Caregivers Leave Managers, NOT Companies

April 12, 2022

By Stephen Tweed

I became of fan of Marcus Buckingham with when he worked with the Gallup Organization and wrote his first book,  First Break All the Rules . He shared lots of facts and data from Gallup surveys of employees, and came to some conclusions that can help companies grow. One of those conclusions was the quote above.

We got a sneak peak at the  2022 Home Care Benchmarking Study from Home Care Pulse,  and the turnover number for last year was 64%. That’s a little better than the 65.2% in 2020, but not much. Turnover has basically been flat for the past six years.

We also learned that 57% of turnover happens in the first 90 days of employment. That’s a refinement on the number we have been using for a while that said that 80% of turnover happens in the first 90 days.

WHAT CAUSES CAREGIVER TURNOVER?

Every month, Home Care Pulse surveys thousands of caregivers. From that data, they have identified the  five big reasons caregivers leave :

  1. Lack of Communication
  2. Pay is too low
  3. Lack of Consistent Schedule with enough hours
  4. Lack of Support from Office Staff
  5. Management is Disorganized and Operates Last Minute

We see that four of the top five causes are related to the action, or inaction, of managers and office team members.

“Caregivers leave managers, not companies.”

WHAT ROLE DOES YOUR OFFICE TEAM PLAY IN CAREGIVER RETENTION?

This month of February 2022, the  Mastermind Groups  in our  Home Care CEO Forum  has been discussing the role that their office team plays in retaining caregivers. Members have had open discussion about what they are doing to help their office staff be more responsive to their caregivers. We have seen that companies with the highest growth rates in 2021, companies with the lowest turnover, and companies with the highest 90-day retention have some things in common.

It is pretty clear from the data and from anecdotal examples that the home care office team plays a huge role in finding and keeping high quality caregivers. Here are some things high performance home care teams are doing to reduce turnover and improve caregiver satisfaction:

  1. Set up a consistent process for communicating with caregivers, particularly in the first 90-days
  2. Set up a system to match caregivers’ desired paycheck with their actual hours worked and actual take-home pay
  3. Clarify who is actually responsible for supervising caregivers, and communicate that to everyone
  4. Provide education and training for team members who supervise caregivers on what caregivers need and want from their supervisor
  5. Set up systems so that office team members are more organized and can devote more attention to individual caregiver needs and expectations

It is pretty clear from our research that the best caregivers stay with a home care company when they are doing meaningful work, when they feel valued and appreciated, and when their take-home pay matches their financial needs.

PUT CAREGIVERS FIRST

We’ve been working with home care companies across the US, Canada, the UK and Australia for over three decades. In all of that time, most companies we know have had a “customer-first” mind set where they do everything they can to create a high level of client satisfaction. And that has worked amazingly well for many companies.

In 2022, the tide has turned and larger, faster-growing companies have proclaimed a  “Caregiver-First Mindset.”  That doesn’t mean that client satisfaction and customer service are no longer important. But it means that in this world where you can’t bring on new clients if you don’t have the caregivers, the company priorities and mindset are shifting. It means getting our office team members involved in working together to understand the needs and wants of caregivers first, and putting in place people and processes to meet those needs. It means using caregiver satisfaction data, recruiting data, and retention data to help office team members work together more effectively to keep our best caregivers.

This shift from  Clients First  to  Caregivers First  is quite difficult for company leaders and team members who have been in business for many years and have constantly focused on client needs. It is taking some major shifts in thinking and in actions to make that shift.

CREATING INCENTIVES FOR OFFICE TEAM MEMBERS.

Just before the outbreak of COVID, we were doing a site visit to one of our Top 5% Mastermind members. As they discussed their growth % in 2019 over 2018, they shared some data on what they had done to improve 90-day retention. The results were very impressive. As we discussed their process, we heard the CEO repeat back the mantra that we have been promoting for years:

“What gets measured gets managed, what gets rewarded gets repeated”

This company had set up a new incentive plan for each of their office team members. The incentive plans varied from department to department, but everyone was incentivized based on three performance Metrics:

  1. Increase in Weekly Hours of Service
  2. Home Care Pulse Satisfaction Survey Results
  3. Caregiver Retention

The were able to show each of their team members how they contributed to those three numbers, and how they would be rewarded when the numbers moved in the desired direction. It became pretty clear from talking with them about how tracked the metrics, and how they calculated their incentives, that nearly every member of the team had bought into working together to grow the business, improve client and caregiver satisfaction, and keep good caregivers.

ENGAGE IN CONVERSATION WITH PEER COMPANIES ABOUT KEEPING YOUR CAREGIVERS

A significant number of our in-depth conversations in our Home Care CEO Mastermind Groups are about keeping high quality caregivers. Developing managers and team members so they have the knowledge and skills to nurture those relationships is part of the process.

If you would like to have regular conversations about issues like this with leaders of other companies your same size who do not compete with you, you may want to consider becoming a member of a  Home Care CEO Mastermind Group  in the  Home Care CEO Forum .

This article 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®.


Should you need assistance with your home care, home health, or hospice agency, then call  Kenyon Homecare Consulting  at 206-721-5091 or  contact us online . We help agencies develop practical solutions for success in the home care industry.

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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.