In this episode of Raising Tech, our host, Amber Bardon, has a stimulating conversation with Bill Lowe, President & CEO at Chicago Methodist Senior Services (CMSS), about how CMSS' international recruiting program is helping their Senior Living community overcome staffing challenges.
Discover how Chicago Methodist Senior Services' innovative hiring program is allowing CMSS to bring on dedicated and professional caregivers to keep their Senior Living community fully staffed by listening to the full episode!
Raising Tech is powered by Parasol Alliance, The Strategic Planning & Full-Service IT Partner exclusively serving Senior Living Communities.
Welcome to Raising Tech . I'm your host, Amber Bardon, and today we have a very, very special guest , someone I've known for a long time, someone who's very famous because I talk about him all the time as one of the original founders and inceptors of Parasol Alliance. Welcome to the show, Bill Lowe.Bill Lowe:
Thank you, Amber.Amber Bardon:
Bill, give us a brief intro about yourself. Who are you, where do you work? Tell us a little bit about yourself.Bill Lowe:
I , I'm the c e O of Chicago Methodist Senior Services. One interesting fact about myself is that ever since college, I've never worked for a for-profit organization. I've been in healthcare my whole career. Started my career at Rush Hospital. I wish I could tell you that I knew at like age 18 or 19 that I only wanted to work for nonprofits. But I have to admit that Rush was the best job offer I got out of college that was fortunate. It was a great place to start a career, and it sort of set me on the path to where I am today.Amber Bardon:
Bill, you are pretty well known . I have to tell you every time I'm talking to someone else, and I always have to mention your name and I always stop and say, do you know him? Because a lot of people have heard your name, and the thing that you're really well known for is your vision in collaboration and joint ventures and trying to bring providers together to try to collaborate, inform new entities and provide services and Paris Alliances and output of that. You are one of the owners of the company and the one who came up with the idea for our business model. Today we're gonna be talking about another service and company that you started, and I know it's actually been around for a while , but I think the topic is really pertinent today because staffing is a big challenge. You know, we saw this really crop up during Covid with the Great Resignation. So we're here today to talk about your nurse recruitment program. So to start off with, let's just talk about what is the environment today with staffing and hiring? What are the big challenges you're seeing and how did that drive the creation of the program?Bill Lowe:
The creation of the program actually goes back a ways , Amber. And so we, I guess you could say maybe we had lucky foresight in that we anticipated back in 2005 that there would be a nursing shortage, but we're a small organization as you know, and so we didn't want to just take care of our own needs. Oh , of course, that's always first in , in primary. But also thought that if we were successful with nurse recruitment, that we'd be able to affect other nonprofit organizations by mitigating their, their staffing needs. If we thought we had a problem back then, we didn't know anything, right, because it's just gotten worse and worse. And it wasn't the year of Covid at all that affected us as an organization on our staffing needs. It was after that. I thought that the great resignation was a white collar issue. It's affected right down to our frontline staff for sure. That's been the most frustrating and humiliating development actually, is that we can't find enough CNAs to do the work. After a number of years after starting, we've always been solid with RNs, a hundred percent of them from, from the Philippines. That covered that problem for us, us, but then we did not anticipate a CNA shortage like we have today, and it's more acute for us. And I hear from my peer set that it's also more difficult for most of us to recruit the frontline staff and retain them.Amber Bardon:
So what is the program? Can you do a little bit of a deep dive into how did the program start? What does it do? A little bit more of the details behind it?Bill Lowe:
Yeah. The founder of our program was Rose Poly Cario , who , uh, for many, many years served as our DON and running this program. But , uh, today it's evolved to the , uh, to the point where we're trying to reach more staff from foreign countries and also recruit both RNs and frontline staff, the c n A or caregiver level. The latter is very challenging, but we sort of look back to our history and, and say that I think many organizations would've threw in the towel that point that we kept persevering on the nurse recruitment. It took our first nurses seven and eight years to get to the United States. What we learned is that they were patient, they were still excited to get here, and we learned that we had the patience and the discipline to stay with it. And so we're really glad we did a few years ago. It really took off and we were really proud to have a lot of our workforce shoulder to shoulder with their American-born nurse peers. Uh , during the pandemic really was a relief. We are proud because, you know , we're not reducing the workforce and then deploying them elsewhere. We're actually increasing the workforce from a country whose number one economic engine is sending human resources abroad and then people sending money back home. We've learned that US immigration , uh, can be a challenge. And uh , right now we're under a program called Retro Aggression that the US Immigration Department uses to basically stall immigrants from coming in and they sort of fall into limbo for a period of time before they open up the gates again. And , and that's challenging. What we've tried to do is reach out and just be very creative. I would say at this point I consider it almost a personal, as well as organizational mission for me to find workforces from wherever. However, we've expanded to Liberia and Ghana and Ghana we think will have success bringing in nurses quicker than we will be able to get them from Liberia, but they're both English speaking countries and we're optimistic that, you know, someday have an abundance of those , uh, folks arriving. We've also tried and successfully to assimilate with the Ukrainian immigrants that have come in, and we've been to three different job fairs. Not sure that we're gonna have a whole lot of success out of the box, but we're just gonna stay with it. We become a known commodity and sort of a friend to the Ukrainian immigrants, which is, we're a very mission-based organization, so we're proud of that, but also , uh, trying to help impact the workforce. It's super challenging. I'll , I'll just say that, but we, we go at it every day . New opportunities, even daunting things like, you know, trying to assimilate overabundance of arriving immigrants into our city and all across the country. Uh , I'm being patient with that one because there's just too much politics afoot, but when they decide that they wanna put those people to work, we'll be prepared to serve them and hopefully disseminate those workers across the country to other nonprofit organizations.Amber Bardon:
This program, any community in the country could reach out to you to potentially look at hiring people through this program, is that correct? Correct.Bill Lowe:
It can, and in fact, we have a pretty long waiting list for both , uh, CNAs and RNs. And also today we have close to 120 nurses working across the country at other facilities by rule , we have to be the employer. Then we report them to other nonprofits where , uh, on a full-time three-year contract , uh, agency basis. So when they arrive, you know, the hope is everyone that recruits one of our nurses, the hope is of course, they stay 20 years. That's usually pretty unrealistic. Uh , we've had some people that have stayed longer in our organization, but on average there's no nursing homes in the Philippines. They've worked in hospitals ERs or, and after their service with us, many matriculate into hospitals.Amber Bardon:
Walk me through, what does this look like for a community? So if they work with you and they're able to get a nurse or c n a, what does the process look like? And I also know you have some , um, assimilation tips. OneBill Lowe:
Of the things that we insist upon is that between our organization and their organization, that we provide two months of free housing for the nurses. There's the , the first time they'll , they land at O'Hare, they don't have the resources, so we support and we ask our clients to support them with the housing. The other thing is to make sure that, that they inculcate them properly in into the organization. If they treat them like agency workers, that's not gonna work for morale. So again, hearkening back to dreadful days of covid, you know, if people were doing a hero's bonus for their own staff, we strongly encouraged that. If they wanted to retain Filipino nurses that they, they should treat them and give them the same bonus. Basically they're on our payroll, you know, we would just say , just tell us what you're gonna pay. We'll pass it through without any markup at all, and it's really gonna help for morale and retention. Another factor of the program is it's, we don't separate families. We usually wait , uh, about two months until they're more on their feet, and then we'll bring over a spouse and children. So that's something that was very important to our board to make sure that we weren't, you know, taking nurses from a third world country that needed them to work in our workforce. That the reality is, is they have an overabundance of nurses in the Philippines all eager to work abroad. And so, you know, that that was a moral thing that was, IM important to our board. And of course, not separating families . Super, super important. But as far as the process goes, it starts with a, you know, with a job order and, you know, then we , we maintain and honor that waiting list. We don't know which nurse is going to arrive next or which group of nurses, but when they do, then we introduce them to the organizations. They can Skype or communicate with them however they want. But no one has ever said, we don't want that nurse <laugh>, you know , I think people are just happy to have the cavalry arriving with, you know, with some nurses in to . It's worked out really well. Uh, again, the only drawback is when the US governments to slow the, the flow and it , it , it seems counterintuitive. The politicians aren't really alert to the issue. Do believe that just like we can't grow food in this country without immigrants, I don't think for very much longer we're gonna be able to provide quality healthcare without immigrants arriving to help out.Amber Bardon:
Can you describe how does using a program like this differ from an agency or other types of staffing solutions out there?Bill Lowe:
The one thing that we profess we never want it to be, because it's very difficult work, is to be like a sort of agency that you have a third shift calling and you call us to fulfill that. That's for others to do. And there's, you know, really extreme premiums paid in order to get that emergency staff and they're, they're never familiar with your organization. So you know, you're paying for something that's not necessarily a really good solution. We have vowed to put full-time workers in and mitigate the need for those third shift call in replacements and so on. And to a large extent, we , of course we've mitigated the problem. I have to admit it's a drop in the bucket, but we feel that any movement expanding the workforce is good work.Amber Bardon:
How does this work from a cost perspective? I know you mentioned that they work for your company and they're sort of treated like agency. Can you just explain that? Sure.Bill Lowe:
It's very , uh, simple system and we're very transparent about the approach. So, you know , it starts with a , uh, $1,000 non-refundable deposit to place a job order per nurse. And so frankly, you know, we use those funds to do our recruitment while we're waiting for nurses to arrive. When the nurses arrive, there's an upfront placement fee that binds pay. And then after that, during the three year period, we send an invoice to the client that includes the hours that were paid for that pay period at most, 25% for benefits. And then there's an hourly mark, which can range from like seven 50 to $10 an hour in many cases. We cover the , you know , practice for the nurses, we cover their health insurance. The nurse costs nowhere near like an hour of overtime, which is really great for the staff. So when we started out, we were delivering nurses even less than $40 an hour with our markup included. Today it's mostly above 40, but always generally under 50, unless it's say on the East coast where the market just demands that they make five or $6 more an hour than here in the Midwest. ThanksAmber Bardon:
For explaining that. I think that'll be interesting for our listeners to hear and consider, you know, the impact and the options that are out there to address staffing challenges. I know you mentioned you are currently bringing in nurses and CNAs. What do you see as the future of a program like this? Do you see it growing and you know, starting to work with more countries like you mentioned? Do you see other positions possibly being offered in the future?Bill Lowe:
Yes, it's possible to add other positions. When we first started out, because of the slowness with which nurses could get here, we were providing therapists, physical therapists, and occupational therapists. We actually were a part owner of a therapy company at the time with a dozen other organizations here in the Chicago land area. All of us nonprofits. And so we were basically providing the staff to the company we had a part ownership of. So that felt really good. And you know, we never were a significant part of the workforce, but we always had some percentage of the workforce was provided by our labor. So, and I think you can address that. There's a teacher shortage right now, right? Uh , we tend to believe we'll stay healthcare space and largely the older adult space. But you know, the idea of just speaking back to our motives again, when we make profits off of that, I call that substitute philanthropy. That's like philanthropy, that it's like philanthropy in that those are dollars we can use to support our mission. It's hard, I think it's harder to raise money for, certainly for a long-term care organization than it is to support an organization that supports education or hunger or museums <laugh> . So we, we try to be as resourceful as possible and adding to the pool of funds that can augment the mission. When you have a lot of programs like we do where there's no fees for the service, they have to be supported some way, right? So this helps. I think for others, and I should say anyone can petition just like we did. The tips I would have there is that it takes patience and perseverance. I guess I would encourage anyone who thinks they're gonna be in business 10, 20, 25 years into the future, it would behoove them now to start, you know, either working with an agency like ours, others, or, or doing it themselves, getting an immigration attorney and learning the ropes and just start petitioning. And our track record shows that eventually they will come. And when they do, it's always a joyful thing, you know, for the receiver of those nurses. And we have yet to, you know, the process for CNAs will take longer. We have yet to have our first one arrive, and it's a much smaller pocket of the immigration program that allows CNAs to come over the , the US government prefers higher paid, higher skilled people to come in.Amber Bardon:
Bill, this has been such an interesting conversation. It's, you're doing something so unique and different and you've come up with a really, you know, different approach to a problem that a lot of communities have. So I've really enjoyed having this conversation with you. Is there anything else that you want our listeners to know or you think that they should be aware of about this program or about this concept in general?Bill Lowe:
I would just reiterate that I think people should take advantage of either doing it themselves or working with someone else that that has the same sort of ethic that we do, which is to not exploit the shortage. I have one interesting fact that I'm talking to our insurance agent and belly yanking about that difficulty in finding and retaining CNAs. He brought up a really interesting point. He said that, you know, a few years ago when he attends his, the conferences like in our space, there might be one, you know, at the exhibitor's booths, right? There might be one in the staffing agency. The last time we went, he said there were 17 of 'em . And so we both began to realize is that what's happening in this situation with the shortage is you have , uh, and this is America, right? And we're capitalists, so you can't blame people, but so you have people leveraging the shortage. What they do is they actually shrink the pool of workers by saying, Hey, you know, you don't have to go work for Wesley Place, our skilled nursing facility. You can work for whoever you want to and whenever you want to, you know, and you'll make a couple more dollars an hour, you know , we'll set you up with technology, which I know any of us could do, Amber, and you help people all the time, but you know, you so you can be paid any time you want. That kind of thing. So that can be attractive with younger workforce and the gig economy. And so, but basically what happens is, is they shrink the pool for people that work directly for the employer, they expand the pool of those come at what I would call you, serious rates of hourly rates. And it just, it's just awful. And so the only way to fight that is, is to get in the game yourself with an approach that you know is not exploitative.Amber Bardon:
I think many of our listeners will resonate with that, for sure. Not , not the person . I've heard that sentiment.Bill Lowe:
Yes. Yes.Amber Bardon:
Well, bill, thank you so much. As always, it's always a pleasure to speak with you, and I really appreciate the time you took to talk to us about this topic. ThanksBill Lowe:
For the opportunity, Amber. I enjoyed it.Amber Bardon:
And listeners, if you like this episode, you can find more of our episodes on our website raising tech podcast.com. If you'd like to send us any feedback, you can also do that through our website, parasol alliance.com . And as always, thank you for listening.