Print this article

6 Critical Areas for Future Survival of Your Home Care Agency

By Ginny Kenyon, Principal at Kenyon Home Care Consulting


Times are changing for the health care industry.  Hospitals are penalized for readmissions for AMIs and pneumonia. Last year was the first year hospitals experienced the take backs. Physicians are under pressure to improve patient outcomes or they, too, will see reductions in compensation. Medicare Home Health and Hospice is not far behind in “pay for performance”.

With increased competition in the private duty market, long-standing agencies are beginning to experience decreased referrals. Add the major changes to the system with the Affordable Care Act and we are moving into uncharted waters for the health care industry. How can you ensure your home care agency survives the future?

We’ve identified six critical areas for your home care agency to thrive in the future. Regardless of the type of home care agency you run – Medicare, Medicaid, Hospice or Private Duty Home Care – the challenges in the six core areas will be similar. While some agencies are strong in several of these areas, to survive the coming changes in the home health industry, agencies must become experts in all of these critical areas.

1. Hiring the best. Everyone says they hire the best caregivers yet, when asked their hiring process, they cannot describe a process that assures they are getting the best caregivers for their agency. No longer can agencies have candidates fill out an application, conduct one interview, and hire. Today the hiring process requires considerable time and effort. Hiring the best requires multiple levels of testing to assure that the individual is competent in all the areas of care you provide and compatible with your agency philosophy and vision.  At a minimum, your hiring process should include an initial sweep of the application or resume to assure they meet the minimum requirements, a written test for knowledge competency, a personality test for fit, two or three interviews, one of which is with the staffing scheduler, and hands on testing to assure skill competency. When following a strong hiring process, you will likely be hiring about 10% of the applicants for work. As one of my mentors once told me, a bad hire is worse than no hire. Better to wait and hire the right people.


2. Comprehensive Orientation. As financing has become tighter, we see orientations shrink to the bare minimum. In states that are licensed, a comprehensive orientation is a requirement. Your orientation should contain the required state and federal rules that your agency staff is to follow, an overview of the agency and the populations you serve, customer service as defined by your agency, and an introduction to the office and staff.  Your orientation program should be based on the special needs of your clients and your home care agency.  Because of your unique services, no two-orientation programs will look the same. 
               Related Reading: Orientation in Home Care Agencies: A Lasting First Impression

3. Retention.  With all the resources expended in getting the best employees, meeting the needs and expectations of your staff greatly improves retention.  This may mean investing in a 401K with company match, health insurance, or other perks that your staff may feel are important aspects of their work. Increased software sophistication for the home care industry creates opportunities that further enhance the working environment for your employees. For example, employing GPS software systems as a means of checking staff in and out of assignments requires staff to have a smart phone. Agencies see this as an opportunity to increase their competitiveness in recruitment and retention by providing a smart phone to all new employees. The purchasing volume allows them to negotiate sharply reduced rates for the phones.  There is numerous offerings home care agencies are using to increase retention.

4. On-Going Education.  Ongoing education and training will become the cornerstone requirement for the future success of your agency. As disease information increases causing changes in treatment modalities, staff must stay current. This applies to the home care aides, as well as, the clinical staff. The home care agencies that succeed in the future have a well thought out continuing education plan that meets the learning needs of the homecare field staff and their patients. The greatest emphasis needs to be on educating the home care aides who spend the most time with your patient/clients. Educating the home care aides to the disease process, the medications, and what red flags need to be immediately reported help your home care agency prevent unnecessary re-hospitalizations. Better overall outcomes will be achieved for the patient/clients.

                Related Reading: Quality of Home Health Care: Luxury or Essential?

5. Services Diversification and Partnering. Years ago, many home care agencies broke apart their services and become a single service homecare agency. They became single service providers.  Now we have come full circle and gone are the days of single service, siloed “vanilla” businesses. In order to survive in the competitive home health market, home care agencies must look at their respective communities and develop additional services that meet the needs and demands of that community. One example is the formation of a separately licensed Private Pay service added to an existing Medicare Home Health agency. Private Pay may add Sick Child Care or Cruise Companion services. Whatever your license or the location in the country, consider how your home care agency can become the “One Stop Shop” for your customers. This may also require partnering with wholesale pharmacies, or contractors for home modifications. Think outside the box and set yourself apart. 

                Related Reading: The Key to Home Health Care Survival:Diversification

6. Software sophistication and Interconnectivity. To keep up with the future of the home care industry, agencies must be computerized internally and externally. With the mandate for all health care providers to be fully electronic and for developed regional health information exchanges, home care agencies must be computerized. Agencies that continue to work on paper will not survive as the home care industry marches forward Computer systems must be time savers if your home care agency is going to be able to compete in the environment where the demand is for reduced cost, reduced reimbursement with increased positive outcomes for clients/patients and staff. Shop wisely! Ask about interconnectivity and the ability of the software to reduce the time and effort for internal and field operations. 


Kenyon HomeCare Consulting is a premier resource for the homecare industry. Our unique understanding of the industry enables us to develop thoughtful, customized, comprehensive solutions that allow you to achieve your goals and sustain success with the ability to develop winning formulas that translate into workable policies and procedures. For more information, visit Kenyon HomeCareConsulting. 

Print this article