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Importance of Image and Respect for Home Health Recruitment and Retention

The increased pressure of the COVID-19 pandemic has presented never-before-seen growth opportunities for home health agencies and their workforce, as Bill Dombi, President of the National Association of Home Care and Hospice (NAHC), noted in a December 2021 webinar titled The State of Home Health.

“Home health is in the best shape it has been in the many decades that I have done this work,” he said. He added that there is a new level of understanding about home health and that the “perception of home care has grown exponentially during the COVID-19 pandemic.”

An unintended, but positive offshoot of the pandemic is that the crisis highlighted home health’s “very quick and successful adjustments” and “versatility” to serve COVID-19 patients and millions of others served under Medicare, Medicaid, Veterans Administration, and other services.

Currently, legislators in Congress are voicing strong bipartisan support for health care at home, along with a profound recognition of how workforce shortages and stresses are impacting the industry. But even though the creativity and stamina of home health workers are publicly recognized, workforce demand continues to exceed the workforce supply.

Image and respect have never been so essential for the home health sector’s continued success in recruiting and retaining staff. But how, exactly, can home health leaders improve on these factors?

Workforce, Workforce, Workforce

Dombi emphasized the importance of keeping the home care sector strong in the future by maintaining a competent and consistent workforce. Home care employers need to focus on supporting every effort to improve workforce availability, particularly for nurses and aides. After all, if we don’t take care of the workforce, who will provide home health?

Replacing staff is expensive and triggers indirect costs such as overtime, as well as direct costs for recruitment and onboarding. But Dombi emphasized that not having enough home health care workers is an issue for society at large, not just employers.

Dombi provided an example showing the ripple effect that occurs when one home health aide quits. That resignation may mean that a patient’s family will have to start taking days off work to provide that care. Other societal impacts might include child care issues for families having to choose between providing care for their parents or their children. These types of challenges can have a trickle-down effect on the economy.

Image and Respect for Recruitment and Retention

Home care workers deserve respect for how they have persevered throughout the COVID-19 pandemic. The workforce itself is responsible for painting a positive picture of home-based care in many ways. Nurses, therapists, and aides have demonstrated their determination and earned praise as front-line healthcare workers.

Most importantly, they have demonstrated their abilities to care for very complex patient illnesses, including patients with and without COVID-19.

Although many would agree that image and respect are essential for recruitment and retention, it is often one area that gets left out of the conversation.

One way to change this pattern, Dombi said, is for stakeholders to collaborate instead of working in a silo. This involves collaboration between employers, home care educators, payers of home care workers, representatives of the workers or unions, and others who impact recruitment and retention.

Without working together to see the big picture, it will be impossible to solve the issue of why so many home health staff members are leaving the workforce.

Solutions To Consider

If you’re a home health leader struggling with ongoing turnover challenges, you may consider a variety of strategies to show you value your staff.

Increased Compensation

Many home health employers may find it challenging to pay clinicians the same amount they might make working in another healthcare setting. However, you can find creative ways to boost compensation other than increasing hourly wages.

Your home health staff may value additional compensation that goes beyond dollars per hour:

  • Paid sick leave
  • Performance bonuses
  • Flexible schedules
  • Health insurance plans
  • Supplemental insurance such as vision and dental
  • Gym memberships
  • Company fitness programs and challenges
  • Training on subjects such as stress management or staff wellness
  • Sponsored employee participation in a fitness event such as a 5K, 10K, marathon, or other event
  • Maternity/paternity leave
  • Longevity bonuses

Improve the Onboarding Process

Professional education and training for new hires can set the stage for competency expectations on the job while providing a more positive onboarding experience. It also shows staff that you respect and value them as employees and understand their daily expectations.

One way to do this is by providing assessments and learning modules to help them succeed and be effective on the job from day one. Other onboarding tools that may be helpful include:

  • Hands-on training
  • Go-at-your-own-pace online training
  • Competency development programs
  • Mentorship programs
  • Clinical assessments
  • Custom training plans

You can continue to develop staff knowledge with targeted training as they progress in their careers.

Professional Development and Education

One way to show respect for home health employees is to provide professional development and education that will help them develop stronger skills.

Providing national training and certifications programs is a win for workforce competency. Also, it helps to provide better patient care in different patient conditions. Supporting employee specializations in home health areas — such as wound care or diabetes — shows good faith in your healthcare team and can improve employee performance, reimbursement, and the bottom line.

Other ways to support staff with professional development may include:

  • Training on subjects such as time management or interpersonal communication
  • Setting up caregiver mentorship programs
  • Arranging for workers to get college internship credits through work
  • Offering wound care education to help staff assess, stage, and treat pressure injuries more accurately

Looking at the Big Picture

Dombi emphasized that compensation seems to be the top factor driving recruitment today. It doesn’t help that — due to staffing shortages — hospitals across the country are paying big bonuses and hourly wages compared to what home health has been traditionally paying.

One solution, Dombi said, is to demonstrate to all potential and current employees that this is a “top of the profession role for them.” It is important to remember that employees are looking at their entire benefits package, and the flexibility that home health care offers is very appealing to many people.

“There is no silver bullet out there” when it comes to whole benefits packages, Dombi said. If a wage increase is impossible, it may be time to provide other assets to show you value employees, such as work flexibility, education, and training.


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