by Stephen Tweed

How do you find terrific sales representatives in home health care and hospice who will stay with you?  How do you select the very best nurses for your home health agency?  What are the core competencies of a highly effective scheduling coordinator?

These are some of the questions we’ve been asked frequently over the past couple of years by owners and CEOs of home health and hospice companies.  To address these questions, we have been working to expand the number of jobs that have been benchmarked for the Caregiver Quality Assurance (TM) program.

In 2006, we recognized that one of the biggest barriers to growing private duty home care was the ability of owners to find and keep high quality caregivers.  The supply of people who were willing to work as caregivers was very thin, and the turnover in the industry was horrific.  We began to explore the best practices for recruiting caregivers, and through industry surveys of the readers of Private Duty Today, we gathered lots of great information.  However, we quickly realized that the issue is not recruiting, it’s selection and retention.  If you have a process to select only the very best caregivers, and you have in place a strategy to retain them, then you don’t need to spend as much time and money recruiting replacements when they left.

At that time, we had a woman working for our company who brought great experience in human resources from her work with Toyota Motor Manufacturing USA, and with Mercedes Benz.  She had returned to Louisville, KY to care for her aging mother and wanted to work part time.  We gave her the assignment to research the psychological testing universe to find a highly effective, valid and reliable online assessment tool that we could make available at a reasonable price to owners of private duty home care companies.

Kathy found such a tool, and we began working with our clients to apply these principles to private duty home care.  Several years later, Kathy moved on to another opportunity, and our long service, terrific office manager, Diane West, asked for the opportunity to take over Caregiver Quality Assurance (TM).  Diane has done a terrific job of developing training programs to help owners of private duty home care learn to apply the principles of selection, and to use the online assessments to hire only the best caregivers.

The result has been a measurable decline in turnover.  The industry benchmark report from NPDA and Home Care Pulse shows that average caregiver turnover last year was about 40%.  And that’s the average.  we have seen companies with 70 to 80% turnover, and one company with 200% turnover.  It’s no wonder they couldn’t grow their businesses.

On the other hand, our friend Leigh Davis an ELDirect In Home Elderly Care was able to reduce his turnover from 25% to just 17% in two years.  That’s amazing!  And the payback in huge.  When you look at the actual cost of recruiting and hiring one caregivers, plus the lost opportunity cost of not having a caregiver to staff a case, the cost to you over the course of the year is a lot of money.  In the book that Leigh and I wrote together, “Get The Best: Nine Steps to Hiring Quality Caregivers and Improving your Bottom Line in Private Duty Home Care” there is a tool to help you calculate the cost of a bad hire.  In the sample we created, the cost is $829.25 to replace one caregivers.  To get that number, look at page 40 in the book.

If you lose ten caregivers a year and have to replace them, that’s $8,290 per year minimum.  If you can cut your turnover in half, that’s over $4,000 in savings, and the full year membership in CQA is less than half of that so you get a really good return on your investment.  And this doesn’t even begin to address how much less stress you will feel if you have fewer caregiver turnover problems.

Now, you can use the same online assessment tool that hundreds of companies are using to select high quality caregivers in private duty home care to choose nurses, therapists, home health aides, sales representatives, and scheduling coordinators in home health care and hospice.  Once we say how effective this program is for private duty home care, we began to explore how we could apply this same assessment and selection process to other positions in private duty, such as scheduling coordinators and sales reps.

Then we began to get questions from home health agencies and hospices about how they could use these same principles to hire field staff and office staff.  So, in response to the need in the industry, we began working on job benchmarks for home health care and hospice jobs.  We’re still building the list, but some of the jobs we have in place are

• Registered Nurse
• Nurse Assistant (CNA or LPN)
• Persuasive Sales
• Home Care Supervisor
• Location Manager
• Project Manager

We’re working on a benchmark for Scheduling Coordinator, and a more refined benchmark for home care sales.

If you are in a position to be concerned about hiring and selecting staff in home health care, hospice, or private duty home care, you’ll want to have some conversation with Diane West at Leading Home Care.  You can reach her at 502-339-0653 or visit the web site at Caregiver Quality Assurance.