Judging Senior Care Agencies Through Employees


When we started our in-home care agency, Support For Home, we knew that we, the two owners, were never going to BE Support For Home.  The heart and soul of the company would always be our Home Care Aides.

As a result of that, we made several commitments — to ourselves and to our employees:

  1. Our Home Care Aides would always be as important as our clients.  We would not tolerate abuse of our employees any more than we would put up with abuse of our clients.  This has actually led us to “fire” several clients because of their treatment of our Home Care Aides.
  2. Our employees would be paid as much as the company could afford, even though that means a significantly smaller margin than other agencies have.  At this point, our Home Care Aides are paid 20% to 30% more than caregivers at other agencies in our region.  We know this, because our employees tell us so and we see employment ads.  For 24-hour assignments, we actually pay 35% to 50% more than other agencies, because those agencies are not complying with California’s Wage Order 15 — and we do not know how they are getting away with it, frankly.  We continue to make the choice to treat our employees the way we believe they should be.
  3. We are still growing rapidly, so we continue to add new Home Care Aides.  That brings down our “average” length of employment.  However, we measure ourselves by our ability to retain great employees.  When we lose an employee, it is almost always because they moved to a different state or have finished their LVN program or Social Work degree.  We love that, even though we miss them.

So, when I read an article in The New York Times, called “One Way to Judge a Nursing Home,” it absolutely resonated with me.  The essence of the story is that the author was evaluating nursing homes for his mother.  With each visit, he asked the tour guides if he could talk with the nurses’ aides.  In almost every case, the answer was, “No.”  His comment was,

I soon realized why. In casual conversations in hallways and dining rooms at more than a dozen facilities, I found only one nurses’ aide who had been on the job more than six months. I was witnessing in real life one of the most dismal statistics in long-term care: More than 70 percent of nurses’ aides, or certified nursing assistants, change jobs in a given year.

When he finally found a facility that said it was fine to sit down with the nurses’ aides that worked there, he was amazed to find that of three aides, the shortest tenure was four years.  That pretty much made up his mind, right there.

We absolutely endorse this approach.  Are employees happy working for their home care agency (or assisted living or skilled nursing facility or other senior care company)?  Do they feel like it is a “we” situation?  — Quick anecdote on that … A Home Care Aide came in for a briefing on a new client this morning.  We recently moved from one office suite to a larger one.  The Home Care Aide’s comment was, “I really like our new office!”  She has probably been in our office four times in the last year, as she works in our clients’ homes, but she clearly felt that the office is hers, not just the administrative team’s.  I love it.

Another significant point about our employee base is the extremely high percentage of Home Care Aides who have worked in nursing homes, who say, “Never again!”  They are asked to take care of so many residents that they cannot take care of any.  They come to us, even though home care is less predictable, in terms of schedule, because they long to be able to express their passion to provide care in a 1:1 setting, in their client’s home.  That makes us and our clients feel very lucky.

Best wishes, Bert

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