Don Spiers

In the never-to-be forgotten year 2020, healthcare leaders saw a shift to more care being provided in the home. Largely motivated by the coronavirus pandemic — as we know all too well — this trend has been a double-edged sword for home health organizations.

The shifts from hospitals and skilled nursing facilities have brought an influx of patients to home health. But the boon came not just from people leaving the hospital and going home; many have been skipping the hospital step altogether. We have seen more physician referrals to home health rather than hospital or congregate care.

Granted, it’s a huge advantage for home health to have more patients and wider access to a variety of referral streams. But we saw some difficulties related to that shift too.

Difficulties keeping up with staffing demands

Agencies didn’t always have the staff they needed to serve the patients referred to them. With the pandemic, some clinicians were scared to provide services, knowing they could be caring for patients with undiagnosed COVID-19 or with positive test results.

With all these tensions swirling around, home health leaders are wondering:

  • How do we build a new workforce?
  • Where do we find new staff?
  • How do we get them trained up?

The industry has all this growth and expansion. But home health agencies can’t grow as fast as demand might allow because they don’t have the bodies — the staff members.

Ongoing challenge just got more complex

Figuring out how to tackle recruitment and retention issues has been an ongoing dilemma for home health leaders. But the pandemic added a new twist.

We still have a lot of older care staff. The demands of the job require a higher-level skill set. You have to think critically. At the same time, home health leaders are trying to attract younger staff.

Unfortunately, education options for candidates interested in entering home health have been limited by the pandemic’s infection prevention protocols. That obviously put a damper on traditional in-person certification programs.

Additionally, ongoing development and education are vital to helping younger staff think critically. Agencies need to consider online options that will support staff members who don’t have that 30 years of  knowledge built up.

On the flip side, the pandemic may potentially open up new candidate pools. So while other industries are suffering, many home health agencies are seeing a census increase.

As the baby-boomer generation is aging, the silver tsunami is raising the tide of people needing post-acute care. On top of that, more people are choosing care at home to limit exposure to the coronavirus. With those dual trends, staff supply and patient demand will definitely be an issue for the next few years, at least.

Double whammy: Initial training and more advanced knowledge

In this context, education is even more important. As home health agencies take in patients with more acute needs, their staff has to be trained to handle those different needs.

This hit the industry with a double whammy: The need to get more entry-level staff and to advance the skills of existing staff. Finding staff with advanced skill sets who can go to work immediately is increasingly difficult.   

Agency leaders will need to get creative to address those issues. We need to seek new ideas and look back at what innovations have worked in the past year.

The debate: Development as investment

Many employees want growth options, yet staff development doesn’t always get leadership’s support. Some view that the investment might be wasted if employees are just going to turn over. Yet others feel that such an investment might be what keeps talented staff around.

My take from experience in home care is that owner-operators can make a difference in retention. Some leaders don’t view their staff as capable of making intelligent choices. When staff members are not being respected, they know it and will leave.

Other leaders seek to understand the challenges individuals on their team are facing. If you listen closely to each person, you may find solutions to problems you didn’t even know you had.

Regardless, knowing that your supervisor cares to listen can make all the difference in keeping people on the job and your agency operating. That can pay off when the market shifts.

One of the greatest opportunities for home health is to serve the really acute patients exiting the hospital. That requires experienced staff with the knowledge and technology to support them.

Supporting your staff with ongoing professional learning will build exceptional teams. You need healthcare warriors who will thrive in the trenches and provide high-quality care, no matter the market shifts occurring.

With that foundation in place, your leaders can build relationships and gain referrals. In this market, staff development can be your Achilles heel or your sword and shield to win against the competition.  

Don Spiers is a senior product manager at Relias, providing market insight on home health, hospice and home care.