Ten years ago, the Companion Exemption was in place. Agencies could pay a live-in per day wage with no overtime pay. Craigslist was a recruiting tool that would yield more applicants than an agency could hire, and caregiver wages were slightly higher than other service industries. Home care agencies didn’t compete with restaurants or, for the most part, retail. Today, none of those things exist. Home care agencies now have to pay overtime for live-ins, administratively manage a live-in or 24/7 case, compete with restaurant and retail establishments for caregivers and watch them walk out the door the next day. What should an agency do to survive in this post-pandemic world? Simply put (but not easily implemented), know where you’re going and what changes you need to make to get there. Below are three ways to help you navigate. 

The Future Home Care 

According to AARP1, more than 80 percent of adults have expressed a preference to remain in their homes and communities as they age and favor a home setting over a nursing home or other institutional settings. Baby Boomers (born between 1946 and 1964) have been vocal about aging in place. This year the youngest will be 58, and the oldest will be 76. This generation is known to be more active, well-educated, and independent. With this thought in mind, the Baby Boomer generation isn’t as accepting of senior living communities as the previous generation. A recent survey indicated that senior living communities are experiencing their lowest occupancy rates in 50 years. The COVID-19 pandemic left senior living operators reporting significant declines in occupancy sustained through 2020 and into 2021. We know the aging process brings increasing physical and mental changes, often interfering with a person’s lifestyle. In four short years, the oldest Baby Boomer will turn 80, and their needs will increase. As a result of most Baby Boomers resisting any congregant setting and their need for physical and mental support increasing, home care is an obvious first choice. In addition, the United States home care market is expected to top $225 billion in two short years. This is in part due to the aging population. The U.S. Census Bureau projects that older adults will outnumber children under age 18 for the first time in U.S. history by 2034, and 73 million will be Baby Boomers. What does this mean for home care? Buckle up! The demand for home care will continue to increase. What should you do? Plan ahead for growth. Know the number of caregivers you will need to handle the growth and develop a plan on how you will win the business, and have the caregivers to staff it. 

Finding Gold – Caregivers 

The demand for home care is positive and negative. On a positive note, you’re in a business that is projected to continue to grow beyond the years most of us will be in it. On the other side, the caregiver crisis continues, and there doesn’t appear to be an end in sight. The increased demand and lack of caregivers have made the best of them throw up their hands and scream, “I’m Done!”. According to Home Care Pulse Benchmark Study, the caregiver turnover rate increased to 76% in 2021, which is a five-year high. What can an agency do with fewer people applying for a caregiver position and the turnover rate inching toward 80%? Here are three tips that will help: 

  1. Realize that caregiver recruitment now requires full-time attention. To stay ahead of the competition, you cannot turn away business, but you can’t take the business without a caregiver. Full-time recruitment will provide the opportunity to keep the caregiver pool filled. It may mean hiring an additional staff member to focus on recruiting, phone screening, and interviewing. This person can also be a trainer, conducting training classes one day a week. Your agency will likely scramble to keep shifts covered without a full-time recruiter. 
  2. Immigrants account for about 25% of the direct care workforce. Recruiting in churches, mosques, synagogues, human service agencies, ethnic grocery stores, and ESL programs could yield a pool of potential caregivers 
  3. Host a one-day seminar on caregiving. The target would be those interested in caregiving but who don’t feel they know enough about it to apply for a position. The seminar could include an introduction to home care, what caregiving is and isn’t, what caregiving can expect, and training on how to do the job. At the end of the seminar, the hosting agency can invite participants to an interview. This can be advertised on Facebook and ask your current caregivers to share it on their social media. 

Keeping a Caregiver in a Resignation Tsunami  

Today, it appears to be a caregivers’ world, and many of them know it. Caregivers understand they are necessary to run an agency and know everyone is hiring. This creates a dilemma for agencies to retain caregivers. Being creative and doing more for their caregivers sets growing agencies apart. What are some things an agency can do to retain their good caregivers? Here are a few ideas to get your creative juices flowing: 

  1. Flexible & Weekly Pay Options. Weekly and daily pay options have become popular with the entire service industry. Paying weekly can be a burden from a payroll standpoint, but it may be the one thing that will keep a caregiver. Some caregivers don’t live paycheck to paycheck but instead day to day with financial needs. Companies like Daily Pay will allow your caregivers to access earned money at no cost to your agency. This ability could be a differentiating factor to keep the caregiver working for your agency. 
  2. Flexible Schedules. A caregiver can be a single mother/father, a person with family obligations, retired, or a college student. Most caregivers have a great deal of responsibility outside of work. Being an agency that provides flexibility in schedules will win every time. Flexibility doesn’t mean changing the schedule constantly to accommodate their mood or unreasonable demands. Still, it does mean understanding the need to be flexible to allow the caregiver to succeed both at home and work. 
  3. Treat Caregivers as Vital Members of the Team. Caregivers are often treated as dispensable employees. Indeed, some caregivers don’t necessarily win the award for employee of the year, but could it be they are responding to how they feel they are treated? Almost 25% of employees surveyed said they believe they are not valued, and 36% of those surveyed reported that their employer’s actions since the pandemic have made them feel even more disposable. Take an evaluation of how your caregivers are treated. Do little things to let them know you appreciate their work and contributions to the agency. Provide ongoing training, so they feel more confident and know you are investing in them. Listen to your caregivers and let them know they are heard. Sometimes that is all it takes to build loyalty and increase engagement. 

The good news is that home care agencies have a growth future. It will take a mindset change on how things used to be and how they are now. The pandemic changed the course of our society, and nothing is really the same. Home care will demand the same tweak as we have had to make in other things in life. The business will be there, but it is up to your agency to make a few changes to meet the requirements to find and keep the caregivers you will need to grow continually. So, hang in there. It is a tough business but remember there are so many that need your service. 

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About Cheryl Hammons CFE, CSA

Cheryl Hammons is an experienced home care professional, published author, and frequent speaker. She has held several roles throughout her 12 years in the home care industry, including training, support, and operations. She currently serves as Strategic Partnership Director at Veterans Care Coordination where she focuses on building value-driven relationships, developing revenue-generating programs, and creating educational materials for home care partner companies. Cheryl is the author of "Embracing a New Normal: Dealing with Grief" and "Respecting Religious Differences in Home Care."