Wednesday, July 24, 2013

Measuring and Managing Caregiver Satisfaction

By Stephen Tweed

Caregiver retention is a critical issue for today's home care company.  Research conducted by Leading Home Care and Caregiver Quality Assurance® shows that is costs about $1,576 every time an employee turns over, whether they quit or are terminated.  The annual turnover rate in the home care industry was 52.6% in 2012, so if you had 100 caregivers and 52 of them turned over, it would cost  you $81,952.00.

That's a lot of money.  And that doesn't count the cost of unhappy clients who really want the same caregiver every day.

Client satisfaction is a huge factor in reducing turnover in your company,  so measuring and managing satisfaction is important.  How do you know how satisfied your caregivers are?  Ask them!

At Caregiver Quality Assurance®, we are seeing a real need for companies to pay more attention to caregivers, engage them in conversation, and show them appreciation and recognition.  The process begins by asking caregivers what they feel and think about your company.

It's hard to do it alone

We've found that most home care company owners have a hard time doing their own caregiver surveys.  It's often easier to ask an expert.  So we are asking our expert, Aaron Marcum at Home Care Pulse to give us some insights into the factors that are important to caregivers and the kinds of questions we should be asking.

Aaron and his team at Home Care Pulse have mastered the process of conducted telephone surveys of caregivers to accurately measure their level of satisfaction.  By asking a series of carefully crafted questions, and then comparing the data among caregivers, and comparing to industry benchmarks, you can get a more clear picture of their satisfaction.

What questions should we ask?

There are really three categories of questions that give you a picture of caregiver satisfaction:

Orientation and Training
  • What has been your experience with new employee orientation?
  • What has been your experience with ongoing training?
Company Culture
  •  How accessible is my supervisor?
  • How accessible is senior management?
  • How much do you feel valued and appreciated?
  • How clearly defined are your job expectations? 
  • What is the overall morale in the company?
Overall Job Satisfaction
  • What is the caregiver's overall level of satisfaction?
  • Would the caregiver recommend this company to another employee?
  • Would the caregiver recommend this company's services to a client?
While these are the categories of questions, a critical skill is crafting the questions, asking the questions, and documenting the results.  Then you need to tabulate the results, analyze the results, and decide what action you want to take to increase your level of caregiver satisfaction.

It's very clear.  The old saying is very true:

"Client satisfaction is a mirror image of employee satisfaction"

To get  more insight into how you can more effectively measure and manage caregiver satisfaction, join us on Thursday, August 8th at 4:00 pm eastern time for a live web conference when our special guest will be Aaron Marcum from Home Care Pulse.  Aaron will be sharing his knowledge and experience on how to measure caregiver satisfaction, and what you can do with the information to grow your company..

This web conference is free to members of Caregiver Quality Assurance®, and to Premium Members of The Academy for Private Duty Home Care®.  Non-members may register on a pay-per-view basis.

If you missed the live web conference, the recorded version is available on the web site.  Members can log in and view for free.  Non-members can order a copy in the Academy Store. 

Thursday, July 11, 2013

HCAOA Works to Protect the Federal Companionship Exemption

As members of the Home Care Association of America, we appreciate what our association does on a
regular basis to advocate for home care companies across the country.  This morning we received an update from HCAOA regarding legislation to protect the federal Companionship Exemption for home care workers.

"HCAOA Member,

Tomorrow, July 11th, the Senate Appropriations Committee will take up consideration of the fiscal year 2014 spending bill for the departments of Labor, Health and Human Services, and Education.  The HCAOA requests your immediate action to support an amendment relating to the companion care exemption under the Fair Labor Standards Act that will be offered tomorrow.

Senator Mike Johanns (R-NE) is planning to offer an amendment to prohibit the implementation of the proposed companionship exemption rule relating to the Fair Labor Standards Act until certain conditions are met.  Specifically, the amendment would not allow federal funds to be appropriated to finalize, implement, or enforce the proposed companionship exemption rule (76 Fed. Reg. 81190) until—(1) the Administrator of the Centers for Medicare & Medicaid Services certifies to Congress that the final rule will not increase the financial burden on State Medicaid budgets; and (2) the National Council on Disability certifies to Congress that the final rule will not increase the costs of in-home care for individuals with disabilities.

As a member of the HCAOA you are specifically being contacted because one of your Senators sits on the Senate Appropriations Committee and will have a vote on the Johanns Amendment.  Please use the link below to submit the message.

Thank you!

Kevin W. Smith
Director of Operations
Home Care Association of America

Click the link below to log in and send your message:"

While it may be too late for you to take action on this immediate request, we want you to be aware of what the companionship exemption is, and what our national association is doing to look our for our members, the clients of those member companies, and the state Medicaid programs that will bear the increased costs of removing the exemption.

Thanks, Kevin and the HCAOA team for all you do.

Tuesday, July 9, 2013

Why Your Mission and Culture Matter

An Interview with Alex Chamberlain of EasyLiving
By Shannon Martin of AgingWisely

Alex Chamberlain, Executive Director of EasyLiving, Inc. in Clearwater, Florida shares some of the innovative ways they have built a strong team culture amongst their caregivers, and how that has resulted in success.

Tell us about your mission and why you think it is so important.

EasyLiving’s mission is to create an environment where we set our team members up for success empowering them to provide the best in home care to the community. To be honest, I don’t think you should be in the home care business if you just see it as a money-making opportunity. There’s been a lot of press about the growing demand of our aging population, and I think that sometimes attracts people who don’t truly care about the client and what it will take to provide excellent care. We approach this as a professional business and take being an employer in our local community very seriously. The only way we can accomplish our goal every day is to hire, train and treat our caregivers the best. This in turn leads to satisfied clients, more business and therefore helps keep our caregivers employed with plenty of work.

We look at everything through the lens of our mission and take any concerns that arise as a sign we need to be doing something better to support that caregiver. For example, if we have a client who requests a caregiver not return, we have that caregiver come in for a caregiver coaching session (which we also perform at regular intervals) to talk about ways to improve or how to resolve the concern.

Tell us more about how your culture ties in with your mission.

We want to rethink the image of caregivers and the culture of home care. Caregivers are amazing people with caring hearts and they need to be thanked for what they do. There are people out there who think of caregivers as “the hired help” and do not always respect them. We expect professional behavior from our caregivers, so we also demand our clients show that respect. We have “fired” clients who do not do so.

We take our mission to mean that we must hire, train, and treat our caregivers in the best way possible. It means constantly figuring out the best ways to do this. When you do this, you demonstrate that you take your mission seriously and your team begins to feel pride not only in what they do, but in where they work. When you have a team that buys into your mission and culture it attracts other like-minded individuals.

What are some of the specific initiatives you have set up to reward and appreciate caregivers?

We believe it’s essential to reward good behavior. A punitive system only reduces bad behavior; it won’t necessarily develop good behavior. We have a comprehensive rewards program we call iCaRewards™ which allows caregivers to earn rewards points they can redeem for great prizes. They can earn points for everything from getting a “kudos” sticker from a client to attending a training or event. Some of the neat things we have done for caregivers include:
  • Sending a personal thank you note when they do something great or we get good feedback.
  • Setting up a “personal pizza party” where we send pizza to their home so they can enjoy a complimentary family meal on us.
  • Providing a “day off” pass, eight hours of PTO.
  • Car washes, massage gift certificates and magazine subscriptions along with a variety of gift cards they can choose from to redeem rewards.
We recently created an “Inspirational Caregiver Award”. Each month we choose five finalists, who exemplify top quality caregiving. They each receive a gift card and we create a lot of excitement about the award. We partner within our community network to feature this award on a local radio show. The winner gets a spotlight on the radio show, our website and social media. This takes the recognition to a whole new level and shows a wider audience the positive picture of caregiving. It’s one thing to be recognized, but it adds a lot of excitement when it’s being shouted out to the world.

What are some of the challenges to creating this culture and some advice you would give to other business owners?

Buy-in takes time. It took us almost two years for every one of our caregivers to acknowledge our rewards program and start to talk about the differences in working at EasyLiving. You have to be persistent and creative and take every opportunity to share about your mission and why you are doing what you do. Culture is so much more than one event. Caregivers have to see that it underlies everything you do…in other words, you really mean it and it shows. Communicating is key. We take a multi-pronged approach to communication…mailing, emailing, calling and texting our caregivers about events and initiatives. We have an intranet site where we share upcoming events and company updates. We also use social media to help us push messages out to the team and build the sense of community. We don’t use social media primarily to reach new clients; we have harnessed its power instead to communicate to our caregivers and spread our mission.

How do you measure your success?

The obvious benchmarks include recruitment (referrals from current caregivers especially) and retention rates. But more importantly, your caregiver efforts should be reflected in your quality scores. We see this at EasyLiving, with consistent top scores in our independent Home Care Pulse surveys. The efforts you put in to your caregivers mean clients will be requesting those caregivers to come back and your clients become ambassadors for you in the community. When our clients are asked if they’d recommend our agency in our surveys, almost all of them respond positively and most have already done so.

Beyond the numbers, you can feel the shift in your culture. We felt it at our recent Memorial Day party, when we had a large crowd of caregivers (and some of their family and clients), staff and friends gathering for camaraderie and relaxation. We also feel it when we see our caregivers telling their friends how great it is to work at EasyLiving, encouraging each other and interacting on our Facebook page.
Alex Chamberlain is Executive Director of EasyLiving, Inc., a private duty home care agency serving Pinellas County, Florida. Alex was recently named Clearwater Chamber’s Young Professional of the Year. Under his leadership, EasyLiving has been named a “Best in Home Care” agency by Home Care Pulse and one of the fastest growing businesses by the Tampa Bay Business Journal. Alex is also the founder of EZFingerprints, an electronic fingerprinting service which is currently offering franchise opportunities.

Monday, July 8, 2013

Top Three Strategies for Retaining Top Talent in Home Care

By Stephen Tweed, CSP

What can you do to keep your caregivers?  The 2013 Private Duty Benchmarking Report shows that caregiver turnover is again this year for the 4th consecutive year, hitting 52.6%.  That means that 53 of every 100 caregivers quit or was terminated last year.

Using the Bad Hire Calculator from Caregiver Quality Assurance,  we calculated that the average cost of a bad hire was $1,576.24.  That means that if you had 100 caregivers last year, and 53 of them quit or were terminated, it would cost you $78,812.

I don't know about you, but there are lots of things I can do with $78,000 to grow my business.

Top Strategies for Caregiver Retention

Because caregiver turnover is such a huge issue in home care, and getting worse, we've continued to do research on this topic to help you understand what you can do to reverse the trend.  Our research shows that the three most significant factors in caregiver retention are:

1.  Appreciation and Recognition - your caregivers will stay with you and your company if they feel valued and appreciated.  That means we need to find innovative ways to show appreciation for caregivers so they feel valued.  And, we need to find innovative ways to provide formal recognition, including tangible rewards.

2.  Meaningful Work - your BEST caregivers are folks who really believe in what they do. They love their clients and really believe they are making a difference in their lives.  As a business owner, you can keep your best caregivers by making sure they have the opportunity to do meaningful work for their clients with a minimum of hassle.

3.  Servant Leadership - there is plenty of evidence to support the principle that caregivers will continue to work for a leader who puts service before self.  The concept of "Servant Leadership" was first describe by Robert Greenleaf, a retired AT&T executive who studied leadership and employee engagement. He wrote a now-famous essay about the concept, and then followed with several books.

If you are serious about growing your home care business, and you would like to create a culture of exceptional customer experiences, then you may want to explore the principles of Servant Leadership.  A servant leader is significant because they:

1.  Create a sense of hope through mission and vision

2.   Are guided by core values that are clear

3.  Accept and show reverence for their followers

4.  Trust others and release control

5.  Demonstrate frequent, persuasive communication

6.  Listen to those they influence

7.  Make a commitment to personal transformation

Over the years, I've met a number of gifted home care leaders who really demonstrate these principles.  The result is a growing and profitable business that makes a difference in the lives of clients, families, caregivers, and office staff. 

To help you develop a more clear understanding of the principles of Servant Leadership, we'll be hosting a special live web conference this week featuring a nationally known author, award winning professional speaker and executive coach Elizabeth Jeffries, RN, CSP, CPAE, the CEO of Executive Mastery ... a Tweed Jeffries company,  will be with us to discuss the principles of Servant Leadership and how you can apply these concepts to increase the quality of your caregivers, reduce turnover, save money, and serve more clients.  

Join us on Thursday, July 11, 2013 at 4:00 pm eastern for Servant Leadership in Home Care with Elizabeth Jeffries.