Home Health agencies that have been in business for a few years can relate to the issue of growing pains. It is almost like you hit a ceiling and cannot grow beyond the increased competition, changes in payor rules and reimbursement amounts, increased regulations and shortages of skilled staff.
So what is happening?
As with all issues, there is never just one cause, but numerous ones that contribute to this problem. It could be that there is more competition, funding sources have changed, a shortage of caregiving staff, a business model that is no longer viable or a mismatch of needed skills with current staff. Any or all of these could be contributing to a decline or a flat line of business growth.
In business as in life, we need to constantly re-evaluate our position and make plans and appropriate adjustments. However, what we see in many home health agencies is that home care organization has never changed or modified their plans, their services or their internal staff. They have continued without any major modifications and are now at a standstill or are declining. What worked when the business was started years ago may no longer be a fit for the environment, the pay sources, the new knowledge in both clinical services and organizational function or skills needed for the new world that is emerging. This is particularly true at this time in our country where health care is undergoing major changes.
The agencies that survive will be those that can re-create themselves to match the changes that are coming. To do this, the agency must first assess their environment.
- What are the challenges and opportunities?
- Where does the agency fit in all of these changes?
- What must the agency do to prepare for the future?
To accomplish a comprehensive analysis, the agency must look inside, as well as outside, to really have a vision for the future. What we have found is that most agencies are fairly good at doing external analysis and making decisions on changes in regards to the service delivery and the financial issues associated with those changes. The area where we find agencies struggling is with the internal operations and staffing. Very frequently, we find that even though the environment has changed and field services have been modified to meet the changing needs, internal structures and most of all the internal home care staff has remained the same.
This is one of the hardest processes for a home care owner or administrator to go through. Many times we see that an employee is kept because of loyalty by them, even though they are not able to perform the needed functions of the new and emerging roles. As painful as this is, an employee analysis must be done if the organization is to survive and thrive in the future.
It all begins with an objective analysis. First, doing an internal function and skills needs assessment requires that the management focus strictly on the functions and skills needed to accomplish those functions. Secondly, evaluate the skill set of the staff in the internal operations to determine the fit or non-fit of the existing home care internal staff. In order to objectively accomplish this task, it requires that the manager eliminate names with positions and only focus on the function of the role. Finally, an objective list of skills that will be needed to achieve success in the role will need to be developed. Only after this is done can an objective review of current staff skillset be done.
If education and training can achieve the needed skills for the re-designed job, then the existing staff may be able to remain in their revised roles. However, it must be clear that failure to achieve results in the re-designed job will mean that the individual will no longer be employed with the organization. This is as important for the managers to understand as it is for the employee.
If you find that making these critical decisions on re-design of internal operations and subsequent job re-alignment and change is a problem, and feel you could use some help or coaching, call Ginny Kenyon at Kenyon HomeCare Consulting, 206-721-5091 or e-mail to firstname.lastname@example.org. We are here to help