This article is sponsored by ShiftMed. In this Voices interview, Skilled Nursing News sits down with ShiftMed CEO and President Todd Walrath to learn how SNFs can drive ROI by offering caregivers flexibility through technology. He also shares insight into how ShiftMed is providing easier access to credentials so SNFs can up flex census without worrying about a shortage in labor.
You’ve been in the post-acute space for over a decade, and are now CEO and president of ShiftMed. What are the most valuable lessons you’ve learned?
Todd Walrath: There are a couple of unique things about health care that anyone pursuing this field should know. First, you should do everything you can to position yourself from a quality and reliability standpoint. That’s what people care about when they are deciding who to work with. Most people in health care stay in it their whole lives. You’re going to get one shot, and you better take full advantage by delivering quality and reliability to your partner.
Second, you always want to set your company up as a giant antenna for customer feedback. Whether that’s related to product development, feature, functionality or competitive pricing, most of the successful companies adapt to what the market needs over time.
That’s something I’ve tried to focus on in all of my companies by constantly asking our clients how we are doing. Do they anticipate renewing their contract with us? If not, why? If so, why? Constant feedback from the marketplace is crucial.
Tell us about ShiftMed. What is its mission and whom does it serve?
Walrath: Our mission is to help caregivers earn a living doing what they love, when and where they want. That mission captures the spirit of the flexibility that we’re trying to build into our service. Our audience is almost exclusively health care professionals. We subscribe to the Richard Branson approach to management, which is, if you have happy workers, you’re going to have great services to offer your partners, and that rings true here too.
Rather than just saying, “Well, let’s make our partners really happy,” we want to give them empowered, engaged caregivers who show up on time and care for the rising senior population. That’s what ShiftMed is designed to do.
You have an interesting perspective on the skilled nursing industry, because you’re able to see it through the eyes of the fleet of contingent workers that ShiftMed places in SNFs. What does the industry look like through the eyes of these workers? What do they tell you about what they see?
Walrath: The post acute space is different than it was 12 or 13 years ago. COVID brought about a change where you saw caregivers being celebrated for the work they do. Historically, “unskilled labor” is the label the industry used for the type of work those people do. However, in a skilled nursing environment, most of the work being done falls on the frontline caregivers and CNAs.
My advice to the industry is to change your relationship with contingent labor. It needs to be an extension of your team. There were 23 million contingent shifts worked in SNFs last year, according to CMS, so it’s a large percentage of the shifts that are worked. It’s not every building and it’s not every shift, but it’s an important complement to compliance.
Our clients have unpredictable census, so the ability to flex their team is important. They need access to a credentialed and compliant workforce, because they’re not going to carry and pay people who aren’t working.
They don’t want to constantly hire and lay people off. Platforms that allow access to that labor have never been more important, because the demand for workers isn’t going away anytime soon. The workers want what all workers want — to earn a living. They want fair compensation for their time, and they want to feel like their role is important in the care that’s delivered.
We have 60,000 workers on our platform and we survey them constantly. When I look back at the results, the number one thing they’re seeking is flexibility. Can they do 12-hour shifts instead of eight-hour shifts? Can they work four days a week, 12 hours a day, rather than five days a week, eight hours a day? They’re providing care for their families and most of the caregivers are female, so they’re caring for their own children in a traditional sort of American family structure.
We’re trying to win their hearts and minds by giving them choice. What shift do they want to work? Can they choose their commute? Can they pick locations that are near public transportation? Can they work around their other responsibilities so they can earn a living? They’re passionate.
You don’t choose this line of work because of the rewards or financial benefits. You choose it because it’s your calling, because somewhere in your DNA, caregiving drives you to give to others. Most of the people who do this longer than a year or two are in that bucket.
You’ve said that workers like ShiftMed for three reasons: choice, easier access to credentials, and next day pay. Let’s talk about the first one: choice. What is the significance and value of choice for workers with ShiftMed?
Walrath: All health care providers need additional workers right now. Literally, all of the buildings, whether it’s a SNF, a hospital or even an assisted living facility — they all need help. We’ve been able to go out and connect with all those providers.
We almost have one thousand providers in our network now. When you go into some of our major markets — Philly, New York, Chicago, Atlanta — there are thousands of shifts to choose from every week. That allows you as the worker to customize. Hourly pay, proximity to your mode of transportation and even work type are all factored into your choice. The power is in your hands. When you work at one building all the time, you only get the dynamics of that building.
How does ShiftMed help smooth out credentialing challenges?
Walrath: The workforce is constantly timing out of their credentials on an annual basis, and even if your workers aren’t leaving you for greener pastures, managing that flow can reduce the number of available workers.
We have created a modern way to remind caregivers of upcoming expiration. Now we can say, “Health professional A, your license is expiring on September 1st, 45 days from now. We’re going to give you enough time to go get that credential because we don’t want any interruption of service or interruption of earning for you.”
We also modernized the actual transaction of getting a credential. For example, our workers can take the app and their QR code down to CVS, get a TB test for free and upload the results overnight. You don’t even have to send us the piece of paper that CVS emails you — we get a copy of that. Then we send you a text message that says, “Hey, got the results of your TB test. You’re ready to go, start swiping and working again.”
There’s a couple of ways that we’ve modernized the credential experience to keep workers eligible so they can keep working and earning. This ensures they’re available to us and all our partners.
Why is “next-day pay” such a game-changer in the SNF world?
Walrath: Next-day pay is an approach hourly employers can use to better satisfy their labor pool. Most caregivers get paid every week if they’re lucky. A lot of them still get paid every two weeks or twice a month, right? Most caregivers have two jobs already because unfortunately, they can’t earn a living doing what they love with one job.
Sometimes, they need a second income to pay their bills on time. In this category, most of the caregivers are using payday loans or even running up credit card debt at high-interest rates. It’s because of access to funds. Ironically, they may have worked every day for the last two weeks, but they have to put their groceries on their credit card, which already has a balance on it because payday is not until Friday.
Next-day pay enables you to get access to your cash whenever you need it in real time. You work a shift, you hit the “next-day pay” button, and at midnight the money goes into your account. It’s just like a direct deposit on your normal payroll, but every day is now payday if you want it to be.
More than 50% of our workers in a given week use our next-day pay platform to get funds earlier than Friday, which is payday for us. We love that they’re using it because it means that they’re enjoying that flexibility. We also don’t use a third party banking application. We don’t make you download two apps and sync them, because that’s complicated.
We made it simple. At the end of your shift, the amount of money you’ve earned is going to be there, and if you want to put it in your bank account for free, there’s no fee. We don’t take a piece of it. We’re not trying to create this as a product or a revenue stream. We just want the workers to be happy.
What’s coming up next for ShiftMed, both for the remainder of 2021 and in 2022?
Walrath: We continue to work with our partners, so we are completing a national expansion. We’ll be in more than 50 cities by the end of the year, so it essentially gives us a national footprint. Our partners are national, and we want to be able to follow them and service them in all markets, not just some of the ones that we’re in.
We are one of the few platforms that offers both in-facility and in-home shifts on one platform. Our at-home shift count is increasing dramatically as well. We’re creating more choices for the workers. About 40% of the workers on our platform have also worked in a home care setting.
We want to find more options that please our target audience, which are these 60,000 workers, so that’s in the works. We’re also adding new worker types, expanding into LPNs and RNs. We envision that, as our partners need other types of workers, we’ll expand into other areas, such as ShiftMed Therapy, which is a therapy line for physical therapists, OT, speech, infusion and everything that’s adjacent to the workers we already engage.
Entering this year, no one knew fully what to expect in skilled care. What has been the biggest surprise to you in the industry in the first half of 2021, and what impact do you think that surprise will have in the industry throughout the second half of the year?
Todd: Unfortunately for the skilled nursing industry, the most vulnerable people to the COVID disease were the ones in their care. They were disproportionately impacted by the outcomes of this disease, which is a terrible thing for the industry to have to overcome.
Now I feel like they’re leading in terms of the protocols. I think some of the most advanced thinking is around how to manage vaccines and promote safe environments within their world. I’ve been pleasantly surprised with how responsive large health care companies have been to changing the way they do business.
I am excited about how analytical our clients have become. They’re looking at the numbers, looking at their shift fulfillments, looking at their cancel rate, looking at their rates of pay against their competitors, and really understanding the drivers of their business.
I thought, “Well, this snuck up on the industry. Can they change the way they do business to stay on top of this?” They did. If we can be a more data-centric industry and use the data that we have to determine the outcomes, it will be a win for all of health care.
Editor’s note: This interview has been edited for length and clarity.
ShiftMed offers a uniquely efficient and user-friendly approach to on-demand staffing for the health care industry, with 90%+ show rates. To learn more about how ShiftMed can help your staffing efforts, visit shiftmed.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].