24. Kevala- Flexible Workforce Management for Senior Living Communities

In this episode of Raising Tech, our host, Patrick Leonard, has a great conversation with Kevala’s Co-Founder and CEO, Todd Owens, about how Kevala’s flexible workforce management platform connects Senior Living community operators with preferred agencies and an internal float staff with automated scheduling, timesheets and credential management.

Discover how Kevala is changing the future of the workforce for healthcare operators and increasing workplace satisfaction for healthcare workers.

Raising Tech is powered by Parasol Alliance, The Strategic Planning & Full-Service IT Partner exclusively serving Senior Living Communities.

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Patrick Leonard:
0:04

Welcome back to Raising Tech podcast about all things technology and senior living today. I’m your host, Patrick Leonard, and I’m really excited to welcome our guest today, Todd Owens, who is the co-founder and CEO of Kevala. Todd, welcome to the show. Thanks,

Todd Owens:
0:18

Patrick. Great to be here.

Patrick Leonard:
0:20

Yeah, we’re really excited to have you. I’m, I’m really interested to learn more in educate our listeners today on our topic, which is really around workforce management. Obviously this is currently and likely always will be a huge topic for the senior living industry. But before we dive into that, Todd, can you take a minute just to introduce yourself, your background a little bit, and tell us a little bit more about how Kevala came about?

Todd Owens:
0:42

Sure. Yeah. So my roots go back to the Navy. I actually grew up in a Navy family and, and, uh, was a submarine officer for about five years back in the 90s, realized that bureaucracy is not my thing. And so went to business school and, and became a product manager. And I would say, uh, product management experience at Oracle set me down the, the technology career path. I’ve always gravitated towards more growth stage companies, and that ultimately led me to my first CEO opportunity. So I guess I, you know, I, I I, I am either crazy enough or lucky enough to have been a CEO four times over, this is my fourth, again, I’m the co-founder and CEO of Kevala. After exiting my last business, uh, which was Azuqua was a future of work integration platform. Found myself on the beach and, you know, kind of wondering what what am I gonna do, uh, with the rest of my life? And, I, I paired up with Pioneer Square Labs. It’s a startup studio here in Seattle. There’s a great guy named Greg Gottesman, founder of Rover.com, our our favorite pet sitting site. He said,”Hey, Todd, you know, let’s sit down, you know, it’d be fun to build a business together,” and I knew I wanted to, to do something related to the workforce. I guess, you know, now I’m in the back half of my career, I’ve decided that I’m, it’s pretty clear to me the quality and the engagement of your workforce is really what drives success in business. And so I wanted to get back to doing that. It was the first company I ran, but then there were two others and they were more infrastructure and technology platforms and, and they were great. They were very exciting, but they didn’t touch people the way that I had always wanted. And so, you know, we sat, sat down in early 2020 looking at workforce dynamics, things that are going on, like for example, the increasing gig economy, the aging population, compliance and regulation, and how much friction that adds in the, in the kind of the, the process of, of building and engaging a workforce. And lo and behold, one day in February, maybe it was late January 2020, covid started to spread, and so, that, that notion, I think sort of was the icing on the cake that we, we should really dig deep into healthcare. You know, you turn on TV, CNN, and they were saying facilities needed to hire more nurses, right? And so we wanted to explore that and, and that’s how we did. We, we started talking to healthcare facilities whether they be skilled nursing or senior living. We spoke to hospitals as well, and we found the same thing. They were all looking for nurses. And so then what’d we do? We went to the other side, let’s go see if we can recruit nurses. And so we took a, a social media approach to recruiting nurses and we asked them, what are you looking for? Lo and behold, they had a capacity and a willingness to do more. And so that was the big aha moment for us today in healthcare, the way that healthcare facilities connect with various labored pools is very manual and it’s very fragmented. And oftentimes the operator doesn’t realize that right around the corner there’s a nurse that would love to pick up the shifts. And if we could get right into the middle of that and do that using technology, not text messages, not emails, not phone calls, that we might be able to be a better, do a better job of, of matchmaking, fill more shifts, um, and keep costs down. So that was the, that was D1 of Kevala that came out of Pioneer Square Labs.

Patrick Leonard:
4:09

That’s awesome! Thanks for sharing that background. I think that’s really helpful. And, and I learned a lot there just in that short nugget. And I think it’s interesting what you said and really valuable how you took really dove into depth on both sides and both perspectives of the operator as well as the nurse or caregiver. Cause a lot of times I think there is a huge disconnect and misunderstanding that, you know, people may say things like, there’s, there’s not enough demand for these jobs. These people don’t want to work, or, or whatever it might say. That just, you know, clearly when you hear things like that, you understand that they don’t necessarily know the interest of the industry or have taken the time like you all did to understand both perspectives. So I think that that’s really helpful and valuable that you shared that with us.

Todd Owens:
4:52

Yeah, no, for sure. I think that, you know, the workforce is changing and, and organizations that recognize that and adapt to meet the workforce where they are, are gonna thrive. So for example, in esp, and this was all exacerbated during COVID, their, their need for flexibility and control over their schedule, right? Whether they are student or a stay-at-home parent, you know, or maybe they, um, you know, aren’t looking for a full-time job or don’t want the pressure of being worked full-time and then asked to do overtime. An increasing percentage of the workforce wants that flexibility and control. So what we’ve seen is that there’s almost been a, a shift away from perm roles where they don’t have as much flexibility and they’ve got a lot of pressure to roles that give them that flexibility. And some of those are labor marketplaces. And you know, and candidly that’s how we, that’s how we cut our teeth at Kevala, right? Was as a labor marketplace ourself putting qualified, certified, um, RNs, LPNs and CNAs into shifts. You know, where are they coming from? It’s possible that they were coming from our, and they were, were looking for that freedom, that choice and that control, that option to work when and where they want to. And so the key here, and this is, you know, what I hope we can talk about is that, you know, we need to develop software that helps the industry deliver that same flexibility to their own employees so that they don’t have to go elsewhere to get what they’re looking for.

Patrick Leonard:
6:17

Yeah, that’s fantastic, and, and that kind of dovetails well into Kevala, hopefully, and, you know, the problem that you all are trying to solve. So for our listeners who aren’t as familiar, can you just give us a high level overview of what Kevala actually does and what it hopes to accomplish as it relates to all these things we’re talking about specifically in the senior living study?

Todd Owens:
6:39

Yeah. Highest level, the mission of Kevala is to improve the quality and cost of healthcare through smarter workforce management, right? If you look at the cost structure in the industry, over half of it is labor. And so it goes without saying that by bringing more intelligence, more data, more automation, more efficiency into that we can actually make care more accessible, whether it’s private pay or whether it’s, you know, a state funded facility. You know, we need to do more with less, not just because the talent’s not there, but because we need to keep it affordable for everybody. So that’s, that’s what we’re doing at the core of what we do. It’s about connecting, it’s about connecting labor pools to a schedule in a very inde, uh, in a very intelligent way. So as to whether or not it’s a permanent staffer that fills the shift, or if it’s a third party agency or another labor marketplace or the Kevala’s Care network, right? Our, we’ve got several thousand W-2 nurses that are there to fill shifts as well. We put the controls in our client’s hands so that they can achieve their outcome, right? And ultimately, I think we all know that the goal is to get agency to an absolute minimum, right? Especially in this industry. There’s not a ton of volatility as it relates to the census. And so we’ve gotta be smarter about making sure that those shifts are exposed in a very convenient and friendly way to the internal staff before they get opened up to, to third parties. And that’s what our ho our software’s gonna do. It’s interesting because on one hand, you know, we, we built our initial revenue stream around a labor market. And on the other hand, what I’m telling you now is that our objective is to, is to get to the right mix of agency, which may not be zero by the way, right? There’s, there could be the right mix. You could, you could argue that zero agency, you might be overstaffed too much agency, you’re probably understaffed, not recruiting well enough, but we wanna help our clients get to the mix that is right for their, their operation, their business.

Patrick Leonard:
8:34

Yeah. That’s interesting cuz you do hear about all those different factors, you know, the, the internal labor pool, the labor marketplace agencies. And so I haven’t heard a, an approach today that kind of integrates the best of all the worlds together. Are there other folks like you out there doing this? And can you tell me a little bit, bit more specifically about when you work with a organization, how do you work with them to find that magic mix between those different parties? Right. Can you tell me a little bit more about

Todd Owens:
9:05

That? Yeah, it’s interesting. So first of all, um, your various to, um, the, the unique value proposition of Kevala is that we are able to bring all of the facets of the workforce together. So there are vendor management systems that can help to bring the agency side under a single roof. Although VMSes tend to be more appropriate for hospitals cuz they tend to be big clunk, and there are scheduling applications that do a pretty good job of the, the permanent staff, right? Scheduling them. But how, you know, at the end of the day, it’s one shift, right? It’s one audit, one compliance audit, it’s, you know, it’s one P and L. And so how are you going to actually measure and understand where you are and where you wanna be if you don’t bring it all together? And so that’s a very core aspect of our strategy. We ha we have no choice but to go broad all the way across the workforce as it relates to, you know, how do we help to establish that proper mix. A lot of it is, you know, helping them to know where they are. You know, if you look at, um, the, the scheduling mix today, there’s a pretty good understanding of where, because you know, whether it’s on shift or you know, Paycom or Smart Links, they, they have really good management reporting and so you’ll know exactly what’s happening there. But then there’s everything else. The agency A, B, and C that each sent a nurse in as well. Oftentimes they don’t know who worked and when and how much until the invoice arrives. And unfortunately the invoice can show up sometimes 60 to 90 days later. So in a world where you’re trying to match the, you know, the schedule to the, to the census and the acuity and you’re trying to control costs in a very sort of thin margin business, and you have to make sure that you’ve got the right staffing ratios to, to sort of deliver the care and stay compliant, you know, it’s, it sort of, it’s do that without the data. And so by virtue of bringing it all together and creating these dashboards at the, at the community level, but then also at the home office level, at least they know where they are, right? They can identify problem areas or locations that might be struggling or they can identify opportunities to recruit a full-time person because you’re using agency in the same pattern week over week. There’s an opportunity to hire. If you don’t have the data, that stuff just isn’t gonna jump out at the scheduler. They’re, they’re sort of struggling to survive, right? 24 by seven job really. And so I’d say a, it’s data and second of all, um, you know, we um, we have a, a sophisticated tiering engine in our product, which effectively allows the, the shift to hit our platform and then go through a very sort of sequential marketing process to agencies. So the worst thing you can do is get into a rhythm where you take shifts that are four or sometimes even eight weeks out and publish them to agencies. Agencies should be there for a last minute use. It’s not there for eight weeks out because geez, eight weeks from now you might be able to hire three or four people to fill those shifts. And then you say, well, well then we’ll cancel the agency. But in reality, schedulers know that you can’t just start canceling agency cuz then the agency won’t work very hard for you. They’ll assume they’re gonna get canceled. And so, you know, I believe that this problem is, it’s a scale problem. There’s simply too many shifts coming and going with too many agencies, too many communications, all manual that you just can’t technology helping you. And that’s so setting up the right tiering so that shifts are exposed to agencies in a logical order so that they’re working on only the shifts that are of utmost importance and that ultimately you get the highest quality, lowest cost nurse into the shift is what the industry needs. It’s automation over, you know, it’s kind of the future, right? Is let technology do what it’s good at so that, you know, people are left to do the rest.

Patrick Leonard:
12:58

Yeah, definitely. So you, you talked a lot about the data from the operator side and there’s a lot of different systems and workflows going into play here. As you’re just talking, I’m thinking about the different stakeholders within an organization that this might impact. Can you talk a little bit about does your platform fully integrate some of these solutions so that all the data is in one place? I assume there’s some reliance on other platforms out there as well, whether it be related to, you know, HR, time sheets, scheduling, things like that, other platforms people might be using the conjunction to Kevala. Can you talk a little bit about that kind of data management and workflow management from that perspective, if you will?

Todd Owens:
13:42

Yeah, so we are ultimately a system of record for the, the shift. So, you know, what, what, who filled the open shift and we also have a time and attendance aspect, not attendance, but a time sheet aspect to it. Why? Because it’s better than paper, which continues to be the primary source of tracking time, you know, across the agencies. Sometimes there’s gonna be a scheduling system in place, not always surprisingly, you know, but you know, sometimes it’s, it’s still a spreadsheet, but sometimes there’s gonna be a scheduling system in place and that could be a, a system like an on shift or a Kronos and that’s going to, it’s gonna be necessary that we integrate with those systems. In fact, you know, I would tell your audience, like we absolutely can and we’ll integrate to any scheduling system that we need to so that we can marry together the permanent staff in that scheduling system with the site system so that you can get a combined view, right? That’s gonna be necessary in the cases where there is a preexisting scheduling system. If there’s not, we intend to develop the capabilities so that they can use, use our system as well. So that’s, that’s a big one. As you think about intelligent scheduling, it starts with knowing what census and acuity is in the building and knowing what the staffing model is based on the, the physical characteristics of the building, right? Number of floors, long hallways, teams zones. And so we’ve got a budding new partnership going on with point click care to, to look at how we can integrate the two systems of care data into Kevala so that we can create the most efficient schedule in the first place. So it’s constantly changing and I think the right answer is not to simply copy and paste what you did last week or the week before, the week before that, and then find that, oh you’re, you know, either you’re understaffed or overstaffed, there’s like drift that happens. The right thing to do would be able to have real-time data come in from the EMR and that’s a, that is isn’t gonna be an increasingly important point of integration if we’re gonna truly realize this goal of being intelligent. Then lastly, I’d just say, you know, by virtue of being in a position to touch the shift or the, the workforce in total, but also those that are on the shift, all of them, including permanent staff as well, we come, we become kind of a last mile point of connectivity to them. And so when you think of all the signals that are kicking off from around the, around the building, whether it’s a fall detector or whether it’s a, an alert coming out of an EMR, we’re uniquely positioned as a system that can deliver that message to those that are on shift at that point in time, and so that the, I guess I’ll, I’ll leave you with this, that, you know, the ecosystem of integrations is gonna be incredibly important to our ability to deliver value to our clients.

Patrick Leonard:
16:18

Yeah, absolutely, and I think that’s been a common thread for the last few years, but it just increasingly becomes more and more important with so many innovative solutions that are specialized in different areas of the operations of the community. You know, everybody has to play nicely together these days to really benefit the industry as a whole. So it’s, it’s really cool to see that happening more and more and then the, the depth of those integrations as well, getting better and better as well. So that’s fantastic. So this is a call to everyone out there<laugh>, to continue to do that, to continue to integrate and open up your platforms to play nicely with Get together. So we, we’ve talked a lot about, you know, and getting a pretty good sense from an operator’s perspective, how this kind of all works and comes together to, to manage these shifts. Can you talk a little bit more about kind of the nurse perspective? How are they feeling about this? How are they interacting with Kevala and what is ultimately the impact on that perspective that it’s having back to the operators and is that being communicated?

Todd Owens:
17:17

Yeah. Well because we started as a labor marketplace with our own W-2 nurses picking up shifts, we get their feedback every day. And the level of satisfaction that they have with Kevala as an employer is, is unlike anything I’ve seen in my professional career. So here we are in a segment of the workforce that is burning out, you know, treating quickly and yet they are incredibly happy. You know, our NPS has gotta be a nine point on average, if you use the true NPS of a hundred to minus 100, we’re at like an an 80, NPS which is exceptionally high. And what it is is flexibility. That’s that’s what it is. That’s what they like and then they like to be treated with respect. And so I think we’re pretty good at, you know, because because we are process-oriented people and we’ve got technology working to help us out, we’re able to manage our, our team very well, even with a light touch. So I, you know, last week we put 400 unique nurses into shifts across the country. Next week it’ll be a different set of 400 and it’s not us telling them where, where to work, it’s them picking the shifts they wanna work at. And so they’ll leverage technology to scale and to do it with a, with incredible loyalty from these these nurses is, is, is high. So flexibility is one, and then I think the other one is, you know, with technology we’ve gotta build highly usable software, you know, and I think it’s a real advantage to companies that are coming out of the gate more recently that we have all of the lessons learned from the last 10 years from the mobile economy, right? You know, the iPhone and apps and, and the gig economy and what it’s like to, to work, you know, a different, you know, gig every day and, and how your software and technologies should behave. So we, you know, our first hire at Kevala was a designer, and it’s something that, you know, we continue to take great pride in is designing a software that is designed first and foremost around the frontline care team. There’s a lot of software out there that, you know, just isn’t usable and therefore becomes shelfware. And so, you know, I’d say that that’s, that’s another perspective. They, you know, we wondered whether or not they would be able to embrace technology and there has been no issue with that thankfully, cuz that would’ve been really difficult to get’em off paper if, if they don’t really want to move off of paper, they all have smartphones and you know, that is how they communicate via text messaging. They’re on Facebook, I need to give them technology that is, that is just as usable as the software they use in their daily lives.

Patrick Leonard:
19:41

Thanks for that, and This might be a segment here. I was just thinking of this question as you were talking about these different, all the different 400 plus shifts being filled last week, I think you said across the country, it made me my mind go to just different labor laws and different credentialing or I guess the compliance side of things across the country. I don’t know if this has necessarily a huge amount of impact of what you all do, but it just made me think of that. Can you talk a little bit about that and how you all manage that, if that is something that you have to keep a pulse on?

Todd Owens:
20:13

Yeah, it does. Thanks for asking the question. Not everybody wants to talk about compliance<laugh>.

Patrick Leonard:
20:19

It’s not the always the most exciting topic, but it’s very, very relevant obviously and important in this industry. So I couldn’t help but think about it as you were talking about that and thought it might make sense to touch on it real quick.

Todd Owens:
20:30

It’s very relevant. I mean, if you don’t know who the individual is, not just where they are and what license they have, but what qualifications and skills and whether or not they’re current from a compliance perspective, it’s pretty hard to put people into shifts. So it’s actually kind of a core capability of our platform to marry up a workforce with a set of policies so that you know, whether or not somebody is either red, yellow or green red, meaning they can’t work yellow, meaning that something needs to be addressed in the next 30 days. And green meaning they’re good to go for for you, they may not be green for somebody else, but they’re green for you because of your compliance requirements or your state’s re compliance requirements, which could be different. So, you know, it is, it is very much a an aspect of, you know, making sure that you’re, uh, dotting your eyes and crossing your t’s with regulators, but it’s also relevant to making sure that you help to schedule so that people are working at the top of their license. So one of the things that we heard early on was, you know, if I, I, you know, if I can do with a, you know, a CNA, I, don’t need a med tech or somebody to pass meds. If I can do with an LPN, I don’t need somebody that’s that’s got a RN, and so again perfect with regards to the profile and the compliance status of the workforce in is a really big deal when you think about optimizing the schedule and getting the most out of your workforce, you know, that you possibly can.

Patrick Leonard:
21:56

Thanks for that. Thanks for, for touching on that side of things. How does it look like if I were a senior living community and, you know, I list this podcast<laugh> and all this sounds very interesting, obviously. What is the, can you break it down practically a little bit to how does, how does an organization go about implementing a solution like this based off of where they’re at today? I’m sure it depends a little bit of course, but, you know, take your, your typical, if there is senior living community and they want to go through this transition to really empower their workforce management solution after community. Can you tell me a little bit about what that process looks like?

Todd Owens:
22:31

Yeah, you know, so from the community-level perspective, it is pain free. So this is, you know, really a decision that, you know, I as a scheduler or an executive director or a GM want to unify and digitize my agency’s schedule so that everybody’s working off the same page. It’s the decision to do that. When we get engaged, we typically do, the agencies that our client work works with are invited to the platform very soon, you know, in the next month they’ll be able to invite their permanent staff employees as well so that they can see shifts before those same shifts get exposed to the agency and they can be up and running, you know, immediately. There’s no extensive configuration. It’s really just a matter of, you know, inviting the participants to the table. And so one of the things that we do to make that super easy for our clients is, you know, we let them make the invitation to the agency, but then we give the white glove onboarding treatment to that agency. And so of course there are questions, what is this technology like? Why are we doing this? Is this going to, is this gonna disintermediate me? And, you know, we’re able to very quickly get them on the same page too. So when we talk about net promoter score, customer satisfaction, our agency satisfaction is very high for the first time, they’re actually looking at a real-time view of the current needs of that facility, right? They’re not working on outdated information or shifts that have already been filled by somebody else. When they apply a few mouse clicks, they can apply a name to the, to the, the, uh, schedule and it can be approved so they, they don’t have to go to a phone call or to a text message, which again, takes it out out of band offline. And, and now you lose all of the efficiency and the trackability of the process, right? Time sheets. Now that time sheets are, are part of it. We introduced to them the ability to actually digitally, so now you and your client are looking at the same approved time sheet, talk about making it a lot easier to get through the, the revenue cycle, you know, in terms of the billing process and the accounts payable process for that agency. So we take them through that and by the end of the conversation they’re loving it. But the, from the, from the client’s perspective, it’s an intro introduction to the platform. We tell them how to, how to, uh, to create open shifts either in bulk or one at a time. We, we go through the process of inviting digitally the agencies into the product. We then take, we go offline and onboard them and they’re off to the races. The question then is this play in this, right? And, and ultimately this is really where the greatest success has happened is when the home office, usually the CEO, COO, CFO and sometimes the VP of HR agree that it is in their organization’s best interest to standardize around a digital process and one that will serve up all of the real- time data that they need to run a more efficient and effective business. And when we have that top down sort of, not pressure, but conviction and maybe a little bit of pressure that we’re, we’re going to the deployment process across a large chain can go very quickly. If that’s not there, then it’s sort of left up to the technology platform to convince every one of the locations. And that just delays progress. That’s all we can do it and we do do it, but I think that this industry is getting to a place here post COVID where change system, systematic strategic change, is gonna have to originate at the home office.

Patrick Leonard:
25:58

Yep, absolutely, and thanks for adding that on there and that, that kind of leads to where I wanted to end our time today, which is what’s next? You know, right now, obviously I don’t even like mentioning the COVID crisis and the, the subsequent staffing crisis as people are calling it, but you know, that is what it is. But looking forward, what, what’s next? Is there light at the end of the tunnel? And the second part of that question is, are there any other words of wisdom for our listeners, particularly the operators who are going through this and living through this every day? You know, if you can kind of leave yeah, and part them with one word of wisdom, what, what would that be?

Todd Owens:
26:33

I think there’s a ton of hope. So I think my sense is, and I I’m new to the industry, I’ve only been in senior living since 2020, so I, I’m only in for three years myself, was that it was a fight for survival, really. And it, it feels to me like we’re coming out of it and now learned as to what was working and what was not. There’s sort of like a, an opportunity to take a deep breath, rethink and reinvent for a better tomorrow. And you know, I think a big part of that is gonna be technology, right? Technology that helps the team be smarter, the team to do more with less, bring visibility and transparency and connectivity to the organization. And so, you know, uh, there is so much innovation going on in the world and when you poke your head into a typical healthcare organization in your living is no exception. There’s still a lot of that is sort of thankless work. And I think that with the right alignment and the right sort of ecosystem of, of innovators and startups and suppliers out there, you know, that we’re gonna be able to lock arms and, you know, and make real progress. So I would say better software, more intelligent software that, that helps to make recommendations, but also software that automates the, the mundane, repetitive task so that, so that, you know, a senior loving community can do what it really wants to do, which is focus on care.

Patrick Leonard:
27:54

Rethink and reinvent for a better tomorrow. That really stuck with me and your sign off there. So thanks for, I wrote it down and I’m gonna revisit that later. But, Todd, thanks so much for being with us today and for your time. I really enjoyed the conversation and I know our listeners will too.

Todd Owens:
28:08

Thanks, Patrick. It’s my pleasure!

Patrick Leonard:
28:09

And listeners, thanks for tuning in for another episode of Raising Tech. I know and hope that you’ll pick up some valuable information from today. If there are any other topics you want to hear about or want to be on an episode yourself, please feel free to reach out on our website at www.parasolalliance.com. Have a good one!