Organizational culture refers to the shared beliefs, values, attitudes, behaviors and practices that define an organization. It includes unwritten rules, norms and social patterns that influence the behavior and interactions of individuals within the organization.

When employees feel a sense of belonging, they are five times more likely to stay with the same company for an extended period, three times more likely to generate revenue faster than less inclusive competitors and nine times more likely to believe that people are treated fairly, according to data from Great Place to Work.

“There has been a positive correlation with retention rates since we’ve doubled down on recognition, culture and employee experience,” Jeff Knapp, chief people officer at Bayada, told Home Health Care News.

Bayada provides home health, home care and hospice services in 21 states and five countries.

“I am a firm believer that building an infrastructure of cultural engagement is a smart investment and recognizing employee contributions that exemplify your values has a multiplier effect across the organization,” Knapp said. “Our high and stable employee experience data demonstrate that a strong, mission-driven culture can drive employee retention and satisfaction. That, in turn, has been correlated with better hiring, retention and productivity.”

Organizational culture is also significant for patients. Studies show that engaged and satisfied employees are more likely to provide high-quality care, resulting in better patient outcomes. Lower engagement rates can increase errors, solidifying that a weak culture is a liability for health care organizations. Moreover, a supportive culture promotes open communication, continuous learning and collaboration, all vital for patient care and safety.

Beyond employee and client satisfaction, culture contributes to a healthy bottom line by keeping caregivers in place and engaged, avoiding malpractice claims. Health care organizations with positive cultures attract and retain top talent, essential in an industry with significant workforce shortages. Additionally, a study by Gallup showed that companies that prioritize culture experienced a 33% increase in revenue.

Understanding the environment and taking action

Understanding the current environment is imperative before focusing on improving workplace culture. Michelle Cone, senior vice president of training and brand programs at HomeWell Care Services, recommends soliciting and acting on client and employee feedback.

“This is table stakes to gauge satisfaction, identify areas for improvement and solicit suggestions,” she told HHCN. “Use this data to shape strategies and make tangible changes when needed.”

HomeWell Care Services, based in Burkburnett, Texas, offers personal care, companionship, and homemaker services for seniors and other homebound individuals.

Providers can start by conducting anonymous surveys to gather honest feedback on various aspects of workplace culture, such as communication, collaboration and job satisfaction. A combination of quantitative and qualitative questions to gain a comprehensive understanding is best, according to sources.

After gathering the survey results, providers can then analyze the feedback, building on strengths and removing weaknesses – where possible.

Using focus groups to impact change after the fact is one way to respond to feedback.

“At HomeWell, our core values are integrity, collaboration, excellence, candor and balance,” Cone said. “We hire, reward, and recognize our core values. We also focus on setting clear expectations and providing support. This includes clearly defined roles, responsibilities, expectations and success metrics.”

The post The Levers Bayada, HomeWell Pull To Retain Home-Based Care Workers  appeared first on Home Health Care News.

These salaries can impact job satisfaction and cause employees to seek employment elsewhere, according to the 2024 Activated Insights Benchmarking Report. Some organizations are turning to recognition to combat this trend.

“Employee recognition is no longer a ‘nice to do,’” Michelle Cone, senior vice president of training and brand programs at HomeWell Care Services, told Home Health Care News. “Recognizing employees should be considered table stakes in this post-pandemic landscape. With a focus on employee retention, engagement, and overall satisfaction and its direct correlation to top-quality care, recognition to support retention and drive satisfaction is vital.”

HomeWell Care Services, based in Burkburnett, Texas, offers personal care, companionship, and homemaker services for seniors and other homebound individuals.

“Recognition is critical to maintaining an engaged and innovative pool of talent because it staves off burnout and invigorates our shared sense of purpose,” Jeff Knapp, chief people officer of Bayada, told HHCN. “All employees – and I’d say even more so in the helping professions like home care – feel energized to give their best when others recognize that their work is worthwhile and that they are making a difference.”

Headquartered in Moorestown, New Jersey, Bayada provides in-home clinical care and support services for children and adults, including hospice, behavioral health and rehabilitation in 21 states and five countries.

With agencies vying for skilled and experienced caregivers, brands prioritizing employee recognition stand out. Recognition programs that attract and retain top talent give agencies a competitive advantage in a rapidly growing industry.

“We have several recognition and reward programs,” Knapp said. “For office staff, excellence awards are one favorite. Employees are nominated and selected yearly and celebrated at our annual gathering. Categories include clinical leadership, client services leadership and enterprise support. We also give years of service awards to recognize employee loyalty and commitment.”

Knapp said that what Bayada’s recognition and rewards programs have in common is that they are peer-driven.

“You can get a shout-out from your colleagues, manager, even clients and families,” he said. “I think employees value this most because it’s tangible and group-sourced. You can see in that honoree what excellence looks like and it illustrates and reinforces for everyone how their own talents and discretionary effort contribute to our larger mission to help the people we serve enjoy a better quality of life in the safety and comfort of home.”

Cone said that HomeWell, as a brand, discovered that what matters most is how you recognize employees. Consistency is key.

“Communicate to your team how what they do matters and is appreciated,” Cone said. “How much their presence and who they are positively impacts their clients’ lives. Share with them how they impact the industry. Don’t assume they know the difference they make.”

She suggested listening to your team. Find out what they need or want. Find out what the company is doing well and what can be improved. Understand why they stay or why they leave.

“Some tangibles that we have found employees prefer include recognizing an employee who has demonstrated outstanding performance and dedication,” Cone said. “A peer-to-peer recognition allows staff members to nominate a team member for recognition. Training and professional development opportunities work well. Ensure it’s paid training and offer certifications. Build out career paths or promotions based on training. Publicize these opportunities as rewards for staff who have demonstrated a commitment to learning and self improvement.”

While some recognition opportunities are set at a monthly cadence, it is important to recognize employees at the moment based on things like client acknowledgments during satisfaction surveys or the willingness to accept emergency shifts. Recognition and positive customer feedback boost morale, help retain team members and enhance job satisfaction, improving satisfaction scores.

Enhanced scores can provide a competitive advantage that can be leveraged in local markets to support client and caregiver acquisition and retention efforts.

“We identified that office staff satisfaction and turnover significantly impact caregiver satisfaction and turnover, as well as client satisfaction and turnover,” Cone said. “We shifted focus upstream of the caregivers by creating a support and retention strategy for office staff – those key internal associates – giving them what they want and need to be confident and successful in their roles.”

Cone said that by building intentional retention strategies around office staff, HomeWell has witnessed an impact on caregiver retention. She said over 75% of HomeWell’s caregivers have been active over 90 days, and less than 10% of franchisees surveyed said they had to turn away business due to a lack of caregivers.

“Retention matters to our home care clients because staff turnover understandably causes them anxiety,” Knapp said. “Entering their homes is a sacred trust. They come to trust and rely on their caregivers and clinicians, but also on the familiar voices who answer the phone every day. We become the family they choose. By retaining staff, you retain the valuable social capital and expertise you invest in building and that is measurably good for client satisfaction, care quality and business results.”

The post Bayada, HomeWell Leaders Share Strategies For Recognizing And Retaining Office Staff appeared first on Home Health Care News.

Overall customer satisfaction and Net Promoter Score (NPS) increased for the first time since 2020 to 6.4, according to the 2024 Activated Insights Benchmarking Report. In 2020, the industry saw an NPS of 6.7, which dipped to 6.0 in 2021. Customers ranked their care staff’s ability as their highest source of satisfaction, followed by caregiver compatibility. However, the report indicates that customers are least satisfied with communication from their provider and say they wouldn’t always recommend them.

NPS is a metric used to measure customer satisfaction, loyalty and enthusiasm. It gauges how likely customers are to recommend a company to a friend or colleague. Customers respond on a scale of 0 to 10, with 0 representing “not likely to recommend” and ten representing “extremely likely to recommend.” NPS has been a standard metric for businesses since its creation by Bain & Company in 2003.

Since client satisfaction with provider communication scored the lowest, Activated Insights suggests proactively collecting feedback and taking action to improve it. The company also proposes training staff in communication, setting up clear communication channels, designating a care manager to maintain regular and scheduled communication with the client and their family, and including the client and family in care decisions.

“Opportunities for improvement often arise from inconsistencies in communication,” Michelle Cone, senior vice president of training and brand programs at HomeWell Care Services, said during an Activated Insights webinar. “When clients and families are not informed of schedule or care plan changes or updates regarding changes in condition that can impact the well-being, it can negatively impact customer satisfaction. Families are left in the dark, leading to frustration and mistrust. Trust is crucial in our industry, and communication plays a vital role in maintaining it.”

HomeWell Care Services, based in Burkburnett, Texas, offers personal care, companionship, and homemaker services for seniors and other homebound individuals.

“Make consistent and scheduled communication a part of your overall customer strategy,” Cone suggested. “Assign team members to handle different touchpoints and ensure that families hear from you regularly, not just during urgent or negative situations. Share the positive news as well.”

On the other hand, caregivers rated the compatibility between clients and caregivers as the most significant factor affecting their job satisfaction, followed by their interactions with office staff.

The report highlights that, while office staff tend to have the highest satisfaction scores among employees, the industry’s customer care coordinators and care schedulers receive the lowest administrative salaries. This wage disparity can negatively impact employee satisfaction. The data indicates that when one office staff member leaves, it can motivate an average of five other staff members to quit. Considering that the average cost to replace a home-based care employee is about $3,900 in turnover costs, the combined turnover costs for a home care provider due to this exodus amount to $39,960.

Care staff are least satisfied with the recognition they receive. Providers have an opportunity to demonstrate to their employees how important they are to their clients. On the other hand, customers are most satisfied with the compatibility and ability of their care staff. However, employees’ dissatisfaction with recognition means they may not fully comprehend their significance to their clients. This lack of recognition could contribute to the record-high turnover rate of care staff, which is currently close to 80%.

Cone proposed retaining long-term employees by showing appreciation for their work through regular employee recognition and positive customer feedback.

“Communicate to your caregivers and office staff regarding how they do, what they do, and how much their presence and who they are as individuals positively impact clients’ lives,” Cone said. “Share and communicate with them how impactful they are to this industry, your agency, and the clients and communities you serve. Don’t assume they know this.”

Cone said the most significant opportunity for recognition remains consistency.

“The key is consistency,” Cone said. “Communicate the desire to acknowledge and act on feedback consistently. Whether the feedback is from a client, a peer or management, specify who said what and establish a process to share that feedback with the relevant stakeholders.”

The report stated that providers who actively managed their employee and customer experience, staff training and employer brand saw over three times greater lifetime value per client than those who didn’t. Similarly, managing the customer and employee experience resulted in providers hiring an average of 90% more care professionals than their competitors.

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Poof — a caregiver has just vanished into thin air.

The caregiver hasn’t shown up to care for their client during the shift, and they’ve left the home care agency without giving any notice.

Generally, this is what’s known as caregiver ghosting, and it continues to be a challenge for home care providers.

Recently, Victor Hunt — co-founder and CEO of caregiver engagement platform Ava — highlighted this industry-wide pain point in a post on LinkedIn. Hunt noted this was a problem, and a growing one at that. 

Specifically, Sheila Davis – the senior vice president of area operations at Always Best Care – believes that in the past nine months caregiver ghosting has gotten worse.

“It’s something that we’re all noticing, and there seems to be an uptick,” she told Home Health Care News.

Ghosting has a detrimental impact on home care companies, according to Erika Ehlers, HomeWell Care Services’ senior director of learning.

“It has that immediate impact on the safety and wellbeing of the client,” she told HHCN. “But then there’s also the longer-term negative impact that it’s going to have on your reputation, revenue and, potentially, your profitability.”

There are a number of different factors that contribute to caregiver ghosting.

Davis pointed out that one of these factors is caregivers leaving for what they believe to be a better job opportunity.

“Caregivers may find a better job opportunity after applying with us, or even after getting a job with us, and then they just don’t communicate that they’re leaving,” she said. “That is one of the main factors that we’ve seen — caregivers would at least give notice, and they just leave without even telling you anything anymore.”

Ghosting providers

At Nurse Next Door, Veronica Tissera, vice president of customer experience, was once made aware of a situation where a caregiver had to choose between putting gas in her car or feeding her children.

Tissera explained that this is something the company would not have known if they didn’t make the effort to get curious about why ghosting happens.

Nurse Next Door has since implemented a number of policies aimed at curbing caregiver ghosting. This includes holding clients to a 12-hour minimum for service hours.

“One of the reasons why caregivers ghost is that they work for several companies,” Tissera said. “If you have a company that offers a [one-hour shift] versus a company that says, ‘We have eight hours,’ caregivers will choose the one that can offer eight hours.”

This offers caregivers more stability, and enables them to earn a higher wage. Nurse Next Door also offers wages that are above industry average and a comprehensive benefits package.

Similarly, Always Best Care also put strategies in place meant to combat caregiver ghosting. One of these strategies is constant communication, especially when it comes to new hires.

“We’re regularly following up with the caregivers, after that initial contact, to keep the lines of communication open,” Davis said. “We’re keeping the lines of communication open after the orientation process, even when they are given their first scheduled shift. We are contacting them the night before just to remind them. We are also making sure that communication is clear and concise. We [lay out] what the expectations are during the hiring process, and make sure that the caregivers avoid any misunderstandings. While we don’t like caregivers calling off shifts, we would much rather have them call off than abandon the shift or ghost the shift.”

One of the biggest factors that leads to ghosting are burned out caregivers.

While HomeWell has largely avoided the impact of caregiver ghosting, Ehlers has still seen the value in tackling caregiver burnout head on.

“We’ve launched a personal development learning track in our learning lab that includes topics like mental wellness, time management, stress management to help owners be able to identify the signs of burnout, and then also be able to provide support and resources to help prevent it,” she said.

Ehlers also stressed the importance of a robust onboarding process for new caregivers.

“It can’t be overstated,” she said. “Our franchise services team noted that the possibility of ghosting on a shift increases significantly when that new caregiver hasn’t had expectations clearly defined, or been properly prepared. They’re basically left to walk into a stranger’s home without any support. It’s really important to ensure that caregivers feel they’re valued members of the team, and that they’re recognized for all the compassion and care that they’re bringing to their work every day.”

The company also believes in setting up its franchise owners to cultivate strong employee engagement.

“We provide these tools to our owners,” Ehlers said. “We have a caregiver connection newsletter, we have award and recognition templates focused around our core values, and we encourage our owners to make use of those to increase communication and engagement with our caregivers. We really weave retention into all of our learning opportunities, so that we can prepare our owners with the skills and resources they need to be able to build a really positive culture and employee engagement.”

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“Our commitment to fostering a culture of continuous improvement and adaptability has been instrumental in our journey leading up to this pivotal point,” HomeWell Franchising CEO Crystal Franz told Home Health Care News in an email. “Recognizing the dynamic nature of the home care industry, we understood the necessity of remaining adaptable to sustain our growth — a goal that can only be accomplished by working together.”

HomeWell Care Services – which is franchised under HomeWell Franchising Inc. – provides personal care and homemakers services for seniors in over 50 locations across more than 100 markets in 33 states.

Over the past several years, HomeWell has been known as one of the fastest-growing home care companies in the country.

Since its rebrand in 2019, HomeWell has prioritized continuous improvement by integrating new systems and technologies into the fold, Franz said.

At the same time, getting feedback from its franchisees has also been a driving force behind its success.

“We’ve welcomed feedback from our franchisees, ensuring that we’re providing the tools they need to excel in their local markets,” Franz said. “This milestone underscores our dedication to ingenuity, collaboration and even a dash of boldness at times — all of which have helped reinforce our position as a growing leader in the industry.”

Earlier this year, HomeWell was one of a dozen home-based care companies that earned a spot on Entrepreneur’s 45th annual Franchise 500 rankings.

In 2022, HomeWell grabbed a spot on Inc. 5000’s annual ranking after it experienced 88% three-year growth.

One of the main drivers of that growth was the company decision to waive its initial franchise fee for new owners. In turn, those owners were able to reinvest this fee into the company, spurring even more growth.

In order to sustain that, Franz said that it’s important to stay rooted in the business principles that have allowed the company to get this far. That includes building on innovation, creating new partnerships and making sure its franchise owners believe in home care’s impact on families and the broader continuum of care.

HomeWell recently announced its Franchise Advisory Council (FAC), made up of elected representatives from its nationwide network of franchise owners, and will use that group to guide its path in the future.

“Looking ahead, we recognize the strength of our diverse franchise system and aim to leverage it to its fullest potential,” Franz said. “We eagerly anticipate tapping into the council’s insights to guide our future endeavors and ensure we continue to equip both new and veteran owners for success. With our brand’s momentum and the invaluable contributions of our owners, we are poised to lead the industry into the future.”

One of the standout programs that HomeWell credits its growth to is a bonus program that rewards franchise owners for longevity with the company and overall excellence.

As far as the future goes, Franz expects a lot of the same: expanding national presence while continuing to build relationships with national vendors.

“By maintaining its commitment to quality, innovation and collaboration, HomeWell is well-positioned to continue driving positive impact and setting new standards in the home care industry for years to come,” Franz said.

The post HomeWell Reaches 2 Landmarks: 100 Location Owners, $100 Million In Annual Revenue appeared first on Home Health Care News.

In order to be ranked on the list, a franchise company needs to be courting new franchisees in the U.S. or Canada. Companies that made the list also need to have had at least 10 units open and operating as of July 31, 2023, with at least one U.S.-based franchise.

Factors such as franchise cost and fees, size and growth, network support and brand strength determined each company’s evaluation.

Companies like Interim HealthCare, Home Instead and Senior Helpers ranked the highest of the home-based care franchises that managed to grab a spot on the list.

Interim HealthCare

— Rank: 59

— 2023 Rank: 55

— Units: 655

— Based in Sunrise, Florida, and a part of Caring Brands National, Interim is a franchise that provides home health, hospice, palliative care and other services across locations in the U.S. and Saudi Arabia.

Home Instead

— Rank: 149

— 2023 Rank: 155

— Units: 1,217

— Home Instead is a Omaha, Nebraska-based personal care franchise company that has locations in over a dozen countries. In 2021, the home care technology company Honor acquired Home Instead.

Senior Helpers

— Rank: 172

— 2023 Rank: 172

— Units: 361

— Maryland-based Senior Helpers has a national personal care network, as well as adult day centers. The company was acquired by Advocate Health Enterprises in 2021.

Homewatch CareGivers

— Rank: 222

— 2023 Rank: 208

— Units: 222

— Denver-based Homewatch CareGivers is a home care franchise company that operates in over 30 states and seven countries. The franchise employs over 4,500 caregivers.

Griswold Home Care

— Rank: 252

— 2023 Rank: 267

— Units: 186

— The Blue Bell, Pennsylvania-based Griswold is also a home care franchise. It provides personal care services in 30 states.

ComForCare

— Rank: 254

— 2023 Rank: 402

— Units: 229

— ComForCare is a home care franchise organization that has hundreds of territories independently-owned and operated in Canada and the U.S. ComForCare operates as At Your Side in Houston, Texas. ComForCare operates under parent company Best Life Brands. Another Best Life Brands company, Blue Moon Estate Sales, also ranked on the Franchise 500 list.

BrightStar Care

— Rank: 279

— 2023 Rank: 141

— Units: 373

— Chicago-based BrightStar is a provider of home care, senior living and supplemental staffing. The organization has been deliberately increasing its company-owned footprint of late.

Assisting Hands Home Care

— Rank: 280

— 2023 Rank: 229

— Units: 193

— Assisting Hands Home Care offers both medical and non-medical assistance for seniors, including meal preparation, companionship, chores and more.

HomeWell Care Services

— Rank: 283

— 2023 Rank: 347

— Units: 136

— HomeWell is a Burkburnett, Texas-based home care franchise that operates across the U.S. The company offers companion care, personal care, as well as specialty care.

Right at Home

— Rank: 318

— 2023 Rank: 260

— Units: 716

— Omaha, Nebraska-based Right at Home is a home care franchise company with locations in the U.S. and six other countries.

Nurse Next Door

— Rank: 418

— 2023 Rank: N/A

— Units: 183

— Vancouver, Canada-based Nurse Next Door is a home care franchise system that operates in the U.S., Canada and Australia. As an organization, the company provides personal care, companionship care, homemaking services, dementia care and more.

FirstLight Home Care

— Rank: 438

— 2023 Rank: 327

— Units: 197

— Cincinnati-based FirstLight Home Care is a provider of non-medical home care. The company also has a specialized care program aimed at seniors with dementia.

Synergy HomeCare

— Rank: 449

— 2023 Rank: 483

— Units: 453

— Synergy is a Gilbert, Arizona-based non-medical home care franchise. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services.

Home Helpers

— Rank: 475

— 2023 Rank: 396

— Units: 308

— The Cincinnati-based Home Helpers is a home care franchise that provides personal care, nutrition and companionship services, among others. It serves over 1,000 communities in the U.S.

Visiting Angels

— Rank: 479

— 2023 Rank: N/A

— Units: 692

— Bryn Mawr, Pennsylvania-based Visiting Angels is an in-home senior care company that provides companion care, personal care services and more.

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LaunchWell will emphasize continued learning, as opposed to live, long in-person sessions that HomeWell didn’t believe franchisees were getting a lot out of. Staff training is also a part of the program.

“We created role-based learning paths for all those key associates that typically work at the agency level,” Michelle Cone, SVP of training and brand programs at HomeWell, told Home Health Care News. “We also wanted to be able to scale and meet the needs of our growing system. We’ve had record year-over-year signings.”

HomeWell Care Services – which is franchised under HomeWell Franchising Inc. – provides personal care and homemakers services for seniors in over 50 locations across more than 100 markets.

Cone mentioned that the characteristics of franchisees have changed after the pandemic, which is part of the reason the company is providing more learning services and support.

“It’s been very interesting in this post-pandemic landscape,” she said. “We talk often about the spotlight on home care. But there was also a spotlight on home care franchising. So, for the past 18 months, we’ve seen interest in home care franchising like we’ve never seen before. It has allowed for innovation, an investment in learning, and more tools and resources that our owners can tap into.”

The LaunchWell program is also available to longtime operators within HomeWell’s system. But, for the new franchisees, the company has taken note of new types of expectations.

LaunchWell, is, in part, helping HomeWell meet those expectations. Cone said the feedback from the program has already been “great.”

“We wanted to move away from that talking heads type style, and provide them with more flexibility in their learning, a more engaging platform, more relevant topics,” she said. “We want it to be much more interactive, giving them the confidence to be able to launch their business, to make a difference in their communities and to be profitable.”

The post After Record Year-Over-Year Franchisee Signings, HomeWell Bolsters Support Systems appeared first on Home Health Care News.

At the Home Care Association of America’s (HCAOA) annual conference last month, providers offered a peak behind the curtain on how those determinations take place.

Hillendale Home Care CEO Jesse Walters, A Long Term Companion (ALTC) Vice President Brett Ringold and Michelle Cone – SVP of training and brand programs at HomeWell Care Services – all offered up different perspectives on how they approach compensation.

“What we can do to try to attract the workforce to the home care industry is something that we all carry on our shoulders, and it’s important for us to come together in industry settings such as this and share with one another,” Cone said during a panel discussion. “What we normally see is very ill-defined processes, right? … And we want to be process-driven.”

Based in Burkburnett, Texas, HomeWell is a home care franchise with over 80 locations across the U.S.

HomeWell reevaluates caregiver compensation two or three times per year, according to Cone. Ringold said ALTC reviews compensation “at least annually,” but that that process changes based on circumstance. For instance, during COVID-19, those reviews came quarterly in some cases.

Walters said once per year is the “bare minimum,” too, but that “triggering events” can always change that.

“We look at the compensation strategy as a holistic strategy,” Ringold said. “Yes, what you pay per hour, you have to make sure that you’re competitive. But, for us, it’s total compensation, it’s a robust benefits package, affordable and comprehensive health insurance, a great menu of supplemental insurances, very advanced PTO and sick time paid time off. We also use overtime as part of our compensation strategy as well, because our caregivers love to work a lot of overtime.”

ALTC is a home care provider based in Jenkintown, Pennsylvania.

Ringold added that him and his team vigorously look over home care industry reports to make sure their offers are in line – or above – industry standards.

But part of the process is also taking into account what’s going on at the local market level.

“There’s such an opportunity for us to improve our processes and our touch points, and it’s not always pay related, but you do absolutely need to make sure that you’re not underpaying based on your local market,” Cone said. “That’s the first thing we need to solve for.”

Walters also added that a greater understanding of the local market can help in negotiating with applicants. He mentioned that an applicant may suggest they’re getting paid $30 or more per hour at a nearby agency, but his team’s market research knows that’s likely not true.

“If I have a new staffing manager or new recruiter coming on board with the team, part of their training and development is understanding the market,” Walters said.

Based in Walnut Creek, California, Hillendale provides home care services in Northern California.

In regards to the aforementioned “triggering events” that may cause Hillendale to look at compensation more than once in a year, those are often numbers based.

For instance, if Hillendale is not hiring 25 caregivers in a month, Walters knows him and his team should take a closer look at what’s happening.

“That’s usually it, I’m looking for signs that something’s slowing down, or something’s changing,” he said.

And, although the local market may change from month to month or year to year, Cone emphasized that strategies should be set with a long-term view in mind.

“Design your comp structure with the end in mind,” she said. “What is going to lead to the desired goal for your organization? And I think, again, pay is going to be incredibly important. I think we have to look outside of the obvious, though, which is just, ‘If I pay you more, you’re going to stay with me.’”

Caregiver compensation is generally directly tied to billing rates in home care. The client is charged about double what it takes to pay the caregiver per hour.

But as both have risen over the past few years, home care provider leaders have started to consider how that business model could be altered in the future.

“If I have like 60, 70, 80 core clients that want to age in place for a long time, I’m looking at those clients, and I’m looking at those caregivers, and the average length of stay,” Walters said. “Historically, for us, it’s been like six to eight months. And it’s 50% margin. But what if in the future, it’s 18 months, 24 months at 40% margins? If I’m able to build alignment on what I want and what the caregiver wants, can I pay those people much better to maintain clients on a long-term basis? Does that change the unit economics in our business?”

Those are the sorts of questions providers are going to have to begin asking themselves. Home care isn’t getting cheaper, and hiring caregivers isn’t getting easier.

The sales side

Some of the questions Walters asks himself as he’s going through his compensation strategy are: What do I want at my most selfish? What does the salesperson want at their most selfish? What does the caregiver want at their most selfish?

“I try to find where people are at their most selfish,” he said. “If I can get them to tell me where they are at their most selfish and that aligns or intersects with where I am at my most selfish, then I hire that person.”

That strategy is particularly applicable for salespeople. They may want to be in home care, but caregivers are less likely than salespeople to be motivated strictly by compensation.

Leaders taking the time to talk to their workers about what they want, though, is generally always productive.

“As somebody who has shed plenty of tears in this business, I want my team to cry in the shower once per quarter,” Walters said. “I want them to show back up on Monday and figure out how they can do better.”

There are, indeed, ebbs and flows in the home care business.

That’s true for compensation and revenue, too. One thing that Ringold cautioned against was being unthoughtful about handing out raises.

“If you’re not giving out performance-based [bonuses or raises], I highly recommend you put together a strategy,” he said. “But there’s only one direction, it’s only going to go up. You can never have pay go up and then decide next quarter to take it back down. That’s never going to work. So, you have to be really thoughtful about how you’re going to approach performance-based pay.”

The post How Home Care Providers Merge Art, Science To Form Compensation Strategies appeared first on Home Health Care News.

However, creating a sustainable workforce model – one that promotes retention up and down the ladder of an agency – is about more than just the caregivers.

“When we’ve taken a [closer] look at how we can really move the needle, the low-hanging fruit between recruitment and retention is retention,” Michelle Cone, senior vice president of training and brand programs at HomeWell Care Services, said last month at Home Health Care News’ FUTURE conference. “Not just the retention of our caregivers, but retention at the agency level of our key associates.”

Cone referred to a study that suggested that retention at all positions within an organization begets retention elsewhere.

“That, by default, positively impacts the retention of our caregivers,” she said.

HomeWell is a Burkburnett, Texas-based home care franchise with over 80 locations across the U.S.

HomeWell leaders believe that those in middle management and higher-level positions need to be supported in order for caregivers themselves to thrive.

“One of our strategies at HomeWell is to focus on giving those key associates,” Cone said. “The resources, tools, learning, education and support that they need so that they can — in turn — support and advocate and be there for that caregiver workforce.”

Hiring practices

Companies like Aveanna Healthcare Holdings (Nasdaq: AVAH) have shifted their focus to hiring at a quicker pace.

“For us as an organization, this really comes down to speed to hire,” Elias Lee, regional director of talent acquisition at Aveanna, said during the panel. “We do spend advertising dollars attracting applicants to us, so making that speed-to-hire process where it’s timely and caregivers know what to expect, they are then able to move through the process quicker and ultimately be in our patients’ home sooner — which is the end goal.”

Based in Atlanta, Aveanna provides home health, hospice and pediatric care services across 42 states.

Lee and his team took stock of the company’s hiring and onboarding processes.

From there, Aveanna decided to focus on what it could control, which was that speed component.

“We pulled a lot of our departments together, sat down and challenged each other to really dissect and innovate our onboarding process,” Lee said. “There’s a lot more technology involved in our applicant tracking system that helps manage that. That’s proved to have a real upside. We’re utilizing that technology, pulling the data and making decisions based on what it shows us. It’s been really beneficial to us to create the best onboarding process that we’ve streamlined across Aveanna.”

The accuracy and reliability of that data are also important for other parts of the business.

“We need to — as an industry — make sure that our owner-operators are extracting as much value from the platforms as possible,” Cone said. “It’s credit in, credit out, right? You need to make sure that all of our teams are putting the right information in, so we can use that data to direct and provide insights into making strategic business decisions.”

As both Cone and Lee said, it’s all about those first 90 days.

“We know that when we’re able to place them with a client quicker and we’re able to provide as much support and encouragement and appreciation as possible in those first 90 days, that’s when the magic happens,” Cone said. “That’s when we see the success rates of retention start to climb.”

Old-school approach

Technology will continue to play a major role in how agencies improve their staffing situations.

At the same time, old-school approaches can be just as beneficial.

“Before we look at technologies and dashboards and these other tools, I think the first thing we need to look at is the mirror,” Griswold CEO Michael Slupecki said during the panel. “I feel like it starts at the top. We need to look in the mirror to make sure we’re attracting the right talent because A players don’t work for B bosses.”

The Blue Bell, Pennsylvania-based Griswold provides personal care services via more than 170 locations in 30 states.

Slupecki, a veteran of the industry for more than 20 years, said a key aspect of recruitment and retention is finding folks within a team that mirror a company’s culture.

“If you match up those cultural aspects, you keep that retention at the middle manager level — which I think also then drives caregiver retention and recruitment,” he said. “Everything flows from the top. I always say to people, “If you’re working on getting all A players, and you’re wondering whether or not so-and-so is an A player, they’re not. You never wonder about your A players. We really have to look at our teams and make sure we’re optimizing those teams to the best of our ability.”

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For them to continue to flourish, however, they may have to bring new ideas into the fold.

“One of the biggest opportunities out there is collaboration with your competitors in your local market,” HomeWell Care Services CEO Crystal Franz said during Home Health Care News’ FUTURE event in Nashville. “Some of our franchise owners have territories right next door to each other, and what we find is that when they work together with a fellow competitor, all ships rise even higher.”

HomeWell is a Burkburnett, Texas-based home care franchise with over 80 locations across the U.S.

While home care providers are bound to compete with each other in every market, Franz sees natural ways for competitors to learn from each other – in ways that ultimately better the lives of patients.

“When you have a lack of caregivers, you’re able to share knowledge, share caregivers and share referral sources,” Franz said. “If you can’t service a client but your fellow neighbor can, then it’s an ‘I scratch your back, you scratch mine,’ mentality. The demand is always going to be there.”

With staffing shortages, not every agency can take on every referral they receive. Clients who don’t receive care in a timely manner generally run the risk of experiencing worse health outcomes.

“I tell our employees all the time that we can’t do this alone,” Family Tree Private Care CEO Alex Bonetti said on the panel. “Family Tree is not going to be the only company to do this, hence why we collaborate with people all over the country to share best practices and ideas.”

Family Tree offers concierge-level caregiving, private nursing and care management services throughout Texas and Colorado.

Bonetti said he wishes he saw more collaboration across the space.

“At the end of the day, what I want to see from a lot of home care owners, is them taking a similar approach to the one we’re taking,” he said. “I want to see them get in the home more often and see them take on more service lines that allow a real continuum throughout the client’s journey.”

Opportunity for innovation

One of the main ways home care leaders are trying to advance their businesses is through data tracking.

“I think the opportunity for innovation is internal and external,” Executive Home Care Brand President Kevin Porter said on the panel. “I think there’s an opportunity in the health care space to be more diligent with gathering data. Taking the opportunity to truly understand where your business is coming from, and the impact that you have on the broader health care spectrum.”

That data collection doesn’t have to stay in house, either.

Sharing data with payers, health systems and other providers also helps the patient.

“In the past, when you’ve seen the collaboration between agency competitors, the satisfaction is higher,” Porter said. “We’re WellSky customers, but it would be really great to start seeing our SaaS platform partners pulling some collaborative data so that we can actually present that to the higher health care systems and to promote the continuum of care.”

The burden to collect and share reliable data doesn’t have to be on the shoulders of agencies and franchise owners, Porter said. It should be an industry-wide effort.

“It’s going to be extremely important that we let these other providers in the continuum of care know how we’re helping them with readmission rates, fall rates,” Franz added. “As home care agency owners, it’s been the wild west for a really long time. But I think there’s an opportunity to be more savvy in your own data, in your house, under your roof.”

Franz pointed to referral sources as being a key data point – that should be tracked meticulously – in order to make informed, cost-effective decisions.

“It’s so important to really track where those referrals are coming from so that you know what you want to double down on or what you’re wasting your money on,” she said. “For instance, finding out what chronic diseases have a longer length of stay so that you can not have so much turnover with your clients. Then talk to your referral sources and say, ‘I want those specific people.’”

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