Home-Based Care Providers Are Still Finding Success With Word-Of-Mouth Recruiting

Solving the toughest workforce issues in home-based care will come down to consistent messaging, a detail-oriented focus and intense advocacy.

That was the message during a joint webinar from the Home Care Association of America (HCAOA) and the National Association for Home Care & Hospice (NAHC), which took a closer look at ways to combat the caregiver shortage.

“Creating a culture of caring is something that has really surfaced as one of the top reasons why home care workers go to work for a specific agency,” HCAOA CEO Vicki Hoak said. “They are looking for a company that has a culture of caring, not only caring for their clients but that they care about them as professional caregivers.”

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Proactively addressing caregivers’ areas of importance is a critical step in the recruitment and retention process.

The top two considerations providers should be aware of are compensation and whether or not a provider will give employees the tools and processes they need to do their jobs effectively.

Stephanie Johnston, a growth advisor with the consulting company Transcend Strategy Group, said providers need to be upfront about how they will address those areas of need.

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“These are the two gaps that you need to close right away,” Johnston said. “The best place to close gaps is in the career section of your website. You have to make sure that you’re articulating how you determine fair compensation and how you support your teams.”

Messaging and getting ahead of FAQs can be a way to attract employees. Those prospective employees then apply for a job they feel already fits their needs.

Safety is another major concern that has cropped up in the last few years, Johnston said. That’s especially the case when caregivers who are not used to going into homes are switching careers from a facility-based job to one in home care.

Agencies should answer those safety questions from the outset. Those may include questions such as: What are our policies and procedures for helping people feel safe in the home? If there is an incident where someone feels unsafe, how can an employee expect the provider to handle that situation?

“Proactively addressing this is key,” Johnston said. “Putting this on your website and talking about this in the interview process rather than waiting for somebody to raise the issue is really important. Addressing these things in conversation through the recruitment process will pay you back in spades.”

Employee testimonials on company websites are another tactic, particularly if caregivers have stories of how they have felt safe and nurtured in a time of distress.

Offering fair and competitive compensation, meanwhile, is always a moving target. But if a provider has the wiggle room, it’s important to keep the alternative in mind.

“The cost of finding people is going up,” Johnston said. “I’ve seen the costs to hire a caregiver rival — when I was in Fortune 500 land — the cost to hire a C-suite person. When you think about signing bonuses, hours associated with recruitment, advertising costs, all of those sunk costs to hire one person means you’ve got a very protracted payback period on that investment.”

Sometimes agencies should also rely on old-school, reliable word of mouth.

Pattie Rodgers, the VP and director of operations at the Pennsylvania-based home care provider Waverly Care, said her agency currently has 232 caregivers on staff.

Rodgers considers those caregivers to be more effective recruiters than any hiring website.

“We have 232 recruiters,” Rodgers said. “What companies have 232 recruiters? Paying them 500 bucks [as a referral bonus] to bring one person who stays three months and works 20 hours a week is way more valuable than throwing money into Indeed. They are recruiting the people they know can do the job. They come in with knowledge of what caregiving is about and they are recruiting people they’re proud to have worked with.”

Having employees actively recruit and promote their agency is easier said than done. That’s when culture stops being a buzzword and actually gets results.

“If you have that culture of caring, they’re going to want to do that,” Rodgers said.

Advocacy at work

Advocacy for home-based care and the effects they can have on actual change can be hard to track. Luckily, there is some new data behind that idea, and the results are encouraging for the industry.

David Totaro, chief government affairs officer at Bayada Home Health Care, has been advocating on behalf of the industry for a while now. Recently, Totaro was named president and CEO of Bayada’s advocacy arm Hearts for Home Care, which formally launched in January.

“For the first time, we actually have some data that indicates that advocacy yields a high rate of return,” Totaro said. “Every time I talk about this, it makes CFOs actually spin their heads and take another look at what we’re doing.”

Of the 24 states Bayada operates in, 13 of them have dedicated staff members for advocacy alone. That includes teams of volunteers as well.

“These states, since 2013, on average have had Medicaid reimbursement rates increase by 23%,” Totaro said. “That’s a pretty good success rate. Also pretty satisfying is the fact that in what we call our secondary states — states that don’t have a full advocacy program but where we have a partial program — we’ve seen on average an increase in rates of about 15%. Still pretty good.”

In the states that Bayada has zero advocacy presence in, Medicaid rates have decreased by an average of 7%.

“That’s a gap of between 22 and 30 percentage points in states that have advocacy programs or have a strong advocacy presence compared to those states that do not,” Totaro said. “We all know the expressions: the squeaky wheel gets the grease and in order to be fed, you’ve got to be sitting at the table. I think that this proves it over and over again.”

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