Jenny Johnson (00:00)
you

Miriam Allred (00:00)
⁓

Welcome everyone to the lab. We are live here in Austin, Texas, and I am joined by Jenny Johnson, the CEO of Heart of Gold Nursing. Jenny, thanks for being here and welcome to the lab.

Jenny Johnson (00:23)
Thank you for having me. I'm a long time listener and I've learned so much.

Miriam Allred (00:25)
from

you. You are the sweetest. Tell me how long you've been listening to the show.

Jenny Johnson (00:29)
Well before you were at the lab. Good few years back in the day, so yes.

Miriam Allred (00:34)
Okay, well this is such a treat for both of us to be live in Austin. I was just telling you, I interview a lot of people, but only so many people in person, so this is a real great experience for both of us. And we just got connected through Becky Reel, the sweetest. We did an Orange Theory class together, so we're feeling good physically and mentally and excited for this conversation. Let's go ahead and start with a little bit about your background. But in the form of storytelling, tell us about the personal event or events.

that led you to founding your home care company.

Jenny Johnson (01:05)
It was a very interesting, unique and traumatic experience for me well before I knew I was going to have a business. First of all, I'm a nurse of 25 years and literally thought I would retire in a hospital. I love nursing that much. I was in fifth grade dissecting a cow's eyeball and that is my story. And that's when I knew I was going to be a nurse. But in 2016, I had a seven year old daughter who went to bed. We're going to say normal child air quotes around that, but high functioning child.

Woke up the next day, pretty much non-functioning. ⁓ She was bordering everything on the walls, urinating and defecating all over the house, refusing to swallow, therefore not eating or drinking much, ⁓ would not step on cracks. To leave the house, we had to go through the front door. We literally had to carry her over thresholds. She refused to walk through doors. So immediately got her into therapy. We're trying to figure out what the heck happened to her, but she... ⁓

Literally had massive OCD within eight weeks. She was admitted to the UCLA Psych kids program only could come home on weekends for intensive therapy and it turns out she had

Lyme disease, but we did not know that. When we got to UCLA, of course, my husband at the time and I were traumatized by what we were seeing, and they just told me literally, quote unquote, your kid will be a mental cripple. they literally, I remember so clearly when they handed over her psych pills, and this was going to be our story. ⁓

That is prefacing a little bit about how it unfolded. The reason why it's important is because I'm the one who figured out she had Lyme disease. They painted this picture. They definitely helped her with a cognitive behavioral therapy. But it would not sit well with me that my kid was going to be on psych meds for the rest of her life without due diligence and figuring out what happened to her. So she was there for 13 weeks. But I was doing my little detective work behind the scenes. I always say Facebook actually saved my kid's life because I found other moms who went through what I did.

⁓ And that is how I found the diagnosis through other moms.

Miriam Allred (03:09)
and you were a nurse. So one might think that you were better equipped to handle a situation like this. Do you feel like you were or being the mom in the situation made it hard regardless?

Jenny Johnson (03:23)
Looking back, was a mom on a mission. That was it. ⁓ I probably...

could have used my nurse skills then, but I mean, I didn't know anything about mental health. That was not my specialty. I did not know anything about Lyme disease. In fact, I was shocked when she came back positive for it. But when you're on a mom on a mission and you have a kid that's sick, you will figure it out. ⁓ I just did a lot of research on the lab work that was being done on her and to convince doctors to get the lab work done, by the way, that was another thing. People very much poo-pooed my ideas, but I wanted to figure out what happened to her. ⁓ So when we got the Lyme results back, the way Western medicine looks at Lyme is very different ⁓

Lyme results. So I had to do a lot of sleuth detector work to figure out like what these results meant. ⁓ Found a actual Lyme disease doctor, doing my detective work there to figure it out, but yes he officially diagnosed her. But very non-traditional ways.

Miriam Allred (04:11)
And so leading up to this, were working in the hospital as a nurse. Did you have to put your whole life on pause or were you still working shifts as a nurse while this was unfolding?

Jenny Johnson (04:21)
9 p.m. that night ⁓ my kid's dad called me and said you need to get home. I can't manage her. She's trying to escape the house with knives. That's the truth. And he was weeping. He was scared. Yeah, so I literally left the hospital that day in 2016.

Miriam Allred (04:35)
And quit your job. Quit your job. And put your nursing on pause. But like you said, you love it and you were doing it for so many years and you saw like this was the rest of your life. But here in a moment, blink of an eye, everything changed. So we're going to kind of fast forward a little bit. There's a lot to unpack with your daughter's journey. And I guess I even want to just say to this audience listening, like.

Lyme's disease is not super common or super talked about. And so if anyone even listening to this has thoughts or questions about it, you are now kind of a resource in that regard. But to fast forward, ⁓ you start a home care company amidst all of this going on, at what point in time did you decide we're gonna start a business?

Jenny Johnson (05:10)
Ha.

Yeah, that was in 2020. So she took about a year to get better, but she did. So super grateful. I always just say I was just sprinkling in nursing at this point. I didn't want to go back to the hospital to have our shifts. So I was doing like home IV infusions. I was doing ⁓ some urgent care work, just very easy stuff while I was now homeschooling my child. ⁓

I had the opportunity to take care of a gentleman who had a lot of wealth, and I say that because he had round the clock nursing care. And he found me through word of mouth. I recruited my ICU nurse friends, and we took care of this gentleman 24-7 as RNs. And I...

I like, I didn't know this existed. I love the freedom ⁓ and I love the income that came with that freedom because I always said I have to know I can always take care of my kid again. So I started it as a private duty nursing firm and I focused on plastic surgery. After he passed away, focused on the plastic surgery side of it and then it was just me doing about eight to 10 shifts a month.

Miriam Allred (06:17)
then

at what point did it turn into a business? He employed you and you were kind of a contract worker, correct? You weren't working under a hospital brand.

Jenny Johnson (06:26)
any sort? It was actually

just all through me. I mean, just on the side. And he liked what we did. But what was happening, I actually did turn it officially into a business while that was going on, because I really loved the model. But I started getting calls for home care. I had some internet traction going on. I think I'd gotten some reviews. And I would just literally Google quickly some agencies in my area and send them off. Well, I also quickly realized I was getting a little more entrepreneurial savvy. And I thought, wait, people don't need nurses long term. They would need like,

like home care, you know. So from the entrepreneurial lens, I thought, ⁓ okay, I can be making an income actually while I'm sleeping, because it was officially relying on me most of the time to do the plastic surgery recovery. ⁓ And so then we brought in home care.

Miriam Allred (07:10)
And you said people were finding you the families, the clients, who was finding you online?

Jenny Johnson (07:15)
Yeah,

families. And it was just a few. Like it wasn't like I was getting calls a lot, but that's what opened my eyes. I never thought ever about entering home care into my business. But what's interesting when we brought in home care into the business, that's when the real business owner had had to come on. I wasn't used to, I didn't know people just didn't show up for shifts. I didn't know that people would come in late. So we almost threw in the towel on it. It was pretty frustrating, but it was very low level at that time. Remember I'm still a mom. I called this my mommy's side hustle, but I was starting to get a taste of like business life.

and I actually loved the challenge of it and how it was expanding my brain. So that was fun, fun for me.

Miriam Allred (07:50)
So explain today three service lines. You started out, you know, like private nursing, in-home nursing, but then you're talking about this home care piece. Explain kind of like the service lines in that first year, what you started with, and then how you layered in each service.

Jenny Johnson (08:08)
So

I brought in home care and I at the time would go out and do all of the assessments and I was only billing a couple hundred hours a week. This was not fancy what I was doing. you? Just me and then you know my husband. We're no longer married but he did more the admin side and I was more the face of the company. But me being a nurse I would go out there and they would say my mom is falling we need a caregiver four hours a day. Well okay well what are we going to do the other you know times of the day when we're not here to help you. So just naturally what meds are you on? What's the past medical history?

when are they going to see that doctor? You were just discharged from the hospital. You can't get in for three months. So just naturally I wanted to help them. And I discovered that geriatric care management was a true profession where we can come in and oversee that type of a care. Started offering that literally on the whim as a service line. I had no plan, no service agreement for it, but knew that it could be another way that I could support the clients of my community.

Miriam Allred (09:01)
Did you know as a nurse at a hospital about geriatric care management? Did you know that existed and what it was? Okay, because isn't this interesting? know, where you were and now where you are, there's all these components that a nurse like you isn't aware of, but you became aware of all these things through the journey. So, so sorry, then the nursing, the home care and then care management because you.

Jenny Johnson (09:09)
Not at all when I worked in the hospital.

Miriam Allred (09:28)
kind of stumbled upon it, like I need to be able to do these things for these clients. Yeah.

Jenny Johnson (09:32)
But

I also couldn't just let them come in and they need support. They needed help. They didn't understand what a discharge plan looked like. They didn't understand how important it is to follow up yesterday when you need something. You don't realize how hard you have to work to ⁓ stay on top of these providers. ⁓ I already knew that through the lens, but also, again, through my daughter. And literally, I had no idea how much I was channeling that energy from my daughter through now my new business lens.

Miriam Allred (10:00)
I think this is good to hear because oftentimes people start into home care and there's boundaries. There's these like guardrails of what you can do and what you can't do. And I see more more home care leaders pushing the boundaries. Okay, do we get into hospice? Do we get into care management? Do we get into home health? There's a lot that you can do in home care, but there's a lot that you can't do. And for people like you that want to be able to...

do it all and to end for the client you have to start to layer in these services. Is that how you see it?

Jenny Johnson (10:30)
100%, I almost don't even know how an agency can run without some sort of service line where you can support the family like that, or at least closely partner with a geriatric care manager. mean, I'm lucky I have that within my business, but I mean, these families do need more than just like a task-based service, in my opinion. I love it, our caregivers are task-based, and this is how I always describe it to a family. They're amazing, they're phenomenal. We absolutely need them, and they are very important in keeping our clients out of the hospital or being readmitted.

or having to continually go back to their doctors. But they do need to have somebody on their team that knows the big picture. And so then I say our care management services, we're the solutions-based service. We are here to get you through this little mini crisis, and then we're gonna use our caregivers to like execute.

Miriam Allred (11:15)
And so I kind of see it as you have you have kind of three types of employees of your office team your administrators and your care managers and maybe you have four you have nurses and then you have caregivers do I have that right? Yeah, I'm four types of employees and they all roll up to you as a nurse Do you feel like you can relate to and empathize with each of them because of your background?

Jenny Johnson (11:41)
Well, one,

I started as a caregiver. People don't know that. It actually was more of a CNA. ⁓ yes, so I started there. I absolutely empathize with them. Of course, I empathize with my nurses. But my good nurses, like the care managers, they love that solutions for side of things. And they love that they're not inundated with what corporate nursing has to tell you how to do it. And of course, I love my office staff and the multitasking part of nursing, which is very much a part of that.

Miriam Allred (12:05)
But you said some rude awakenings in that caregivers don't show up for shifts. You were so trained in kind of this like hospital professional arena. And this is different. This demographic is different. This autonomy being out in the homes rather than the hospital setting is very different. And it sounds like that was a challenge. Talk a little bit about those early hires and some of those hard lessons learned at the beginning. Yeah.

Jenny Johnson (12:31)
I literally almost threw in the towel because I was very surprised. But it really got me honed in on making sure I'm hiring the right fit, ⁓ making sure they understand how we work, those clear and defined expectations up front, ⁓ but also being vulnerable and open. I'm absolutely open. I love telling my caregivers, like, hey, I was once in your shoes. Like, I literally would go to someone's house, first shift, knowing who I was. And I think also what I like to point out, I don't think we respect the fact

how hard that is to show up to someone's home for the very first time. they are the face. They are the one representing you, but more than that, how nerve wracking that can be for them. You know what mean? Good caregivers want to do a good job, but they're walking into sometimes something they, we don't even know. They just started with us, the client, right? So I think that's something to truly respect and support them through.

Miriam Allred (13:22)
And when you, we talk a lot about like right fit client, right fit caregiver. You talk about how hard it is for them to show up to the home. How do we find the right fit? How do you find the needle in the haystack caregivers? How do you, thinking about just like the interview processing, the onboarding process, getting to really like know them for who they are. What are some things that you've learned and how you can hone in on that?

Jenny Johnson (13:47)
Well, the number one thing that all of our caregivers say, first of all, they love how well we communicate. And I think that we start that from day one. We are great communicators with them from the time they submit their application, from the time that they do their interview, from the time they whether they're hired or not, they get a notice of whether they're hired or not. Orientation day for shift. have apps built in. We have two way messaging apps. We use something called CELO. So back and forth, we communicate with them about changes in clients conditions. We use loom videos a lot.

They love that. ⁓ And we can already tell by the caregivers who are communicating well with us, ⁓ receiving the information, that they're going to be a great fit for our team. So we continue to nurture and grow them. I have a position called a field support manager. that person is literally all her whole job is to make sure my clients are happy, making sure care plans are being followed, but also that caregivers, because again, these are good caregivers. They really want to know the changes and conditions. So when they show up to their shift, they, by the way,

He fell last night and he's now in bed. Or he had an ER visit last night. Meaning I'm talking about the client, of course. And so they appreciate that.

Miriam Allred (14:56)
And field support managers, what you called that. I'm guessing that was a role that evolved over time. saw the need. Because often, it's easy. The pitfall there is everybody owns it, nobody owns it. Everybody's responsible for all of those things, but putting one person in charge of it to make sure that it's foolproof. The client's and the caregiver's well-being is always on somebody's radar.

Jenny Johnson (15:19)
Customer service is absolutely number one to me. Like, it is, we cannot mess that up. And so that's why I created that position. And absolutely, she shows up to most of the first shifts, if not right when the caregiver starts the shift, ⁓ mid-shift. If she's busy somewhere else, we have to kinda negotiate there. So she knows the clients really well from the get-go. In addition to the caregiver skill level, she knows ⁓ what the caregiver needs training on, she creates the care plans, we'll follow up so we...

We have this thing where we do the meet and greet, then we do a 24 hour follow up, we work to have a three day follow up with a family and our client, and then a seven day follow up. Nurturing that client in those first seven days is to me absolutely imperative. Because we're also getting to know them. You don't get to know them even on that initial assessment. You you try to capture as much, but somebody's way of being.

matters, you know, and then we suddenly discovered that, you know, maybe they had a past medical history of something, but that's me using my nurse brain ⁓ and learning in how that can impact how we do home care.

Miriam Allred (16:22)
I don't know if you just said it, what about on the caregiver side? What are those check-ins look like in that first? We talk a lot about the first 90 days, but for you, first shift, first week, first 30 days, what are the key touch points for the employees?

Jenny Johnson (16:33)
The main thing that we

do with the caregivers when they're first starting, obviously my field support manager is checking with them and frankly, how did you like your first shift with us? How did it go? On the admin side, we're checking like, okay, did they clock in on time? What were their notes like? We're really strict about how the caregivers do their notes. They don't just do two sentences of how their shift went. I don't care if it's a companion case. ⁓ The details on that, we are checking in and reading their notes because that also helps us see how well the client is doing. ⁓ We check with them actually more than just after the first

in that within that first seven day window, but obviously well after. ⁓ So we can see the caregivers, how they're doing that way. We respond, great notes you did last night. Thank you so much. And they can feel that feedback and that sense of connection to the office. ⁓ And so we get great feedback on that.

Miriam Allred (17:19)
I'm going to put you on the spot with this one. What about ratio? Your field support manager is overseeing approximately how many clients and approximately how many employees?

Jenny Johnson (17:28)
⁓ She is overseeing all of all of our clients at this point. Yeah, not care management side just the home care side

Miriam Allred (17:35)
So all the clients and all your employees, all the caregivers.

Jenny Johnson (17:38)
Yeah,

but so what we do is we have a classification system. So we classify clients as a high or a low and so the high she sees every week or has some sort of contact with every week. The lows depending, I would say one to two times a month.

Miriam Allred (17:51)
And I'm guessing that's interesting. I'm guessing that's condition based or what categorizes a high versus a low.

Jenny Johnson (17:57)
Well, like an example, pretty much all of our hospice cases are high. A brand new admission to our agency is always going to be high, at least for the first seven days, until we can kind of wean out and really kind of see where they're standing. So those would be examples.

Miriam Allred (18:09)
Do you have any sort of categorization for the caregivers? Yeah, it could be a high-low system it could be something else people that have a history of calling out a history or I also I talk a lot about this on the podcast but making sure your people that have been with you for a long time are being checked in on those people it's so easy for them to fade away and to not be checked in on because they're so consistent and reliable but

Jenny Johnson (18:12)
Just curious? No. We've talked about it,

Miriam Allred (18:36)
you know, they could easily drop into the low because they're consistent and reliable. so factoring all of those things in.

Jenny Johnson (18:42)
And I think it's really important too, you'll have a caregiver that they always clock in on time. They never call the office. Like in a great way. They're just content. They're on this steady case for a long period of time. And I think sometimes we've talked about that in the office. They're often overlooked, even for special accolades. And then suddenly it dawns on us, like, oh my gosh, we haven't checked in with Sally for a while. And they're the ones that sometimes deserve the most recognition, because they've got it handled, right?

Miriam Allred (19:06)
I want to shift gears a little bit. You having the nurse background is unique. There are a lot of clinicians, nurses that get into home care and start these companies. There are advantages, a lot of them. Everything you've already shared is advantages of you as a nurse knowing how to handle communication, conditions, check-ins, all of those things. I'd imagine there might be some disadvantages or some kind of like self-awareness of

you know, and maybe know too much about certain things and it's hard to let go or set boundaries. Could you share maybe vulnerable, vulnerable, any maybe disadvantages or things that you had to learn and work through having come from the nursing background?

Jenny Johnson (19:45)
Absolutely. Well, first of all, I love the vulnerability. I will tell you, I had this idea when I first started a business that I had to be perfect. And I was so intimidated by entrepreneurs because I thought they knew it all. And I have learned so clearly, like, we don't know it all. I don't care what your background is. But as far as the nurse lands, will say the things that I know I struggle with the most would be, first and foremost, the

boundaries of like availability. That is very hard for me. I want to be available to everybody at all times because I'm their leader. I'm the one that they're looking to. So that has been a disadvantage. Nurses love to fix and change everybody. Like that is in our DNA. I think a really good nurse. Like we're codependence by nature. And I think like knowing that we just can't fix every problem or it's also not our job to fix every problem.

⁓ I will have a caregiver that just is always on the bad side of luck, right? And I always want to try to see how I can help and fix them. And sometimes I can't. Same thing with the family. You know, there's times where we do everything we can and either they're just not receptive to the change, maybe they don't have the means to make those changes. So that part is also definitely, I would think, pretty hard.

One other thing I was just gonna say I also see like the good in people and I just like come on you got this and it's really hard You know, and I really want to inspire and it's like I've got some great caregivers I love my caregivers and some will say come on like go to nursing school and they just And the caregivers is awesome. We need them. They're so important

They don't believe in themselves, you know, and I want so bad. Like, I have even said, I will go down to the office at the counselor. They don't even realize that a counselor can exist at a college, you know, and I want to get them in, it doesn't always work out.

Miriam Allred (21:29)
I love it. You see their potential. They don't know what's out there and you expose them to that and give them more to dream, more opportunities. I want to ask about the first thing that you said, is availability and protecting your time. Owners of all shapes and size and tenure and background struggle with this, protecting and preserving.

your time and it gets harder as you scale, which you have over the last year or so. As you start to scale, you still want to be involved in everything, but you have to step back and let your team lead. What has really helped you set those boundaries and step back and let other people lead and delegate?

Jenny Johnson (22:09)
Still very hard. In the last two years, would say June of 2023 is when I put the foot on the gas and I said, I'm going to do this. And then it just keeps growing exponentially over the last two years. ⁓ As far as boundaries, ⁓ well, tactically, I literally just turn off my phone. And I know no matter what team, like I will support you in any decision you make. Truth be told, they do it better than I do. Like honestly, when I exit and I let them shine, they do just fine. And then it allows me to have more trust in the team. ⁓

then I know that they will handle it. So tactically, absolutely, just exit. I think I've developed it enough where they can handle it. Other things though is letting them like say what they think can be done and let's take a chance. Let's do this, let's see how we can let your idea shine because that is another downfall. I think I'm so used to being in control and handling it all and so innately I just, nope, that was not my idea. So allowing them to like.

Give me their idea, but let's execute on what you have to share.

Miriam Allred (23:09)
And the other thing is you have had support through consultants and coaches. wanted to give you just a moment to highlight the people that you have worked with that have helped get you to where you are because nobody should walk this road alone. Nobody. And we don't have to. There's so many great people, resources, podcasts. There's so much at our fingertips. And sometimes people don't know that or don't take advantage of that or ⁓

don't feel, I don't know, worthy, you tell me who and what have helped you significantly. ⁓

Jenny Johnson (23:43)
So,

know, 20 to 2023, it was just my mommy's side hustle. 20, June of 2023, I went to Clint and Jessica. I would not be where I am without them. So I definitely want to give them a shout out. spent about a year, maybe 15 months in their coaching program. And then I was ready for that more one-on-one high level coaching. And then that's when I found Becky. both, between both of those groups, Clint and Jessica and Becky, they got me to where I am today. Absolutely. And sometimes I would tell them, I'm just paying to have a bestie on my side.

Like I knew what I needed to do, but it is really worth it like having somebody on your team that can validate what you want to do

Miriam Allred (24:21)
Yeah,

and a sounding board for when the high through the highs and the lows. You need a sounding board, a friend, an advocate, someone that you can call that has walked the road that you can sound board off of. ⁓ And kind of closing here, where are you headed? Where are you taking this business? What's lighting you up? What are your hopes and dreams for this year and even beyond? ⁓

Jenny Johnson (24:42)
Gosh, well obviously

we all love as business owners now that I know all about like trying to grow a business. Obviously I love revenue and that's fun. ⁓ I would just really love to inspire. I have a dream, I don't know why 10 years is my goal for this, but I have a dream that it's completely ran without me. But I would love to have a non-profit where I can put my caregivers through nursing school. Even if it's just one. I could almost cry like talking about it. ⁓ I would love to be speaking. I always love the underdog. I would love to be speaking and nurturing them.

and growing them and letting know that there's a lot of possibilities out there. So that's my goal.

Miriam Allred (25:17)
You're so inspiring. And how many years in are you? You say 10 year goal, where are you at right now?

Jenny Johnson (25:22)
I call it two and a half just because 2023 is when I put my foot on the gas, but technically 2020. ⁓

Miriam Allred (25:29)
Two and a half,

and we haven't highlighted all of your accolades and your growth and your success, but two and a half years in to maybe a 10 year and beyond journey, you're so inspiring. Your story, where you're at. I'm excited to just continue to follow along. I've learned so much from you and I love this connection and where we are and what we're doing. There's just so much good ahead of us. Jenny, thank you so much for joining me in the lab. This has been a great conversation. We'll go ahead and wrap here.

Jenny Johnson (25:47)
I'm excited.