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Workforce: The Employment Journey in Home-Based Care

Date: November 14, 2022 Lincoln Intelligence Group

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Demand for home-based clinicians and caregivers is heading in the opposite direction from the demand for care. As such, home health, personal care, and hospice and palliative care providers have a unifying mandate: To be best in class as an employer.

To help our members compartmentalize this daunting challenge, we have identified five key phases of the employment journey during which clinical and non-clinical home care providers need to excel. Namely: Awareness; Exchange; Orientation; Management; and Development.

1.  Awareness: Candidates find out about an employer in a variety of settings and through a wide range of communication channels. By shaping the initial impressions of the employer brand as early as possible, you have a chance to cut through the noise and stand out in a crowded field of employer and career options. Successful employers view themselves both as credible ambassadors for their own brand and the home-based care brand.

2.  Exchange: Employment is no longer typified by the paradigm, "I interview you – I decide whether to hire you." Today’s employment relationship beings with a mutual exchange of propositions that, in our digitally dominated world, begins well in advance of an application. Carefully chosen language and “employer branding” make recruiting now seem more like a marketing exercise than an HR function. The competition for talent is so fierce that many providers view the caregiver much like a client who needs to be nurtured throughout a frictionless process that mirrors their customer acquisition cycle. This nurturing continues seamlessly into the hiring and orientation phase.

3. Orientation: With high turnover in both clinical and non-clinical, we need to thoughtfully shepherd new hires through the first six to twelve months of employment to clear the first hurdle toward a long-term hire. Preceptors and mentors, increasingly in demand due to COVID-related retirements, supply the guidance for new hires to learn the technical and emotional ropes of home-based care while they are considering the early-tenure “stay or go” question. In low-turnover organizations, leaders and other managers inject themselves at key junctures of each person’s orientation to provide a variety of voices.

4. Management: As in general industry, in our sector the manager/employee relationship is highly correlated with the duration of the employee's tenure. Operators are investing considerably more in management training than in the past, quite simply, because that investment is dwarfed by the cost of turnover. Trained managers represent the employer brand and ensure that cultural expectations are met while they coach for continuous improvement and monitor employee satisfaction. Predictive tools are available to augment the judgment of management in the quest to reduce turnover.

5. Development: Another key determinant for longevity is the presence of career ladders. Our members report significantly longer tenure when they have been able to both influence the employee early in their career trajectory and offer a ladder to growth. While some employees do not value development opportunities (versus, say, additional pay or quality of life), growth is very important to new entrants in the caregiving field. Growing our field requires a commitment to growing people.