How Specific Hiring Strategies Lead to Better Retention in Home Care

To consistently recruit home caregivers, service providers and human resources departments need to better understand what workers want and what they struggle with.

This was one of many findings from a study conducted by the MissionCare Collective and the National Association for Home Care and Hospice Care (NAHC), which focused on the current challenges and opportunities for caregivers.

More than 65,000 personal care workers from over 90 data sources participated in the study.

“It’s important that providers ask themselves questions such as: ‘Who are you bringing into your organization? What do your posts look like? What are you doing today to keep these people?” said Maggie Keane, vice president of corporate development at MissionCare Collective, during a Polsinelli webinar on Wednesday. “Home care providers have the option of not recruiting, hiring, or retaining everyone as if everyone is the same.”

One of the high-level findings that Keane pointed out when analyzing the results of the study is that caregivers are seven times more likely to live in the lowest income category compared to the average US population.

“The reality is that 63% of CNAs and nearly as many home health assistants have a net worth of less than $25,000,” Keene said. “We already know that retention is a struggle in this industry, with 57% of caregivers leaving within the first 90 days and 85% of all home care providers dropping treatment due to staffing shortages.”

Keane added that 61% of caregivers and 59% of home health care assistants reported $0 of discretionary income.

The study also found that more than half of homecare workers and a third of CNAs rely on some form of government assistance, while 90% of caregivers do not have a credit card.

“This report provides some information that we hope can inform early conversations with caregivers,” Keane said. “Hopefully it can be used as a tool to understand some of the challenges our frontline workers may face. This could be both locally and across the industry as we consider expanding our workforce.”

MissionCare believes providers should be able to advertise and sell jobs for different types of caregivers. For example, he uses labels to describe different types of caregivers, whether they are professional workers or those looking for part-time jobs.

“When we think about our own workforce and think about the possibilities of expanding our workforce, challenge yourself and think, ‘Does your current workforce represent all of these groups, or just some of them?’,” Keane said. “Do you have different job postings for each group? Do you have different sales strategies to reach each person? The goal here is to keep them engaged, especially in the first 90 days, so they don’t join the 57% who are leaving.”

In addition to understanding how best to hire and retain caregivers, it is also important for providers to be aware of immigration policies, which will no doubt affect the home care space.

Replacing retirees with US workers seems like a losing battle, said Carlos Ortiz, a shareholder in law firm Polsinelli.

From now until 2031, it is estimated that 332,000 home health and personal care assistants will be laid off each year.

“The difficulty of replacing the retirement workforce with an ever-dwindling population of local workers will create a significant shortage in low- and medium-skill occupations, including the home healthcare sector,” Ortiz said. “Home health is considered a low-skill job, but the position requires a wide range of physical, mental and emotional skills, including the ability to transport people safely and fight diseases like Alzheimer’s or dementia.”

About 2.1 million immigrants work in home healthcare today, Ortiz said.

“Despite the fact that this sector is already heavily dependent on a foreign-born workforce, the US immigration system lacks temporary, nonimmigrant, and immigrant visa categories for low-skilled homecare workers,” Ortiz said.

One key element of the labor law that Ortiz said should be kept an eye on is the expiring rule that allows remote filing of employment and I-9 ID documents. This law was changed during the pandemic for reasons of flexibility, but it will expire at the end of this year.

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