This week I had to focus my blog on answering a question that I get asked of me over and over by our home health friends. That does not mean that our In-Home Care providers should stop reading. In fact, it means the exact opposite.
Evaluation and Management of the Plan of Care is all about home health managing unskilled care providers that are caring for a complex patient that no longer has a skilled need.
Many home health providers have avoided Evaluation and Management patient types because before the Jimmo settlement patients were denied care because claims were rejected because Medicare said the patient had reached their maximum potential.
Once CMS had reached a settlement, of the Jimmo Agreement it required manual revisions to restate a “maintenance coverage standard” for both skilled nursing and therapy services under these benefits:
Skilled nursing services would be covered where such skilled nursing services are necessary to maintain the patient’s current condition or prevent or slow further deterioration so long as the beneficiary requires skilled care for the services to be safely and effectively provided.
Skilled therapy services are covered when an individualized assessment of the patient’s clinical condition demonstrates that the specialized judgment, knowledge, and skills of a qualified therapist (“skilled care”) are necessary for the performance of a safe and effective maintenance program.
Such a maintenance program to maintain the patient’s current condition or to prevent or slow further deterioration is covered so long as the beneficiary requires skilled care for the safe and effective performance of the program.
There are situations in which the patient’s potential for improvement would be a reasonable criterion to consider, such as when the goal of treatment is to restore function. This would always be the goal of treatment in the inpatient rehabilitation facility (IRF) setting, where skilled therapy must be reasonably expected to improve the patient’s functional capacity to be covered by Medicare.
However, Medicare has long recognized that there may be situations in the SNF, home health, and outpatient therapy settings where, even though no improvement is expected, skilled nursing and/or therapy services to prevent or slow a decline in condition are necessary because of the patient’s special medical complications or the complexity of the needed services.
I am going to be doing a webinar for Medicare Training and Consulting on April 14th and invite all of you to grab a spot if you want to learn how to provide these services and how to use this as a way of building your business.
Patients that are frequently receiving Evaluation and Management services often have multiple paid caregivers supporting the patients to remain in their home. Learn who could benefit from the services and how you can be a referral partner and grow your business-to-business referrals.
To sign up for the webinar email Plonsey@aol.com. To learn more on how to grow your agency go to www.homecaresales.com. You can also have a personal tour through our products and services by emailing Mike@homecaresales.com.
I am always reading something to help me understand how to help sales representatives become all they can be.
In my quest for knowledge, I started to read about a theory called “Motivational Perspective.” The idea discussed is why does a student with an average IQ bring home “A” s.
“Motivation is defined as an internal drive that activates and gives it direction. The term motivational theory is concerned with the processes that describe why and how human behavior is activated and directed”.
What does all this mean? Well, salespeople are just like students. They are not born to be A students. Salespeople are human beings that have Grit. You see, doing well in school has nothing to do with IQ and everything to do with Grit.
What is Grit? To make sure that we’re all on the same page, here is a basic Grit definition developed by Angela Duckworth, the psychologist and researcher. She coined the term: Grit is passion and perseverance for the long-term and meaningful goals.
Why is Grit important?
Grit is essential because it is a driver of achievement and success, independent of and beyond what talent and intelligence contribute.
Being naturally intelligent and talented are great, but to honestly do well and thrive, we need the ability to persevere. Without Grit, talent may be nothing more than unmet potential. It is only with effort that talent becomes a skill that leads to success (Duckworth 2016).
A sales representative that has Grit demonstrates the following:
- Sticking it out, making up to 5-12 prospecting sales calls to every qualified account before they get their first referral
- By doing the 5-12 prospecting sales calls, they outlast the competition. Many reps quit calling on prospecting accounts after two sales calls.
- They prepare for their sales calls like they are training for a marathon, not a sprint.
- Gritty reps have a mindset that failure is only temporary
That is why HomeCareSales.com exist. We have the tools to help sales representatives born with Grit turn into High-Performing Sales Superstars!
If you are ready to help your Gritty sales representatives hit their next level of success, look no further than homecaresales.com. Reach out to Mike@homecaresales.com and get a private tour of our products that will push your sales up to the next level.
This past year, I spent a lot of time learning how vital recruitment and retention directly correlate to the agency’s success.
I have found that home health, hospice, and in-home care providers have more and more seniors to service.
With our population of aging adults increasing by over 11,000 new seniors day, WE WILL BE fighting over caregivers.
In a Gallup study, they found that 50% of all Americans have left a job because of their manager. That means we, as owners, need to make sure that we are building a team of leaders and not just bosses!
I’ve said it before, and I will repeat it here, “employees leave managers!”
A good manager needs to be a leader. Someone who can teach others. Someone who wants to make a difference in the world with other people. The real power of leadership comes from what we can do with and for others.
The value of leadership doesn’t come from having a position.
It comes from just being passionate about a cause; you can work with others to achieve a worthy goal. We all need great employees!
Home Care Sales believes so much in our agencies that we built a Caring Agency Mastermind for administrators and owners to learn what strategies are working right now. We call this our CAM FAM, and one member just signed on 55 new clients last week! You can do it too.
Learn what works and also get a chance to contribute by sharing your success stories to help other agencies grow while avoiding wasting time, money, and resources. As an agency owner, I want you to be able to support your administrators and executives.
Give your leadership the CAM FAM membership to have executives run challenging situations by experienced leaders and gain an accountability partner for taking action to move your needle. Sometimes leadership can be lonely. The CAM FAM has your back!
Cheryl Peltekis, RN “The Solutionist”
This week I’m back on the road doing sales training with live audiences!
Wow, it is incredible!
I truly missed the connection with an audience. Over the last several months, I had a lot of time to dig through data.
My mission was to study A accounts that sales representatives lost to identify if anything different could have prevented the sales rep from losing the account. I learned quite a bit and wanted to share some of this new data in my sales training.
It was a massive success, so I decided to share it with all of you!
Ask yourself this question. Are any of your “A” accounts vulnerable? You may think they are not. So did the next four sales reps.
Sales Rep #1
Account Type: Whole Life Community
Service Line: Private duty, Home Health, and Hospice
Length of time “A” Account: 5 years
Sales rep #1 was maintaining this account for five years. The sales rep visited the account at least twice a week, and he knew all of the leadership. They liked sales rep #1.
Sales Rep #1 had a monthly bereavement service for hospice patients, family, and staff and a monthly education talk and invited the community to attend.
Change occurred. The clinical director of the personal care facility retired. The position is filled by a nurse who works per diem for a competitor hospice, home health, and private duty company.
The new nurse manager complains and mistreats Sales Rep #1’s staff. New Nurse Manager goes to the administration and complains repetitively about Sales rep #1 and every aide, nurse, therapist, or social worker that walks into the building.
Everyone from Sales Rep #1’s leadership gets involved in trying to fix the problem. Within eight weeks, the account is lost. The new nurse manager now gets paid from her full-time position in the building and gets per diem pay for doing nursing visits from patients on home health services.
What could have prevented this from happening?
I do not think anything could have prevented this from happening. Maybe the sales rep could of help with finding a replacement nurse?
Sales Rep #2
Account Type: Hospital System
Service Line: Private Duty
Length of Time “A” Account: 7 years
Sales rep #2 visited this account twice a week and sometimes more often based on referrals. He was getting about 5-10 referrals/week from the discharge planners.
Change occurred. Hospital has a press release on the local news channel to announce that the hospital will close in 30 days.
What could have prevented this from happening?
The sales rep would have known that the hospital was closing if the representative had read the hospital’s annual report on their website. It was documented a year in advance that the hospital would be closing in their annual report.
Sales Rep #3
Service Line: Home Health
Length of Time A account: 3 years
Sales Rep #3 worked closely with the physician who was the medical director of the rehab center. The relationship was a fantastic one that resulted in consistent referrals each week.
Change occurred. The physician was offered a job as a consultant from a competitor home health agency on reviewing charts of patients that had readmission to the hospital within 30 days from discharge. The physician accepted the job and then diverted all his patient’s referrals to the new company he was consulting.
What could have prevented this from happening?
There are several ways that this change could have been diverted from this “other agency” to sales rep #3’s company. However, without also offering a potential legally questionable relationship with that physician, the solution may not have ultimately worked.
The point I want to drive home is this:
If you are not continually prospecting for new business, you will lose referring accounts and not hit your goals.
If you don’t work towards goals, you simply won’t reach them. Getting comfortable and relying on previous relationships to propel your business forward is the downfall for many top producers. It’s critical to long-term success that you consistently focus on non-referring or minimally-referring accounts during your weekly visits to referring accounts.
I know prospecting is hard.
You hear “no” all the time. I also know that our High-Performance Sales Academy Certification Course helps you become a fantastic prospector. We teach you how to prepare for your prospecting calls so you can convert prospecting accounts faster, gain more referrals, and hit your admission goals. To learn more, reach out to Mike@homecaresales.com or go right to our website www.homecaresales.com and buy directly to get started immediately!
Cheryl Peltekis, RN “The Solutionist”
This week I got to spend time coaching one of my most favorite owners of all times. We first met when I was speaking at the annual nurse entrepreneurs conference two years ago.
I remember him quickly standing and walking towards the side of the stage, waiting for me to wrap up my presentation to about 1000 nurses.
I was thinking:
“What did I say that motivated this man to make sure that he got time to speak to me.”
To my delight, he was a wonderful gentleman who was an owner of a private duty and wanted to open a home health and hospice organization.
His first words to me were, “How did you learn to provide direction and delegate work to remove obstacles to let you open multiple businesses, and work as a consultant?”
I immediately recognized where he was in his leadership journey. He had reached that major career transition point when a person needs to shift from doing the work to getting work done through others.
This transition is difficult for many. It means giving up direct control over the work which involves more risk. More need to trust and equip others to get the work done and a shift in focus.
Changing your view from personal achievement to enabling and empowering others to achieve. I invited him to be mentored by me for a few weeks to see if I could help him push through the change.
Over the next few weeks, I coached this owner. I uncovered another difficult transition that he and many owners face as they remove themselves from the daily grind of running their organizations. A major transformation happens when the owner stops being the expert in a particular function, area, or discipline and instead starts to lead others to become the experts.
Personally, this was the hardest transition for me to experience. Having to give up being the person most in-the-know felt like giving up a child. I could see that this was also a challenge for the owner that I was mentoring.
Leaders who succeed at these transitions start developing new skills and know when it is time to stop relying on the old ones.
They learn to set clear expectations, track progress, and communicate information that people need to do their jobs. I was able to help this owner shift his focus to helping others develop their skills and gain confidence.
If you are having a hard time letting go of work, maybe you feel like no one else will do this the right way. You may even be correct, but this will undoubtedly lead to burnout. Instead, change your focus from doing the work yourself, to one of guiding, delegating, and trusting others to do the job.
Shift your focus to helping others develop their skills. Navigate these leadership rites of passage and you will not only help other people be successful in their roles, but you’ll be also on your way to becoming more successful in yours.
If you are ready to evolve as a leader. You may want to join our mastermind group.
Members have worked on skills like:
- Providing clear direction and accountabilities.
- Delegating and distributing assignments and decisions appropriately.
- Monitoring progress of leaders by maintaining the flow of work and results (don’t worry…we provide the steps)
- Providing appropriate guidance and direction based on people’s capabilities.
- Intervening as needed to remove obstacles.
I enjoyed seeing this leader evolve. He created his leadership training manual. He implemented standards on patients on service for each clinical leader to manage. He mapped out a monthly calendar of expectations for the leaders to be prepared for the survey. Then he automated the process and just followed the calendar. This lead to him to open new companies the same year! Both Medicare-certified home health and Hospice.
When he needed to jump in and remove obstacles, he did but just by offering consultants to support leaders. This meant him not taking on the work himself.
He has several phenomenally successful businesses and a very happy life which gives him time with his family.
It is exactly what most agency owners are looking for. That is what a mastermind group can do for you!
Are you ready? Apply Here! Your transformation awaits you.
Want to try to go about it yourself? Check out a great read Harvard Business Review Blog Network, Stop being a people-pleaser.
Cheryl Peltekis, RN “The Solutionist”
It doesn’t matter if you are a marketer, sales representative, or clinical liaison, you will face many objections when you are out selling services. As a matter of fact, I struggled with what objections to write about here!
Each of my clients has shared so many with me.
When I coach sales representatives or sales managers, I always assign a homework assignment to compile a list of objections.
Here are the most common objections:
- We offer Choice (list)
- We have a preferred provider.
- We do not refer.
- We need someone to take x insurance patients.
- You need to do a lunch and learn.
- We have our own agency and for ease we just use them.
- We let the patient pick from our brochures.
- We use different providers based on where the patient lives.
- Our patients cannot afford your services.
- We let the hospital or Skilled Nursing Facilities place the referrals when a patient is discharged.
What I found during the past few years consulting is that a lot of the organizations that hire Home Care Sales to be their sales consultant have worked with other sales consulting companies first.
Some of them have shared that they spent $20,000 on coaching for one rep. That is a lot of money! Sadly, these representatives come to Home Care Sales because they just could not succeed. They join home care sales and purchase the HPSA for under $500 and our weekly sales messages for under $6000 for the year, and they finally hit their dream results. Why?
What is the key difference?
I believe the key difference is teaching the sales representative how to deal with the most common objections for all the account types that they are calling on. I also believe that the sales representative should be able to learn from their peers.
When our clients purchase the Weekly Road Map to Referrals, it includes monthly coaching on overcoming objections with a group of over 100 reps that show up for the coaching calls. I believe a lot is learned by attending these sessions. Hearing how one of your fellow sales comrades is getting past objections is truly one of the best ways for someone to learn.
In addition, during these calls, Melanie and I provide email templates, voice mail scripts, and do several live roleplaying sessions to demonstrate to the reps that are in attendance how to get past objections. We then invite the sales reps to bring up any objections that they had to deal with that week!
After the coaching session, the sales representatives can log into their learning platform, Home Care Sales Pro and access the recording with the transcript so they can practice and refer to it before they walk into any account, they would like to finally gain access to referrals!
I think many other consultants are either completely missing the boat or they are just not capable of offering coaching on overcoming objections in this format. I am not picking on any other sales consultant as many of them are excellent, genuinely nice people who with the best intentions to help your organization grow.
I also know that many just do not have the life experience that Melanie and I bring to selling services. I do not believe there is any other consultant company out there that is like home care sales.
I am an RN and agency owner for over 26 years. That is a long time to have to maintain a collection of successful businesses! I started in 1995 and built (from the ground up) an extremely successful home health, private duty, and hospice organization.
While still helping run and manage my agency, I was the full-time salesperson for all three service lines and named “Sales Manager of The Year” in 2013.
My business partner Melanie was first an OT who wanted to service more clients. However, the agency that she worked for did not have enough patients. So she had to go find them. She fell in love with sales and has been incredibly successful at selling services for the last 20 plus years!
Sales Representatives must know the steps to take, and you must be aware of where to find the data you need to overcome sales objections. Once you find the data, how do you then turn that data into a sales call that gets you in front of the decision-makers who have the control to win you a hospital account?
So here it goes. In today’s example, I’m going to focus on a home health provider that really wants to get referrals from hospitals in their territory.
They have one hospital referring to them and now they want to build on to that list. Right now, their sales reps are hearing the following objections from the hospital d/c planners. (The prior sales coach got them this far.):
- We offer choice
- We have a list.
- We have preferred providers.
I asked the rep, “What did you learn from the other sales consultant that you worked with?”
The sales rep responded, “he helped get me to have the courage to approach the discharge planners and introduce my agency and provide them with information about what we do to help patients going home.”
My response was, “that was where you made your mistake.”
The hospitals’ discharge planners do not need other agencies’ brochures placed in their hands. They need agencies that can solve their most pressing problems. To do that you have to know the right information and use it in a way to ask the questions that will allow you to identify what they need help with!
Imagine if you responded to the objection of:
“We have our preferred providers,”
…by saying: “How do you help a patient navigate through the list of providers?”
Listen, to the response closely and ask a follow-up question. Now we teach our sales representatives to go deeper in Step 1 of the High Performance Sales Academy: Identify. If I’m speaking to a cardiac floor discharge planner, the rep that follows the sales process would have already investigated the hospital’s readmission rate for CHF and identified what cardiac diagnosis’s the hospital has selected for their bundled payment initiative program.
We also instruct the sales representatives to know who their top competitors are. The Sales Reps need to be aware of the current market expectations in order to be able to cause an opportunity to shift the market expectations.
Being prepared gives you the confidence to push past through the objection and ask an important follow-up question.
Would you like to learn how we are helping other hospitals in the area by keeping their CHF patients out of the hospital?
If they are working on bundled care for CHF patients, you should hear a resounding yes. Then you can respond with your facts.
If that sounds too complicated for your team, don’t get overwhelmed or afraid! We have what you need to build accounts. We show you (and your sales reps) how to grow new “A” accounts and get more referrals.
We also can support your leadership with recruiting and retention issues with our CAM FAM mastermind group. If you want to learn more about how we can help your organization grow, just email Mike@homecaresales.com or go here to set up a consultation where he can share what’s working.
As an agency owner, I hate to waste money. I am always looking for products that have been tried and proven to be successful over and over again. I bet you feel the same way. Well, good news: You just found it. From one owner to another – This can help your team become what you need them to be.
Cheryl Peltekis, RN “The Solutionist”
Training Sales Representatives has been one of the most rewarding things I have done in my life. One of the first things that I learned about sales in private duty, home health, or hospice, is that I am not selling anything. I am doing the work of a superhero.
Many of you have read my blog posts and often have seen me write about how a salesperson must adjust their perception of themselves from that of a sales representative to a problem solver.
I love teaching this. I show an image of a used car salesperson and share with them that is how I felt at the beginning of my post-acute sales representative journey.
So what made me change my perception?
Well, one day when going to do a strategy sales call at one of my A+ accounts I ran into the chief of cardiology at the hospital that I was visiting. He happened to get in my elevator. I sheepishly said, “hello” and he saw my badge. He said, “oh your that health care consultant that stops in my office and provides our patients with information.” He reached out his hand to introduce himself with a big smile. (Pre-Covid).
I reached out my hand and introduced myself. I said, “I’m happy to meet you, but you must have me confused with someone else.” He said, “No, it’s you, Cheryl the consultant. Unless you have a twin, aren’t you the girl who brings me information on advance care planning and CHF program for our patients?” He went on. “Every month you put new educational flyers in our exam rooms for our patients.”
…And that is the moment it really hit me.
I was not a sales representative to this important physician, who (despite my best efforts) I never even got to meet. He perceived me as a “health care consultant.”
Many years have passed since that great 2-min elevator moment, but the impact was significant on my sales career. I was, a health care consultant. I remember thinking about what I did at his office practice location that obviously put me in good standing with the Chief of Cardiology for one of the nation’s largest hospitals in the U.S.
Today, my company, Home Care Sales teaches these successful strategies to sales representatives across the nation. This simple exchange has helped to further impact other soon-to-be superheroes to realize the impact they have on the lives of care providers and patients across their market.
It’s not the educational flyers you deliver to a doctor’s office or at senior fairs. It isn’t the promo items that you bring them once a month that cost you a dollar. It is how you service your accounts. It all comes down to how you approach your account as a business partner or, more importantly, as a problem solver. Not someone doing sales emails or sales voice mails, but someone who helps solve their problems.
I went back into my CRM to look at the sales notes from my stops at the Cardiologist’s office. I read in my documentation that they were trying to capture more revenue by adding additional services to patients visits. (Before you read too far into that, we are talking about handling more in-office…not referring for un-required MRIs or anything of that nature)
I did some homework and found out about advanced care planning. I made up an advance care planning book of forms and delivered the books to that office. I trained the billing person on the “how-to” and prepared a recording of me talking to the doctors at the location about what was in the 1-inch binder book and how they could maybe use them to add an additional up code for advance care planning to their routine visits. We teach these strategies in our Master’s program for High Performance Sales Representatives.
If we break down what I did it would be something like this:
- Changed my self-perception to be “The Solutionist.”
- Approached my account as a problem solver.
- Asked questions to identify what this doctor’s office is trying to get accomplished right now.
- Provided the necessary resources to solve the account’s problem.
- Collected patients referrals and delivered incredible customer service
Now it may seem complicated, but it really isn’t. I used a weekly sales plan that had me consult on patient types that required more of my accounts time (and therefore resources). I provided educational materials that my accounts could share with their patients/residents on how to live a healthy long life.
It is the same weekly sales plan that has been upgraded every year to get results for our sales reps, our Weekly Roadmap To Referrals.
I believe that sales representatives may need help to become or evolve into a sales consultant.
Fortunately, I have had an advantage. I am a nurse and worked as a full-time case manager in patients’ homes so I could easily speak of the benefits that the patient and the referring account would receive when a patient was on my agency’s services.
Now we know many sales consultants need to be taught these things in order to really produce high-value accounts that consistently refer. That’s why Home Care Sales, lead by two clinicians, built our “Weekly Road Map To Referrals Program.” It infuses all the clinical knowledge you will need to become a community health care consultant without having to be clinically trained.
The Road Map To Referrals is a weekly plan that allows you to be all that you want to be to your accounts. You gain clinical insights and the exact questions to ask to uncover what is really important to your accounts.
It also comes with an hour of coaching every month with Melanie and I to have you overcome any objections you are facing while you are trying to sell your services. If you aren’t using our Weekly Road Map to Referrals you should be.
Cheryl Peltekis, RN “The Solutionist”