This article is brought to you by KanTime. The article is based on an interview that took place during a live Q&A session with Lucy Lopez, VP of Implementation at KanTime; Allan Levine, Senior Vice President of Growth and Revenue at Nevvon; and Malka Trump, CPA and CPP at Viventium. The interview took place at the Home Care Conference in Chicago held on December 9, 2021. The interview has been edited for length and clarity.
Home Health Care News: Today, we want to focus on a few retention strategies that could help with the ongoing workforce issues that we’re seeing in home care. Can each of you give me a brief intro on your role within your company and your passion when it comes to home care?
Malka Trump: I am a CPA, a CPP, and I’m the Director of Compliance at Viventium where I’ve been for about 12 years. At Viventium, we are really focused on helping our agencies be in the know with all the latest compliance regulations that affect the payroll industry, because they’re always changing and it’s a daunting task to stay on top of it all. We also pride ourselves in providing software that helps our agencies streamline their compliance. I’m really excited to be here together with you all.
Lucy Lopez: I’m a Physical Therapist Assistant by trade. I’ve been in the home health world for about 17 years. My current role is the VP of Implementation at KanTime Home Healthcare Software. In the field, I’ve spent time as a clinician using software as an end-user through being the Director of Operations at a home health agency using KanTime as our agency software before I made my move here to KanTime about four years ago.
Today, I am a little bit of a nerd of sorts when it comes to KanTime. I get a lot of joy out of helping agencies standardize their process and really take full advantage of electronic software and technology to improve their processes and efficiencies throughout managing the agency.
Allan Levine: I am the Senior Vice President of Revenue and Growth at Nevvon. I’m newer to home health care, specifically to Nevvon. My background is coming out from the human capital management space, so the HCM space, as well as FinTech in a previous role in health care.
At Nevvon, our motto is better training, better outcomes. That’s truly what we’re passionate about, is really training the home health care aid and making sure that they’re getting what they need. From a compliance perspective, we ultimately want to make sure that there are truly better outcomes when it comes to training.
HHCN: Allan, I read a staggering statistic from Gallup that says only 12% of employees believe their companies’ onboarding programs adequately train them for their roles, which leaves roughly 88% feeling inadequately trained. Since it is important to get off on the right foot, what are some of the types of learnings that caregivers appreciate?
Levine: When we take a look at training caregivers, it’s really about ease of access. We’re very much a caregiver-centric company. We constantly put ourselves in their shoes. There’s many different terms for it, so we look for things like ease of access. People don’t want to sit in front of an hour-long Webex that needs to be engaging. It needs to be bite-sized. A caregiver doesn’t necessarily always have a lot of time to do their training, maybe they’re sitting on the bus, taking the bus ride home, and that’s a fifteen-minute increment.
The way that we design our training is really what we call micro lessons or bite-size learning. It’s easy to access, it’s mobile-centric, and then ultimately, we train them in their native language. We are constantly developing new languages for our content. It’s something that’s very important to them. It’s a lot of the feedback that we get from the agencies as well, so we train on up to 14 different languages right now, not using Google Translate. We actually translate it with native speakers.
HHCN: Lucy, in the EMR world, can you answer the same question about the types of training that caregivers appreciate?
Lopez: Absolutely. In the EMR world, and especially in the post-pandemic world, we see that caregivers greatly appreciate still the ability to have hands-on training. Within that hands-on training, they also appreciate having the convenience of being in their own home now that we’re in the post-pandemic world, and they also want to be able to do that at their own pace.
Anytime you have the ability to allow your caregiver to touch the software, see the software, learn how to navigate it in advance of their first assignment, you’re going to have those better outcomes, and have the training be much more appreciated by the caregiver themselves.
HHCN: Allan, what shifts have you been seeing in training recently?
Levine: There’s a common theme that I’ve heard today, and I’ve heard since I got into the industry, and it’s about schedule flexibility, training flexibility, and personalization. We’re seeing more content around obviously, infection control when it comes to things like COVID, we’re seeing, things like compliance really bubbling up to the surface, especially when we go state by state.
HHCN: What learning programs are important for onboarding? There are few areas that also need to be in place for caregivers to have a great onboarding experience. Things like scheduling, and paying more. Lucy, what challenges do you hear about when it comes to caregiver scheduling?
Lopez: I hear a lot of challenges on two sides of the house. You see the two different points of view from the caregivers. We hear a lot of challenges regarding them having advanced notice of their scheduling that’s coming up or what their plan to be working.
Then there’s the other side of the house, the agency side of the house that we hear about and their challenges that they experience with being able to accurately staff a caregiver quickly which comes with being able to identify that information and who’s available for this patient at this time in this area very quickly.
Then, of course, internally within the agency themselves, we hear a lot of challenges of the interdepartmental communication between HR knowing that there’s a new case that needs to be staffed and so we have to hire, as well as the schedulers, the coordinators knowing there’s a new employee who’s ready to go and needs to be staffed and they need their first shift, so we hear a lot of those challenges on those two different sides.
HHCN: Lucy, in your opinion, how can agencies better manage scheduling to reduce caregiver turnover?
Lopez: Thinking about caregiver turnover in regards to just scheduling, if you stripped away everything else on all the other challenges too, that there are to maintain an employee with your agency. If you’re keeping them happy and your pay is all right, and we’re looking at just scheduling that’s causing the turnover. We look at the consistency of their hours and their ability to earn a paycheck week after week that’s the same, that they can count on, and rely on.
In my opinion, when it comes to how to mitigate those challenges, you really have to look at the core of that issue and find ways to keep their hours consistent and unfortunately in home health, that’s the nature of the game. Identifying areas where you can supplement those hours with some other type of work, being able to present ways to incentivize caregivers to pick up shifts that are available, whether that’s in a pay rate increase or a quarterly bonus for the caregiver who is willing to pick up the most shifts.
Then also on the scheduler side of the house, incentivizing that group of employees with who’s able to staff the most shifts that need to be restaffed and replaced. There’s some ways to help improve that.
HHCN: I want to talk about another important area, which is pay. Can you talk about the importance of pay accuracy and caregiver trust?
Trump: Pay accuracy is so important, and often it’s overlooked or maybe taken for granted, but in the home care industry specifically, where every dollar really counts for these caregivers, it is so important that their pay be accurate every single time. Making sure to prioritize pay accuracy is really key for agencies, and also to make sure that your caregivers know that this is your priority, and to keep the lines of communication open.
If they have a question or they don’t understand their paycheck, they have a process to get clarification or if there’s a change coming up maybe because of a new regulation or some internal change, making sure that’s communicated beforehand and that there is an understanding there. It’s really hard to rebuild trust once a worker finds an error on their paycheck. There’s no room for error and the stakes are high. Making that a priority is really going to be where you want to go because in the long run that is going to build and maintain your caregiver’s trust and loyalty.
HHCN: Part of trust is making sure that payroll is accurate every time, how can agencies ensure pay accuracy?
Trump: It’s complicated as I’m sure many of you are familiar with. There is a myriad of regulations on the federal level, on the state level, and on the local level, especially in the home care industry where there is this trend to pass regulations to protect caregivers. We are seeing our agencies dealing with a vast array of payroll compliance issues, things like daily overtime where you have to pay your employees overtime for hours worked in excess of a certain amount in a day, or seventh day overtime, or even double time on that seventh consecutive day of work.
There’s a lot to keep track of and there’s many ways to make sure that you’re on top of it, but I’m going to mention two things that I think are really important that agencies do. One, stay educated. Make sure that you have that reliable source of expert guidance and knowledge to keep you informed so you know what’s relevant to you.
Number two, is to make sure you have technology that’s going to simplify compliance. Software that has features like automatic pay calculations help tremendously . If a caregiver gives in retro pay to make sure that it’s calculating correctly. It’s going to take out the manual work. It’s going to minimize errors and ensure that every single caregiver pay is accurate each and every time.
HHCN: How do you show pay transparency to your caregivers to prevent turnover?
Trump: Pay transparency is really important. I touched on communication earlier, making sure that the caregivers have a way to ask questions and they know what’s coming up if there are any changes, but even taking a step back from that, pay transparency really comes down to a pay stub that’s not only accurate, but is easy to understand because you can be paying caregivers 100% in compliance with every regulation out there. If they’re looking at their stub and they’re confused and they don’t know why they’re getting paid and what they’re getting paid, they’re not going to be happy.
The best situation is they leave, which is not good for retention, and the worst situation is they’re going to log a complaint with the department of labor which you don’t want to get into. Pay transparency is key here, and many states have actually passed regulations requiring certain disclosures on pay stub for this reason, so that employees know why they’re getting paid. Being on top of those regulations, those disclosure requirements are really important and that is going to instill this confidence in your caregivers that their agency is paying them what they’ve earned and what they’re entitled to.
HHCN: Allan, what correlations do you draw up between training and retention?
Levine: When you take a look at the training life cycle, I would say it all comes down to engagement. You need to have an engaged employee to retain an employee. If they’re not engaged, they’re going to be looking elsewhere. They’re going to be motivated by other things. Right from onboarding through in-services, there has to be many different engagement touchpoints. When we talk specifically about training, how we do that is through different modalities of learning as an example, so we gamify it.
We have many touchpoints, we shorten the lessons, and we do a lot of different things to create those engagement touchpoints to keep the caregiver engaged with the training. They want someone to be reaching out to them once a week, to know that they have access to other resources when it comes to pay, when it comes to scheduling, and when it comes to training. The more engaged the caregiver is, the higher the retention rate will be for that caregiver.
HHCN: As we look to the future, I would like to hear some perspectives on what agency owners can expect. Allan, what does the future of training look like?
Levine: There’s always going to be regulatory compliance that we’re going to need to stay in touch with. We see a lot of technology integrations happening. There was a conversation before about data, and we’re developing more and more partnerships to give those agencies access to the information that they need and it’s not siloed anymore. It has to be in a data lake or reported against in a very holistic way. I would think that there’s also going to be a lot more content and personalization coming with respect to content for caregivers and for agencies as well.
HHCN: Lucy, what does the future of training look like?
Lopez: I think everything Allan just mentioned, I agree with 100%. When it comes to the technology training and the specific software it’s part of their on-the-job training. This is part of what they’re expected to do on their daily shifts. Being able to have that training experience and continue with that short quick convenient hands-on type of training for their specific job and their specific skills is where we’re headed for sure.
HHCN: I’m sure today most agency owners are adopting even greater metrics to determine whether their tactics are working when it comes to retention. Lucy, what metrics should agencies pay close attention to in order to proactively reduce turnover?
Lopez: I spoke a little bit earlier about what the caregiver experience is in their job and I don’t think it’s any different than what we all hope for from employment. It’s consistent pay and accurate pay, and being able to rely on a paycheck. Looking at metrics and how to use metrics to reduce turnover, those are big indicators that a caregiver could be at risk for turnover. Monitoring the metrics that show their fluctuations in hours from week to week, that can be a good key indicator that somebody may be at risk for a turnover if you’re not able to provide them consistent hours and consistent work and pay.
If you approach a caregiver and say, “Hey, I see you’re working all these extra hours. That’s great. Can we offer you a full-time position with benefits?” That’s going to show those caregivers that you’re actually paying attention and you’re engaged in their work with your company and their future with your company. Anytime you can do that you’re going to increase that retention.
HHCN: I wanted to know if any of our panelists had any final thoughts that they’d like to leave the audience with. Then I want to thank you all for your time. Any final thoughts?
Levine: I think we’re in for a pretty exciting 2022. I think from a training perspective what COVID accelerated was a move to mobile, a move to hybrid, and a move to online. I think that agencies are now seeing the advantages of that. What we’re really interested in seeing is how that moves forward. We see a model of 100% online really engaged employees. There’s still going to be interactions with the caregivers for sure, but from a training perspective, there’s a massive amount of opportunity which potentially leads to cost savings for agencies that are now starting to be recognized. I think that will be a trend to also look forward to in the future.
Lopez: Yes, so just to add a little bit there, we talked a lot about trying to be able to have this accurate pay and helping with the staffing and the scheduling challenges that in overall, when you’re reducing those frustrations for both the caregiver and the employee, you’re going to improve that retention.
You’re really looking for electronic solutions and technology that can help with the efficiency of that and searching for solutions. Not being afraid of making those changes to something new that will be better in the long run, is definitely important in this new landscape that we find ourselves in with staffing shortages and the amount of work that it takes to hire somebody to staff a new case. You really have to have a strong electronic solution and technology that can help support those efforts and keep your full-time employees steady as you grow your census.
Trump: Yes, I think that as we move into 2022, COVID is still with us. As we all know, 2020 and 2021 saw an unprecedented amount of legislation, and a lot of it specifically in the payroll arena. With the Employee Retention Credit, the Paid Sick and Family Leave, Deferred Employee and Employer Social Security, the Paycheck Protection Program. Now a lot of that has actually winded down already or will as we get to the end of this year. As COVID continues to be our reality, we’ll have to see how it’s going to affect our economy and what action the different state or federal legislative bodies will take to address that. It’s definitely a possibility out there, and we’ll see how that plans out.
Also, there are some other trends, one of the major trends we’re seeing is the movement towards paid family and medical leave. On the federal level, there is a part of the current infrastructure bill that includes four weeks of paid family medical leave. We’ll see how that pans out. It doesn’t look hopeful, but you never know, that could be coming this year.
On the state level, we’re going to see many states starting to institute these requirements. It will continue to be a trend, especially if the federal government doesn’t take action. Definitely, something to keep an eye on. It’s going to probably be legislation that is going to affect employers across the board, so we’ll see what happens. Always exciting in the payroll.
Editor’s note: This interview has been edited for length and clarity.
KanTime is a home health and hospice EMR solution that aims to streamline all aspects of the care agency from beginning to end. To learn more visit https://kantime.com/ .
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