Ep:34: 7 Proven Tips to Help You Retain Caregivers

Miriam Allred (00:08):

Welcome to Vision | The Care Leaders’ Podcast. I’m Miriam Allred with Activated Insights. My guest today is Chelsey Ammons, the Vice President of Nursing at Care Advantage. Chelsey, welcome to the show!

Chelsey Ammons (00:20):

Thank you so much. Good to see you, Miriam!

Miriam Allred (00:23):

It’s great to be here with you. Thank you for joining me. We had Olivia on the show and now we’ve got you and Olivia shared with us some secrets about scheduling, but you are the VP of Nursing and you really help with the recruitment and retention piece of Care Advantage. So I’m excited to have this conversation with you today.

Chelsey Ammons (00:39):

Sure! Excited to be here. Thank you!

Miriam Allred (00:42):

All right. So let’s talk about retention. You know, like we were just talking about COVID has presented a number of challenges and we’ve always talked about the caregiver crisis and just the lack of staff there are out there, but COVID has presented even new challenges that we may not have expected. So I want to talk about how Care Advantage has focused and honed in, on retaining caregivers at this time. So I’m going to just kind of tee you up to talk about some of the tips and experiences you all have had. So if you’re ready, let’s get started. Sure. I’m ready. Great. So what is the first tip around retention?

Chelsey Ammons (01:19):

So my first tip would definitely be culture. Probably the most important tip. You know, having that positive culture affects nearly every aspect of the business. At carrot vantage, we have very strong values. We actually call them care, values and care stands for compassion, attitude, respect, and excellence. We truly live by those values and, and really emphasize them and our mission and all that we do. So they’ve truly become the basis of our culture.

Miriam Allred (01:49):

Yeah, that’s great. What are some specific ways you’ve seen your culture and the culture you’ve built help you retain caregivers during COVID specifically?

Chelsey Ammons (01:58):

During COVID I think, you know, transparency you know, we had clear goals and we organizationally promoted those goals. Making sure that we stayed there for our patients and the time that they needed us most we had objectives that were far from a secret you know, we, we over communicated things and in, during a crisis, like, COVID, you really can’t over-communicate everyone was aware of where we stood you know, the best practices, policies, procedures, everything in place to keep us safe. So I think that transparency was a big part of our culture through COVID and remains a big part of our culture today. And you know, also you know, we are actually a family. We say that a lot oversee the clinical team specifically. We are friends in the office and we, we call ourselves the clinical family and we have fun at what we do.

Chelsey Ammons (02:54):

You know, it makes coming to work easy. So humor is always allowed. That’s a big part of our culture here at caravan and we love to have fun and, and use humor to help us get through tough times. You know, for example, the clinical team, we have dress up days, we’ll get on zoom and dress up as funny things just randomly. And we like to share that with our caregiving staff, because, you know, it’s important for them to know that we’re a fun place to work and, you know, we, we care and have that positive culture.

Miriam Allred (03:24):

Yeah. Great insights, communication, transparency, even the humor piece, you know, it’s been a stressful time, you know, the last 12 months, a lot of unknowns, a lot of questions, a lot of stress. So just keeping things light and fun and fresh and encouraging is, is so important. You mentioned being transparent in your objectives and your goals. Do you mind just sharing maybe one or two of those objectives that, you know, stand out to your caregivers or motivate them or help them see the vision of the company?

Chelsey Ammons (03:55):

Sure. Well, one it’s actually a visual. We have you know, the Rosie Rosie that was, she puts flexing her muscles Porter, she’s flexing her muscles. That’s a big visual that we use because you know, our frontline workers, they’re heroes and, you know, you see a lot on television about the hospitals, but you know, home care it’s really important and that they stayed course and continue to provide the excellent care that they do. So I think that visual was, is awesome to use because we’re just so proud of them and appreciate them. And our objective was to make sure that they knew that and that really wanna, you know, help them understand that we appreciate all that they did.

Miriam Allred (04:39):

We’ve, we’ve heard a lot about frontline workers and most often on the news or, you know, on the internet, we see a lot of hospital or health care workers, but yeah, you’re right. I don’t know that our home care caregivers are getting enough recognition and so doing whatever we can as an agency to make them feel recognized. And a part of that frontline is so important. Definitely. So let’s dive into the second tip. What do you have?

Chelsey Ammons (05:03):

All right. Second would be relate-ability advocacy and support. So for example I started with this company in 2012 as a part-time home health supervisor and I’ve actually served in every clinical position within the personal care division. So I understand what, what each individual is going through, you know, the good, the bad and everything in between. So with that, you know, being able to relate with him there, you know, the struggles or hardships and, you know, the ability to give advice or techniques on ways to overcome some of those things has been a good way to retain, you know, my clinicians and then, you know, the trickles down to the caregivers as well. You know, each person has their limits and boundaries. So as a leader, it’s important to understand those for your team members and find ways to help them, you know, overcome the struggles that they experience. And you know, that that’s a big part of helping to prevent that burnout that I know so many healthcare workers have experienced, especially through COVID

Miriam Allred (06:09):

I’d like to ask, we get a lot of questions about like the internal structure of caregivers and care managers and care coordinators, and there’s a million other names. You’re the VP of Nursing at the corporate level. You mentioned having some staff, you know, maybe call him office staff, or you had some clinicians inside of the office, but then maybe oversee the branches. Can you just explain to me kind of what that breakdown looks like and about how many care managers you have for however many caregivers just kind of walk me through that structure briefly.

Chelsey Ammons (06:40):

Sure. Of course. Well, there’s myself. And then we have an Assistant Director of Nursing. She oversees actually our Western region predominantly. And then we have what are called Director of Clinical Services, who are regional leaders and, and oversee, each of them have roughly two or three branches under them. And then next is our Home Health Directors and Supervisors. Those folks oversee the caregivers, so the PCA’s and CNS, and I’d say we have altogether 35, so probably 28 Home Health Directors and Supervisors and those folks each oversee roughly, I’d say depending on the branch size, roughly from 50 to up to 150 caregivers, depending on the branch.

Miriam Allred (07:32):

Okay. Appreciate you explaining that. So we can kind of visualize, you know, just the structure because it looks a little bit different at every agency, but like you said, with this tip support advocacy, relate-ability all of that comes, you know, you need enough staff to make sure every caregiver feels that way. And when we talk about 50 to a hundred to 500 caregivers, you know, not one to two, to even three people can make them all feel advocated for or supported. And so you need a pretty good number of additional staff to oversee the caregivers.

Chelsey Ammons (08:06):

Definitely. Yes, we you know, one thing that Care Advantage I love is that we always welcome feedback. You know, that’s a big part of the support is, you know, listening to that feedback, not just asking for it, but actually taking it to heart. You know, we have actually a team of caregivers that meet on a monthly basis and they provide a voice. So they advocate on behalf of the caregiving staff to our corporate team so that we can then take that back and discuss ways that we can help them through some of their struggles or overcome things or support them in ways to, to make their jobs easier. And of course improve the care that they provide.

Miriam Allred (08:44):

Yeah, that’s awesome. And it may just seem like, Oh, one more meeting or, you know, one more thing to do for the admin team, but hearing the voice of the caregiver directly and giving them a, or a space to talk directly to the executives. That’s that’s really cool. Yes, it’s so powerful. Cool. So let’s, let’s keep moving. What is the third tip?

Chelsey Ammons (09:05):

The third big one communication. So I mentioned that we are our family we’re extremely close and, you know, one positive in my mind that came out of COVID was the bond that was built with increased communication and engagement. You know, that has been extremely important to ensure that everyone knew how to stay safe. You know, how to follow the policies and procedures that we put in place during COVID. You know, some may say we had, you know, they get a lot of messages or we’re over communicating, but in the end they all realize that it’s, it’s just to keep them safe the clients safe and then everyone around them safe.

Miriam Allred (09:47):

That’s honestly a good thing to hear that you’re, over-communicating we get so much caregiver feedback and communication is consistently one of the top complaints or issues that caregivers bring to light. So I would say if you’re an agency, you know, like your advantage and you’re hearing that you’re, over-communicating, that’s honestly probably a good sign, especially during these times.

Chelsey Ammons (10:08):

Yeah, I agree. It’s, it’s really important. And you know, we have everything from videos to you know, messages that we send out through our platform that we use for communication. We have you know, Facebook of course that we use Tik TOK, even we’ve, we’ve done it all just to make sure that no matter what you know, age group, our caregiver falls, and they have a way to access that communication and hear what we have going on. And what we feel is important to keep them safe. And of course, ways that we’re, we’re supporting them throughout this.

Miriam Allred (10:44):

Yeah. Can I ask what platform or channels you mentioned a couple, but maybe name a few more. What, what do you find works the best for the majority of your staff?

Chelsey Ammons (10:54):

Probably text messaging has been the most effective because of course everybody has that. Facebook is another huge platform that we see a lot of activity on. And we use our Facebook to of course get people to go to our website. And we have a COVID resource center. It’s, it’s, it’s up and live for the public to see that’s where we post all of, you know, our clinical updates, any, any changes, any big right now, of course, is the vaccinations. So you know, having a place for people to go to for resources you know, so everything we do, we try and drive people to our website because that seems to be the central hub for most of the communication. But I’d say of all the choices, text messaging is, is certainly the best.

Miriam Allred (11:40):

Yeah. Thanks for elaborating on that. And honestly, I just can’t overstate. It’s so great to hear that you’re over-communicating and using all those different channels, because the last thing you want is for your caregiver to feel like they’re not being communicated to or communicated to in the way that they would be most responsive. So it’s really important to test out different channels and find what works for your staff and make sure they feel heard through that communication. Certainly. Yes. So let’s talk about the next step. What do you have

Chelsey Ammons (12:08):

All right. Next would be career development support. So I mentioned, you know, there’s the opportunity for growth within our company. You know, these types of opportunities don’t always exist with personal care agencies. Especially if you’re looking at the upper level, so clinical RN positions, for example. And so having that career ladder in a sense is a big source of retention for us. The caregiver comes in and desires to one day, be a nurse, you know, an LPN or an RN. We do have ways to help them get to that. We actually offer classes here locally and virtually now which is a huge way of recruiting at this point with, with everything going on with COVID, you know, having that virtual ability has, has been major for our recruiting efforts. So if somebody comes in has zero experience and wants to learn about how to become a caregiver, we’re able to bring them in for virtual classes, get them trained. And if they desire to, you know, further their education, then we have resources to help them do that, you know, to become a nurse or even further, if they

Miriam Allred (13:15):

Career ladders are so important and giving them those opportunities to learn and advance and achieve their personal goals is really important. I want to ask a little bit about your, your demographic, you know, just kind of general don’t have to get too specific, but are a lot of what what’s kind of the overall demographic of your caregivers in general

Chelsey Ammons (13:40):

In general. I’d say, you know, age wise it really, really varies and it depends on, on the area because we service roughly 90% of the state of Virginia. So you know, we’re all over. So it really, really varies, but most of our caregivers are probably between, let’s say 30 to 45 or so. It’s probably the most common age group. And but of course that just depends on where you are.

Miriam Allred (14:07):

Okay. Yeah, no, totally. Which is totally fine. Which is interesting, you know, I think you’ve got to find incentives or career letters that work for different demographics. Some agencies may be hiring a lot of high school graduates call, you know, people in college, people that are maybe working towards a nursing degree and just looking to get experience, but where, you know, your demographic 30 to 45, they may have different intentions. Some of them may still want to, you know, further their education or become a nurse or a CNA. But you’ve just got to find the right career ladder and opportunities for your demographic. Sure.

Chelsey Ammons (14:44):

And I think you know, the good part about here is there’s a lot of different options, you know, with that 30 to 45, they made us desire to even look to office work. You know, we we’ve recruited and Olivia actually talked about it. She started as a caregiver and now she’s Executive Vice President. So there’s opportunities to grow in so many different ways, you know, for each age group. So if someone coming out of high school wants to become a caregiver, you know, when they turn 18 and then wants to become a nurse and that that’s, you know, something that we can help them with. And, you know, if they come in at 30, they’re just looking for some extra income on top of maybe their full-time job, you know, we can support them there. And if they desire to, you know, look elsewhere outside of their full-time job and look for a full-time position here within an office, that may be an opportunity as well.

Miriam Allred (15:31):

Yeah. I love that. There’s so many different opportunities and it’s just finding out what the individual wants and making that happen and customizing their journey with your agency to them. Definitely. Cool. Love that. What, what’s the next step? I think we’re on five. Is that right?

Chelsey Ammons (15:47):

Yep. Five. Fifth for me would be given recognition recognition is due. So carrot vantage, that’s extremely important to recognize you know, those that go above and beyond. It’s, it’s really a part of our culture and certainly motivates a team. Every year there’s a circle of excellence awards where many awards are extended from our caregiving team to our corporate accounting team, everybody has the ability to receive an award. For example, for my team, it’s, you know, top clinician in the personal care division. And that’s something that everybody strives for. You know, we also every meeting we have and this isn’t just the clinical department, it’s every department. There’s typically a moment where we highlight an unsung hero. You know, most, most everybody’s pretty humble. They, you know, they, they don’t admit when they go above and beyond, but once, you know, as a leader, when we hear of something that they do we’re going to put it out there because people love to, to, you know, have that recognition amongst their peers. It really means a lot. So we love to get those stories about caregivers, you know, from our clients or if the nurse goes out and recognizes a caregiver, that’s, that’s doing something you know, above and beyond for the client, then, then we’re going to make sure that’s known and, and broadcasted across the, the our field.

Miriam Allred (17:12):

Yeah. The, the people that land and stay in this industry, like you said, are oftentimes pretty humble and compassionate and genuine, and maybe don’t get a lot of recognition, but it’s so important to find those moments. You know, those lungs here is, like you said, when they’re serving and recognize that because what they do every single day is so important and we want to recognize them as much as we can to make them feel valued and a part of the family.

Chelsey Ammons (17:39):

Yes. Just saying, thank you. I mean, saying thank you on a regular basis, it goes a long way. And we are truly thankful for each and every person in this organization. Yeah.

Miriam Allred (17:50):

Any specific examples you could share of when you recognize the caregiver and what that resulted in, you know, whether they stayed or, you know, we’re working through something, any, any examples come to mind around recognition specifically?

Chelsey Ammons (18:02):

Sure. We actually just had a caregiver who celebrated 30 years with us. You know, and she came in she got a big gift basket full of what we call swag, I guess Care Advantage swag. And you know, she had a lot of pictures taken and that was displayed on all of our platforms, you know, Facebook, our website she’s featured in a number of pamphlets that we use and distribute. So just a really good moment for her. And she was so appreciative, you know, very tearful and just thankful for the recognition.

Miriam Allred (18:38):

Yeah. Great example, 30 years. That is incredible.

Chelsey Ammons (18:41):

It definitely has. She’s wonderful.

Miriam Allred (18:44):

And just swag. I just want to hit on that briefly. I think it’s, it’s simple, but it honestly is a really good idea to do that. You know, it’s because it feels like you belong, you know, you’re part of something and whether it’s a water bottle or a shirt or pens, you know, it’s like so simple, but it can really help people feel like they’re a part of something, especially with caregivers, I’m thinking of a lot of us working remotely. It kind of ties us back to the organization in a really simple way. And you feel kind of a sense of pride or belonging when you use it or wear it or whatever that is. I think it’s so simple, but something that people should definitely take advantage of

Chelsey Ammons (19:24):

Yes, yes. Making a brand. I mean, that’s, our marketing department is absolutely amazing. They’ve done such a great job in giving us so many options that we can extend to our caregiving family and our office teams and, you know, really building that brand to you know, it’s, we’re proud of it. Like I said, this positive culture, I’m so proud to be a part of this company that’s displayed with a pink cart. And so wearing that just it just shows that, so we all want to do, you know, to display that.

Miriam Allred (19:55):

Yeah, absolutely. I love that. Let’s talk about tip number six. What do you have?

Chelsey Ammons (20:00):

All right. So six would be improved engagement. So quickly identifying risks situations and then acting on them. You know, increasing employee engagement is extremely important for, you know, both leaders and the employees. It’s, it’s really the best way to build trust and respect both ways. So if I’m speaking to the caregiving staff, it’s, you know, we have touch points with them after their first shift, you know, we call and see how things went. You know, how, how did everything go with their patient? Because it isn’t just important how the patient reacts to the care, but also how the caregiver reacts to the patient’s situation. You know, not always is it a good fit and that’s okay, but as long as we identify that situation is not being a good fit right away then can make some changes.

Chelsey Ammons (20:48):

So that in the end everybody has you know, what they need in place on both ends. Of in the office side, of course we we use what’s called one-on-ones. That is, is a really important time for the employee to you know, review everything that they have top of mind. It may even be just a vent session, but it’s okay. It’s, it’s their time, you know, that’s, that’s their moment with their leader and they can review whatever’s on their mind and it’s a good opportunity for the leader to identify any situations that could be a risk. As far as retention is concerned for that employee,

Miriam Allred (21:29):

You mentioned a couple of touch points, what’s kind of just a general frequency of those touch points once a week, once a month, or, or are there kind of milestones as to when you reach out? Or what does that cadence look like?

Chelsey Ammons (21:43):

So are you speaking to the caregivers? Yeah, the caregivers. So for caregivers, we like I said, if it’s a new shift or a new client for them, then we’re following up right after their first shift. After that they typically are talking to the office, I’d say on a weekly basis. We are initially initiating that first call, but they typically call back and give us updates after the week and then each week they have your records. So they have basically a report of how things went with the client and the nurse that oversees that case reviews that and that’s also a point where we get feedback from the caregiver. They’re the ones that are completing these time records. So they’re letting us know if there’s any issues or concerns on either the patient or the caregiver side as far as care is concerned. Also on top of that, we have you know, regularly scheduled what we call reconnect nights where we all come together and reach out to our caregivers just to make sure that they’re doing well. And typically that’s a quarterly event.

Miriam Allred (22:51):

Okay. Is a lot of this communication happening virtually right now for you guys or are you starting to do more in person

Chelsey Ammons (22:59):

I’d say more virtually right now just to, you know, keep everyone safe. You know, we do have our caregivers they’re welcome and that they make an appointment to the office. You know, that, that’s fine if, if we feel like we needed to talk in person. But right now most everything can be handled telephonically.

Miriam Allred (23:17):

Just curious, which yeah, there’s no right or wrong. It’s just, yeah. Everywhere is different. I think what I continue to hear, I mean, we’re out on the other side of the country, but yeah, people are anxious to get back in person and the caregivers are providing the care obviously in person. But I think having that office staff member or yourself to talk to in person may just help them open up a little bit more and feel like they can have more of a conversation, you know, virtual communication just sometimes presents a little bit of a barrier, which isn’t a bad thing and it’s kind of our only option, but I’d imagine a lot are anxious to get back in person to have more like human interaction.

Chelsey Ammons (23:54):

Yeah, definitely. And we’re still doing that. You know, we, we allow appointments that if the situation presents where we feel like an in-person you know, visit would, would be more warranted than we’ll certainly do. So you know, we have the ability to social distance and keep everyone safe that way. So you know, we’ll do that if necessary.

Miriam Allred (24:14):

Yeah. That’s great to have those options. Let’s jump into the last tip, tip number seven,

Chelsey Ammons (24:20):

All right. Seven would be continuing growth and learning opportunities. So, you know, continual education is really important from the caregiver to the RN that oversees the case. You know, you know, personal care has been seen in the past is a very transactional form of care. We want everyone to know that that’s not the case what caregivers do and then our clinicians do in the homes are so important on the care continuum. So a patient’s journey let’s say from the hospital to home, that home care is, is really detrimental to their life. And we want, you know, the caregivers to understand that and to understand that that what they do is so important. So we like to build them up, you know, continue to help them grow in different ways. So we actually have what’s called a high touch program, which has given an example of, of ways that we help them grow to sum it up.

Chelsey Ammons (25:25):

We’re you know, we’re really putting emphasis in collaboration centered around some of our sickest and frailest patients. We come together with other members of that healthcare team for the patient and determine new interventions that will keep the patient healthy, happy, and then at home, which is a force where they want to stay. So using these interdisciplinary approaches we look for ways to reduce ER visits inpatient admission, improve outcomes. And then of course the patient satisfaction all of this ties into our caregivers more than anything, they’re our eyes and ears in the home. So we work at ways to, to help them grow, to teach them, you know, how to, how to do a blood pressure, what weight to watch for, if the person’s having heart problems different things like that. So really, really focusing on education and opportunities on where they can further grow their clinical ability. So it helps them. And then of course the patient in the end,

Miriam Allred (26:30):

All I’m thinking right now, my head is Care Advantage is so caregiver focused, which is so important. The clients are equally important. The whole office staff is important. There’s so many important elements of our organizations, but putting the caregiver at the heart and center of your business will reap rewards. And I, and I just keep thinking, you know, Care Advantage is doing that and is seeing the result of doing that. And I think everything they’ve talked about today has just kind of honed into that point in my mind. This has been great Chelsea we’ve, we’ve covered a lot in the last 30 minutes. But I just want to say thank you for sharing these tips. This information has been invaluable and I just, you know, want to reiterate it, it results in a lot of long-term success when you put the caregiver at the heart of your business and I think Care Advantage is a great example of that.

Chelsey Ammons (27:19):

Wow. Well, thank you so much, very much. I appreciate your time and I appreciate the opportunity.

Miriam Allred (27:24):

Thanks for listening to this episode of Vision, to learn more about your business and how you can improve caregiver retention. I’d like to invite you to participate in the 2021 Home Care Benchmarking Study. The Study is open now through March 31st, visit benchmarking.homecarepulse.com to participate. Thanks again, and we’ll see you next time!