Employee Retention: Building for Success

Employee Retention: Building for Success

Is your agency struggling with staffing retention? You aren’t alone. It’s estimated that Home Care providers turnover rate was almost 80% with over a 12% increase in turnover in the past two years. [i] To ensure quality care and patient outcomes, hiring and retaining skilled staff is more important than ever.

Top Reasons for Agency Turnover:

• Instability in Management and Leadership
  • With excessive staffing turnover comes management burnout and turnover. Turnover is not just isolated to field staff with management burnout contributing to the turnover cycle. Without management longevity, agencies are without key leadership to ensure effective processes, oversight and field staff support. Instability in management creates a chaotic work environment and decreases employee satisfaction.
• Excessive Workload and Scheduling Inconsistencies
  • Increased turnover, management changes and increased focus on agency growth can lead to staff feeling overwhelmed and dissatisfied.  The repeated need to pick up additional caseloads to ensure quality of patient care often leads to the burnout of the agencies’ most valuable staff.  Repeated scheduling changes contribute to instability and decreases work life balance.
• Competitive Compensation
  • Better compensation continues to be one of the primary reasons given for resignations. For many agencies, competitive wage wars are a common challenge to recruiting and retaining qualified staff.

• Lack of Training
  • Home health is a complex business that requires extensive training in order for clinicians to be successful in providing high quality patient care and meeting expectations . OASIS-E1, HHVBP, and  PDGM  are key areas of focus for home health training to ensure success. There are ways that agencies can stop the revolving door associated with staffing turnover and build a successful team despite the challenges.

Consider these strategies to combat the frequent challenges to Home Health Agency staffing:

• Improving Management and Leadership Stability
  • Focus efforts on ensuring incentives outside of pay when recruiting, such as work life balance, ensuring a positive working environment and building a culture in which leaders will thrive.
  • Invest in ongoing training and leadership development. Develop your leaders by offering ongoing training opportunities, opportunities to obtain desired certifications and providing them with a clear vision of company or agency goals.
  • Ensure leaders have all the tools in their toolbelt to manage the agency successfully including process development, employee development programs and resources to manage and monitor key home health metrics.
  • Communicate frequently to ensure that leaders feel supported and empowered. Weekly 1:1 meetings are an effective way to allow autonomy as well as ongoing support consistently.
  • Celebrate the wins. Make an effort to not only focus on what is going wrong, instead, celebrate success and ensure your leaders feel valued.
• Preventing Excessive Workload and Scheduling Inconsistencies
  • Focus efforts on ensuring that your agency has a streamlined intake process that works closely with scheduling. For example: While agencies must focus on timely initiation of care, failure to coordinate new admissions and routine follow-up visits can lead to frequent scheduling changes, increased workload and ultimately staffing burnout.
  • Schedule daily “stand up meetings” between management, intake, scheduling and fields clinicians to discuss upcoming admissions, PRN visits and any foreseen scheduling changes that might impact the team. This minimizes clinicians being “blindsided” by scheduling changes and improves communication between all key members of the team.

• Ensure Competitive Compensation
  • Know your market. Do your research to determine what competitors are paying, so that you can appropriately adjust rates accordingly  while avoiding over adjustments that will negatively impact your bottom line.
  • Develop pay scales that consider years of experience, and avoid hiring new staff at higher rates than those who have been long-term employees. Failure to recognize experience and longevity can lead to frustration and feelings of being undervalued.
  • Keep performance increased a priority and develop an annual employee evaluation process.
• Develop a Training Program for New Hires
  • Keep in mind that first impressions matter. They set the tone for positive and successful onboarding and orientation. Effective orientation is a strong predictor of job satisfaction, so it’s important to have a plan for each new hire and ensure that they receive a warm welcome on their first day.
  • Develop a detailed training/orientation plan for each position within the agencies, both field and office.
  • Schedule 1:1 meetings throughout the employee’s orientation to track progress and to identify any problem areas that the employee has encountered. Always ask “how can we improve your orientation experience and is there anything that you need?”
  • If the new hire is a field clinician audit at least 50% of their documentation to identify areas of improvement and prevent bad habits such as failure to document home bound status or medical necessity. Provide feedback and guidance as necessary.
  • Keep it positive. Avoid providing only negative feedback to new hires. Always highlight their strengths as well.
  • Avoid letting the need for the new hire to pick up a full caseload cut their orientation short. Increasing caseload, especially for clinicians who complete OASIS, can be overwhelming and hinder proper training.
• Implement Exit Interviews
  • Ensure that your HR department is conducting exit interviews to monitor and track turnover reasons. The information gained from an exit interview can help to repair issues with your process that potentially contributed to the employee leaving. You can’t fix what you aren’t aware of.

Keep in mind that your employees are an investment and turnover is costly. Your employees are the biggest investment that your agency will make. Don’t just invest monetarily, but invest your time as well.

Contact Proactive to assist in analyzing and reducing your agency’s turnover percentage through process development, leadership training, orientation curriculum and program improvement.

[i] Famakinwa, J. 2024 July Home Health Care News Home Care’s Industry-Wide Turnover Rate Reaches Nearly 80% Home Care’s Industry-Wide Turnover Rate Reaches Nearly 80% – Home Health Care News

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