Before joining Vivo Infusion, Rodgers was CEO at AccentCare for over a decade. He was also formerly CEO of OptumHealth Collaborative Care, a division of UnitedHealth Group (NYSE: UNH) that owns, manages, and provides administrative and technology services to health care delivery systems.

Earlier in his career, he was a health care executive at General Electric, responsible for purchasing health care benefits.

Vivo Infusion provides cost-effective infusion care to patients in partnership with their physicians.

Accra names Frette as chief solutions officer, Chad Derner CFO

Accra has named LeAnn Frette as chief solutions officer. Frette transitions to her new role after serving as chief financial officer (CFO) for over a decade. The company has also appointed Chad Derner to succeed Frette as CFO.

“Over 18 years of service at Accra, LeAnne has guided our organization through tremendous growth and helped us maintain financial success despite constant disruption in the home care industry,” said Accra President and CEO John Dahm said in a statement. “Her expertise will be critical in clearing the future hurdles we face to best serve the thousands of Minnesotans who need care at home.”

Accra is a nonprofit organization providing individualized home care services to people with disabilities and older adults. Headquartered in Minnetonka and operating in all counties throughout Minnesota, Accra helps people who need care get self-directed assistance with activities of daily living.

As chief solutions officer, Frette will partner with leadership on all operational and strategic issues and provide recommendations based on financial analysis and projections, cost identification and allocation, and revenue/expense analysis.

“I am excited to dive into my new role as chief solutions officer and look forward to collaborating with Accra’s executive leadership team on strategies to build an ecosystem that better meets the needs of Minnesotans who require personalized care at home,” Frette said.

Frette started with Accra as a system analyst in 2006 and supported the company’s growth by building out its financial operating systems and practices. She was named CFO in 2014.

Taking on Frette’s former role as CFO, Chad Derner will manage Accra’s accounting and billing departments, oversee all financial activities and operations and provide strategic guidance to leadership. Derner joins Accra with 25 years of experience in finance and accounting, the last 16 of which have been in leadership.

“I am thrilled to welcome Chad Derner as Accra’s new CFO,” Frette said. “Having dedicated many years to this role, I understand the importance of having a leader with Chad’s extensive experience and strategic vision. I am confident that Chad’s broad health care experience will help Accra grow and thrive in our ever-changing industry.”

Derner will focus on identifying opportunities to optimize financial strategies across all of Accra’s business ventures. He will be critical in ensuring Accra fosters financial excellence and strategic growth.

“I am excited to join this dedicated team and contribute to Accra’s mission by ensuring financial excellence and strategic growth,” Derner said. “I look forward to leveraging my experience in financial management and technology-focused health care to support Accra and significantly impact our community.”

CaringBridge announces new board members

CaringBridge, a Bloomington, Minnesota-based health care platform supporting family caregivers, recently announced new members to its board of directors: Sandy Chung, American Academy of Pediatrics immediate past president, CEO of Trusted Doctors, Medical Director of the Virginia Mental Health Access Program; Kristy Lindquist, co-founder and partner at Chasm Partners and Steve Margolis, retired health plan executive, independent board member and current president of the Vitality Group.

The company also announced that retired health care executive Sarah Krevens was the board chair, and Linda Ireland, an independent board director, was the board vice chair.

Calvin Allen, executive vice president and chief human resources officer at Children’s Hospital of Philadelphia has joined as Treasurer, Finance & Development Committee chair.

Cris Ross, chief information officer at Mayo Clinic, is the new Impact Committee chair.

Adrian Slobin, chief growth officer at Huron Consulting, has joined as the Governance Committee chair.

Scott Spiker, board director and chairman at First Command Financial Services, is board chair Emeritus.

“I am thrilled to welcome our new members to the CaringBridge board,” CEO Tia Newcomer said in a statement. “Our board comprises seasoned professionals in health care with deeply personal connections to caregiving. I am truly excited about the future and what we will accomplish together. The board is essential in continuing our path of meaningful and transformational work to surround family caregivers with emotional, social and functional support as they care for a loved one on a health journey.”

nVoq welcomes Iddings as chief revenue officer

nVoq announced Dawn Iddings as its chief revenue officer. Iddings brings over 20 years of experience in health care, technology and electronic health records. Most recently, she served as senior vice president and managing director of post-acute care at Netsmart Technologies. 

“Dawn is an incredible addition to our executive team,” President and Chief Operating Officer Debbi Gillotti said in a statement. “Her deep expertise in the in-home health care market, combined with her career-long commitment to creating technology solutions for our industry, will elevate our ability to service our agency customers and industry partners.”

nVoq Inc., headquartered in Boulder, Colorado, provides HIPAA-compliant, SaaS-based technology for the in-home health care industry.

“The in-home health care market is on the brink of a significant transformation, and AI is at the heart of it,” Iddings said in a statement. “nVoq has been developing and evolving this technology to meet the unique needs of clinicians for over a decade. Our solutions continue to redefine efficiency, quality and accuracy in clinical documentation, and I’m thrilled to be a part of this journey.”

One Senior Care expands executive leadership team

Erie, Pennsylvania-based One Senior Care announced the expansion of its leadership team.

As chief medical officer, Dr. Jerry Wilborn, a 25-year veteran in post-acute care, will work alongside the organization’s medical directors to drive clinical strategy and positive health outcomes.

“Over the last few years, it’s become increasingly clear that seniors want to age in their homes. One Senior Care is making this a reality for the older adults we serve in Pennsylvania, Virginia, Kentucky, and soon, Ohio,” Wilborn said in a press release.

The newly appointed chief operating officer, Craig Worland, brings a professional background in leading growing health organizations, having previously served in Southeast Primary Care Partners and Tanner Health System.

“I’m honored to join One Senior Care, which has great potential to expand this truly integrated and participant-centered program to serve more older adults and communities across the country,” Worland said in a press release.

As chief quality and compliance officer, Laura Lyons will enhance the company’s quality and compliance programs, according to the release.

“As we look toward the future, we look forward to building upon our reputation in quality care and continuing to ensure that older adults can live healthy, happy and independent lives in their own homes and communities,” Lyons said.

Element Care appoints Thompson new CEO

Element Care announced the appointment of Douglas Thompson as chief executive officer (CEO). Doug brings experience in health care leadership, financial management and community engagement to the company.

“In seeking a new CEO, it was essential to the board of directors to select a candidate that not only has the leadership and technical skills necessary to manage such a complex organization but also someone committed to providing high-quality health care to low-income seniors,” President of the Board of Directors, John Feehan said in a statement. “We are extremely excited to have Doug join the Element Care team and look forward to working with him to bring high-quality, wrap-around medical services to many more seniors in need.”

Element Care, based in Lynn, Massachusetts, provides managed care for senior care options (SCO) under a contract with Commonwealth Care Alliance. The company serves over 1,000 Program for All-Inclusive Care for the Elderly (PACE) participants and 2,000 SCO members across 60 North Shore, Merrimack Valley and Greater Boston communities.

“I’ve worked with diverse populations throughout my career and am passionate about developing innovative programs to serve patients with complex health needs,” Thompson said. “I am excited about the mission and high quality of health care that is the foundation of Element Care. I look forward to building on the success of this organization and leading its next chapter as the population of aging seniors continues to grow.”

Thompson was previously the CEO and founder of Perfect Health Inc., where he developed a comprehensive primary care clinical model as a risk-bearing provider organization focused on serving seniors with complex health care needs at home. He was also the former chief financial officer of the Massachusetts state Medicaid program and three Medicaid managed care organizations.

Avenues Home Care welcomes Hendrix as senior care coordinator

Avenues Home Care announced Grant Hendrix as senior care coordinator for northwest Georgia and southeast Tennessee. Hendrix will help families and veterans living in Dalton, Chattanooga and surrounding areas engage with home care services to meet their needs.

“At Avenues Home Care, we are committed to offering those we serve professional, compassionate and flexible home care solutions,” CEO Doug Markham said in a press release. “With our years of experience and industry knowledge, we empower our local teams to foster meaningful connections within the community. Grant’s extensive experience, education, and the Avenues’ vision and support give him the essential insights and resources to ensure we meet our clients’ distinct needs.”

Dalton, Georgia-based Avenues Home Care is the parent company of community-centric home care agencies spanning multiple communities across the South. The company provides in-home senior care, activities of daily living, medication assistance, meal preparation, companionship, transportation, light housekeeping and more.

“Avenues’ motto, ‘your journey, our care,’ is something I will strive to remember every time I visit families and their loved ones,” Hendrix said. “My passion is to connect people to exceptional home care services that will help improve their quality of life. With their excellent reputation and resources, Avenues Home Care has given me a great opportunity to help families in the areas we serve.”

In his new role, Hendrix will analyze the market, visit communities and meet with clients in their homes.

Integrated Home Care Services Inc. welcomes Ajani Nimmagadda as CMO

Integrated Home Care Services Inc. (IHCS) announced that Dr. Ajani Nimmagadda has been named the organization’s new chief medical officer. Nimmagadda will assume clinical and medical management leadership across the organization.

“Dr. Nimmagadda’s leadership in driving clinical outcomes, quality of care and health care affordability will be instrumental in helping us continue to fulfill our mission and support our continued growth,” CEO Christopher Bradbury said in a statement. “Her proven track record of achieving better outcomes for patients, providers, and health plans and her expertise across the health care ecosystem will further accelerate our innovation and value-based care solutions.”

Integrated Home Care Services is a home care benefit manager that enables and accelerates value-based home care for health plans and risk-based provider organizations. Headquartered in Miramar, Florida, the company services millions of patients across many states and Puerto Rico.

“I am honored to join IHCS as chief medical officer,” Dr. Nimmagadda said. “I look forward to leveraging my experience in successful health care operations and improved operational efficiency while optimizing clinical outcomes. IHCS’s approach is reinventing home care benefit management, replacing fragmented approaches with an integrated, insights-based, coordinated model that improves clinical outcomes and patient experience and reduces health care costs. Improving care in the home has always been a passion of mine, and I look forward to unlocking the full potential of care in the home with our team members, providers, caregivers and health plan partners.”

Dr. Nimmagadda has nearly three decades of experience in health care, both as a practicing internal medicine and infectious diseases physician and as a health care executive.

Most recently, she served in various leadership roles at Cigna Healthcare, overseeing comprehensive medical and pharmacy utilization management programs and specialty drug clinical programs, including gene therapies.

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But some provider leaders are hesitant – for a number of reasons.

“For our patients, consistency is key,” Innovive Health COO Kristen Palumbo told Home Health Care News. “It would be challenging to have many different clinicians rotating in and out of a patient’s routine care schedule. We really do try to minimize that. Establishing trust and consistency is super important for improving our patients’ outcomes and achieving goals for our patients.”

Innovive Health is a Massachusetts-based home health provider with a unique patient population, one that includes patients with both complex medical and psychiatric comorbidities.

Broadly, workforce sharing is an employment model that utilizes independent contractors, on-call or temporary workers to fill in for full-time employees. Theoretically, it could help out home-based care agencies at large, allowing them to share a larger group of workers to fill shifts.

On average, Innovive’s patients have about 10 to 12 comorbidities, Palumbo said.

“They’re quite complex,” she said. “So it’s important for us that we attract and retain highly skilled nurses to be able to provide care for them.”

Introducing a workforce-sharing model could potentially add complications when it comes to providing quality care to patients, some believe.

“Take our patient demographic out of it, the reality is that you’re talking about seeing a patient in their own space, in their own home and welcoming a stranger — essentially — into your home,” Palumbo said. “Whether it’s strictly related to their medical or psychiatric conditions, I think in-home care, in general, it’s uncomfortable to be on the receiving end of not knowing when someone is coming or who is coming.”

Innovive’s patient population is likely even less suited for the model than other home-based care providers because of the psychiatric component. But, either way, home-based senior care can be an area where trust is hard to build up in the first place.

And, the company does implement some types of workforce sharing. For instance, it does have groups of clinicians who share the same patient caseload within a defined area.

However, deploying a workforce-sharing model at scale is not something Innovive is considering.

The same goes for Accra, which is the largest provider of home care services in Minnesota.

Among its offerings, the nonprofit company delivers assisted living, home health and mental health services, caring for more than 9,000 clients statewide.

KC Ferk, the home health program director at Accra, told HHCN the company hasn’t considered workforce sharing.

“We haven’t considered anything like that, in part because I don’t think we have enough information about it,” Ferk said. “One thing that comes to mind is that home health is a very regulated industry and it sounds like that would be too major of a change to our business model.”

Ferk also wondered about the complications that might come from scheduling, sharing electronic health records between employees and losing that consistency between patient and caregiver.

“Our patients are oftentimes coming from a fragmented care delivery system,” Palumbo said. “We really strive to be that case management hub that eliminates that for them. So, again, we do have clinicians who share a caseload of patients and we’re able to do that as long as, within that, we’re able to establish consistency and routine scheduling.”

Workforce sharing could certainly work for some providers, especially down the line. It could also work for certain services within a company.

At the same time, right now, it may be too big of a reach in such an intimate patient setting.

“One of the important things around home care is that you really, truly are collaborating over this care plan with the patient,” Palumbo said. “Having somebody just pop in, I think that it’s valuable when it comes to certain tasks. But as far as really marching forward towards patient goals, I think it’s really challenging to have many different providers coming in and out of your home, and still being able to work towards that goal.”

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Home-based care providers are regularly touting their ability to establish and cultivate organizational culture.

One of the ways to do that is to create clear paths for employees at all levels to be promoted.

“Agencies — especially in home care and hospice — want to create a culture that they want to be known for,” Hannah Patterson, vice president and general manager for workforce management at Netsmart, told Home Health Care News. “They’re very passionate about their cause and want people that have that same understanding. I think the longer tenured people you have, the more they understand what the passion and desire behind that organization is, and they become the brand.”

For instance, in the past, home health and home care providers looking for leadership talent would often look outside for the best possible candidate. But to maintain a consistent culture – particularly since the onset of COVID-19 – more providers are starting to hire from within.

They’re also reconsidering some roles entirely, opting to shift duties around to a number of employees when a high-level manager leaves, Patterson said.

According to a recent study from consulting firm BerryDunn, 63% of home health agencies across the country are predicting leadership turnover in the next three to five years will have a negative impact on their organization.

On the bright side, 89% of home health agencies have a formal strategic legacy and staffing plan for leadership vacancies when they eventually arise, which is a far higher number than in hospice.

It’s important for providers to pause and reassess the company’s goals when filling positions, Patterson said, whether it’s caregivers or C-suite positions. This goes for hiring caregivers all the way up to C-Suite positions.

Why this trend is good

A term that is brought up regularly in regards to hiring and promoting from within is institutional knowledge.

Especially in an industry with such specific nuances such as home health and home care, leaning on institutional knowledge at all levels of a company is important to growth, Amedisys (Nasdaq: AMED) Chief Strategy Officer Nick Muscato told HHCN.

“It’s an incredibly complicated space, just in general,” Muscato said. “It takes a while to learn the business that you’re in, how to operate the business and then it takes a while to learn how to interact with the people internal to the company. Once you’ve built that institutional knowledge, I think you become a significantly more productive employee and as such, you become more of a value add to your organization.”

In 2007, Muscato worked for Humana Inc. (NYSE: HUM) in a corporate development and strategy position. He eventually worked his way up to run the company’s venture investment arm and then was recruited by former Amedisys CEO Paul Kusserow to join Amedisys in 2015.

After his first year at Amedisys, Muscato started to take on more responsibilities around investor relations, treasury and data analytics, which all led to his promotion to chief strategy officer in April.

“There are people internally at Amedisys today, at all different levels from our CEO, CFO, down to our manager and analyst positions, that I would view as subject matter experts around specific functions,” Muscato said. “Whether you’ve been in the industry for 30 years, or whether you’ve been with Amedisys for 10 years, everyone has a different kind of knowledge set.”

Looking at the leadership roles at Amedisys now, two-thirds of all positions were filled through internal promotions. It’s not necessarily an easy process to get to this point, however.

“In order to drive a culture, it has to disseminate from the top, but it has to live, breathe and be enacted upon in all layers of the organization,” Moscato said. “If you’re allowing people to progress in their career and keeping good people, that culture just gets solidified at different layers of the organization.”

Other examples of this include Jeff Leer at Newtown, Massachusetts-based AlerisLife Inc. (Nasdaq: ALR) being promoted to president and CEO, Glee McAnanly being named CEO of FirstLight Home Care a year after she was named president and the Minnesota-based Accra promoting Susan Morgan from chief compliance officer, to chief program officer, to COO.

These in-house promotions, Patterson said, are also indicative of how quickly the home-based care space is evolving. It helps create stability in a company’s mission when the same decision makers are there for every step of the journey.

What agencies can learn from this trend

One of the things agencies can do to help cultivate a more supportive culture when it comes to internal hires is to publicly promote those promotions.

“A lot of times, earlier career promotions are not traditionally exposed to what I’ll call a board presentation or an executive presentation,” Patterson said. “If you create these little pockets of ‘tiger teams’ and get people engaged, I think you’d be fascinated to see how quickly something starts buzzing around the organization and the agency.”

Treating an in-house promotion from an LPN to RN can be treated similarly to when a CSO is promoted to the CEO, Patterson said. That shows employees that their work is valued.

It’s also important for agencies to remember that not every employee is as ready as the next for one for these promotions.

“A great part of being an executive leader is you see skill sets in people that they don’t traditionally see in themselves,” Patterson said. “But oftentimes when folks are asked to step into a bigger role, they may not have been prepared for that, personally or professionally. [Executive leaders] need to have that open dialogue and make sure that they feel 100% supported on all facets,”

That same mindset seems to have caught on at places like Amedisys and other large agencies.

“Our most precious asset is our employees, whether it’s someone in the mailroom, a caregiver at the bedside or our CEO,” Moscato said. “We are a company of people and in an environment when it is becoming harder and harder to hire good people, keeping the top talent that we have once we recruit those people is paramount to our success. We want to foster and develop a culture where people want to come here and they want to stay here.”

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The Minnetonka-based Accra is the largest provider of home care services in Minnesota. Among its offerings, the nonprofit company delivers assisted living, personal care, home health and mental health services, caring for more than 9,000 clients statewide.

Although Accra has been around since the early 1990s, in recent years, the company has seen its financial management services division grow exponentially. Generally, financial management services cater to clients who want to self-direct their care services instead of receiving support from a professional provider.

Accra’s financial management services program supports people who want to specifically self-direct their care services through the Consumer-Directed Community Supports (CDCS) program or the Consumer Support Grant (CSG) program. The program enables clients to hire and employ their own caregivers, while Accra supports them in fulfilling their responsibilities as a participant employer, Susan Morgan, Accra’s chief operating officer, told Home Health Care News.

“We process employee timesheets, vendor payments, expense reimbursements, workers’ compensation enrollment, and federal and state tax filings,” said Morgan, who was recently promoted to COO after serving as Accra’s chief program officer. 

Staying ahead of the curve when it came to enhancing its service lines for clients was the main appeal of entering this space.

“Accra has always been a leader when it comes to developing new programs,” Morgan said. “We decided right away that this was a service that we wanted to offer to our clients. We were learning right along with everyone else, but we knew it would offer more independence to the clients. To do this, we had to contract with the state to become what, at the time, was called a fiscal-support entity.”

The program is approved by the state of Minnesota for Medicaid recipients.

Accra’s financial management services program initially started small, but in recent years it has become the company’s largest service lines across the state.

“It actually took a while for the counties to even wrap their head around what this program was,” Morgan said. “In the last five years, the program just has continued to grow.”

While the program isn’t responsible for bringing in Accra’s largest profits, Morgan pointed out that as a nonprofit organization, the company’s financial targets tend to be lower.

Plus, the strength of the program lies in the fact it provides Accra’s clients with hands-on assistance.

“We don’t just provide the client a manual and expect that they’re going to be able to manage this on their own,” Morgan said. “We assign a service coordinator … who stays in touch with the family to assure that all the appropriate paperwork is completed. We stay in touch with the county case manager to ensure that the reimbursements that they approve are appropriate for the family.”

As a provider working in the Medicaid space, Accra has its eye on the new law that raises the federal matching rate for Medicaid home- and community-based services spending by 10%.

It’s too early to tell what kind of impact that bump will eventually have, according to Morgan.

“We don’t know exactly how those dollars are going to be distributed across the state of Minnesota,” she said. “We have government affairs staff who are staying in touch to see how it will benefit the clients we serve. We anticipate that there will be some type of a benefit, but, at this time, it’s difficult to speculate what that might be.”

Ultimately, Accra’s goal is to develop an ecosystem of care, one that will bring primary care into the home of clients in order to improve health outcomes and lower the total cost of care. The company is hopeful that additional reimbursement can aid in this effort.

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Accra has promoted Susan Morgan to the role of chief operating officer.

The Minnetonka-based Accra is the largest provider of home care services in Minnesota. Among its offerings, the nonprofit company delivers assisted living, home health and mental health services, caring for more than 9,000 clients statewide.

Previously, Morgan served as Accra’s chief program officer. Before that, she was the company’s chief compliance officer.

In her new role as chief operating officer, Morgan will be responsible for operational performance and the overall client and caregiver experience, according to Accra, which has helped its client live independently for more than 25 years.

“Susan’s leadership is critical to Accra’s ability to deliver exceptional home care services in every county across Minnesota,” John Dahm, Accra’s president and CEO, said in a press release. “With her operational expertise and unique understanding of the home care experience, Susan is well equipped to help guide Accra through future expansion of services and collaborations with new partners in the health care system.”

ConcertoCare appoints chief growth officer

ConcertoCare has hired Nevada Griffin to be its next chief growth officer.

Backed by Deerfield Management Company, the Aliso Viejo, California-based ConcertoCare offers in-home primary care, virtual care and PACE services to dual-eligible seniors and those enrolled under Medicare Advantage.

In his new role, Griffin will lead the company’s business development, growth strategy and marketing.

“Nevada’s understanding of the challenges associated with access to health care, coupled with his tremendous skills and experience in transformative health care settings, make him a valuable asset to the company as we venture to serve a wider network of vulnerable patients nationwide,” Dr. Julian Harris, chairman and CEO of ConcertoCare, said in a statement.

Prior to his appointment, Griffin was interim co-head of Uber Health, where he led business development and strategic partnerships. Before that, he was an expert consultant at McKinsey & Company’s health care practice.

Additionally, ConcertoCare recently named Dr. Amy Flaster its chief medical officer. Flaster previously served as the senior vice president of population health at Health Catalyst.

“ConcertoCare” was formed in February following the merger of ConcertoHealth and Perfect Health.

“The care models, technology platforms and cultures of Perfect Health and ConcertoHealth were incredibly complementary and provide the foundation for a new company,” Harris told HHCN at the time.

Clover Health adds new board member

William Robinson has joined Clover Health Investments Corp. (Nasdaq: CLOV) as a member of its board of directors. Clover Health is a Franklin, Tennessee-based Medicare Advantage insurer.

The company’s in-home care model utilizes technology, including data analytics and machine learning, to identify its highest-risk members. It then finds solutions to lower their risk of adverse health events.

As a member of Clover Health’s board of directors, Robinson will serve as chair of the talent and compensation committee.

“Bill’s track record of building and leading world-class operational and HR teams for global companies is unparalleled,” Vivek Garipalli, CEO of Clover Health, said in a press release. “His expertise and guidance as chair of Clover’s talent and compensation committee will contribute greatly to our success as a publicly traded health technology company, and we are thrilled to have him on board.”

Previously, Robinson served as executive vice president and chief human resources officer at Sabre (Nasdaq: SABR), a software and technology provider.

Before that, Robinson was the senior vice president and chief human resources officer at Coventry Health Care, where he played a key role in executing the sale of the business to Aetna.

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This demonstration project is an opportunity to bring new interventions and experiment with possible solutions to the dramatic shortage of both home health aides and personal care attendants, Susan Misiorski, vice president of workforce innovations at PHI, a Bronx, New York-based research and consulting organization that focuses on the direct care workforce, told Home Health Care News. Misiorski began her career in nursing, specifically as a direct care worker.

“You can imagine that given the fact that we already have a shortage in non-rural communities that [it] is just magnified in rural locations where there simply aren’t as many people available to be trained and hired for these roles,” she said.

The landscape

The initiative began with a landscape study that analyzed the current home health care situation in both states. PHI released two reports last year and began searching for providers to be a part of the pilot program.

Knute Nelson Knute Nelson

Accra, Benedictine Health System and Knute Nelson were chosen in Minnesota to be a part of the program. In Wisconsin, Community Living Alliance and Lori Knapp Companies were chosen.

The grant will go through October 2020 and there are many pieces of it, from coaching and leadership training to creating new and innovative career paths for home health care workers. It’s all mapped out, Brooke Zabel, vice president of human resources at Knute Nelson and Knute Nelson’s project lead for the PHI grant, told HHCN.

Knute Nelson is a provider of assisted living, home health care, hospice and long-term care in 21 counties in West Central Minnesota. The organization served 6,386 patients in 2017 and currently employs 553 people.

Turnover, wage and retention challenges

Part of the focus of the program is on finding solutions to problems in the sector.

“There is no reliable source of turnover data in home care. So, what we have had to do is gather the data from specific employers, and what I can report is that the turnover amongst home care workers is high in general. Most employers report turnover rates between 40% and 60%,” said Misiorski. “And that’s partly because of the overall quality of the job itself—it’s not a high paying job so we are talking about individuals that are not making high wages and they find it difficult to live on the hourly wage that they get in home care.”

For example, the hourly wage in 2016 for personal care aides in Minnesota was $11.48 and for home health aides it was $12.45. The state hourly wage for all occupations is $18.88, according to data from PHI and the State of Care, Minnesota’s Home Care Landscape report.

“Part of the challenge with the wage issue is that it is directly tied to the reimbursement system. The reimbursement rates are not high enough to support higher wages,” said Misiorski. “Home care agencies are challenged to try and offset with a variety of different income streams, like private pay clients.”

But more issues arise for a provider in rural areas because there aren’t many private pay clients to increase its income streams.

In Minnesota, people 65 and older living in rural areas with income 200% below the federal poverty line make up 46% of the population, according to Misiorski.

Another challenge is how far some workers have to travel to each patient.

“[One] of the things that may hinder home health care workers from being successful is just having access to transportation and having a reliable vehicle because really they are working out of their car,” said Zabel.

Hoping for results

With big challenges come sweeping solutions.

Zabel said that there a lot of ideas around finding new hires and looking outside of their usual staffing pipelines.

But as far as retention goes, Knute Nelson is trying to continue and improve on providing a culture where workers feel connected, she said.

“When they’re out working in the homes, they are on their own and so increasing that feeling of being connected to a bigger picture is something we work towards and strive to do each day,” said Zabel.

One of the interventions PHI focuses in on is developing mentor relationships so that newly hired staff feel connected, heard and have a person to look to for advice and support. This specific role also allows some care workers to advance in their careers by eventually becoming a peer mentor, which can include a wage increase and more responsibilities in their day-to-day.

The organizations within the program believe that most of the solutions can be applied outside of Minnesota and Wisconsin. The idea is that the pilot program can be an example for how other states can combat similar in-home health care issues, whether in rural or urban areas.

The plan is to release several reports over the next few years.

The program almost certainly can be replicated, according to Kathleen Murray, an organizational learning developer and trainer at the Benedictine Health System (BHS).

“[BHS is] in five states, [so] we want to take what we see is successful and roll it out within our community and facilities,” Laura Campbell, the director of organization learning at BHS, told HHCN.

BHS is a Catholic nonprofit health system based in Duluth, Minnesota. The system provides senior care and complete long-term care, independent living and assisted living services across five states.

For PHI, the ultimate goal is to improve recruitment and retention of health care aides and personal care attendants, and by doing so, to also increase access to services in rural locations.

“We’re going to bring a variety of interventions to try and improve the overall job quality so that it becomes a job that people want to stay in,” said Misiorski.

Written by Kaitlyn Mattson

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