Home-Based Leaders Are Focusing On Culture, Creative Benefits To Mitigate Staffing Challenges

Workforce pressures are a constant variable in home-based care. But today’s issues require far different solutions than yesterday’s, providers believe.

For Accurate Home Care, the biggest pain point isn’t retention, it’s recruiting new nurses to hire.

“If I had 200 nurses show up in my parking lot, I would hire them all without interviewing them,” Bill English, president and CEO of Accurate Home Care, said in jest at Aging Media Network’s Continuum conference last month.


Accurate Home Care is a Minnesota-based provider that offers home health care, private-duty nursing and non-medical home care.

The nursing shortage isn’t an issue that English believes can be solved in the next five years.

“The country is not producing enough nurses coming out of the schools,” he said. “If you talk to any president or CEO of a major health care system, they’ll tell you the number one thing is nurses. We lost so many nurses during COVID.”


English noted that prior to the start of the pandemic, Accurate Home Care had about 350 nurses. The company currently employs roughly 220.

One of Accurate Home Care’s biggest strategies for combating the nursing shortage is positioning the company as the employer of choice and focusing on culture.

“We have to focus heavily on culture, and we have to focus heavily on purpose, and try to attract those who have a heart for home care, and the money is secondary to them,” English said. “Those are the nurses that we went after. Today, we were voted as one of the top 200 workplaces in Minnesota by the Star Tribune.”

Pictured: Bill English

Similarly, Ari Medoff — CEO of Arosa — believes that home care providers looking to recruit new caregivers need to position themselves to offer a more appealing alternative than industry competitors.

“For every one of our teammates working for Arosa, there are 32 other caregivers out there working for Visiting Angels, Home Instead, Comfort Keepers [etc…],” he said during the conference. “We need to go find the best of those [people], and show them that we have a better package and better opportunities for them. In our world, I don’t think there’s the same overall labor shortage that may be on the nursing side.”

Arosa is a Los Angeles, California-based home care company that has 29 locations in nine states.

The company isn’t just thinking about recruitment on the caregiver side, Arosa is also working to build a pipeline of care managers.

“There are not many care managers out there in the country, there’s probably 2,000 or 3,000,” Medoff said. “We need 5,000 to 10,000. We need the best, most entrepreneurial social workers, nurses and occupational therapists, thinking about the possibility of care management. We’re doing internships, and we are out there looking for those individuals.”

On a company-wide level, Arosa has leaned into building creative employee benefit packages. For instance, the company set up an emergency assistance fund as a response to the pandemic, but continues to build it today.

As for the future of home-based care, English hopes that he will soon see more legislators that understand business, which could in turn lead to a better staffing climate for providers.

“I would say you can’t be a legislator unless you’ve run a business and have lost at least $500,000 out of your own pocket,” he said. “Then we will get better legislation, and regulations across the board.”

English thinks that home-based care being covered under private insurance could be a way forward.

“If it [were up to] me, I would set this up entirely through private insurance,” he said. “I would incentivize private insurance, through the tax code, to provide a safety net for everybody.”

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