Why ‘Name-Only’ Promotions May Fall Flat in Home Care

Companies across the United States are more frequently trying to recognize and retain their employees by offering promotions that come without raises attached.

It may be a popular tactic, but it’s unlikely to work in the home health and home care industries, experts say.

“It’s an interesting idea, but it gets really difficult when you start trying to compare home care—and, in particular, home care aides—with other industries and professions,” Hayley Gleason, interim executive director of the Massachusetts-based Home Care Aide Council, told Home Health Care News. “The work and the people who do the work are just different.”


Nearly 40% of U.S. employers commonly award promotions without salary increases, up from 22% in 2011, according to research from the California-based staffing firm OfficeTeam. American employees are typically taking their employers up on those offers, too, as about 64% of employees say they’d accept a higher title that doesn’t include more pay.

Male employees and workers ages 18 to 34 are most likely to take a name-only promotion, the OfficeTeam research found.

While technology startups, financial firms and other businesses have widely moved to a retention strategy of recognizing workers with name-only promotions, pay and other tangible benefits still remain the top priorities for home health and personal care employees, according to industry insiders who spoke with HHCN.


“When I talk to home care aides—and I do quite a bit of focus groups, interviews—they do say that they want better pay,” Gleason said. “That is always part of the discussion.”

The Home Care Aide Council—formerly the Massachusetts Council for Home Care Aide Services—is a not-for-profit trade association that promotes home care aides and the services they provide. As part of its mission, the council advocates on behalf of the home care aide workforce at local, state and federal levels.

Evaluating retention strategies remains important for home health and home care providers alike, as demand is expected to skyrocket as baby boomers continue to retire and grow older. Indeed, providers will need hundreds of thousands of more workers to meet that need, according to the U.S. Bureau of Labor Statistics.

But adding to that importance is the fact caregiving turnover at large remains high.

“I would challenge anyone to name an industry that’s going to hire that many people [by 2024],” Senior Helpers CEO Peter Ross told HHCN. “We need to figure out how to make caregiving a [career] destination—it’s more than just a title.”

Senior Helpers is an in-home provider of personal care services, including specialized care programs for individuals with Alzheimer’s, Parkinson’s and similar diseases. A franchisor, Senior Helpers currently has more than 300 locations in its network with roughly 25,000 total employees.

“Every time you can move that [turnover] number down, it makes a big difference in terms of client satisfaction and overall productivity of your business,” Ross, who also serves as president of the Home Care Association of America’s board of directors, said. “But I think recognition more so than just a title change goes a long way for making people want to stay and be part of your organization, to give back and keep doing what they’re doing.”

Creating a ‘caregiving ladder’ and why title alone won’t reduce turnover

On average, professionals are promoted after two years and five months in a role, according to the OfficeTeam research, which included responses from more than 300 human resource managers and more than 1,000 workers.

Beyond workers mostly wanting higher wages, there are other barriers to successfully implementing the name-only promotions strategy in home health and home care. Perhaps the biggest, Gleason said, is the reality that promotions in health care often require additional certifications or licenses.

“In order to really move up in health care, a lot of it requires that additional training and that additional schooling,” she said. “It’s not like other fields where you can move from a frontline role to maybe getting a manager title.”

Promotions that come without raises may, however, be appealing to workers in select instances, Gleason said.

For example, if a home care aide who had high travel demands was offered a new role mostly operating in a single location, he or she might find very real value in that promotion. That might include transitioning from remote work throughout a large coverage area to working in a single facility or complex.

“If there’s an improvement for the home care worker on how they view their job, that could help,” she said. “That maybe means making it more stable, but there has be some kind of benefit to the worker other than just a change in title.”

In a recent survey, about 85% of Senior Helpers’ workforce said they felt respected in their role, according to Ross. The No. 1 thing workers asked Senior Helpers to look at related to recognition, however, was compensation.

“While they do appreciate the proverbial gift card or gas card or things like that … the recognition they want now is more compensation,” he said.

Senior Helpers is working to continue strengthening its retention and slash turnover rates by creating “caregiving ladders,” according to Ross. That means launching dedicated training programs that give workers avenues for becoming specialists in certain areas, such as dementia care, he said.

The franchisor also is active in handing out monthly and yearly awards to its caregivers.

“You need as many arrows in your quiver as you can get, but you can’t do it just on [title] changes,” Ross said. “Recognition, compensation, work environment, training all need to be blended together to be effective at what we’re trying to do it this industry.”

The value of culture, environment

Chapters Health System was recognized by the Great Place to Work Institute in July for the culture and environment it had created for its employees.

Chapters Health—headquartered near Tampa, Florida—is a not-for-profit, community-based health care services organization with more than 1,500 total employees. In addition to being to being one of the largest hospice organizations in the country, based on average daily census, Chapters Health also offers home health services. Good Shepherd Hospice, HPH Hospice, LifePath Hospice, Chapters Health Palliative Care and HPH Home Health are among its affiliates.

In 2017, HPH Home Health provided services for more than 1,300 home health patients, while Chapters Health Palliative Care served about 8,000 palliative care patients. Across all affiliates, Chapters Health helped care for about 15,000 hospice patients.

Andrew Molosky, president and CEO of Chapters Health System, agreed that a name-only approach was not a viable as a standalone strategy.

“As a ‘main strategy,’ I would not view this as viable in the long run, for any organization or industry,” Molosky told HHCN via email. “A ‘one-size fits all’ approach almost never works, as all strategies must be adapted to the history, context, culture, characteristics and goals of the specific organization.”

In regards to compensation, Chapters Health strives for pay that’s “fair” relative to market, experience and other factors, Molosky said. That helps to ensure long-term commitment to the organization, he said, adding that if pay isn’t viewed as fair or doesn’t provide for basic employee needs, then it’s hard to see non-pay factors having a significant impact.

About 80% of Chapters Health employees say they take pride in working for the organization, according to an independent analysis by Great Place to Work.

“We’ve made it a strategic priority to pursue becoming an employer of choice,” Molosky said. “We focused on a systematic employee engagement survey and action planning process involving all of our team members in identifying what mattered most to them, and what would move the levers the most in terms of organizational actions.”

Written by Robert Holly

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