Miriam Allred (00:01)
Hey everyone, welcome back to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's so good to be back in all of your ear listening to this. I hope you are having a great week. Today in the lab, I am joined by Olivia Jones, the Executive Vice President of CareAdvantage. Olivia, welcome to the lab.

Olivia Jones (00:21)
Hi, Miriam. Thank you. Thanks so much for having me. It's my pleasure to be here.

Miriam Allred (00:25)
It's

my pleasure. It is so good to see you. I was just telling you before we jumped on, I interviewed you almost six years ago on my first show, many, many years ago, and you and I have both come such a long way. So it feels like long overdue to have you back. So thank you for being here.

Olivia Jones (00:42)
Absolutely, absolutely my pleasure.

Miriam Allred (00:44)
Let's,

For those that don't know you, let's start with a brief introduction of yourself and then we'll talk a little bit about CareAdvantage as well. talk about yourself, your background and your story.

Olivia Jones (00:52)
Okay.

Yeah, sure. So I grew up in home care. I've been with CareAdvantage for 28 years. I know, hard to believe. I started when I was five. ⁓

Miriam Allred (01:05)
Yeah.

Olivia Jones (01:06)
Throughout my time here, I've worked in just about every capacity you can imagine. Care coordinator, recruiter, ⁓ I've managed individual locations. And the only thing I haven't done is be a nurse, but I think I could play one on TV at this point because I've been around them long enough. ⁓ yeah, it's been an amazing journey doing this work worth doing here at CareAdvantage.

Miriam Allred (01:23)
Yeah.

28 years, we should be talking about what they've done to keep you for so long because we talk about retention all of the time, including at your executive level. They're clearly doing something right to keep you for so long.

Olivia Jones (01:44)
Yeah, yeah, 100%. You know, it's a ⁓ culture. I know people say it all the time, but it really is a family culture. You know, the poster behind me, your family is our family and the people that I work with. So many have been here right alongside of me for all that time as well. So, been a fun ride.

Miriam Allred (02:05)
That's so precious. For those that are just listening to this, Olivia has a poster of her two sons, both football players behind her with kind of the CareAdvantage logo and their logos all painted together. I just love that imagery. Let's talk a little bit about CareAdvantage. Where's the headquarters and about how many states are you guys in and about how many locations total?

Olivia Jones (02:28)
⁓ So we are headquartered out of Richmond, Virginia in the downtown area. We have 28 locations across our footprint and we cover five states as well as DC. So that's Virginia, South Carolina, North Carolina, Delaware, Maryland and DC. Not a franchise.

Miriam Allred (02:50)
and not a franchise, it's

a different structure. What do you call it in your own words?

Olivia Jones (02:56)
⁓ So I still consider us to be privately owned ⁓ with a sponsor.

Miriam Allred (03:03)
Okay, great. In five states, lots of locations, huge footprint. What is ⁓ the payer mix? Are you guys heavily private pay or government payers?

Olivia Jones (03:15)
We are, the mix has shifted as we've acquired new brands into our company. So we're about 80 % Medicaid and the other 20 % is made up of private pay and VA.

Miriam Allred (03:31)
Okay, awesome. And what about the the back office operation? A lot of large companies of your size have some consolidated operations, something still out in the field. How would you describe just kind of the breakdown of operations high level?

Olivia Jones (03:50)
Yeah, so you know, I think we've tried to centralize as much as possible over the years. Like those functions, intake, our recruiting functions, accounting and finance, things like that that can be...

centralized, we've taken the opportunity to do that. years ago, growth meant you expand by entering new markets. So we, our growth strategy from an organic standpoint was de novo locations. You want to get capture more market share, you pop a de novo into that spot.

But recently we've realized caregivers with technology and everybody's getting more comfortable with it. And I think some people might say in the home care world, we're a little slow on the uptake on that end. But.

we're advancing and caregivers are adopting technology with EVV and things like that. So they are coming into the physical locations less. So recently in the last year, we've consolidated some of those physical locations into more.

Welcoming, I guess is the word I would use and sophisticated professional engagement centers. So we went from in our central and East regions as an example, we went from five physical locations all located within 30 minutes of one another because that again used to be the way it was. If you wanted to recruit caregivers, you had to be in their backyard. And now we have found,

We invested in those centers, branded it, featured some of our longer term caregivers on the walls and have a training lab in there, computer stations so they can come in and access that at any time, a big conference room for trainings. that's been a bit of a shift, but so far it's worked really well and they've appreciated that kind of upscale place that sets the

when they come in for onboarding.

Miriam Allred (06:11)
You called them professional engagement centers. Is that just the verbage you use internally or externally as well?

Olivia Jones (06:17)
Externally, we actually branded them as Caregiver Engagement Centers specifically.

Miriam Allred (06:23)
Okay, I love that. Wow. You're already sharing interesting things. Every time I talk to you,

the really neat thing is CareAdvantage has been around for a long time, but every time I talk to you, you guys are thinking differently and pushing boundaries and reestablishing yourselves in an example like this of, maybe five years ago we did it one way, but the market's different, the landscape's different, technology is advanced. Like we have to do things differently at every juncture. And that's been part of your success and your growth is leaning into

new ways to structure your processes and operations, which leads us to today's topic. You and I were both skeptics, but we have landed on something fantastic for your organization, which is so fascinating, which is how you all have integrated virtual assistants into your recruiting and on-call function. And the reason why I wanted to bring you on, I have people reach out to me every single week about virtual assistants. They have kind of taken the industry by storm lately.

Olivia Jones (06:56)
Yes.

Thank

Miriam Allred (07:17)
And like

us, there's a lot of skeptics, you should we offshore? Should we be doing this? Is technology catching up to where we don't need virtual assistants? Like we're in this really unique time in home care where there's a lot of resources and opportunities to differentiate. And you and I, again, we're both skeptics. reached, you know, we connected a couple of weeks ago. You told me the story of you listening to this podcast while you were in bed, which I don't know how I feel about that.

Olivia Jones (07:43)
Yeah.

Miriam Allred (07:43)
but

you decided to take a chance and hire a virtual assistant. Talk a little bit about your, just like your sentiment, your hesitation before, your fear, your concerns, and then what like tipped the scales in your mind.

Olivia Jones (08:00)
Yeah, so that's funny because, you know, even in my downtime, I'm focused on home care. And I find the lab is a great place to learn new ideas. So

Miriam Allred (08:07)
Yeah, you love it.

Olivia Jones (08:14)
You know, I think, I don't think we're alone in our skepticism. I started out, you know, when I clicked on that particular podcast, ⁓ that night, that's kind what I started out with. Hmm. Let me see, you know, how this is because I think we've all experienced that offshore, ⁓ whether it's as a consumer, and you call in and you experience an offshore team that's kind of helping you navigate what you need. ⁓

And then, you know, I immediately thought, some of the things Debbie was actually saying on that podcast that day really resonated with me. The accents, you know, I was concerned about that. ⁓

Our clients, our demographic is oftentimes hard of hearing, has a low tolerance for things that maybe cause frustration for them. And that's one of them, not being able to understand communication. I mean, we've had that even sometimes with caregivers that go out to a home that may have an accent. So, you know, that was probably the biggest reservation I had. I also...

thought about

are they just going to be really transactional? Because, I think of other services that we've outsourced, like an answering service that ends up being really transactional. Again, putting on my consumer hat, when you call in and you have a specific need and you know where you want to go, but you have to go through the list because they are following a script. Like, that's been my experience and that's really where my skepticism was rooted.

Miriam Allred (09:56)
So you listen to the podcast, some things resonated with you and then ultimately you thought like, should take a chance. I should hire one and see how it goes. I'm guessing you took it back to the team. What was kind of the vibe, I guess, of the leadership team of bringing in virtual assistants? Like, was it an uphill battle to even bring one in or what was kind of the general feeling?

Olivia Jones (10:20)
Yeah, I so immediately I think it was that night. It might've been around 11 o'clock. I forwarded the podcast out to a number of my colleagues. and the very next day I was like super pumped about it. And I was like, you know, I think we should, we should talk about this and we set up a demo and started the conversations, taken kind of a deep dive. Everybody shared, I think that same.

skepticism going into it. Like, you know, it's appealing because it's more cost effective than hiring here, in the United States. So I think you get the, that's the hook, right? It is more cost effective. That's the hook. Okay, now you've got my ear, let's talk. And then you start to kind of dig in and really the thing about

Helper Heroes virtual assistant is

they're trained specifically in home care. And that was, I think that is a differentiator and was appealing and our team get their mind around it and talking to the team there about how they train, how they select, the fact that they have a manager that kind of helps you manage the offshore team. All of that was appealing and kind of had

I had a lot to do with the getting the green light for that.

Miriam Allred (11:50)
Okay, and you started with one. You all kind of came to the consensus like, let's give one a shot and literally just see how it goes. Where did you place that very first person and why?

Olivia Jones (12:02)
So we were really intentional about it. ⁓ I came in really stoked about after hours, if I'm being honest. But as we started to talk, we decided to go first, our first placement in our talent acquisition team focused on recruitment. The reason is we already had a remote...

team that was sourcing candidates, you making sure, running our ads, screening applicants. So that team was already remote working here. We, in fact, we had a vacancy that was already open that we were in the process of backfilling. So voila, perfect opportunity to plug in a virtual assistant. ⁓

The other thing about recruiting is it's very, I won't say transactional, but it's very process driven, right? And it's pretty structured in the way that you approach it. So.

it's structured and the way it's approached, the KPIs, how successful you are, that's relatively easy to measure. How many screenings are you doing? How many candidates are being processed? How many people are being onboarded? So not a lot of complexity there and managing productivity. those, couple those things together and I think it's pretty low risk and it became a why not?

we

moved forward and did that.

Miriam Allred (13:37)
And then let's talk about the onboarding and the training. So you said you had an open seat. Did you onboard this virtual assistant as if they were any other employee located anywhere Like was the process to onboard them the exact same or different in any way?

Olivia Jones (13:42)
Mm-hmm.

100 percent. So if you're taking notes while listening to this, that's probably one of the things you're going to want to write down or type down in your electronic note taker. ⁓ But the ⁓ onboarding, the expectations, like how you introduce the virtual assistants to your organization is so important. We were very thoughtful.

Miriam Allred (14:04)
Thank

Olivia Jones (14:20)
I think we've created something special here at CareAdvantage, a culture that I protect relentlessly day in and day out. so anyone that's gonna join our team, that's gonna interact with our clients, our caregivers, with internal team members, we wanna onboard them in exactly the same way. There's no separate lane. If you're a part of the team, you're gonna go through the same onboarding process, have the exact same expectations,

experiences anyone else we would hire.

Miriam Allred (14:51)
Okay.

And then what about from a training perspective? said with Helper Heroes, for example, they are trained and come with a level of home care understanding. I'm guessing when you bring on a recruiter, there's also some form of training. does that look like? Is it a couple of weeks before they're live taking action or what kind of was the training period?

Olivia Jones (14:57)
Mm-hmm.

Yeah, so.

One of the great things is a lot of the candidates that were presented to us when we were filling our recruiter roles were, some of them had worked with other companies in the United States already in a similar role. If they hadn't, they had some kind of recruiting experience in their background. So when we onboarded them, we gave them the, I think it was two weeks for the

recruiting team, two weeks worth of training, really focused on learning our systems. What's the culture here at CareAdvantage? How do we measure success? Where to go when you need support? ⁓ What resources are available introducing to our standard operating procedures and...

the rules and regulations of the various states that we serve. So just those kind of tactical things and then cultural aspects is what the two weeks was spent on.

Miriam Allred (16:11)
Okay.

Okay. So like you said, there's like a few important things to set them up for success. Again, you and I talked about before this, it's easy for an agency just to bring on a virtual assistant and just hope for the best and train them loosely, but let them just kind of be autonomous too early without all of the infrastructure. But you put them in recruiting because that team was remote. So you're already used to remote onboarding. There was clear SOPs.

Olivia Jones (16:35)
Okay.

Miriam Allred (16:39)
clear KPIs and then you onboarded them and trained them as if they were any other employee. so agencies not doing those four things kind of out of the gate, like make sure you're hitting those marks to set them up for success. I want you to address specifically some of your concerns which were around language and then also them being too transactional. How did you mitigate those being issues like in the interviewing and onboarding process?

How did you combat the fear of the language or was that an issue or were you pleasantly surprised that it wasn't an issue?

Olivia Jones (17:12)
As far as the language goes, that was definitely a pleasant surprise. they spoke English very well.

very little gap in the communication. I proceeded during the interview process as I would with anybody. I didn't feel like I needed to slow down in my speaking or adjust my line of questions in any way, or form to help with their understanding of the intent. And likewise, when they provided answers, I felt like the communication was very clear.

then as far as be really pointed in the questions, I spent a lot of time around.

identifying the ability to apply critical thinking skills. You know, want someone who can think on the fly, who can solve problems in real time, you know, within the established boundaries, whatever those may be. But also at the same time, follow a process and understand the importance of that. ⁓ customer service, ability to use critical thinking skills and solve problems in real time,

and comfort with technology, think, if I had to drill it down to three key points during the interview process.

Miriam Allred (18:34)
Yeah, I like

that specific call to critical thinking because like you said, a concern around it, them being transactional in that you kind of put them in a box and that's all they're good for. But you want someone that can think outside the box, that can think on their feet, that can solve problems, that can be proactive within the guidelines that you establish, but also, you know, giving them some autonomy. A lot of these individuals are college educated. Like they have expertise and knowledge and bandwidth to like

Olivia Jones (18:52)
Right.

Miriam Allred (19:03)
bring a lot of value to your company operationally, but you have to empower them to think critically. I don't know if I'm putting on the spot with this, but any specific questions or scenarios that you would tee them up to in the interview to help kind of suss out their critical thinking.

Olivia Jones (19:19)
Yeah, so, you know, what comes to mind right now, because we've been interviewing to onboard for the ⁓ coordinators for after hours, you know, we focus on some of the things we see all the time. The caregiver has not shown up. You know, it's a 24-7 case. You've got a caregiver on the case already. The relief hasn't shown up. How do you respond?

And, you know, just kind of leaving it open and not even, again, some of them had home care experience specifically, but others didn't. And just kind of seeing where they go with that question. Do they ask more clarifying questions or do they just take a stab at it? You know, those, that's one that I use every time I'm interviewing for the care coordinator role for the recruiting role. ⁓ know, it recruiting is in a way is sales.

⁓ and you're influencing, you're selling the benefits of joining the team. So I did a lot around that. Like, what are the benefits to taking a job with the home care company? What would you highlight?

And what if someone says they're unable to locate a copy of their certificate? How would you help them troubleshoot that? So those are a couple of examples.

Miriam Allred (20:44)
Yeah, those are great.

Like just real scenarios. And I actually like what you said with the first one, like give them an open ended scenario and see where their mind takes them. Like don't even don't give them too much. Like keep it really open ended and and let them process in real time and kind of like work their way towards a solution. I think that's great. And that's really all we can do in interviews is just kind of give them ideas and concepts and then let them literally like process in real time and figure things out. And that's a good indicator of what

Olivia Jones (20:54)
Yes.

Miriam Allred (21:14)
that will look like on the job. So you started with one in talent acquisition. There was enough success for you to hire more. What were your early to mid indicators that they were successful? Like you have all these KPIs. How did you guys decide like, okay, this is working. This is successful enough for us to keep hiring more.

Olivia Jones (21:16)
Great.

Yeah, so today we have six total in our recruiting team. all obviously they work remote ⁓ and they support what we call the top of the recruiting funnel. So collectively I'll give you averages. On average, each one of those virtual assistants completes about 220 outbound calls in a week. So they're screening app.

applicants going through that process and then once they've done the screening they determine using established criteria who makes sense to move forward in the process. So about 10 % of

those that they screen move forward in the hiring process. ⁓ And from that about 50 % of those they then process to be selected to join our company as a caregiver and they are set up to be onboarded and go through our orientation process. Collectively our team of six VA's brings minimum of 40 new qualified

caregivers to our team every week. And that's in addition to what our folks at the local locations and the local sites, what they do.

So it really has kickstarted our ability to connect people to care more quickly because when you have caregiver supply, our founder, the founder of CareAdvantage, Debbie Johnston, used to say all the time, two things work in this business, recruiting and sales. And it doesn't matter how much things change and Lord knows they're changing every single day, that remains true. And if you were to ask,

any member of my team, they'll tell you that I probably quote that to them at least once a week, among other things, I'm sure they'd tell you. ⁓ but so, and I'll also note that we have three of those virtual assistants also really honed in on entry level candidates. So people who don't have a certification that are interested in becoming a caregiver, entering the home care work,

Miriam Allred (23:43)
You

Olivia Jones (24:04)
and we put those three virtual assistants alone put 48 people into our PCA classes weekly.

Miriam Allred (24:14)
Amazing. Thank you for sharing all those numbers and coming with that. Those are that's big volume. You know, that's why I had you share about CareAdvantage at the beginning to make sure people understand you're a big organization. And so that volume is huge to get to to get to 40 new hires a week. Look how big the top of that funnel has to be. It has to be huge. And you literally need manpower calling people to get them into the funnel to start hiring them. I want to ask getting into recruiting just a little bit more. You say these VAs are ⁓

calling people, what are the channels that they are finding people to call on? Are they just going through Indeed, through LinkedIn? What are the primary channels that they are finding people to then call

Olivia Jones (24:58)
Yeah, so ⁓ I think Indeed is probably our largest source of applicants.

We use an applicant tracking system and so when we post they distribute those postings ⁓ into various sites like ZipRecruiter, Indeed, all the different places. But I think Indeed gets the largest response pretty consistently. We also leverage social media, sponsoring ads on Facebook. We have a heavy following of Care.

and ⁓ clients on our Facebook and other social media platforms. We do when we have something specific we'll sponsor it on to LinkedIn but that's not a place that we heavily lean on for recruitment. So I'd say to simplify it indeed it's probably the top one.

Miriam Allred (26:01)
Okay, and are you getting enough inbound on Indeed to fulfill all of this top of funnel or are these VA's also proactively going out and just seeking people out to contact in?

Olivia Jones (26:15)
Well, so

we do have resume search that they do. We also have candidates that come in through our website, right? Through SEO, they put a note of interest on the website that gets sent over to the VAs. Our grassroots effort happens at those local sites with our caregiver managers and recruiters that are based there. ⁓

you know, believe it or not, still today we use yard signs, we host open houses and job fairs, we attend all of those community events still that's still very much an important part of, you know, being a good corporate citizen and a part of your community. ⁓ So as those candidates come in, it kind of feeds the top of that funnel as well for the virtual assistants.

Miriam Allred (27:08)
Got it. And I'm guessing all of those applicants, all of that gets filtered into the ATS and then the applicant tracking system is the source of truth for the VAs to call on. Is that accurate? Okay. Okay.

Olivia Jones (27:17)
That's right.

And you have a high degree of visibility in your applicant tracking system. So you can see where everybody is in that funnel. We can see through our phone system how many calls are being made. It's really a high degree of visibility into that role specifically.

Miriam Allred (27:39)
Okay. So, and just to go back to the role of these VAs in talent acquisition, they are like kind of sourcing and screening and setting interviews. Are they doing any of the actual interviews?

Olivia Jones (27:53)
Yeah, so when they call, someone applies, they're the first point of contact. They reach out, thanks for your application, would love to set up a time to talk further with you, or if the time is good now, we can chat now. So they do that. They do the initial screening, and then if they are selected to move into the next phase, the VA still stay with that applicant throughout the hiring process.

all the way until they hand them off for onboarding and orientation at the local site.

Miriam Allred (28:28)
Okay, got it. So they maintain that relationship through several, do do several rounds of interviews? There's kind of that initial screen interview and then due to a second interview.

Olivia Jones (28:36)
That's correct. And then there's the background screening and the reference checks that they manage that process as well, which is like the final step.

Miriam Allred (28:49)
Okay, awesome. But I think that's great to keep that initial contact, the virtual assistant involved in their journey all the way through. Also, it's just someone that represents the brand and the company and gets to know them and can kind of answer questions along the way. actually think that's really powerful until they're literally onboarding and starting their first shift and then that's where the transition takes place.

Olivia Jones (29:08)
Yeah, and we have not heavy on the meetings, but we do daily stand ups each morning and weekly meetings by discipline. I think the real cool moment, for lack of a better way of putting it, showing up to our talent acquisition meeting and seeing the recruiters and caregiver managers. And there's our virtual assistant to our talent acquisition specialist.

on camera, part of our team, celebrating the wins, like the level of ownership was, it's just, it's really cool and seeing them become a part of the Our Larger team, you know, again, skeptic at the start, so was excited to see that.

Miriam Allred (29:56)
But like you said, culture is so important to you personally, but also to the organization that bringing them into the fold in every way possible is so important. so like you said, on a virtual meeting, what you do with other team members, they are right there, cameras on, a part of the team. You don't even know that they're overseas. It's like they're just a part of the team doing the work, hiring people, getting to know people as if they were any other employee, which is...

Olivia Jones (30:15)
Yeah.

Miriam Allred (30:22)
which is how it should be, right? They're not disconnected. They're not this like kind of like fictitious, you know, out in the void. It's like, no, they're real people, part of the team, part of the process doing the work and should be reaping all the rewards alongside everybody else. So let's talk about on-call. So what you said is, so you started them in recruiting for all the reasons that we mentioned and saw success there. Your initial vision was, okay, we've got all of this.

Olivia Jones (30:23)
Yeah, yeah.

Yes.

Miriam Allred (30:50)
⁓ after hours and weekends and just all of this additional call volume that could be tightened up and covered lower costs essentially with. So talk about bringing your first one or two into the on-call piece and what was kind of like the sticky points, but then the selling points for bringing them into on-call.

Olivia Jones (31:15)
I think at the start, the biggest hurdle, was how do we untangle this big, call center that we've built and how do we get here? How do we unravel this without creating disruption and,

taking what's already a pretty expensive model and layering more cost on top of it. Sure.

Miriam Allred (31:41)
Can you talk a little bit about that to set the standard? Because people probably don't

know that when you say you have a call center basically established, how many people is that and what what calls are they answering?

Olivia Jones (31:50)
Yeah, it's a it's roughly Gosh, I'm gonna probably say the wrong number but between 30 and 35 team members today that work weekends and overnight or was we're kind of working our way through that now, but

that are PRN, part-time PRN. they, we have an answering service that takes all of the calls that come in. They then send an email to our team who action those emails. We have them kind of set up in regions, this is your region, and they function just like a regular care coordinator would Monday through Friday, but.

by triaging emails as they come in. So that's kind of where we've been most recently. We don't have enough time on this podcast to go through all the iterations as we've gone from the days of me rolling my bag of books with all the schedules to where we are today. But it's very expensive. The answering service, you're paying by the minute.

and the more call as you get the higher that bill goes and if you go over your package you know you've got these incremental costs so that alone is difficult to manage but then throw into the mix

part-time PRN team members who are working full-time jobs most of them Monday through Friday. So come Saturday, they call out because they don't feel like working and there's no ownership and we are

we are operating in a really reactive way, which does not create a positive experience for our caregivers and our clients. You you call in, have, in home care, needs are generally, if someone's calling your phone, the need is urgent. Or, you know, there's a high degree of urgency to that. So ⁓ when they call in,

Miriam Allred (34:02)
Mm-hmm.

Yeah.

Olivia Jones (34:10)
they have to leave a message after they've gone through the very transactional process. No offense to the answering company because they're just being thorough, gathering all the information, following.

the process being very transactional. imagine you're a caregiver and you have to call in and say, I'm running five minutes late. Can you let Ms. Jones know? And then you've got to say, what office are you calling from? And what time do you think you'll be there? instead of reaching someone who can give you that first call resolution, can then hang up, notify Ms. Jones that you'll be there in about five minutes. ⁓

Miriam Allred (34:38)
Yeah.

Olivia Jones (34:53)
and make sure that everything's okay. And you can hang up and feel like you've done your due diligence and feel confident about that. The way it is today, you have to leave a message with the answering service after you've spent time answering all of their questions, then an email gets sent, and then you're waiting for someone to action that email. So that's kind of the context around the way it was running.

Miriam Allred (35:22)
Okay, a couple of questions. This is super interesting. I like nerding out because I think this is so fascinating. A couple of clarifying questions of kind of the old way and then we'll talk about the new way. This PR, this on-call PRN team that you just said, you said they're working kind of 40 hour weeks and then this is kind of an additional layer of work. Are they working for CareAdvantage full-time and then this is additional or they have other jobs and this is kind of a part-time weekend sign gig?

Olivia Jones (35:24)
Bye.

They have other jobs

and this is part time. So I think we leaned heavily on.

for many years on our existing team. For years we had on-call that was done locally. So if it was a branch with five team members, those five team members rotated who would take the on-call home that night. And it was each little location had someone on-call. ⁓

I didn't mention that when we talked earlier about centralized functions, but that was one of the functions that we centralized before COVID, we centralized it. And ⁓ it was a huge undertaking and it made sense, logistically, what made sense was a little bit more challenging than I think we expected. But... ⁓

Over the years, it's kind of morphed into what it is today But we used to lean on our team a sale of that to get to this point that leads to burnout That leads to you know, it's it's easier because they know the clients they know the caregivers In some cases they were even happy to do it because they wanted to make extra money But at the end of the day it leads to burnout which then leads to turnover and you may lose talented people

people that you don't want to lose if you lean on them and they don't get to step away ⁓ from this work that we do.

Miriam Allred (37:22)
Okay, this is great. That was like earlier evolution. We're talking current evolution and then where we're going with this. With the current team, Pre-VAs, were these, again, on-call PRN staff, were they remote now? Are they all remote?

Olivia Jones (37:37)
They were, had

a, we had a pre-COVID, we had a center and it was like a call center and they came in and reported to work.

Miriam Allred (37:42)
Okay.

Olivia Jones (37:49)
every weekend, every holiday, in this big like office with a bunch of pods and computers and headsets. And that's how we functioned post COVID. It became a bit of a hybrid. Some people wanted to come in to an office location, so we still had a spot for them to do that. But the larger

the larger team was remote. And today, 100 % remote.

Miriam Allred (38:16)
Got it.

Okay, got it. And these are important distinctions leading up to again, setting VAs up for success. If you already have a remote function, it's like easier to plug them in. So today, this is all happening in real time. So what we're talking about is like literally the problems you're solving today. So some of this is like, I'm asking you about it, but you're also figuring this out. I know. No, don't sweat. This is great. You're doing so awesome. This is like, this is really you thinking through this in real time because you're literally implementing this right now. So,

Olivia Jones (38:27)
Yes.

Yes. So you see the sweat off my brow.

Miriam Allred (38:49)
in present day, you have two virtual assistants in OnCall. I'm guessing it's been similar as recruiting. was like, let's place one, let's kind of get them established and see how it goes, and then two. And now you're about to really expand, but talk about just bringing those first two VAs into OnCall. How did you integrate them and how has that gone?

Olivia Jones (39:12)
Yeah, so we did a number of interviews. We selected two right out of the gates and kind of onboarded them together. So everything they did, we did together. I think something I haven't mentioned previously was the fact that we have had great success with, is it asynchronous when you independently are learning? So we have a shared drive.

with our VA's and we post videos or SOPs and they were eager to log in and review those documents, watch those videos. They were in constant communication when they completed different pieces and I'm ready for my next part. They were super excited to get started. So we partnered them with care coordinators in our local sites ⁓ for

various pieces of their training and they did it virtually. They logged into a Teams meeting, they screen shared and watched our care coordinators in action doing the normal course of business, so no disruption there. And then after they did that for a bit,

then they got to log in and the care coordinator observed the virtual assistant taking live calls and going through that activity so they could jump in in real time and course correct if needed. But I'll tell you when it comes to...

learning the system technology was, was not an obstacle. ⁓ they were quick to pick up on, mean, most of the home care EHRs are relatively user friendly, you know, it's pretty intuitive. So, ⁓ but that's not taking anything away from their ability to pick it up quickly. They just embrace technology are excited to learn. And I think that makes a big difference in how quickly they absorb and

ready to hit the ground running.

Miriam Allred (41:20)
How long did that, like you said, the back and forth with them kind of training with the team and then taking over, how long was that kind of onboarding training process? Because this is a lot of information and this is very hands on. And like you said, they're learning the technology piece. there's a lot of onboarding here about roughly how many weeks did that take?

Olivia Jones (41:39)
So three weeks for our two overnight.

VA is functioning as a care coordinator essentially, which is a week longer than the recruiting because again, I think there's a lot more nuance and a lot more of the gray area and care coordination. ⁓ know, there's it's not as structured. ⁓ You know, some of the aspects of it are, you know, how to cancel a shift and we've got the SOPs for those things. ⁓ And we've certainly got talk tracks that kind of help

guide, but we use those with our teams anyway. So, you know, it was more about making sure that they felt comfortable, that they knew members of our team. So if they did come across something, had a question, they could shoot a quick teams over to somebody. ⁓ And we went at their pace. I think, I think that was one of the adjustments I had to make. And as we were kind of mapping out the

the shift in the model internally. That was a learning for me. In my mind, I said, it'll be about a two week onboarding and boom, we'll be gone. It got extended to three. And so that was a little adjustment. But again, if you can put three weeks of time into onboarding and again, we did it parallel. So we onboarded two people in that same timeframe. And I think we could easily do because it's virtual.

could easily do three, maybe even up to four in a group. And then you create kind of this self.

supporting unit of after hours team members that you onboard together so they have a relationship. If one of them wants to switch a day they kind of do that and then they just send a message and let us know. And yeah so did I answer the question?

Miriam Allred (43:37)
Yes, honestly, honestly,

I think three weeks is not that much time. Obviously, when you're hiring these people, you needed them yesterday and you're putting up fires and you're like, okay, let's get up to speed as quickly as possible. Three weeks to me to bring someone in remotely and get them up to speed and get them self-sufficient is like super impressive. So in my kind of outside looking in, I think three weeks is amazing. And I like what you're saying too about hiring like a couple and like a pod.

Olivia Jones (43:42)
Yeah.

of new.

Yeah. ⁓

Miriam Allred (44:06)
so that obviously you can kind of like cut down the burden of training them, but also they help each other and can relate to each other and bounce ideas off of each other. Like there's just value in being able to do that. Can we get into kind of the nuts and bolts of how you structure your after hours and weekends? Because where this is going, you have to, you said a couple of minutes ago, you're trying to like unravel your call center and create basically a new model for on-call and,

Olivia Jones (44:24)
Sure.

Miriam Allred (44:36)
weekends and in order to do that you have had to restructure kind of the way that you approach this. So guess I'm curious how you structure your after hours and weekends so people can understand.

Olivia Jones (44:50)
Yeah, so current state answering service takes all of the live calls, sends an email and our team actions those emails. They kind of triage in real time, action them and make the updates. There's a, you know, a...

It's a smooth process at this point, but again, not creating the experience we want. So phase one was transition overnight to the VAs. Overnight we had one team member because the call volume was very low. One team member and the answering service was still answering calls, but if something urgent arose, they would patch through the call to the overnight.

person effectively waking that individual up so that because they weren't on we were paying for that entire overnight shift

for someone to be on in case something occurred. And very rarely, on wood, did something occur. So a lot of hours paid for a little bit of ⁓ productivity. And so when we introduced the VAs to the overnight, Sharina and Rochelle, they're amazing. ⁓

We did it in segments, so one region first, and they take live calls. So we cut the answering service off for the overnight and we phased it. So three weeks of training, you're going live, here's your first night, but they've only got one region. So very few calls coming in, and you you have that time to kind of learn in real time.

Then after two weeks of that, we introduced another region and so on and so forth to now we're live with all regions as of last Monday. So they're taking all of the calls live overnight. They're actioning that in real time. So being proactive and that proactivity goes beyond what happens overnight.

They are doing visit verifications. Again, autonomous activities that help set up the daytime team for success. Activities that our previous model didn't address.

Touch points, sending happy birthday, happy anniversary emails and notes to our caregivers and clients. Updating caregiver availability. That's an ongoing constant thing. ⁓ it's done by, know, caregivers can send a message and then it's just got to be input. So it's data entry. Those are just a few examples of the autonomous things that they do to support our operations. And then they're on all the way

through.

until our team comes in. So previously, I'm the care coordinator. I walk in at 8 a.m. I've got my Starbucks in my hand and I'm about to start my day and boom, you start out, you've got three cancellations. One of them's the client that's already giving you heck from an issue that occurred last week. And now you've got to deal with that first thing that sets the tone. And you're not able, you just start the day

and you're in that wheel running all day. Now they come in.

they can enjoy their coffee while they are reading the passed down notes from that overnight team and they can hit the ground running and the tone is more positive and it's not reactive anymore. They feel good about the work that's being done overnight. So next step, ⁓ effective.

In May 1st, we are done with answering service completely. We are going to onboard and layer virtual assistants, a total of 12 before it's all said and done. But we're going to start with five. We're going to do these pods and integrate and.

kind of work our way backwards because when you talk about unraveling, that is kind of where we landed. We'll remove the answering service, we'll go to a 100 % live answer, we'll continue to analyze the call volumes and the peak times and adjust staffing accordingly.

Miriam Allred (49:32)
This

is fantastic, Olivia. Talk about when I get chills. It's like over this type of stuff. Like you have spent years building something up. Times have changed. Look at you totally unraveling something and it becoming something completely different, but so much better. One thing that we haven't even identified that I want to make sure we do right now, which is the time difference. So our overnight...

Olivia Jones (49:36)
Yeah.

Miriam Allred (49:58)
Is there, I don't know the time difference off the top of my head, but it's their daytime evening, correct?

Olivia Jones (50:02)
That's right. Yeah, I should know, but I don't, but I think it's almost like right at 12 hours. So it's perfectly aligned. They're overnight is it's daytime there in the Philippines. And so it's absolutely perfect because they're wide awake, ready to go. Conversely, like our recruiting team members are working overnight there, but it's daytime here. But, ⁓

Again, we don't even notice, ⁓ you know, John's one of our recruiters, he's always on bright and you know, it's, it's, ⁓ it's just really a pleasure to interact with people who are so excited to show up to work every day. You know, that's not to say we don't have people like that, but

Like it's legitimately every single one of the VAs is just so excited to be here, to be a part of this work that we're doing. And that can be felt by caregivers and clients in every interaction that they have with them. And it's just a breath of fresh air.

Miriam Allred (51:15)
A breath of fresh air. That's what I was going to say too. That's what comes to mind in that when we think about after hours and overnight here, it's like nobody in their right mind wants to do that. Okay. We totally offload this to people that are doing the work during the day. And like you said, because it's our overnight, it's not that many calls coming in, but you empower them to do 10 other tasks that then set the in-person team up for the next morning to be successful, to be brighter, lighter, happier.

proactive instead of reactive rather than starting the day putting out fires. They can just like take a breath and proactively look at, okay, here's what we need to do and be more strategic. You know, when you're always on the defense, you are just burning out and that's not good for anybody. But when you're on the offense, you can think clearly and strategically and, and your team here in the U.S. in person can

Olivia Jones (51:56)
Yes.

Miriam Allred (52:09)
Ideate and be creative and come up with new solutions and start looking for you know What's the next wave of CareAdvantage because now we're not just putting out fires, know handling overnight and on call so I At this at the beginning, you know, I want to just kind of close the loop on this was a a cost saver a cost strategy for CareAdvantage, but what you said to me that I think is so powerful now it is a growth strategy now that you have cut costs but created more efficient processes, this is a

Olivia Jones (52:19)
That's right.

Miriam Allred (52:38)
growth strategy for CareAdvantage. You know, you are large at this point, but what can this become if you continue to iterate and create efficiencies with these people? So what gets you excited about where this is taking you guys?

Olivia Jones (52:47)
again.

Well, you know, I think a couple of things. I get really excited when I think about what you just said. ⁓

our teams being able to come in and work from the offense versus the defense because having been in this industry for 28 years, you know, I wish I could say that I spent the bulk of that on the offense. But you know, a lot of times that's what it feels like. Like we're on the defense, whether it's regulatory challenges or, you know, this and that. that is number one. And I think as, as home care,

Miriam Allred (53:18)
Yeah

Olivia Jones (53:32)
operators, you know, look to how can I be more efficient, improve accessibility, because at the end of the day, it's about accessibility, Quicker response times, better continuity for your clients. I think in the original podcast, Debbie said something about turnover in the care coordinator seat. You know, we...

I don't think we've experienced like that heavy turnover in our daytime care coordinator seat as much. I think we do experience it in the recruiter seat. So again, when you're looking at that and you're trying to keep up with ever increasing ⁓ demands with wages and rising costs of literally everything.

you're dealing with compressed margins. I don't know how home care won't incorporate more of this into the day to day. But important that I'm not saying replace because sometimes there may be eyes sparkling with dollars being saved into the piggy bank, but. ⁓

I think you can create efficiencies. I think you absolutely can save money if you apply the VAs in the right way. But the biggest win is being able to scale while improving accessibility, creating a better environment that sets your daytime teams up for, or even...

layering into your daytime teams so that they can have more productivity, more success in an environment that they can thrive in versus survive in.

Miriam Allred (55:23)
And you also told me, and another way you put this is it's a growth strategy, but also a quality improvement strategy in that the answering service, that infrastructure, you put it in place, you're doing the best that you could with what you had, but the answering service, it wasn't actually as good as one might think. And this is a quality improvement going back to live answer at a fraction of the cost.

Olivia Jones (55:47)
Yes, first call, we have our catchphrase is first call resolution. ⁓

You know, and I think actually that as we continue to roll this out, we're going to see a reduction in call volume. So, you know, we'll continue refining the model as we move through the process. But one thing is for certain, our virtual assistants will definitely be a part of that process.

Miriam Allred (56:18)
Yeah, I like that phrase

first call resolution. We're all consumers. We've all been on the receiving end of the lack thereof of first call resolution. We are just strung along to different people. It's exhausting and it's so discouraging and it's a terrible experience. And so first call resolution is what we should all be striving for in our business. There's so many phone calls and home care and we have to have the person that answers the call can be able to solve the problems.

Olivia Jones (56:27)
Yes!

horrible experience. Yeah.

That's right. Yeah, it's underrated.

Miriam Allred (56:48)
It's underrated. Olivia,

thank you so much. You are phenomenal, girlfriend. I'm so proud of you. I know you get so nervous doing this, but this is your wheelhouse. This is your bread and butter. What we have just covered, like you talking through this in real time and the iterations that CareAdvantage has gone through, like you have been on the front lines and you're still doing it.

Olivia Jones (56:53)
Absolutely. ⁓ Well, right back at you.

I did it.

Miriam Allred (57:13)
And I just, again, love that you all are leading the charge on innovation and thinking differently. We haven't talked a ton about technology, but a lot of people think, okay, you can AI do a lot of what these virtual assistants are doing? We're not there yet. Like, it doesn't mean we're not going to get there, but I said this to you in the way that we think about it is it's technology plus in-person team plus virtual assistants. That is the hybrid approach to home care right now.

while we're waiting to see what technology can really accomplish, but it's all about efficiency and productivity and quality. know, there's great things that technology is doing today, but we also have to be really careful of quality and there just has to be people in the loop for the foreseeable future.

Olivia Jones (57:57)
That's right. Yeah, couldn't have said it better. You summed it up perfectly. It's a combo. Yeah, that's right.

Miriam Allred (58:04)
It's a combo. We're in the combo stage of home care.

So Olivia, thank you so much for joining me in the lab. This has been an absolute pleasure. If people want to reach out to you, I highly recommend that you do. We've just talked about kind of like a couple of areas of your expertise today, but you are a wealth of knowledge. So reach out and connect with Olivia.

Olivia Jones (58:20)
Thank you.

Thank you, Miriam.