Hire and Retain the Best CNAs

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We saw that. I mean, a ton of the often

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low income single moms who we were working with, they wanted to start

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a career out in healthcare. They love helping people. They love

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being able to invest in their communities and care for people.

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But what was stopping them was just getting the license itself.

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You can start and get your CNA license for as low as, like,

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$800, but for people who are living paycheck to

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paycheck, that can be really expensive.

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Welcome to the nursing home podcast. Your goto source

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for professional insights in the longterm care industry.

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Hear from leaders and experts as they share current and practical insights

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to help make the most of your day. I'm the long term care financial specialist.

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What that means is I help people plan for the inevitable.

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Nobody wants to think about getting old, but it's possible that someday we might need

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a little bit of care. Here's your host nursing home administrator turned podcaster

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Schmuel septimach.

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Today we're going to talk about DNAs hot

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topics. Anyone who's involved in nursing homes.

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Today's guests, we have Athena Khan.

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Athena, I think I said that right,

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is the CEO of Dreambound, the number one platform for students

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to find a register for CNA and other training programs.

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Dreambound works with customers like Brookdale and Goodsmaritan, says sponsorship

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programs and hire work is straight out of school. All right, we'll hear

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more about that later. Tina. Welcome to the nursing home podcast.

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Thank you. You're excited to be on? Yes, excited to have

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you here as well. So for our listeners, they've heard about

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me before, have not heard from you before. So give us a

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brief background of who you are and how you got to do what you're doing.

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Yeah. So I started my career out at Johns Hopkins

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doing research. I was looking at minority health

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and health disparities. It's pretty much

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obvious now, but you can see that people who are low

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income, who are people of color are set

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up pretty much for so many disadvantages.

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Later down the road, you see maternal education is the biggest predictor for

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a child's health. And so it became really, really important to

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me to be able to help people achieve greater education and greater

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income so that can impact them and their children's outcomes

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and health outcomes and financial outcomes for the foreseeable

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future. And just talking to a lot of the different

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patients and residents that we worked with at Johns Hopkins, we saw that

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a ton of the often low income single moms who

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we were working with, they wanted to start a career out in healthcare.

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They loved helping people. They loved being able to invest

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in their communities and care for people. But what was stopping them

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was just getting the license itself.

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You can start and get your CNA license for as low as,

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like, $800, but for people who are living paycheck

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to paycheck, that can be really expensive. And at the same time you

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have nursing homes who are paying $3,000 signing bonuses.

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And so I was thinking where is this disconnect coming from? And so

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I wanted to make it really easy for someone to sign up for school if

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they could afford it. And if they can't afford it, we match them with an

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employer who can help them pay to go through training.

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Interesting, very interesting couples. First of

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all, you made the connection income to outcome, which is interesting,

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but your income can will affect outcome

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where you going to end up. But on top of that,

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where were you working with the students where

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they wanted express interest to become a CNA. But they had this problem.

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What was that setting and was set up? I mean, in this specific case

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it was out at community health clinics just talking to a lot of the patients

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that were part of the studies that I was looking at. But I mean,

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working through Dreambound we encounter people everywhere.

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People in local communities who are going to

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church, people who have graduated high school and now working as

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a home health care aid or a caregiver. Maybe they're working at Amazon

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or retail warehousing, any number of these other roles.

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And they want to be in healthcare. But what's stopping them is

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the upfront cost of going to school. And we

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wanted to make that easier for them to solve. Okay,

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the second part of the equation I'm very familiar with and

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deal with all the time, the fact that there are employers who are willing

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and they'll do anything. Like you said, they'll give

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sometimes insane sign on bonuses and all sorts of perks

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and pay the wages that are necessary in order to

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get CNAs on board. Not just CNAs,

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but CNAs is definitely a big piece of it. That's certainly

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true and that's what I see every day. But the

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other half that there are these potential CNAs,

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these are not yet soon to be health caregivers, but they're

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not yet healthcare givers. They're interested

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and they want to and they're very excited to get into health care. They have

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this barrier of the training which is getting in the way.

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And the more specifically the barrier is paying for that training which

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the providers, your 100% provider,

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would be really glad to pay for

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that training. So let me ask

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a question this way. We've seen since

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COVID that a lot of people who

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are CNAs and they are licensed are leaving healthcare. They're going into

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the going to the Amazon and they're going to the local restaurants

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and the guns are placed where they don't have a lot of the stresses that

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direct line caregivers have.

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These people who are coming into your network

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and to coming through your company,

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are they not aware of the challenges? Do they not care?

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And I'll even make it not even related

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to COVID Even before that, as an administrator, I always used to

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wonder why people become CNAs. It's a

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very, very difficult job. It's very physically labor

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intensive. The people that you're caring for in a nursing home setting

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many times are unable to express their appreciation.

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Many times they don't appreciate what you're doing. You can get yelled at,

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you can get beaten up. And I had to discard anyone. And if

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you mess up, if you do something, you can kill people.

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It's pretty serious. As opposed to working in Amazon.

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It might not be as fulfilling maybe, but you

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can get paid the same amount or more. You're not mandated for

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overtime. You don't have all the risks involved.

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So that's really why I find that interesting.

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It's encouraging. But I'm also trying to understand the

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people who you encounter there like oh, if only I could become a

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CNA. Are they aware of all

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this? Yeah, it's a great question and you're right,

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it is surprising. Especially as you see Amazon is

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increasing their wages. You see Target, Walmart all doing the same thing

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and you look at CNA and sometimes it pays a lot less. And sure

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there's all these like travel CNA roles that can pay a lot more potentially.

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But yeah, it is a question that a lot of,

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especially like nursing home recruiters

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are thinking about how do I compete and position myself against not just other

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nursing homes, but also against Amazon and Walmart and Target.

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But I mean, we talk to hundreds or thousands

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of CNAs who are about to start training and ask

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them why they want to do this. Especially as they are about to

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get sponsored by an employer. And that employer wants to make sure that

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that CNA is actually going to stick around. And we see the

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people who are excited about enrolling in a

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class. They want to do it for a couple of reasons.

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The most important that we see is that none of them want to stop at

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being a CNA. They don't want to just get a CNA and then stick to

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being a CNA for 30 years. They want to level up and

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be like a medication aid. We see very quickly after, people want

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to become like a phlebotomist six months after their training, they want to become a

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medical assistant. Pct love to a hospital. A lot

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of them want to do travel and especially during the pandemic they're hearing from all

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their friends about travel. CNA makes so much I'm excited to get

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trained because I want to do this travel position. We see

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also a lot of people who are about to start their nursing school,

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the LBN or RN and then they want to get that hands on

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experience. They want to get started and get

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their foot in the door before they start getting trained as an LVN

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or RN. But even just the career advancement part. I mean, people love

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caring for others or at least the ones that we work with. We've heard countless

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stories of students who are talking about how

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they took care of their grandmother when they were 17 and their grandmother had dementia

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or Alzheimer's and they wanted to be able to do the same thing for the

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community. And so people are coming in really informed.

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They either have like a parent or a sister or

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friend who's become a CNA. They know what it's like, they know they

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want to do it. People who haven't heard about it, they need to

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know what that is before they make this commitment because it is a really hard

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job. But I mean, people see that there is mobility,

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they see that there is wages

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are starting to increase. And I think all of that is really attractive,

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interesting. So for the most part it's

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also interesting that you actually ask this question head on because

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you're right. If I'm hiring a

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company to help me get CNAs and help them get trains and I'm paying for

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their training, I want to know that they know what they're getting themselves into

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so that actually start to stay. And they don't say, oh, my goodness,

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I didn't realize that I'm going to be on my feet for many hours

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in a row. I don't realize I'm going to be dragging things through the hallway

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and all these responsibilities and everything else

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that goes on in all nursing homes for the most part.

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It's very fascinating. But I always

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had this question and I think what you said

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is 100% sure. It has to start some things. I want to go into health

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care. Someone who's making a statement.

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Everyone has something that they like to naturally do,

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at least in a general sense. Some people would love to sit in front

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of a computer and just do stuff,

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technology. And those people are probably not the same people who want to be CNAs

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or nurses or doctors for that matter, or a lot of other things or mechanics.

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Some of them become a senior. That means that they deeply care about. They really

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want to help other people hands on. Yeah.

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And think about all the home health aides'and, the unlicensed caregivers who are

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doing a lot of the very similar work that a CNA would do and they

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just get paid two dollars to three dollars less an hour. They are looking to

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get their CNA for them ability and pay bump.

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Yeah. At the same time, the amount of people that

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schedule interviews to come to a nursing home and don't

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show up, not the people who come and they're hired

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and they fill out all the paperwork and they don't show up to orientation or

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leave after a week or two weeks, the same pool. This is

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not your fault. Maybe not completely your fault.

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We see that all the time.

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Okay? Yeah. Obviously they want to give to other

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people. They also want to provide for their families and they need to go to

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the place that's going to pay them the amount that's necessary.

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But if someone's coming in in a clear path

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and it's not just about the rates, let me

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flip the question two

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things. What is important to CNA when they're

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looking for a job? From a facility standpoint,

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what could a facility do to make a attract that CNA

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to come and work for them and to get a longer term

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commitment that they're going to want to work for them and stay and grow with

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them? Yeah, I mean, it's something that we think about every day.

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And I like to break down the problem into three different

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stages on those. The first would be just like, how do you get those initial

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applications? And most CNAs are going to be looking

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for some bar of pay and then distance from wherever

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their home is, or maybe a distance from they need to drop their kids off

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or something like that. Just like a convenient location. So those are always going to

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be the most important. And pay, especially you're going to see as

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the most number one thing for CNA is trying to pick a role,

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or really anyone trying to pick a role in health care where it is so

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competitive. And so that's why you see travel. Nursing is

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picking up so much demand. You see all these Facebook groups where

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it's literally just like 25 an hour. And then you have 40

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comments of people saying, send me more info because that's all they care about.

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So that's definitely true. CNAs just have so much optionality in the

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market that they are willing to leave their facility for an extra 25,

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$0.50 an hour. More distance I would say is becoming more important.

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Especially like gas prices are going up. No one wants to travel 30 minutes

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each way for a $0.25 an hour increase when

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they could work somewhere that's like five minutes away and it's a lot closer.

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It doesn't cost them as much in gas money.

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And then I think after that, when it gets to the actual interviewing

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and job offer stage, I think speed really matters a lot.

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You see people are really trying to

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care for themselves and their families. They're trying to work as soon as possible.

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And so we have heard our employers that

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are really fast about responding, they whatever go to indeed.

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And they look at people who have updated their resume in the last day.

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They contact them immediately. And then that person who's actively looking

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is now able to get a job offer in a day or two.

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That makes a huge difference. But even if you do all of those

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things, you still might end up having a ton of turnover just within the first

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30 days. I mean, at this point, nursing homes aren't even recording

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the turnover because just so many people like show up

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or don't even show up to orientation. Or if they show up the orientation,

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they might not show up in day one or stick out through the first week.

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And I think that's when you see more of the culture coming

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in, people want to see is this facility filled

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with workers who are really like depressed and who are overworked

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and understaffed and people can really get that vibrant when they

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are starting to actually work. Do they feel like they had

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a good orientation or do they feel like they're kind of thrown to the wolves

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and have to figure out everything themselves? Especially for a new training

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that can be really overwhelming versus some of our best facilities

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that we work with. Set up someone with like a mentor who's more experienced.

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They set a clear ladder of here's what your next

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year is going to look like. The first six months, you're going to have this

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mentor who's going to teach you how to do these things. After your six months,

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you can either become a mentor yourself,

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you can take more of a senior lead for this shift,

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or you can even go back to school and become a medication aid.

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Those are things that people really care about. Otherwise staffing

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ratios are important to people want to feel like they are delivering

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good work to the people that they're serving. People really, really deeply

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care about their patients and the residents. And so they want to feel like their

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coworkers are not cutting corners, that they don't have

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to cut corners themselves because they're serving 15 people.

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I mean, all of that, yeah, basically it all matters. I would say,

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in order of importance. It's pay, then distance and then

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more of the cultural things that you see.

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Very fascinating, very complete answer. Thank you. I think that's really

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fantastic because I

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sit down with clients all the time and say we're doing our onboarding calls and

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I will ask them, why should somebody work for you versus the nursing

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home down the block? And I can't tell you how many

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times they draw a blank

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like, well, we have a good culture, we pay good.

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Like, okay, so is that place and they also pay well,

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they also have a good culture. Many times

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the boys are out to culture and

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everyone at least claims that their culture is better. Some people genuinely

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believe that way. In some places it's true. But I completely

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agree with what you said, is that that's not going to cut it. First of

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all, you can't sell that in your ads in person. It doesn't

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matter how you're selling the job because

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everyone's going to say that that's something you have to see and experience in order

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for it to be meaningful. And if that's the only thing you have to sell,

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even if it's true, you're never going to get the first base because

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how are they supposed to know that? So the first thing, like you said,

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the wages have to be competitive. At the very least, competitive, if not

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higher in the location and that's where

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it kicks in. I think the other thing is that everyone

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calls it the revolving door. You finally work so hard,

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you pay so much money, time,

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resources to get people in the door. And once they're finally

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there, like I said, if they show up to orientation,

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if they stay for a week, but it seems like you

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alluded to this. But I think it's true that after a certain point, if they're

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in, not that they're in forever, you always have to work in retention. But if

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you could get past that first month or two months, however long that period

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is, then they already know what this is and they're comfortable with it.

18:00.700 --> 18:04.102
They feel like they're getting compensated fairly. They feel like

18:04.195 --> 18:08.272
the distance, the older technical things that works out with

18:08.455 --> 18:12.102
their life, and they are comfortable

18:12.132 --> 18:15.432
with the people that they're working with, with the level of care that they're providing,

18:15.597 --> 18:19.147
and they feel like there's room for advancement. People actually care about them.

18:19.255 --> 18:22.672
They're not just thrown to the wolves. So then you have a chance

18:22.705 --> 18:25.327
of actually holding on to this person for a little bit longer. And you have

18:25.345 --> 18:28.897
to be open and willing to give

18:28.930 --> 18:32.232
them the next step, even if it means losing them as an employee. Because that's

18:32.247 --> 18:35.975
the only way you have to really care about them. Like you can't fake that

18:36.787 --> 18:40.102
because if the next step means going to

18:40.120 --> 18:43.477
nursing school now, they will no longer work for you. You have to allow them

18:43.495 --> 18:46.702
to do that. You have to genuinely care about them in order for that to

18:46.720 --> 18:50.637
happen. I think one of the challenges though, that operators,

18:50.787 --> 18:54.942
that administrators, whatever it is people running nursing are feeling,

18:55.077 --> 18:58.362
are experiencing that it's kind of a circular

18:58.437 --> 19:01.627
problem because you don't want to throw them to

19:01.645 --> 19:04.552
the walls, because you want to give them a mentor and you want to do

19:04.570 --> 19:07.767
everything that you describe. Those things are great in theory,

19:07.902 --> 19:10.787
but right now today on their first shift,

19:11.512 --> 19:15.427
we don't have enough CNAs, and their workload is

19:15.520 --> 19:19.087
13 patients and really should be six or eight or ten.

19:19.225 --> 19:22.627
And it really is too much. And the person was just trained and we just

19:22.645 --> 19:26.047
paid for that training. And the way the number is going to go down is

19:26.080 --> 19:31.550
by getting more people on. But you can't get more people on because

19:32.137 --> 19:35.742
you're ready for staffs. And the orientation has to be done much quicker

19:35.802 --> 19:39.547
because the same type of reasons, the urgency to get people

19:39.730 --> 19:42.802
on board. So it's very difficult to get out of that,

19:42.970 --> 19:47.527
flywheel out of that

19:47.545 --> 19:51.247
flower, getting out of the trap. Someone had to deal with

19:51.280 --> 19:54.772
that. You don't have to have an answer to this. I'm just talking

19:54.805 --> 19:58.250
about this. This is what actually happens. I'm sure you see this. Yeah, of course.

19:58.912 --> 20:01.927
We hear it all the time from our employers and most of them end up

20:01.945 --> 20:05.427
trying to solve it by hiring staffing agencies, of course, the vein

20:05.457 --> 20:07.562
of every nursing home's existence.

20:08.887 --> 20:12.217
For a lot of nursing homes, they have found a lot of success doing that

20:12.265 --> 20:15.652
because you can have on demand these two or three

20:15.670 --> 20:19.327
people that can actually plug the holes. So you can spend time and actually take

20:19.345 --> 20:22.187
the time to hire and invest a lot in hiring.

20:23.062 --> 20:26.847
But yeah, that can be really expensive. We hear from networks that they're spending

20:26.967 --> 20:31.152
millions, tens of millions of dollars a month at the peak of COVID in January.

20:31.257 --> 20:35.092
And having to eat that cost can be really difficult. And that's why,

20:35.140 --> 20:38.750
I mean, I'm a big fan of sponsoring training or setting up

20:39.337 --> 20:42.897
training programs themselves. I think it's hugely beneficial

20:42.942 --> 20:45.997
to be able to train a whole cohort together so that you have

20:46.030 --> 20:49.372
like ten or 15 people starting at the same time. And so,

20:49.405 --> 20:52.977
yes, they might not have a mentor, but they have that peer mentorship where they're

20:53.007 --> 20:56.602
able to learn from each other. And you also are able to

20:56.620 --> 21:00.337
relieve the full strength in the system through one block of people that are starting

21:00.400 --> 21:03.532
work at the same time. I think that's really great. I think there are a

21:03.535 --> 21:06.832
couple of different ways to do that. One is starting your own CA

21:06.910 --> 21:10.987
program, which comes with its own challenges, but the benefits as well. And then also

21:11.050 --> 21:15.200
hiring directly out of training programs, whether that means sponsoring people

21:15.862 --> 21:19.072
or even just like building relationships with those

21:19.105 --> 21:22.507
schools. I mean, we've heard of facilities that have just like,

21:22.585 --> 21:26.077
clean sweeping an entire class of like a

21:26.095 --> 21:29.767
CNA program has 20 people graduating and they hired like 18 out of 20,

21:29.815 --> 21:33.172
and immediately that solves their hiring problem. Right? And so,

21:33.280 --> 21:36.800
I mean, yeah, people have to be creative about where they hire from.

21:38.962 --> 21:42.652
Okay, so interesting. It is true that agency is

21:42.670 --> 21:46.752
a very slippery slope, especially for the ones who are responsible for scheduling

21:46.782 --> 21:50.167
and staffing, because if it becomes too easy to fill those

21:50.215 --> 21:54.425
holes, they're not paying for it and their paycheck is staying the same,

21:55.762 --> 21:59.197
then it's true. It can slow things down a little

21:59.230 --> 22:03.202
bit if you have the proper orientation process already in

22:03.220 --> 22:06.892
place and you know exactly what you're doing. The only issue

22:06.940 --> 22:09.892
is that you don't have the bandwidth to do it. That can be a good

22:09.940 --> 22:13.175
band aid if it's really controlled. Yeah,

22:13.612 --> 22:17.377
not just like a crutch. Right, exactly. Otherwise it

22:17.395 --> 22:20.457
does become a crutch. And that crutch can bring down the whole facility

22:20.547 --> 22:24.147
because they lose the margins.

22:24.342 --> 22:27.050
Many times margins are slimming up as it is,

22:27.562 --> 22:31.477
and contrary to what people on

22:31.495 --> 22:35.237
the street may think, many times the margins are much, much slimmer.

22:36.637 --> 22:40.627
And then they really are. Then taking agency costs and throwing it could

22:40.645 --> 22:43.822
really do them in. But your other

22:43.855 --> 22:47.300
point and also everyone tries to connect with

22:47.962 --> 22:51.877
training programs, programs, and they're not always available in every location. But even

22:51.895 --> 22:55.117
if they are, what does it take for a training

22:55.165 --> 22:59.262
program to want to partner with a particular facility,

22:59.412 --> 23:02.452
because that would be amazing. I can think of so many people that could get

23:02.470 --> 23:06.112
18 CNAs from a program that could save

23:06.175 --> 23:10.572
hundreds of thousands of dollars in the first month. But besides

23:10.767 --> 23:14.227
the care, it's just the stress level on the facility. It's a

23:14.245 --> 23:17.512
game changer. So I guess

23:17.575 --> 23:21.532
what does it take for a facility to be wanted

23:21.685 --> 23:25.337
by such a program other than asking to be connected?

23:26.587 --> 23:30.247
Yeah, I mean, we're starting to see a change in the industry where people

23:30.280 --> 23:33.217
are being more creative about reaching out to schools, which I think is great.

23:33.265 --> 23:36.652
I think it's a very natural next step. And you want to

23:36.745 --> 23:40.567
invest in creating new supply of CNAs so that the whole system,

23:40.765 --> 23:44.352
you aren't just like, reaching out to the same people in the revolving door

23:44.382 --> 23:47.752
over and over. You're actually like introducing new people who can help ease the

23:47.770 --> 23:51.132
root problem. I mean, we see a big range

23:51.147 --> 23:54.172
of approaches from facilities. We see some that just,

23:54.205 --> 23:57.837
like, reach out and are saying, hey, can you drop off a flyer?

23:57.912 --> 24:01.182
Can you let your students know that we have job offers?

24:01.272 --> 24:04.550
The problem is every other nursing home is doing that as well.

24:05.137 --> 24:08.437
To stand out, you have to do a couple of things.

24:08.575 --> 24:13.027
One, like the golden thing to do is be a clinical site for

24:13.120 --> 24:16.572
a CNA training class. That would be super ideal because you're

24:16.617 --> 24:20.602
already in touch with these students before they're even up on

24:20.620 --> 24:24.142
the job market. They're already working at your facility. They get a chance

24:24.190 --> 24:27.592
to see what the facility is like. And so,

24:27.790 --> 24:30.652
I mean, you see most of the students end up going to work at that

24:30.670 --> 24:34.147
clinical facility after they graduate if they don't have something lined up already.

24:34.330 --> 24:37.642
Also, because they're used to going in that location, the location is close by.

24:37.690 --> 24:41.247
All of that helps a lot. But I mean, for people who don't

24:41.292 --> 24:44.842
offer clinicals other things, you can offer to sponsor students

24:44.965 --> 24:49.262
who can't afford to pay. That is a very popular

24:50.212 --> 24:53.572
request from schools. They're like looking for employers to do that. Not every

24:53.605 --> 24:57.942
employer is willing to do that because it does take some risk and some operational

24:58.002 --> 25:01.552
coordination between the recruiter and

25:01.570 --> 25:05.317
the HR people who are at the nursing home with the actual program

25:05.365 --> 25:09.007
director of the school. And if you have your HR person leave, then you

25:09.010 --> 25:12.592
have to set up that program again. But other things

25:12.640 --> 25:16.102
we see creative things, like one of our schools has

25:16.120 --> 25:19.972
a graduation ceremony and always reaches out to nursing homes who

25:20.080 --> 25:24.067
can sponsor the graduation ceremony. It's probably like $250,

25:24.115 --> 25:28.422
like pay for pizza, pay for a nice venue

25:28.467 --> 25:31.822
to have the graduation ceremony at, but a huge exposure to those

25:31.855 --> 25:35.062
students. Other things we see are people

25:35.125 --> 25:38.375
trying to buy pizza for our students,

25:39.037 --> 25:42.172
like during class. Some schools like that, some schools don't really,

25:42.205 --> 25:46.100
because they want to just focus on class time. But I mean,

25:46.687 --> 25:50.227
a lot of other approaches work too. Interesting. So to

25:50.245 --> 25:51.800
be a clinical site, though,

25:53.887 --> 25:57.847
you have to have good

25:57.880 --> 26:01.882
survey results. Because I

26:01.885 --> 26:04.767
just remember one of the buildings where we were managing. We had our own CNA

26:04.827 --> 26:08.150
training program before Cope just goes back a little bit,

26:08.737 --> 26:12.172
but then we had one deficiency. I forget what

26:12.205 --> 26:15.372
level it was, but it was enough to say that, OK, we had to cancel

26:15.417 --> 26:18.072
that program in the middle, that we can't do it anymore.

26:18.117 --> 26:21.847
So not every facility is going to qualify. And even if they

26:21.880 --> 26:25.342
had a resurvey and they cleared whatever, it was something

26:25.390 --> 26:29.232
that could take many months until they're officially cleaned

26:29.247 --> 26:34.372
of whatever it is that happen there. But a

26:34.405 --> 26:38.667
practical question, I would think that CNA programs

26:38.802 --> 26:42.652
would be inundated by nursing homes that are like dying to

26:42.670 --> 26:43.625
pay for anything.

26:46.087 --> 26:50.022
Pizza will put a paper on their chairs, we'll redo your sailing,

26:50.217 --> 26:54.275
put our logo and you. Is that not the case?

26:55.237 --> 26:59.502
I mean, we see most facilities typically stop at the flyer

26:59.532 --> 27:02.900
and buy pizza market. Very few facilities go beyond that.

27:05.287 --> 27:09.267
Interesting. So this is a very real opportunity. So if anyone is struggling

27:09.327 --> 27:12.282
with that facilities and listening to this episode,

27:12.447 --> 27:16.342
this is a very real opportunity here where the

27:16.390 --> 27:20.092
ability to, let's say, to sponsor a student,

27:20.215 --> 27:23.527
that's very basic, and instead of creating the

27:23.545 --> 27:27.172
program, managing the program, yes, there's a risk, but there's a risk of

27:27.205 --> 27:31.242
doing nothing too. And it's very, very expensive. So if you sponsor

27:31.302 --> 27:34.927
five students and three of them work out, you've made your money back

27:34.945 --> 27:37.552
in one month. Especially if you have agency, you can make it back in a

27:37.570 --> 27:38.150
week.

27:42.562 --> 27:45.792
And you're not finding the CNAs, you're not convincing

27:45.852 --> 27:49.402
them to become CNAs, you're not telling them to move to

27:49.420 --> 27:52.672
your area like they're here, they want to be CNA, they want to work.

27:52.780 --> 27:54.650
You're the one who helped them out.

27:55.912 --> 27:59.782
That's extremely valuable, becoming a clinical side, if it's possible.

27:59.935 --> 28:03.247
But who wouldn't want to do that? Even just while they're there,

28:03.280 --> 28:07.077
a little bit of extra help is always very helpful.

28:07.182 --> 28:10.072
We also see a lot of schools do struggle to find clinical sites. It really

28:10.105 --> 28:13.402
depends on the location. Yeah, you don't have to be like

28:13.420 --> 28:16.567
a five star facility in order to become a clinical site.

28:16.615 --> 28:20.302
Sometimes you have a new school that's just starting up and they're looking for a

28:20.320 --> 28:23.727
clinical site, or once I switch over because they're expanding

28:23.757 --> 28:27.427
their program, I mean, opportunities there if you start to build that relationship

28:27.520 --> 28:31.102
with local school leaders. So the main thing is to figure out how you

28:31.120 --> 28:32.150
can help them.

28:33.937 --> 28:38.002
Let's talk about Dreambound. So what does Dreambound do to

28:38.020 --> 28:41.527
address this problem? Yeah, I mean,

28:41.620 --> 28:44.422
a couple of different things. One, we just want to make it really easy for

28:44.455 --> 28:47.932
people to sign up for classes, not just CNA. But CNA is

28:47.935 --> 28:52.107
a big focus. We see that a lot. Of these schools are pretty outdated.

28:52.197 --> 28:55.992
A lot of them don't have online registration or websites

28:56.052 --> 28:59.497
or posts like their class dates on their website. And so we get all that

28:59.530 --> 29:02.827
information, make a common application. So a student just

29:02.845 --> 29:06.247
needs to fill out an application once, and then they can get started with any

29:06.280 --> 29:09.725
school that we're partnered with. And at the same time,

29:10.837 --> 29:13.947
if they can't afford to pay and they're willing to work at an employer,

29:13.992 --> 29:17.932
we help employers plug into all the different schools in a given city

29:18.010 --> 29:21.352
so that they can sponsor people. So an employer can see,

29:21.445 --> 29:25.707
here are 20 people who are currently looking to get their class sponsored.

29:25.797 --> 29:29.392
Let me interview them, let me screen them, see who might be a good fit.

29:29.440 --> 29:32.752
If I want to sponsor any of these, I'm able to do that as an

29:32.770 --> 29:36.787
employer and then start creating a pipeline. We also see

29:36.925 --> 29:39.875
employers upskill their existing staff that way as well.

29:40.237 --> 29:43.852
I think that's another really great creative source of talent. A lot

29:43.870 --> 29:46.557
of success in upskilling housekeepers,

29:46.647 --> 29:50.157
dishwashers, other roles that are unlicensed

29:50.172 --> 29:53.547
to become CNAs. A lot of these people are already working at the facility.

29:53.667 --> 29:56.407
They know what it's like to be a CNA and to work at that specific

29:56.485 --> 30:00.667
facility. And so it's a no brainer to try and upskill them to an

30:00.715 --> 30:04.072
exchange that people feel really invested in. They want to stick around because

30:04.105 --> 30:07.492
they've already stuck around for six months or

30:07.540 --> 30:11.047
whatever, how long they've been at the facility. And it's a win

30:11.080 --> 30:14.797
win for everyone. Could the

30:14.905 --> 30:17.997
platform facilitate training within a facility?

30:18.192 --> 30:22.497
If there isn't a training already there? Is it just connecting training programs

30:22.542 --> 30:25.972
with employees or does it actually help or does

30:26.005 --> 30:29.525
the company, I guess, help setting these things up as well?

30:30.112 --> 30:33.202
We don't do that right now. It's definitely something I'd love to

30:33.220 --> 30:36.592
do in the future, especially just like if a

30:36.640 --> 30:39.802
facility already has a program up and running, we would love

30:39.820 --> 30:43.342
to just send them people who are looking to get started with training.

30:43.390 --> 30:46.792
That's great. That'd be great. Got it.

30:46.915 --> 30:50.302
Because we said now about upskilling people, that makes a lot of

30:50.320 --> 30:54.822
sense because I could say just from what we're doing, a quality recruit.

30:54.942 --> 30:57.747
We're helping our nursing home clients recruit.

30:57.792 --> 31:02.012
So for housekeeping positions, for dietary positions,

31:03.262 --> 31:06.652
we get tons of applicants because they don't need to be certified or

31:06.670 --> 31:09.777
anything. Tons of no colonial shows. It's a separate

31:09.807 --> 31:13.400
conversation, but there's people to work with.

31:14.587 --> 31:17.947
If we can get those people in the door. In other

31:17.980 --> 31:21.127
words, if you're going to train your current CNAs and dietary AIDS, they're easy to

31:21.145 --> 31:24.297
replace, easier to replace,

31:24.417 --> 31:28.100
but to get those DNAs, that's a little bit more difficult.

31:29.812 --> 31:34.025
Very, very fascinating. Anything else you would tell? I wanted

31:37.087 --> 31:41.412
specifically for nursing homes that are looking to track CNAs.

31:41.487 --> 31:44.300
Anything else you would like to tell before we wrap up today?

31:45.562 --> 31:49.317
Yeah, it's rough out there, so you got to be creative.

31:49.377 --> 31:53.182
You got to move fast. And, I mean,

31:53.335 --> 31:56.277
working with a bunch of different schools in an area can be really tough,

31:56.307 --> 31:59.532
but it's really rewarding. We're trying to make it easier at Dreambound so you don't

31:59.547 --> 32:03.327
have to manage as an HR representative, like, 20 different relationships

32:03.357 --> 32:06.952
with schools. You just have to manage the one on Dreambound through the platform.

32:07.045 --> 32:10.927
And so we're trying to

32:11.095 --> 32:15.942
create a new supply of health care workers to make healthcare

32:16.002 --> 32:19.702
for patients better, make facilities lives easier, and make the

32:19.720 --> 32:23.532
workers lives easier as well. Yeah, I think it's a phenomenal idea, and I'm

32:23.547 --> 32:27.172
happy that you're doing what you're doing. Are you in

32:27.205 --> 32:31.192
certain locations? We have schools all over the country.

32:31.390 --> 32:34.562
Our biggest markets are definitely Texas, California,

32:35.437 --> 32:39.612
Arizona, Colorado. I was wondering if you say Massachusetts,

32:39.762 --> 32:42.982
new York. We do have a school in Massachusetts and New York. Yeah,

32:43.060 --> 32:46.717
we work with over 150 schools around the country. Got it.

32:46.840 --> 32:50.572
If there's a school that's not currently on

32:50.605 --> 32:53.000
the platform, what does it take for them to get on the platform?

32:53.437 --> 32:56.752
Yeah, they just need to go to Dreambound.com, sign up as a

32:56.770 --> 32:59.237
school, and they can start getting students immediately.

33:01.087 --> 33:04.837
Got it. I'm playing this out because

33:04.900 --> 33:09.292
I think like a nursing home person, but if someone

33:09.490 --> 33:12.802
I have my facility. I live in Massachusetts. That's what I'm

33:12.820 --> 33:16.227
thinking. But let's say in Boston, I have a facility, and I know that there's

33:16.257 --> 33:19.852
a training program here as well, but I know there must be many other

33:19.870 --> 33:23.397
training programs so I can reach out to them directly.

33:23.517 --> 33:27.352
It would be convenient if I could press a button and your platform would

33:27.370 --> 33:30.607
already be connected with all the schools in my area. That would be very nice

33:30.685 --> 33:34.177
for me, for sure. Probably nice for them, too, because they'll be connected with

33:34.195 --> 33:37.557
places to put CNAs.

33:37.722 --> 33:41.182
Okay, I guess I guess they can go to

33:41.185 --> 33:45.112
the Dreambound.com. Exactly. Yeah. I mean, we are seeing

33:45.250 --> 33:48.297
off ad hoc relationships with some schools,

33:48.342 --> 33:52.002
work with some employers, but when you start working with multiple employers

33:52.032 --> 33:55.282
or multiple schools, that's where it gets crazy out of hand, and that's where

33:55.360 --> 33:58.562
we're trying to provide value and make that easier.

34:00.487 --> 34:03.697
If you want to manage that relationship offline, so to speak,

34:03.880 --> 34:07.557
that can work. They can work to some extent. I think the biggest,

34:07.647 --> 34:11.587
besides the fact that you dropped a lot of very valuable practical tips for

34:11.725 --> 34:15.642
nursing home folks to be able to attract and routine

34:15.777 --> 34:19.542
DNAs, which is the title of this conversation.

34:19.677 --> 34:23.687
But besides that, you're bringing out something encouraging,

34:24.337 --> 34:27.562
is that there are plenty of people that want to become

34:27.625 --> 34:31.072
CNAs and are unable to, and would be

34:31.105 --> 34:35.307
very happy to have a partnership with a health care provider,

34:35.322 --> 34:38.977
a nursing home that will help them get from where

34:38.995 --> 34:42.922
they are to where they need to be. My only question is, what is the

34:42.955 --> 34:46.927
relationship between the number? And I doubt that you have this number or if

34:46.945 --> 34:50.002
anybody has this number, but what is the relationship between the number of people

34:50.020 --> 34:53.977
who are interested in becoming CNAs? The number of CNAs that are running

34:54.070 --> 34:57.875
out of nursing homes? That's a good question.

34:58.837 --> 35:02.502
Yeah, I mean, we see for people who are leaving a nursing

35:02.532 --> 35:05.137
home about, I want to say,

35:05.200 --> 35:08.737
70% go work at a different facility and then maybe 30%

35:08.800 --> 35:12.425
bounce between different industries. Maybe they're going back to their Amazon job

35:13.087 --> 35:16.522
or whatever have you outside the industry. A lot of them still work,

35:16.555 --> 35:19.447
like, part time or PRN as a CNA. So I would say they don't leave

35:19.480 --> 35:22.025
the industry altogether. It might be their second job.

35:22.837 --> 35:26.362
But yeah, we would love to be

35:26.425 --> 35:30.552
more people coming in than leaving right now. That's not the case because CNN

35:30.582 --> 35:33.425
class is expensive, but that's something hopefully we can fix.

35:34.012 --> 35:37.447
But here's the question. I know we're a little bit beyond our

35:37.480 --> 35:40.562
end time, but if you're okay, I just want to continue to drop.

35:41.887 --> 35:45.207
If we were to completely remove the ping

35:45.297 --> 35:48.792
obstacle for potential CNAs and completely remove

35:48.852 --> 35:52.282
all the technical issues of finding a class and finding a

35:52.285 --> 35:55.057
job, all you got to do is click this button,

35:55.210 --> 35:58.852
basically, and we will pay for your training and get you a

35:58.870 --> 36:02.727
job somewhere near you. Because there are nursing

36:02.757 --> 36:06.127
homes everywhere. Wherever there are people in this country, at least there are

36:06.145 --> 36:09.502
nursing homes. And by the way, there are places where there

36:09.520 --> 36:12.727
are no people still are nursing homes. And I don't know how that

36:12.745 --> 36:16.182
works, but we have clients like that, really rural areas

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that they have a nursing home too. So if that was

36:19.870 --> 36:23.227
to be the case so you believe that there's I

36:23.245 --> 36:26.152
mean, you know, I guess because this is what you do, that there is a

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significant number of a very significant

36:29.787 --> 36:33.397
number of people. This is what I'm I don't know if there's a question or

36:33.430 --> 36:37.147
a comment, but what I'm hearing is that it's not as bleak as

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it looks like when you're dealing with nursing home recruitment or seeing a recruitment all

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day, is that there are a lot of people, even without quantifying them,

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who, if you remove these barriers, they would be very interested.

36:53.587 --> 36:57.127
Are you bringing people into these nursing programs as

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well, or are you just connecting?

37:01.087 --> 37:05.157
I guess the question is there's

37:05.172 --> 37:08.902
a number? How many people are in this bucket of they're entering the

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workforce, they graduated high school, or they're kind

37:12.520 --> 37:15.892
of in between jobs, or they're busy with the family

37:15.940 --> 37:19.537
now they want to return to the workforce and

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they would love to become a nurse CNA and begin their

37:23.005 --> 37:26.347
health care journey, and they have these obstacles. I guess

37:26.380 --> 37:29.797
the question is, how do we get more people into the funnel so that they

37:29.830 --> 37:33.397
actually end up going along this path and

37:33.505 --> 37:37.372
solving this problem? I think one

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that will definitely help is as the industry

37:40.962 --> 37:44.422
has more people enter and then understanding becomes less

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of an issue, then some of the stigma around

37:48.340 --> 37:51.472
this is a really tough job. I'm overworked. I have to work so much over.

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Time starts to go away and it's more about taking care of

37:54.970 --> 37:58.477
patients who are now having a really great experience that

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don't have these violations of policies that

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people are kind of horrified to see the reputation of the whole industry improves.

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And we're starting to see this in some of the cities where we're biggest in,

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we have fully staffed some of our employers because they have hired

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people who that they sponsored and now they don't have staffing

38:17.517 --> 38:20.812
problems anymore. And we're starting to even see, like in the whole city

38:20.875 --> 38:24.517
as a whole now there are enough CNAs such that

38:24.565 --> 38:27.747
hiring becomes less of a problem compared to some of the other cities

38:27.792 --> 38:32.047
where we're just entering. And then that's the

38:32.080 --> 38:35.977
number one problem for nursing homes. That's very interesting. So a

38:35.995 --> 38:39.472
city that personally comes

38:39.505 --> 38:43.372
with sharing, you don't have to a particular city where the

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staffing is not really such an issue.

38:46.462 --> 38:48.650
Houston is definitely a big one.

38:50.512 --> 38:53.087
People are fully staffed in many facilities,

38:53.437 --> 38:57.287
which is crazy. That's not a little town.

38:59.287 --> 39:02.652
That's very interesting. So you're

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saying potentially that if you connect that's

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the thing. The most effective thing is sometimes very

39:10.990 --> 39:15.062
simple. So basically what the company is doing is connecting

39:16.162 --> 39:22.122
schools with employers. Right. And employers

39:22.167 --> 39:25.797
are usually just trying to pull CNAs from other buildings. Right. The typical

39:25.842 --> 39:29.502
recruitment is you're posting the job. If some of the CNA they're

39:29.532 --> 39:32.832
working most of them are working already as a CNA. And they're

39:32.847 --> 39:36.082
going to either try you out or do you as a second job or a

39:36.085 --> 39:40.167
part time job or whatever, and you're forever fighting with the facilities down the block,

39:40.302 --> 39:43.822
raising your rates to levels that you cannot afford or

39:43.855 --> 39:47.077
sustain. Hoping the government's going to bail us out, which do

39:47.095 --> 39:50.150
not hold your breath, because it probably won't happen.

39:50.512 --> 39:53.392
At the end of the day, if there's not enough money to sustain the business,

39:53.440 --> 39:56.225
the whole nursing can close down. And many of them have.

39:57.862 --> 40:00.952
You're saying this so simple solutions is not a theory, something that

40:00.970 --> 40:04.672
you've actually done. It's just by connecting the schools with

40:04.705 --> 40:08.047
employers in a very effective, seamless way that itself.

40:08.230 --> 40:11.892
You've fully staffed some of those clients,

40:12.027 --> 40:15.772
which is amazing. Okay. I find this very

40:15.805 --> 40:20.202
fascinating. I appreciate you sharing what you're doing here on the podcast.

40:20.382 --> 40:23.762
We're definitely going to share this with our listenership.

40:24.862 --> 40:28.850
Look out for that at the nursinghomepodcast.com.

40:32.212 --> 40:35.750
When you see an innovation like, how come I didn't think of it?

40:37.762 --> 40:40.262
This is a very simple concept,

40:41.962 --> 40:45.382
but it really makes a lot of sense. I definitely have to check out

40:45.385 --> 40:48.502
your website a little bit better and see if it makes sense for some of

40:48.520 --> 40:51.125
our clients to implement this.

40:52.762 --> 40:56.122
Amazing. Thank you very much for sharing that with us.

40:56.305 --> 40:58.175
Yeah, thank you for having me on.

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I'm just trying to think, if I know people who

41:06.957 --> 41:10.480
have facilities really struggling with staffing in particular areas, they want you

41:10.527 --> 41:13.290
to focus on getting set up in these areas.

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Is it just like grassroots effort that if people discover it is what it is,

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or can they work with you directly to try to create a network

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with injury bound if it doesn't already exist,

41:24.775 --> 41:28.420
we can do all of the above. I mean, there are definitely certain I

41:28.422 --> 41:31.540
mean, we're getting a lot of demand, I would say. So when we get more

41:31.557 --> 41:35.215
demand, we're prioritizing more than others, but we

41:35.232 --> 41:38.287
want to scale up to serve the whole country and millions of people.

41:39.475 --> 41:42.865
Amazing. All right, thank you so much. It's a pleasure meeting you and discussing this

41:42.882 --> 41:46.570
today. Keep it doing what you're doing. Thank you.

41:46.647 --> 41:47.600
Likewise.

42:00.625 --> 42:04.195
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42:04.272 --> 42:08.220
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