Screening tool predicts job performance

Better hiring decisions improve bottom line

Recruiting home health aides is hard enough, but retaining them can be even more challenging. Despite their scarcity in relation to the demand for their services, home health aide turnover nationwide averaged more than 21% in 1997, according to research from the National Association for Home Care in Washington, DC. Repeated absenteeism and poor job performance cause employers to terminate services, while home health aides often leave over seemingly minor differences, providers say.

At the same time, recruitment costs remain high. Experts estimate the hard dollar cost of advertising, criminal background checks, drivers tests, TB tests, and physicals, combined with staff interviewing and orientation time, can add up to over $1,000 per home health aide. With such a large investment, identifying candidates with staying power is vital to home care human resource managers.

Help is on the way, according to one person who operates a home health aide training program that supports four Madison, WI-based home health agencies. Kay McGee, director of the CNA Career Alliance, uses a written test that predicts attendance, job longevity, and job performance in her overall screening process. McGee combines the CurryScreen Nursing Assistant and Home Health Aide test with thorough interviews, criminal background checks, and drivers tests to select participants in the CNA Career Alliance’s eight week home health aide training program. "I don’t use it to determine whether they’re in or out, [but] as a tool to [see whether] they follow instructions," says McGee.

It’s really a test of honesty and integrity’

But the test’s reliability and validity would enable a provider to use it as a hiring disqualifier, according to its developer, Michael McDaniel, PhD, principal of Curry Business Systems in Glen Allen, VA.

"Those who score low on the survey have only a 25% chance of staying on the job five years, a 44% chance of having excellent attendance, and a 38% chance of [performing excellently]," he says.

Questions on the six-page test deal with such topics as reasonable reasons for skipping work, how long applicants usually stay on a job, how well they follow instructions, and general cognitive and math skills. Most applicants complete the survey in about 30 minutes, according to McDaniel.

"It’s really a test of honesty and integrity. [Some applicants] are real honest and take time to write explanations [even though the exam doesn’t require it]," says McGee. "[I don’t see it as] an intellectual skills test but more of an emotional balance [indicator]."

About 40 CNA Career Alliance applicants have taken the exam since McGee began using it more than a year ago. She has not yet correlated their exam scores with program or subsequent job success. Of the 35 people who have entered the Alliance training program since its inception about 18 months ago, 25 have completed it, she says.

Some applicants eliminate themselves

Some applicants screen themselves out of the process after learning of the exam in the initial interview, McGee says. "To you and me it sounds like a wonderful opportunity, but to someone living on the edge, it may not seem worth it."

She reassures those who return to take the test that it is not the sole determinant of their continuing in the program. "I observe the applicants to see how they approach the paper. Some people don’t read well or process information quickly, [but that doesn’t mean they won’t make good home health aides]. A lot of them freeze up on the math, and while I hope they can add 2 and 2, I look at it as a test of honesty," McGee explains.

Providers who use the exam as an employment screen can score it in about five minutes, according to McDaniel. Their efforts will lead to a better hiring decision. "Unlike other screening tools, which don’t have empirical data, I can prove on average that this [predicts attendance, job longevity, and performance], he adds.

Editor’s note: The home health aide screening tools are available from Curry Business Systems. A starter kit with four surveys and an administration and technical manual costs $100. Subsequent surveys are $12 each for less than 50, and $10 each in quantities of more than 50.


Michael McDaniel, PhD, Principal, Curry Business Systems, 12401 Linwood Dr., Glen Allen, VA 23060-7121. Telephone: (804) 364-8474. Web site:

Kay McGee, Director, CNA Career Alliance, YWCA of Madison, 101 East Mifflin St., Madison, WI 53703. Telephone: (608) 257-1436.