NIC Chats Podcast On the Road with Brett Landrum and Paul Jarvis

Lisa McCracken (00:03): 

Well, hello everyone. Thank you for joining us at the NIC Chats podcast. We are live from Washington DC at the NIC Fall Conference. Very excited to be with you here today. You can see the energy behind us, and I'm triple excited 'cause this is a three-peat. For those of you who don't know, we have ProCare HR, Brett Landrum with us, their CEO and founder. And this is the third time that we have been together for this. I think you're just back 'cause you like the headsets. 

Brett Landrum (00:32): 

That's right. Good company. 

Lisa McCracken (00:34): 

That's right. The conversation's gonna be great. The headsets look awesome. So we're gonna have some really engaging conversation today. So, before we dive into the conversation, I'm gonna ask the two of you to introduce yourselves, 'cause Brett, you've got a colleague here with you. Tell us a little about ProCare HR and your respective roles in the organization. Brett, we'll start with you. 

Brett Landrum (00:56): 

So my name's Brett Landrum, I'm the founder and co-CEO of ProCare. Really, at a high level, when we talk about ProCare, I like to start with the vision. The investment thesis and vision for our business is that people and people-related functions, and really enhancing the outcomes we can drive in those areas, can translate to outsized impact on the business outcomes our clients are trying to drive, which are quality of care, resident satisfaction, financial performance, and the capability to grow and scale. Everything we do is about how do we build a model that can produce superior HR outcomes, and how can we quantify how those superior HR outcomes translate to the drivers of our client's success? 

Brett Landrum (01:47): 

And how we position ourselves in the market is we have a foundational HR services layer. We're providing comprehensive HR services, every area of HR really optimized for senior care. On top of that, we have developed some unique solutions around labor and optimizing labor expense and controls in senior care. And then, as we're talking about today with Paul and his business partner Henry, we've recently made an acquisition of Claret to build a data muscle around everything we do. 

Lisa McCracken (02:23): 

And we're gonna talk about that a little bit. And I should know the answer to this, but I don't, so I'm gonna ask, are you guys solely senior living? 

Brett Landrum (02:30): 

So we are about 90% senior care. About 90% senior care and then 10% disability services. And there's a little bit of crossover when you get into dementia or different states where you might have behavioral health and senior care in a particular community together. But it's all, I'd say, senior care and a little bit of disability services. 

Lisa McCracken (02:52): 

Okay. I knew you were quite specialized in senior care, but I wasn't sure if there was some carryover to others. Alright, Paul, we've got a new guest this time. Introduce yourself. 

Paul Jarvis (03:02): 

Thank you. Happy to be here. I'm Paul Jarvis. I'm responsible for sales and marketing at ProCare. I joined the organization in May of this year via the acquisition of a company I had started called Claret. We did business intelligence for senior living owners and operators. We pulled together financial and operational data, payroll, CRM, chart of accounts, rent roll, and brought it into integrated systems and dashboards for analytics. When Brett approached me about potentially working together, HR is the largest expense item. What I had found from talking to operators and owners was it was also the place where they felt they had the least ability, the fewest levers into their business, and the highest degree of complexity. So it was an opportunity to take the technology we had developed and marry it to the expertise and service muscle at ProCare, like the people, the relationships with clients. So it was a really cool partnership. I've really enjoyed being part of the organization since May. 

Lisa McCracken (04:01): 

So when we chatted in advance of this a little bit, I was reflecting back on a year ago when we were sitting in Chicago doing this podcast. I remember asking you, I don't know if you remember this, so I'm gonna remind you, asking you about the role of data and analytics as it relates to labor and workforce management and so forth. And you said then, we have a vision for growing that, and we realize the importance and value of that data analytics. And I observe we're here and you've done it. So do you want to reflect back on connecting the dots of one year ago, saying, yeah, we're gonna commit to that, and now you have? And I think probably partly, and largely due to this partnership and acquisition, it's pretty cool. 

Brett Landrum (04:44): 

Yeah. It's really surreal. I mean, you look at ProCare, it's been around for 10 years, and if you would've told me we were gonna be doing what we're doing today eight years ago, I would've thought you were crazy. And so it's really, you know, there's a Jim Collins principle that there's no big winning move. There's not one thing where you just look back and think, oh, I made this really excellent decision, and the business suddenly transformed. The transformation is really a series of intentional actions and hard work over a long period of time. And then all of a sudden you look back and you're like, whoa, this is where we're at, and we're doing some really interesting and exciting things. 

Brett Landrum (05:29): 

And I think last year was a big year for us in getting really clear and focused on what the vision for ProCare is and the impact we want to have on the market. ProCare's really, I always describe us as a mission-based growth company. Growth is the conduit to being able to drive the change in the industry that we believe can be really impactful. And last year, we got really clear on that vision of how we're going to do it: getting really good at data and using data as the way to convince the market that people functions are not just important, but critical to do well. And then, number two, providing the insight on where to resource both financially and with sweat equity into those people functions to drive the business outcomes we're looking for. As we got clear on that last year, data was a big part of it. What I didn't appreciate at the time is that, in our organization, we had absolutely no technical expertise in data. 

Paul Jarvis (06:35): 

<laugh>. 

Brett Landrum (06:36): 

And so we created this really grandiose vision of, hey, we're gonna build this data platform, we're gonna be wildly successful, and it's gonna drive all these great results for our clients in the marketplace. We got into Q1 and we're like, we have no clue how to actually do this. We're in trouble. I was fortunate enough that we have really great customers, and one of our larger clients, who was actually a client of Claret, was giving me some ideas and advice and said, you really should talk to Claret. And that was how it all came about. 

Lisa McCracken (07:14): 

Yeah. Well, you know, so much of success, and with any leaders, is through those partnerships and recognizing where we can fill in the gaps. And having a partner who does know the data, I think, for your clients is tremendous because it can be incredibly daunting and overwhelming. And I wanna talk about that a little bit. So you had shared that you have about 20,000 customer employees? 

Brett Landrum (07:36): 

We're probably sitting around 20, 22, 24. 

Lisa McCracken (07:40): 

Wow. Okay. So that's significant. And as somebody who's a researcher, and I like numbers too, that's a wealth of data and information. So can you share some perspective on what's most valuable about that data pull, and how do you use it? What do you see as some of the key pieces to pull out of that? 

Paul Jarvis (08:00): 

Yeah. My experience has been, there's a couple of ways that people always want to use data. One of them is essentially, am I doing a good job? And that's a combination of benchmarks, trends, industry averages. Are you hitting your targets consistently? So that's one category. The other piece is really around operational improvement. And I think there are certain areas in this business, scheduling is a great example where the rubber meets the road. Same thing with talent acquisition. These are high-volume, day-to-day tasks where if you look at it on a dashboard, you say, okay, that's my schedule, that's my hiring pipeline. But how are you actually using that information? It doesn't really help you to say, oh, here's my agency spend. What you want to say is, where do I want that number to be? 

Paul Jarvis (08:44): 

If I want this one to go down, what are the levers I have available? And so I think that has been the mindset shift we've been working on. I had a mentor where I started my career at Palantir, which was a little startup then. It's now in the SB 500, a big data analytics company. But he would always say, you never have a dashboard without a decision. And I think the trap a lot of software and companies fall into is you have a really shiny dashboard, but what do you do with it? So, operationalizing that data, particularly in these high-transaction areas where the money goes out the door, or where decisions get made around recruiting and scheduling, those are the biggest opportunities. 

Lisa McCracken (09:23): 

Yeah. There are a lot of empty dashboards out there that serve the purpose of a monthly report or informing a weekly update, whatever it might be, but it stops there. 

Paul Jarvis (09:33): 

Exactly. 

Lisa McCracken (09:34): 

You mentioned the scheduling piece. The organization has made a very specific commitment to being a partner on that front. So frame the problem you're trying to solve there. What are our challenges on the scheduling side of things, if you were to boil it down to some key issues? 

Paul Jarvis (09:53): 

Do you wanna take this? 

Brett Landrum (09:55): 

Scheduling in senior care is so complex. The reason it's so complex is, number one, you're dealing with human beings who are unpredictable and sometimes unreliable. You've got a dynamic and fast-changing need to meet. Our census changes, our acuity changes frequently, our pay by employee can change on a regular basis, and employee status changes quite frequently. Actually getting the schedule right takes triangulating a number of different variables all at once in order to get the schedule right for the future. And now here's the real challenge: that changes every single day. 

Lisa McCracken (10:45): 

Within the day 

Brett Landrum (10:46): 

365, 24/7. It's constantly changing. And we're asking schedulers who typically don't have real analytical training to come in and compute a number of different variables all day, every single day. That is going to control a large part of our financial success. So really, the problem comes down to a complex environment, a lack of skills and training to meet the needs of the job, often a lack of data availability, and then resourcing it from having the focus and discipline to drive it day in and day out. We talk about labor as the tree you never cut down. It's never done. As soon as you take your eye off the ball, as soon as you lose discipline or focus, you see a pop in overtime or agency, or shift bonuses, whatever it might be, or your HPRD goes up. It's just a really hard area to be consistently good at. 

Lisa McCracken (12:00): 

How much are you dependent on that scheduler? I mean, it's not like people come in with a bachelor's degree in scheduling, and candidly, it's probably not the sexiest job. I would suspect that when a scheduler leaves, it's like a bit of a starting over point. Yes. 

Brett Landrum (12:16): 

It's arguably the hardest job in senior living. You're constantly going after employees, trying to beg, borrow, and steal to get shifts filled. In a number of scenarios, the scheduler is the backup if a shift can't get filled. And you're dealing with people's lives. It's not like, oh, we're just going to have this particular checkout lane closed. It's, hey, if I can't fill the shift, we could have a real health problem. 

Lisa McCracken (12:44): 

Right. So where does your platform help mitigate some of that? Where are the solutions coming into play? 

Paul Jarvis (12:51): 

Sure. I can't give away all the secret sauce, but we'll go through it. 

Lisa McCracken (12:56): 

Just wet the whistle a little bit. 

Paul Jarvis (12:57): 

Exactly. So essentially what we do is take data from two places: the payroll system and the scheduling system. We bring it into a proprietary data analytics engine that we've built, which looks at the leading drivers of labor cost. Things like how far ahead are you able to build a complete schedule, or what percentage of your employees have not used all their regularly available hours before you start getting into overtime. Some of those are more predictive than others, but essentially you look at the largest drivers first. Then we have a group of people on staff with deep operating expertise, whether it's building schedules or, for example, one guy was the CRO at a large organization. They provide expert coaching and support back to the organization. So it's the combination of using a good scheduling software, looking at the right pieces of data, and providing coaching on a very regular and timely basis that creates the flywheel. We have the inputs, the analytics, and the follow-up. 

Lisa McCracken (14:00): 

Yeah. I love that integrated model because I think there are some solutions and platforms out there that just end with, here's our plug and play. But that coaching piece and that onsite piece is critical to where the rubber hits the road and making things move the needle. Do you have any move-the-needle stories or use cases you want to share? Because at the end of the day, it's about improving operational efficiencies, improving the employees. There's all those things you talked about in the beginning, but you're doing it right. There's some cost savings in there because it's a big cost strain if you got the scheduling wrong and messed up. So talk to me a little bit about some of the successes you've had. 

Brett Landrum (14:42): 

We have a really fantastic partner, a client of ours. They have a number of different communities, and they have a very large skilled facility, about 380 beds. It's a great community with a long, storied history, but it's got a ton of complexity. They brought us in to be their HR partner, and we've developed a fantastic working relationship with them, which is part of the reason we were able to get to the results. With that particular organization, in about 45 days, we took them from a 4.2 HPRD to a 3.6. We eliminated just under $120,000 per payroll from their labor cost. That wasn't agency; it was overtime, overstaffing, shift bonuses, clock creep, etc. So it was about $3 million a year we carved out. 

Lisa McCracken (15:49): 

That's not jump change 

Brett Landrum (15:50): 

No, and I'll say, we can do all of the right work, but to this organization's credit, they're a fantastic partner. The type of organization that will call and say, "Hey, what do you need to drive the outcomes?" We give them a barrier, and they remove the barrier. They look at us as a member of their executive team, as part of their organization, and it's allowed us to collectively drive really fantastic results. 

Lisa McCracken (16:22): 

And I want you to elaborate on that to the extent you have some additional thoughts. What makes a fantastic partner? Because, again, you guys can do your part, but there's still dependency on those boots on the ground and those folks in the community. So what makes an ideal partner? 

Brett Landrum (16:38): 

I think anytime you're outsourcing or choosing an HR partner versus having an in-house solution, it's a big cultural shift, and that's hard to overcome. So having executive buy-in across the entire executive team to say, we're committed to this, and this isn't an option, and this isn't a trial run, ProCare is our partner. ProCare is part of our team. We're gonna look after them, and we're gonna be invested in their success just like they're invested in ours. From a philosophical perspective, there's gotta be a degree of comfort and buy-in that we're getting married and staying married, so we need to figure out how to work this out together. Then, on a more operational level, it's having the connectivity and working relationship where we can call and say, here's a barrier we have with a particular leader on your team. 

Brett Landrum (17:33): 

Here's what we're observing. We really need support on removing this barrier or overcoming it so that we can drive a particular outcome. This particular organization, we met with them every single day for 90 days, just on labor. Their head of operations was on that call every single day for 90 days. The messaging to her team was, this is important. This is a priority. We have a high degree of trust in ProCare. The last aspect is a level of vulnerability and trust. They're willing to come to us during these discussions and say, I'm not sure what to do here. What do you think? And then the trust and willingness to have that back-and-forth dialogue and problem-solve with us, using the collective intelligence we've amassed over the last 10 years. Bringing in a great team, great people, and experts, that's available to all of our clients. By and large, our clients are great about being open to tapping into that. 

Lisa McCracken (18:44): 

Do most realize they have a problem? I mean, workforce obviously, it's not like everybody's saying, oh, it's going great and there's a select few that are struggling. But do you think they necessarily have that insight into where the problem areas really are? 

Brett Landrum (18:59): 

Yeah. I, 

Lisa McCracken (19:00): 

Because I perceive that sometimes there's just this paralysis. Like, we don't know where to start. We've got challenges. We know what our payroll looks like, we know what our turnover looks like, and we're scheduling on paper and pencil. I'm just curious. 

Brett Landrum (19:13): 

It's like there's a perpetual staffing shortage nationwide. So everybody knows we have challenges with staffing. From a labor perspective, all the operators we interface with are looking at overtime and agency use. They're looking at all of the key financial drivers within labor on a regular basis. I don't know that they always have the data they need to say, we see what the problem is, but what are the inputs into the problem? What are the leading indicators that we need to address to fix the problem? 

Lisa McCracken (19:52): 

Yeah. So if I'm someone just getting started on this journey, and let's talk specifically around the data and analytics, and I know I'm weak with that, what suggestions do you have for organizations that are just beginning to go down this path? Maybe Paul, we'll start with you and Brett, you can add on. 

Paul Jarvis (20:10): 

I would always say be simple. I think it's very easy to run away with complexity when it comes to data. There's also a technology piece and a process piece. Something we often run into is, does everyone on your team agree on what metric for turnover we're measuring? Are we gaming it? 

Lisa McCracken (20:25): 

I've seen so many formulas for turnover, but go ahead. 

Paul Jarvis (20:28): 

Yeah. So like, is it turnover? Is it retention? Is it 90, is it 180? Pick the North Star for your organization and start there. Build a culture around, we're going to have good data that we look at. We're going to make a decision with our dashboard. We're going to actually look at it as a group together, and then layer on increasing complexity. I think you can only solve a few problems at a time. So you have to say, what are we trying to do? Is it get agency down to zero? Is it retain the staff that we're hiring for a longer period of time? Is it optimize labor? That would be my advice for folks who are just starting: keep it simple, keep it prioritized, and it's always easier to get more complicated. It's a lot harder to strip stuff back because you can get addicted to a dashboard with lots of widgets, even if it doesn't do anything for you. 

Lisa McCracken (21:13): 

Right. Is there anything organizations can do to be a little more proactive, even in terms of what they're measuring? Because I suspect you probably have organizations across the board where some are already measuring this, and others are starting with no data. There's a "junk in, junk out" element to it too. So from a data sophistication standpoint, let's just start with collecting the data. Any words of wisdom on how to build that infrastructure, keeping it simple, starting simple? 

Paul Jarvis (21:44): 

You need to pick software that's easy to use. That's a starting point. You need to train the folks, and you need to make an expectation that it's part of the job. I think carving aside specific amounts of time for data input is important, but really, there needs to be a review. If people know you're not doing anything with the data, there's no incentive to enter it correctly. Why would you do that when you have a lot of other responsibilities? That's where creating these mini feedback loops within an organization is key. If people know the data they're providing is being used in a way that benefits them and the organization, and they're rewarded and coached for it, it changes things. Some of the most successful groups we worked with at Claret created bonus scorecards based on hitting certain KPIs. If you weren't entering the data in, you wouldn't have the data coming out, and you wouldn't unlock the bonus. It's little opportunities like that where you say, I don't expect you to do everything, but these are the things I need from you because it's on top of their day job. People have to understand the context. 

Lisa McCracken (22:44): 

Right. And people get pulled in so many different directions. You get sucked into the weeds really quickly in some of those day-to-day positions. This may be my stupidity, but what positions are you dependent on to enter the data? When you're talking about incentivizing people to be contributors to data, who are we talking about here? 

Paul Jarvis (23:03): 

At the community level, you're talking about the scheduler, the business office manager, the executive director. If you're doing acuity-based scheduling, which we do in some areas, like in Oregon where you have to do that, then you also require the nursing staff. So, you get the point, it's kind of everybody. It's not just one. 

Lisa McCracken (23:18): 

Person line drum in the sand. Okay. 

Paul Jarvis (23:19): 

And that's where it's a cultural expectation, right? That this is something we care about—accuracy, and as an organization, being well-run, being operationally efficient. That starts from the bottom, and it starts from the culture at the top. 

Lisa McCracken (23:33): 

Right. So for an organization that's in a place where they're like, you know, ProCare, that platform sounds great, that integrated model, but we just don't have the resources right now. Brett, what could I do on my own? Is there anything you know, that either of you have suggestions for, in terms of, Hey, here's a great starting point, whether it's ProCare or not? 

Brett Landrum (23:56): 

Yeah. I think particularly related to labor, I'll narrow it from data broadly to labor specifically. It's really getting tight to Paul's point about what are the handful of really critical inputs we want to measure. The important point there is, what are the inputs, not the outcomes? Everybody's going to know their overtime, shift bonuses, agency, etc. But it's about the handful of inputs we can action every single day and create a cultural emphasis on getting better at. I had a college coach who used to talk about getting better 1% a day, and if you get better 1% a day, at the end of the year, you're a whole lot better. I think you take that same approach to labor. What are the handful of inputs that are really critical to reducing overtime, hitting my HPRD numbers, and getting agency out? What are those behaviors? How do I measure them? And then you just work on them over and over again. As your team develops the muscle around a couple of those and gets really great at it, you reward them, acknowledge them, and then add a couple more. 

Lisa McCracken (25:10): 

I wanna get up on the balcony, like 10,000-foot level, just on that agency piece. What I'm hearing and observing as an industry is that things have gotten a little better. 

Brett Landrum (25:19): 

Quite a bit 

Lisa McCracken (25:19): 

And the agency usage, I think we hear a lot of variability still across operators. But I also hear, okay, we're less dependent on agency usage, but our own internal overtime is killing us. So we're just shifting the dollars to our internal staff. Have you seen groups create their own internal agency pools and have success with that? 

Brett Landrum (25:39): 

Yeah, we have. There are some natural challenges that creates. Like from an incentive perspective. 

Lisa McCracken (25:49): 

You're robbing, you know, 

Brett Landrum (25:51): 

Employee. Well, if I'm an internal agency employee, I'm probably gonna get paid a little bit more. So, do I want to work a normal shift, or does everybody want to be in the agency? I've talked to some operators who've done it successfully, and I've talked to a few who used to do it and then eliminated it. My belief on labor is that really successful labor performance comes down to two things. Number one is having a really strong and consistent talent acquisition function, so we're getting the volume—sounds very cold, but the units of labor—in. Then it's the discipline, the data, and the follow-through from an execution perspective on how we are optimizing and deploying those units of labor. That's the secret sauce. We have to be able to do both of those things well and consistently, and measure what the inputs are and how we're tracking on both fronts. 

Lisa McCracken (26:49): 

Yeah. Okay. I got a final question for you. If we're here a year from now, what's the vision for ProCare in the next year? Where are you headed? What are you thinking of doing? Talk to us about that. 

Brett Landrum (27:06): 

Paul's very nervous right now. 

Paul Jarvis (27:08): 

I was gonna say, 

Brett Landrum (27:08): 

What's about to come out of my mouth? He, he 

Lisa McCracken (27:11): 

We're releasing the new strategic plan right here alive. Yeah. 

Paul Jarvis (27:14): 

He Brett's about to write a blank check that I have to go cash after this. 

Brett Landrum (27:17): 

That's what he always accuses me of. Really, for the next 12 months, it's continuing to work on and grind on being best in class at labor. It's having a solution that isn't available in the market, one we're able to quantitatively prove produces material results, where we can go into an organization and change the financial trajectory of the organization. That's where we're heading. We have a lot of the pieces in place. Now we just have to accelerate the development of those products and services and, frankly, just execute. We have a lot of great clients that are buying in and trusting us to do this. Now it's like, we've talked a lot about where we want to go. It's time to show up, do the hard work, and drive the results. 

Lisa McCracken (28:06): 

Well, it's been great to see you grow, and it's been great. I think the addition is just a perfect alignment with where all of you need to go. So, thank you for your time. Any final words of wisdom, Paul? Any final comments? 

Paul Jarvis (28:21): 

No, this was a great conversation. Thank you for having us. 

Lisa McCracken (28:23): 

Yeah. Well, thank you, Brett. We wish you the best of luck with the rest of the conference, and until we sit down and do this again. Really appreciate it. We appreciate everybody joining us today with the NIC Chats podcast live from DC. We look forward to seeing you again. Enjoy the rest of the conference.