The road to success is paved differently for every provider. But for Larry Kraska, CEO of Sunrise, Florida-based Interim Healthcare, mastering the art of Recruiting and retention has played a big role in the company’s overall growth.
Founded in 1966, Interim Healthcare provides a range of in-home care services, including private duty care, home health and hospice. In addition, the company also provides health care staffing services to other health care facilities, as well as schools and governmental agencies.
In 2017 alone, the company is on track to make more than $800 million in system-wide revenue, according to Kraska’s estimates. Currently the company has roughly 330 franchise locations spread across 44 states, and a workforce of approximately 40,000 health care professionals.
Home Health Care News caught up with Kraska to discuss his strategies for combating the industry’s ever-persistent recruiting and retention problems, as well as industry issues he’s keeping a close eye on in the new year.
What are the unique ways in which Interim delivers in-home care? What would you say sets your company apart?
There are a couple of things that we think make Interim unique. One of them is the fact that we’re a franchise model, so each of these locations [are] owned and operated by franchisees that live and work in the community where they operate. We think that gives us a unique approach because the folks that run these offices, it’s their own personal business. … One of the things that we really focus on is we make sure our offices are very focused on the recruiting and retention piece around the caregiver. We have a really great trained staff and a really good continuity of the folks that we have who are staffing our different offices.
You bring up recruiting and retention, which has become the biggest challenge for a lot of providers. What are your strategies in combating this challenge?
I spent about 10 years of my career running a large, national health care staffing company. In the 10 years that I spent doing that, I learned a lot about recruiting and retention and how to actually become really great at identifying and keeping health care professionals. At Interim, we’re trying to apply a lot of the same principles that the large hospitals and even the large staffing companies have been doing for years to really focus on helping our offices become the employer of choice in their market. So, we’ve developed training programs and tools to really help our owners with identifying and recruiting really great caregivers that really want to work in the industry. … In addition to recruiting, the equally big issue is around retention. If you get really great at recruiting, you really lose sight of the fact that if you find great people, you have to figure out how to retain them, or it’s just going to be a revolving door. At Interim, a lot of our focus for our owners is around training in both of those areas.
What are some of the best practices you follow in terms of retaining top talent?
There are a lot of programs that we’ve developed internally. I think one of the core ones is … we make sure that the owners do a good job when they hire somebody to really onboard them to the culture of what Interim is and the fact that they have a lot of pride, not just in our brand, but in the type of work that we provide out in the communities where they’re working. We think that that cultural piece is very important so that they really feel a strong bond with Interim and the managers and owners that they work with. Also, a lot of our work around retention is trying to make sure that we’re attracting part-time workforce, because not everybody who works in a home care office has to be a full-time employee. … Part of our retention is around culture, but the other part is really around a flexible work force and being flexible with our hours and our ability to work with people on their schedules.
With the start of the new year, what are the top industry challenges in 2018?
Anybody that you talk to that provides home care is this movement around family members and patients really wanting to age in place. … We’re watching that trend very closely on how do we develop the right approach and the right training for our staff to allow people to age at home and age in place as long as they can? The other one is I think that there is going to be more and more of a movement towards home care providers being able to demonstrate outcomes and improved quality from the care they provide. So, we’re doing a lot of work internally with our training and our own internal measurements, looking at our quality measurements and our ability to support our franchisees and being able to demonstrate high quality and improved outcomes with the work that we’re doing. The last one would be around the trends that are developing around advances in technology that’s helping with home care, whether it’s helping with offset some of the challenges with recruiting, with things like tele-monitoring and tele-medicine, or even technologies that are helping our caregivers with communicating back to the office or communicating with the patients that they’re taking care of.
On the regulatory front, what issues concern you the most?
I think anybody in health care is always watching the changes in reimbursement trends and what’s happening from a payer perspective. The way I’ve always looked at it is … anybody, whether it’s a hospital that you work with or a family that’s looking for care, they’re always looking for the best quality provider that they can have. We tend to feel that quality is largely driven around caregivers and the type of work our caregivers provide. There’s a lot of discussion around how great home care can really help prevent readmissions. But, we also think that as more and more partnerships are developing between post-acute care providers … there’s a really important place for home care in actually preventing admissions in the first place.
How important is it for in-home care providers to create partnerships with other post-acute care providers? How are you achieving this at Interim Health?
Our philosophy as an organization is we do think that there is an opportunity for more of that to happen, with hospitals and other health care providers partnering more with home health companies. And it’s not just from a discharge perspective; it could really be on the front-end, as well. How do you allow the folks to remain at home as long as possible, without having to be admitted in the hospital? Once they’re discharged, how do you work with the right home health care company to really stabilize the patient, help them get better quickly and prevent them from being readmitted. Doing that in partnership [with other health care providers] is going to be something that continues to be a big trend.
Discuss the role hospice care is playing in post-acute care.
There’s been a growth in local and national providers for hospice. That’s why it’s an important part of our continuum. Not every one of our owners has a hospice program, but we have large number hospice programs across the U.S. We believe that that is, for many of our owners, a very natural part of the continuum for the patients that they serve. They go from receiving home care until they get to the point in their life where they need to transition into hospice. And our owners, the ones that have hospice programs, are able to seamlessly have the patients transferred into the hospice program so they could spend the last portion of their life, many times, getting treated by the same folks who have been taking care of them previously in home care.
What were the company’s biggest accomplishments for 2017? What are the biggest opportunities for improvement in the new year?
We think we actually made really great progress in 2017 around that recruiting and retention topic. Across the industry, it is the No. 1 thing that people talk about. One of the advantages I think we have is the number of people on our executive team that came out of the staffing industry. So, along with having really deep, really great health care experience, we also have some folks who have a really strong staffing background and we’re using a lot of the training, a lot of the techniques from the staffing industry to really help our owners with that recruiting and retention challenge. So, 2017 was a really big year for that for us and that will carry into 2018, as well. We’ve also had some really good luck with helping our owners realize that they could provide more of the continuum of care within their offices. We continue to see expansion in our hospice offering and more of our offices that were doing private duty are moving into the skilled care area.
What are your plans for growing the company in 2018?
We’re very, very optimistic about 2018 for our owners. We think that with this whole trend of aging in place … our owners are very excited about the demand for the work that we do. We’re focused on recruiting and retaining high-quality professionals who can provide high-quality care. So I think, organically, our offices are very excited about providing care in their communities and the prospects for additional growth in what we’re doing. But, we also have a number of markets across the U.S. that are still open, so we’ve got franchise development team actively speaking with a number of people about becoming new franchisees with Interim.
Written by Carlo Calma