Tips for attracting, retaining field staff
Tips for attracting, retaining field staff
Benefits, pay guarantees, personal connections
Attracting and retaining field staff is an ever-present challenge facing private duty providers. The National Association for Home Care staff research places the industry turnover rate at 16%. Regional and local labor market characteristics may push figures even higher for certain home health worker classifications.
Tackling such significant, persistent odds requires innovation and experimentation. While some companies focus on maintaining a supportive work environment and providing special training, especially for home health aides (see Private Duty Homecare, March 1998, p. 36), others offer different benefit plans, pay guarantees, and office-field staff personal connections to boost retention.
While no one strategy has an edge over others, combined efforts offer the best chance of success, sources say. Hit hard by a communitywide chronic certified nursing assistant shortage, Geriatric Services of Delaware in Dover now offers a package of health, retirement, and vacation benefits, as well as permanent full-time employment to reduce turnover. The company hopes hiring 40 to 50 people will help it meet increased service demands and encourage staff to stay on-board, says Rosa Yoder, clinical nurse coordinator.
Consider benefits for part-time employeesOffering benefits may also retain part-time employees. Senior Home Care Connection, a San Diego-based private duty company, will soon fund 50% of the health benefit expense for staff working "somewhere between 20 to 30 hours a week," says Virginia Pinkerton, owner.
"If you're offering benefits, even if your pay rate isn't as high as other agencies in the area, you have to pick and choose what you're going to offer and to whom," she adds. "Our biggest competitors for qualified staff are the Medicare agencies because all give the staff benefits."
Pinkerton will closely track the benefit package to ensure that it is retaining employees. If not, she says, "I'll drop it. Our thought is, [staff will] maintain a consistent schedule of at least 20 hours a week. We have so many people who don't want to drive or work in certain parts of San Diego, maybe this way they'll be persuaded to work more hours and will have to take on some of the less desirable jobs."
The companies' experiments with benefits follows limited success with other activities. Pinker ton offered $50 sign-on bonuses, employee of the month recognition, and end of the year incentives. She found that "they all work to an extent but fall short of keeping a steady, reliable work force."
Geriatric Services' previous bonus, gift, and recognition strategies did not make "one iota of difference," says Yoder. Even the agency's higher than average pay rates have only marginally affected retention. "If the CNAs don't like you or someone in your agency, they'll move on," she explains.
Sources agree that higher wages alone may not improve retention. With a burgeoning business, Chris Davison, staffing coordinator at ACT for Health, a private duty nursing agency in Denver, is experimenting with pay guarantees. ACT pays staff who pledge 40 hours' availability over four consecutive days for 40 hours, regardless of actual hours worked. So far, Davison has hand-picked four of 90 staff to participate. He hopes this stable core will help the agency better manage its staffing demands and avoid turning down new clients, as it has been forced to do in the past.
Relationship building proves successfulWhen all else fails, make a personal connection, sources say. One-on-one interactions may fill in where benefits and wages leave off. Pinkerton recently instituted a new policy requiring all staff to pick up their checks in the office, rather than have them mailed.
Olsten Health Services in Phoenix also maintains a personal touch with field staff to boost retention. The most committed, long-term staff are those who walk into the office to pick up their checks, says Mary Beth Eichenbaum, recruitment and staff development specialist. Just last month, she barbecued hot dogs in the parking lot on payday so everyone coming in for their check got a free lunch. The agency sends birthday and holiday cards and ensures that field staff phoning the office speak with "a real live person."
"We've made it so that all caregivers have positive experiences at each point of contact in the office, whether they phone or walk in," says Eichenbaum. "We greet them, get personal, and talk about their experiences with the patients. Our goal is to make it personal. Most private duty [workers] rotate through different agencies. But the ones they stick with it - it's not the pay - but they either get the hours they want or are connected to the office staff."
Any retention strategy comes with a cost, sources say. Olsten's benefit package for full-time field staff includes up to 28 paid days off each year. But "the program isn't cost-efficient for us. If someone decided to take the benefit all at once, we'd have to find replacement staff," she says. The office is now considering ending the program.
Most private duty agencies cannot afford benefit packages, says Chris Nolan, account executive for Livermore and Associates, a home health benefits insurance company in Rancho Cucamonga, CA. "With competition being what it is between these agencies, they have to be able to keep their rates down. Typically, health insurance can run anywhere from $80 on the low end, to $150 a month for each employee. This doesn't even take into account their dependents. Offering benefits, if [providers] want to stay cost-competitive, can be cost-prohibitive."
Pinkerton agrees. Offering health insurance will cost about $40 a month for each of her 70 employees, she estimates. It will eventually drive up Senior Home Care Connection's rates, but they are an important retention strategy, she says. "People are going to have to come up with some creative things. I hope that offering benefits is going to be a real pull, even if our rate of pay isn't as high as other agencies in the area."
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