Home-based care providers are facing numerous obstacles right now — workforce shortages amid an increased demand for care services, challenging reimbursement environments and more. In response, home-based care leaders are pushing themselves to come up with innovative strategies that drive efficiency.

Companies that have successfully implemented creative strategies to address staffing, achieve operational efficiencies and streamline care delivery have seen returns on their investments in the form of improved retention, increased referral sources and millions in savings.

Alysha Humpert, senior director of sales and patient services at Healing Hands, highlighted the constant pain points driving providers to evolve, including Medicare cuts.

“You’re asked to do the same quality of care in the home, but for less pay,” she said last month at Home Health Care News’ Capital+Strategy conference. “On top of that, we’re trying to stay competitive in the market, to offer good pay for nurses. It’s challenging when you’re going up against the bigger facilities that can offer the bigger sign-on bonuses, and then a constant struggle is just staffing, always trying to figure out how to find the right people.”

Healing Hands offers home health, hospice and private-duty home care services to over 20 counties in North Central Texas.

Improving retention and stretching clinical capacity

To cope with these challenges, New Day Healthcare has implemented a program they call CPR to help the company retain its staff.

“CPR is connect, promise and reach,” G. Scott Herman, CEO and founder of New Day Healthcare, said. “It goes through all of our organizations. We contact people early, and we touch base with them on a regular basis. They’re receiving live calls from their supervisor. They’re receiving text messages. What our data found was that if we can keep people for 180 days, they’re staying five years plus.”

Fairview, Texas-based New Day Healthcare has roughly 33 locations across Texas, Missouri, Kansas, Illinois and Missouri. The company offers various home-based care services, including home health care, personal care services and hospice and serves nearly 150,000 patients annually.

New Day Healthcare’s CPR program has resulted in the company cutting its turnover rate by half. The company’s current rate is 22%.

Herman noted that creating CPR has been a major effort on New Day Healthcare’s part.

“It began with the implementation of a human resources information system platform,” he said. “It began with the extension and integration of ongoing recruiting and retention efforts. We can now build those contact points, look in our data system, which we have an overlay system called Carelytics that we feed human resources data into, and we can actually see that data in every service line down to every individual. That’s a critical piece of our ability to expand strategically and fight the labor world — it’s stabilized us significantly.”

In terms of ROI, New Day Healthcare’s strategies to address turnover have led to savings in the millions.

“We spend about $2 million a month recruiting, hiring and onboarding staff … it comes out to close to $20 million a year,” Herman said. “By cutting that turnover rate from 45% down to 22%, we’re saving $5 million a year, before we even replace anybody. That’s real money that we put into innovation.”

At Healing Hands, stretching its clinical capacity has been a key tactic for navigating working with fewer staffing resources. Job sharing and utilizing telehealth are among the tools Healing Hands leverages to safely do so. .

“We’re utilizing phone and video to not overload any of our nurses — to handle some of those needs that aren’t necessarily hands-on at that time,” Humpert said. “We’re also using job sharing. We cross-train our home health nurses to also transition with our hospice. It’s easier on the patient [and] on the family. They don’t have to tell their story over and over. It’s also easier and more beneficial for us as well.”

Healing Hands also relies on staggered visits to help stretch its clinical capacity, according to Humpert.

“We’ve been creative putting more eyes on the patient during the week, so the PT goes in two days a week,” she said. “You have your skilled nurse going in, and then you have your aides going in for bathing as well. The patient is getting more touches during the week, but you’re also not overloading one clinician at a time.”

Due in part to these efforts, the company has been able to achieve a 10% turnover rate.

Achieving operational efficiency

For Healing Hands, streamlining has been the key to improving operational efficiency. One of the ways the company promotes efficiency is through the use of business intelligence tools.

“We’re using business intelligence tools to help predict census growth, and where we need to target, whether it’s our sales department or potential patients that are at high risk and could potentially flip to hospice soon,” Humpert said.

Healing Hands has also centralized its intake process. This means having real-time communication with the people on the ground working on referrals. This has allowed the company to get back to referral sources in a timely manner and contact patients sooner.

Plus, the company is introduced templates to help its nurses with documentation. This has the added benefit of minimizing the risk for potential audits, Humpert noted.

Additionally, Healing Hands implemented a leadership course called Operational Excellence last year. The course focused on middle management at the company and included weekly courses.

“[The courses] really dove into the ‘why’ behind things,” Humpert said. “I’m a ‘why’ girl. I ask questions all the time. For me to do my job effectively, I have to connect all the dots. I’ll follow, but I won’t blindly follow. Operational excellence did a great job, because we went cross-department, going over the workflow and trying to understand what they’re in charge of and what they’re doing.”

On its end, New Day Healthcare has invested heavily in tying technology and data systems together. The company’s Carelytics platform, for instance, combines data from electronic medical records (EMRs), patient records and payer systems nationwide.

This has helped the company zero in on what Herman refers to as “data desert.” Data deserts are the parts of the business New Day Healthcare systems cannot track.

“If we can figure out what’s going on in the data deserts … we can figure out what’s happening when things really go wrong for a patient, when they’re in the home and not in our hands,” he said.

Ultimately, Herman believes that all home-based care leaders should be striving to innovate their operations.

“Build for the future, be courageous, jump out there and find a new path,” he said.