Your agency can become the local home health care employer of choice

Corporate culture, clear expectations, and recognition prove successful

(Editor’s note: This is the first of a two-part series covering strategies home health agencies can use to successfully recruit and retain qualified employees. This month, we look at how a home health agency can establish itself as the employer of choice within its community. Next month, we will examine how hiring the right supervisor or manager can greatly help with successful retention of employees.)

Name brand recognition is the key to success for product manufacturers. It doesn’t matter if the manufacturer makes soap or soup. The goal is to make the package memorable, the name familiar, or the benefits so attractive consumers automatically think of just one brand when they go to purchase that item.

Home health agencies that are successful employers also brand themselves, but not in the same way that product manufacturers brand their products, says D. Mark Hornung, senior vice president of Bernard Hodes Group in Redwood City, CA. "Home health agencies brand themselves as the employer of choice for their community by developing a strong relationship with current, former, and potential employees."

While this relationship can be described in advertisements and brochures, the home health agency management has to go beyond using words to describe a strong employer-employee relationship. The management staff members must "walk the walk," he adds.

A successful employer-branding program involves commitment from all levels of agency management and staff, Hornung explains. The program needs to include a true focus on helping employees do the best job they can by providing them with resources they need and recognition they deserve. "Most home health agencies are aware of salary and benefits offered by other agencies in their community; so in most cases, these items are comparable from agency to agency," he says. The differences among agencies show up in areas such as scheduling, continuing education opportunities, respect for employees’ skills and efforts, and general work environment, Hornung adds.

At Henry Ford Health Care in Detroit, employees don’t have to guess about their employer’s commitment to them. "We have printed our mission, vision, credo, and values on a wallet-size card for all employees," says Greg Solecki, vice president. "We make it clear that we put patients first by caring for them as we would a family member, and that we have a work environment where employees respect each other and work as a team. Then, we work to create this environment every day," he adds. By making these promises and working to keep them, his agency has proven that management takes the relationship with all employees seriously, Solecki explains.

Any relationship with an employee starts with recruitment, Hornung notes. "A nurse or aide who is thinking about changing jobs looks at the local newspaper or a trade publication that is filled with advertisements for jobs.

"The challenge for any home health agency is to make sure its ad stands out from the rest of the ads," he points out. If your recruitment ads are the typical, small, job-opening ads that every other agency runs, the job seekers may never see them, he explains.

At Henry Ford Home Health, the ads don’t just describe a position that is open — they describe the type of person who is needed for the job, adds Solecki. "We don’t want just any home health nurse to want to work for us. We want nurses who look at this as a profession, and we want nurses who understand this is a hard job," he says.

Recruitment advertisements for his home health agency describe the nurse who works at Henry Ford Home Health as "wanting to make a difference, wanting to care for the sickest home health patients, and wanting to be true to a mission of caring," Solecki points out. "When we first showed our ads to our human resource personnel, they told us that no one would read them and that we wouldn’t get any response," he admits. "We’ve proved them wrong by not only getting applications for job positions, but by getting applications from a different caliber of nurse," Solecki says.

Nurses who respond to their ads generally are more committed to home health than applicants for traditional ads, he notes. "They understand that home health is hard work, but they also understand that there are rewards in home health that don’t exist in other areas of nursing," Solecki adds.

Job applicants at Henry Ford Home Health get a sense from the start that this employer is different, he says. "We have a policy [of getting] back to the applicant the same day that the resume is received." Solecki’s organization is so quick to respond and to schedule the interview that some job applicants have said that they’ve already accepted positions at Henry Ford before other home health agencies even acknowledge receipt of their application, he says.

A successful recruitment program shows current employees that you are providing resources they need to do their own jobs, Hornung adds. "The nursing shortage means that when someone leaves, other employees have to cover the extra caseload until a new nurse is hired. With a successful, ongoing recruitment program that creates a pool of qualified applicants that can be contacted immediately, you show your staff that you understand the pressure of taking on extra patients, and you don’t want them handling extra work for a length of time," he explains.

Just hiring someone doesn’t mean you are meeting the needs of your organization, Solecki says. "We are very upfront about our expectations of employees in terms of how we all treat each other as well as our clients. We are also very honest about how home health is not an easy job. "We want to make sure we hire the right person in terms of clinical skills as well as [addressing] likelihood [that person will] stay with us," he points out.

Solecki’s approach seems to work. Even though he admits that his agency loses 50% of new nursing hires within the first six months, with one-half of those leaving during the orientation period, the average tenure of his nurses is 9½ years. "If we can keep them during the first six months, we have them with us for a long time," he adds.

At HomeReach HomeCare in Worthington, OH, the "Get it right from the start" program is a systematic way to interview, select, welcome, and support new employees.

"All managers receive training and a binder that contains information to help them make sure they hire the right people," says Lisa Lerdon, employment specialist for HomeReach. This support tool has helped managers better evaluate people they interview and identify the people who will be successful in home care, she adds.

One of every new employee’s key concerns is not knowing anyone, Lerdon points out. To address this issue, all new employees wear a lapel pin that lets other employees know that they are new, she says. "They wear the pin for 90 days — the length of their orientation — and all other employees know to stop and introduce themselves, ask if the new employee has any questions, or offer to help them if they need assistance."At the end of their 90-day orientation, the group of new employees celebrates with a breakfast and a graduation gift from the agency, she adds.

Although new employees spend six weeks in the classroom and the rest of the orientation period working with a preceptor, Lerdon says managers emphasize the fact that it can take as long as a full year for a nurse to feel completely comfortable as a home health nurse. "We want to make sure that everyone feels comfortable asking for advice, even after the orientation period."

This approach has helped many new employees avoid feeling discouraged when they realize that they still have a lot of questions after the initial 90 days, she explains.

After establishing an environment in which people want to work, advertising your agency as a great place to work, and hiring the right people, it is important to recognize people in ways that make them want to stay, Hornung says.

"We base an annual bonus to employees on the achievement of home health agency goals," says Jean R. DeLong, RN, MSN, director of clinical services for HomeReach. Every employee gets a copy of the balanced scorecard that shows how meeting goals in each of the categories (quality of work life, patient satisfaction, financial status, and clinical outcomes) contributes to success throughout the agency, she says. "We make it clear that we can’t meet our patient satisfaction goal of 90% of patients saying they are very satisfied unless we are also scoring high in our employee satisfaction surveys and meeting our clinical and financial goals," DeLong adds.

"We all know the goals at the beginning of the year, and we review progress toward those goals in staff meetings throughout the year," she says. This keeps employees up to date and reminds them that their day-to-day actions contribute toward meeting the goals, she explains.

Keys to Success also are used to recognize staff members’ efforts throughout the year, DeLong notes. "Any praise for an employee is written on the Key to Success form and must identify what the employee did and which service standard their action met," she says. Keys are collected, and when employees receive certain numbers of keys, they can choose different levels of awards, she adds. The awards range from restaurant gift certificates to a day off with pay, DeLong explains.

It is important to evaluate how employees perceive you, Solecki continues. "We conduct an annual employee survey; and this past year, 89% of employees responded, with the great majority of the responses overwhelmingly positive. People wrote that they got a personal sense of satisfaction from their job and that they enjoyed working here," he adds.

Making sure your employees are speaking well of you as an employer pays off in recruitment efforts, Lerdon notes. "I am constantly told by applicants that they chose to interview with HomeReach because their friend or neighbor has told them that this is the best place to work."

For information about employer branding, contact:

Jean R. DeLong, RN, MSN, Director of Clinical Services, HomeReach HomeCare, 404 E. Wilson Bridge Road, Suite D, Worthington, OH 43085. Phone: (614) 566-0888. E-mail:

D. Mark Hornung, Senior Vice President, Bernard Hodes Group, 333 Twin Dolphin St., Suite 400, Redwood, CA 94065. Phone: (650) 264-1134. E-mail:

Greg Solecki, Vice President, Henry Ford Home Health Care, One Ford Place, 4C, Detroit, MI 48202. Phone: (313) 874-6500. E-mail: