Home Health & Hospice Week

Labor woes limit growth potential.

Staffing shortages are hitting everyone hard, from the biggest to the smallest operators. You may get some ideas on how to tackle the issue from publicly traded home health and hospice chains’ comments on the topic in their latest earnings calls.

Demand for in-home care has climbed during the pandemic (see related story, p. 76). But staffing shortages are hampering providers’ ability to meet that demand. “The game is going to be do we … attract and retain and make us productive, the people that can do these types of things in the home,” asked Amedisys Inc. CEO Paul Kusserow in the Baton Rouge, Louisiana-based chain’s Feb. 24 call.

“The labor pressure that the industry is facing, that’s not going to go away any time soon,” Amedisys COO Christopher Gerard added in the call. (See HCW by AAPC, Vol. XXXI, No. 9 for more details about publicly traded companies’ staffing challenges.)

Home health and hospice companies must be “laser-focused on both the recruiting and retention aspect,” observed VITAS Healthcare Corp. CEO Nick Westfall in parent Chemed Corp.’s Feb. 25 earnings call.

Take a look at what the big guys are doing to fill their ranks during the labor shortage:

1. Boost recruiting staff investment. “We’ve now had five consecutive quarters of the highest numbers of hires we’ve experienced in our company’s history,” LHC Group Inc. COO Josh Proffitt pointed out in the Lafayette, Louisiana-based chain’s Feb. 24 earnings call. LHC Group has increased its recruiting staff by a whopping 80 percent, he said. “We have a centralized talent acquisition model, but they are deployed ... out into the local markets that we serve, because recruiting is very localized,” Proffitt explained.

LHC Group isn’t alone on the hiring boom. “We hired at a much faster rate than ever in the history of VITAS” last year, Chemed Corp. CEO Kevin McNamara said in the earnings call.

Encompass Health Corp. “added a Chief Human Resources Officer and a Vice President of Talent Acquisition to [the] leadership team” to its home health and hospice division, Encompass Health Corp. CEO Mark Tarr reported in the Birmingham, Alabama-based company’s Feb. 2 earnings call. “These roles did not previously exist at [the] home health and hospice segment, and these hires round out and solidify the senior management team for this business,” Tarr said.

“We are throwing everything we can come up with at this challenge,” Tarr emphasized.

2. Show staff the money. Nearly every publicly traded home health and hospice company mentioned boosting staff wages and offering both recruitment and retention bonuses. “The decline in supply of health care workers continues to increase pressure on salaries and wages,” McNamara noted.

VITAS gave workers two wage increases in 2021, McNamara pointed out.

Amedisys plans to spend about $16 million in incentive compensation in 2022, CFO Scott Ginn confirmed in its call.

Don’t expect the wage pressure to let up any time soon. “We view it as inevitable that health care wages will continue to be elevated for as long as there is a nationwide and systemic imbalance in supply and demand for licensed health care professionals,” McNamara said.

3. Benefits count too. It’s not just money that talks. Potential employees are also looking for better work-life balance and other benefits.

VITAS is offering increased paid time off in addition to wage increases, McNamara said. “The increased PTO was substantial,” he told an analyst. “It was two weeks extra the first year, which is 4 percent.” That cost VITAS about $10 million in 2021, confirmed Chemed CFO Dave Williams.

“We made some nice progress on our net full time nursing hires and a lot of that’s been around the focus of our talent acquisition team,” recounted Encompass Health Home Health and Hospice CEO Barbara Jacobsmeyer in its call. “Not so much focused on that rate of pay, but the flexibility that home health and hospice allows for that clinician in their daily schedules and focusing on those other benefits of being employed in home health and hospice,” Jacobsmeyer noted.

4. Utilize your employees as your recruiters. “We did roll out last year, in January, our employee referral program,” LHC’s Proffitt highlighted. “We closed out the year right around 2,000 hires from that program alone.”

5. Slim down your hiring timeline. Potential staff are getting snapped up quickly, so you have to move fast. “We’ve got very specific metrics for our hiring managers on time from application to get the candidate [up to] speed to provide feedback and schedule the interview, and all of those types of process measures,” Proffitt revealed.

6. Put diversity front and center. Proffitt praised LHC’s diversity, equity and inclusion (DEI) program. “We have a chief diversity officer that leads that effort for us,” Proffit related. “She is very engaged and integrated into all of our recruiting efforts.” DEI is also crucial for retention, he added.

7. Keep tabs on how your employees feel. LHC Group touches base with its employees with both internal and external tools. Managers “completed over 40,000 engagement sessions with our employees, and had an overall engagement score of four and a half out of five, which is extremely solid,” Proffitt reported. And externally, LHC uses “a third-party engagement partner” to administer “consistent pulse surveys for employee satisfaction and engagement,” he said.

8. Simplify administrative procedures. “Anything you can do to streamline and improve your workflow processes, your scheduling practices to find ways to automate and make things more efficient for your frontline workforce in today’s environment of employees really comparing a lot where they want to work, I think, is another big leg up for us that we’ve put a lot of effort into,” Proffitt said in the call.