Latest / Home Health Revealed (+Palliative and Hospice) / Real Heroes of Home Care with The Davis Brothers of Patriot at Home

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Real Heroes of Home Care with The Davis Brothers of Patriot at Home · Home Health Revealed (+Palliative and Hospice)

• 0:02
  Speaker A: Welcome to Home Health Revealed, where we share real stories from industry leaders about home health, palliative and hospice care. Brought to you by Velocity. Grow your home health or hospice agency with the power of Velocity. Velocity's easy to read. Coding and revenue cycle dashboards let you grab your cup of coffee and quickly see the health of your organization. That whiteboard behind you, Man, I love me a good whiteboard. Sticky notes, even.
• 0:27
  Speaker B: Gosh, that's the master plan. I shouldn't let you see it. That's the secret sauce.
• 0:34
  Speaker A: Greg, I know you were a nurse. Sean, were you a nurse as well?
• 0:37
  Speaker C: Physical therapist.
• 0:38
  Speaker A: Physical therapist. Okay. So, yeah, just kind of start from the beginning, how you started. And you know, Greg, I would love for you to get into some scalability kinds of things, because I know that's where your brain is.
• 0:50
  Speaker B: What you guys don't know is he just basically told me, you got to let me talk. So.
• 0:55
  Speaker C: Trying to be mindful.
• 0:56
  Speaker B: I'm the.
• 0:56
  Speaker C: He's our. He's our talker. So, you know, sometimes I just sit back and just watch him.
• 1:01
  Speaker B: Let him go make make fun of me. Yeah.
• 1:04
  Speaker C: Oh, yeah.
• 1:05
  Speaker B: You guys, we're brothers.
• 1:06
  Speaker C: I don't know if you knew that or not.
• 1:08
  Speaker D: Yeah. Who's the oldest?
• 1:09
  Speaker C: I'm the oldest by four years.
• 1:11
  Speaker D: All right, so I think we should start out with the best fight.
• 1:14
  Speaker C: The best fight.
• 1:15
  Speaker B: I hit him with a baseball bat one time. I mean.
• 1:17
  Speaker C: Oh, yeah? Yeah.
• 1:19
  Speaker D: Like, where. Where'd you hit him at?
• 1:21
  Speaker C: Right in the back of my legs walking past. He was actually hiding in my bedroom, and I walked past my bedroom door. He jumped out behind me and got me right in the. My legs.
• 1:30
  Speaker D: Have you guys ever seen those? They're a bunch of dudes. And of course, Hannah, you know, guys are stupid, right? Naturally. That's why we needed women in our lives. But have you seen those guys? About four or five guys, they have a tennis track it, and they'll just pick up a ball and swing it and hit somebody in the back. Oh, have you seen.
• 1:47
  Speaker B: No, I haven't, but I'd like to see that. Sure.
• 1:49
  Speaker D: Oh, it's. They're so good videos. They just like. And then one of them will be, like, laying down asleep, and they'll do it and they'll hit him. He'll pop up another guy, slam a pie in his face. It's pretty fun.
• 2:01
  Speaker B: That's the difference between guys and gals right there. We think that's funny. You're probably like, what the hell is the matter with you?
• 2:06
  Speaker D: Yeah, right. Like, do you guys Even like each other. That's what my wife always says. Do you even like any of your golf buddies? It's like, yeah. She's like, well, you guys don't talk nice to each other. It's like, no, we don't. Why would we do that crap.
• 2:16
  Speaker E: I'm Lisa Von Lemden, executive director of the Ohio Council for Home Care and Hospice. Home care is more than a profession, it's a calling. Every day, caregivers across the country step into the homes of those who need them the most, bringing not just medical expertise, but compassion, comfort, and hope. This special series of Home Health Revealed is sponsored by the Ohio Council for Home Care and Hospice and honors the real heroes of home care. Through these episodes, you'll hear real stories from the field. Some are funny, some will warm your heart, and some will break it. But every single one reveals the dedication, resilience and humanity of those working on the front lines of home care. These are the moments that matter. These are the real stories, and these are the real heroes of home care.
• 2:54
  Speaker D: Yeah, Greg, the scalability is really important. I think, you know, companies get to a certain size and they want to scale. And I think that's where the point comes into how do you scale? Because if you don't scale, you could, you could plateau, right? And I think that's one of the biggest things that we see is, you know, agencies wanting to do better, wanting to grow, putting the right processes in place or at least trying to do that. But then they get to the part of how do we scale it with, you know, especially if they don't have a source of revenue that says, okay, here's the revenue we're going to dump in your pocket for you to take this to the next level.
• 3:31
  Speaker B: Yeah, yeah, so, yeah, that's actually an interesting question. And a lot of this stuff, candidly we learned by, you know, by the seat of our pants. I have a background in, I'm an rn, as we kind of discussed. I was a nursing home administrator for down in Atlanta, was a deal in, at the nursing home, did, did everything. Long term care for a stint in Atlanta. I moved back and then I got into sales and marketing, you know, up here in Ohio. And then Sean and I got together. Obviously we're brothers and always wanted to scratch the itch of owning our own business. And unfortunately we had a failure. Before this Patriot thing, we got into import export. We had no business in that space at all. And the interesting part is I'm clinical as an rn, he's clinical as a pt. So duh, why didn't you do something in healthcare? The answer is I don't know, because we're stupid, I guess. But so anyway, so we were approached by somebody down in Columbus to buy a Medicare billing number in this area. And Sean and I, you know, start the business, run the business, so on and so forth up here in Youngstown market. Well, that fell through. And at that point we, I think we took about a six month hiatus and licking our wounds after all of that because we put about six months due diligence time into that first business opportunity. And after the six months we licked our wounds. And I, I remember vividly sitting in my mom's kitchen filling out the 855 form, which if you don't know, that's the form you fill out to start an agency. And again, had no idea how to fill that form out. But we kind of muddled through that together. That was like 20, 2011 that we went through that whole process. And then beginning of 2012, chap came in. And at the time I was working for kci, the wound vac people, and I was in Columbus. And I remember Sean vividly, he was at the office calling me to tell me that CHAP was there. And I had the experience of dealing with the state. I was a nursing home administrator in a former life and was pretty calm about it just because I'd been through that whole process a million times in the sniff world. Sean was a little freaking out at the time. I remember the call was actually kind of funny. But we'd have everything wiretight at the time. We had all the binders that we needed, we had all our employee files, spic and span, ready to go. And what was interesting about it now is like looking back, we did all that work, you know, we did all the work to get everything up and going and so on and so forth. So from that point we got in 2012, mid-2012, we got our Medicare billing number, which was like the coolest thing ever because Sean will tell you, the financial fumes at my house were getting a little thin. So it was time to actually get paid for, for what we were doing. So Q3 of 2012, we got our medic, we got our first check in the mail, which we have framed, you know, kind of like the dry cleaner. You see their first dollar they ever made. Same thing here in Atlanta check. Which is a really proud moment for us again, that way I could keep my lights on at home and keep my wife happy. But from that point we, we started marketing it was me and another guy. And interestingly, I tell the story all the time. I'd be at a local SNF or a rehab center, and I'd be sitting across from a case manager or a social worker. And I remember thinking to myself, and. And mind you, I had a. A background in sales and marketing, so I kind of knew how to do all of that. And she didn't really know us from Adam, and I'm telling her all the great things we want to be when we grow up, maybe embellishing a little. But it always struck me as really surprising that they sent us patients. I'm like, you don't know who we are, but they sent us patients. And, you know, from that grew the idea, yeah, we kind of knew what we wanted to be. And, you know, people ask us all the time, how'd you grow so fast? You know, we're one of the larger agencies in Ohio after 13 years, and it's really simple, actually. You know, you go into an account, you figure out exactly what they want to work with you. And I see the opposite, actually, in the marketplace. If I'm a home health operator or a marketer, I come in and say, here's the things you have to do to work with me. We kind of reverse that. What are all the things that I need to do to work with you? We check all those boxes. And not that we hit the mark every single time, perfectly, you know, but we have an intentional detail for all of those things. And when we make a mistake, which we do make mistakes, we like to think we're perfect, but we're not. We own that mistake. We. We fix the mistake. We walk back, hat in hand, hey, look, we did X, Y, and Z. We talk to the family, we talk to the patient. Then we talk to the account. You know, we check all those boxes to make sure everyone's happy. And. And. And we try to make good on the.
• 8:33
  Speaker D: On.
• 8:34
  Speaker B: On that situation, and we try not to make that mistake again in the future. And it's really just that simple. You know, having the integrity to do the right thing most every time is really the secret sauce to our development and where we are today. So there's certainly struggles. Oh, I'm sorry, Mike. Go ahead.
• 8:52
  Speaker D: No, go ahead. But from a marketing standpoint, once you started getting all the referrals, right? That's the first thing that you always try to do, kind of like in sales, right? You gotta. You gotta build your pipeline. Then we start closing deals. Now you gotta fulfill the promise. So when you started you did the reverse psychology here, right. And you're likable guy. So I can tell when you're talking to those people, you know, wherever you're at, they're probably like, hey, I like this great guy, you know, I'll give him some referrals. You know, I think people overlook that, but that's a talent that most people don't understand is, are you approachable and likable from the get go? Right. So you check that box. So now people are. And I bet people probably tell you, Greg, they've, they feel like they've known you forever, they've just met you. Right. Because you're probably so real.
• 9:34
  Speaker B: Right.
• 9:34
  Speaker D: Have you ever had someone say that to you?
• 9:37
  Speaker B: Not my wife all the time. But yeah, I mean, I've heard it before, I guess.
• 9:41
  Speaker D: Well, yeah, your wife probably doesn't like you, but that's okay. I mean we're not.
• 9:44
  Speaker B: Someday she does marriage counseling.
• 9:46
  Speaker D: Yeah. But I think it's interesting because if you are starting to, you're starting to see referrals, now you say, okay, wait a minute now, now we've got to make sure that we're staffed appropriately. Tell me a little bit how you, you guys approach that.
• 9:59
  Speaker B: So, so I'd say this. I was kind of the outward facing person in the organization initially and Sean was inward facing. You know, organizationally he had and I, he can certainly speak to this, but he had like almost 20 years experience as a staff PT at a local home health company here in this area. So he was kind of the guy to make sure all of our processes, he and I worked on it together, but he had a better understanding of home health and how all those processes need to work. So then therefore all the promises that.
• 10:31
  Speaker D: I was making out in the community.
• 10:33
  Speaker B: Were fulfilled on the back end in our care delivery. And I can tell you this, and it's still like this to this day. I think I talked to Hannah about this maybe at a different time, but if there's, if we get a complaint or we get a bad review, which thankfully doesn't happen that often. It's like a five alarm fire here. We take that so very seriously culturally because the line of expectations way up here, we do not meet it. I have, well, my fellow owners know about it, my C suite people know about it, my mid level managers know about it, and the clinical staff in the field sometimes know about it too. So it's that expectation that we deliver the same awesome experience time and time again and when it doesn't happen, everybody knows about it. And we're scrambling to figure out this, what the situation is firstly. Secondly, how do we fix it? Thirdly, how do we communicate back to whomever was upset about it?
• 11:29
  Speaker D: Now, is this going back to your guys's vision or for the agency? You know, in terms of what do we want to be in our community known for?
• 11:38
  Speaker B: Yeah, I think that both Sean and I have a real distinct understanding of reputation.
• 11:42
  Speaker D: You know.
• 11:45
  Speaker B: I'll tell you this, like neither here. I. We're both kind of introverted in a way. We're not the guys that are going to be out the community and getting the key to the city, you know, via the mayor. We're not really those guys. But we understand internally how important our relationship, our interface is with our accounts. That's where we focus all of our energy on, is providing good service to our accounts and obviously good payment patient care to our, to our, to our patients too. So that's where we shine.
• 12:14
  Speaker D: Is there a certain training program that you put your team through to meet that expectation of service? Because service, you know, you hear people talk about service all the time, right? But then they fall short of the service. And I always use like chick fil A versus McDonald's, right? You go to Chick Fil A, it's like the best experience in a fast food restaurant ever. And then you go to McDonald's. Sometimes they only put their head below the, the wall where you can see who's collecting your money. And there's a massive difference in that. Right? Yeah.
• 12:40
  Speaker B: So interesting you mentioned that and then just put a pin in that for a second. I will say before this point here, we didn't really have training. It was a cultural thing. And it started truly from ownership as far as the expectation, because as I referenced before, Sean and I were the people actually carrying our bags, our clinical bags out in the community to see patients. But then also creating all the operational process and things and the expectations for service. And that's kind of trickled down to our C suite. We have a dynamic leadership team and that's really the secret sauce, man. I mean, everybody says how important it is to hire the right people, but we really believe that and we have the right people, which carry on that vision that Sean and I created so long ago, 13, 13 years ago now, but we just instituted actually leadership training. So we have all of our mid levels and all of our C suite people going through leadership training now actually as we speak. It's like a eight month process. And they take really what's important to Sean and I as Far as our visions go for growth and all those sorts of things. But then customer satisfaction too. And they do eight every month they're gonna do, they do like a three or four hour training and then afterwards or in between those trainings, they have one on one coaching they're doing. And again, understanding our vision and more importantly, you know, the whole growth thing. One of our, we have our cultural pillars, one of which is growth. You know, obviously growth, you know, meeting our numbers financially and you know, increasing the business side, sure, but their personal growth too. If, if Mike, if you want to be the CEO of Patriot, why need to get you there? I need to first identify that you want to be that person. But secondly, how do I, how do I get a track in front of you to get there? So we're focusing on developing our people now, which keeps everybody happy.
• 14:33
  Speaker D: And that's not an inexpensive expense. I mean, so you got to be from a leadership perspective or two owners. Knowing that your brand, knowing what your vision is. How'd you guys decide we're going to invest in that type of leadership training? Because again, that's expensive. So I don't think people understand that's expensive. And I think a lot of agencies want to do it, but they don't, they don't, they don't make time for it. And I think that's a big mistake. And I congratulate you guys on doing that because that's, it's awesome that you're doing it.
• 15:03
  Speaker B: Well, it's scalability. I mean, it's, it's funny when you're in this journey and fortunately we've been blessed to be in part of this, this journey the entire time, obviously. And you, you hit certain milestones and those milestones certainly are centered around census in, in financial stuff, but they're also, you know, you reach these plateaus of the census. That's just say, hypothetically, I have something in my phone here of a picture of our census being 50. You know, I have a, I have a. And Sean has a variety of them too. I think once you hit around your senses around 500, 500 plus, it's almost like, you know, at 500 below, you could kind of micromanage and navigate things and as an owner, really know every piece of minutia going on your agency, you get past 500 into the thousands. You need to have really strong systems and reporting to really see the bigger picture. So I'll pun it to Sean, he's the financial guy. So I had to actually convince the financial dude that we Needed leadership training.
• 16:06
  Speaker D: Well, yeah, because 5% of. Maybe a census of 50 of lost revenue is not a big deal. You get to 500.5% of that. That's, that's a big deal. You get to a thousand. That. That's a big deal. So, Sean, talk, talk a little bit about that. As you were growing and scaling, how important did AR really start hitting your radar? And you're like, man, we've got to start really monitoring this.
• 16:26
  Speaker C: Well, you know, knowing what I know about the industry, we're always very cognizant of staff productivity and revenue coming in the door and revenue going out the door. So basically, we're very much cognizant of keeping staff productive and making sure that. That the revenue coming in is more than the revenue going out.
• 16:54
  Speaker D: Yeah.
• 16:56
  Speaker B: Was there a point of question for him? That's the one thing that keeps this guy up at night.
• 17:00
  Speaker C: So.
• 17:00
  Speaker D: Yeah, it is. Right. But I mean, it. Was there a point where you said, Holy cow, 5%. That wasn't that big of a deal, but 5% today is. Holy, holy cow. Right.
• 17:09
  Speaker B: It's a lot of money.
• 17:10
  Speaker C: Oh, yeah, yeah, yeah. Gosh, I don't know. Maybe when we hit 10 million in revenue.
• 17:16
  Speaker D: Yeah, well, let me.
• 17:18
  Speaker C: Numbers got really big then.
• 17:19
  Speaker D: Yeah. Maybe this is a better, maybe this is a better question. At what point should agencies not, not that they shouldn't from day one, but at what point should agencies really look at processes when it comes to ar? Because, again, you know, as they're growing, you know, a lot of them are caregivers that, you know, and they do a great job. They, they love the business, so they, they want to own something just like you guys did. But then there's another part of that business. You can love people and love taking care of people, but now there's the operational side and the financial side of things.
• 17:49
  Speaker C: Well, if you don't have that side of your business, right, you're not going to be able to take care of people properly, or more importantly, you're not going to be able to take care of your employees properly, which your employees are the ones making your patients happy. So they have to be happy. In order to do that, you've got to have the cash to pay them appropriately and have proper benefit packages. And so the answer to your question is you have to do that that day one. That's got to be as important as taking care of patients or you won't be able to take care of patients.
• 18:20
  Speaker D: Yeah, yeah, yeah. Great, great answer.
• 18:23
  Speaker B: Yeah, yeah.
• 18:25
  Speaker D: How do you guys retain if I can ask in your journey. You know, we hear all the time, clinicians, tough to get them, tough to keep them. Is there anything you guys do differently that where you retain or, or that helps you recruit talented clinicians?
• 18:42
  Speaker C: Well, here's what I can tell you is, and it's very simple, and it's been our philosophy since the very beginning. We treat our employees exactly the way we wanted to be treated when we were employees. I know that sounds so, so simple and elementary, but it's the truth. And we have always treated our employees that way. And our reputation, the community is now that. That's how we are. So we, we don't ever have a problem with retention. We don't have a problem hiring clinicians or admin people or anything, because they know from our reputation, when they come to us, what they're going to get.
• 19:21
  Speaker D: Let's get into the meat and potatoes. What? Tell me the biggest mistake you guys made. Like, holy crap. We. Everyone needs to know not to make this mistake. So.
• 19:30
  Speaker B: That's a long list, man.
• 19:33
  Speaker C: Yeah, you're talking this year or. Yeah.
• 19:36
  Speaker B: Or last year.
• 19:38
  Speaker D: Whichever one you want to share.
• 19:40
  Speaker B: I'll bounce this back to you and I'll answer this in a little bit different way. We've made a lot of mistakes. Too many to count. I mean, I, I think, one, you need to have the humility to know you're going to mess up is the first thing. Secondly, I think resiliency is extremely critical in this space. Look, I don't need to explain to you two the revenue cycle involved in what we do. This is what you guys do every day. This is what you eat for breakfast, okay? But you need to have the resiliency to know. You know, you're going to get something figured out, and six months later, they're gonna. Someone's gonna change it, and there could be a hiccup in revenue or so on and so forth. You need to be extremely resilient to know you're working in such an imperfect space with such an imperfect. Such imperfect processes that change all the time. There's going to be a lot of problems. You need to be extremely resilient and have a very thick skin in this industry because you're going to make mistakes in it. That's the best piece of advice I can get. Any new owner, operator, anybody who wants to scale their business, know that you're going to screw up.
• 20:46
  Speaker D: Yeah, we always share. We always have a quote says, imperfect leadership working with imperfect staff members that refuse to give up on each other.
• 20:53
  Speaker B: Yeah, well, And I think that's a great point, Michael. It's, it's. You need to have the right team around you, too. Look, I, I think, I think the operations of the organization have outgrown Sean and I's talent to some degree, you know, at times. You know, Sean says this all the time. And I, I agree to some, to some degree. I, I agree with what he says. We're not formally trained, you know, Ivy League business people and running this giant thing. You just need to surround yourself with really great people and know when you need certain, you know, to outsource certain things like revenue cycle or accounting or so on and so forth and get those experts in here and fill those, fill those, you know, breaches in the hall as they come and surround yourself. And look, if you do that, I think you'll be okay.
• 21:40
  Speaker D: Yeah.
• 21:41
  Speaker B: And you don't have to do it all. I reference like a census around 500 being, at least in my opinion, where things, you know, you need to take a radical turn towards, you know, systems and processes and reports and things, you know, same thing once, once, once the job out, you know, kind of outpaces your skill set as a human. You need to outsource some stuff for sure.
• 22:05
  Speaker D: At what point when you guys are growing and scaling did you, you know, when you guys are looking at your plan saying, okay, we get to this number, we're going to hire maybe a CFO or CEO or, or whatever level type people. How'd you guys go about planning that out? Because you mentioned. And the reason why I'm asking the question, Greg, is you're saying that, hey, when you're, when you're looking at growing, there's a certain time you're going to bring somebody in or you're going to outsource or, or whatever. How'd you guys go about looking at that together, especially as brothers, right? I mean, there's no way you guys always get along, right? I mean, Sean seems like the smarter guy.
• 22:41
  Speaker B: Greg getting better looking. Oh, God, I'm never going to hear the end of that one. You know, I wish there was some kind of silver bullet I could tell you relative to that. It's like. And it's going to be different for every agency because you're going to have different team members with different strengths and weaknesses. I think you're just going to know when you're heading down a certain road that, hey, there's nobody here that can do that thing really well. Sean referenced revenue cycle and, you know, accounting and those sorts of things. Once you Reach a certain threshold. You know, you need to get your act together because these numbers get really big and you need to meet a ginormous payroll number every two weeks. Which if you really sit down and think about it, is kind of scary at times. But you know, you kind of know when you know. Sean, do you have anything to add?
• 23:32
  Speaker C: Yeah, I would. I'll just give an example. Like recently, within the last year or two, we hired an actual revenue cycle manager. And you know, kind of what we were, what I was noticing in the, you know, the day to day AR was, you know, maybe, maybe we've got orders are kind of like slow coming in or there's some old orders or, or you know, billing is not being followed up on appropriately or the RCD process was, was kind of jacked up for a few cases. So it was just too much for one person to look at and try to keep all that under control while they're doing other things. So that led us to say, hey, maybe we need like a full time manager looking at all these separate departments that are directly involved in ar so that that's running smoothly. And that's kind of how we made that decision. We needed an AR manager was just noticing little problems and nobody was following up on them because nobody had time.
• 24:34
  Speaker D: Yeah. How do you guys go about. Oh, go ahead, go ahead.
• 24:38
  Speaker A: Well, they've mentioned a couple times having the right people around you and, and I know from talking to you that culture has been a very big thing from the, from the get go. Right. Those values. What is your secret if you have one around? Hiring and knowing who the right person is. Because it's more than just a skill set.
• 24:56
  Speaker B: Yeah. So I'll take this one. And this is going to sound corny and simple. Simple, stupid hiring character. You know, you're going to have resumes that come across your desk or do interviews with people that come highly credentialed and are way smarter than you. And you think to yourself, well, I have this huge need and I know this person can do the job, I know it. But you're going to have that little gut instinct that says, well, maybe this person doesn't align with our culture, maybe they're not a good person. And you think, well, you know, there's been times, Sean, and I have overlooked that gut feel and I can tell you get burned by it every single time. It's really important you hire people with high quality character. Look, we can teach you anything, you know, we can teach you how to be the best nurse in the world. We can teach you how to be the best revenue cycle person on the planet. I can't teach you to be a good person. I can't teach you to interact with my other staff or lead. You know, we can in, in, in a way that really represents the organization well. So that's my, I guess that's the secret sauce. So I think it's, it's, you know, that's another thing with us organizationally. And everyone says they're a family run business. We truly are a lot of our family here. So, you know, that culture, that chemistry is really important. And you know, I, I do try to take my wife's advice sometimes, you know, with, with hires and things. And I can tell you on the other side of the equation, whenever I don't listen, a lot of times I can hurt too. So.
• 26:27
  Speaker D: Yeah, y. How do you guys go about. Because you're, you guys. How many employees today do you have now?
• 26:33
  Speaker B: We're pushing 500.
• 26:35
  Speaker D: 500 employees?
• 26:36
  Speaker C: 470 or something.
• 26:38
  Speaker D: Yeah. Do you guys sometimes wake up and say, holy cow, we have 470, 500 employees.
• 26:42
  Speaker B: The realest, the realest thing ever to that regard, Michael, is when we have our annual Christmas party. And Sean can tell you, we started at the back room of a local bar that everyone knows around here that has good food. And now we look out and there's literally 400 people sitting in this giant room. And it's, he and I have conversations every. Can you believe this happened? You know, it's just, it is, it's, it's, it's incredible. And I, I think we have plans to, to take it even further. So it's, it's hard to believe sometimes. I'm the go guy and he's kind of the reel you back guy, but.
• 27:17
  Speaker D: Really the end guy.
• 27:18
  Speaker C: I'm the money guy. I'm the one that looks at meeting that payroll every two weeks. It's a pretty big number.
• 27:23
  Speaker D: So, yeah, payroll seems like it's every day, doesn't it? It's like, oh my God, didn't we just pay.
• 27:27
  Speaker C: Oh, yeah, it's every day.
• 27:28
  Speaker D: Yeah. Yeah. How do you guys go about communicating with 500 people to keep it. Because you talk about communication, you've talked about your culture. I mean, that's got to be a pretty tough challenge, right? How do you communicate with 500 people? How you get them on the same page?
• 27:42
  Speaker B: Yeah, there's a variety of things. So obviously their managers interface with them. We have a clinical manager set up and they're responsible for roughly 150 nurses or therapists. You know, that's one way. Second way is we have a communication platform to basically text things out to each one of our employees, which is great. Thirdly, we have, and it's getting hard now we have to rent a local church out like a church hall to everyone. Here in our Youngstown office we have roughly every six months now we have, we have meetings in person. But it's interesting you mentioned that because that's one of the things I've been thinking about. And we have a gal here that has a master's degree in communication. So we're toying with the idea of having her do us. She did her thesis, her thesis on, you know, inner organizational communication. So we want to kind of replicate what she did there in our organization to figure out better ways to communicate because it is very difficult. It's not only. I mean, in our model, all our clinical people are decentralized, but post Covid, it's really hard to get people to come back in the office. So a lot of our office staff are decentralized too, but you know, it's actually kind of working out because I don't know where we put 500 people, you know, anyway, or even 150 staff people. Yeah, office people. It's, it's gotten to that point.
• 29:01
  Speaker D: So how do you go about trusting your leaders? Because you've mentioned your leader several times and you know, you guys can't be everywhere at once. Everyone knows you guys vision, your mission, your brand. How do you empower your leaders to where you now trust them, that they're going to fulfill what you guys need them to fulfill.
• 29:22
  Speaker B: Yeah. So all of our leaders, our senior C suite people, started in other jobs that weren't C suite jobs. So we got to know them, they were promoted into leadership roles and then they were kind of got keys to the kingdom, so to speak. So it's through, you know, a long road of trust and working with them, you know, at increasing intervals to our now. I mean honestly, we certainly interface with staff, but we interface with them most times and we don't even really interface with the mid levels all that much. It's RVPs now interfacing with Sean and I. So you really do have to trust them, you know, and it's the easiest thing in the world as a leader is to try to micromanage. I'm sure you both have experienced either, you know, trying to, you know, get away from micromanaging people or being micromanaged by somebody. You just can't work that way, you know, I, I think, you know, and everyone says this thing too, but it's true. You have to find the, the smartest, best people you can and trust them. And trust them. You know, obviously you give them guardrails. That's part of this leadership training I referenced earlier. Earlier. Creating these guardrails for everybody and letting them lead their departments or their nurses or so on and so forth. That's one of the things culturally and growth wise that we need, we're trying to embrace because this is Sean and I's baby. You know, we had this baby 13 years ago and, you know, it's kind of been a slow process of he and I's roles changing literally every year wearing so many different hats. So now it's turning into something way different, you know, you know, more of a board role where you're kind of overseeing, creating vision, vision strategy type stuff, which is kind of fun.
• 31:05
  Speaker D: What's a. One more question, Hannah, and then I'll stop, I promise. But I'm so into the conversation. I know. Would you.
• 31:11
  Speaker C: What?
• 31:11
  Speaker D: If you guys would both share with me and Hannah, what's the one thing about leadership you thought you knew that. Now you, now you, now you know that, like, oh my God, thought you're a great leader, but what's the one thing you're like, man, I would have known that or what you thought you knew and all of a sudden you're like, crap. I didn't really know that. Very good. Is that a good question? You can see where I'm going with that.
• 31:34
  Speaker B: No, I see where you're going. I think the first thing I kind of led into is micromanagement. You need to unwind and let better, smarter, younger people do their thing. You know, I think that's the biggest takeaway for me. And secondly, you know, Sean and I are both military dudes, so we've had opportunity to lead people for a long time. It's just that people are difficult to lead. They are. You know, even if you have the best people, there's going to be challenging times, challenging situations that make making, make leading very difficult. And again, like, I think our organization has changed over the years and years, gotten bigger and better and badder, I hope. And that's changed our roles and really us, he and I, as leaders to figure out, okay, how do we lead now versus five years ago versus last year? It's been a challenge and he and I have grown. I don't think he would have wanted to lead much of anybody. You know what, when he started this whole thing and now you see him in meetings like he's leading a charge. So, you know, we've both grown exponentially in this evolution. So it's been fun.
• 32:41
  Speaker D: About you, Sean, what about you, Sean?
• 32:44
  Speaker C: Well, I would say it's, it's really kind of made me realize what my limitations are as a person. You know, you're leading all these people and they're looking to you for vision, for strategy, for answers. And you know, sometimes you don't have the answer. So you know, you, of course, you know, we rely on the people around us but it's really made me kind of come to realize my own limitations sometimes.
• 33:11
  Speaker A: Was there a point? I know it's my turn, I guess. Here's something that I would like to know. You've, you've referenced that 500 mark. Was there a point when you said, okay, we've got to make a major structural or a major technology or some kind of major change within the organization and kind of. How was that?
• 33:33
  Speaker B: Yeah, I would say two things. Firstly, I would say the EMR that we have is great. And I think you and I might have talked about this, Hannity, but like the back end reporting for owners and operators and managers isn't what our vision is. So I think getting better data, you know, the revenue cycle, again, don't explain that to you too, how important that is, how you know, metrics in reporting making. So the first thing I will say is getting the right reporting and we're building that out. The second thing is, is like right now we're one of the larger agencies in Ohio and we just went through an acquisition which was really cool, never done that before. But we're sitting here now and we're thinking, okay, what's next? You know, what's next? So we're kind of building out that vision, that strategy for what's next, which is really fun.
• 34:30
  Speaker A: Yeah.
• 34:30
  Speaker B: Really hard and somewhat scary at the same time because it's like we could certainly hang where we are. Everything's going great. You know, not that we're perfect but you know, we certainly have problems. We could do that or we could take things to the next step, which we're going to take to the next step. So it's just. What's that look like? And we actually have a meeting in about a month to kind of. I want to pitch something to my other two owners and hopefully they bite on it. Hannah.
• 35:00
  Speaker D: Or it's going to be a rough Thanksgiving. That's right.
• 35:02
  Speaker B: Yeah.
• 35:02
  Speaker D: Right.
• 35:03
  Speaker A: Yeah. So it seems like there, I always say There are people who ask why? And people ask why not? And so it seems like you're the why not guy, Sean. Right?
• 35:13
  Speaker B: Yeah. Right.
• 35:14
  Speaker C: So great. Greg and I, we have this funny dynamic, and it's always really worked for us.
• 35:19
  Speaker B: Number one.
• 35:19
  Speaker C: Worked complete and total opposite types of people. And he's the guy that's always pulling us forward. Always, always, always. No matter what, he's pulling us forward. And I'm the guy not pulling back. I'm just pulling back on him. So we always end up, though, with him pulling forward and me pulling back right where we need to be every time. It's a pretty good dynamic.
• 35:42
  Speaker B: Yeah, I know it is. I agree. And we don't fight. Like, yeah, we got in fights when we were younger, sure. But, like, we really ever rarely fight about business because we've come to a spot where I respect what he is and he respects what I am, and we both respect what he said. It's like we understand the beauty in what we've been given relative to the situation with he and I. So it's fun.
• 36:09
  Speaker A: Well, I love the story. I love the trajectory that you've been on. And I think, you know, I'm looking forward to what you have in the future because I. I know that you are a person who pushes the envelope, so to speak, when it comes to what's next and what's next. I've just been over the last few years, interact with you at conferences, and you're always a great question asker, which is key.
• 36:30
  Speaker D: Was he, Was he in any of our stuff? Did he ask good questions?
• 36:33
  Speaker A: Yeah.
• 36:34
  Speaker D: What do you ask?
• 36:35
  Speaker A: Are you kidding? I feel like I was having a conversation with the both of them. The first year we were at the Ohio Financial Management Conference. They were just very engaged. And, you know, I think just that being willing to think through processes and I'm sure military and being in the field and having all of the really rich experience that you have for all the aspects of the business has played a key role. And then I think your foundation in a culture and going with your gut on hiring and working with people who are out in the field because they are representation of your business, they are your, your brand in the marketplace. And so you have to be able to trust that when they're out there taking care of patients, they're doing it to the best of their ability because it does represent you and who you are and what you started.
• 37:22
  Speaker D: So as you guys, let's just pretend for a second because I think starting a company is super hard. I, you Know, I think I worked for a lot of people. I've been fired five times, so I'm really good at that. And I was like, well, I'm unemployable, so I need to probably start my own company. And a lot of people want to start their own company, but then you get into that side of things and it's a whole nother world. Right. I mean, it's very, very hard. If you guys had to do it all over again, would you start your. Would you start. Would you start your own company again?
• 37:50
  Speaker B: 100.
• 37:51
  Speaker D: 100.
• 37:53
  Speaker B: Love it. I actually. Listen, I don't want to be dorky again, but I wake up every morning and think about what I'm going to do at work, and it makes me happy. Yeah, it's fun. And look, it hasn't always been fun. When we started the business, I know Sean will agree, it was a massive amount of stress, like a massive more stress than I think I've ever had in my life. But, I mean, that's the key as, you know, starting your own company. You have to wade through all that and keep. You got to be like a bulldozer. Every day is a bulldozer until you get to the point where things are kind of static and then get back up in your bulldozer, baby, and start bulldozing again.
• 38:36
  Speaker D: Yeah.
• 38:36
  Speaker B: And that's how you win.
• 38:37
  Speaker D: One last question. I'm just curious about it is that you guys have been in business for how many years now?
• 38:43
  Speaker B: 13.
• 38:44
  Speaker A: Lucky 13.
• 38:45
  Speaker D: Lucky 13. What year was it where you either felt like you were going to plateau or you got really, really get, get it going?
• 38:51
  Speaker B: I'd never felt that.
• 38:53
  Speaker C: I don't think that has ever happened. We've been growth, growth, growth, growth, growth. Every year is bigger than the last.
• 38:59
  Speaker B: What I will say, though, the. The seesaw that you will be on if you want to grow, grow, grow is quality.
• 39:07
  Speaker D: Yeah.
• 39:07
  Speaker B: You can't compromise being the best for, you know, being the biggest. And that's the struggle. That's the yin and yang of all of this, you know, and that's where your leaders come in that have. Share your values.
• 39:20
  Speaker C: Sure.
• 39:21
  Speaker B: They want. They have a growth mindset and a growth mentality, which ain't for everybody. But then they also want to be the best at the same time. And that's rare air to find those people. You got to dig deep. Sometimes they're in your organization. You can grow them, but sometimes you have to outsource and find them other places.
• 39:37
  Speaker D: Well, I. I appreciate you guys sharing your story. I mean, it's amazing story. And you're right about being humble. You're not going to be perfect. You're going to make mistakes. And I love how you. You own those. Hannah, any. Any final thoughts?
• 39:49
  Speaker A: No, I just. Thank you guys so much for coming and recording with us. I really appreciate it. It's been great to get to talk to you.
• 39:55
  Speaker B: Well, thanks for the opportunity. Thank you very much.