How One Home Care Franchisor Boosted Caregiver Retention

While many home-based care providers have struggled with high turnover in recent years, one home care franchisor is bucking that trend.

Headquartered in Cincinnati, FirstLight Home Care has an average retention rate of 80% across its entire network of 240 franchise territories in 33 states. The franchisor offers non-medical services such as Alzheimer’s and dementia care, personal care, companion care and light housekeeping.

Combatting turnover is no easy task, especially as the in-home care industry continues to face regulatory and pricing pressures, and an average industry turnover rate reported to be upwards of 60%.


“Finding the right caregivers and retaining them is critical to quality,” Bill McPherson, FirstLight’s executive director of franchise development, told Home Health Care News. “If you have the right caregivers, and they’re happy and they have longevity with the company and the families, they’re going to not only do better, they’re going to want to do better.”

FirstLight seems to have found a winning formula by helping its franchisees implement improved screening and matching practices, numerous training opportunities and offering more perks for employees.

“The cost of retaining employees is probably five times more beneficial than having to replace them,” McPherson estimated.


Road to retention

One of the biggest retention-boosting tools FirstLight offers its franchisees is a customized behavioral assessment used during the hiring process.

“[Our franchisees] are supposed to use it in every interview,” McPherson said. “It helps them bring in caregivers that align philosophically with our care.”

The assessment isn’t used just for hiring; It’s also later used to match caregivers and clients, which in turn boosts satisfaction for both sides. McPherson did not disclose specific cost savings or satisfaction analytics results, but said it helps franchisees with the retention of caregivers.

FirstLight also focuses on training as a way to help its franchisees retain caregivers. FirstLight caregivers have access to hundreds of training modules, including curriculums on how to perform CPR, how to care for someone with Alzheimer’s and instruction on state-specific rules or regulations.

Both the behavioral assessment and training modules come bundled in a software suite designed for FirstLight’s franchisees. The suite varies in cost per month, depending on the amount of payroll support franchisees want.

Big benefits 

FirstLight has helped its franchisees offer health care benefits compliant with the Affordable Care Act (ACA) for the last four years. It has also required its franchisees pay caregivers for overtime hours, requirement that was in place before the Department of Labor (DOL) changed its regulations in 2015.

“We knew the right thing to do was to pay the caregivers for overtime,” McPherson said. All these home care concepts that were not paying overtime and or health benefits…they’re scrambling because they now have to pass that cost on to a client or lose the business.”

In addition, FirstLight forbids franchisees from hiring independent contractors for caregiver roles. As a result, all caregivers are full-time employees who go to staff meetings, get awards, receive bonuses and wear uniforms.

FirstLight also recommends its franchisees pay their caregivers $1 to $3 more per hour than their competitors to attract top talent. However, pay is usually not among the top reasons the company’s caregivers choose to stay on, McPherson said.

To pay for this pay hike, FirstLight has a higher price point for its services.

“If the average bill rate to a client for personal care is $20 to $23, we’re probably going in at the higher end,” McPherson said. “And we get clients because of our retention, quality and service, and all of the tools our franchisees have at their disposal.”

Written by Tim Regan

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