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Today, this article will look at little different than out typical articles. We all know the costs of losing employees and trying to hire and train new ones. It is exhausting and expensive. So, we think about our wages and benefit packages all the time. What can we do differently that makes people stay? We can’t change the job and we don’t want to keep people that don’t like the work itself. So, how do we acknowledge employees in a way that is valuable to them and that our businesses can afford to do? 5 Things To Consider About Employee Recognition At Your Christmas Party: 1. Years of Service: These can be based on milestone work anniversaries (5, 10, 15 yrs, etc.). If a person has been at your agency 11 years, you pull them up and acknowledge them in the group of employees who have been there at least 10 years up until the time they hit the 15 years landmark. This way longevity is recognized yearly. 2. Special Employee awards: Now, this may be difficult if your staff is very small, but acknowledge the employee who has gone the extra mile in the job they do. Tell the story. The employee needs to know when the employer is proud of the work that has been done. Consider a plaque or certificate. Don’t minimize the value of the employee having them to display. 3. Acknowledge all employees in the mix: Because we are a clinical industry, the administrative staff is often overlooked on day-to-day operations. Ultimately, don’t miss the chance to acknowledge the employee who was able to catch billing errors or collect on a large account. Staff doesn’t like to hear about money, but those types of collections keep Christmas bonuses in place! So, make sure the other staff knows the accomplishments of the finance department or the office manager that every caller loves to speak to. Don't ever forget the IT staff that is on call more than any clinical person in your agency! 4. Letters from the administration: Add a personal note to your staff either collectively or individually depending on the size of your agency. If you are larger, there are employees you don’t often see or get to talk to on a regular basis, so take the time so send a note with that Christmas bonus. 5. Consider the Christmas bonus: Listen, some of you can afford to do substantial monetary bonuses and that is fantastic. However, if you are not in that position, consider something in its place. Maybe small gas cards go with the letter from administration. With the cost of groceries, consider something that helps with the costs of daily living for employees. Big box gift cards in your area will always be used. You may do a lot of these things on a yearly basis to employees. All this being said, it doesn’t mean there aren’t reasons for acknowledgement throughout the year. However, your annual Christmas party is a good way to do it collectively. Between your annual party, write the individual cards to employees when you hear a patient interaction worthy of praise. Or, maybe you buy a gas card for the employee who has picked up extra shifts and always shows up on time. Ultimately, employees will feel valued. You will not regret the time, effort, and energy put into these efforts. Merry Christmas! If you want help with recruitment and retention strategies for your agency, please call Kenyon Homecare Consulting at 206-721-5091 or contact us online today.

By Stephen Tweed As the home care caregiver shortage continues, we recognize that there is no short-term fix. If you want to be successful in home care over a long period of time, you will need to develop a long term strategic initiative to attract and retain the caregivers you need. That means working diligently to create a great place to work. Crafting Your Company Culture: Creating a great place to work for caregivers means crafting a company culture that is in alignment with the needs and wants of your best caregivers. The most recent Best Caregiver Study from Leading Home Care and the Home Care CEO Forum showed that the most reliable workers in home care want: To do meaningful work To feel valued and respected by their clients, their supervisors, and company owners To have a flexible schedule To receive the proper education and training to do their work To feel fairly paid We define company culture as … “The way we do things around here.” Your culture is influenced by four factors; the leadership style of the CEO, the core values that guide your decisions and actions, the behavior you expect, and the behavior you permit. Building a company culture that will enable you to systematically find and keep the caregivers you need is a long-term commitment. Seven Steps To Crafting Your Company Culture: Crafting your culture is not easy, but there is a system that works. After studying dozens of companies that have crafted amazing cultures, and after interviewing CEOs of these companies, we have developed seven specific steps that are necessary to build a strong culture over the long haul: Define your Core Values Define the behaviors you expect for each Core Value Communicate your values and expected behaviors Train your leaders to Live Your Values Engage your Caregivers Promote Your Culture Reinforce Your Culture After leading this process for a number of home care companies, we’ve found that this seven step process takes at least a year to get through, and you are never done. The largest, privately owned home care company in the world has spent over 40 years working on their culture, and they are not done yet. The good news is, you can start today. Where To Start: The place to begin this process is defining your core values. When we lead this process of crafting your culture, we begin by brainstorming a list of values that members of the leadership team believe are important. Then we discuss each value, and define its meaning. We talk about what it means to live this value. Then, we narrow the list of values down to three. Why three values? Because people can’t remember more than four. If you have seven core values, and people can’t remember that last four then why have them? Pick the three that are most important and that your team members resonate with. Begin there. Top Tier Home Care Companies Are Working on Their Company Culture: As you know by know, through the Home Care CEO Forum and our Home Care Mastermind Groups , we work with companies in the very top tier of our industry. One of the common characteristics of our Top 5% Mastermind Group and our Top 7% Mastermind Group is that they are all working on crafting their company culture. They are working through the steps in this process in varying degrees. The fastest growing companies in these groups have built on their company culture to develop systems to recruit and retain caregivers. We’ve learned that you can only grow your home care company when you are able to attract and retain high quality caregivers, and crafting your company culture is part of that process. This article is being re-published with permission of the writer, Steven Tweed: Stephen Tweed, CSP, is an internationally known health care and business strategist, award winning professional speaker, and published author. He is the CEO of Leading Home Care… a Tweed Jeffries company and the Founder of The Home Care CEO Forum® and Caregiver Quality Assurance®. If you need assistance in your recruitment and retention efforts as well as looking at company culture, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help.

How many nights are you awake trying to figure out the recruitment and retention puzzle? You changed your benefit package, tried sign-on bonuses, raised salaries and still employees leave. Are you completely frustrated facing Value-Based Purchasing (VBP) and more budget cuts? Are you feeling burned out as an owner and/or administrator? Maybe it is time to take a look at you and where you are in taking care of the person responsible for everyone else. What's Going On With You? On a scale of 1-10, how engaged are you in your agency? Compare today to a year ago, 5 years ago and 10 years ago. What is the difference? Have you moved agencies more than once in that timeframe? The thought process is that we are there to take care of everyone else as well as the agency itself. That’s what we are paid to do, right? Well, yes and no. If you are at wit’s end, then how can you possibly be effective to to keep your employees engaged? That isn’t a judgment, but a legitimate moment to step back and ask who is taking care of you? If you have a very engaged board of directors, then you may have someone actively working on your recruitment and retention. If you don’t, then you need to recognize your own needs to make sure you are as effective as possible for the long haul. Do you have employees with an “A” scorecard who now consistently perform at a “C” level? Ask yourself what has changed? If they are coming into the same job and same conditions, same leadership etc., then something else is happening. Normally, we take the time and ask. We learn of things that may not have anything to do with the job that still affect it. It is usually situational and short term. These are things as administrators we work through with employees. What about your situation? My team are called into agencies where the leadership is frustrated whether it is financial or clinical or both. Agencies aren’t calling a consultant if everything is going well. You try to do everything not to pile more responsibility on everyone else often at your own expense. Have you evaluated your own breaking point? Who's Looking Into Your Recruitment And Retention? This is the big question, right? And just like employees, it may not be about the money. There may not be enough money for you to miss another child’s ballgame or family get together. So, what do you do to find the balance? Disconnect when you aren’t at work: This is the biggest “easier said than done” statement of them all. However, it is the most important. Ask yourself what happens to your agency if you don’t check your phone and email for the next 8 hours? Do you fail your agency if you don’t answer every email that comes through during the evening? How many times are you interrupted by things that could wait until the next morning? Here’s the tougher question: How much of it do you do to yourself? Have limits as to what you jump and run to do: You will not regret time spent with family, but you may regret vacation time talking with the office unnecessarily. Disconnect and develop reasonable boundaries so you don’t end up resenting going to work in the morning. Maybe you need additional vacation time: Let’s face it, the job isn’t the same as it was 5, 10, or 20 years ago. If you sit at the same vacation time you did 10 years ago, maybe it is time for more. Maybe the ability to disconnect hinges on the ability to truly get away from your physical location. Go somewhere with a different time zone. It doesn’t mean you aren’t available to employees, it just means they may be more willing to problem solve before calling if it is 4 AM your time. Get the right person to cover in your absence: We see a lot of agencies where the administrator and the back-up work well together. If your number 2 in charge doesn’t have autonomy and confidence to make decisions independently, then you don’t have a good number 2. Your back-up administrator needs to be confident to make what decisions are within his or her wheelhouse. If you go away for a week and get called several times, then you need to work with those in charge in your absence. There are certainly times where contact is necessary, but it needs to be the exception and not the rule. Successful recruitment and retention strategies for your agency have to consider you in the process too. What do you do to change your focus: I have to admit that this one was a tough one for me. How many times do you find yourself engaged in something else and realize you are right back to work in your mind? It is one thing to disconnect from something physical like your phone or your laptop, but a whole different story when it comes to your brain. Find what works for you. Podcasts (that have nothing to do with work), guided meditation, exercise, music, and time with friends/family all take you actively focusing on something else. Learning to keep your mind focused on something other than your business takes time. Everything Starts With Operations: You can know the regulations, have a great policy manual, maintain optimal recruitment and retention and onboarding , and yet still struggle. Being able to put the pieces together for operational efficiency and excellence is a different issue and skill set. So, understand your limitations and get the people around you that have the talents to complete the things you struggle to do well. We see it with employees everyday. Employees gravitate to the tasks they are good and thrive doing, so why would you be any different? You can have the best plan but need to have people around you that can help with the execution of it. At Peek Consulting , we work with homecare, home health, and hospice agencies who are looking for clinical, financial, and operational solutions for their agencies. This article is being republished with the permission of the writer, Shelly Barrett. Call Kenyon Homecare Consulting To Help With All Your Consulting Needs: If you need assistance with your homecare. home health or hospice agency or are looking to start and agency, Kenyon Homecare Consulting can help. Please call us today at 206-721-5091 or contact us online to see how we can make things easier for you! We have a comprehensive line of products and services to help you with all your need.

If you follow this blog, you will know that our last post dealt with some information obtained in the National Healthcare at Home Best Practices and Future Insights Study . There are so many excellent data points and today we want to look a little more into expectations for new employees and retention of staff as well as legacy planning. If you have not downloaded the entire report, then please do. When you read the items we reference from the report here, then consider where your agency culture could potentially change to improve retention of staff. Recruitment of Nurses to the Industry: It is no surprise that topping the list of barriers is compensation being higher in other healthcare venues than home health and hospice. This is not new considering our our reimbursement in comparison to hospitals, etc. However, within the top 3 barriers was a misinformed or wrong perception of the industry. This was true for Home health and Hospice Centers of Excellence reporting as well. Our industry is somewhat handcuffed on the reimbursement issue, but what does that tell us we need to do to help those nurses understand the industry differently? How can we reach people to change it? After a few years working in the industry, I had several nurses communicate to me a feeling that they did not believe their assessment skills were good enough to be in home health or hospice. I communicated the opposite. When working with other staff directly around me, I always felt I didn't need to figure things out on my own. My assessment skills got much better working independently in home health and hospice. How many nurses shy away for this exact reason? Recruitment of Aides to the Industry: Again, the biggest barrier lies in reimbursement. This is a tough thing, but we as home health and hospice agencies don't utilize aides to their fullest capacity most of the time. If we did, then what resources in terms of additional visits made by higher cost employees could be decreased. Doesn't this allow us to train, increase expectations of certain skilled aides and change rates of pay because of the advanced care provided by these staff? The biggest take home here is that the Centers for Excellence agencies are more likely to utilize colleges/ universities and preceptor programs as sources of recruitment than those non Centers for Excellence agencies. Are you looking into this in your area? Legacy Planning: This data point was very interesting from a consulting standpoint. We all know that major changes to leadership can be very disruptive to employee job satisfaction as well as recruitment and retention. Hospice agencies reported the effect of leadership changes in the next 3-5 years as having a 64.13% neutral impact. Meanwhile, when home health was surveyed, it reported a negative impact of 62.57% and very negative impact at 35.50%. Only 2.23% of home health agencies reported leadership changes as a neutral impact. Although the industries have differences, the stark contrast to the impact of leadership changes is drastic. It is clear why over 89% of the 1,000 home health agencies involved have formal legacy planning. Meanwhile, only 11.41% of hospice planned for change. As far as best practices, 99% of Home Health Centers of Excellence agencies have formal legacy planning. Kenyon Homecare Consulting can Help: Our next article will focus on another portion of this report. We would suggest agency leadership use the metrics involved to understand their own agency strengths, weaknesses, and need for planning. Ultimately, there is so much data here to digest and so much of it can help you look at your agency through a different lens. At Kenyon Homecare Consulting , we help agencies improve clinically, financially, and operationally to function the best way they are able. If you would like assistance with your agency, then call us today at 206-721-5091 or contact us online to see how we can help!

By Stephen Tweed This month is Company Culture Month for the Home Care CEO Mastermind Groups, and our Mastermind Town Hall will focus on creating a “Caregiver First” Culture. You’ve read our posts before so you know that we define company culture as “The way we do things around here.” And you also have heard me talk about the four elements of your company culture: The Leadership Style of the CEO The Core Values the Guide Your Decisions and Actions The Behavior you Expect The Behavior you Permit Using our Values Worksheet, we’ve guided dozens of home care companies through the process of defining their core values, describing the behaviors that to with each of the values, and communicating those expected behaviors to all members of the team. Holding Team Members Accountable My wife and business partner, Elizabeth Jeffries, RN, CSP, CPAE is a world class Executive Coach. She coaches CEOs in large hospital systems, and she coaches Physician Leaders in academic schools of medicine at several esteemed universities. Elizabeth works with these executives on their leadership skills, and helps them develop relationships with the members of their leadership teams. Here favorite coaching is on-boarding new leaders as they move into a new role in the organization. One of the elements of leadership that Elizabeth works with is accountability, and helping her coaching clients hold people accountable for what they committed to do. She has even developed a Seven Step Accountability Script that leaders can use to prepare that conversation. The seven steps are: Describe – the opportunity for developmental coaching Express – how you feel about this situation Question – what questions do you want to ask? Suggest – what outcomes you want Explain – the benefits to the person for this course of action Ask – for commitment Account for : – what you will say to hold the person accountable You can read the details of this process in Elizabeth’s newest book, What Exceptional Executives Need to Know. The Behavior You Permit You Promote In developing her coaching process over the years, Elizabeth has developed a mantra that holds true for most situations. “The Behavior You Permit you Promote.” This is very true when it comes to crafting your company culture. And when you are crafting an “Employees First Culture,” you will need to be observing the behavior of leaders toward their team members, and holding them accountable for demonstrating the behavior you expect. We have learned over the years that it is very easy for leaders to speak the words that describe the company culture. It is much more difficult to demonstrate the behaviors that go with living your values. What do you do when a member of your team behaves in a way that is outside of your expectations? What do you say? What do you do? What are the consequences? How do you hold Caregivers Accountable? In today’s world of high turnover, no call – no show, and unreliable caregivers, how do you hold caregivers accountable for the behavior you expect? While it is not easy, there are some steps you can take to increase the probability that your caregivers will behave the way you want them to, and they’ll stay with you. Here are some specific concrete steps you can take to get your caregivers to buy in to your company culture and demonstrate the behaviors that you expect: Communicate your company values in to your job ads Build “Culture Fit” into your selection process Use behavioral interview questions to determine how the applicants core values align with your company values Focus on company culture in your on-boarding process Train your office team members on the values and behaviors of your culture Be very specific with caregivers about the behavior that is expected and the consequences Make sure that your supervisors and managers are holding caregivers accountable Ask very specific questions when having conversations about behavior. Build your values and behaviors into your reward system. Reward caregivers for living your company values and expected behaviors Enforce your expected behaviors and implement the consequences for bad behavior. Use the Seven Step Accountability Script when having those conversations. There is no magic answer to the process of implementing your culture and getting your caregivers to behave the way you want them to. But the companies we work with you are really focused on crafting their company culture are seeing measurable improvements in their ability to attract high quality new hires, and in retaining those new hires. Another Mantra that has come out of our work: “People who want to work, want to work with people who want to work.” When you build an amazing culture of attraction and accountability, you’ll find that these suggestions really do work to find and keep the people you need to grow your business. Discuss These Ideas with your Peers One of the great ways to test these principles is to discuss them in depth with your peers, and learn from OPE – Other People’s Experience . You can do that by becoming a member of a Home Care CEO Mastermind Group . Nobody really understands what you are going through as a home care company owner except another owner of a home care company your same size. This article is being re-published with permission of the writer, Steven Tweed: Stephen Tweed, CSP, is an internationally known health care and business strategist, award winning professional speaker, and published author. He is the CEO of Leading Home Care… a Tweed Jeffries company and the Founder of The Home Care CEO Forum® and Caregiver Quality Assurance®. If you need assistance with your homecare. home health or hospice agency or are looking to start and agency, Kenyon Homecare Consulting can help. Please call us today at 206-721-5091 or contact us online to see how we can make things easier for you!

If you follow this blog, you will know that our last post dealt with some information obtained in the National Healthcare at Home Best Practices and Future Insights Study . There are so many excellent data points and today we want to look a little more into expectations for new employees and retention of staff as well as legacy planning. If you have not downloaded the entire report, then please do. When you read the items we reference from the report here, then consider where your agency culture could potentially change to improve retention of staff.

By Stephen Tweed

" Small home care agencies believe that they are small because they can't get client referrals. Big agencies KNOW that they're big because they can recruit and retain caregivers ."

Clinical employee retention is such a loaded subject. There are so many facets to what makes a clinical employee stay or leave an agency. You have to consider everything important to the employee while realizing generational issues greatly changes the focus for each individual. So, in considering wage, benefits, vacation, family leave, onboarding and the generation of employee involved, have you thought about what robust educational programming brings to the table? Have you ever considered it as a retention measure?