Beyond Incremental: Transformational Growth in Home Care

Beyond Incremental: Transformational Growth in Home Care

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Hello dear listeners, Welcome to CareSmartz360 On Air. I’m Dennis Gill, Senior Sales Consultant at Caresmartz. Today, we are joined by Joseph Smithberg, Franchise Business Performance & Sales Coach at Right at Home. With more than 15 years of experience across home care, hospice, and behavioral health, Joseph has helped franchise owners drive turnarounds, build high-performing teams, and scale far beyond incremental
gains. So in this episode today, we’ll explore the systems, the leadership principles, and referral strategies that fuel

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sustainable growth and transform care operations in today’s complex homecare landscape. So welcome to the podcast, Joseph. >> Thank you, Dennis. I appreciate it. >> All right. So we’re really glad that you were able to take out the time today for our listeners and I hope this session would be a very fruitful one for all listeners that have tuned in. Okay. So without wasting any time, I’ll straight away jump on to my first question for you. Uh so Joseph, what are the biggest strategic shifts franchise

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owners must embrace to move from incremental to transformational growth in homecare? >> Yeah, with the current landscape, there’s just so much coming at us, especially from AI. You know, I’m working with different companies that are handling AI scheduling, um AI for lead management, uh AI for all kinds of things. Like I, feel like I get a new vendor, you know, approaching me via LinkedIn or email on a weekly basis just to, you know, talk about their product and what’s out there. There’s also

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things with new devices that are going on in the home or that are wearable or either auditory that are listening to um what’s going on within the home. And so there’s just so much more technology going on. And so owners are always asking me, you know, how do I create differentiators, you know, and and and now more than ever in our space, there are just so many differentiators that you can kind of implement with into your business or just or changing of structures or or finding AI to make

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things more efficient on how you typically have run the business in order for you to kind of invest time in other resources or money in other resources in order to scale in order to grow your business. uh via client uh acquisition. >> Okay. And uh how do you diagnose whether a franchise location is ready to scale versus need its stabilization first? >> Yeah, it’s a great question. You know, part of what we do here at my company is we have a right start program. So, it’s really for that those initial six

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months, nine months or so, kind of depending on um you know, how long that owner takes to really kind of grasp the model and how they want to go about building their business within this franchise model that I work in. Um and so typically for those people, you know, unless it’s the right um product at the right time in order to like with orientation of caregivers or to implement certain strategies right out the gate, you know, it might be a little bit of a spend, but sometimes it’s smart

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to just like this is the way we’ve always done it, so we’re going to continue to do it that way. Um a lot of the time with the new product, the new technology that’s coming up, you know, owners kind of look at it or as a shiny new penny. You know, there’s a lot of things coming at us and it’s like, well, let’s jump on that. That sounds great. in a lot of these companies have really slick salespeople, you know, and so I think it’s important to like either, you know, have a conversation with your your

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coach or consultant or just those in your network or or your allies out there in our industry on um if they have experience, what they’ve experienced with these different products because if if we’re not buttoned up operationally within your office just on the traditional way of running home care with the the recruitment and hiring of caregivers, the recruitment and retention of our clients, uh if we’re not efficient in doing that, um that adding to something new is just going to complicate things, muddy the muddy the

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water, so to speak, you know. So, we’re trying to do so many things at once when we don’t do the basics well, you know. So, once I work with an office and I and I really feel like they’ve got the basics down, there’s not a lot of cracks in the, you know, in the armor, um things aren’t falling through the cracks with their sales or their, you know, their uh pipeline, so to speak. Then it’s like, okay, well, let’s talk about ways we can stale scale, especially for an owner that’s been in

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the business for seven years, 10 years plus, you know, where they’re just kind of they have their processes in line. Um, but they’re kind of stagnant at growth. We did a data analysis where looking at different franchise systems within homecare and usually we see like a seven-year plateau where about year seven the growth kind of stalls and it kind of plateaus and so a lot of owners like, I don’t know what to do. I feel like I’ve penetrated my market to a high degree. Uh but we’re

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still kind of stuck at this hour mark. And so what’s next? And so so then some of those conversations about these new products, these new differentiators uh come to light in an effort to be able to um kind of take that next step towards uh growth and innovation. >> Got it. Got it. Basically, the foundation should be strong. So that’s why then they can build up on that part. >> All right. And continuing with this that what common referral ecosystem gaps do you see in franchise home care system

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and how can leaders close them according to you? >> Yeah. Do you mean as far as just our different referral partners or there like resources we’re not tapping into? >> Referral partners I would say to start with. >> Yeah. You know I think gosh I sales is my favorite thing to talk about. I was a sales representative for a long time before I started doing coaching and consulting. And so what I always coach is um consistency is key, right? If if we’re not out there and if we’re not,

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you know, knocking on doors and building relationships, then good luck. You know, uh I have a lot of people that want to spend on uh mobile leads and uh SEO and those types of things. And I found that that landscape is as competitive, if not more competitive, than it is to just be out there boots on the ground doing that marketing. So I always encourage that we have to have some sort of a presence. If you’re an owner of a business uh and you hire salespeople or marketers, community lison, whatever you might

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title them to do that work for you, that’s great. But the one consistent in these businesses is that the owner is the person that you know has skin in the game. You know, >> those sales people will come and go. I’m sorry to say that. If you feel like you have a rockstar, they might they might leave you in two years. >> I know that. I know that. >> Um the one consistent though is you. And so even though they’re there out there doing their marketing and make building these relationships, they need to be

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able to see that owner, too. Whether that’s a ribbon cutting or a 10-y year anniversary of a of a hospital in your area, whatever that may be, that presence is important, that the owner is known in the community and a part of it to, you know, uh it shows that they like care about the the people that we serve, the clients that we serve, the people we employ. Uh and we generally want to give back to our, you know, not only our referral partners, but our competitors as well. There’s so many people that

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need care and so I think it’s important that owners shows face in that fashion um with referral partners again it comes down to approach and consistency in that approach people don’t um buy because the the name on your shirt they they buy from the person they’re going to need to know you and trust you and that’s so important so in sales relationships is key to any sale but in home care hospice etc it’s it’s relationships on steroids so to speak. Uh they really have to know

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and trust you in order for them to say yes, you can care for my loved one. Yes, you can care for this patient that was in a really serious situ critical situation in the hospital. Now they’re discharging home. I trust you to take that on. So relationships are so important and and in order to establish those consistency in your approach and being visible is is vital. >> Got it. Got it. And what leadership habits have you found most effective in building high performing sales and operation teams across multiple markets?

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>> Yeah, one thing u I run into a lot is we hire a good person and then after 6 months an owner will be like well they’re not really performing and so the question that I always ask next is next is well how much have you how much time have you spent with them? How have you tried to manage them? How have you worked with them? And often what I find is people may or not know how to hire the right person, but no more often than not, they don’t know how to manage that salesperson. I interact with a lot

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of owners that aren’t from this home care healthcare space. They came from the tech world or or or wherever it may be. And so it’s a little bit foreign to them, you know, so uh a managing a salesperson within home care. And so I think it’s super important that you kind of brush up on your skills on how to manage those people. You have check-ins, you ride alongs, you spend time with them in the field, you, you know, do warm handoffs and help them create handoffs for you. Um, all those things

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are important. We need to sit down with each other and how did the week go? Create plans for followup. Followup is so important in our business. And after each day, I would like the owner to sit down with or at least the sales rep do it at first and then maybe on a weekly basis, the owner reviews it. but let’s review the calls that we made this day and then this day and then what’s the plan for follow-up? Is it helpful if I come with you? So, there has to be a level of checks and balances. There has

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to be some KPIs that have been established in order for us to make sure they’re doing their job as salespeople and to hold them accountable when things aren’t going well. But, and not only that, but to really kind of celebrate wins and to create a bonus structure or commission plan that makes sense and that’s obtainable so it keeps them motivated and excited to grow. Um, I think uh when I hire someone or when I interview someone for a sales role, I’m never turned off if they’re motivated by

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money. You know, that’s what motivated me when I was in sales. I cared deeply about the clients that I, the patients that I cared for in hospice and the and the clients in home care, but I also had a family. And so, um, I think it’s important that we dangle that care that that >> obtainable commission plan or bonus structure so they can achieve greatness and in the meantime help a lot of people because uh, if you’re going to be successful in this space as a salesperson or an owner, um, the money’s

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great, but the real value is like the difference we can make. and you walk into a living room as a stranger and you’re leaving hugging everybody because they’re so grateful for your expertise and that you’ve really given them a kind of a bridge or a path forward. >> That’s correct. Correct. And now the most important thing everybody talks about is AI. How should franchise owners be thinking about adoption in homecare beyond hype to real operational impact? Yeah, like I mentioned earlier in the

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call, like there’s um just so many options out there. Uh there’s some that I’ve vetted and I trust and you know, some that uh owners in our system have jumped into and through that word of mouth happen. So I would have conversations and learn from different platforms and really understand and then ask questions of your neighbors, of them. Um if it sounds too good to be true, it probably is, you know, but there are some really good solutions out there. I a couple for example that and I

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won’t name names but u some really slick AI tools as far as um on call u issues you know people that’s kind of one of the biggest issues owners talk about is on call is just too much >> um AI features that handle that 24/7 uh shift replacement caregiver engagement all those types of things uh there’s awesome tools out there and so I think it’s worth a listen um you know I I’ve even heard AI agents that are so good they’re probably better than 80% of people taking phone calls as far as

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inside sales is concerned because it’s it’s empathetic and it just continues to learn you know so the responses just get better and better and so I say it’s it’s part it’s AI is now and it’s only going to be become more and more robust and so I would you know take your time to identify which ones are going to help your business but I think it’s also smart to really start thinking about how you can integrate some of that into your day-to-day And lastly, continuing with the previous

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questions, the last question from my side would be that looking ahead to 2026, what market trends or pressures do you believe will most influence in franchise growth strategies? >> Yes, good question. If you’re not on board with the Medicare guide program, you should be. Um it it’s a really exciting demonstration that u most people are probably aware of in our space that or would be listening to this podcast. U Medicare’s guide program that’ll run through 2032 has been such a big

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differentiator if you can become the expert in that space and seen as that local expert then you’ll get referrals for that program. But the real benefit that I’ve seen is that it essentially schedules meetings for you. You mentioned Medicare, you mentioned free. People want to listen if they don’t know about it. And from that, you open doors you couldn’t get into before, you’re having deeper conversations, uh you’re seen as that trusted advisor. And then not only that, when you get these

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clients that are receiving that guide benefit, recognizing the need for additional care, having that conversation with them, because I have several people that have done this really well where they have they may be billing 480 hours this last couple months of guide, but they’re billing 450 additional VA hours because they identified that that client was a veteran and they worked them through the process of getting those VA benefits for HHA or they recognized the family just loved the care and they wanted more and

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so they’re getting their guide hours. their respit hours, but they’re also getting uh private pay hours. So, that’s one thing for sure. I think people really need a VA. The safest thing in the world is your private pay, right? But the VA reimbursement rates in most states are pretty healthy. You know, you always have to be a little cautious of that because they can change those rates any day. But I think owners should really be invested or every year I should say, but owners should really be

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invested in that education of identifying veterans and how do I hold their hand through the process of getting those hours that they need. There’s 4.4 million veterans out there that have a service connected disability and last time I checked about only 175,000 of that 4.4 are actually receiving those benefits. So there’s a huge population of veterans that are eligible that just don’t know, right? So, let’s be that their advocate to get them those hours, ask the right questions, understand the process, learn

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about your VA’s community care network uh department and identify those vendors outside of the hospital that are also part of that system. So, between guide and Medicare, which is exciting, the VA increases your knowledge and understanding of how to work their systems. Medicaid is increasing rates all over the country. You know, it’s typically not sometimes it’s not the smartest way to pay in our space because the margin is pretty low, but in some states that margin is getting higher and higher and closer and

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closer to our regular private pay rate. So, eyes on that. Um, and I think as we, you know, as things evolve, there’s differentiators within the home that are technologydriven, um, that are like in home wearables or in home, like I mentioned before, listening devices, not so much listening, but like listening for cues on what could be happening. So, there’s a lot of new new things that can help differentiate yourself in your market. I learned a long time ago if if you have a 100 competitors in your area, though,

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only about 20% of those or about 20 of those are actually out there boots on the ground marketing. So just getting out there and having a sales process and getting out there and knocking on doors, you’re already in the top 20, right? So stay consistent, create good follow-up, create differentiators for yourself. And if it’s not with technology, it’s with your people, it’s with your team, it’s with your training. So you can go out there and talk about it confidently in order to kind of earn trust and gain

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additional business. >> Wow. Thank you. Thank you. Thank you for >> a lot. Sorry there, Dennis. >> Thank you for your inputs. I feel it was a pretty good session and pretty incubative one for our listeners. Uh they must be aware about many new things. Obviously they must be aware of few things and they would be learning more and more about it and uh I’m really glad you were able to take up the time today for our listeners and um uh we hope to have another session with you shortly for more of your inputs for more

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for our listeners. >> Great. Yeah, my pleasure. Thank you Dennis. >> Thank you and thank you listeners. Thank you for your time today. I’m Dennis Gill signing off. So I’ll see you soon.