Promoting From Within Is Becoming An Advantage For Amedisys, Other Providers

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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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