that? You know, I just, and then I started seeing a lot of these assisted livings they have...

pools and bars and happy hour and it's like, where do I sign up? You know, so I get it, I get it. But, ⁓ you know, assisted living is assisted. It's not one-on-one and ⁓ people are aging in place and they need that extra attention. So that was a side of home care I did not know. so it's not just home care, it's wherever these people in need call home.

So we'll go wherever they are.

Miriam Allred (06:34)
And that's a part of gratitude's service is placement then. I'm assuming that's what you're referring to. So yeah, maybe break down a little bit of like the demographic of gratitude because that will be helpful for the conversation, the service lines, the payers.

Nick Provost (06:39)
Yes.

Well, it's not.

Yeah, so it's not the placement aspect. These are actually people in assisted living that need that one-on-one with a home health aid. So we also do placement and that service line came from, know, this mainly happens with our patients in the home with dementia and being in the home.

It wasn't, it's not stimulating their mind. They get to a certain point where their quality of life just isn't as high as it should be. And these families really trust us and we, and that's everything we strive for, but we have had to have the hard conversations that your loved one isn't, the best place for them is not in the home with a home health aid anymore. And

We think they'd be better off in a memory care. And then we said, why not get into that aspect where we are going to place them in the places we know. We have patients in a lot of these communities. We know a lot of the people in these communities. Let's help them get to what's appropriate for them and their preferences geographically.

That's why we added on the place.

Miriam Allred (08:09)
This is already really good insights. I don't know about you. I'm just thinking when I explain home care to people, I almost pit home care against assisted living, skilled nursing facilities. It's almost like us versus them. And it sounds like that was your philosophy before meeting the owner of Gratitude was home care is home care. We don't do that other stuff. And there's a reason why we're different and there's a reason why this is better. But it sounds like your thinking has like matured and evolved in that.

Nick Provost (08:17)
Yeah.

Miriam Allred (08:37)
It really is what the individual needs and wants and that's best for them. And even as a home care company, we can partner with or it sounds like you all provide those services in these assisted livings. And so there's a lot of different ways to like piece that together. That's best fit for the individual. How did it sounds like the owner helped you kind of like bring you into this mindset. And it sounds like you going to the assisted livings helped you grasp the value of them. But how

Nick Provost (08:42)
Thank you.

guys.

Miriam Allred (09:07)
I think that was difficult for you. Like how did you work through that and how did you warm up to all of these concepts and how they fit together?

Nick Provost (09:14)
For me, there's a lot of there's a lot of juggling that these assisted livings have to do and You know a lot of people are paying top dollar to be in these communities So when it's recommended that they get one-on-one care, they're they're not happy a lot of the families are like what am I paying for all this for but when I saw

a couple of the assisted livings in the area, you know, some of these places are massive and, and, and as people are aging in place, they're not getting around as well anymore. You know, they're not as independent anymore. And like I said, this is assisted living. It's not one-on-one. So

We're actually helping with the independence. Our caregivers are helping them be more independent in these communities because they just don't have the staff ratio all the time to get people where they need to be, make sure that they're down for their meals, make sure they're getting to activities, you know, if they're not as mobile. So when I started seeing how much it really helped and

the connections and the relationships that we were building with a lot of similar people with the same mindsets as us. My mindset switched. It was pretty early on. And I mean, seeing some of these places, they're amazing.

Miriam Allred (10:47)
Yeah. And so you have pretty deep experience in like the New Jersey market, it sounds like, in all of your experience from your previous, from your family-owned company to that kind of like mid-company before Gratitude. Did you already have pre-existing relationships with a lot of these communities and facilities or were these all net new relationships that you've built since your time at Gratitude?

Nick Provost (11:09)
So my experience was through, it was through hospitals and discharges from hospitals. we had ⁓ a lot of contracts with, you know, different organizations throughout the state, the VA and there was a bunch, but.

That was what I was familiar with. I was not familiar with the assisted living. I was not familiar with independent living. I knew nothing. I knew nothing. So, seeing this, it was all new. I was creating these relationships through our owner and the people here.

Miriam Allred (11:53)
So this is what I want to unpack. think people listening to you already may think like, who is this guy? You know, he seems like really humble and calm and quiet in nature. But I just want to like interject right here and say like, you're a dynamo and you've had a lot of success and I think you're going to undersell like the success that you've had in the last, I don't know, decade or so. And so I want to I want to ask you, you have no formal sales training. You've grown up in home care. You've built all these relationships organically.

Nick Provost (12:11)
Okay.

Miriam Allred (12:21)
because you don't have formal sales training, you've learned all of this on the job. You've built these relationships just naturally and organically. What works for you? From a sales perspective, you walk in to meet these people, again, with not a lot of training. At this point, you have a ton of experience, but not a lot of formal training. What's your approach? What's Nick's secret sauce and approach to being a person that they can trust and then ultimately pass referrals to?

Nick Provost (12:50)
So it really is, ⁓ I really rely on my overall knowledge of home care and the industry. And I can't stress enough how important it is to understand what's going on in operations. And when you can really, when you know the caregivers, I mean, I told you I was driving caregivers. I still see some of these caregivers that I drove when I was younger and they're,

They're the OG caregivers now, but they have family that are now caregivers and they're like, hey, weren't you with the, yep, that was me. So when you really pull in every aspect of the industry and the home care company, that general knowledge is really gonna help you be transparent and build that comfort with accounts and patients alike.

No, no sales training, but I went in, I tried to be genuine, I still try to be genuine and I always, I think when people see how I can communicate with families, that's where the trust comes in and.

My secret sauce, I can't give it all out, but this is what I tell people. So, the industry, particularly here in New Jersey, is trending in a certain way. It's getting a lot younger. And 10 years ago, I was the only, 15 years ago, sorry, I was the only 23 year old around in this industry. And I was speaking to families and people are like, what the heck do you know about?

anything. And, you know, you're learning on the fly. And so it really is leaning on that leaning on the knowledge of the industry and your experience. But listening, you got to listen. And you got to listen, everybody, what's what are these people's biggest needs, in these accounts? ⁓ And what can you do for them that's going to make their life easier? So

you can walk into a hospital assisted living or whatever it is and people could just look right in your hands. Where are my cupcakes today? Where's my coffee? And that's, you're looking in the wrong hands for me because what I can tell you is that, say you're a social worker, what I can tell you is we don't know where we're gonna be in 10 years, but I'm gonna be in home care probably. ⁓

As long as you're around and you trust me, we can grow together and we can surround ourselves with professionals that are in it for the right reasons.

When people really see that and they see how much easier that their life can be, ultimately who you refer reflects upon you. And by referring over to me, to us, your gratitude is you're enhancing the patient experience because you put us in contact with the person that needs help. So.

I tell the people that I work with that as we grow, you can always rely on me. I'm always here for you and I'll never make you look bad. You call me at 10 o'clock on a Sunday night, I'll get out of bed, I'll take that call. So it's the loyalty, it's the passion. And when people see that and they recognize that.

the good ones will take that in run with.

Miriam Allred (16:45)
And when you talk about like demonstrating your depth of knowledge for home care, what does that look like? We talk a bit about like a data driven approach, like, look at our numbers, look at our stats, look at our readmission rates. Like, I'm curious if you take that approach or do you tell like your personal story or do you talk about clients and caregivers like to demonstrate because sometimes you don't have a lot of time and these relationships take a good amount of time to get to even the first referral and to then to get to lots of referrals.

But it's hard or it's challenging to build that initial moment of interest and that connection. I'm curious what you lead with. Do you lead with your personal story? Do you lead with data? Do you lead with a relevant client story or what's your approach to lead in?

Nick Provost (17:32)
Yeah, I mean, just, number one, just being personable. You know, I just have to be able to get along with anybody. And, you know, that's just, I don't know, I guess it's a gift. I've never been awkward around people. You know, this is an industry predominantly of females. And, they say that people are more willing to work with people that look like them.

you know, I'm behind the eight ball. And so what, what, what's, what am I going to do? And it's really just being a professional and, and, chipping away until you get that shot and, you get that referral and you have to make the most of it. And, know, there's some, I was in a sub acute and there was an intern social worker that was helping a patient and

She was setting up meetings for ⁓ home care liaisons to come out and speak with them. And so I come in, I meet with her, we walk up to the room, she goes, just stay here for a second. And I go, what's going on? She goes, well, they're meeting with another home care company. And I go, how many? How many have they met with? And she goes, well, you'll be the fourth. And I go, how many are they meeting with? She goes, four. I go, so you saved me for last. In four hours, they've been talking to home care company. And...

I said before I walked in, said, you should come in, with me and see how I do this and see how I talk to the family because they're exhausted right now from talking to all these people. And I go, if I bring this client in, make sure I'm number one next time. anyway, long story short, yeah, that client went with me and...

The social worker has now moved on as a case manager in a major hospital in the area. And that relationship, that moment right there, that shot that she gave me, it set us up for a lot of success. And now a major hospital in the area, she knows where to send people that need the help.

Miriam Allred (19:47)
That almost felt like a cliffhanger. Like you open the door to go and speak with the family and then it's like, wait, what did you say? How did it go? Like, tell us, you know, it was like you like set it up, but it's like, what is what is your philosophy to care? Like this is one of the questions I had written down was like, what is your philosophy to care? How do you go in and help the family feel like you are the right fit for their family?

Nick Provost (19:54)
You

It really is about listening to them. People want to talk. And you know what? They don't want home care. Nobody wants home care. Okay? So this is not something people want. This is something people need. Okay? So you need to know that right away that you are going in and people don't want this. But it's listening. It's providing comfort. It's asking open-ended questions.

that are going to get them to talk. it's like, I don't know, going to a therapist, you know, they're a neutral source. They ask these type of questions and then, and you're just talking and you're, and all of sudden you feel better because you're talking it out, talking about, you know, you're realizing what you need and the type of, and, but I think when it, when it comes time for you to speak,

put your two cents in, you have to be that professional. Okay. You have to guide them. I mean, educating is so big and 75 % of people that are looking for home care have no prior experience to home care. So, you know, a lot of the calls, a lot of the families that I speak to, they're like, I'm new to this. So I, you know, I don't know. I don't know. So you have to shed light on what you see a lot of.

Okay, we know each patient is specific and everyone has their own needs, but you know, I'm getting discharged next week and you know, what do you think? Well, you know, the first two, three weeks are the highest point of readmittance. we need to make sure that your transition home, wherever you call home, is a safe one and we'll get you back on your routine and...

after these next two weeks, three weeks, let's see how your transition is doing, your recovery is going, and then let's dial back if you feel you need it. So it's being transparent, being the professional that they're looking for. And a lot of people don't realize they're calling for pricing and they're shopping around. And then you have the right questions. You're listening.

picking up on certain things that they're putting down, then all of a sudden they're asking you, what, you know, have you seen this before? you know, so they're asking for your experience and then that's where you step in and you become that resource. And that really is, I think back to your previous question, one of the things that I pride myself on that we pride ourselves on is that we are a resource first.

people that calls, we are resources for them. Okay, if we can't help them directly, we are going to put them in the right hands. And that creates future business. That creates word of mouth referrals. when you start getting word of mouth, you know, I got your card from my neighbor. When you start getting word of mouth referrals, it really shows that you're establishing something good. So being a resource and making sure that they're put in touch with the right people if you can.

help them yourselves.

Miriam Allred (23:30)
And we've all been on the receiving end of that level of service. When I'm calling about something that you can't help me with, but you direct me to somewhere else that can help me. That is like the peak of customer service is like, wow, I came to you with a problem and you can't solve it, but you know who can solve it and you're pointing me to that. And then I go and then it works out. I love that. In a world where customer service is diminishing in quality, we all experience that side of it. ⁓

Nick Provost (23:43)
Right.

press.

Mm-hmm. ⁓

Miriam Allred (23:59)
customer service and in this case, you in your position, just it goes such a long way to develop that trust. So you talk to a lot of families like you are still like very much on the front line talking to families, and then helping with that transition of care, etc. with your team. then you're also developing the relationships with the referral sources themselves. How much of your role today?

Nick Provost (24:12)
Thank

Miriam Allred (24:26)
fits into each of those buckets just for context.

Nick Provost (24:29)
Yeah, so you have to wear two different hats. And the way that we're growing, there's been talk about that we should probably have an intake coordinator, somebody that's going to speak to the families. Whatever way I feel about this doesn't matter. And we laugh about it quite a bit. I love talking to the families.

That is something that I wish I could just do all day long. Some people really thrive going out and making the connections and, establishing accounts. But when they finally give you your shot, you need to be able to put on the other hat and talk to those families. This is a very delicate, sensitive time.

their lives and you need to take off your networking hat and put on your active listening and resource and establish that trust and comfortability. So it's not easy for a lot of people. ⁓

Miriam Allred (25:31)
Because those

are two different skill sets, like you're saying, want to go out and be vibrant and drum up a relationship with someone that's tired and has talked to 10 other people that day, like that's a skill set. And then like you're saying like shifting gears, like, okay, now I'm talking to a family member and I am listening. You know, I'm doing 10 % of the talking, they're doing 90%. Like it's just, two different skill sets. But I think what you're saying is in your role and a lot of other business development leaders, they have to be able to do both.

Nick Provost (25:37)
I know.

things.

Mm-hmm.

Miriam Allred (26:00)
successfully. And so can I push you a harder, like quantify, because you're also a leader and you manage people. so you kind of wear three hats, like your management hat, making sure your team is set up for success. You're still talking to families as if you are the intake coordinator you are. then also talking to and developing those referral accounts. Is it a 30-30 split or what is kind of the breakdown of your day or your week?

Nick Provost (26:01)
Yeah.

Mm-hmm.

Miriam Allred (26:27)
Ballpark. It doesn't have to be exact. Just ballpark.

Nick Provost (26:28)
Yeah, ballpark. mean,

yeah, yeah.

I think that when you establish yourself with people that really do trust you, you know, you can set up a schedule and you don't have to be on top of these accounts as much as you really think. And they're, the people that are, have you done for me lately type of accounts and that are looking in your hands, they want to see you every week and they want their coffee and.

But when you find people that are like, just want the best for my patients, then you don't need to be on top of them as much. But that takes a long time to establish. in terms of the split, when you get really busy, it all depends. It's really hard to establish a firm schedule because of just you don't know what the day to day is going to bring. You don't know how many people are going to be calling you.

for help. So in terms of the leadership aspect, yeah, I have to make sure every morning that my team is set and they're focused before I even get myself set. And that's been really, that has been a challenge for me, for sure. But, I have great mentors and I have great people around me. we're there and we're

we keep expanding our reach and we're doing a great job. So I feel good about it. But yeah, I mean, we're probably 40, 40, you know, it's hard.

Miriam Allred (28:08)
No, this is great. Don't take this wrong way. You're not giving me the answer that I wanted, but you're giving the answer that I probably need to hear, which is there is no rhyme or reason. Before we started recording, I was asking you about January. How is January coming off of the holidays? January is a crazy time. You could be doing intake calls 80 % of the time in January because that is where the need is. That is where your skill set is. And that's what the team has like agreed upon. And so this is good for me to hear of, know, I'm like,

Nick Provost (28:13)
Thank

for nine.

Miriam Allred (28:36)
Give me, know, like put yourself in a box and give me the numbers and make it rigid. But you're telling me that is not the reality. One month it could be 80, 10, 10. The next month it could be 40, 40, 20. Like there is no rhyme or reason, but that is the nature of your role in this business.

Nick Provost (28:51)
That's right, yeah. I mean, there are times ⁓ that I'm going out and I'm gonna go see six accounts within half a day. I always start my morning in the office. I do things a little differently than how other business professionals would do. But there are times I pull out, I get on the highway and my phone rings and I pull over and...

I get off the call and my phone rings again and my phone rings again. And I just have to come back to the office and start putting all this in, making sure that we have caregivers ready to go. it's a day by day thing.

Miriam Allred (29:34)
Yeah,

that's the reality is you've had a lot of success. so my mind is like, OK, give us like the formulas, like how have you been successful? But it's not that rigid. It's not that set in stone. Every day is different. And I think your skill set is just your nimble and your understanding and you're listening to the people that are all talking to you, your direct reports, your owner, your families, your referrals.

Nick Provost (29:56)
right

Miriam Allred (30:00)
you are just listening and assessing on a daily basis as to where you're needed most. Doesn't mean you can't be strategic and step out of that. You were talking to me about like December and like Q4 and planning and thinking about this year. Like there's a time and a place for the strategic, but really your day to day is very much in the weeds, which is what you like and what you're good at, but also just the nature of home care.

Nick Provost (30:04)
Mm-hmm. Mm-hmm.

Yes, for sure. It's definitely the nature, but it also means something's working, so it's a good thing.

Miriam Allred (30:33)
I

want to talk about your top accounts. What I picked up from your last response was also you have spent years developing really strong relationships with the right fit partners for yourself. Like you said, your right fit isn't someone that needs you week after week, bringing him a coffee, checking in, leaving a note. Like that's not the right fit partner for you. But I think everybody wants

what it sounds like you're right fit, which is you develop this really deep relationship. They know you, they trust you, they know your level of care. And so when the need arises, you're the first to call and you're getting that referral. So you're getting a lot of inbounds and you're getting a lot of word of mouth. Who, who are your, who are your top of mind accounts? I'm just curious, are they hospitals? Are they assisted livings? Like who, for you personally, not necessarily your team, but like for you personally, who are your

big accounts that you are most focused on and have developed these really strong relationships with.

Nick Provost (31:31)
So it would be hospitals, know, subacutes, rehabs and assisted livings right there.

Miriam Allred (31:40)
Okay. Those are the three. And when you say those three categories, that's great. Is it several in each of those categories? Is there kind of like a big front runner in each of those categories?

Nick Provost (31:50)
It's several. mean, so, you know, without giving everything away, but I'll just break it down. So in 2025 at Gratitude Home Care, we received referrals from 113 different accounts. So in the areas that we serve, that's 113. So it's, that number really stuck out to me. And it means that

You can't rely too heavily on any one or two. It's just not, that's not the recipe for success, but you know, we've worked extremely hard to be present where we are. Hospitals, the assisted livings, you know, in home health organizations, there are financial planners. I mean, I have realtors that call me that have known me for 10 years, so it's.

It's all about relationship building and but the hospitals and you know, the number one thing is you have to really establish the clientele that you're looking for. And this is private pay home care. So, you know, it's the top 5 % of America. These are people that can afford our services and it's not cheap, know. So, you need to know the regions that you're looking at and ⁓

the people that have set themselves up for retirement, which I'm scared for when I get there because I don't know how I'll be able to handle this. But the growing population right now, the seniors really set themselves up well for retirement and care.

Miriam Allred (33:36)
So 113, I knew you had some numbers for me. 113, that is a huge number. You are one of like three sales business development people in the organization. So 113 across three of you is a big number. Do a majority come from a small handful of those referrals or is it very much divided across the 113?

Nick Provost (33:40)
Okay.

it would be fair to say that, probably 25%, 30 % of them are really the ones where the most of our business is coming from right now. it's, and listen, it's not just my team here. It's, it's our owner, we get her executive director, you know, our director of care management.

Everybody here has been handpicked from healthcare, okay, and put into a role that we have made a team where we're all on the same page. so there's, yeah, I mean, it's probably 30, 40%, you know, that we're getting the majority of our business, but, you know, at the beginning of 2025,

Our owner said to me that she wants a new or revived account. One new or...

And, you know, anytime someone's gonna throw a challenge at me, I really, you know, I get a little too intense about it. So, you know, I think we hit that by like month four. You know, we hit the 12 by like month three or four and we ended with, I think it was 42 on the year of Nuke.

Miriam Allred (35:13)
if

New accounts, okay. To be honest, 30 to 40%, I know this is all just kind of ballparking, but 30 to 40 % coming of your business coming from like a select few of those referrals, that's actually not that much. And I don't mean to discredit or downplay like the 113, like there is value in every single referral from every single account. Like you said, like a financial planner could give you one referral.

Nick Provost (35:46)
Yeah.

Miriam Allred (35:52)
we know how much one 24-7 client could do in a year. It's like every single referral matters. But I actually think it's interesting that only 30 to 40 % come from like a majority. The other 60 % are coming from all of these different sources. And you and I both know that adds up. Like every single referral matters. so having that like wide net of accounts really does drive business. Even if that financial planner is only sending you a referral once every six months.

Nick Provost (35:58)
Mm-hmm.

Right.

Right.

Miriam Allred (36:21)
That's okay.

You're top of mind. You got the referral and that client is being taken care of, know, in your jurisdiction. And that's, that's the end goal here.

Nick Provost (36:29)
Right, you need to have a wide reach. And it's not just within the healthcare industry, it's everywhere. ⁓ yeah, it isn't that much. But some of the the accounts that have become our biggest, okay, they, you know, were just established, you know, a couple months ago, six months ago. that's...

great, that's a true teller of what we're doing right now.

Miriam Allred (36:57)
Yeah, it's back to the business ebbs and flows. It's never going to be the same every month with referral accounts. Their business is changing, your business is changing, people are changing. There's just so many variables. I like what you said a minute ago. was kind quantifying the 113 to the three of you, but you said there's all these other people in the office. I think the best home care companies, every single person is doing a level of sales and business development. Even the caregivers, they're walking billboards. You hear that in this industry, they're walking billboards.

Nick Provost (37:14)
Mm-hmm.

Yes. Yes.

Miriam Allred (37:24)
Every single person has the ability to bring in net new business. And I think that should be kind of baked into the culture. Like the philosophy every business is we're all doing this. Like, yes, there are people with official titles, official roles and responsibilities doing this, but really everyone has the opportunity to bring in referrals via any one of these sources or other sources.

Nick Provost (37:29)
Mm-hmm.

Absolutely and I'm glad you brought that up because like I said before I start my day in the office and you know there are some sales professionals that you don't see you know for a week you know a couple days they're out in the field they're doing their thing what what I do is I need to talk to everybody here everybody is on the same page everybody

including the caregivers, make them part of the business development team. Okay, you you go to the coordinators or schedulers, hey, this is a, you know, I got a referral from new account.

just letting you know this is our first case here. We've been working really hard to get here. And they're like, no problem. You know, I got you. All right, we're going to. So and it goes from them to our nurses, letting letting our nursing know that who oversee our caregivers in the field, like letting them know this is a new account. You know, let's make sure that we're, ⁓ you know, on our on our on our A game, not that we aren't ever, but just a little extra.

You know, and it even goes as far as, you're not going to see many people do this, but picking up the phone the night before a new account and calling the caregiver and making them feel like they are part of something that is really special, which they are. mean, without caregivers, we're not having this conversation. but picking up the phone the night before, giving them a call, letting them know, I've been talking to his family,

Miriam Allred (39:12)
Mm-hmm.

Nick Provost (39:19)
This is really big for our business. This is really big for what I've been doing, making them feel that they are part of something bigger than the really hard task of caring for somebody that, that really needs this help. It gives them that extra motivation. And I can't tell you, I can't stress enough how important it is to keep everyone on the same page and make sure everybody has that mindset because...

when you all have that long term, that big picture goal in mind, know, the day to day, yeah, you can get dragged down by the day to day, but as long as you all have the big picture.

It works out well, it works out well.

Miriam Allred (40:04)
I get the sense that you're like the glue, the glue of this organization holding just everyone together, which is such a key role because we talk about in business development, developing relationships with people externally. It's equally as important to develop relationships with people internally. You to the nurses, you to the caregivers, you to every single person internally, because like you're saying, and I'll tell you where I'm going with this,

when you get a referral, that is so important that every single person understands how important that is so that you can deliver on it because what you do with that referral dictates whether or not you're gonna get the next referral. so you could just willy-nilly, nonchalantly, the caregiver knows that they need to show up and the team knows what needs to happen, but it could just roll forward, but you take the time.

to develop that trust and those relationships internally, call these people, give them the context, give them the level of importance that this is. Like those little details matter with every single referral and those referrals lead to more referrals. And so doing this just like extra work internally really adds up and matters.

Nick Provost (41:22)
does. And it's hard to think about day to day, but when you just add these, they're little things, they're just, they're small things. When you can just add these things to your day to day, when you take a step back and you realize what you've done in the last couple of years and you see where you are, all of these little things, they've added up to something that is really special.

Miriam Allred (41:50)
Yeah, that's been my latest thinking lately and I sent you a document that had this line on there, but home care is won or lost in the details. Home care is not hard. I think a lot of people would say that, but it's the details. It's you calling the caregiver the night before their shift with this new referral. That dictates, that single action could dictate the success or the failure with a large account that could then refer you.

Nick Provost (42:17)
Absolutely.

Miriam Allred (42:19)
We're talking hundreds of thousands of dollars of business or beyond. Like one referral matters, one phone call matters, and home care is literally one or lost in the details. And what you're saying is a great example of that. It's just all these tiny micro touch points that when we talk about scaling, we have to think about, how do we document these processes? How do we document where those phone calls happen so that we make sure we do that every single time? Like that's another conversation, but it really is.

Nick Provost (42:22)
Mm-hmm.

Sure.

Miriam Allred (42:45)
these details because my question, is like kind of a blanket question is like, what are your tactics for closing every referral or majority of referrals? What would you say to that? I'm getting it's like it's kind of what we're talking about is like there's so much more to closing a referral and having success with it.

Nick Provost (42:57)
Yeah.

It's all in the details, you know? So, I mean, there are things that are small as, you're on the phone with someone's ⁓ loved one who, mom needs help, she's Italian, she used to love to cook. She can't cook anymore, her hands aren't as steady.

And do we have any Italian caregivers? We don't have any Italian caregivers, but this is what we can do We have a really good caregiver. She's not Italian. I just ordered a Italian cookbook off Amazon and I'm gonna drop it off tomorrow and Mom and the caregiver together Okay, can can make a meal so like it's something so small that can really satisfy, you know

patient, the patient's family. I we've done these little things time and time again, and the feedback that we get is so incredible. And in turn, the feedback that our accounts get is so incredible. Like, they're willing to go the extra mile, okay? And it's not even that hard. You order a cookbook, it's nothing. So it's really the details, the small things.

Miriam Allred (44:14)
the personalization that is memorable. And then like you said, the account, the referrer gets word of what happened in the home, game over. You win the extra mile that nobody else has gone and that in turn will keep them sending referrals to you day in and day out. And like you're saying, it's just these really simple acts that are so personalized to the individual that goes such a long way.

Nick Provost (44:40)
Yeah, for sure, for sure.

Miriam Allred (44:43)
biggest way to identify what that person wants, like the cookbook example, really comes down to probably the intake and that conversation and the listening that happens. What's your approach to just making sure you can extract those details that really matter to the individual or to the family?

Nick Provost (45:02)
Yeah, so it's having the right open-ended questions. You have to let them talk. They will talk. Everything that you need out of the intake can be done with just a couple questions. you know, some people will pull out an intake form and be like, okay, I need your name, I your date of birth, I need your address, who's your primary care physician. If you have the right couple questions. ⁓

You're gonna learn all that. You're never gonna have to ask those questions. It's never gonna feel like that the person that's calling you or the person that you're speaking to is going through an intake process. You're just doing it because they're talking and they're telling you everything. that and making sure you got your notepad, you're writing everything down and...

and then, you know, okay, like, likes Italian food. Yeah, everyone likes Italian food. But how much does she like? She likes cooking Italian food. So let's let's get her a cookbook. Okay, so, you know, it's little it's being creative, but it's really the act of listening, not trying to not trying to put too much on their plate. You know, you want to educate them, but you don't want to overwhelm them. You know, you want them to work out.

their problems with you on the phone and it's going to happen by asking the right questions and letting them talk it out.

Miriam Allred (46:24)
How do you strike the balance though of, you know, this is medical grade care, you know, there's obviously a need. How do you balance? Like, I'm just imagining you having this conversation. How do you balance making sure you cover like the base needs while also extracting those personal details? Like, do you, wet my palate a little bit of like how you do that successfully to make sure you get both.

Nick Provost (46:38)
Mm-hmm.

So yeah, you really need a really clear understanding of what's going on clinically and the limitations. there's a set of questions for that too. There's a set of open-ended questions for that too. But the matchmaking process is really important. And we don't.

Our schedulers don't just shift fill. They don't see an open shift and they just fill it with whoever's available. We need to make sure that there's the, can't risk our quality of care by just shift filling. We need to make sure that these are the right caregivers, somebody that has experience with, you you don't put someone who works with people who have hip replacements on a dementia patient, you know, you have to make sure it's the right fit. So yeah, you have to get,

down to the nitty gritty and make sure that you have a full understanding. But there's also a lot of times that people aren't going to give you the full understanding. that's where, nursing assessments and, stuff that I can't do really come into play. So I get as much information as I can. And then we we go from there. Did I ignore your question again?

Miriam Allred (48:03)
No, no, no, no, no, it's a hard question

to answer because it's so personal. that's cliche to say, but every single conversation warrants like its own set of questions. You ask one open-ended question and there it's like this podcast. It's like, I ask you one thing, you respond. And then we just like snowball from there. That's how good intakes and assessments go is they say something and then, know, to dig in and like just follow, follow the conversation.

Nick Provost (48:25)
Right.

Miriam Allred (48:33)
I want to end here, these last few minutes, you have had a lot of success and I knew you were going to downplay it, but I would just like to share, know, like 45 % year over year growth the last few years and you guys are, attempting to tackle that again this year. That type of growth is incredible, but it is not easy and it's not something that just happens. It's something that you proactively strategize and work towards. it's again, all these micro

moments that lead up to that type of growth. just am curious starting this year, new year, know January is kind of like hot and fast and a little bit of everything, but what are you setting your sights on for this year as far as maintaining those accounts, developing new accounts? Like where's your focus as we start this year?

Nick Provost (49:17)
You know, we have a lot planned out. Obviously, we want to keep up the pace and ⁓ do something that's unprecedented as far as I know. the growth that we're seeing is amazing, and it takes a lot of upkeep, and you have to make sure that you're staying on top of it. But we can't focus of the big picture.

I think the main thing that has really driven success and what we're going to continue to do for 2026 is, home care, you need to have the perfect balance of short-term gain and long-term goals, you know, like these short-term...

things that'll pay off and, you know, I want to be in a major hospital system. You know, I'm working with one of my, one of the people on my team right now. She really wants to be in a major hospital system and we're chipping away at that together. And, I think that what,

our owners have done for me, I'm trying to do for them for 2026. And the way that they've showed me how to do certain things, I'm gonna portray onto them. I mean, the mentorship that I received and the...

I don't know, I guess that equates into the success that we've had. I want other people to feel the way that I feel, you know? This is not, I love coming into work every day because this is, it's really amazing to be part of something special. And I told you, I felt out of love with this industry. There was a part of me that wanted no part of this anymore. And to feel as passionate and

excited as I am to continue this on a day-to-day basis. I want everyone to feel that way. ⁓ whether it's my team, whether it's schedulers, coordinators, nurses, caregivers, that's the way we operate. And...

You know, the culture is great. It's huge and it means everything. So I want to pass that on and see other people be as successful in their own region and their own field that we have been doing as a company and add to that. think that's the only way to really continue on with this growth is by expanding our reach. And because, you know, it

It'll burn you out quick to try to keep up this pace.

Miriam Allred (52:04)
Yeah, expanding the reach, also like what you're saying is like deepening the passion, making sure everyone in it feels it, believes it, wants it, and has the endurance because this gets hard. I wanted to actually ask you that. You said you wanted out during the pandemic. I think a lot of people wanted out. Nobody wanted to go through that. It just it burned people out, including someone like yourself that like loves this and has like a personal passion for this.

Nick Provost (52:08)
Okay.

Miriam Allred (52:32)
got to the point of burnout, how has that experience helped you even now? I know you say you love coming to work every day. It doesn't mean there's days that are hard and long and you don't want to do this, but where do you dig deep to? What's inside of you that can pull you through those hard moments?

Nick Provost (52:43)
Yeah.

You know, Yela, our owner, me once she saw I was getting a little burnt out. And it's not often you have an owner that sends you a text, like, need to take a week off. And she gets it. She's been on the business development side. And before she was an owner, she was an executive director, and she was in business development and home care. So.

she recognized it, but you know, she told me, Nick, when it starts to get a little repetitive and you're not feeling as passionate, like get down to the little things, go talk to a family, go talk to a family that you've, we already have, like just go see one of the patients that we currently are active and with us, go talk to the caregivers, go, I, I always joke, I used to...

When I came back into the industry, was a coordinator that just was in this company that I joined onto. she's, and it turns out I used to drive her grandmother when I was 17, 18 years old. And, and.

Her grandmother always remembers because every time we stopped in Teaneck, we always had to get bagels. Always. She said, Nick, pull over. We got to get bagels. I'm like, come on. I got a schedule. But it was the little things, like at the time it was annoying, was the little things like that that would really, I think back on and I laugh. So it's like go to a caregiver, bring that caregiver her bagels, have a laugh with the caregiver. Just breaking it down and...

Miriam Allred (54:08)
Thank

Nick Provost (54:30)
I don't know, the little things that you remember that I was so fond of when growing up and having caregivers in my home and breaking it down and getting back to the basics and seeing the joy that you are giving people. I started, when she told me, when my owner, I'm back and forth, when my owner told me to...

Miriam Allred (54:55)
It's okay.

Nick Provost (55:00)
break it down, go see a patient. I started doing that. And honestly, I don't know if I could have ever gotten better advice. It held off the burnout. And so, you know, I still do it. And, when I go to these accounts, particularly the assisted livings that I'm going to see, I'll always stop in and see our patients and talk to the caregivers. it just, it brings light to.

sometimes stressful days.

Miriam Allred (55:30)
That's

what I was gonna say, brings out the light in you. And I can relate just kind of on a personal level, you know, when I'm down to get out of the funk, you just talk to people, like a good conversation, a good, just like honest, raw conversation with someone that you care about or someone that you don't even know. Like you just have a good conversation. It pulls you right out of like the dark days. And it sounds like that's the case for you too, is talking to the families, talking to the people that...

Nick Provost (55:41)
Mm-hmm.

Miriam Allred (55:58)
are impacted every single day by the day in and day out behind the scenes work that you do, go talk to the people that benefit from that. That will pull you out of any funk, out of any hard, kind of dark time is just talk to people and talk to the people that you care about and that you are doing work for. And that'll just zap the bad mood. I agree. I think that works personally and professionally for me as well.

Nick Provost (56:05)
Yes.

sure it does.

Miriam Allred (56:25)
⁓ Nick, this has been amazing. I feel like this has been a little bit unconventional for me. talk to lot of owners and C-suite, but this has been really healthy and refreshing. think you've downplayed but also simplified what this is for you. When you talk about being a business development leader, this is what it is. No two days are the same. You are building relationships internally, externally. are supporting your team.

Nick Provost (56:42)
Mm-hmm.

Miriam Allred (56:51)
You are prioritizing every single client like they are your only client. Like it really is just a bunch of micro efforts that lead to the 45 % year over year growth. You know, I could sit here and ask you like, how do you do that? The conversation we just had, that is how you do it. You literally just focus and double down on these really important moments and touch points and tasks and phone calls that go further.

than any high-level strategy or tactic ever could. It's really just these micro-moments that go a long way. So this has been a great conversation. I feel like you have shared things that I wasn't expecting, but it's been amazing and helpful all the same. So thank you.

Nick Provost (57:31)
Thank you. Thank you, Miriam. I really appreciate being on your podcast. This is I mean, I've been listening for the last year and change and I'm a big fan. And yeah, I mean, you have some really in depth interviews and, it was kind of intimidating to come on here to share what what I have, But, you know, it

I appreciate you just taking the time to talk to me, so thank you.

Miriam Allred (57:58)
Yeah, the pleasure is all mine. I think you've done yourself and your company justice and I'm excited to follow your path this year. You guys have another big year ahead of you. You told me before the show this past year 2025 was really about like reestablishing your base, re strengthening your foundation. And now this year you just want to like double down and compound on that reestablishment. And so I'm excited to see what's in store for you this year. I'm sure it'll be nothing but great things, but you and I both know it's a lot of work and a lot of time that you have to put in to achieve these goals. But

I'm confident that you can do it and we'll stay connected and see what we can do together. So Nick, thanks for joining me in the lab.

Nick Provost (58:33)
Thank you so much. Thanks for having me.