Home Health 360: Presented By AlayaCare

How culture, vision, and systems drive home care success with Stephen Tweed

• Erin Vallier • Season 1 • Episode 75

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In this episode, Stephen Tweed, Chairman and CEO at Leading Home Care, shares essential insights from the highest-performing home care companies, revealing seven critical lessons that drive success in today's competitive market. His extensive research and mastermind groups with top companies uncover the strategies that separate industry leaders from the rest.

Those strategies include:

• Crafting a strong culture based on leadership style, core values, and consistent behaviors
• Being purpose-driven and sharing authentic stories that create emotional connections
• Building amazing teams through sophisticated recruitment and development processes
• Thinking systematically with repeatable processes that enable scalability

Episode resources:

If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.

Stephen Tweed:

Last year when we did the survey, the system that was important to our respondents was caregiver recruiting, followed by caregiver retention. This year it flipped a little bit. Caregiver recruiting is number two, retention is number three. Number one is caregiver scheduling. So there's been a renewed awareness and thought processes for that system of scheduling, which includes using software, scheduling software or home care operating system, and what all is involved in making that system work both for the client and for the caregiver. And how does technology come into play?

Erin Vallier:

Welcome to another episode of the Home Health 360 podcast, where we speak to home-based care professionals from around the globe. I'm your host, Erin Vallier, and today I am joined by Stephen Tweed. Stephen is an internationally known home care business strategist, award-winning professional speaker, published author and strategic business advisor. He has spent the last three decades working with home care companies that want to grow and with home care leaders that want to get ready for the future. Currently, he is CEO of Leading Home Care, a Tweed Jeffries company, and founder of the Home Care CEO Forum. Stephen has authored or co-authored eight books written specifically for the home care industry. Welcome to the show.

Stephen Tweed:

Stephen. Thank you so much, Erin. It's great to be with you again and looking forward to a wonderful conversation.

Erin Vallier:

Oh, likewise I am, so looking forward to this. I'm just imagining you have a wealth of knowledge to share with the listeners today about the topic at hand. I believe we're going to get into some of those key learnings that you have uncovered by working with the top performers in the home care industry. So let's dive in Before we get too far in the weeds. I'm wondering if you could tell our audience a little bit more about your work with the Home Care CEO Forum and this top five mastermind group.

Stephen Tweed:

Sure, be happy to do that, Erin. My company, Leading Home Care, started back in 1982 when I was called by a friend to facilitate a strategic planning process for the board of directors of a home health agency in western Pennsylvania. That led me into the home health, hospice, home care arena. So for the next 20 years I did a variety of different things, mostly around strategic planning. Then, in 2012, my wife and business partner, Elizabeth Jeffries, and I introduced to the home care industry the mastermind concept. Mastermind is a concept of bringing people together to share ideas, to solve problems, to support one another.

Stephen Tweed:

Elizabeth and I have been in several mastermind groups with other professional speakers. We started our first group in February 2013, called it the $5 million mastermind group. To be in that group, you had to be doing $5 million in revenue At that time. That was a pretty big home care company. We had five companies, eight individuals at our very first event and the invitation was come and meet with us for a day and a half. If you like it, join the group. If not, no hard feeling. Well, all eight people stayed in the group and that group still exists today.

Stephen Tweed:

Today we call it the top 5% group based on percentile of revenue in the industry and that data comes from the Home Care Pulse benchmarking study. One of those five original companies is still in the group. Oh wow, the other four have sold their businesses and gone on to do other things. The 5% group has been around for 12 years, 13 years, and then in 2014, we started another group and then another group and another group. So today the Home Care CEO Forum has five mastermind groups, about 55 companies, and each group is made up of 10 to 12 companies. No one in the group competes with anyone else in the group, so they're spread out geographically and they're all independents. There are no franchises in the groups. At this point, We've looked at forming some groups of franchisees, but up until now the members have elected to limit it to independent home care companies.

Erin Vallier:

I love what you're doing. It started humbly and now it's expanded to something quite sizable, and it sounds like you're providing a really nice service to companies who just want to come together and learn as a group, learn from each other. I think you probably have a lot to share in terms of what you've learned from these top five percenters. I think there's seven lessons from our previous conversation. There's seven lessons from mega companies that you have identified are key to success in today's market. Could you give us a quick rundown of these seven lessons, and I'm sure we'll double click on some of them as we go through?

Stephen Tweed:

Yeah, I've been asked to speak at a number of home care conferences around the country, and the topic that I offered was seven lessons from the mega companies. These are principles that we have extracted from this decades long work with these top tier companies and with the other companies. We have our top, this decades-long work with these top-tier companies and with the other companies. We have our top 7% group, our top 10% group and then two groups that we call strategic growth groups. Lesson number one is to have a huge vision. The thing that we learn from these leaders in the top companies is that each of them sees themselves running a bigger company. Them sees themselves running a bigger company. They have a clear mental picture of what it is that they want to accomplish, and having that picture in mind has enabled them to move forward in that direction. As I mentioned, this group is 12 years old and some of the companies have grown quite dramatically since then. We also have had a number of companies that have exited out of the group because they have been acquired by other large companies or by private equity groups. These leaders see themselves running big companies and they see themselves exiting at some point via the sale. Closely tied to that is the second lesson, which is to craft a strong culture. When we talk about culture in any business, particularly in home care, we define culture as the way we do things around here, and the way we do things, or the culture, is influenced by a couple of factors. First of all is the leadership style of the CEO, and clearly the CEO sets the theme, sets the framework, sets the culture. Second element are the core values that guide actions and decisions within the company.

Stephen Tweed:

Over the years, we work with a number of home care companies to guide them through this process of defining your core values, and what we've learned over the years is that to be most effective, you need to have three, maybe four, core values. I learned this lesson 15 years ago from the CEO of one of the large franchise companies, who was speaking at a national conference and he said we only have three cultures because people can't remember five, and I thought that was interesting and so I've literally tested that out. If I've been with a company that has five or six or seven stated core values, I'll ask somebody off the top of your head, list for me your company's core values. They'll get three easily, maybe four. Most people stumble at five and don't get six or seven. So if you can't remember more than three, why have more than three?

Stephen Tweed:

And so, as we've worked around that principle and have gotten folks to clearly define their three core values, then the next piece is the behavior that you expect. And so we work around the core values to define behaviors. What does it look like when somebody is living this value? Let's take excellence, for example, and if excellence is a core value, what does that mean? What's the definition and what's the behavior that people demonstrate when they're providing excellence? And then the fourth element is the behavior you permit. So the leadership style of the CEO, the core values that guide your actions and decisions, the behavior you expect and the behavior you permit.

Stephen Tweed:

I mentioned my wife and business partner. Elizabeth Jeffries helped me organize the CEO masterminds in the CEO forum. Elizabeth is a professional speaker and author, but she also coaches C-suite leaders in hospitals and health systems. She coaches physician leaders in academic medicine, and one of the principles that Elizabeth shares with her leaders is the behavior you permit, you promote. We see that all across home care. When you have people demonstrating unacceptable behavior but you permit it, it's in essence saying it's okay. And so whether you get into people. No call, no show. People not documenting properly all of the things that folks do. That is unacceptable. If you permit that, then you're promoting, and so those things really lead us to this notion of crafting a strong culture. So, lesson number one have a huge vision. Lesson number two craft a strong culture. Lesson number three is to create distinction.

Stephen Tweed:

What is it that separates your company from all the other companies in home care? I just updated my estimate of the number of companies in home care and we estimate that there are about 29,000 companies providing home care in the US, including all of the home care companies across Canada. While there are only 30 states in America that license home care companies, there are 20 states with no licensure from our data tracking franchise systems and from our data tracking what we call affiliated home care companies. Those are home care companies affiliated with a home health agency, a hospice, a senior living community or a hospital system. We've organized this into some estimates of the number of independent agencies, franchises, affiliated companies and the number of registries and, of course, in America, I'm not the registries in Canada. In America, registries are basically a broker intermediary between a client and an independent caregiver, and I just got some new numbers in doing some research with the Home Care Association of Florida, so we're guessing there are about 2000 registries in the US.

Stephen Tweed:

Yeah, it's very popular in Florida and East Coast and Georgia Florida actually incorporates registries into their legislation, as do Pennsylvania and Maryland, and then there are other states that permit registries and states that prohibit them, so it's a very interesting segment of the population. And so if there's 29,000 companies out there, what is it that separates your company from all the others? In most major metro areas in the US and across Canada, there's really a saturation of home care companies. I think that creates confusion on the part of consumers as to where do I start when I Google home care. I live in Louisville, kentucky. Pick home care in Louisville, kentucky and the proliferation of agencies that pop up, how do you differentiate yourself? Too many options, that's right. So we've done a lot of work and we've identified what I call the seven sources of competitive advantage and we dig deeply into each of those and I'm not going to list them all, but things like creating excellence, creating exceptional customer experiences, narrow market focus, concentrating on what I call your ideal customer, creating specialty programs around disease states. We have a number of our home care mastermind members who have created specialty programs around Alzheimer's and dementia or around Parkinson's and other movement disorders, being highly specialized in a narrow list of disease states and really being the expert in providing care in the home for those persons with those diseases. So that's creating distinction.

Stephen Tweed:

Lesson number four is to be on purpose and tell your story. What we've learned over the years as as professional speakers, is that stories and language create feelings and feelings spark behavior. If we want somebody to behave in a certain way, if we can make an emotional connection with them and stories are a great way to do that. What I've learned over the three decades of working in home care is that pretty much every home care company owner has a personal story about how they got into this business. Why they got into this business. It was caring for a family member. It was seeing the need out there. Whatever the case might be, many people who have heard me speak have heard my personal story.

Stephen Tweed:

When my son was one year old, he was having some issues with movement and so we went through a series of doctors, ended up at Pittsburgh Children's Hospital in Pittsburgh, pennsylvania. As I opened the story, I said I walked into the office of a world-renowned pediatric neurologist. It was a dark, gloomy office, but then he was a dark, gloomy doctor. He said to us, after being here for 10 days and doing all the tests that I know how to do. I'm not 100% certain, but I believe that your son has a rare neuromuscular disease called Wernig-Hoffman syndrome anterior spinal muscular atrophy. He said it is very rare. I've been practicing medicine here for 30 years. I've seen 12 cases. I have no idea what causes it. There is no known cure. I believe your son will probably live to be three or four. Take him home and love him. Well, back then we did what the doctor ordered, so we took him home and loved him.

Stephen Tweed:

And there's more to the story. But today my son, jason, is 54 years old, he's married, he has twins that are 22. He owns his own company called MediaStead, which designs and produces websites and digital marketing for home care companies. Jason has the physical ability to use the fingers on his right hand. Everything else he needs assistance with the activities of daily living. So he is a consumer of home care on a daily basis, daily basis. And it is because of Jason and our family experience and the impact of home care that we are committed mentally, intellectually, emotionally to the home care space, and we know from our own personal experience that home care makes a difference for the clients, but it makes an even bigger difference for the family, and so that's just a little tiny piece of my story, but it illustrates why we do what we do.

Erin Vallier:

Yeah, it's compelling. It draws people in too. Exactly.

Stephen Tweed:

So it brings us back to being on purpose. We have learned that if every home care company and every leadership team can get clear about their story and purpose, then it brings much deeper meaning into what we do and why we do it, and people trust you.

Erin Vallier:

That's right. They know or they feel that you have their best interests at heart.

Stephen Tweed:

Exactly. I'm reading a book right now called Story Brand 2.0, from a marketing leader talking about how we take our personal history and craft stories that communicate the message of what we do. The more that we can use stories and emotions and have a sense of being on purpose, the more we connect with families, with clients and with high potential referral partners and the more we enjoy what we're doing. Right, Exactly. So that's number four. Then we go on to number five, which is to build an amazing team, and it's very clear to me that the companies in the top tiers of this industry have leaders who see themselves growing a big company. They recognize the need to bring in great people and they have developed a process for identifying and recruiting and attracting great team members and then bringing them into that corporate culture. So we see how the pieces fit together vision, culture, creating distinction, being on purpose, building an amazing team. And that leads to number six, which is to be a systems thinker team. And that leads to number six, which is to be a systems thinker, and again, the top tier companies, the leaders are systems thinkers and they're thinking about how do we replicate tasks, processes, procedures so that they're highly repeatable, Because that's the secret to growing a big company is having that repetition and consistency that enables the team to do the same tasks over and over again on a large scale.

Stephen Tweed:

And then that takes us to number seven, which is to measure performance and communicate expectations. What is it that we want the team to do? How are we doing? How do we measure that feeding back to the team to again continue to grow the expectations of what we want to accomplish. So those are the seven and they're broad lessons.

Stephen Tweed:

And then, as we have worked each of our mastermind groups, we are able to dig deeper into the details of how these processes work. So, for example, we said be a systems thinker, and we're just now completing the 2025 future of home care study that we're doing and we identified 12 systems that can be put in place in a home care company, and the participants in our survey have told us which systems are most important. So that report will be coming out in the next couple of weeks and we'll be sharing that data. But we learned a lot from these. I think we had 250 some home care leaders who participated in the survey and gave us some great insights into what's important to them the systems, the major trends in the industry, the threats or the pain points that are keeping them awake at night. So we continue to dig into what's moving leaders in home care forward and what's getting in the way of them growing more quickly.

Erin Vallier:

That'll be a really interesting report to get your hands on and learn some stuff. You've mentioned several things here that really strike a chord with me. One of my passions is leadership and I speak on it and coach people on it from time to time. And some of your points here like building a strong culture and building an amazing team those to me seem very closely tied together to having a really strong leadership team and having the right mentality, being a servant leader. And it's amazing to me, like when I talk to different agencies.

Erin Vallier:

I talk to different agencies every day and you'll talk to one and they just struggle so much with getting people to even like clock in and clock out to their visits and then you'll talk to another who is like well, I have no problem with that and I have no problem with retaining my employees. I'm doing these things, these things. It's like how are these people so different? I think it has everything to do with leadership and change management and setting up that strong culture and enforcing it and building an amazing team. What do you say to those people that are struggling in the area of having a good culture, where people want to be there, and how to go about building that amazing team, if that's what they're lacking.

Stephen Tweed:

Yeah, I think you're exactly right, and as we have identified these, I went back. We did a study back in 2016 on what we called the DNA of a CEO and we used an online assessment tool called the Trimetrics DNA that measures behavioral styles. It measures workplace motivators, and then it measured what the developers called DNA, or the 25 leadership characteristics, and from that we identified the typical behavioral profile of a CEO. As part of that study also profile of a COO we looked at what motivates them and then we looked at these 25 leadership competencies and we were able to rank them in order, and so we've done a lot of work with the members of our mastermind groups around helping them develop leadership skills and just at our December meeting of the top 5% group or November, I'm sorry we were all in Dallas, texas, for three days and as we were talking about what we call their big burning issues what are the issues that they're facing, that they're working on, that may be frustrating them, that they want to talk about, and one of the things that the leaders talked about was leadership development.

Stephen Tweed:

That we've done a lot of work within the group and typically in our mastermind group, the people who attend are the CEO and the COO, and some of our members are family-owned businesses.

Stephen Tweed:

We have a couple of husband and wife teams.

Stephen Tweed:

We have a family business with the father, son, another son, a son-in-law, a daughter, and so at that level they've learned a lot and they've come back and said well, what we'd like to do now is develop a leadership curriculum for our middle managers.

Stephen Tweed:

And again, these companies at the top 5% range in size from $10 to $30 million. So a $25 or $30 million home care company has a fairly significant leadership team, including a large group of middle managers, and so we're in the process of working with them to take this information from the DNA of a CEO study and look at how we develop an educational curriculum so that we can develop the competencies at the middle management level and then carry some of those same competencies down to the frontline supervisors and schedulers and those kinds of folks. Leadership is a big piece and most home care companies have not really done a whole lot in terms of developing their middle managers. A lot of owners and CEOs go to outside programs run by maybe their state home care association or run by their franchise organization, but there's not a lot available for that middle management group.

Erin Vallier:

Yeah, and they need a lot of attention. They have a direct impact on the people who are doing the actual work in the field. So, yeah, that's important.

Stephen Tweed:

And, of course, we know that turnover has been a huge issue in home care and we know from other research that I think it was a Gallup organization that did some research and one of their conclusions was people don't quit companies, they quit their manager. Yeah, that's right, and so if we have a high level of turnover, we need to look at what's the relationship between the caregiver and their immediate supervisor. And again, that builds back into the corporate culture piece, but it also builds back into leadership skills and leadership competency 29,000 plus agencies across the US.

Erin Vallier:

That's a lot. That's a lot of competitors out there for you to make yourself stand out against. So I'm curious. You mentioned a few ways that people can do that by building specialty programs. But let's just break that down a little bit. How can a home care company go about thinking about making themselves a standout amongst the masses who are all providing basically the same type of services?

Stephen Tweed:

That's right. Yeah, there's 29,000 companies, and we know from Home Care Pulse now activated insights that the median size company last year was 2 million and changed like 2,009,000 and whatever, and so that means that if there are 29,000 companies, there are 14,500 companies smaller than $2 million in annual revenue. So that's a pretty small company. And so, again, they all begin to look alike. And so how do we create distinction? And, as I mentioned, we've done some research and had lots of conversations, and I'll mention just a couple of them. Probably the top two that we've seen people build on are number one, creating exceptional customer experiences, which really goes back to the consumer primary family caregivers and referral partners. And so we look at, well, what's the experience that the consumer is having, what's the experience that the primary family caregiver is having? And our data show that 60% of the time the primary family caregiver is the oldest daughter, and so we've labeled that the oldest daughter syndrome is the oldest daughter, and so we've labeled that the oldest daughter syndrome, and then 20% of the time it's another daughter, and then other 20% it's another relative, in-law, or it might be a third party, like a bank trust officer. And so what is that family of the client experiencing. What's the communication like with the home care company? What's their level of satisfaction? What's the communication like with a home care company? What's their level of satisfaction?

Stephen Tweed:

Home Care Pulse now Activated Insights has their client satisfaction management process that they use, and they have lots of data around what clients and families expect from home care company. We did a lot of research earlier on about what the individual consumer says they want, and what we learned from our focus groups and from our qualitative research is consumers tell us they want two things Reliability, that is they want a caregiver that shows up on time every time, and continuity, that is they want the same caregiver every time. And so if that's what the consumer expects, then is that being delivered and what's their level of satisfaction and so creating that exceptional customer experience? Then we go over to referral partners and what's their experience? And I think so many companies focus on what they do for the client that they lose sight of what they do for the referral partner and what their issues are, what their problems are and how does working with our company benefit that referral partner, whether it's a discharge planner in a hospital or a social worker in a rehab facility or a bank trust officer. We've done a lot of work around helping home care companies increase their income by selling to bank trust officers and other trusted advisors, and the data show that the dollar value of a client coming from those trusted advisors is much higher than the dollar value of a client coming from that traditional healthcare continuum hospitals, home health, hospice, skilled nursing facility, and so understanding the customer expectation. Another example is creating what we call caregiver quality assurance and that is really focusing on the whole process of attracting, retaining caregivers, and what we're seeing is a trend and it's the early phases of it.

Stephen Tweed:

But we're seeing a number of leading companies who are making a conscious choice to shift from a client or customer first culture to a caregiver first culture and they're saying how do we adjust what we do to take care of our caregivers?

Stephen Tweed:

Under the premise that if we take care of our caregivers, they will take care of our caregivers, under the premise that if we take care of our caregivers, they will take care of our client. And sometimes that means saying no to a client because what the client wants is in conflict with what the caregiver wants or needs or finds important, and so an example of that is reducing the number of short shifts or setting minimum hours per week. And so a client calls up and says I want three hours a day, two days a week, and the company says, no, we can't do that because we can't staff that shift, because our caregivers want stable, steady schedule, certain number of hours a week, and so we're going to focus on what our caregivers need involved, and that means that the client may need to fit their schedule into what's best for the caregivers, and that's a sort of 180 degree mind shift from what has happened in the past Kind of goes back to setting that strong culture.

Erin Vallier:

That's exactly right. So what I'm hearing you say in terms of being able to create distinction is that you really need to understand all of your customers. So you have the recipient of the care that's a customer. You also have their family that's a customer. Then you have your internal customers, your schedulers, your caregivers and all of the people that are making this whole machine run, and then you have all of your referral partners that are customers as well. So you got to really understand who all those people are, what their problems are and be a part of the solution in order to make it super easy for them to do business with you and make your company attractive.

Stephen Tweed:

And we have really dug deeply into that and looked at how home care companies can identify their ideal client Gotcha and we've looked at how they use their own data. And so at the end of I guess it was the third quarter of 2024, I released a new ebook called Six Secrets to Selling Home Care to your Ideal Client and it works through how you identify your ideal client and how do you build the relationships, and I'm happy to offer that to your listeners and readers. If they want to look at that, they can go to leadinghomecare. com and click on the store button and you will see that ebook Six Secrets for Selling Home Care to your Ideal Customer. And we put up a coupon code just for this podcast. Awesome. The coupon code is ALAYACARE25, A-L-A-Y-A-C-A-R-E 25, and that will get them a 50% discount on that ebook. Fantastic.

Erin Vallier:

That's a wonderful resource. We appreciate that. We'll make sure that the code and how to get to this ebook is in the show notes so people can take advantage of that offer. Thank you.

Stephen Tweed:

I think people will find that very useful and helpful to come back to looking at this principle of narrow market focus when you're clear about your ideal customer and you're clear about which referral partners tend to bring you your ideal client, and then what the ideal client is concerned about in terms of caregivers and how we can recruit caregivers who are comfortable caring for that ideal client. So the pieces of the puzzle come together and it means you grow your business larger, increase your revenue, have more hours per client per week, longer length of stay, your caregivers have a regular schedule, your schedulers are less stressed, your recruiters are less stressed because you don't have as much turnover and all the pieces of the puzzle come together quote internal and external customers to get them motivated and bought into your story and your way of doing things.

Erin Vallier:

Can you talk a little bit more about that and how to leverage the individual's story throughout company communications and throughout communications to the referral network and clients?

Stephen Tweed:

Well, two of the other sources of competitive advantage or sources of distinction are personal relationships and relationship selling, and I'll share the difference. So, in personal relationships, the owner, the CEO, the leaders of the company are out in the community building relationships, particularly with high potential referral partners, and for them being able to use their own personal story about why they started their company, what are the impacts, who are the people that they were caring for, what are the stories? And, as we said, stories and language create emotions or feelings, and feelings spark behavior. And if the behavior we want is for people to buy what we're selling, then we need to spark that behavior by making that emotion connection. And so home care owners and leaders are out there in the community building those personal relationships. Relationship selling is the same principle, except that instead of the owner being out there doing that, it's a sales professional or a sales team, a business developer, and we have a couple of examples in our top 5% group of companies that grew dramatically because the owners and CEOs were former sales professionals. They knew how to sell, they knew how to recruit salespeople, they knew how to manage them, and so they would build a team of sales professionals that were out there and again using story and making personal connections to persuade those referral partners that this is the company that's going to do the best job for your clients. And part of that personal relationship is understanding the needs and wants of the referral partner.

Stephen Tweed:

As I think I mentioned earlier, most companies do a good job of explaining what we do for the client, but most companies don't do a good job of explaining what's the benefit to the referral partner of using our company versus any of the other companies across town. What's in it for them? All of those people have that little radio call sign stenciled on their forehand W-I-F-F-M. What's in it for me? So, as we have these salespeople, learn to really understand the business of the referral partner. So if it's a hospital discharge planner, what's important to that discharge planner? If it's a social worker in a nursing home rehab unit they've got people being discharged pretty much every day what's important to that social worker? If it's a bank trust officer who's working with high net worth clients who have large trusts in the States, what's important to that bank trust officer? And I think most home care leaders have not sat down and really developed those kinds of relationships and thought through how does what I do in my company, benefit, that discharge plan or that social worker, that trust officer.

Erin Vallier:

That's an important exercise.

Erin Vallier:

I know that when I was on the provider side, we spent some time really thinking about how we could serve our referral partners better, and we were always on the cutting edge, the leading edge of new programs of making their lives easier.

Erin Vallier:

Maybe we set up shop in the ALF and we have an office there so they can just come, tap us on the shoulder and we partner with them in different ways in order to make it more synergistic for both of us and get the job done with less resources and a lot less paperwork and headache. So it's worth the effort to sit down and think about what your referral partners really need and how you can give it to them in a way that nobody else has ever thought of. So get creative there, which probably leads to some of the systems that you've mentioned. You say be a systems thinker and there's roughly did I remember correctly about 25 different systems that you guys have identified. I know you're going to release that paper in a little while to expand on all of those things, but I'm curious from your initial learning from that study, what are the most important systems for home care companies to develop in order to scale their business? Can you share?

Stephen Tweed:

We've actually identified 12 systems. The 25 we talked about earlier was the leadership competencies of CEOs Gotcha the leadership competencies of CEOs Gotcha With systems. We've identified 12 systems, starting with a sales system, a marketing system, a conversion system to convert callers to clients, a recruiting system, a retention system, right through the business. We came up with 12 of them, and so I'll give you just a quick sneak peek of what we learned from this survey. Last year, when we did the survey, the system that was important to our respondents was caregiver recruiting, followed by caregiver retention. This year it flipped a little bit. Caregiver recruiting is number two, retention is number three. Number one is caregiver scheduling. So there's been a renewed awareness and thought processes for that system of scheduling, which includes using software, scheduling software or home care operating system, and what all is involved in making that system work both for the client and for the caregiver, and how does technology come into play. And then there's a whole other section of the survey on technology and we're looking at things like where does artificial intelligence come into play and how does artificial intelligence get built into scheduling software, into scheduling software, and how do we teach schedulers to use the software and the artificial intelligence to improve the scheduling system.

Stephen Tweed:

When we talk about systems, there's two parts of it. There's the process, that is the step-by-step process that we go through, and there's the people, and the people that have the discipline to follow the system, to document the things that take place, to recognize when the system has a flaw and we need to fix it, and so it's a combination of process and people that makes these systems that are repeatable and consistent, and there's 12 systems. We know that most home care companies can't deal with all 12 of them. And there's 12 systems. We know that most home care companies can't deal with all 12 of them. So it's a matter of where do you start, and by having this data from 250 home care leaders, we give folks a clue on where to start, what to focus on, what to work on. So scheduling, recruiting, retention.

Stephen Tweed:

Number four on our list this year is home care marketing, and it's interesting because last year home care sales was up there and we know that sales is a subset of marketing, but it's specific.

Stephen Tweed:

And then number five is billing and collection looking at systems, and, of course, what we're seeing is more and more home care companies thinking about other revenue streams and other payers beyond private pay or beyond Medicaid, and so there's a lot of very interesting data that's coming out of this study, and so we'll hope your listeners will be looking for that. One of the ways that they can learn about the research that we're doing at Leading Home Care and that we're doing with our various partners in the industry would be to subscribe to my weekly newsletter. I have a weekly newsletter called Stephen Tweed's Thursday Thoughts. It comes out every Thursday at 7 am Eastern time and it's a little short story or example, but when we're releasing new information we'll write about it in the newsletter. So when this wait paper comes out, I'll do probably a whole issue of Thursday thoughts on some of the lessons that we've learned from this research.

Erin Vallier:

Fantastic. We'll make sure that the listeners have that also in the show notes so they can sign up. Sounds like there's a lot of good information that you're passing around. You've got me excited. It sounds like a lot of these systems that need to be in place involve technology. I heard you say artificial intelligence, being able to bill and being able to streamline and all this stuff. So there's an intersection of technology with people there, and I always enjoy hearing about that and working for a technology company, I know that we've butted up pretty much against our time. This has been a really informative conversation. There are some resources that you have mentioned and we'll make sure that people have access to those in the show notes, but I'm curious if there's any parting wisdom you want to give or just another way to get in touch with you to have conversations about, or more targeted conversations about, how you might be able to help a business grow and thrive or how they might be able to get involved in some of these groups that you've got going on.

Stephen Tweed:

Well, thanks for asking, and in 2025 is an interesting year. As many people out there know, I formed the Home Care CEO Forum in 2012, grew that for 12 years. I sold that business in January of 2023 to my friend and colleague, jensen Jones, who was one of our top 7% mastermind members, and I had a two-year agreement with Jensen to continue to run the 5% group and to do some other things within the CEO forum. So that agreement has come to completion. We're going to continue to do some other things together.

Stephen Tweed:

But I sort of stepped back and a friend of mine sent me an article called I'm not retiring, I'm rewiring, and I love that. I said that's me. I'm not retiring, I'm going to stick around own care, but I'm doing some things differently. I love it. And so I thought about it and prayed about it and talked to some of my advisors, and so my focus going forward will be three things. One is serving on some boards of directors of home care or home care related businesses. The second will be to shift my focus as a strategic advisor to work one-on-one with a handful of CEOs who really want someone to walk side by side and be a sounding board and be a resource to help them strategically think through where they're going. And then the third is continue to do industry research, and I love doing research and gathering data, and so I'm going to continue to do some of that on my own through Leading Home Care and for third-party organizations that come to us and say I need to know more about whatever.

Stephen Tweed:

So the 2025 Future Home Care Study is an example of that kind of research, and so, if your listeners are looking for a board member or in some cases with closely held companies that have only on their board, they have an advisory board of experts who know the home care industry, and so I'm putting together a couple of advisory boards for member companies. I'm putting together a couple of advisory boards for member companies, and then I'm also working one-on-one with some CEOs to be that strategic advisor, walking side by side. So the website's leadinghomecare. com and there are the three sections on that website. Also, the store has that ebook Six Secrets to Selling Home Care to your Ideal Client, and the coupon code ALAYACARE25 to get a 50% discount. So there's also a spot. If somebody wants to just have a conversation, they can fill out the form at the bottom of the page and we'll respond and set up a time to talk.

Erin Vallier:

Fantastic. Thanks so much for sharing your knowledge and for letting everybody know how to get in touch with you. I really do hope that a bunch of people listening to this today will take advantage of your offer for the ebook and get involved in what you got going on in some way. So thank you so much for coming on the show today, Stephen. It's been a real pleasure.

Stephen Tweed:

Thank you, erin, best wishes. Have a great rest of the year.

Erin Vallier:

Thanks. Home Help 360 is presented by Alaya Care and hosted by Erin Vallier. First, we want to thank our amazing guests and listeners. Second, new episodes air every month, so be sure to subscribe today so you don't miss an episode. And, last but not least, if you like this episode and want to learn more about all things home-based care, you can explore all of our episodes at alayacare. com/ home health 360 or visit us on your favorite podcast platform.