See Why Dr. Michelle Rankine Wins 85% of Her Business Through Referrals

00:00:03 Romi Gubes: Michelle Rankine, hey, how are you?

00:00:05 Dr. Michelle Rankine: I’m doing well, yourself?

00:00:06 Romi Gubes: I’m good. Thank you for joining me.

00:00:07 Dr. Michelle Rankine: Thank you for having me.

00:00:08 Romi Gubes: I’m super excited to have you today. I’m sure you’re going to have so many insightful and meaningful lessons learned to share with our industry. I have been following your journey for a while now. It’s amazing to see from the side how you think about your business so strategically, how you think about growth, and how you think about providing the best care possible. So if you can just introduce yourself real quick so the audience will learn about you and your agency, and then we’ll dive right in.

00:00:34 Dr. Michelle Rankine: Sure. Dr. Michelle Rankine, I’ve been in home care for the past 13 years, and I’ve been with Right at Home. I service the north Dallas suburbs in Texas.

00:00:46 Romi Gubes: How big is your agency?

00:00:48 Dr. Michelle Rankine: My agency runs around 2,000 hours a week.

00:00:52 Romi Gubes: Okay. I know that during your journey, you focused a lot of your time and your strategies on referral sources. We’re speaking about growth theory in this podcast, and I think that many owners are interested to learn about how they can penetrate referral sources. Where should I put my focus first? Referral is also a very wide term—an umbrella term for many different directions. So if you can walk me through your thought process: how you think about that, and how you decide where to approach and how to approach facilities or other communities.

00:01:31 Dr. Michelle Rankine: You know, I take the referral source journey just like any other. We’re in healthcare, and healthcare is a feeling industry, right? I think from a referral source perspective, they want to know who they can trust, who they can call, and who is going to answer the phone—and probably in that order: Do I trust you? Will you answer? And will you follow up?

00:01:57 Dr. Michelle Rankine: When you’re trying to look for a referral partner, it has to be one that is like-minded. When you’re going on this journey of home care, you want to make sure that every one of your values for your team and your caregivers aligns with that of the referral source. For myself, when we go to referral partners, I want to make sure that they understand what we do and how we do it. But my biggest thing is how I make them feel. So I’m always looking to create “Wow” moments with my referral partners, and those “Wow” moments are our stories. You have to paint the picture of what’s going on with the family and how we solve problems because one of those stories is going to speak to your referral partners. No matter who that referral partner may be—it could be a hospital worker, it could be a skilled nursing facility, or it just could be a lady that you met in the grocery store—all of them equally have the power to refer to you.

00:02:54 Dr. Michelle Rankine: If you know your key success stories, make sure to communicate them effectively to show how you can solve the problems. That emotional journey of who they can trust with the people they’re caring for is just like trusting someone with their own family. So I always take it from that point of view of emotion: how can I handle the anxiety that they’re having? Maybe it’s the emotion of stress because they’re a director of nursing and they can’t really figure out the right partners who will communicate well to reduce their stress. So I think always taking that perspective and making sure that you’re bringing that level of peace of mind with the data that you’re able to supply is key.

00:03:41 Romi Gubes: It’s amazing. What you’re saying basically is, “How can I make them feel?” It’s not about speaking to the rationale, speaking numbers, staying up here, or saying all kinds of general statements like, “We provide compassionate care.” It is actually making them feel and bringing them something to remember. Can you walk me through an example you have in mind of something that was very successful from your point of view?

00:04:06 Dr. Michelle Rankine: I think one of the biggest success stories is when you have a very complex patient. One of the biggest things that we see with the patients that we serve is we serve 70% dementia patients. Usually with that case, there is a behavior or an incident. We had a patient who was constantly exit-seeking and exhibiting very aggressive behaviors. One of our biggest successes was having that patient with a very well-matched caregiver and having that caregiver be able to assist that client. Even with the most successful caregiver, you have to make sure you have good staff. We have a trainer on our staff that acts as an extra toolkit they have. Having that, along with products like Sensi that can deliver insights instantly in addition to our in-person care, just adds an extra benefit.

00:05:07 Dr. Michelle Rankine: In total, you have that experience of the client and the caregiver being a good match, turning around a situation that was very high anxiety. He didn’t really adjust to the community setting well, and so his behaviors heightened the energy of others in the room. That’s very typical sometimes when you have persons with Lewy body dementia or vascular dementia, and their behaviors have really increased. Having that caregiver strategy works.

00:05:37 Dr. Michelle Rankine: When speaking to the director of nursing, who is your direct referral source, I was able to give peace of mind by offering a good caregiver. But where the added value comes in is that I actually have data to support it now. With having devices like Sensi and showing her what has happened as good communication when our staff is there—and even for her own staff because it is picking up that data—it changes things. When I’ve gone back to the memory care director or the director of nursing and had those conversations, they’re like, “Wow, you not only can relieve a little bit of stress for me, but you have data to support it.” The feeling piece is one part, but the data shows proof. You have to have both; you have to have the compassion that leads with numbers because we all know numbers don’t lie. The truth-teller is within that.

00:06:36 Dr. Michelle Rankine: I always used to say that before technology really came into our industry, our caregivers were the ears and the eyes when we weren’t there. Sometimes they don’t know what might be the most important thing to report because I’m leaving it in their control. Right now, having informed data gives us the opportunity to say, “Hey, we heard this happen. Can you tell me more about what happened throughout the shift or what tools you need?” Then, going back to that referral partner, it just gives more opportunity to have a meaningful conversation about the care from start to finish.

00:07:11 Romi Gubes: That is an incredible story. So you said it was a memory care facility, right? And you went to the memory care director and the director of nursing?

00:07:20 Dr. Michelle Rankine: Yes.

00:07:21 Romi Gubes: Sorry guys, one more quick second. I’m going to push this a little bit more right there.

00:07:31 Dr. Michelle Rankine: Sure.

00:07:32 Romi Gubes: Move this. Perfect. Thank you. Do you want to test that real quick? No, we’re good. It was just that the mic was covering her face a little bit. My bad.

00:07:44 Dr. Michelle Rankine: Well, no, but you can lean in for now.

00:07:46 Romi Gubes: Okay. All right. He wants to see your face.

00:07:59 Dr. Michelle Rankine: Okay, that’s a good thing.

00:08:05 Romi Gubes: So you’re saying it’s a memory care facility, and you approached the memory care director and the director of nursing. They heard that story, which I’m pretty sure was an exceptional story—they are not hearing that from all the agencies out there. How did this impact your business? Did they start to direct more clients your way?

00:08:26 Dr. Michelle Rankine: As soon as I introduced it—well, let me say this, let me start back. That was part of the actual process once we had everything set up. Because this patient had behaviors and was a busybody, he also wanted to take the devices out. So I had to come in and tell the community, “I am the internet guy, and I’m coming in to set up these pods.” Then he was like, “Oh, okay, you can do what you want.” I knew if he saw me set them up, he was going to go back and grab them. We were able to find discreet areas in the memory care unit to put them. That was the first introduction of what I was doing to the memory care director. She was like, “What are you doing?” I explained, and she was like, “Okay.”

00:09:12 Dr. Michelle Rankine: Then, when I came back with the care report after we had a successful staffing experience, she was like, “Oh, I get it. With this information, you’re able to know what’s going on.” One of the key things when we went into the memory care unit and went through the care summary—that was a big takeaway—is that I was able to call her. There was a day where it indicated a safety concern. When I called to check, she was like, “Oh my gosh, how do you even know that’s going on?” That was something happening in the kitchen, but the technology was able to pick it up. In her point of view, it was like I gave her an extra ear, even for her own staff. From that point on, we became besties. Now I have gotten other clients in that same community because she sees that we’re more proactive versus reactive. Prior to that, when running our business, we would have the caregivers, hope everything goes well, and react after something happens. Now I am able to give her even more with a device that gives her more information too.

00:10:28 Romi Gubes: That’s amazing. It goes back to the trust element you spoke about, right? This is how you build trust successfully. Can you help me understand how much of your business is referral-based and how much is pay-per-lead or other sources?

00:10:47 Dr. Michelle Rankine: I would say most of my business is referral-based, mostly because we are very big in the communities. I would say 85% of our business is referral-based.

00:10:59 Romi Gubes: That’s amazing. Is that mainly memory care and independent living?

00:11:03 Dr. Michelle Rankine: I am very strong in communities. So a lot of assisted living and a lot of memory care. I find that I’m actually least needed in the residential home right now based on where we are seeking to get business. We do very well in community settings.

00:11:21 Romi Gubes: What would you recommend to those who are just taking their first steps in communities in terms of who should be the one working with them? I’m hearing from you that you are personally managing those relationships. What should be done on that aspect, and who should they approach in the community to get their attention?

00:11:41 Dr. Michelle Rankine: I think when you go to a community, the biggest thing you do is a pulse check when you walk in. When you walk into a community and you see a whole lot happening and you’re unable to speak to the key people, it’s usually because there is a whole lot happening in that community. For me, I’m able to gauge how I need to approach it because usually that means they’re understaffed, working double shifts trying to handle the floor, or they’re not able to completely manage. That means they have even a higher need for me. I love when I walk into that situation because I think, “Okay, great. This is my opportunity to offer education.”

00:12:21 Dr. Michelle Rankine: Then I ask myself, “How can I come back to help that director of nursing and help that memory care director?” Usually, because they’re so busy with other necessary care tasks, this gives me an opportunity to come and help them with training. “Is it possible I can volunteer and do training for your staff?” That gives me an opportunity to show my value as a subject matter expert, as well as an opportunity to be not only part of their community but also to give added value to them. The biggest thing that referral sources don’t want is for you to just walk in and say, “Let me help your next client,” making it just a business give-and-take. You have to integrate yourself to be part of those communities. We’ve seen success with that because I want to be part of their home. That is the home where these clients live, and they manage that home, so I want to make sure we’re giving to them equally. It’s a mutual relationship for both partners.

00:13:21 Dr. Michelle Rankine: When you approach communities and you’re reaching out to the executive director, the memory care director, and the director of nursing, the biggest focus is outcomes. Part of what we are able to deliver is that outcome data that they need. We are able to speak to the care outcomes with the care providers—who are the nurses and the memory care director—and then for the executive director, we help them understand what that means for safety as a whole and how we can complement that. Knowing who you’re talking to and how to gauge that conversation based on where their pain points lie really gives you the opportunity for success.

00:14:02 Romi Gubes: You spoke about so many different strategies. You spoke about pain and feeling—we need to understand their pain specifically, we need to build trust, and we need to lead with value. What is the value we can give them before we ask for something in return? This is all part of building relationships and trust. How do you do it at scale? How do you scale this way? Because it sounds like a lot of that is on you specifically—you’re the one leading that effort. How does it work?

00:14:34 Dr. Michelle Rankine: Well, I think it’s just training your staff. I have marketers and salespeople, and we have to value the same thing. You have to be able to teach that so you can do it at scale. But the biggest thing is rinse and repeat. If you build the system, then you can rinse and repeat it again. The biggest asset for us is having Sensi to assist with that and having the care reports to go in and hold those meaningful conversations. As a salesperson—I wear the hat of sales in my franchise—I also have other sales partners and marketers who go out. One of the key things that we have to do in unison is speak the same language. Regardless of whether I walk in or my marketers walk in, you should be hearing the same tone. I always joke about it: we need to sing the same song. If we’re all singing different songs, the referral source will get confused. Having that approach and making sure that you train correctly on how you want to approach things is the biggest piece of making those connections successful.

00:15:47 Romi Gubes: You’re thinking about that both from a marketing perspective and a sales perspective: How can we brand? What are our brand values? What is our theme message song? And then, what is our sales tactic? How do we come in and ask for the check or close the deal? I love it. What I’m hearing from you is that you are incorporating Sensi as a part of your sales process to help you expand or extend the relationship and have them send more clients your way.

00:16:17 Dr. Michelle Rankine: Oh, yeah. Sensi is the key thing that I speak about. I have a running joke: I wear a little button that says, “I have good news.” Someone usually asks, “What’s the good news?” and I’m like, “Girl, I got Sensi, you know?” It gives an opportunity to have a conversation. I’m always looking for “Wow” moments every day. If you incorporate that in your agency as a core part of your culture—regardless of whether I’m on a podcast, in front of one person, at a senior center, or anywhere—it’s that same song we have to understand. Sensi is part of the full journey of our business, and that was the key differentiator for me in making the decision. The journey of our business includes the referral source journey, the client journey, and the caregiver journey, and those journeys need to align. If you have the opportunity to have something that merges them, it just makes sense to me. It’s an easy decision.

00:17:15 Romi Gubes: I hear you. From knowing you for a while now, I know that there is an inner belief in you that providing better care will lead to better business outcomes. This is how I interpret the things you’re saying. Are you looking for specific ROI metrics? How are you measuring success at the end of the day?

00:17:37 Dr. Michelle Rankine: I think it starts first with what your beliefs are, then the ROI follows. For me, I have always looked at this business as caregiver-first. If I offer great care and my caregivers are having a good experience, I will have good client outcomes, and then my data will all make sense. But it has to start with the caregiver first because that is my product—that is what I’m selling. If I invest in them, it will all make sense from an ROI perspective. It’s about educating at every level. For example, when we launched Sensi, we launched it internally, and then we launched it to our clients. We have also now taken the step of launching it to our caregivers. It’s incorporated into our orientation so they understand what we’re doing. What’s so interesting, and what we loved about that, is that the caregivers are excited we have it. This is how you build that culture and create brand ambassadors because the caregivers are excited that we have a device that ensures they don’t have to hold the entire burden alone.

00:18:43 Dr. Michelle Rankine: Everything is about feelings in this business. Imagine you’re with a client, and the client can only afford four hours a day, three times a week. As a caregiver, when you leave and go home, you’re worried about that client. You’re concerned: Are they okay? Let me give them a call. Caregivers do that innately if that’s their purpose and passion. Now, when we set up those pods, they say, “Oh my gosh, Michelle, I’m so happy you made that investment so I know the office is going to make sure they’re okay.” That makes our work more meaningful. For me, that’s the biggest ROI—where qualitative data speaks even louder sometimes than quantitative data. I know the quantitative will match the qualitative because of what we’re doing.

00:19:35 Romi Gubes: Hearing the caregivers and how much they are excited about that is a leading indicator for growth later on. How do you look at growth in terms of goals, like for 2026 and 2027? How much are you looking to grow year-over-year?

00:19:53 Dr. Michelle Rankine: I look at it always from the caregiver perspective. Of course, yes, we are running a business; if you don’t have margin, you don’t have mission, so you have to have that. But for me, as we scale the business right now, I’m constantly looking at how I can grow quality caregivers. My goal for the next year is that I want to get to 350 quality caregivers because then that will equate to the hours I need to be able to support what they want. If caregivers want full-time work, I need to be able to deliver on what their needs are, and if it’s part-time, I need to be able to meet that need. We have to be able to meet their needs first. That’s my goal. My goal is looking at how I can build quality caregivers—caregivers for whom one of our core values is “evolve and elevate.” How do I get persons who want to subscribe to us and evolve and elevate, not even just as a caregiver, but as a person?

00:20:53 Romi Gubes: And how do you do that? That’s the million-dollar question, right?

00:20:57 Dr. Michelle Rankine: Every opportunity is an opportunity to engage your cultural values and constantly applaud when people show those values. We have done a caregiver brunch where we highlight all the caregivers who are evolving, elevating, and showing up for our trainings. If you take little cultural moments and make them a proud moment within your system—whether you’re texting it on the platform or putting it on social media—show what you value because they’re going to be watching, and others see that. I walked into an orientation the other day and a caregiver said to me, “I saw your TikTok video, and I wanted to be a part of an agency that valued training because you guys are five-star.” I had to ask myself, “Do we have an ad that says five-star?” No, we don’t, but that’s how she interpreted our videos. To me, that means a lot because it means technology is amplifying what our core values are. I think Oprah says if you have a magnifying glass, whatever you are just gets amplified. For us, we’re just trying to rinse and repeat with our culture and make it louder.

00:22:04 Romi Gubes: And this is your moat—this is how you look at a moat.

00:22:07 Dr. Michelle Rankine: Yeah, that’s how I look at most things, yes.

00:22:10 Romi Gubes: It’s amazing to hear. It’s a good song.

00:22:12 Dr. Michelle Rankine: Yes, it is.

00:22:14 Romi Gubes: Oh my god, you’re building something that is truly not replaceable and hard to compete with. We’re seeing many new agencies popping up like mushrooms after the rain. It’s very easy to decide you want to build a home care business today and take the first steps, but there is something special about what you’re describing. I had another question here on how you build your moat, but I think you already answered that. From hearing that, I’m just thinking about building a business next to you—I don’t want to get excited. You will attract all the good caregivers out there. I know you hold a very high bar when it comes to caregivers, which is very important and amazing. Are you happy with the cadence at which you’re growing today?

00:23:07 Dr. Michelle Rankine: Yeah, I am. I am happy with the cadence. I am happy where we are right now in regards to where home care was 13 years ago versus now. I remember when I first came in, it was HomeTrak—it was a very antiquated system—and I’m excited about what technology is doing. I’m excited that social media is informing people. I’m excited that we have video capabilities that can send this culture instantly. The era we’re in right now just gives a greater opportunity to show what we’re doing. It is the biggest thing that many owners miss because we put it as the last thing, when it should be the first thing—everything needs to go in sync with that.

00:23:55 Romi Gubes: I imagine working in your office can be very satisfying. Many people can relate to this song and feel like they’re working in a place where clinicians, care managers, and people coming with clinical backgrounds have their hearts in the right place for the mission. But then also, I guess you’re holding very high standards, right?

00:24:16 Dr. Michelle Rankine: We do.

00:24:17 Romi Gubes: How do you make sure you’re hiring people who are a part of this DNA that you’re putting in place?

00:24:22 Dr. Michelle Rankine: You have to make sure you communicate it within the orientation and hold everyone accountable. The biggest thing that I have learned is even when a caregiver makes a mistake—let’s say they call late and say, “You know what? I just realized I can’t go to my shift.” In orientation, we like to say, “At least give us four hours,” but sometimes life happens, and you have to give grace where grace is needed at all times. You have to be selective in how you handle discipline. If you set the expectations before the event happens, then they’ll know. We have a “three strikes, you’re out” policy. You have three opportunities to really show up, show out, and show our values. You have to be able to just give grace.

00:25:12 Dr. Michelle Rankine: That is something that we expect as a home care owner for the clients. “Oh my gosh, the client is in the hospital now. I’m so sorry, you’ve just lost all your hours. We’ll try and get you on another case.” What grace are we showing to the caregivers when they’ve just lost their work? At the same time, I’m going to try my best to put them on another case. We are always in a business of giving and taking, and it’s feast or famine, as they would say in the home care industry. There are times where I have all the hours to give to all the caregivers, and then there are times when it’s not like that. It’s something that I’m constantly working on, and I just feel that we have to keep reiterating our culture.

00:25:56 Romi Gubes: Can you think of an example of a mishire, and what did you learn from it?

00:26:30 Dr. Michelle Rankine: That’s a very hard question in regards to a mishire. If I had a magic wand and could assess people’s personalities better earlier, that would be the biggest success. Some of the mishires that I’ve had have probably resulted from not being able to support them in different ways. I say this because life happens to our caregivers and the demographics serving as caregivers. We were in meetings earlier showing how they’re more likely to be depressed, anxious, and come from a lower socioeconomic background. When you think about those three things, we are also asking them to leave their problems at the door and walk into a home with a smile. Sometimes we as an agency have to make sure we’re supporting them equally.

00:27:31 Dr. Michelle Rankine: To even say that we have poor hires—I think sometimes the real issue requires a humble approach: It’s not you; it’s actually me. Did I give you enough resources to help with your issues? And did I give you a platform to be transparent and tell me about all those issues? I hate to say we make wrong hires; I think sometimes it’s just the wrong time in that person’s life when they probably needed different resources. Maybe she hadn’t been showing up and called late because her childcare was not reliable, so due to her childcare not being reliable, she couldn’t be reliable for us. Is that fair? I don’t know. I’m always thinking from the caregiver perspective because I think that’s where our lens should always be. Grace is just something that I hold really deeply, and if it is a bad hire, I always have to think about what I did not give that person versus what that person did.

00:28:34 Romi Gubes: I love hearing that. I think we heard recently from another owner that there are three types of caregivers: the ones who are pros and have been in the field for a while—they have both their heart in the right place and all the knowledge, representing maybe 10% of caregivers. Then you have the majority of the caregivers whose hearts are in the right place, but they might be more shaken by all kinds of personal reasons and need further education and support—that’s the vast majority, let’s say 80%. Then you have another 10% who look like they hate all older adults. How do you make sure you’re hiring either the top 10% or the other 80%? What are the processes you have in place to really validate that? Because it sounds like you’re holding a very high bar for your caregivers and see it as a main core element for growth, which I very much agree with.

00:29:43 Dr. Michelle Rankine: That’s a very hard question. You have to look at every level of your business equally, including the ads. You may have a professional caregiver who wants 40 hours, but we also know that many of our clients just want 20 hours, and some of our clients may just want one hour. We have to make sure that our ads speak to the people we’re trying to attract. I think that’s first. The next piece is, once you have them as part of your organization, how are you reiterating that cultural piece? How are you making sure they’re getting what their needs are? Sometimes as an agency you can have all the hours, but sometimes the fit isn’t right for the caregiver. Just make sure you’re creating safe spaces for them to have those conversations, like, “I really feel this client is not a good fit for me,” whether it’s due to distance, skill, or the whole gamut.

00:30:39 Dr. Michelle Rankine: It’s such a hard question, but I really think that you have to take time during your orientation process to see what those skills are and where they need more opportunity for training. Right now, we have brought working caregivers in to lead the orientation, and that has been a major shift in our business. We used to have an office staff member do it, and there was always a divide between office staff and caregivers. Now we have our caregivers orient the new staff, and that has made a big cultural shift in our business because she’s saying, “I’m a caregiver right now, too. I know what your struggles are. I know where your challenges are, and I’m going to be the one who’s going to tell you about our culture, our organization, and the vision from my perspective.” One of the key things that I always tell everyone is that this is not difficult if you are able to lead with your heart. If you’re able to lead with that, understand that, and make sure you have the proper protocols, it really isn’t that hard.

00:31:51 Romi Gubes: According to what you’re saying, sometimes the orientation serves as another step in the interview process, and they might not even start work after the orientation day.

00:32:02 Dr. Michelle Rankine: Oh, yeah. Really. “You’re not a good cultural fit for us.” This is the most time you’re spending with them through the onboarding process, so this is your best time to do the final validation of whether they’re the right fit or not.

00:32:16 Romi Gubes: Yeah, exactly.

00:32:17 Dr. Michelle Rankine: That is our final validation of really knowing their “why.” We do a caregiver video as part of orientation, and we ask them on camera—kind of like a podcast setting—”What is your purpose in home care? What does home care mean to you? Tell me about a success you’ve had with a client.” You get deep answers. I was witness to one the other day, and the lady was crying about her response, how the client impacted her life, what that meant, and how she was able to manage end-of-life care.

00:32:55 Dr. Michelle Rankine: We don’t talk about mental health enough in regards to caregivers and the burdens they carry from caring for others. That is a heavy load to walk into someone’s home and care for them when they’re not at their best. I would love to say we have Hollywood clients who smile and everything is perfect, but that’s not an everyday thing for what they go through, so they carry that with them. It’s not an easy job, and they deserve millions for what they do.

00:33:23 Romi Gubes: It’s maybe one of the hardest jobs out there. You said something interesting about communication: allowing this safe space and making sure that they reflect back and share their experience. I heard another agency at some point saying that they opened off-hours communication processes instead of outsourcing it to a technical call center in the Philippines just for taking notes. It was important for them to have an off-hours service just for the sake of the caregivers because if a caregiver needs to pick up the phone and talk to someone after a shift at 10 p.m., they wanted to have that availability. How do you make sure that your caregivers have this safe space to talk back, ensuring you’re not just getting a no-show at some point because they didn’t feel comfortable approaching you with an issue?

00:34:11 Dr. Michelle Rankine: What you said is so true. We are a 24-hour business. Ideally, sometimes you want your caregivers to communicate with you from 9 to 5, Monday through Friday, not during the after-hours, but that’s not realistic. One of the things that we have in our office is our staffing department is available from 8 a.m. to 8 p.m., so they’re always able to check in and have those real-time conversations. We do have an after-hours system, and if they need to call, it goes to our on-call person so we’re able to speak with them. That makes a huge difference because you have to make sure they know they can call 24/7.

00:34:54 Dr. Michelle Rankine: Another thing that we put in place—I think it’s been three years now—is free counseling. We offer six free counseling sessions for our caregivers. One of the major things that we don’t talk about enough is caregiver burnout and identifying that burnout. As an owner, you can look at a caregiver and say, “She shows up every day; she’s been perfect on every shift.” But what does her burnout look like? Are we talking about that? Do we need to give her respite care because she’s equally important to the success of the client? Sometimes a caregiver works for someone for a long period of time and then just kind of fades, and you’re like, “What happened? This is a star caregiver.” But we didn’t address the burnout in advance. We have to be more thoughtful. I don’t have a specific metric for it, but we have to be conscious that sometimes those perfect caregivers need more support than anybody.

00:35:49 Romi Gubes: It’s crazy that you’re saying that. I’m thinking about our business, and it feels like just as we provide our employees with a laptop, you need to serve your employees with something of that nature—consultation or mental health support—because it’s so basic to what they’re doing and so much needed. This is the first time actually I’m hearing that. It’s very innovative and reflects your approach of looking at the caregivers as the most valuable asset that we have and truly supporting them. I love it. Any other tips when it comes to caregivers? You shared a lot, so if you don’t have anything else, that’s okay.

00:36:34 Dr. Michelle Rankine: The biggest takeaway for me is the burnout—we’re not talking about it enough. We applaud caregivers who are Caregiver of the Year, but we need to make sure we support them. We actually just did this—I don’t know how it’s going to pan out long-term—but we added a massage chair to our office for caregivers.

00:36:56 Romi Gubes: Can I come?

00:36:57 Dr. Michelle Rankine: Right? We have a care council, and they said, “Yeah, that’s something that we think we’ll need.” I can’t afford to give everyone outside professional massages other than our Caregivers of the Month. But having the opportunity for them to get a 15-minute break, come sit in the office, relax, and unwind helps. We literally put the chair in a week ago. Sometimes with caregiver burnout, we wait until we see the signs, but it should be a strategic approach. Just like we tell our office staff to take 15 minutes to step away from what they’re doing, we don’t do that enough for the caregivers. After your shift, come spend 15 minutes in this chair and let us appreciate you. It’s always there for you, no matter what.

00:37:46 Romi Gubes: It’s not only the massage; it’s the message you’re sharing: “We care about you, and we understand that you’re going through some tough times.” The reason it’s genius is because the side effect is getting more face time with them. You’re bringing them to the office, you’re able to speak to them, and you’re able to develop this relationship. They don’t have that much time to come and visit all the time, so it’s a good incentive for them to stop by, for sure.

00:38:14 Dr. Michelle Rankine: Any “Wow” moment you can create for them is huge. Another thing I forgot to mention as we were talking about culture is we use these thoughtful items. Basically, I like to call it a fortune cookie with no calories, and I give them out to our caregivers. When we do supervisory visits, they receive it, they get it first at orientation, and anytime they see me, I give them that—that’s like my currency. The currency is I’ll hand you this, you pop it open, and it will feature an uplifting quote. For whatever reason, it always speaks directly to that person. I never know what it’s going to say, and I always ask them to tell me what it says. Sometimes it brings tears, and sometimes they say, “Oh my god, this is exactly what I needed.” That is what I think is the core of our business.

00:39:13 Dr. Michelle Rankine: We are working with clients who are very stressed on many different levels, and we have a caregiver force that is also very stressed. We’re caring for a client in between that period of time, managing the family members and the client. Everyone needs just a moment of uplift. If you can institute that as part of your culture through simple acts of kindness, whatever that may be, it makes everything simpler.

00:39:54 Romi Gubes: How do you get your uplift?

00:39:56 Dr. Michelle Rankine: I have a jar full of these things, and I literally just open one every day. If you see my house, it starts from my place of solitude, which is my shower. I have shower inspirations—you get these cards wet and stick them on the shower wall. I read them out loud because I believe your mind is a powerful thing, and I believe in affirmations. That’s my mantra for the day. That’s my little pick-me-up, and that’s what energizes me because sometimes you can get locked into the day-to-day grind.

00:40:34 Romi Gubes: I love it. Before we’re done, I am very interested to get your thoughts on how you envision home care with everything being introduced right now. How do you envision home care in 3 to 5 years from now?

00:40:51 Dr. Michelle Rankine: Wow, that’s a very big question. I really think it’s only going to get better. I get excited because this is the first time in 13 years I have felt we have data that backs what I’m doing and gives a proactive approach to what we do. When I think of the growth and where we’re able to take things—exactly what you mentioned—if I can have more touchpoints with my caregivers, my clients, and my referral sources to have more meaningful moments, this is only going to get better. Technology is going to be able to take those mundane tasks away so that we can have more meaningful moments. That leads to better care outcomes, better experiences keeping people out of the hospital, and it validates what we do every day. That just makes sense to me. It’s only going to get better.

00:41:48 Romi Gubes: I feel the same. I feel like it’s the most exciting time to be in our space. I’m so happy to hear you say that because when we started Sensi seven years ago with this big goal in mind to provide visibility and to enable home care agencies to become proactive for the first time ever, it was kind of like a dream. No one really did that before, and we didn’t have anything to look at and say, “Okay, this is what we’re going to replace.” This concept didn’t exist back in the day. Hearing you speak about the fact that it gives so much power to you, your agency, your clients, and your caregivers super excites me. Thank you so much. Thank you for the partnership, thank you for letting us be a part of your journey, and thank you for sharing everything with our audience.

00:42:47 Dr. Michelle Rankine: Oh, thank you for having me. It’s been fun.

00:42:50 Romi Gubes: Thank you.