Let’s Talk About the LOOMING CRISIS IN LTC HCSS: Part 1of 7

Are there reliable solutions available to head off this crisis?  You bet.

This is an article that promises to offer new and classic tried and true approaches for not only surviving the coming ‘Silver Tsunami’, but to ensure you come out on top of it with hefty profits to show for all your good work.

Are these solutions expensive and / or difficult to enact?  Nope.

There are lots of steps, but none are complicated and most cost nothing but time to plan and prepare and enact.  Think of it as a magic formula, that if performed correctly will produce the results you seek.


Please take the time to read through this entire article, take notes, and then repeatedly act on those notes, yes over and over and over again.  I guarantee you will be please with the results.

There are many parts to this particular Let’s Talk About Recruitment and Retention series (yes, it is a very long because there is much to say), so be sure you don’t miss any of them- check back often for the rest of them.

In case you do not know,

Long Term Care  = LTC

Home/Health Care Services Supports = HCSS

Let’s get started!

So, what is this looming crisis that this article series will address?  Care Aide and all types of nurse shortages and the associated recruitment and retention challenges AND solutions. We are going to discuss how to flip the crisis to your advantage, twist it around so it serves you and your organization, and how to use it to help you make more money.

The looming talent shortage is going to be a huge challenge for the HCSS industry. It will be interesting it watch how very soon the talent pool will become an employee’s market where they will have the ability to pick and choose where they want work and to change their commitments as opportunities beckon elsewhere. This will make recruiting and retaining two of the biggest ongoing challenges facing the majority of home care organizations world-wide.  The surviving agencies and facilities will get this element of their business right, or face certain doom.

In this Let’s Talk About series, we will cover the gamut of what needs to be acknowledged and addressed, and what you and your team can do about the recruitment and retention problems.  You will find a clear action plan, that WILL WORK if you enact and commit to the ongoing application of the plan.  Over the course of this series we will cover the problems and challenges and solutions facing agencies related to quality Care Aide staffing strategies and solutions. I will show you how to get your recruitment and retention prayers answered and made manifest.

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Home Care and Home Healthcare employee recruitment and retention has emerged as one of the primary challenges facing HCSS employers today. More so than ever before, employers need to develop and implement effective human resource strategies to find and keep the employees they need to compete in this burgeoning marketplace.

Did you know that recruitment and retention are really elements of talent management?  Calling it ‘talent management’ seems to take the drudgery out of the work and makes it seem more exciting, yes?  Talent management includes the area of human resources which includes the areas of recruitment and retention which is (or ought to be) an extremely important focus of your company’s assets and time.

Recruitment and retention are two essential human resources functions that require strategic thought and planning. Each is indispensable to your organization’s growth and survival.


The looming caregiver – nurse shortage problem / challenge

More than 60 percent of caregivers working for private duty home care companies quit or were fired from their jobs last year, according to the 2015 edition of the Private Duty Benchmarking Study.

The 2014 median turnover rate of 61.6 percent is the highest recorded since the Benchmark Study began in 2010.  Turnover rates among home care agencies in the bottom 25th percentile exceeded 100 percent, the study shows. Median turnover rates were much higher in the Great Lakes (88.7 percent) and Central (80 percent) regions of the U.S., compared with the Southern, Northeast, and Pacific regions (54.5, 52.2, and 50.9 percent, respectively).

Another recent study shows 85% of HR executives state the single greatest challenge they have in managing the workforce is their organization’s inability to recruit and retain good employees and managers.  The Benchmark Study shows that 62.8 percent of home care agency administrators identified “caregiver shortages” as one of the top three biggest “threats to the growth of [their] business in 2015.”

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Access to qualified workers (ranging from entry level positions to highly-qualified occupations, and from temporary workers to full-time employees) is critical to meet the challenges of a growing and flourishing industry. LTC HCSS entities must be poised to respond to changes and opportunities in the labor market and prepare strategically for them.

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Consider this typical reactive scenario: Bruce is the Head of a large LTC HCSS Agency experiencing high turnover. His Human Resources staff spends more and more time recruiting, hiring, and training replacements. As soon as they get them trained, they are gone in six months. Customers are upset and complaints are increasing.

Bruce decides to explore the main reasons people were quitting.

He identifies new strategies and tactics such as creating an emerging leaders program, providing training for managers, and improving their employee recognition program. As a result, they are now attracting better talent and more importantly, have retained their best people. The Human Resource Department is happier because they are not spending all their time conducting interviews and training.  Bruce feels good about having solved a nasty problem for many people.

The cost of this learning experience = $1,335,000.02 and many former clients who are still bad mouthing his agency.

What could Bruce have done to avoid this undesirable outcome?  He could have been proactive about putting recruitment and retention strategies in place, thus saving his agency street cred and lots of money.

Few businesses realize how much employee turnover impacts their bottom line. Typically it takes $7,000 – $14,000 to replace a lower level employee. In the healthcare arena, it costs up to $185,000 to replace a critical care nurse.

The costs associated with employee turnover can include lost customers and business as well as damaged morale. In addition, there are costs incurred in screening, verifying credentials and references, interviewing, hiring and training a new employee. The direct and indirect costs associated with employee turnover can range between 70 and 200 per cent of salary.

Employers will increasingly face major challenges and difficulty finding employable, skilled people while simultaneously contending with a younger workforce that shares different attitudes about work demands and time spent at work, and a growing population of older workers heading toward scaling back from strenuous work or retirement.

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You better have a good proactive plan in place…and follow it over and over again.


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Specific assumptions have guided the development of the strategies presented in this series. Assumptions are critical factors not controlled by the strategies, but which influence their implementation and chances for success.

A key assumption is that increased competitiveness and cyclical economic fluctuations may impact the personal care / nurse labor market and that LTC  providers need to be proactive in order to achieve or maintain economic growth.

Assuming there will continue to be long-term shortages of skilled workers and that development of LTC  projects will require employers to focus on recruitment and retention activities, the strategies presented herein offer an approach that is proactive toward the end of ensuring a highly-skilled and educated care aide / nurse labor force now and into the future for your senior care organization.


Recruitment Problems Strategies and Solutions

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Recruitment is defined as the act or process of supplying organizations with new members or employees.  The process of attracting, screening and selecting qualified people for a position within an organization is the overall act of recruiting. Good recruitment is about finding the right person for the job.  However, anyone with Human Recourse recruiting experience knows this task is much more difficult than its definition might suggest.

Good recruitment is important because it has implications for business performance, image with customers and industry, staffing levels and profitability.

Selecting and retaining great staff is key for business success. Talented people who continue to develop skills and increase their value to your organization and to your customers are your most important resource.

Problem: A good employee is hard to find, especially in the personal care level of the home care industry.

Why is this a problem?

It is a problem finding good employees because it has been easy to get a job providing personal care to frail elders and other challenged adults, whether or not they are prepared for the numerous demands of the job or not.  It is a problem because Personal Care work does not pay much, the work is often difficult – literally heavy lifting- and the hours can be long and stressful.

It is entirely unglamorous work

As it is today, personal care services and supports in the home care industry, from the standpoint of the care aide, borders on charitable heavy lifting, and charity does not pay the bills. As a result, those who can find other work do, and those who cannot either hunker down and do their best, or take it out on clients or their organization by being unreliable, decidedly inefficient or otherwise acting out in ways which are as counter-productive.

So, what can we do about this sad soup?  Let’s try to change the image of what a Personal Care Aide is and the express more honor and gratitude for the necessary work they provide.  Let’s  raise their and our expectations of the likely outcomes of this career choice.   Much comes down to attitudes and beliefs as they are vs. what they could be.

If a person who is a Personal Care Aide learns that they can move up from that position with education opportunities, some will choose to do so.  This grows your staff from within-saving you time and money on recruiting.

Provide the chance for your staff to get credentials that will help them feel better about their work and improve and enhance how they are perceived by others.

Offer your personal care staff opportunities for career growth by opening the door for them to inexpensive and accessible career pathways (like Senior Care Auditing) and encourage them to avail themselves of professional care aide group membership information and activities.

You say,…

“Hey, that sounds like a lot of time, work and money you are suggesting I spend on my care staff.”

I say,…

“ No way, that is not at all what I am suggesting.  I am suggesting that you take advantage of a one stop shop, simple and inexpensive way to have all that done for you!”

You say, …

“Really?  Good gracious!  Why have I not heard of this simple, sane, one stop shop solution before?”

I say,…

“I dunno.”

You say… (now slightly impatient with me),

“For Pete’s sake, tell me, tell me, tell me what it is!”

I say,…(my tender feelings slightly twinged)

“ Well, alrighty then, geez!  First you must read this article, then I will tell you more about why CertifiedCare is the answer to almost all of your personal care aide recruitment and retention prayers. Then,  you have to do is follow all the advice in this (labor of love) article and last you must avail yourself of the sweeping services offered by the willing and able hard workers at CertifiedCare.org.

At this point you are probably thinking,..

I thought this was going to be another boring article about recruiting and retention strategies. I was only going to read it so I can feel that my time has been responsibly spent. Now I am finding that my recruiting and retention prayers have been answered!

Well,… not just yet. Your recruiting and retention prayers at this point are still a work in progress, but the full manifestation of them is harkening near.

Keep reading

Let’s Talk About (beware of imitators) is a CertifiedCare.org sponsored series of full length articles about cutting edge topics and trends impacting the Long Term Care industry service providers and the people that industry is meant to serve.  The articles are authored by Rev. Dr. Cathleen V. Carr JD MA MscD,  a down to earth ordained minister, a dozen times over experienced caregiver, Executive Director of CertifiedCare.org, and author of the CertifiedCare multiple award winning Personal Care education and certification programs, and “Grand Poobah” of the CertifiedCare Professional Care Aide membership organization.

©Copyright 2016 All Rights Reserved

Make sure your #caregiver is educated, tested, certified and registered by #CertifiedCare prior to hire or as a condition of continued #employment.

To continue on to Part 2, where you can read more about Recruitment and Retention Strategies and Solutions, and where we begin to talk about how to select and retain these valuable people for the greater good of all, click here

Did you know experienced caregivers make GREAT Senior Care Auditors. Get CSCA accredited certification from CertifiedCare.org 


About Elder Care Advice blog

Get professional elder care giving advice, advocacy, education and tips for those who care for and about the frail elderly at the ElderCareAdvice blog. We are generously sponsored by CertifiedCare.org. Most posts are written by Cathleen V. Carr, unless attributed otherwise. We welcome relevant submissions. Submit your article and by-line for publishing consideration (no promises!) to Havi at zvardit@yahoo.com, our own editor who will ensure submissions are given the best possible treatment and polish before publication, ensuring a professional level of publication. There is a nominal service fee involved ($45). Allow up to 30 days for publishing.
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