This article is part of the HHCN+ membership
The talent shortage is perhaps the most unifying factor within the home-based industry. It usually doesn't matter whether your provider addresses these concerns or not. It's how they deal with them.
Conversations around staffing often come down to the fact that providers need to improve retention rates, as the hiring pipeline shows little sign of improvement. While I agree that retention must be a top priority, I don't think these efforts are enough to significantly change the staffing status quo. And it's not just a matter of “strengthening recruitment.” Providers are seeing success by overhauling their hiring practices, including leveraging AI and building employee referral systems, but the spending doesn't stop there.
The hurdles to securing staff have worsened in recent months. Strict immigration policies are already eliminating jobs for caregivers and taking workers away from older people who need home care.
Nursing work is not an easy job. Employees struggle with the hassle of traveling to and working from customers' homes. This work is very mentally rewarding, but the pay is often low. Due to low wages, the median annual income for direct care workers is less than $26,000, and 36% of direct care workers live in or near poverty, according to PHI. Almost 50% rely on public assistance programs. In short, Medicaid budget cuts threaten home care providers and access to care. In response to the government shutdown, the Trump administration stopped issuing Supplemental Nutrition Assistance Program (SNAP) benefits starting November 1, despite reserves. The discontinuation of SNAP benefits puts hundreds of thousands of direct care workers and the people they care for at “unacceptable risk,” according to PHI.
What I can say is that it is a difficult profession to attract people. To improve recruitment strategies, providers need to think outside the box of typical industry practices. In my view, the next step in your recruitment strategy is not just to attract people who are already ready to become caregivers. That must include attracting people to the career in the first place and facilitating training protocols.
In this week's members-only HHCN+ update, I'll be sharing my perspective on the hiring practices that are transforming the industry, providing analysis and key takeaways, including:
– Why are traditional nursing care recruitment methods insufficient?
– Why training programs and educational partnerships are the wave of the future
– The benefits world awaits a revitalized hiring pipeline
What providers are already doing
Because staffing issues are not a new concern for home care, savvy healthcare providers have continually innovated their recruiting and staffing techniques. The problem is that the math doesn't work to ensure there are enough caregivers to care for an aging population. And caregivers who are already employed in caregiving roles don't stop there. PHI estimates that worker turnover will result in a total of 6.1 million job openings in the home care industry in 10 years.
Some home care providers are beginning to experiment with training programs in partnership with educational institutions. For example, one home health franchise launched a program earlier this year in partnership with Ocean County Vocational and Technical School in Toms River, New Jersey.
“Home Helpers need highly skilled CHHAs, and OCTVS has the resources to train these people and get them involved in the community,” Home Helpers Director of Nursing Melissa Magabilin previously told HHCN. “By joining forces, both organizations will help close the gap between the shortage of qualified care workers and at-risk populations in our communities by training the right people to meet those needs.”
Through this program, adult students complete 60 hours of classroom instruction and 16 hours of hands-on clinical training, preparing them to work as certified home health aides.
As another example, Delaware-based Silver Lining Home Healthcare opened a Home Health Assistance Academy in September.
In my view, programs like this represent the future of home care worker recruitment strategies. They don't just involve workers; they create new things.
long term benefits
Changing the way an industry hires isn't just about changing the status quo. It helps future-proof the industry. This increases the pool of qualified caregivers not only for providers developing programs, but for the industry as a whole.
Of course, if caregivers don't stick with providers who have invested time and resources in developing such programs, the question arises whether the investment is worth it. But these programs appear to give home care providers a prime choice for new workers. The Home Helper Program allows students to work in a home care agency. Alternatively, you may be directly employed by a home helper.
These programs also benefit the associated education systems.
“Partnering with industry provides the latest lessons in meeting consumer needs,” Jeremy D'Souza, principal of adult education at Ocean County Vocational and Technical Schools, previously told HHCN. “We also create a short path from the classroom to career by establishing relationships with recruiters and their representatives. Educational institutions that partner with businesses to provide sustained community service have proven to be successful models, and we aim to play our part.”
We also imagine that becoming a caregiver through a program like this can be a unique benefit for caregivers, as they can receive assistance with tasks such as completing the application process and connecting with employed care providers. I've heard in the past that getting caregivers to work as soon as possible after orientation is helpful for hiring. If we can help you move quickly from the education process to the recruitment process, I think you'll get similar benefits.
Expanding the home care recruitment process and further expanding educational partnerships can also reduce hospitalizations and overall care costs.
“Expanding the workforce can increase access to care and reduce the need for costly services such as institutional care (hospitalization and nursing home care),” the U.S. General Accounting Office fact sheet states.
Home Helpers Magabilin told HHCN that she would love to see a program like this implemented at the state or national level. There is a real and urgent need to establish a national training program for home care workers. Such efforts seem unlikely in the current policy climate. Federal support for the industry continues to decline, Medicaid budgets are being cut, and home health reimbursement rates face an unprecedented threat. These challenges highlight the broader need for policymakers to better understand the critical role of home care.
Until then, I believe home care providers can and should step up efforts to build partnerships with educational institutions, strengthen the caregiver pipeline, and ensure the long-term sustainability of their organizations and the industry as a whole.
