Ensuring Compliance and Excellence across Multi-Level Franchise Operations

Ensuring Compliance and Excellence across Multi-Level Franchise Operations

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Erin Cahill: Welcome to CareSmartz360 On Air, a home care podcast. I’m Erin Cahill, an account executive at Caresmartz.

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Erin Cahill: I’m thrilled to have with us Sheila Davis, the Senior Executive Vice President of Operations at Always Best Care Senior Services. Sheila is an accomplished healthcare administration expert with a wealth of experience in directing successful operational strategies and driving academic and research facility initiatives.

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Erin Cahill: Sheila’s background is truly impressive. She has spent extensive years overseeing healthcare operations, spearheading, financial reporting and management budgeting staff recruitment, revenue generation and service line expansion.
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Erin Cahill: Her expertise in these areas has been instrumental in helping organizations thrive and deliver exceptional care to their communities.

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Erin Cahill: Today we’ll be diving into Sheila’s insights on the evolving landscape of senior care, the challenges and opportunities facing healthcare leaders and the innovative approaches she’s championing to ensure the best possible outcomes for clients and their families. This is sure to be a fascinating conversation. So let’s get started, welcome to the podcast Sheila.

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Sheila Davis: Thank you. Appreciate it very much.

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Erin Cahill: So we’ll jump right into it as a senior care franchise spread across multiple locations. What are some of the key regulatory and compliance challenges you face in maintaining consistent quality and safety standards.

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Sheila Davis: Sure. So you know, operating a senior care franchise across multiple locations, as you stated, presents itself significant, regulatory, and compliance challenges particularly to ensure consistent adherence to all the rules and regulations on the local state and federal level.

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Sheila Davis: You know these vary from licensing requirements to labor laws, patient privacy acts which everybody knows is hipaa and meeting safety standards across all the locations. It’s a day-to-day balancing act. I think a lot of people think that home care agencies are regulated by the State, and don’t understand all the other

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Sheila Davis: aspects of regulatory bodies that also oversee them. So you know, maintaining consistency in care, delivery and meeting those safety standards across. You know the locations while navigating the different fireworks that come at you day to day is really challenging.

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Sheila Davis: But you know, ensuring compliance with all of those evolving regulations in areas such as elder abuse, prevention, medication, management, infection control requires constant diligence and adaptation. And we’re just constantly trying to adapt to new technologies. There’s all kinds of new AI adaptive tools that are coming out in our software platforms that are helping with those aspects of it.

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Sheila Davis: So I think that technology is really the one that is going to play a real big presence in our key, regulatory and compliance challenges going forward to help us meet those challenges in compliance.

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Erin Cahill: And how do you approach staff training and development to ensure all caregivers, regardless of location, are delivering the same high level of personalized compassionate care.

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Sheila Davis: We’ve implemented. We’ve implemented a standardized training across our platform, you know, to all of our franchise locations, not only for our caregiver staff, but for our back office staff, too.

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Sheila Davis: This includes a combination of in person and online and ongoing refresher courses focused on core competencies. To ensure that our client. Safety is always up.

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Sheila Davis: the up, much upfront, most important aspect of our care. You know, we. We deal with patient safety. We deal with dementia, care, communication issues and barriers every day. So making sure that that training is there for our caregivers and our staff also. That’s a lot of times, too. What people mistakenly think is that

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Sheila Davis: You know there’s just that caregiver obstacle that you have to overcome, that’s the only one that the patient and the patient’s family is ever going to be communicating with, but they’re also communicating with that back office staff as well on scheduling purposes. If there’s a billing issue. So you know there’s those communication and technologies that you have to also train your back office staff as well as your caregiver staff.

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Sheila Davis: We emphasize that importance of empathy as well. You know my motto has always been, you don’t want to take care of someone. If it wasn’t your own family member, and that’s kind of the motto that our franchise system stands behind. We also want to ensure that our teachings and our knowledge are compliance and regulatory specific. So it’s what the industry is wanting, teaching on.
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Sheila Davis: and what we feel like. Our caregivers are needing teaching on. We use a learning management system to track our learning and our knowledge base of our caregivers, so that we ensure that they’re getting the adequate number of hours per year, and we’re also always open to any caregiver or employee who comes to us and ask us for more knowledge and training to afford that opportunity to them.

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Erin Cahill: That’s great. What strategies have you found effective in fostering a culture of excellence and accountability across your franchise network? And how do you empower local franchise owners to uphold your brown values?

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Sheila Davis: you know, we encourage local franchise owners to embody those values and lead by example

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Sheila Davis: to empower them, we provide tools and resources like leadership, training, operational support performance metrics that help them monitor and assess their quality of care

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Sheila Davis: regular meetings and performance reviews and sharing best practices across the network helps reinforce accountability. So you know, encouraging that open communication, those feedback loops, and recognizing that outstanding performance which promotes a sense of ownership and accountability at the local level.

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Sheila Davis: We really do empower, empower our franchisees too. You know they are independently owned offices and operations, and so we want them to feel empowered to operate in such a manner, but consistent with the brand standards as well, so really empowering them.

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Erin Cahill: Right and managing finances and budgets can be complex for multi-site operations.

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Erin Cahill: What best practices have you implemented, implemented to maintain financial oversight and transparency throughout your franchise system.

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Sheila Davis: We use a centralized financial management system software that allows for real time monitoring of key financial metrics. Our Emr, our platform that houses all of our key metrics for our clients as well. So we’re able to utilize and and see what those kpis are and measure those against our financials.

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Sheila Davis: You know. Really. We use key financial metrics, including revenue expenses, payroll budgeting for each location best practices, including, you know, our standardized financial chart of accounts.

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Sheila Davis: We also have a set of performance groups that is based on really looking at those financial metrics and those kpis, and those groups kind of form their own board of directors per se, because some of our franchise locations are only owned by an independent, or maybe a couple, and sometimes it’s real hard to hold yourself accountable for your own finances, you know, I mean, and sometimes you get too involved in the day to day operations to really think about that. So

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Sheila Davis: We form some performance groups. We have like, I said, 5 or 6 in our system that encompasses about 80% of our franchises, and they get together 4 times a year. They like it, I said. They’re their own board of directors. They hold each other accountable for their metrics and their Kpis.

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Sheila Davis: They share their information with each other. And so we’ve seen just little bitty wins, you know, that maybe somebody is having more overtime hours than their peer is over here, and so they’ll share ideas on how to cut back on that overtime hour. Or maybe it’s the cost of their office space is a little bit more expensive than that of their peers. So how do they adjust that?

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Sheila Davis: And by seeing those little bit of adjustments. We’ve seen some really good financial wins and aspects come out. Of course, you know we encourage all of our owners to do a what is your bottom line? Knowing what your metrics are, knowing what your cost of service is, and knowing what your out of pocket owner’s discretionary profit is, that’s what they’re all in the business for. So

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Sheila Davis: and what is their Break Even analysis? So we really go over those metrics and those worksheets and teaching them how to calculate those things on a monthly and quarterly basis, and then bringing them together to share with their peers, and to help them hold each other accountable, and make changes.

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Erin Cahill: Oh, that’s great. Yeah, technology plays a critical role in home care today. How do you leverage digital tools and platforms to streamline operations enhance caregiver coordination and improve client outcomes across your locations?

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Sheila Davis: We really use our electronic health record, our Emr or Ehr to ensure accurate, up-to-date information. We use the Wellsky platform, and they are very good about customizing reports, customizing Kpis, but we really look for that up to date, client information to be shared seamlessly among caregivers. We think that the more the caregivers know, the better outcomes and the better patient care that can be given.

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Sheila Davis: Scheduling and workforce management platforms help to efficiently assign shifts and scheduling and make sure that care is delivered across the platform. We also use telehealth services and mobile apps for real time communication with caregivers, and then enabling families and quick adjustments to some of those shifts. We also have a digital solution. We’ve introduced some AI technology this year to improve caregiver coordination and patient outcomes.

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Sheila Davis: We feel like that. You know anything that we can do to help the clients. Sometimes they can’t afford 24 h care, but maybe they can afford 4 or 5 h of care, and we can put telehealth, or we could put an assistive AI device in the home, and it is showing that there are better outcomes for those clients to assure their safety, and to allow them to age in places which is where they want to be, is in their home.

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Erin Cahill: Hmm!

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Erin Cahill: And my last question for you, Sheila. Recruiting and retaining quality caregivers is an ongoing challenge in the home care industry. What innovative approaches. Have you taken to build a strong stable workforce that delivers exceptional service.

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Sheila Davis: You know. I wish I had a secret sauce to share with everybody right here, because I think this is, you know, the number one issue across the spectrum right now, but you know it is. It’s very tough, and I don’t think any of us in any of franchise system or any individual of office has actually developed what that secret sauce is. But it’s really offering those competitive wages flexible schedules.

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Sheila Davis: opportunities for career advancement that really helps retain and attain and retain attention. And so we’ve implemented those we have a caregiver

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Sheila Davis: rewards program that we have. So that’s in place. It’s very easy. It’s through our Emr system as well. So that reward system has really helped with recruitment and retention.

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Sheila Davis: We also emphasize employee recognition, recognition and engagement programs.

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Sheila Davis: We feel like that, those foster loyalty and help reduce turnovers. And you know, really to address the recruitment challenges. We’ve partnered with local training programs and schools.

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Sheila Davis: We’ve offered some internships and scholarships which have attracted new caregivers. And additionally, we’ve implemented some referral bonuses which have been proven to be very effective. So it’s all the things that everybody out there is doing. It’s just hopefully that we’re doing it in a little bit more streamlined. And of course, the continuing education.

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Sheila Davis: I think that that’s 1 of the things that, in my personal opinion, is so often overlooked. The 1st thing that people mainly think about is that caregivers are so focused on wages, and it’s that quarter of an hour here, or 50 cents of an hour over there

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Sheila Davis: That really drives them. But caregivers. They want to do a good job. They want to be acknowledged. They want to know that they’re part of a system, and they want to continue learning. They’re like the rest of us. They want to learn. So providing that continuing education and allowing for additional education when they request it has really helped our retention. Efforts here.

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Erin Cahill: Yeah, no, that’s great. Well, thank you so much, Sheila, for sharing your expertise. I know it’s really valuable. And to our lovely off audience. Thank you for tuning in until next time. I’m Erin Cahill, signing off.