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July 17, 2019

Intelycare: The Uber of Nursing Home Staffing

In this episode of The Nursing Home podcast, we look into how Intelycare is solving one of the biggest challenges in the nursing home industry.

The shortage of nurses to fill the necessary open shifts is a really painful and challenging problem for nursing home operators.


Let’s meet Chris Caulfield RN, NP-C, co-founder and chief nursing officer at Intelycare. He has been a nurse for 10+ years and experienced a variety of work settings within the nursing industry.

Chris tells us more about Intelycare, from why it was conceived and how it continuously helps both hospital administrators, nursing homes and nurses with a system that is reminiscent of Uber.

The nursing home industry, specifically from the nursing home staffing standpoint, there is definitely significant struggle. There are more open shifts than LPN’s. There are simply more nurses that are needed than there are nurses available.

Intelycare, as in ‘intelligent way of caring for residents’, aims to address the problem. Nursing agencies that works with nursing homes are typically doing blocked book assignments.

Intelycare is best known easing the gap between nurses and nursing homes, and they are continuously adding to those services.

Chris also discussed how their system rates their shifts. It is both rated by the nurses that you are passing the assignment on, and also the administrator, the DON and the scheduler.

He also relates to us how Intelycare deals with compliance, background check and licensing.

From going with a traditional agency type of recruiting, verifying licenses and references and adding more ways to verify nurses background.

He discussed the pricing standpoint of their system compared to a traditional nursing agency. He tells us how nursing homes who have used Intelycare has increased their staffing ratings, improving their future profitability.

There are also nursing homes that are exclusively using Intelycare staffing solutions, as Chris also tells us, because they can meet all their needs including consistency.

A total of 8,000 nurses and nursing assistant have worked with Intelycare.

Intelycare aims to provide a complete staffing solution for nursing homes. Helping them mange, maintain, retain their own internal staffing while supplementing as necessary.
Intelycare is currently expanding in Illinois and New Jersey.

Intelycare website:
https://www.intelycare.com/

Intelycare Facebook:
https://www.facebook.com/IntelyCare/

Intelycare Twitter:
https://twitter.com/intelycare

The Nursing Home Podcast website:
http://thenursinghomepodcast.com/
LinkedIn:
https://www.linkedin.com/in/shmuelsep/

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Transcript

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It's both sides of the equation. It's helping nursing homes. Nursing homes. It's the most

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at need facility that needs a staffing. Like we talked about, hospitals don't have

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aside situation. That's kind of what we build our platform off of.

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I hate to say that we're the uber of, but in the on demand economy,

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it's instant gratification to say I have a shift coming up right

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now not able to redo.

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Welcome to the nursing home podcast. Your goto

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source for professional insights in the longterm care industry.

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Hear from leaders and experts as they share current and practical insights

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to help make the most of your day. I'm the longterm care financial specialist.

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What that means is I help people plan for the inevitable.

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Nobody wants to think about getting old, but it's possible that someday we might need

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a little bit of care. Here's your host. Nursing home Administrator

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Turnpodcaster Schmoel,

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Septimashptimash.

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Welcome to this episode of the nursing home podcast.

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We're really excited to bring you another episode of the

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show. My guest today is Chris Coldfield.

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Chris has a very innovative software solution

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to a very painful nursing home problem.

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And Chris, first of all, welcome to the show. And please, just before

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we even jump into the solution, tell us a little bit about who you are

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personally, just to give us an idea of who we're

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talking to and professionally how you kind of evolved to where

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you are right now in your business. Sure. First, thanks for having me.

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So I've been a nurse for about ten years. I've worked in a couple of

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different settings long term care, nursing informatics, home health. I also been

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a nursing union representative, so I was working about

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five years ago in the labor world and also in nursing

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informatics. We were having a lot of issues at our facility with

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covering shifts that were short notice. So all of my fellow

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colleagues were being mandated to stay 16 hours. We weren't

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having just gaps in our holes being filled. And we went

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to the administrators. There were some great people. We asked them,

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what type of solutions can we use agencies? But there was really no agency solution

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out there or kind of solution to fill in short periods

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of time when we really need staff. We just didn't have it. So we started

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in telecare. I actually formed it with the director of it at that hospital long

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term q care facility. We've been going at it for about four years now,

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and we specifically focus on nursing homes. Okay, well, so basically

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you've lived and breathed the problem. You understand what it's

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like to be mandated to stay an extra shift, and even though it's not

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legal, but sometimes there are nurses that end up saying three shifts.

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How they physically do that, I have no idea. I do know probably

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they must leave somewhere in the middle. It's not good for patient care, let's just

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say that. But it happens not good for patient care. It's not good for staff

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care. Of course it's not good for patient care. It's not good for anybody.

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It does not make any sense. Nobody could work 24 hours straight. Yeah,

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some of us struggle to get through the regular nine to five and

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working 16 hours as nurses are sometimes used to. So let's

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talk about the problem before we talk about your specific solution. I can tell you

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from my experience as a nursing home administrator that there are

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many times filling the nursing shifts is a challenge because the rates

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that we pay in the nursing home is significantly less. The nurse will

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get paid in other settings. The work is significantly

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more labor intensive and with limited resources.

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So it's difficult to get nurses to work in a nursing home to

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begin with. So let's start from that angle. Again, talking to your nursing

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background, what type of nurses are actually more

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prone to choose a nursing home setting versus hospital setting? I'll just tell you.

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My son was born around a year and a half ago. We ended up in

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the NICU for a week or two, and I was an

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active nursing home administrator. And I come in there, and there's one nurse

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that's dealing with one or maybe two babies for the entire shift

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and for a lot of that shift, and again, the babies in the NICU.

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But it was a slight breathing issue. It was checking oxygen

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levels and just changing a diaper. It was, like,

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so quiet and calm and just the exact opposite of what

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I'm used to. And from what I intend to pay is that much higher.

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Why would someone choose a nursing home over such a setting? And then let's figure

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out why there's a problem. Sure. I mean, in my experience in nursing homes

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all over the country, I primarily see a high concentration of

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LPNs. Being the staff nurses at nursing homes, I've actually seen

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in Massachusetts, there's actually more RNS working than other parts of the country,

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but primarily it's somebody that has gone out of school,

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they got their first job, and they actually really like to work in nursing homes.

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They like dealing with geriatric care patients as well as certified nursing

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assistants. Our big pool is actually a big bulk of nursing assistance,

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and it's about 33% that we staff for LPNs

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and RNS. So it's somebody looking for consistency, somebody that likes geriatric

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care. And some do take jumps and move into the IC level care,

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which it's much different working with one patient compared to 20

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in the daytime and 40 at nighttime, but you usually have to

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love it. Now, I don't want to jump into it, but in our pool of

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nurses, we do have a vast different amount of types of nurses.

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We do have hostile nurses that pick up shifts at nursing homes. We do

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occasionally have the ICU nurse pick it up, but they usually don't like to jump

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away from their one patient. But there's a big, vast amount of

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nurses that will work in long term care if it's picking up a shift here

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and they're covering getting some extra money. But as far as committing

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in a full time spectrum, 40 hours per week, a lot of nurses get burned

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out in the nursing home setting because the amount of Acuity that they're dealing with

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in the rehab floor, just the amount of patients that they're dealing with in the

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general typical floor. Got it. Again. So the nursing home industry is

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specifically from a nursing staffing standpoint, so it's definitely a very

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significant struggle right. To staff them. And so you're right

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that the LPNs, and there are those who prefer the geriatric

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population over, let's say the ICU, even though it might

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be commerce on some level, but at the same time, there's still

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a tremendous shortage. So that means that if you just add up, if you do

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the math between the open shifts, let's say in Massachusetts,

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and the number of available nurses, it can't add

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up, then there's a shortage. There are more open shifts

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available than LPM segorio which is why every nursing

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home is struggling. Absolutely. Is that correct first? Yeah. What adds

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to that too, is if you take, for example, a hospital

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setting where they have 30 units in a full management staff,

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that's there they're able to flex different nurses based off of call

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outs. So they're able to better accommodate their shortages,

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severe shortages than a nursing home where there might be two units there in

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the nighttime. Nurse is the supervisor, so there's not much room to wiggle.

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Sometimes you have the DN kind of come in, which makes them kind of really

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stressed out because they're already working a lot. But there's even more of a shortage

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in the nursing home just because the logistics within that nursing home

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is not as set up as a hospital to float to multiple different units in

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the amount of nurses they have in their pools. So it's twice as bad just

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for the small sitting that you're working with and the opportunities that you have.

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Okay, so that's definitely true. Each organization definitely much smaller.

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Yup. And therefore you don't have the ability to just

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say, oh, you were supposed to work on Friday. How about you working on Tuesday?

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And by Friday we'll figure it out. Although we do that sometimes in the nursery

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I'm sending as well. We certainly don't have the same luxury like you're pointing out

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as in the hospital setting. I think at the end of the day, there's more

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nurses that are needed than nurses that are available.

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Absolutely. So someone's always going to either be short staffed or working

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too many hours in a row the way that it shouldn't be. So your company

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is Intelli care, right? Am I saying it right? That's correct.

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Intelli Care. Okay. I was calling Intelli Care, but I see. It's called Intelli Care,

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I guess. Intelligent way of Caring for residents. I assume that's

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the name. Yeah, that's what we came from. Yeah. All right, awesome. So tell

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us what the system is and how does it address this problem?

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Yeah, so, I mean, we focus on the short need kind

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of one shift off care. So nursing homes,

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when they typically work with staffing agencies, staffing agencies, they love

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to get these big blocked book assignments, and that's what they're really good

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at doing because it's easier to get a nurse to kind of commit than

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to call up a bunch of different nurses and say, can you work this shift?

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And a shift is coming up in 6 hours. That's kind of what we build

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our platform off of. I hate to say that we're the Uber of, but it's

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in the on demand economy. It's instant gratification to say, I have

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a shift coming up right now and I'm able to work, and that's what we

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do. So we've been doing that since we started the company.

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We've been continuously adding to that product of not

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just filling last minute shifts. That's what we're good at, that other people can't necessarily

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do. Of course, we've built on some consistency levels of reprioritizing

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the same nurses that you rank high to keep coming back. And we've added

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the block booking as well because the sniff standpoint, you still want an agency

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and the same person coming back. So we've definitely added that. But our subject or

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topic that we're really trying to address is somebody calls out

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or I don't have somebody on Sunday, and how do we get one nurse to

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fill that spot rather than having to have this long commitment?

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Because your census is fluctuating based on your rehab settings

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and also your call outs and your negotiations of, I'll work

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today a double, but if I take off Saturday and I've done that in a

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bunch of different times, then all of a sudden the facilities, what do I do

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on Saturday? So that's what we are. We have a lot of our clients massachusetts,

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a lot of our clients put in their shifts on Wednesday for the weekend.

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A lot of them come in the day before. A lot of them come in

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that day. And that's what we do. We fill just

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intermittent shifts. And if you want to go beyond that, of course we can offer

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that solution. But it's a lot of flexible nurses that are just looking for part

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time work that don't necessarily want to do any more hours in their unit.

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They're just sick and burnt out of it. They want to have a different setting.

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And we take nurses from Med search units

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at Mass General and Brigham and women's. They also work for us as well,

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just picking up shifts the last minute. So that's our pain point that we address.

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So you don't want to call it Uber for staffing, but that is exactly what

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it is. Right? It's on demand, filling a shift. And just

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like Uber, I'm going to use that example because I think it's phenomenal.

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I mean, just like it has a certain built in transparency where riders

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can rate their drivers and drivers can rate their riders,

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and next time a certain driver comes and they have a low rating, you might

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cancel that ride and say no. And the same thing if a ride request comes

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in as a driver, you might say, I'm not interested in this person. So when

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the agency comes in, it's almost like the nursing home is desperate and the

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agency knows that, the nurse that picks up the shift knows that. So it

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doesn't matter what level of care she provides. Also, it's like a one

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off thing. So as long as she gets through the 8 hours, she's going to

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get paid regardless of what type of care she actually

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provides. And nursing home is kind of stuck with that because at the end of

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the day they need someone to take the shift. Yeah, exactly. We're adding the extra

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layer of transparency so every shift is rated, the shift is

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rated by the nurse that you're passing the assignment on them in the first hand.

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And also for the administrator, for the Don, for the schedule, also gets

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to go back and wait. They get the experience. They get the real word in

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the street of what happened in the shift. So all of those shifts that are

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rated one through three, I've listened to a previous podcast about

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repute I tickets created and that's followed up by our clinical team and also a

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professional team. If there's a bad experience, we're following up with that.

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We call them Intelli Pros, our clinical employees, seeing what the situation was. And we're

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also following back up with the Don, the scheduler, the unit

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manager, and addressing that because we need quality in the

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particular organization to actually continue to thrive. Facilities won't continue to

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request if we're sending bad quality individuals. When we do find the really good

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quality, they're reaching out. They're trying to prioritize them back and

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also block book them as well. So it's kind of a try before you want

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to commit to somebody for a longer period of time, but also fill

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when you really need to. Okay, interesting. So it's not just

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here's our platform like Uber and use it

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and knock yourself out and enjoy it. And if it doesn't work, too bad.

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Try Lyft or buy a car or whatever. You're really holding

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their hands through the process to make sure that it works. It's a little bit

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more complex than getting a ride. Obviously we're talking about care for

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frill geriatric patients. We're talking about fitting

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in dynamically with the staff that's already present, that already is

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somewhat hesitant to welcome in agency

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staff. And you're also solving another big problem. I don't know if this was done

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intentionally or not, I could say from a nursing home perspective, whenever we get desperate

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for staffing and we try to get our per diem list. So those are

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not familiar with the term. Our nurses that signed up, or any staff members signed

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up, where they're promising to pick up a certain minimum number

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of shifts on a monthly basis, let's say, and many times they don't keep

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to that minimum. Then we go through the whole list, and we say, we have

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the schedule of the business office manager called them up, say, if you don't pick

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up by this date, then we take you off the list. And then they'll pick

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up for a little bit until next time we get that we have time to

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call them again. And that doesn't work for either way, it doesn't work for us

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because unless we chase them down, for the most part, even though they get paid

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more than regular staffers, many times,

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they're still not going to call us unless we reach out to them proactively.

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And for them also, they're not going to get those shifts. They're not

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going to go and pick it up. But you're saying that they could be now

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nurses anywhere. And now if a nurse knows that, you know what, they spent a

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little bit extra money, they went out, you know, over the weekend and went above

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their budget, and now they want to, you know, want to balance checkbook.

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They go into their app, they look for a shift, they pick a nursing home

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in their area, and if there's something available that sounds good,

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they can jump on it. So was that done intentionally? Yes.

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As far as giving nurses more opportunities to work around

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their schedule, absolutely. It's both sides of the equation.

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It's helping nursing homes, nursing homes, it's the most at need facility that

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needs a staffing. Like we talked about, hospitals don't have as bad situation.

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So for nurses, if you've worked as a

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nurse and you've moved your way up to medical, surgical, and other type of units,

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a lot of times you've already worked as a nursing home nurse as well.

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So it's actually more relevant for the experience, nurses to also jump back

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and actually jump back into geriatric care. So there's so many

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different facilities out there. I know that you're in, I think, the hangham

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area and our clientele in that area, there might be ten facilities that we're

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servicing within somebody's driving distance in that area.

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So I have a lot of opportunities, a lot of different facilities I can work

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at. And the shifts, there's usually a lot of different shifts available.

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So for them, it's definitely the most amount of supply because Uber drivers,

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they work for Uber because there's demand for them to work. A lot of them

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aren't doing lift because they have to wait around for their shift. So definitely in

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nursing home space, it's a generalist type of field for nurses.

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You don't have to be an ICU nurse, but you do have to have some

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great experience. But a lot of the nurses have done nursing homes before in

14:38.035 --> 14:41.392
the past. They can go back very easy, and they can

14:41.440 --> 14:44.952
jump back into it. So it definitely allows the flexibility for that nursing

14:44.982 --> 14:48.337
pool and for the CNA staff as well. Well, a couple of things.

14:48.400 --> 14:51.792
Sure. So if there are operators, they're saying, how can we just take Uber

14:51.852 --> 14:55.117
driver off the street and put them into the nursing home? So how do you

14:55.165 --> 14:59.097
deal with compliance background checks and licensing

14:59.142 --> 15:02.517
and all that? How do I take someone off the street and know that they're

15:02.577 --> 15:06.537
safe and incomplete to provide care for my residents?

15:06.612 --> 15:10.117
Sure. That's the administrator and me talking. Yeah, of course. We started

15:10.165 --> 15:13.452
off doing a traditional agency type of recruiting,

15:13.557 --> 15:17.122
going through verifying their license, verifying their references. Something that we're going through

15:17.155 --> 15:20.607
now is the Joint Commission accreditation. So we've added on Skills checklist,

15:20.622 --> 15:24.172
we've added on Joint Commission competency exams. We've added all the

15:24.205 --> 15:27.207
additional tests, testing, competency exams,

15:27.297 --> 15:30.867
training that you could possibly have in addition to the compliance

15:30.927 --> 15:34.642
checks, which is state approved background checks. And I'll say in Massachusetts, it's pretty easy.

15:34.690 --> 15:37.477
The Quarry check is a pretty online, streamlined system.

15:37.570 --> 15:40.582
When we moved into other states, we've moved into Ohio. It's a

15:40.585 --> 15:43.747
lot of fingerprint systems, which we haven't gotten in Massachusetts yet. But the other ones,

15:43.780 --> 15:46.957
it involves a little bit more complexity. I'm hoping Massachusetts pushes this way

15:46.960 --> 15:50.302
and other states push to it that they have a fingerprint background system. But,

15:50.320 --> 15:53.907
you know, it's OIG checks, Sam checks, all these different checks that you're

15:53.922 --> 15:57.727
doing at your facilities. We're doing no different. I think the one thing that we

15:57.745 --> 16:01.662
are doing is we're running some bots to continuously check OIGs,

16:01.737 --> 16:05.127
continuously check to see if there's any nursing license findings.

16:05.307 --> 16:09.207
So there's some additional features we're doing that I don't necessarily think that all nursing

16:09.222 --> 16:12.907
homes are capable of doing. I haven't seen a software solution out there for

16:13.060 --> 16:16.417
that. But it's very much what you're doing. But I think the difference is

16:16.465 --> 16:19.927
that we have, you know, after they start working, we have this minimal package which

16:19.945 --> 16:23.572
is rather robust to get them going. As far as Credentialing, then it's that real

16:23.605 --> 16:27.052
time reviewing, because a lot of the stuff that goes on

16:27.070 --> 16:30.732
the field may be a professional aspect of somebody having bad communication, which you wouldn't

16:30.747 --> 16:34.077
see in the first interview. But we're getting all the feedback every single shift

16:34.107 --> 16:37.977
to actually re rate retrain. And if they're not succeeding

16:38.007 --> 16:41.422
in the network, we're kicking them out. Are you offering any level

16:41.455 --> 16:45.237
of support to help them succeed? Yes, we have a full operation

16:45.312 --> 16:48.757
team. Well, let me add to that. So we have gamification in

16:48.760 --> 16:51.847
our system that we reward our employees for getting

16:51.880 --> 16:55.332
ranked high, for showing up on time, for not calling out of their shifts.

16:55.422 --> 16:59.427
So that system actually brings them into levels. We have a bronze,

16:59.457 --> 17:03.147
gold, platinum level that once they start hitting the high levels, they're getting bonus

17:03.267 --> 17:06.802
structured for the amount of shift they complete, they're eligible for bonuses. So to be

17:06.820 --> 17:10.572
in that level, you have to really perform and get really good reviews from clients.

17:10.692 --> 17:14.577
So there's definitely more that we're getting to that point. But definitely we're motivating

17:14.682 --> 17:17.917
and demotivating people to do particular acts, which is basically

17:17.965 --> 17:21.597
perform at a high level. Yeah, it's basically their reviews.

17:21.717 --> 17:25.087
The feedback directly impacts their compensation. Absolutely, yes.

17:25.150 --> 17:29.287
All right. At least bonus structure. We don't like to pay different rates. Rates are

17:29.425 --> 17:32.872
based on the demand of the nursing home. If a nursing home is having

17:32.905 --> 17:36.372
a really hard time filling, we will increase rates

17:36.417 --> 17:39.942
to get that nursing home filled. We want to support all our businesses.

17:40.077 --> 17:43.027
The price that they see will be the same based on that shift. But if

17:43.045 --> 17:46.257
they're performing, they'll get bonuses on top of that, on top of what they're

17:46.272 --> 17:49.972
actually saying for prices. So what would you say to,

17:50.080 --> 17:53.767
let's say, administrative operators? A lot of people are very wary of

17:53.815 --> 17:57.507
bringing in agency staff. And I know you may or may not define

17:57.522 --> 18:00.952
your company as agency, and some of the reasons are

18:01.045 --> 18:04.552
practical, operational, as you mentioned earlier, that you

18:04.570 --> 18:07.857
bring someone off the street who doesn't understand the dynamics of the building. They don't

18:07.872 --> 18:11.067
know the culture, might not know any specific clinical

18:11.127 --> 18:14.922
needs. And many times the level of care, even for a good agency nurse,

18:14.967 --> 18:18.352
is less than acceptable or at least challenging. A good

18:18.370 --> 18:21.252
agency nurse will be good, but it will be a challenge.

18:21.357 --> 18:24.702
And then the other concern is that some agency nurses,

18:24.732 --> 18:27.982
unfortunately, really from their performance, it seems to be

18:27.985 --> 18:30.747
apparent that they couldn't care less the goals they want to get through the shift

18:30.792 --> 18:34.522
and get paid. So that's one concern, is the level of care. Actually, let's focus

18:34.555 --> 18:38.302
on that first. So I would be reluctant to allow,

18:38.470 --> 18:41.752
even if it's in telecare, at the same time, they don't have a

18:41.770 --> 18:45.247
connection to the building. How do you address that? Yeah, kind of two questions.

18:45.355 --> 18:48.927
There are kind of conditions. One is sending a nurse that's unfamiliar

18:48.957 --> 18:52.507
with their facility just because the complexities where's the glucometer? Where's all

18:52.510 --> 18:55.537
this other information that you need to know when you get there? We do have

18:55.600 --> 18:59.467
options with facilities that in our system, you can show up an hour early before

18:59.515 --> 19:03.262
your shift. There is some facilities out there that have gone and

19:03.325 --> 19:06.667
thrown on different type of orientations, which doesn't as much

19:06.715 --> 19:10.027
work for the on demand culture, but we can also accommodate that.

19:10.120 --> 19:13.227
I think right now, my mom's in a nursing home. She went for a rehab

19:13.257 --> 19:16.447
patient and she's at a facility that we're not staffing and they don't use

19:16.480 --> 19:19.527
agency. And when I'm there and I see all of a sudden there's a bunch

19:19.557 --> 19:22.807
of call outs and there's actually a nurse or nursing assistant taking on

19:22.885 --> 19:26.452
double the amount of patients to say that having an

19:26.470 --> 19:29.952
agency nurse there to help. They may not be performing

19:29.982 --> 19:33.432
right away at 100%, but if they're performing at 80% because they're

19:33.447 --> 19:37.467
not familiar with some systems, somebody there is far better than nobody

19:37.527 --> 19:40.787
there. If you're taking on double the load, it is unsafe.

19:41.362 --> 19:45.022
It's not good for patient care, particularly known in my family situation.

19:45.130 --> 19:47.677
I'm kind of wishing, hey, let's staff them just so we can get somebody here.

19:47.695 --> 19:51.517
Because not having anybody there and having her wait for 2

19:51.565 --> 19:55.032
hours with the call light is just unacceptable. And that's what happens when you don't

19:55.047 --> 19:59.017
have the staff there. Now, the second question, I believe it

19:59.065 --> 20:02.577
was in relation to nursing quality. The nurses

20:02.607 --> 20:05.647
that we're sending, are they just not caring? Are they just kind of the ones

20:05.680 --> 20:08.992
that float around to different agencies? And I've seen that, I've seen

20:09.040 --> 20:12.682
nurses that float to agency to agency and they get fired and they kind of

20:12.685 --> 20:16.347
keep on hustling around different agencies. I would say the staffing agencies

20:16.392 --> 20:19.572
that are having them don't have a good system of quality, of ranking,

20:19.617 --> 20:22.657
of actually acting fast based on information.

20:22.810 --> 20:26.722
I mean, there are individuals that could potentially scam anybody to

20:26.755 --> 20:30.022
get hired into a spot, particularly when nursing home is really

20:30.055 --> 20:33.117
desperate for hiring somebody, interviews. Well, in a facility,

20:33.177 --> 20:35.827
you can really recognize this person isn't performing. You can get them out of the

20:35.845 --> 20:39.672
door. For an agency that doesn't have feedback, that kind of loop of feedback

20:39.717 --> 20:43.077
that shows what they're doing, who's performing, who's not performing,

20:43.182 --> 20:46.837
and somebody follow up consistently from our clinical team

20:46.975 --> 20:50.122
back and forth with the clinical employee and the nursing home.

20:50.230 --> 20:53.377
That's when somebody stays in the agency and they just kind of ride the

20:53.395 --> 20:56.452
system and they stay on for a while until something really bad happens.

20:56.620 --> 21:00.102
With our technology, with our systems and processes in place, we're catching

21:00.132 --> 21:03.427
that much, much earlier than somebody else. So the chance of

21:03.445 --> 21:06.837
that happening is very, very minimal compared to another agency.

21:06.987 --> 21:10.747
Got it? Okay, so it is possible. I mean, you'll have one of those people

21:10.780 --> 21:14.182
who do float from agency and that they will be in the system for

21:14.185 --> 21:17.662
a while. Basically you're saying that the feedback is real and it's in real time

21:17.725 --> 21:20.782
and you can act on it as opposed to a regular agency. That like you

21:20.785 --> 21:24.007
just said, that I guess until something really bad totally kill somebody.

21:24.160 --> 21:27.502
Unfortunately they'll stay in the other agency for longer. For us,

21:27.520 --> 21:30.942
it'll be out right away. I mean, of course we're pre checking, we're doing competency

21:31.002 --> 21:34.122
testing, things like that. But as you know, you may have hired

21:34.167 --> 21:37.522
somebody that and other administrators out there that may have hired somebody that didn't work

21:37.555 --> 21:40.872
out. That happens. But how fast can you react to that in a facility?

21:40.917 --> 21:43.522
You can see it right away. Our goal is to be able to see that

21:43.555 --> 21:46.972
just as well as a facility sees that if that ever does happen, we act

21:47.005 --> 21:50.862
right away so that person doesn't continue working in the network. What about pricing?

21:50.937 --> 21:53.977
So we know that one of the reasons why they had a place where you

21:53.995 --> 21:57.582
just experienced that there was a nursing shortage and they didn't call in an agency.

21:57.672 --> 22:01.567
Because bringing that agency nurse, even assuming that it's the perfect person

22:01.615 --> 22:04.462
who's going to compliment everyone who's already there,

22:04.600 --> 22:08.542
it is going to be beneficial for the staff. At the end of the day,

22:08.590 --> 22:12.277
the price points, maybe not the nurse themselves might not be making that

22:12.295 --> 22:16.027
much more money, but they're charging because they need to make money. So how do

22:16.045 --> 22:19.587
your pricing, I guess compared to regular agencies,

22:19.662 --> 22:23.307
and this is something that I think could be a big benefit,

22:23.397 --> 22:26.227
how do you deal with that? I don't work in the pricing sector, but I

22:26.245 --> 22:29.722
can talk upon it. We're competitively priced. We're not in the low end

22:29.755 --> 22:33.232
of agency. But I would have to say that from a business

22:33.310 --> 22:36.757
perspective, which you know much more about the business of nursing home than I do,

22:36.835 --> 22:40.522
we do have clients that have started using us that used to be three star

22:40.555 --> 22:44.247
staffing for CMS, and we brought them up to five star staffing. So overall

22:44.292 --> 22:47.872
picture of their future potential profitability, I think

22:47.905 --> 22:51.747
that using US is probably a little bit less than overtime

22:51.792 --> 22:55.822
rates of their own individual clinical employees. So it's worth

22:55.855 --> 22:59.427
in the long run what I believe is safe staffing increasing

22:59.457 --> 23:03.177
your Star rating, having your overall employee pool not ditch

23:03.207 --> 23:06.502
out on you because they're working too much. So I think there's been studies out

23:06.520 --> 23:10.057
there that have shown both ways that agencies cost more or less now

23:10.210 --> 23:13.402
as CMS and different type of payment restructuring models are

23:13.420 --> 23:16.822
actually going out there, and star rating and facility referrals is

23:16.855 --> 23:20.317
becoming more important, some of our bigger clients have been able to

23:20.365 --> 23:24.187
boost up their overall Star ratings. We don't have studies yet

23:24.250 --> 23:27.547
on their turnover for their own internal employees, but I can go out there and

23:27.580 --> 23:31.032
bet that with them working less overtime, they're going to be sticking

23:31.047 --> 23:34.357
with them longer. So I don't have definitely a solid answer. I don't have a

23:34.360 --> 23:37.432
white paper on it yet, something that I'm definitely looking to work on, but I

23:37.435 --> 23:40.872
would say that the cost is competitive to other agencies.

23:40.917 --> 23:43.872
But you get a lot more than you would for an agency just doing block

23:43.917 --> 23:47.422
booking versus us filling in and stopping that mandatory overtime of

23:47.455 --> 23:51.022
your current employees. Okay, so just to clarify here,

23:51.055 --> 23:54.927
because I actually wasn't sure about this point. So your pricing is saying it's

23:54.957 --> 23:58.212
competitive with other agencies in the agencies,

23:58.287 --> 24:02.652
other staffing agencies in the industry. However, where other agencies

24:02.757 --> 24:06.352
are, maybe they're just allowing the facility to continue to

24:06.370 --> 24:10.327
operate. They're actually helping solve the problem because you're not taking an

24:10.345 --> 24:14.377
agency nurse. I think what operators are concerned about. Is that

24:14.395 --> 24:17.422
you're going to come in with an agency. So we need to hire a full

24:17.455 --> 24:20.737
time nurse from seven to three or five days a week.

24:20.800 --> 24:24.427
So if you're going to have an agency take that shift, there's nothing making the

24:24.445 --> 24:27.727
facility replace that agency person. The band aid is on, it's going

24:27.745 --> 24:31.222
to stay and that's very expensive and sometimes that could be more than

24:31.255 --> 24:34.702
over time. The amount that the difference between what the

24:34.720 --> 24:38.632
facility is paying and what the agency is charging and that could be

24:38.635 --> 24:42.427
a serious concern. However, if like you're saying that you're stopping the

24:42.445 --> 24:45.847
bleeding or at least as a main focus and the other

24:45.880 --> 24:49.627
nurses see you as a resource, the facility sees you as a resource and

24:49.645 --> 24:53.352
you can actually help with the most crucial with call outs.

24:53.382 --> 24:56.827
And of course the nurses, after turning out to call outs, they're going to

24:56.845 --> 24:59.527
leave because they can't deal with it and they have a life as well and

24:59.545 --> 25:03.472
they can't stay 16 hours shift three times a week. Yeah, that's exactly correct.

25:03.505 --> 25:06.352
You know, we do provide a band aid. So if you lose one of your

25:06.370 --> 25:10.102
staff, I mean we can cover you for 80 hours a week.

25:10.120 --> 25:13.177
We can cover you for 120 hours a week. Some facilities go much more than

25:13.195 --> 25:16.792
that, but it gives the Dyn and the administrator and the schedule time

25:16.840 --> 25:20.767
to go recruit their own staff. Sometimes they're just trying to deal with their own

25:20.815 --> 25:23.677
mess and trying to fix what's going on, but they actually don't have time to

25:23.695 --> 25:26.947
really reach out, to really even take some of our staff as

25:26.980 --> 25:30.507
a really good performer and ask them to transition to their own staff. And that's

25:30.522 --> 25:33.892
something that facilities in around the whole country have done before,

25:33.940 --> 25:37.702
is find really good staff in Telecare and worked out a deal to actually have

25:37.720 --> 25:40.947
them come on staff with them. So that works as well. But it's a band

25:40.992 --> 25:44.227
aid so you can actually deal with your own stuff going

25:44.245 --> 25:47.392
on rather than the do in covering shift itself. Right. Which only

25:47.440 --> 25:51.007
exasperates the problem because the Dyn is going to be the one that's supposed to

25:51.010 --> 25:54.687
be finding the appropriate candidates and if she's

25:54.762 --> 25:58.642
or he's on a cart and filling shifts, then that doesn't work

25:58.765 --> 26:02.677
and that makes it even worse. And another point also is that

26:02.770 --> 26:05.947
as long as there's that you're trying to hire staff in

26:05.980 --> 26:09.742
a rush because the other one is just too tired, you're going to take anybody,

26:09.865 --> 26:12.922
as long as there's no big red X on them, then they're going to be

26:12.955 --> 26:16.507
hired. If they're available and you're stuck with them, you're stuck with them.

26:16.585 --> 26:20.362
And sometimes I think that's good because I'll pick up shifts, but sometimes

26:20.425 --> 26:24.502
I'll just make the problem worse. They start calling out as opposed to

26:24.595 --> 26:28.327
calming things down. There's that tension every time somebody calls out like, oh my

26:28.345 --> 26:32.362
goodness, who's gonna have to stay tonight? And now people started yelling at each other,

26:32.425 --> 26:36.517
and yet it's not pleasant. So with having such a system in place,

26:36.640 --> 26:40.497
you can definitely help with that. Are there any facilities that staff exclusively

26:40.542 --> 26:44.062
within telecom? Does that even make sense? Yeah, I think in the business

26:44.125 --> 26:48.102
side and the the company, they're looking at the PBJ data, but there are nursing

26:48.132 --> 26:51.397
homes out there that are exclusive within Telecare because we can meet

26:51.430 --> 26:55.002
all their needs, including more consistency. So they're

26:55.032 --> 26:58.672
booking out a long period of chunks. 10% of their staff is

26:58.705 --> 27:02.502
actually being utilized by intelligence and there's no reason to have other agencies.

27:02.607 --> 27:05.922
There still is nursing homes out there that I see that they're kind of stuck

27:05.967 --> 27:09.402
on this the block booking. They're using two other agencies

27:09.432 --> 27:12.727
and they're kind of continuously coming. And I know that you said that sometimes the

27:12.745 --> 27:15.702
higher up corporate level doesn't like that because you're not getting your own staff.

27:15.732 --> 27:19.342
They're still doing that and they're supplementing us using for call us using

27:19.390 --> 27:23.427
for if their census rises and falls. That's something that we're definitely expanding

27:23.457 --> 27:27.072
into because we realize that sometimes it is better to use one source

27:27.117 --> 27:29.977
and have the quality and all the records and all the data you can pull

27:29.995 --> 27:33.372
for PPj data and GPH reports and things like that when surveyors

27:33.417 --> 27:36.967
come. So we're working to enhance our service to if you do

27:37.015 --> 27:39.987
want to have block booking out there, we can replace your other agency.

27:40.062 --> 27:43.737
But right now we have been a good chunk of our clients

27:43.812 --> 27:47.467
have been exclusive with us. There's other chunks that are still using other agencies just

27:47.515 --> 27:51.262
because they've been stuck with this not stuck, but they really like this one person

27:51.325 --> 27:54.247
or two persons. I'm a CNN or nurse and they want to have them keep

27:54.280 --> 27:57.532
on coming the same schedule. Right. That's interesting. What I

27:57.535 --> 28:00.732
meant was question was if anyone staffed their entire facility

28:00.822 --> 28:03.967
with intelligence as opposed to other agencies. Yeah,

28:04.015 --> 28:07.717
so I've seen it done before. When we started three or four years ago,

28:07.765 --> 28:10.932
I was the first nurse going out to these facilities. Now we've

28:10.947 --> 28:14.052
had a total of 8000 nurses and nursing assistants. So I don't

28:14.082 --> 28:17.452
staff as much. But there's 8000 nurses and nursing assistant right

28:17.470 --> 28:21.052
now in intelligence that have worked for us yes, in the past.

28:21.220 --> 28:24.982
Each week right now it's between two and 3000

28:25.060 --> 28:28.642
or in six states right now. And some nurses come on and they

28:28.690 --> 28:32.272
work once a month. Sometimes they work once every three months and some do more

28:32.305 --> 28:35.707
full time work with us. But in regards to that question

28:35.860 --> 28:38.917
exclusive, when we first started off,

28:39.040 --> 28:42.487
we were trying to fill 100% shift no matter what.

28:42.550 --> 28:46.437
We're still working on that goal, but we would do anything, including losing

28:46.512 --> 28:49.822
our own money and business, to just fill your shift. We did

28:49.855 --> 28:53.302
staff some facilities that I've been to personally that there

28:53.320 --> 28:57.142
are three units and two nurses on each unit. And we were staffing six

28:57.190 --> 29:00.432
nurses per shift. Then for CNAs, I see that we're

29:00.447 --> 29:03.952
staffing eight CNAs, and I'm thinking to myself, well, where's their

29:03.970 --> 29:07.707
own staff? How can you run a whole facility on agency personnel?

29:07.797 --> 29:11.127
I don't personally agree with that. I think that it's

29:11.157 --> 29:14.082
good to have your own staff there. So when the agency comes in, if they're

29:14.097 --> 29:17.677
not familiar with it, they haven't been going consistently, and not all of the

29:17.695 --> 29:20.677
nurses that have been there 20 times, when you hit a certain point of being

29:20.695 --> 29:24.112
there 20 times, you probably feel pretty comfortable with that unit. But it's happened

29:24.175 --> 29:27.547
before that. We may have staffed the whole unit, and they have an

29:27.580 --> 29:31.197
on call there as well, but most facilities

29:31.242 --> 29:34.402
out there don't do that. And I don't necessarily think it's the best thing of

29:34.420 --> 29:38.157
staffing your whole facility with agency. So we've had talks with these individuals

29:38.172 --> 29:42.037
that have done it before and say, hey, it's not best practice. I understand

29:42.100 --> 29:44.452
that our staff has been a lot of times, but you still need to have

29:44.470 --> 29:47.692
some of your own agencies. It's very, very rare. I don't think it happened.

29:47.740 --> 29:51.922
It happened before in the past. And I would say that usually just

29:51.955 --> 29:55.602
looking at the numbers, it's 5%, 10% of their staff is ours.

29:55.632 --> 29:58.797
If you actually look at the PBJ data compared to one shift,

29:58.842 --> 30:02.517
somebody may have done it before the past. Now, in your interactions

30:02.577 --> 30:05.917
now with facilities, in your role as the

30:05.965 --> 30:09.702
Cofounder in Tel Acare, is there any practices

30:09.807 --> 30:14.037
specifically in regards to staffing that strike you as surprising

30:14.187 --> 30:17.407
from the outsider's perspective and what you

30:17.485 --> 30:21.417
see or feel is prevalent in nursing home operations?

30:21.552 --> 30:24.727
In your interactions, like, are you coming across things that are

30:24.745 --> 30:28.302
like, wow, they should, why they do things this way, or the opposite

30:28.332 --> 30:32.322
of like, wow, look how amazing they're doing it? They have Uber for dining

30:32.367 --> 30:36.057
trucks, for other innovations that nursing

30:36.072 --> 30:39.547
homes are using. It's hard to answer that. I do know

30:39.580 --> 30:43.327
our business. I know staffing. What I'm really hoping to

30:43.345 --> 30:47.002
get out of potentially supplement in the future of helping out,

30:47.020 --> 30:50.202
as I see some needs for internal scheduling software

30:50.307 --> 30:53.667
from the workforce management. I've seen some of the rating machines

30:53.727 --> 30:57.547
that you've talked about your podcast before, that families can rate particular

30:57.655 --> 31:00.907
experiences, which would also be rating our nurses, because our

31:00.910 --> 31:04.777
nurses are their nurses when they're there. I've seen over the

31:04.795 --> 31:09.027
last couple of years, many facilities switching over to EMR systems

31:09.057 --> 31:12.222
because there's still major corporations out there that haven't

31:12.267 --> 31:16.107
upgraded to the Matrix or the PCC. And that's a little bit harder

31:16.122 --> 31:20.142
from a staffing standpoint of sending nurses in there to do paper documents.

31:20.277 --> 31:23.572
It's easy to miss records and things like that. So I've definitely seen

31:23.605 --> 31:27.127
the evolving of a more digital sense, and some of

31:27.145 --> 31:30.427
the shocking moments are really what? That's not optional to

31:30.445 --> 31:33.457
go to Amar. I mean, I kept on pushing it off. I actually don't know

31:33.535 --> 31:37.477
what the final deadline is. Maybe you know better than I do, but everyone was

31:37.495 --> 31:40.867
supposed to have already been electronic. There are still facilities that

31:40.990 --> 31:44.647
you send us to that are on paper, there are in Massachusetts or other

31:44.680 --> 31:48.127
states. In all states, it's the select few of facilities that are

31:48.145 --> 31:51.732
out there. Usually they're part of a corporation that really hasn't upgraded their systems.

31:51.822 --> 31:55.267
They're definitely transitioning, and I've seen more transition over the last

31:55.315 --> 31:58.872
couple of months. But from a standpoint of an agency

31:58.917 --> 32:02.022
nurse coming in, it's actually much better to be in a computerized

32:02.067 --> 32:05.467
system because just managing that long book of different

32:05.515 --> 32:09.472
records that some pages are falling out and things like that, it turns into

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a lot of nurses coming back because they didn't see a page. So it's

32:13.257 --> 32:16.782
usually some of the big corporate facilities that have been transitioned,

32:16.797 --> 32:19.957
but they're still in process of it. So I've seen that highly recommend

32:20.035 --> 32:23.892
as CMS mandating, to switch over to computerized copies

32:23.952 --> 32:26.912
or medical administration records. It would make my job a lot easier.

32:29.437 --> 32:33.447
Yeah, it would make everyone's job better. Patient care overall. You mentioned scheduling

32:33.492 --> 32:36.907
software. I've worked with a bunch myself. Is there anything in particular

32:37.060 --> 32:41.202
that you would think should be included in a good scheduling software?

32:41.307 --> 32:44.347
Yeah, I've seen some products out there that are

32:44.380 --> 32:47.752
starting to implement this. Usually they're expensive, but it's running your

32:47.770 --> 32:51.607
own internal pergian workforce. I think that's kind of the key to the future.

32:51.760 --> 32:55.432
Right now. We consider our self workforce management where staffing outside

32:55.510 --> 32:59.502
nurses to COVID shifts. We definitely feel like either partnering

32:59.532 --> 33:03.022
with a solution that uses our technology, their technology,

33:03.130 --> 33:06.802
to supplement your own internal pool, and it may be harder to run that with

33:06.820 --> 33:10.282
a small facility. But if you can bulk up your different facilities that

33:10.285 --> 33:13.702
are relatively close to each other in a corporate chain of five or ten and

33:13.720 --> 33:17.152
as well as using the same system almost as a VMs to connect with your

33:17.170 --> 33:21.202
agencies. I definitely think there's a big opportunity for

33:21.295 --> 33:25.042
not just taking that to the hospital system, but down to the nursing home level

33:25.165 --> 33:28.162
and putting that into a package that kind of combines everything,

33:28.225 --> 33:31.797
and it just makes it one system. I think there's a lot of inefficiencies

33:31.842 --> 33:35.272
or it's communicating with your own workforce. I've worked a lot of facilities before,

33:35.305 --> 33:38.827
and they're making phone calls at five, six in the morning trying to get you

33:38.920 --> 33:41.797
using the same technology we're doing, using with in, app,

33:41.830 --> 33:45.282
notifications, a bunch of different other methods of getting people to pick up shifts

33:45.372 --> 33:48.642
with your own pool is definitely going to be of benefit.

33:48.702 --> 33:52.402
Now people are doing tech groups and WhatsApp groups and things like

33:52.420 --> 33:55.867
that. We have a shift and people responding to the whole group

33:55.915 --> 33:59.247
and they should have been private messaging. And it's effective.

33:59.367 --> 34:02.887
It's much more effective than it used to be. Specifically WhatsApp which

34:02.950 --> 34:06.247
a lot of people use. But at the same time, there's no

34:06.280 --> 34:09.697
real way to track who said, what? You have to go back. That happens also

34:09.730 --> 34:13.297
a lot of times I know from schedulers I've worked with that

34:13.405 --> 34:17.122
unless they pick up a shift and some, you know, they respond in

34:17.155 --> 34:20.647
some means, let's say on a text, and then they don't show up and they

34:20.680 --> 34:23.452
pick up the shift. You have to find the go at your phone, try to

34:23.470 --> 34:27.027
find a text, remember what time it was and take a screenshot

34:27.057 --> 34:30.322
and send it and like no, you did. The nature of it would

34:30.355 --> 34:33.502
have to be, I mean, I guess web based system might be nice, but I

34:33.520 --> 34:36.352
think it would have to be a mobile app because it's just the nature of

34:36.370 --> 34:39.472
the business. We're not talking about people sitting in an office. We're talking about someone

34:39.505 --> 34:42.612
at the dinner table getting a text from someone in the facility

34:42.687 --> 34:45.877
that someone just called out or maybe even a better system for calling out as

34:45.895 --> 34:48.652
well because that also who do you call out to? Do you call out to

34:48.670 --> 34:51.822
the nurse manager called to the Dom? Do you call it to the scheduler?

34:51.867 --> 34:55.477
What happened? The schedulers not there. The schedule is all and I called out and

34:55.495 --> 34:57.802
then, yeah, but the nursery had to write it down or they wrote it down

34:57.820 --> 35:00.967
somewhere, but then telling me what these things happen all the time.

35:01.015 --> 35:04.057
Yeah, it happens on the weekend especially. There's more call outs on the weekend and

35:04.060 --> 35:07.287
there's nobody really there to manage the call outs in some facilities.

35:07.362 --> 35:10.777
So the spring fever items, right, and it's a nice day

35:10.795 --> 35:13.582
to go to the beach and all of a sudden everyone's not fairly well.

35:13.660 --> 35:17.122
They post on Facebook and pictures. So there's a lot of technology that

35:17.155 --> 35:20.772
we can in the future and other companies will be doing as well. Is bringing

35:20.817 --> 35:24.597
the same type of on demand status and mobile apps into your scheduling

35:24.642 --> 35:27.807
platform. And a lot of our clients are using Excel spreadsheets.

35:27.897 --> 35:31.522
They're using our schedule. It is bringing that into a

35:31.555 --> 35:34.927
premium version that somebody could use that's not expensive because I

35:34.945 --> 35:38.232
understand that there are tools out there that are really targeted to hospitals

35:38.247 --> 35:41.377
that are going into nursing homes and they charge you hundreds if not thousands of

35:41.395 --> 35:44.952
dollars a month. Sometimes it's cost inhibited and some of the administrators,

35:44.982 --> 35:48.297
in a higher level, their opinion could be like, oh well, we have a scheduler

35:48.342 --> 35:52.227
for that, figure it out. Well, yeah, we can figure it out, but it's

35:52.257 --> 35:55.297
not that effective. It's not that efficient and it doesn't really work that well.

35:55.330 --> 35:58.747
We can do it much better. Right. So the problem with that, the problem

35:58.780 --> 36:02.002
with that type of mindset, and it's true, is that if

36:02.020 --> 36:05.652
it's just going to make someone's job easier and it doesn't dollar and cents

36:05.682 --> 36:09.492
bring me in more revenue or cut expenses, then finance

36:09.627 --> 36:13.297
whoever makes those financial decisions, at the end of the day, it's hard.

36:13.480 --> 36:16.492
So I'm happy that the schedule is going to go home

36:16.540 --> 36:19.767
and be nicer to his or her spouse or whoever

36:19.827 --> 36:23.407
they meet on their way, that's great because I'm paying for a

36:23.410 --> 36:26.107
better software for them when they could have figured out themselves.

36:26.260 --> 36:29.862
But if we can prove how it's beneficial financially,

36:29.937 --> 36:32.752
you could say, well, it's not just going to be easier, but it's actually going

36:32.770 --> 36:36.477
to decrease overtime or employee satisfaction or retention.

36:36.582 --> 36:40.282
Increase turnover. Absolutely right. It's going to decrease turnover because

36:40.435 --> 36:43.642
they know that when they call out it's going to get to the right person

36:43.690 --> 36:47.152
because everyone gets that notification in real time and they

36:47.170 --> 36:50.047
know that they're going to be held accounts well and they're okay with that because

36:50.155 --> 36:53.137
transparency, some people are still scared to put everything.

36:53.275 --> 36:56.572
They're scared to have conversations like this that are recorded in

36:56.605 --> 37:00.202
videos and putting anything out on social media because people are

37:00.220 --> 37:04.737
going to see. But most people are biting the bullet and welcoming the transparency

37:04.812 --> 37:07.897
and the honesty that it brings out in people because you can't just get

37:07.930 --> 37:11.707
out there anymore and just tweet about whatever you want. I think

37:11.785 --> 37:14.122
that no one's going to see it. I'm not referring to anyone for this.

37:14.155 --> 37:18.117
I was just saying in general, there's a certain level of accountability that exists

37:18.252 --> 37:21.667
when we have this technology affords us this level of

37:21.715 --> 37:25.297
transparency and, you know, we can actually see who people

37:25.330 --> 37:28.942
are and how they interact with people. So my point is that

37:29.065 --> 37:32.847
if you can show decision makers have dollars and cents,

37:32.967 --> 37:36.307
this is going to be not just easier. I mean, I've worked with

37:36.310 --> 37:40.452
some really primitive systems going back a few years where the selling

37:40.482 --> 37:44.517
point was you're getting away from the spreadsheets. But there are some very basic

37:44.652 --> 37:48.472
texting systems inside. We could send the initial text out from

37:48.505 --> 37:51.727
the system to a million people, but you can't see the responses and you have

37:51.745 --> 37:54.202
to go back to your phone and it doesn't sync and you don't know who

37:54.220 --> 37:57.532
said what. And some of them were fairly costly and at

37:57.535 --> 38:00.712
the same time not very effective because that wasn't the focus.

38:00.775 --> 38:04.152
The focus was scheduling the shift. Their focus was knowing what's

38:04.182 --> 38:06.907
going on. If you're a nurse, you come and you see your name on the

38:06.910 --> 38:10.647
schedule and you don't think that you're supposed to work then or the opposite,

38:10.692 --> 38:13.002
you come in and you schedule your whole day and you come to schedule,

38:13.032 --> 38:16.527
you're not on. That also makes people not come back. So they solve

38:16.557 --> 38:19.827
that problem well where when people are on, they're supposed to be on. When they're

38:19.857 --> 38:23.472
off, they're off. But as far as the communication piece that they haven't

38:23.517 --> 38:26.887
done yet. So I'm expecting you guys to work this out, right?

38:26.950 --> 38:30.352
Yeah, I mean, we haven't seen too many solutions out

38:30.370 --> 38:33.592
there that really have adjusted for nursing homes, there has been

38:33.640 --> 38:37.542
a couple, but we're open to partnering with other solutions and enhancing

38:37.602 --> 38:42.132
their services, linking up with different type of VMs system or MSP

38:42.222 --> 38:45.697
for an individual facility that runs their own per diem pool. What was

38:45.730 --> 38:49.522
VMs? MSP. So it is basically two

38:49.630 --> 38:53.152
systems of EMS. You usually are a group that contracts out

38:53.170 --> 38:56.907
with a bunch of different agencies. MSP is almost a managed

38:56.922 --> 39:00.352
service provider. It's the same thing. But somebody, another company is actually running this for

39:00.370 --> 39:03.772
you. And we see this in the staffing world that bigger hospitals run

39:03.805 --> 39:07.042
these services. And I know particularly Genesis, they do

39:07.090 --> 39:10.807
this type of system, they use this platform where they're connecting all their agencies and

39:10.810 --> 39:14.587
they're also having something manage it for them. Our idea is to have this

39:14.650 --> 39:18.342
kind of scheduled platform that you're running your own pool

39:18.402 --> 39:21.682
and you're running ours. Hopefully it will be within ours or an

39:21.685 --> 39:25.702
integration with another vendor that actually delivers good service. But it's the

39:25.720 --> 39:28.737
price. The price that we can reasonably

39:28.812 --> 39:32.467
tell a nursing home if there obviously there's some reimbursement issues

39:32.515 --> 39:36.342
going on right now with nursing homes and how can we do it that's sustainable

39:36.402 --> 39:39.462
and is not too much of a sell, but also is functional.

39:39.537 --> 39:43.377
It provides value, it's not expensive. And because we're

39:43.407 --> 39:46.972
over here actually making a business on staffing that we can

39:47.005 --> 39:50.557
still reasonably provide this solution for you for a much cheaper cost.

39:50.710 --> 39:54.027
The vendors out there and the software vendors that just focus on scheduling

39:54.057 --> 39:57.177
sometimes, that's how they're trying to make all their money. They're trying to stay afloat

39:57.207 --> 40:00.822
as a business by just selling your software. And that's the margins that investors

40:00.867 --> 40:03.502
are looking for are high. They're looking to make a lot of money off the

40:03.520 --> 40:06.862
software. So we're in the world that we're doing another business.

40:06.925 --> 40:10.572
It's very relative to our business. And right now we're aggressively

40:10.617 --> 40:14.407
looking for partners or developing our own software to kind of connect

40:14.485 --> 40:17.922
that together to have the workforce management solution that's affordable.

40:18.042 --> 40:20.647
Also you can use some staffing if you need it. So you want to create

40:20.680 --> 40:24.177
the complete staffing solution for nursing homes.

40:24.207 --> 40:26.937
In other words, help them manage, maintain,

40:27.012 --> 40:30.427
retain their own internal staffing while at

40:30.445 --> 40:34.357
the same time supplementing as necessary. Yes, I am very

40:34.435 --> 40:37.597
proactively into two D and three

40:37.630 --> 40:41.197
D animation for clinical nurses as well. We're very

40:41.230 --> 40:45.252
much enhancing our education platform for our own nurses

40:45.432 --> 40:49.087
with this type of solution. I would love it's kind of my dream to have

40:49.150 --> 40:52.477
a platform that you can also provide CEOs to your own staff as well as

40:52.495 --> 40:56.602
our staff. That's the dream. Adding education to that. Yeah, we have education

40:56.695 --> 41:00.592
to our own nurses right now. We're enhancing it. We're adding different

41:00.640 --> 41:05.017
features, we're adding different diagnosis, change of conditions, things like that. And just

41:05.140 --> 41:08.797
plain straight patient handoff, the appropriate way to do a patient handoff to

41:08.830 --> 41:12.142
decrease falls, things like that are the basics. But you know, if we're training

41:12.190 --> 41:15.577
our own nurses, my dream out there, which I always look for in

41:15.595 --> 41:19.372
the future, is how can we push this to more nurses. There is

41:19.405 --> 41:23.002
technology out there that we're utilizing for our own. If a client out

41:23.020 --> 41:25.857
there in the future subscribes to our package,

41:25.947 --> 41:29.277
our scheduling workforce management system, how do we give them all the tools that we're

41:29.307 --> 41:32.572
developing for our 8000 cart nurses that we're working with

41:32.605 --> 41:35.802
right now? It's definitely far fetched, but we're

41:35.832 --> 41:38.977
looking to make big changes in the nursing home world. I think that a lot

41:38.995 --> 41:42.352
of companies are focused on big hospitals, and nursing home

41:42.370 --> 41:45.697
is always the kind of the secondary. Like, there's not enough money

41:45.730 --> 41:49.267
to be made. And I think that there's just so much patient care

41:49.315 --> 41:52.522
experience that you can increase in nursing homes. There's so much opportunity and

41:52.555 --> 41:55.642
money to be made. There is. It has to be a good price point

41:55.690 --> 41:59.562
for nursing homes because Medicaid is not reimbursed

41:59.712 --> 42:03.052
exactly. So that's our goal is of course we're going to keep

42:03.070 --> 42:06.547
on concentrating on staffing, but how do we add additional features that makes it better

42:06.580 --> 42:10.522
for nursing homes to increase their own workforce management? That's really our

42:10.555 --> 42:14.212
dream. So there are solutions that do provide certain

42:14.275 --> 42:18.052
levels of online learning for nurses. Some of

42:18.070 --> 42:22.057
it, they're expensive and some of them are limited. They're expensive because

42:22.210 --> 42:25.552
nursing, by definition, some things have to be hands on. But I like

42:25.570 --> 42:29.122
the idea that you're trying to use some advanced technology to

42:29.230 --> 42:33.297
be able to bridge that gap to some extent. Absolutely, yeah. You need some interactivity

42:33.342 --> 42:37.042
within a digital sense to really have somebody understand and to test

42:37.090 --> 42:40.012
off and to compensate on it. It's not just looking at a piece of paper,

42:40.075 --> 42:44.467
reading and then answering some questions that learning is not effective. Chris, it's really

42:44.590 --> 42:49.267
refreshing to see someone apply this level of technology to

42:49.390 --> 42:53.047
an industry that's traditionally very behind when it comes

42:53.080 --> 42:57.112
to these types of cutting edge solutions and

42:57.250 --> 43:01.062
really solving a real pain point. I mean, it seems from this conversation

43:01.137 --> 43:04.927
that being short staffed and the staffing agency problem on

43:04.945 --> 43:08.277
a personal level to you, and tell me if I'm wrong, was a painful

43:08.382 --> 43:11.902
problem. It was. You seem to be on a mission to make sure that

43:11.920 --> 43:15.652
the problem is decreased until it could exist as the

43:15.670 --> 43:20.232
least amount possible. And which is why you're not stopping at supplying

43:20.397 --> 43:24.402
nursing homes with nursing, which is wonderful. And CNAs,

43:24.432 --> 43:27.607
right? Yes, CNAs are a big part of our business for nursing homes as

43:27.610 --> 43:30.627
well. But we really want to turn into a full solution.

43:30.807 --> 43:34.312
So staffing is the agency piece,

43:34.450 --> 43:37.897
is what you have right now. But I'm just trying to envision the full thing.

43:38.005 --> 43:41.197
Presenting it to an owner or an operator is

43:41.230 --> 43:45.222
that we're the full service nursing home staffing provider.

43:45.267 --> 43:49.027
So we help you hire your own staff, we help you schedule your own

43:49.045 --> 43:52.437
staff to help you educate your own staff. We help you with retention.

43:52.512 --> 43:55.477
We help you when they call out. They have a way to do that.

43:55.495 --> 43:58.647
They have communication and when you need assistance,

43:58.767 --> 44:02.532
we can help you with this. And being that you're very well positioned,

44:02.622 --> 44:05.227
again, I think this is pretty much what you were saying before. You're pretty well

44:05.245 --> 44:08.547
positioned because you have this income from the agency.

44:08.667 --> 44:11.577
You can offer some of the other solutions, the software solutions,

44:11.607 --> 44:15.022
without charging that very high premium like other

44:15.055 --> 44:18.247
companies have to charge. The software itself is not

44:18.280 --> 44:22.222
necessarily the expensive part of the development, but once it's there,

44:22.330 --> 44:25.927
it's there. And if you have a team in house that can do

44:25.945 --> 44:29.547
such things, either in house or like you said, partnering, it sounds like really exciting

44:29.592 --> 44:32.797
things aren't to come down the road and you're just getting started.

44:32.905 --> 44:36.852
We are just getting started. And what you said is describes

44:36.882 --> 44:40.602
us. We do something really well right now. We're adding different solutions.

44:40.632 --> 44:43.972
We have an in house development team that is innovative. It's the things

44:44.005 --> 44:47.097
that we're doing aren't really out there, but of course we're bringing in some pieces

44:47.142 --> 44:49.852
out there that are out in the market that we think we can enhance but

44:49.870 --> 44:53.277
also provided lower cost, particularly for nursing

44:53.307 --> 44:56.512
homes. We are 99.5%

44:56.575 --> 45:00.052
nursing homes. There's been some assisted livings that have just asked to join and

45:00.070 --> 45:04.032
we supplement them because it's not much different. But we focus on nursing homes.

45:04.122 --> 45:07.647
And I think that technology has except for maybe PCC,

45:07.767 --> 45:11.047
has come to nursing homes in a big way. A lot of these other

45:11.155 --> 45:14.992
vendors have overlooked and really concentrated their resources on

45:15.040 --> 45:18.622
large, acute care, massive organizations, and they

45:18.655 --> 45:21.502
kind of left out nursing homes or they want to charge a real lot of

45:21.520 --> 45:25.327
money and nobody can afford the solution. So we're bringing that together in a

45:25.345 --> 45:28.897
package that's affordable and also keeping our staffing, which allows us to grow

45:28.930 --> 45:32.197
the other parts of our business. Awesome. I really appreciate your time,

45:32.230 --> 45:35.452
Chris, for sharing some of your knowledge and your background a little

45:35.470 --> 45:39.057
bit about your company. It's really exciting. It's really innovative

45:39.222 --> 45:43.267
technology. And tell me something in a real way. Our listeners want to

45:43.390 --> 45:47.092
learn more about your company and see if it's available in their state

45:47.215 --> 45:50.602
and understand how they can sign up and avail themselves to your

45:50.620 --> 45:54.157
services. Where is the best place to send them? Sure. Our website is

45:54.235 --> 45:59.017
Intellikare.com. It's intel y cere.com.

45:59.065 --> 46:02.377
We're on Facebook, Twitter and the rest of the social media platforms as

46:02.395 --> 46:05.647
well. Well, I really appreciate it. Any final thoughts before we

46:05.680 --> 46:09.127
let you go? It really is so innovative and we just

46:09.145 --> 46:12.172
need to kind of let this all sink in. But is there anything else that

46:12.205 --> 46:15.982
we don't know about your company that we should know before we

46:16.060 --> 46:20.472
close up this episode? Yeah, I think right now we're expanding into Illinois,

46:20.517 --> 46:24.397
New Jersey, so if anyone out there is in those two states, definitely look

46:24.430 --> 46:28.012
us up. We usually start off and within three,

46:28.075 --> 46:31.917
four months we're usually one of the bigger vendors

46:31.977 --> 46:35.647
of staffing. So we spread throughout the street pretty quickly. So looking forward to seeing

46:35.680 --> 46:39.172
you guys and girls out there from those dates. Awesome. Okay, that's good

46:39.205 --> 46:43.222
news. We certainly have listeners in both of those states, so head on

46:43.255 --> 46:46.467
to Intelligair.com. Chris, it's been a pleasure.

46:46.527 --> 46:50.150
Thank you so much for coming on the nursing home podcast. Thanks for having me.

46:54.187 --> 46:57.972
I hope you've enjoyed this episode of the nursing Home podcast.

46:58.092 --> 47:01.372
Be sure to share this episode with all of your friends in the nursing home

47:01.405 --> 47:05.917
industry and just tell them to head on over to the nursing homehomepodcast.com.

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In the meantime, head on over to itunes. Leave me an honest,

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wonderful review, take a screenshot of it, and I will send you a

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gift straight and special for you. Again, head on over to itunes.

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Leave me an honest review, take a screenshot of it

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and send it on over to me on LinkedIn, and I will be sure that

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we send something out special just for you.

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Have an awesome day.