Kenyon Connects

Nothing is more unsettling to a home care organization than the loss, or impending loss, of an essential leader. Home care agencies that fail to plan for this event experience major disruptions in their business; initiatives lose momentum or are completely lost, uncertainty increases staff resignations, and business drops off causing a decline to the bottom line. To avoid this problem, a home health, or hospice organization must have both an emergency succession plan, as well as an established succession plan.

What is a Succession Plan? A sound home care succession plan is an ongoing process that contains the following:

1. Identification of critical positions needed for your home care agency.

2. Determination of the requisite skills needed for those positions.

3. Identification and assessment of potential successors or sources capable of providing individuals with the requisite skills.

4. Management and leadership involvement at all levels throughout your home care agency in developing the plan.

5. Ongoing commitment to developing internal talent and monitoring their progress.

A successful home care agency leadership succession plan identifies the environment, prepares for contingencies, and minimizes disruptions. Therefore, effective succession planning must be an ongoing process of regularly identifying, assessing, and developing talent to ensure leadership continuity for all key positions in a home care agency. The process must be in keeping with your home care or hospice agency’s ongoing strategic goals and objectives. This may mean that the kind of leadership style, skills, and behaviors needing to be developed and promoted might be different in the future from those in the existing culture. Therefore, the plan must be visited yearly and updated to match what your home health or hospice agency needs going forward.

“It must be understood that “succession planning is not a “replacement” strategy. A properly prepared succession plan is a proactive, systematic effort designed to ensure the continued effective performance of an organization, division, department, or work group.”

Christopher Simoneau, The Business Review

With an up-to date succession plan, a situation creating one or more vacant leadership positions is less of an emergency for your home care agency. If, however, individuals within your home care agency are not capable of taking the helm and leading your organization, an alternative will need to be implemented as soon as possible to prevent damaging disruptions to your business. This replacement frequently is an interim home care manager with the requisite skills to fill the position.

With both an emergency and a succession plan in place, the selection of an appropriate interim home care manager is considerably easier. The requisite skill sets have been identified and updated, and the essential work elements are in place with all staff on board with their identified responsibilities during the interim home care manager’s time with your agency.

As with all things in our lives, planning makes a big difference. We never want to think of disasters occurring, but we all know that they do. People experience fires at their homes and business, hurricanes occur, earthquakes happen, and people become ill or die. How we plan to meet these times dictates the outcome. As interim home care managers, we too often see the failure to plan.

Kenyon HomeCare consulting can assist agencies with succession plans that help them through leadership transitions and lay the groundwork for when an interim manager is needed to fill the gap until a permanent leader can take the helm. It you need assistance with either developing succession plans or interim management, call Kenyon HomeCare Consulting at 206-721-5091 or e-mail gkenyon@kenyonhcc.com. We are here to help.

You have just experienced the loss of the top leader of your home care agency. There in no one in the organization with the skill set or leadership to temporarily take on the role. What to do? Some agencies turn to consulting firms that offer interim home care managers. However, not all interim home care managers are equal. To assure you are getting the right fit for your organization, there are several factors to consider in your selection of the interim manager.

First, what is the reputation of the consulting firm or interim home care consultant? If you’re working with a consulting firm, you will want to know how they vet their interim managers. What are their requirements for the position? And, how does the home health consulting firm assure the associates have the requisite home health and hospice background, experience, and competency? A quality consulting agency should be able to address all of these concerns with an accurate description of the process and how they determine which interim associates best fit your needs. If you are thinking of using an individual who does interim home care management, you will want to do the vet them like you would a permanent replacement.

Secondly, how much actual experience does the potential candidate have in a leadership position for either home health or hospice? How current is that experience? If your agency is both home health and hospice, do they have experience in both? Do you have multiple offices? If so, has the potential interim home care manager managed multiple offices? What do their references look like and, will the home care consulting firm share that information with you? A good home care consulting firm will have already checked their references and be able to provide those to you if you wish. Most firms we are familiar with do a good job of vetting their consulting associates and this may not be a necessary step for you to take.

Thirdly, you will want to interview the candidate(s) for a fit with your needs and your agency staff. A home care consulting firm will usually have a couple of potential candidates for you to interview. Interview the interim candidates as you would the permanent replacement. Sometimes the interim home health or hospice manager will, in fact, turn out to be your replacement, so it is important that you approach the interviews in the same manner as you will for the permanent replacement. You may want the middle managers and selected field staff of your home care agency to also be involved in the interviews to assure this is someone they can respect and follow.

Finally, even the best interim home care manager will have difficulties initially if you do not have a clear plan for them to follow. Place any major initiatives on the list of objectives for them to achieve. If you are engaging a consulting firm, allow them to do a full organizational assessment that will provide identified issues and areas that the interim home care manager must address and resolve, as well as, the identified initiatives that the agency is working on. We all know that the objective of the home care agency is to find a replacement as quickly as possible. We also find that most home care agencies can take anywhere from 6 to 10 months to find that permanent replacement. In the end, no matter how desperate you are to fill the position, be sure to select the interim home care manager carefully.

View the time you have the interim manager as an opportunity to clean up the agency and set a course for the future with an expert at the helm. Rather than viewing the interim as “just a fill in”, an expert from the outside can take a new look at your agency, upgrade your agency and systems, and prepare you for your next adventure.

Inbound marketing continues to grow in importance for home care, and while it hasn’t made the more traditional outbound marketing techniques irrelevant, it is the way that more and more customers are finding the home care products and services they need. In fact, of all the daily online searches, nearly half (46%) are searches for information on products or services. This means clients are now looking for you, and not the other way around. Is your home care agency easy to find?

In this new marketing landscape, home care agencies should be shifting considerable focus from pushing their services out to prospective clients to pulling customers into their sites with inbound marketing techniques. According to Google, 70% of the links that search users click are organic, or not paid. This means that shelling out money for pay-per-click ads probably won’t get your home care agency the return on investment you were hoping for. So it’s time to start focusing on relevant, search engine optimized content, social media, and blogging, all of which can help bring potential clients to your virtual doorstep.

Use Your Website & Your Knowledge & Get Found

A good way to show potential clients that your home care agency is a home care authority is to provide them with relevant, timely resources that help them solve a problem, make a decision, or simply inform them. Staying current with ever-changing industry information shows potential clients that you are an authority within your industry and understand clients’ needs.

Including industry-related resources to your site is also great for search engine optimization, or SEO. While a home care agency’s website should be a hub of relevant information and communication, it should also be easy to find when potential clients are searching for the services you provide in your area. Search engine optimization is a key aspect of online marketing as inbound marketing continues to replace outbound marketing efforts (advertising, PR, email campaigns, etc) as the number one way in which consumers find the products and services they need. Industry-specific keywords help companies get found and get customers.

In addition, incorporating a blog and staying current with social media can improve SEO and give a home care agency another forum in which to be found online. Blogging provides a virtual soapbox where agencies can voice their industry expertise and inform their customer-base with up-to-date information. Using keywords within your blog and posts on Facebook, Twitter, and LinkedIn will further your SEO efforts and help you be found on the great world wide web.

A Match Made in Marketing Heaven

With all the buzz and focus going to inbound marketing these days, it’s important not to neglect your tried and true outbound marketing. In fact, the two work together quite well. Ensure that your messaging across both inbound and outbound materials is uniform and targeted to the right audience, and include links to your website, blog, and social media sites on all print materials and email campaigns. Post news releases and print articles to your blog, and don’t forget to share them on Facebook! For a successful, well-balanced plan, use all your marketing strengths to create the total package.

Merrily Orsini is the founder and manager of CoreCubed, a full service integrated marketing communications agency with a focus on using the internet as a component of a strategic branded approach. Specialty is senior and elder care businesses, the private pay industry in home care, home health, Hospice, hospitals, geriatric care management, assisted living and retirement communities. Experienced and successful in marketing to and reaching those seeking niche products and services targeted to a mature affluent audience. She if the creator of MOSTSM, the first industry turnkey monthly marketing communications program designed specifically to increase billable hours and referrals for private duty home care, home health and Hospice.

Over the years, we have provided numerous interim home care managers for home care executive level positions. On a few occasions we have been told that the cost of using a senior home care executive is more than they can afford. This has always intrigued me, because when a cost of service comparison is conducted, we frequently find that by the time all the benefits and overhead burden are calculated, the interim home care executive costs about the same and in a couple of situations less than what their actual cost of a permanent replacement.

What we have found is that some home care organizations only look at the monthly salary of the previous executive and measure against that number alone. If the employee burden of an organization is 20% or more, the cost of using an interim home care manager is about the same, or depending on the salary of the previous executive, a little less. There always needs to be a comparison of apples to apples when calculating the cost of an interim home care manager for a senior level position.

Cost, however, is only one area that a home care organization needs to think about in using an interim home care manager. The benefits prove to be so beneficial that, in retrospect, a vacated executive position gives an organization the opportunity to really look at themselves, their weakness and strengths, and develop a meaningful and effective strategic plan to carry the agency forward.

When you fill an interim home care manager position, it requires that an organizational assessment be accomplished in order to make sure that the interim management services are meeting the needs of the home care agency. An initial organization assessment also ensures that the interim home care executive has focused on the issues and goals that need attention.

It’s not uncommon for an organizational assessment to uncover issues and problems that were not apparent to the higher level managers of the home care agency. Sometimes we find that the staff filling certain positions are either not competent for the position or their personality and style are disruptive to the team. This makes it difficult to build a cohesive and effective management or staff team. In other situations, we have found that the home care organization has a very dedicated and competent staff, but the systems of the organization have not kept pace with changes in the environment and the implementation of required processes or software.

In these cases, time-consuming “work arounds” have been developed by the staff to accomplish what they know needs to be done. These situations are costly to a home care agency and frequently remain unidentified because the work is getting done.

An objective outside consulting firm, with interim mangers conducting the organizational assessment, provides you the invaluable benefit of identifying these types of issues, along with recommended solutions . You will then have some direction on how these can be resolved to the benefit of the agency.

Finally, the benefit of using an interim home care manager is that your agency does not lose momentum on previous projects and initiatives. It allows your agency to continue to function effectively and maintain your progress toward organizational goals and objectives. It also gives stability to the organization in a time of stress and flux. Using a seasoned interim home care executive assists the staff to move forward with confidence and know that they will be okay.

The biggest mistake that an organization makes is to allow a key position such as the Director, Administrator, or CEO to go unfilled for 4 to 6 months. Referrals drop, collections fall off and this distresses the business. Without a leader at the helm, critical things fall by the wayside. There is no one at the top with the view of the “world” of the agency. An agency without a leader is an agency afloat on the sea with no one at the rudder.

If you are in a position with an executive level position open and need help during this time of change, call or e-mail Ginny Kenyon at 206-721-5091 or gkenyon@kenyonhcc.com. We are here to help.

Home Health agencies that have been in business for a few years can relate to the issue of growing pains. It is almost like you hit a ceiling and cannot grow beyond the increased competition, changes in payor rules and reimbursement amounts, increased regulations and shortages of skilled staff.

So what is happening?

As with all issues, there is never just one cause, but numerous ones that contribute to this problem. It could be that there is more competition, funding sources have changed, a shortage of caregiving staff, a business model that is no longer viable or a mismatch of needed skills with current staff. Any or all of these could be contributing to a decline or a flat line of business growth.

In business as in life, we need to constantly re-evaluate our position and make plans and appropriate adjustments. However, what we see in many home health agencies is that home care organization has never changed or modified their plans, their services or their internal staff. They have continued without any major modifications and are now at a standstill or are declining. What worked when the business was started years ago may no longer be a fit for the environment, the pay sources, the new knowledge in both clinical services and organizational function or skills needed for the new world that is emerging. This is particularly true at this time in our country where health care is undergoing major changes.

The agencies that survive will be those that can re-create themselves to match the changes that are coming. To do this, the agency must first assess their environment.

• What are the challenges and opportunities?
• Where does the agency fit in all of these changes?
• What must the agency do to prepare for the future?

To accomplish a comprehensive analysis, the agency must look inside, as well as outside, to really have a vision for the future. What we have found is that most agencies are fairly good at doing external analysis and making decisions on changes in regards to the service delivery and the financial issues associated with those changes. The area where we find agencies struggling is with the internal operations and staffing. Very frequently, we find that even though the environment has changed and field services have been modified to meet the changing needs, internal structures and most of all the internal home care staff has remained the same.

This is one of the hardest processes for a home care owner or administrator to go through. Many times we see that an employee is kept because of loyalty by them, even though they are not able to perform the needed functions of the new and emerging roles. As painful as this is, an employee analysis must be done if the organization is to survive and thrive in the future.

It all begins with an objective analysis. First, doing an internal function and skills needs assessment requires that the management focus strictly on the functions and skills needed to accomplish those functions. Secondly, evaluate the skill set of the staff in the internal operations to determine the fit or non-fit of the existing home care internal staff. In order to objectively accomplish this task, it requires that the manager eliminate names with positions and only focus on the function of the role. Finally, an objective list of skills that will be needed to achieve success in the role will need to be developed. Only after this is done can an objective review of current staff skillset be done.

If education and training can achieve the needed skills for the re-designed job, then the existing staff may be able to remain in their revised roles. However, it must be clear that failure to achieve results in the re-designed job will mean that the individual will no longer be employed with the organization. This is as important for the managers to understand as it is for the employee.

If you find that making these critical decisions on re-design of internal operations and subsequent job re-alignment and change is a problem, and feel you could use some help or coaching, call Ginny Kenyon at Kenyon HomeCare Consulting, 206-721-5091 or e-mail to gkenyon@kenyonhcc.com. We are here to help

Do you remember when you and a few others were the only ones in the home care business in your area? While there was competition, there was more than enough business to go around. In some areas of the country this remains true. In other areas, the marketplace has become saturated and agencies are losing market share and staff to the emerging competition. If you have a single line of business e.g. Medicare Certified Home Health, this could be a disastrous situation for the agency, particularly as the industry moves to bundled payments and decreased reimbursements. So what do you do to survive and thrive in this competitive home care environment?

The old adage “don’t put all your eggs in one basket” comes to mind. If your one and only line of business is Medicare Certified business, you are at the mercy of Medicare and the private insurance companies. In order to survive in the years to come, agencies, regardless of the current funding status, must develop additional lines of business. For the Medicare Certified agencies it may be time to develop a private pay, DME or an infusion line of business. All of these services are lines that match well with a Medicare business and have been traditional lines to expand to. Even these lines however are saturated in certain areas of the country.

We would suggest that every home care agency turn to it’s community and listen to what your community is asking for in terms of services. One of the best ways to do that is to keep a telephone log of all calls that come into the agency. (See attached log). Over the years we discovered that the log gave us incredible ideas for new lines of business that our home care customers wanted.

One such program was the home modification program. Occasionally the home care agency would get a call from someone wanting help with a ramp, or modifying doorways to accommodate wheelchairs or to lower counters so the newly impaired individual could be self sufficient in their homes. Initially I found my staff informing the caller that we provided medical home care only and did not provide home modification services. After a few months of reviewing and collating the calls from the log, we had sufficient number of requests for this service that we decided to develop a list of carpenters and contractors that were able to meet these needs. We could have started our own contracting service, but because of time constraints, decided to develop a referral list instead. One of my customers, however, developed the construction program and enjoys a nice side line of business from referrals given by the home care agency.

Additional options for a Medicare Home Health are the value added services such as negotiating a discounted rate with a drug wholesaler for all of you patients. The discounted rate would include home delivery. All patients would be given the opportunity to participate and continue after they leave the home health agency service.

Another option may be providing a medical alert system for all your patients or negotiate with some of the new smart phone service companies that are developing special services for elders that allow them to keep in touch with their family and to notify someone when they need help. With technology changing so rapidly, someone in the agency needs to be appointed to keep up with the latest changes so that the agency is able to offer these devices and services to their patients.

In order to survive the coming changes, diversification must be part of your home care agencies strategic plan. In addition to improving the critical outcomes and becoming masters at chronic care management, agencies must bring other value added features to the table in order to be able to compete for inclusion in the new bundled structures that are being created.

As with all changes, legal and structural considerations need to be made in order to make sure any added lines of business can function without constraints. It is recommended that any new line be established under its own business entity and not under the Medicare program. This will allow the new line of business to function without the constraints that Medicare rules impose on an agency. If you are offering a line of business that could be non-Medicare home care, check with your state to be sure about licensing such a program.

Surviving and thriving in this environment is possible if thinking can occur outside the “Medicare box”. It is time to gather the data, re-envision the agency, redesign the strategic plan and implement for the future.

If you feel you need assistance or guidance with such a project, call Kenyon HomeCare Consulting for consultation services. We are here to help.

The final area to discuss in making your home care successful is retaining the best staff and giving the best possible services. In order to do that you must have oversight and training that meets the educational needs of your staff and the health care needs of your clients. We have already discussed hiring in a previous article. If you have hired right, you have home care staff who will produce or can be trained to produce the kinds of outcomes that benefit the patients/clients and the agency. Critical to success for home care clinical services are systems of evidence based best practices. It is therefore imperative that you have a strong continuing education program and establish and maintain an agency culture of continued learning. Staff achieving continued learning as evidenced by attendance at continuing education offerings should be rewarded. Those who fail to maintain their competence and continued learning should have that reflected in their evaluations and subsequent pay increases withheld until they are achieving at the desired level. Without strong home care leadership support for this culture, staff will consider it the latest “flavor of the day” and slide back into old habits. The price to the home care agency is the eventual failure to achieve quality home care outcomes for your home care clients/patients with a subsequent loss over time of home care clients and thus revenue to your bottom line.

So how does quality home care look like? First it matches the needs of the clients/patients in your home care caseload and is evidence based care. If, for instance, you have a home care caseload with 80% of clients having some cognitive disability or impairment, then a strong in-service program on Alzheimer’s and Dementia would be expected. Since this is a predominate diagnosis among your caseload, all staff including the office staff should be trained in the diagnosis and there should be mandatory, yearly updates for all staff. Newsletters with the latest changes in practices based on new evidence should be regularly developed and distributed to all staff in addition to the required in-service training. In short, you want to develop a culture of continued learning among all individuals in the organization.

Secondly, there must be measurements in place that help you keep your organization on track. Quarterly chart reviews is one process implemented by some home care agencies to track and evaluate the home care services being provided. Supervisory visit notes with identified areas that were not at the agency standard and the corrections made by the Supervisor are part of the measurement system. Additionally complaint logs and incident reports are also traced weekly by the home care management team. On a monthly basis, the incidents and complaints are collated for similarities and trended for causes. Identified areas of concern that indicate failures in either the quality of the home care services being provided to clients/patients, or failures in customer services needs to be addressed with a plan of action for correction. These plans need to be in writing with evidence of follow up and resolution of the issues raised. Potential buyers will look for this kind of system to assure that the agency is focused on quality and has a system of identification and continued improvement.

Finally, the home care agency must have a strong quality improvement program that spans the entire organization, not just the direct home care services. Internal operations are as prone to breakdown and failures as the clinical areas of the home care agency. How does the payroll system work? Are there problems or issues with payroll? How are those addressed and resolved? What is the accounts receivable system and issues cause problems for the office staff? How are those addressed and resolved? Continuing education and training for the office staff in areas applicable to their duties is often an area overlooked and has consequences for the entire agency.

Communications in the organization is an on-going issue for all agencies. Open communications that invites input from everyone in the agency is a must. To achieve this one of the most successful systems is the “hallway huddle”. Each morning the office staff gathers for a 10 to 15 minute meeting to briefly state what they are working on and where they are having issues and need help. That way everyone knows what everyone is doing and where they impact or need to assist their colleagues. This is a hard practice to institute and maintain and requires management commitment. The long term benefits are increased staff satisfaction and productivity.

Every system, every person in the organization has a function and role in making the home care agency great and thus a great buy for a potential buyer. Invest in training and solid oversight systems and you will find the reward not only in a stellar reputation with your home care clients/patients, but when you are ready to sell your agency.

All of the issues raised in this article affect the value and potential sales price for your agency. As a result when we do a Due Diligence for a potential seller or buyer, we look at all the above listed aspects of the business. Weakness or failures in any one area can have a dramatic effect on the value of the agency. If you are planning on buying or selling your agency in the near future and could use our assistance, or just need to situate your agency for a future sale, contact us.

The holiday season is a special time of year. It is an opportunity to gather with friends, family, and colleagues. Regardless of our faith or beliefs, the holiday season is often filled to the brim with an array of festivities that reflect precious memories. While most of us barely have time to catch our breath between parties and concerts, gift exchanges and joyful gatherings, for the elderly, the holidays are often a time to focus on what they have lost.

For many, that loss is defined by physical disabilities that make it difficult for them to participate in customs and celebrations that were once very much part of their lives. For others, the holidays are poignant reminders of the loss of a spouse or a friend.

Yeas ago I realized how important this time of year was and what it meant to my clients who found it harder and harder to take part in the holiday season. In response, I created a Holiday Helper program that allowed my clients to maintain many of their favorite traditions while creating a much needed resource for local college students.

At the start of the holiday season, I began recruiting home care ‘helpers’ from the local universities and colleges. Logic said that college students might be looking for part-time work to earn a little extra money during their break. It turned out my instincts were correct, and almost immediately my office was flooded with responses. All I had to do was match each student to one of my elderly clients.

Here’s how it worked. The home care services provided under the Holiday Helper program varied and depended on the client, as well as their religion or customs. Their personal Holiday Helper provided gift shopping, holiday cooking, decorating the home or apartment, and transporting their client to any special productions or services that were part of their holiday tradition. I charged my clients a fee and paid their personal Holiday Helper a respectful part-time wage.

When I began the program, I thought it would be a good service for my home health clients. What I discovered after the fact was the students were served as well. Universally, they reported they did things they had never done before. For some it was the first time they had made holiday cookies or treats. For others it was the first time they had attended the Messiah or a live production of the Nutcracker or a Christmas Carol. While most had helped their own families with holiday preparations, working as a Holiday Helper allowed them to learn about another family’s traditions. The primary benefit, of course, was the deep satisfaction of helping others.

For the elders, it was an opportunity to be with “the young ones” again. Rather than being isolated during the holiday season, they were surrounded by youthful energy and enthusiasm. Most importantly, they had someone to share the meaning of the season with and to pass on traditions that were important to them. It also refocused their thinking towards positive things in their lives rather than what they had lost.

I encourage every home health agency to instigate a Holiday Helper program. Even though it is a bit late in the year, there is still time to pull one together. While the program generates moderate seasonal revenue, the goodwill garnered from the program far surpasses any fiscal gain. It is the essence of a good deed and the benefits to all can be seen in the happy faces of your clients and the young students. And frankly, from the warm fuzzy feeling you’ll experience knowing that you’ve made a difference in someone’s life and made his or her holiday happy, joyous, and bright

For additional holiday treats see the links below.

KHCC Holiday Traditions: A Kenyon Family Feast

KHCC Holiday Traditions: Dolores Nagel’s Spritz Cookies

KHCC Holiday Traditions: Miriam’s Mandelbrot Biscotti

It is with great pleasure that I introduce Pat Drea, a dear colleague and friend, who has agreed to share some of her great wisdom with all of us. Pat, Chief Operating Officer for Visiting Angels, a leading national private duty company with 430 offices, is a popular featured speaker at national and state private duty events.  Like all leaders in this industry, Pat has her finger in the wind and sees the changes coming and is sharing some of her tips for not only survival but for thriving and growing your home care business.  Enjoy!

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It’s no secret that our economy has changed in crucial, fundamental ways that are redefining what it means to be successful in private duty home care. Competition has increased in some markets as people displaced from other industries see private duty home care as an attractive business opportunity. Consumers are less likely to purchase high-hour services, and nervously seek cheaper, untrained, unsupervised alternatives to what professional private duty home care companies provide. Marketing has emerged as a full time role for Private Duty home care companies that wish to become known as preferred providers with a recognizable brand. Overhead has increased in the form of regulation and oversight, increased expectations of consumer families, due diligence in hiring and orientation, and the requirements for maximum efficiency. Growing your Private Duty home care business, demands that you take several steps to adapt to the new tough economy.

New Rules for the New Economy

1. Make “disciplined reinvention” your mantra. In this new world where consumers’ buying habits, expectations, access to information, needs and resources are changing, there is no substitute for an attitude that says, “What can I do better today than I did yesterday?” Keep your awareness on the opportunities and possibilities that lay in front of you – untapped private duty referral sources, adding growth services, satisfying prime referral sources so they send you more referrals. Celebrate and share your victories. Be determined to create a private duty home care business that will leave a lasting legacy.
2. Become experts at lead conversion. Barbara Akst’s article last week, It Starts With Hello, provided the best practices to achieve a high lead conversion. We invest a great deal in time and money to create leads for the lead funnel. Now is the time to challenge your team to achieve higher conversion rates which translate into more care for those consumers who need your services. The decision about home care is a complex one for families and their loved ones. Let us also achieve a high level of proficiency at assisting our consumers to navigate through the decision making process making it easy for them to say “yes” to the private duty home care services that their loved one really needs.
3. Establish marketing and networking as core functions of your office operations. Gone are the days when a home care agency could achieve dramatic growth by passing out brochures and placing newspaper ads. Internet media, competition, vanishing print media, and the wide variety of senior living and support options create an environment where we must deftly customize our messages to referral sources. The new marketing concept cultivates relationships which exchange high valued resources. We find out what problems they face and become part of the solution. We work to make their lives easier. The referral becomes secondary to a deep connection that has meaning and value to both parties. It’s about the relationship, smartie!
4. Refine your private duty home care operations for maximum efficiency. We have achieved great efficiencies in our scheduling of caregivers with scheduling software and telephony. Technological advances have made our operations more efficient: enhanced communications through the use of smart phones, voice mail blasts, customer friendly bill-pay approaches, safety and security technology for the care recipient when they are alone. To enjoy some of the latest technological advances for older people view the Para Robotic Seal and listen to NPDA’s Consumers conference calls, “Ready Talk,” by going to the Consumer tab at the NPDA site: www.privatedutyhomecare.org. Use some of the sophisticated and affordable options to compare your dashboard results to national benchmarking private duty data and motivate your staff and your caregivers to be at the cutting edge of extraordinary performance measures. Consider comparing your results to those of the Home Care Pulse 2011 Survey or Stephen Tweed’s Benchmarking Study.

So what if it’s a new world. You wouldn’t be in the private duty home care business if you didn’t love a challenge.

Please attend Pat Drea’s presentation “New Rules for the New Economy” at the PDHCA conference at the Bellagio, Las Vegas, January 23 – 25, 2012. Website: www.nahc.org/meetings/PD/12/

Frequently we see agencies that have a good basic financial system such as QuickBooks or something similar that helps keep their financial data in a manageable format, but most do not go beyond that basic information. You will know your gross income, your net cost of doing business, and hopefully your net income. However there is a lot more information that you will need to really stay on top of your home care business on a weekly basis.

First of all you need to know what your cost of sales is for your home care agency. To accomplish this you will need to know the cost of all advertising, cost of your sales staff, the number of leads from advertising, the number of leads from your sales staff, and the number of leads or referrals from other referral sources. This information will allow you to analyze the data in a way that gives you the information needed to determine where your referrals are coming from, the cost of each of the referral streams, and finally the cost per lead generated. Keeping a good handle on your home care cost of sales is one of the biggest challenges in the home care industry and one that is frequently not quantified in a way that allows the home care owner/manager to really see where their marketing and sales dollars are spent and then be able to determine if that is the best way to spend those dollars.

Second you need to be able to track the number of home care inquiries/referrals and the percent of conversion. You need to target a conversion rate of between 70% and 80%. Additional to that data, on a weekly basis you need to know the number of active home care clients, the number of home care clients that discontinued services, and the net gain or loss of clients for the week. In addition, and probably more important for the bottom line is the number of hours lost and gained for the week and the value of each. It is possible to have gained 5 new clients and still have lost financially. If you experienced one lost client that was a 24/7 case and gained the 5 new clients that totalled hours less that the hours generated by the one lost case, the net to the home care agency is a loss, therefore you need to track both numbers.

Next you need to track your direct costs (caregiver costs). Be sure to include not only their pay and associated taxes, but their mileage and any supplies that you provide on a regular basis like their gloves. In addition to the direct costs, you need to tract recruitment and retention data; total number of caregivers paid for the week, number of caregivers hired, number of caregivers terminated, total number of caregivers in the pool, and the total number that are active. Some home care agencies also track the cost of recruitment and retention activities. By tracking all of this data, the home care management team will have a better idea of what their recruitment and retention activities are really costing the agency and again the ability to make decisions about where the home care agency should be spending their time and money. The final data collected in this section is the ratio of active caregivers to active clients. A good rule of thumb is to have at least 30% more caregiver time available than what your current client case load requires. That way you will always have caregiver time available to take on new clients without making them wait.

You must have good home care financial analytic systems that tell you where your business is and assists in projecting future growth. There must be basic systems in place that help you or your staff determine pricing, pay to employees, gross and net margins by line of business, cost of sales, conversion rates of inquiries, compensation packages for sales and marketing staff, in other words, anything and everything that effects the financial health of your agency. Agencies frequently develop a dashboard to assist with this element of managing your business.

If you feel you could use some assistance with creating financial systems or your dashboard for your home health agency call us at 206-721-5091 or contact us. We are here to help.