Home Health Staff Poaching ‘Unavoidable,’ But Providers Are Still Fighting Back

For an industry already facing challenges due to staffing shortages, competitors poaching employees can be a devastating blow.

Over the past few years, between the COVID-19 pandemic and an exacerbation of other factors that contribute to poaching, it has become a reality that more home health providers are facing.

“We have seen poaching happen at our company, and we’ve done everything that we can in order to mitigate it, because it is a significant challenge,” Beau Sorensen, chief operating officer of First Choice Home Health & Hospice, told Home Health Care News.

Founded in 1996, the Orem, Utah-based First Choice Home Health & Hospice serves the Wasatch Front region. In addition to core home health and hospice offerings, the provider delivers a variety of Medicare Part B services, including outpatient therapy and Clinical Laboratory Improvement Amendments (CLIA) laboratory services.

For the majority of providers, the pandemic compounded the recruitment and retention difficulties the home health industry was already dealing with.

One of the factors contributing to this issue is the shortage of registered nurses in the U.S. There will be roughly 175,900 openings for registered nurses each year through 2029, according to data from the Bureau of Labor Statistics.

Adding to these difficulties is the fact that home health providers typically have a smaller pool of nursing candidates to choose from, and are often competing with hospitals — that may have larger budgets — to recruit staff.

So, while getting employees to leave their employer and join a different organization is nothing new, the nursing shortage and the COVID-19 emergency have, arguably, created a perfect storm of stressors that have put a strain on the home health industry.

Poaching tactics

One tactic that has been used to lure away home health staff is higher pay and sign-on bonuses. For some workers, the opportunity to see an increase in wages directly addressed an area that contributed to poor working conditions.

During the pandemic about 18% of health care workers quit their jobs, and 31% considered leaving the sector in general, according to a nationwide 2021 Morning Consult survey. Along with burnout, inadequate wages was one of the reasons cited.

The opportunity to change course and go after higher paying opportunities have also had other unintended consequences.

“The whole idea of a two-week notice has gone out of the window,” Cleamon Moorer Jr., CEO of American Advantage Home Care, told HHCN. “At any given point, you could get a resignation letter that’s written in past tense, in terms of, ‘today was my last day.’ It leaves HR departments and some organizations a bit baffled.”

Dearborn, Michigan-based American Advantage Home Care provides skilled nursing, rehab and specialty care services to nearly a dozen Michigan counties.

Still, Sorensen casts doubts on sign-on bonuses’ ability to create long-term retention wins for providers.

“Typically, if you have individuals who are looking for a sign-on bonus, and just going after top dollar, and there are those nurses out there, then they don’t have a lot of loyalty to your company,” he said. “As a result … you get people who cycle through jobs pretty quickly because they can jump from sign-on bonus to sign-on bonus.”

Employment websites and job board sites have also streamlined the ability to poach employees, according to Moorer Jr.

“Some of the largest companies in this space … do allow organizations to subscribe to resumes,” he said. “At any given time, any HR department or recruiter within an existing home health care agency can search a database for resumes and actually reach out to individuals even though they haven’t classified themselves as a candidate.”

Hospice also feels the heat

Home health providers aren’t alone in facing potential staff poachers. Some may be feeling it on the other side of their houses as well, as hospice has been feeling the heat too, according to a Hospice News report.

Similar to home health care, providers in this space are seeing employees receive offers for higher wages or sign-on bonuses.

“Hospices have long sought to find experienced clinical employees by recruiting them away from other hospices,” Lynne Sexten, president and CEO of Agrace, one of the largest nonprofit hospice and supportive care providers in Wisconsin, told Hospice News last month. “Each time a new for-profit hospice attempts to enter our market, they desperately try to recruit away our staff with exorbitant sign-on bonuses or hourly wages.”

Reimbursement rates not keeping pace and inflation, which reached 8.6% in May 2022, have also added to the problems hospice providers are facing.

Typically, small- and mid-sized home health and hospice providers are bearing the brunt of staff poaching woes.

“I would say that larger companies tend to be the ones that poach more than anybody else, just because they have the financial ability to poach,” Sorensen said. “Smaller companies often can’t absorb the higher prices that are needed to keep their staff. It does put smaller providers at a disadvantage relative to larger providers.”

Retention strategies

As far as retaining staff and curbing poaching, Sorensen believes that it’s crucial to be aware of the staff’s concerns.

“Know where they’re at in terms of their concerns with the company, or with the job,” he said. It’s important to be in constant communication with them and let them know that their voice matters, and that they matter.”

Sorensen noted that part of this involves staying on top of where employees are at wage-wise.

“If you haven’t looked at somebody’s pay in the past, I would say every six months, it’s time to reevaluate it and be transparent with the staff member,” he said.

Though Moorer Jr. believes that poaching is somewhat “unavoidable,” he does stress the importance of cultivating an appealing environment and culture that will aid in retaining workers.

“You want to be an agency that employees are proud of,” he said. “A place where the bottom line is not the only thing that matters. A place where you compromise the bottom line to ensure that patients get the highest quality care, supplies, et cetera, that they need to move toward some foreseeable goals. Additionally, communication and collaboration amongst team members and clinicians is key.”