Home Care Hindsight

Jamie Arber, Executive Director of Supported Living Group, shares how his organization supports individuals with brain injuries, autism, and other complex care needs across Connecticut. He discusses the major gaps in access to Medicaid brain injury services, why home care operators need to think beyond traditional in-home care, and how advocacy, community-based programs, and specialized services can create better outcomes for the people they serve. Jamie also reflects on the career mistake of staying too long in an organization that didn't align with his service philosophies, the risks of relying too heavily on technology, and how giving people purpose can transform both care delivery and business growth. In this episode, you'll discover: 1. The Eight-Year Wait for Brain Injury Services: Why Connecticut's Medicaid Acquired Brain Injury Waiver program leaves individuals waiting years for the support they need. 2. Why Advocacy Matters in Home Care: How working with lobbyists, legislators, and industry associations can help providers influence funding, access, and policy decisions. 3. The Problem With Replacing Community-Based Care: Why moving brain injury services entirely into the home can create challenges for behavior, independence, and social connection. 4. Building Services Around Real Needs: How Supported Living Group developed neurodivergent employment programs, counseling, resume development, and interview preparation. 5. The Cost of Staying in the Wrong Organization: Jamie's biggest career mistake and why leaders need to work somewhere that aligns with their service philosophies. 6. Why AI and Technology Aren't Always the Answer: How highly specialized organizations can lose the value of human connection when they try to force generic systems into niche care environments. 7. Giving People a New Identity: How creative arts and vocational programs help individuals move beyond being defined by a disability and rediscover purpose. Lesson Takeaways: 1. Don't accept the Status Quo. Long-standing problems in healthcare and home care still need people willing to challenge the system. 2. Advocacy is a long-term investment. Meaningful change requires relationships, education, persistence, and a seat at the table. 3. Community matters. For many individuals with brain injuries or disabilities, care should include opportunities to participate, socialize, work, and feel connected. 4. Services should reflect the individual's needs and goals, not simply what is easiest for the provider to deliver. 5. Staying in a comfortable role can come at a personal and professional cost when the organization's values don't match your own. 6. Be careful with one-size-fits-all technology. Tech should support the work, not replace the specialized knowledge and human relationships that make care effective. 7. Bringing in professionals from different backgrounds can create new ideas, stronger programs, and better business decisions. 8. Helping people develop skills, employment opportunities, and a sense of identity can be just as important as providing direct care. 9. Operators need the right infrastructure, management, oversight, and quality assurance to deliver the services they advertise. 10. Growth is more meaningful when it creates independence, purpose, and better opportunities for the people being served. Timestamps: 00:00 - Introduction 03:23 - The lack of access to brain injury and disability services 04:02 - Connecticut's six- to eight-year Medicaid waiver wait list 04:36 - Comparing Connecticut's services with New York 04:55 - Why Supported Living Group invests in advocacy 10:04 - Jamie's biggest career mistake 10:39 - Jamie's experience as a brain injury survivor 12:38 - Why leaders should not be the smartest person in the room 13:32 - Developing neurodivergent employment programs 18:13 - Hiring people from outside the traditional home care industry 20:20 - Why AI and ERS systems can be overrated 21:05 - The importance of human connection 23:00 - How technology should support—not replace—care 25:00 - Reducing turnover through connection and purpose 27:46 - The mistake of giving up community-based locations 28:50 - The danger of overpromising statewide services 34:42 - Jamie's proudest recent accomplishment: Inspire Arts CT 35:07 - Creating vocational opportunities and micro-jobs 35:49 - Purpose beyond a disability label Quotes 1. "Currently, on paper they say it's a six-year wait list. It's more like an eight-year wait list." — Jamie Arber 2. "People don't know there's a problem until you're sitting down with them." — Jamie Arber 3. "They go from being a stroke survivor, a brain injury survivor, somebody on the spectrum, to being an individual who's an artist." — Jamie Arber Resources: 1. Supported Living Group: https://www.supportedlivinggroup.org/ 2. Jamie Arber on LinkedIn: https://www.linkedin.com/in/jamie-arber-b215a1242/ 3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/ 4. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/ 5. Powered by Zingage: https://zingage.com/ 6. Watch Episode on Zingage's YouTube: https://www.youtube.com/@Zingage

Emily Harlan, Vice President of Business Development at 24/7 Solutions and longtime home care sales leader, shares the lessons she learned from building referral relationships, navigating hospital systems, and becoming a top-performing salesperson in home care. From getting her foot in the door of the largest hospital in her market during COVID to completely changing how she approached referral marketing, Emily explains why home care sales isn't about being everyone's best friend—it's about delivering value, asking the right questions, solving problems, and confidently asking for the referral. In this episode, you'll discover: 1. The 10-Minute Hospital Strategy: How a handwritten note and a promise to take only 10 minutes eventually earned Emily access to an entire hospital case management team. 2. Why Relationships Are Overrated: Being a referral source's best friend isn't necessary for sales success, and why results matter more than relationship-building alone. 3. The Secret to Better Sales Conversations: How spending roughly two-thirds of a sales conversation on needs discovery helps you deliver value that actually matters to the referral source. 4. How to Turn Referral Sources Into Your Sales Team: Educating and empowering referral providers can create an "army of salespeople" advocating for your agency when you're not in the room. Lesson Takeaways: 1. Lead With Value, Not Giveaways: Referral sources remember useful information that helps them serve their patients, not the latest trinket you dropped off. 2. Don't Make Sales About Friendship: You don't have to be someone's best friend to earn referrals. Show up consistently, deliver professional value, and focus on outcomes. 3. Let Curiosity Drive the Conversation: Ask questions about struggles, patient populations, bottlenecks, and outcomes before pitching your solution. 4. Position Yourself as the Expert: Your goal isn't simply to represent your agency. Become the person referral sources think of when they have questions about senior care. 5. Ask for the Business: Don't leave referrals to chance. Give the referral source a clear trigger, timeframe, and action. 6. Your Operations Matter: Salespeople can only confidently sell what the organization actually delivers. If you can't authentically say your company is the best, fix what's happening inside the business. 7. Think Like a Problem Solver: Sales becomes much less intimidating when you stop thinking about yourself as someone interrupting someone's day and start thinking about yourself as someone who can solve a problem. Timestamps: 00:00 - Introduction 02:11 - Meet Emily Harlan 03:07 - How Emily built hospital referral relationships during COVID 05:05 - Getting access to a hospital's case management team 08:29 - Overcoming affordability objections 09:34 - Sell the result—not just the service 10:27 - Emily's biggest sales mistake: leading with trinkets 12:19 - Switching from gifts to education and value 13:35 - Positioning yourself as the senior care expert 15:02 - Why needs discovery should drive the sales conversation 16:08 - Reframing the customer's real problem 17:53 - Turning referral providers into your sales team 18:55 - Why relationships are overrated 19:28 - Relationships don't bring revenue, referrals do 20:18 - Why sales isn't about you 23:26 - Can you honestly say your company is the best? 24:56 - Emily's journey from caregiver to salesperson 25:30 - Why everyone is in sales 26:04 - Getting rid of the "slimy salesperson" mindset 27:30 - Why you should ask for the business 28:02 - You don't have to be everyone's best friend 30:01 - The small mistake that costs home care salespeople referrals 31:09 - The power of staying quiet after asking for a referral 32:02 - How to use a referral script without sounding robotic 33:15 - 24/7 Solutions' six-week sales training program 34:40 - Where to learn more about 24/7 Solutions Quotes 1. "Relationships don't bring in revenue, referrals do." — Emily Harlan 2. "You are selling a result and a solution." — Emily Harlan 3. "Whoever is asking the questions during that conversation controls the conversation." — Emily Harlan 4. "You are really creating an army of salespeople on your behalf." — Emily Harlan 5. "After you ask for the referral, be quiet." — Emily Harlan 6. "If you cannot say that with authenticity, go back to the office and change some things." — Emily Harlan Resources: 1. 24/7 Solutions: https://247solutions.co/ 2. Emily Harlan on LinkedIn: https://www.linkedin.com/in/emily-harlan-5412a9181/ 3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/ 4. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/ 5. Powered by Zingage: https://zingage.com/ 6. Watch Episode on Zingage's YouTube: https://www.youtube.com/@Zingage

In this episode of Home Care Hindsight, host David Knack welcomes Guy Tommasi, a seasoned leader in the home care industry with over 25 years of experience. Guy shares his journey from hospital care to pioneering innovative, data-driven strategies in non-medical home care. He takes us to a discussion of the importance of differentiating your agency by aligning with stakeholders' needs, leveraging data to demonstrate outcomes, and the pitfalls of overemphasizing "scaling" as a measure of success. Guy also highlights the transformative power of collaboration, both within teams and with clinical partners, and why home care agencies should seize opportunities in higher-acuity care.   Lesson Takeaways: 1. Success is Defined by You: Don't let external benchmarks like "scaling" dictate your agency's success. Focus on what aligns with your goals and values. 2. Speak Your Stakeholders' Language: To stand out in a competitive market, translate your services into outcomes that matter to referral sources, such as reduced hospital readmissions and improved patient satisfaction. 3. Empower Your Team: Leadership isn't about making all the decisions—it's about involving your team, fostering ownership, and trusting them to drive innovation. 4. Don't Assume Clinical Programs Aren't for You: Non-medical home care agencies can play a critical role in value-based care and hospital-at-home programs. Challenge assumptions and explore new revenue streams.   Timestamps: 00:00 - Welcome to Home Care Hindsight 02:10 - The competitive landscape of Connecticut's home care market 04:35 - How data became a differentiator for Guy's agency 08:28 - The power of speaking stakeholders' language 12:19 - Overcoming the "private pay" objection with referral sources 16:39 - Guy's "Neuralizer" moment: The 2004 Yankees-Red Sox World Series 19:48 - The big mistake: Trying to lead alone instead of empowering the team 25:00 - A team success story: How a supervisor transformed their data program 29:47 - Why "scaling" is overrated in home care 33:25 - The problem with calling caregivers "unskilled" 36:24 - The mistake of leaving clinical opportunities on the table 42:10 - Guy's proudest moment: Helping an agency join a hospital-at-home program 45:00 - Final plug: Home care's strategic role in the future of healthcare   Quotes: Guy Tommasi: "Success is what you feel it is. Don't let the word 'scale' intimidate you or dictate whether you're successful or not." David Knack: "An urgent problem in home care is also an important one, which makes it crucial to respond with emotional maturity." Guy Tommasi: "Don't assume because something is 'clinical' that it's not for you. 80% of health outcomes are non-medical—that's our space." Guy Tommasi: "Leadership isn't about dragging people along—it's about directing their energy and letting them own the results."   Resources: 1. Guy Tommasi on LinkedIn: https://www.linkedin.com/in/guy-tommasi-a0a4bb18/ 2. Corcoran Consulting Group LLC: https://www.corcoranconsultants.com/ 3. Corcoran Consulting Group LLC on LinkedIn: https://www.linkedin.com/company/corcoranconsultinggroup-llc/ 4. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/ 5. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/ 6. Powered by Zingage: https://zingage.com/ 7. Watch Episode on Zingage's YouTube: https://www.youtube.com/@Zingage

Jeff Salter, Founder and CEO of Caring Senior Service, joins host David Knack for an unforgettable conversation about leadership, growth, and a cross-country adventure. Jeff shares how a 9,500-mile electric bike journey to celebrate his company's 30th anniversary transformed his perspective on delegation and leadership. Along the way, he raised $170,000 to install grab bars in senior homes, creating a lasting impact. This episode dives deep into Jeff's mindset shift from "doing it all" to empowering his team, the lessons learned from mistakes, and his innovative approach to improving the home care industry with tools like InkyScribe. Packed with stories of perseverance, humility, and progress, this is one you won't want to miss.   Lesson Takeaways: 1. Trust your team—delegating unlocks time for bigger goals. 2. Bold milestones, like Jeff's bike ride, can inspire movements and strengthen company culture. 3. Data-driven decision-making should focus on internal metrics, not industry averages. 4. Clear, respectful communication is vital to retaining employees and clients.   Timestamps: [00:00:00] [00:00:00] Introduction to Jeff and his career in home care. [00:03:00] The 9,500-mile bike ride: celebrating 30 years and raising $170,000. [00:09:00] Lessons in delegation: what Jeff learned on the road. [00:14:00] Jeff's big mistake: not asking for help earlier in his career. [00:24:00] Why internal data is more valuable than chasing industry stats. [00:31:00] Communication as a key to employee retention. [00:37:00] Delegation and automation tips to kickstart the new year.   Quotes: 1. Jeff Salter: "I celebrated 30 years of business by biking 9,500 miles—and I learned I'm not as important as I thought." 2. Jeff Salter: "Anything you think only you can do, someone else can learn and thrive doing." 3. David Knack: "Big change starts with a bold move—Jeff's bike ride is proof."   Resources: 1. Connect with Jeff Salter on LinkedIn: https://www.linkedin.com/in/jeff-salter-10871a7/ 2. Caring Senior Service: https://caringseniorservice.com/ 3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/ 4. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/ 5. Powered by Zingage: https://zingage.com/ 6. Subscribe on Zingage's YouTube:https: //www.youtube.com/@Zingage

In this episode of Home Care Hindsight, host David Knack sits down with Julio Briones, CEO of The Briones Group Consulting, to explore his unique journey in the home care industry. From his start in home care at the tender age of 15 to becoming a well-respected consultant, Julio shares valuable lessons learned along the way.  The conversation takes a deep dive into the challenges of hiring, the myth of the caregiver shortage, and the importance of proper legal documentation. Julio's story is a mix of humor, hard-won wisdom, and a surprising love for karaoke.  This episode is a must-listen for anyone in the home care industry looking to avoid common pitfalls and find innovative solutions to their staffing challenges.   Lesson Takeaways:  • Always invest in having your service agreements professionally reviewed to protect your intellectual property and avoid costly mistakes.  • Relying on one client or one type of service can be risky. Explore additional verticals to ensure business stability.  • Whether it's with clients or caregivers, nurturing relationships is crucial for business growth and employee retention.  • Make quick decisions based on measurable outcomes and don't be afraid to cut losses when necessary.   Timestamps: [00:00:00] Getting to know Julio and his career in home care. [00:01:50] Julio's perspective on hiring stay-at-home moms for flexible roles. [00:06:32] Discussing Julio's biggest mistake in consulting and the lessons learned. [00:12:00] The importance of proper legal documentation in business. [00:17:21] Overrated vs. Underrated: Julio's take on the caregiver shortage myth. [00:30:30] The art of failing quickly: why making quick decisions can save your business. [00:38:40] Julio's latest business ventures and what excites him about the future.   Quotes:  • Julio Briones: "The best lessons that we learn in life and what creates true wisdom are usually the most painful and most expensive for us to learn."  • David Knack: "Learning's always expensive."  • Julio Briones: "There's no shortage of caregivers; there's a shortage of agencies that know how to retain them."   Resources: 1. Briones Consulting Group: https://bcgclienttools.com/is-our-partnership-the-right-fit 2. Julio Briones on LinkedIn: https://www.linkedin.com/in/julio-briones/ 3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/ 4. Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/ 5. Powered by Zingage: https://zingage.com/ 6. Watch Episode on Zingage's YouTube: https://www.youtube.com/@Zingage