It’s not just about non-competes.
Why do caregivers leave to work privately or with a client moving to another agency?
You may find yourself wondering why your caregivers are leaving agency work and making the switch to work privately.
There are a variety of reasons. However, it’s important to note that while seniors hiring private caregivers can be a beneficial arrangement in some cases, it often leaves both parties without vital safety nets provided by a home care agency.
If the parties choose to leave an agency to work directly together, it also shorts the agency on the investment they’ve made in both parties. Many of these situations occur because either or both parties are not educated on the benefits and safety measures provided by going through a home care agency.
You put a lot of time into your marketing and sales efforts to secure clients. You put a lot of time and effort into your hiring, onboarding, and training process. And you are entitled to a return on that investment if both parties want to forego the middleman. The caregiver and client would not have worked together without your hard work.
Let’s dive into the reasons why this happens:
They’ve worked together for a long time
The client is offering to pay the caregiver more
The client is going to give them more hours
They want to eliminate the middleman (this may be caused by not being responsive to calls, invoicing and pay issues, or maybe the client is low on funds)
This isn’t an exhaustive list, but these are major reasons that caregivers leave to work privately. What you can do is to help both parties understand what they are losing by cutting their agency out of the equation.
What can you do to stop caregivers from leaving to work with former clients?
While there are financial and legal defenses as well, the best defense against caregivers leaving to work privately is being a workplace they never want to leave. What might that look like? Here are some aspects to focus on:
Building a great culture: Your culture can be established early on in the hiring process from the job posting to the in-person interview. Every interaction you have with a caregiver is a representation of your agency’s culture.
Offering consistent and timely recognition: Recognizing caregivers is crucial to retention. Sending them a text with “thank you” can go a long way.
Providing a career ladder through training: By establishing a career ladder, each caregiver has a goal and path to achieve. To advance within the company. Caregiver mentorship programs are great tools to establish trust and build meaningful relationships.
Each of these three benefits to working with an agency can help to lower your caregivers’ chances of leaving to work privately. Here are some other best practices:
Paying caregivers competitively: By paying caregivers more, you can improve retention rates, in turn, making caregivers feel valued for the work that they do. You should aim to pay in the 75th percentile of your local market.
Timely and effective communication: Stress the importance of building the relationships that your office staff have with both your clients and caregivers, rather than only the relationship between your clients and caregivers. Keep your clients and caregivers loyal to your agency in the quality and care that you bring. This can include promptly responding to messages and calls as well as checking in on clients and caregivers for changes/updates to care.
Educate your clients and caregivers on the back-end work that goes into making a home care agency successful, like:
Caregiver and client matching
Supervisory visits and evaluations
Care management: This includes making referrals to auxiliary services that the client may need or recommendations for durable medical equipment
24/7 support with office staff and caregivers on-call
Benefits like worker’s compensation, liability insurance, PTO, coverage for time off, managing client and caregiver conflicts
Finding new work for your caregivers if their current client no longer needs help
Financial consequences: Your service agreement for clients should have a non-compete clause that outlines the consequences and cost of hiring a caregiver from you.
For caregivers, there should be a section in their employee handbook that outlines the consequences and fees of working with one of your clients after discharging services.
These fees are important because there are financial costs to finding a client and caregiver. A lot of sales and marketing efforts take place to nurture a client from the inquiry to the start of care.
For caregivers, you spend time and money posting job ads and attending career fairs. After that point, you take the caregiver through an interview process, hiring process, onboarding/orientation, and continuous training. Those costs add up. This also gives you legal leverage, if it needs to go that far.
When calculating these fees, it is important to be reasonable. The caregiver’s non-compete fee should not be greater than the costs to hire and train. The client fee should also be within reason.
Consult your agency’s attorney or seek legal guidance when drawing up your contracts to make sure that they are reasonable and enforceable.
How do you address caregivers?
This can be an awkward topic to bring up in conversation, but it is important to establish boundaries. Here are some points to bring up with caregivers who may look to work privately:
Private caregivers are responsible for damage and can be sued directly by the client/family
Some caregivers have given a client their phone number and may experience irritation of being contacted at all hours of the day. This would become a normal occurrence for them.
Clients may want to pay them table which can result in legal issues to those who receive government benefits
Without the agency, they no longer have protection for damages, replacement/relief caregivers, travel and mileage reimbursement, etc.
Caregivers would no longer have
They would also be responsible for saving up for their taxes
Most don’t make enough or have enough saved in order to pay a non-compete breach fee
There may be some others, but these are talking points that will help educate your caregivers on the highlights of working with a home care agency, as opposed to private work.
How do you address clients?
Now that we’ve discussed what points you should bring up to caregivers, let’s dive into how to address the concerns that pertain to clients.
This caregiver becomes their only caregiver (they may not be able to find a friend or coworker to relieve them or cover for vacation/sick time)
Many clients may not be able to pay the non-compete fee
Clients no longer have the protection of a service agreement
Care management will be eliminated, they won’t have access to the nurse or on-call support
Hiring an independent caregiver is 30-40% cheaper than agency costs, however, if that caregiver decides to end their relationship, they would be without staff
The agency acts as a mediator in conflicts. By only working with the caregiver, they will also have limited access to senior-related services and referrals to necessary providers.
How do you expand your applicant pool while helping unpaid family caregivers?
You can also use existing family caregivers and work backward, to help them secure care through an agency. By working with Medicaid and other third-party payers, you can help unpaid family caregivers get paid to care for their relative. And they will also have the stability and administrative expertise of funneling care through a home care agency.
This can also help in your agency positioning and sales/marketing process. Caregivers know their family members better than anyone else.
In exchange, you would have a steady client with a reliable caregiver. Family caregivers may also have an interest in working with your other clients, and be willing to help out in a last-minute shift request.
Reasons to Stay
With 57% of caregiver turnover occurring in the first 90 days, these best practices can help you recruit and retain your staff long term. The best defense against your caregivers going private is to give them reasons to stay. That could look different depending on your agency, but it can include:
Caregiver and client matching
Having a variety of clients to work with
Recognition and other perks
Blended learning options (online and in-person)
Your caregivers and clients came to work with your agency for a reason, and with these tips and tricks you can keep them longer. If you’re looking for more ways to improve retention, we held a webinar on creating your caregiver retention strategy – and this can help you retain caregivers across the board.