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Retain employees during the labor shortage

How Agencies Can Reduce the Effects of the Labor Shortage

The United States labor shortage is creating stress for employers across the country, but especially for providers serving the I/DD and behavioral health communities. Their work is crucial to the communities they care for, but they are struggling to fill positions. The situation appears more critical by the day. Fortunately, it is possible for an agency to hire and retain employees, even if it cannot raise wages.

What is Causing the Labor Shortage?

The labor shortage does not have one simple cause. The American Network of Community Options and Resources (ANCOR) released a report in 2017 to address some of the reasons for the shortage, and some of them are surprising.

For example, take a look at a United States Supreme Court case called Olmstead v. L.C. In this case, two women with mental illnesses received treatment at state-run institutions. Eventually, mental health professionals said the women were ready for community-based programs, where they could lead more “normal” lives. However, the women were kept institutionalized for years afterward. They sued, and in 1999, the Supreme Court decided that separating disabled persons from society longer than necessary violates the Americans with Disabilities Act.

Since that decision, the federal government has made policies that encourage more home and community-based care for people in the I/DD and behavioral health communities. The problem, however, is that these policies are not backed with an appropriate increase in funds. If more people want home-based care, more workers need to take jobs as care providers. But if the states are unable to expand their budgets proportionally, wages are stretched thin.

Another reason for the labor shortage is that the working population is shrinking. Too few people are entering the workforce to replace retiring baby boomers. Even worse, the primary direct support professional (DSP) demographic (working-age women) is getting smaller. This means that even if DSP wages increase, there will still be a shortage of workers from the typical DSP demographic.

At the same time, the need for DSPs is rising fast.  The Bureau of Labor Statistics predicts that the job outlook for home health aides and personal care aides will grow 40% between 2016 and 2026 – that is much faster than the 7% average growth rate for all jobs.

How is the labor shortage affecting human service agencies?

Providers are feeling the sting of the labor shortage most of all in their turnover rates. The DSP turnover rate is at 45%, according to the ANCOR report. A 2015 survey by National Core Indicators found that more than half of DSPs leave their jobs within a year, and about a third leave within six months. A rate this high means that clients don’t have time to get to know and trust their caregivers before they leave.

Turnover isn’t the only adverse effect. As noted earlier, job vacancies will rise in the coming years, causing extra agency expenses. The ANCOR report says that every unfilled position costs an agency between $4,200 and $5,200 in direct and indirect costs. Even worse, job vacancies could affect your agency’s DSP-to-client ratios and incite hefty fines.

As positions remain unfilled, employees need to work extra hours to fill shifts. This often leads to overtime. USA Today reported that worker shortages across the country have “quietly provided a financial boon to many full-time employees, who are notching lots of overtime, and part-timers, who are toiling more hours or shifting to full time.” This is nice for people eager to work more hours, but it is costly to their employers.

Most importantly, the labor shortage hurts the people within the I/DD and behavioral health communities. Many clients rely on provider services to live healthy lives. Without enough employees, agencies can’t take care of their clients properly. This is obviously disastrous for clients as well as providers.

How Can Human Service Agencies Cope With These Effects?

These stats are sobering for any business, but particularly for agencies that rely on state and federal funding. Even though most providers are at another’s mercy for funding issues, there are still ways for them to boost retention and cut costs.

Promote a work-life balance for employees

“Work-life balance” is a buzzword in most workplaces today, especially among younger generations. According to the 2017 State of the American Workforce report by Gallup, 53% of employees say that greater work-life balance and better personal well-being is “very important” when  considering a new job. This attribute ranks higher than job security, significant pay increase, and company reputation. The percentage may also increase in the coming decade, since millennials and Gen Xers assign more importance to this than baby boomers.

An excellent way to ensure your employees have a good work-life balance is to manage their schedules well. One of the biggest complaints employees have is lack of advance notice for their schedules. Poor scheduling or last-minute schedule changes can cause conflicts with employee’s home lives and cause them to seek alternative employment, even at a lower pay rate. It is important to track employee preferences and restrictions when creating the schedule. Doing so will maximize employee satisfaction and help you avoid a hassle. Allow enough time between shifts for employees to go home and rest, and avoid calling employees back in when they have just finished a shift.

Also, take advantage of the internet to simplify scheduling. Publish schedules online so employees can access them anytime, anywhere. Save time for everybody by letting employees see not just their own schedules, but also who they are working with, open shifts, their PTO balances, etc. Allow employees to request PTO online, avoiding telephone/email tag.

Empower employees

All employees need to feel respected in the workplace. One way managers can respect their employees is by giving them a certain amount of autonomy. Researchers from the University of Birmingham recently found that employee autonomy directly correlates to job satisfaction. For women, in particular, autonomy translates to scheduling and location flexibility.

One way to give employees a sense of autonomy is to allow self-service. Self-service means employees have some control over their schedules, PTO requests, training requirements, and benefits information. This can mean allowing them to change their schedule preferences online, giving them full-time access to their PTO balances, letting them receive notifications whenever extra shifts are available, and setting up automated alerts so they are always aware of their training deadlines. Self-service can also mean enabling employees to request corrections to their attendance records (like forgetting to clock out). When employees have some autonomy, they are more likely to feel respected—and it reduces the administrative burden on managers!

Improve time and attendance

A high turnover rate causes payroll costs from overtime and position vacancies. While overtime can never be eliminated, using an insecure time and

attendance system encourages poor attendance and low-level payroll fraud. Save your agency from additional costs by using a secure time and attendance system.

Biometric fingerprint readers, for example, eliminate the risks of buddy punching and fraud. These errors can add up to 1-3% of an agency’s payroll-related costs. That does not even take into account the lost productivity from payroll calculations and data entry. Since the cost of biometric fingerprint readers has dropped in recent years, they can give agencies a great return on investment.

For in-home programs, where fingerprint scanners are not feasible, telephone timekeeping is effective. Use voice authentication to inhibit buddy punching, and use location-based caller-ID to prevent fraud. Telephone timekeeping also allows for more advanced features, such as no-show alerts and employee HR alerts at clock-in.

Recruit creatively

Another way to cope with the labor shortage is to get creative with recruiting. Since the number of women in the workforce is shrinking, agencies need to expand their horizons when looking for employees.

Millennials are the up-and-coming group to dominate the workforce. According to LinkedIn’s 2015 Talent Trends Report, they will comprise 50% of the workforce by 2020, and 75% within a decade. Millennials like social media, so link to your job applications on Facebook and Twitter. Offer paid or unpaid internships, open houses, and career days to attract job seekers. Also, emphasize your mission – millennials, in particular, want to feel like they are contributing to the greater good at work.

Additionally, find ways to speed up your recruiting process. For example, try using a web-based system to track the entire applicant process. An online system can save you time by automatically notifying passive job seekers of new positions, parsing resumes, and tracking every step of the way, among other things. It can also make the process more intuitive for applicants, which makes a good first impression (millennials, especially, expect clean and user-friendly websites).

While the labor shortage continues, the employment outlook for your agency may appear grim. But even if your agency’s budget isn’t as flexible as you’d like it to be, you can take steps to rise above the competition by attracting and retaining valuable workers.

New Hires

Tips for Competing with Walmart and Others During the Hiring Process

Walmart and other retailers or fast food outlets use aggressive marketing tactics to attract, hire, and retain employees. Agencies must compete with these industries in order to build and retain the best workforce they can.

One way to make your organization stand out among competing employers is to compile a checklist of advantages your agency offers. Communicate these benefits to all prospective new hires through your job listings, and feel free to share with existing employees as well!

Here is a sample list you can use to market your agency for new hires and existing employees:

  • We have a mission to help others
  • The average weekly pay for a direct support professional is ____
  • Minimum 40-hours a week
  • Overtime available
  • Any qualified employee can request extra hours from our website
  • Never miss a shift! We remind you by text of your next shift
  • 150% to 200% extra pay for working on any of the ___ holidays per year
  • Fixed schedule with the option to pick up more hours
  • View your schedule anytime, anywhere
  • See who you are working with
  • Earn paid time off
  • Receive unpaid time off with no penalties
  • Get 6-month reviews
  • Structured career path

Speed Up the Process with myApplicants

The labor shortage has a dramatic effect on human service agencies. Higher turnover and extra overtime make things even harder. In times like this, we know that applicant tracking and onboarding are more important than ever. That’s why MITC is pleased to announce the addition of myApplicants to Agency Workforce Management!

myApplicants is a robust, web-based, end-to-end hiring solution complete with applicant tracking, pre-employment assessments, background checks, and drug screens. It even has the ability to push your new hire data right into MITC Time & Attendance with just a click.

Contact info@mitcsoftware.com or read this free fact sheet for more information on myApplicants.

Fill out the form below to be emailed the download link.


Payroll Costs Rising from the Labor Shortage

Payroll Costs Rising from the Labor Shortage

Services are increasingly getting more expensive to provide thanks in part to ongoing labor woes, according to the latest Cost of Care Survey from insurer Genworth Financial.

The national median cost of home care pay shot up 6.17% to $21.50 per hour, or $4,099 per month, from 2016 to 2017. Among other care settings, this is the most pronounced increase. The cost of home care services, including household tasks, reached a median of $21 per hour, or $3,994 per month. This is a 4.75% increase from last year.

Over five years, the median cost growth rate was 2.5% for home health aide services and 3.08% for homemaker services.

This year’s cost increase was particularly notable, says Gordon Saunders, senior brand marketing manager for Genworth’s U.S. Life Insurance division. Overall, the annual median cost of long-term care services climbed an average of 4.5% from 2016 to 2017. It marks the second-highest yearly increase for nursing homes and home care since the study began in 2004.

“We have become accustomed to seeing steady increases in the cost of long-term care services, but this year, we saw a marked acceleration in the cost of home care over previous years,” Saunders told Home Health Care News. “This is based on external factors in the marketplace related to supply and demand: increasing demand for long term care services as our population ages versus shortage of workers and rising labor costs.”

By comparison, the national median cost for a one-bedroom unit in a private-pay assisted living community reached $3,750 per month, or $45,000 a year. That’s an increase of 3.36% from 2016 to 2017.

National median rates for semi-private room nursing home care increased 4.44% and hit $7,148 per month. Also, private room nursing home care reached $8,121 per month, a 5.50% increase.

Labor Woes Crank Up Costs

The labor shortage isn’t the only factor driving up costs, but it has impacted all care settings, says Saunders.

“[U.S. Dept. of Labor] changes have resulted in minimum wage and overtime protections to more domestic service workers who enable individuals with disabilities and the elderly to continue to live independently in their homes,” Saunders said. “Also contributing to the increase in labor costs is the Affordable Care Act (ACA), which requires employers of a certain size to offer some type of health insurance, or pay a penalty.”

For nursing homes, higher labor expenses and tightening Medicare rules have resulted in shorter hospital stays. Instead, sicker patients are sent to rehab nursing homes for shorter stays, driving up costs, Genworth noted.

Room and board for assisted living communities has risen to accommodate residents who are sick, but not sick enough to require nursing home care. Luxurious amenities commonly found in private pay communities also increased costs of care.

What Agencies Can Do About It

This eBook explains the factors driving the labor shortage, and how a two-pronged approach can minimize the costs for agencies.

Download the new eBook and check out the complete library of ebooks for agencies here.

Millennials

Attracting and Retaining Millennials at Your Agency

According to LinkedIn’s 2015 Talent Trends Report, millennials will comprise half the workforce by the time 2020 rolls around. In less than 10 years, they will make up 75 percent of the workforce. Yet many agencies, despite hiring and retention problems, have not considered the unique opportunities and problems of attracting and retaining this growing segment of the workforce. Who are millennials, and how do agencies make themselves more attractive places for millennials to work?

Who Are Millennials?

There are no precise dates for when the millennial cohort starts or ends, but demographers typically agree that millennials were born between the early 1980s and the mid-1990s or early 2000s.

In reality, there are strong similarities between millennials and the generations that have preceded them: they want security and variety in their career, they want to be stretched and challenged, they want to work for a company of which they can be proud, and they have every intention of being loyal.

But there are many ways in which this growing proportion of the workforce is different. They have strong beliefs and expectations that extend to the workplace.

Where Millennials Want to Work

Data suggests millennials are driving a shift towards the public service sector. In 2010, the Journal of Business and Psychology published a study showing that this age group’s volunteer activity increased almost three times more than the volunteer activity of the overall population between 2007 and 2008. More recently, a 2014 Millennial Impact Report by consulting firm Achieve shows this generation has a high level of interest in public service. Out of the 1,514 employed millennials who were surveyed, 47 percent volunteered for a cause or nonprofit in the past month. The same study shows that 87 percent donated to a nonprofit organization in 2013.

This interest in public service bleeds into choice of work. In a recent Capital One Survey of millennials, 93 percent of respondents think it’s important that their career path that aligns with their personal values. Additionally, a 2013 survey by the National Society of High School Scholars (NSHSS) and a 2011 survey by Universum both show that they prefer to work for companies engaged in the betterment of society.

Political Views

Millennials are the most highly educated and culturally diverse group of all generations. Surveys suggest that their political views are more liberal than previous generations, both socially and economically. According to the Pew Research Center, they are the most likely of any generation to self-identify as liberals, and they are the only generation with a liberal majority. A clear example of this is 2016 presidential election cycle, in which Bernie Sanders was the most popular candidate among 18 to 29-year-olds. In fact, one polling director said of Sanders: “He’s not moving a party to the left. He’s moving a generation to the left.”

Regarding religious beliefs, millennials are less likely to identify with a religion than older generations. A 2014 survey from the Pew Research Center reports that about three-in-ten are unaffiliated with a religion, which is possibly the most of any generation ever recorded.

Use of Technology

Millennials are using technology at unprecedented levels. According to a 2007 survey of students born between 1983-1992, almost all of them owned a computer and a mobile phone. In addition, 76 percent used instant messaging, 40 percent got most of their news from the TV, and 34 percent got most of their news from the internet. This means that, as a generation, millennials are comfortable with technology in all areas of life.

One of the most popular forms of media among millennials is social networking. In fact, a study published in the Elon Journal of Undergraduate Research in 2010 claimed that students who tried to quit social media showed the same withdrawal symptoms of a drug addict quitting a stimulant. Millennials are very active on social networking sites such as Facebook, Twitter, and Instagram. Social media can help them create a sense of belonging, make acquaintances, and remain connected with friends.

12 Tips to Attract Millennials to Your Agency

Employers can take steps to address the needs and preferences of millennials. Consider these 12 tips to ensure your agency is millennial-friendly:

  1. Emphasize your mission. Since many millennials are interested in giving back to the community, encourage them to see work at your agency as an opportunity to do this. Invite them to fundraisers and offer volunteering opportunities. Show them that they can have a positive impact on the world at your agency. This should give agencies a hiring and retention advantage with millennials over other competing employers.
  2. Focus job postings on the greater good. Putting your agency’s work in the context of the global good will help emphasize your mission. Focus your job postings on their importance to the organization and society.
  3. Keeping in touch with millennials is key, whether it’s during the recruiting process or while they’re employed with your organization. According to LinkedIn’s Talent Trends Report, 95 percent of millennials want to hear what you thought about them after the interview. Keep an open line of communication through email or text and provide post-interview feedback opportunities.
  4. Use technology. While older employees may be more comfortable with paper timesheets and schedules, millennials prefer to use technology whenever possible. To appeal to their preferences, post timesheets, schedules, documentation, benefits, and training online. Use automated digital alert systems like next shift reminders, review notifications, or birthday and anniversary greetings to connect with them. Agencies that appear unwilling to adopt technology will not be attractive places for millennials to work.
  5. Be a mentor. Offering guidance is a way to create trust with millennials. To court millennial workers, send regular updates from the hiring manager to people in the application process. If your agency has a mentorship program, call attention to that during the interview process.
  6. Document your procedures. For some, part of the learning process is to learn by doing — to figure out a process that others in the organization already know. But millennials have a different approach to problem solving. They don’t want to “go figure it out” if someone can tell them how to do it more quickly. Set aside the perception that 10 minutes of downloading information is laziness. Allowing them to take it forward will challenge and excite them.
  7. Make work fun and challenging. For millennials, work is supposed to be fun. Keep your employees engaged by giving them more responsibilities so they feel like they are moving somewhere. Millennials love change, so mix it up for them. Also keep in mind that a millennial’s time frame for completing goals is 18 months or less – anything beyond that may not motivate them.
  8. Provide frequent feedback. Millennials enjoy instant gratification, which means they’re always on point to deliver rapidly. As a manager, provide frequent feedback to fill this need.
  9. Promote collaboration and creativity. Both culture and space can contribute to collaboration. In a collaborative culture, managers may encourage staff members to propose new ways of doing things. A collaborative space may be smaller to make interaction easier (e.g. a cozy conference room versus a 20-person boardroom).
  10. Offer individual recognition. While teamwork is meaningful, millennials still want individual attribution. They will embrace the challenge of a single-person task that is part of a larger team project. When they are successful, call them out for a job well done.
  11. Create a work environment that allows a healthy work-life balance. This is one of the things this young generation desires most. Emphasize benefits like PTO. Improving the quality of life both in and out of the office — with social events, benefits, and flexible schedules — will appeal to people looking for more than just a salary.
  12. Avoid an excessively rigorous hiring process. Millennials are informal. Your agency may be weeding out high-potential employees on a regular basis. To avoid this, try to loosen things up a bit. In place of the usual two- or three-round interviews, you can hold professional development classes, host open days, conduct informational sessions, or show potential candidates around the facilities. That way you can let the candidates decide for themselves whether they fit your company’s culture or not.
Strong Job Posting

Four Tips for a Strong Job Posting

A strong job posting is a crucial part of an organization’s hiring process. As the economy improves, organizations are growing more concerned with attracting and retaining talent. In a 2015 study, Travelers created a Business Risk Index Summary. This study found that organizations were more concerned with talent acquisition then they had been the previous year. 53% of businesses surveyed said they worried about attracting talent. Additionally, 14% of organizations felt that organizations were not prepared to cope with the challenges presented by employee acquisition and retention.

Attracting the right employees takes planning, but is something any organization can do. Here are three tips for more effective job postings.

1. Make Sure the Job Title is Descriptive

Indeed.com found that job titles that were descriptive, such as “Marketing and Events Coordinator”, got significantly more traffic than those with less descriptive names, such as “Marketing II”. Make sure the job title both accurately represents the position and avoids generic labels.

2. Have a Realistic and Thorough Job Description

Make sure the job description makes it clear what you expect from a strong applicant, including qualifications, certifications, or availability. The description should include the tasks that the hired candidate will perform on the job.

If you’re looking to hire a person who can lift 200 lbs, be aware that some organizations often use “feminine” language when creating certain job postings. Words like “nurturing” and “caregiving” are often at the forefront, which may not be the image you’re looking to project.

Similarly, avoid emphasizing education or experience requirements unless they are necessary to the position.

3. Make the Online Submission Process Simple

Be clear about required materials, including information on resume format, references, or salary requirements. Make it as easy as possible to submit (ex. allow attachments instead of requiring employees to fill out an online form with information redundant to their resume).

4. Mention Any Non-Pay-Related Perks of the Job

Make sure the post presents your organization in a favorable light and gives the applicant a good idea of company culture.

Pay is not the only factor for employees when considering a job (or changing jobs). If your organization allows flexible schedules, the ability for employees to apply for opens shifts internally, or a strong benefits package, be sure to emphasize those facts in the job posting.

Staffing Survey

Agency Staffing Survey Reveals Acute Labor Shortage

MITC recently conducted a staffing survey of 137 agencies employing nearly 40 thousand people across the United States. The results showed a severe shortage of direct service professionals (DSPs). As they struggle to deliver vital services to a vulnerable population, agencies are looking for ways to hire more employees and retain the ones they have.

Across the board, from smaller agencies with less than 50 employees to the largest providers with over 2,800 employees, agencies reported an excessive number of open positions, primarily for DSPs. The average agency employed 320 people when fully staffed and had 25 open positions (nearly 8 percent). The total number of open positions was over 3 thousand.

The Hidden Costs of a Labor Shortage

An employee shortage is not just inconvenient; it is costly. For example, agencies have responded to the shortage by authorizing more overtime. Of the agencies who participated in the survey, 65 percent reported overtime was higher than they wanted.

Overtime is not the only cost of the labor shortage. Turnover costs money, both directly and indirectly. Direct costs include overtime, lost billing if services cannot be delivered, recruitment activities, and fill-in staffing. Indirect costs include lost productivity while managers are busy interviewing and training new employees. Less obvious, but no less costly, are the negative impacts to staff morale and performance, which can lead to diminished quality of client care. Among the survey respondents, turnover rates varied quite a bit. For example, agencies in Maryland, New York, and Pennsylvania reported turnover rates under 10 percent, while some agencies the Carolinas, Indiana, and Illinois reported DSP turnover rates as high as 80 percent. This is not surprising, since the states with the lower turnover rates are able pay about 20 percent more for DSPs.

As if the shortage isn’t difficult enough, agencies also reported problems with the quality of applicants among those who are available. Common problems were applicants who failed drug or background checks, had no relevant skill sets, failed to complete training, had poor concepts of attendance responsibilities, or did not show up for interviews/training.

Ways to Improve Retention and Hiring Rates

Almost all agencies participating in the survey have already taken steps to improve their hiring and retention rates. These steps include:

  • Better applicant screening to concentrate resources on those most likely to stay
  • Annual review of retention and on-boarding process
  • Improved, more organized on-board training
  • Working with local colleges, such as nursing schools
  • Emphasizing total compensation value, rather than hourly rate
  • Developing career ladders
  • Referral bonuses and new hire bonuses
  • Graduated pay scales
  • Early access to benefits
  • Mentoring/buddy programs
  • Contests and awards
  • Employee appreciation days and events
  • Monthly staff newsletter
  • Shift differentials
  • Profit sharing

In addition to these things, agencies can focus on several areas to increase retention and attract workers.

Follow Good Scheduling Practices

One of the biggest complaints employees have is lack of advance notification for schedules. Poor scheduling or last minute changes can cause conflicts with your employees’ home lives. A DSP will be much less motivated to show up if they are constantly being rescheduled, especially at short notice. Frequent rescheduling leads to a culture of frustration and uncertainty in your workforce, and it encourages absenteeism and turnover.

When scheduling employees, it is important to track their preferences and restrictions. This will help you avoid calling them in to cover shifts they can’t take. Capture these preferences during the new hire process. Also, allow enough time between shifts for employees to rest, and avoid calling employees who have just finished a shift back in. Also, planning for holidays well in advance can avoid disruption and lead to better attendance.

Good scheduling practices, together with an accurate time & attendance system, help your agency track frequent offenders who regularly show up late, leave early, or call in sick. These employees set a bad example to others, causing lower productivity and more overtime.

Of all the agencies that participated in the staffing survey, 42 percent are considering new scheduling systems. Additionally, agencies reported that they had already changed some of their scheduling practices by:

  • Investing in new scheduling software
  • Allowing flexibility in how different sites schedule staff
  • Introducing rotating weekend shifts (one on, one off)
  • Creating more full-time positions
  • Increasing the number of part-time staff
  • Creating scheduler position(s)
  • Monitoring hours to ensure employees get breaks
  • Scheduling longer shifts on fewer days
  • Using salaried staff to cover open shifts

Empower Employees Through Self-Service

Employee self-service refers to a system that gives employees a certain amount of autonomy. For example, an online self-service system allows employees to see their schedules, who they are working with, which shifts are open, their PTO balances, and more. This saves time for you and your staff. It also reduces the amount of phone calls and emails between you.

Another popular self-service feature is an automated text or email alert system to remind employees about licenses, training deadlines, upcoming reviews, and more. An alert system can also send birthday and anniversary greetings or HR updates. It can improve communication between employees and managers, too, by sending notices when PTO is requested or approved. Using text/email reminders to notify employees of their next shifts can also reduce absenteeism and helps motivate employees. On the same token, including a digital checklist to assign duties helps employees know what they are meant to do; this is especially helpful if an employee is covering a shift for someone else.

Recognize Excellent Employees

Employees like to feel like their hard work is being rewarded. To do this, make sure your agency provides clear career paths for DSPs. Give them written guidelines on what factors will help them advance, such as good attendance records. Reward hard-working DSPs by gradually increasing their responsibilities. A DSP who has advanced from an entry-level position to a manager role is more likely to be loyal than one who has done the same job for years. For this reason, try to promote from within your agency workforce, rather than recruiting outsiders.

Also, employees want to know where they could be headed and how they can get there. Annual reviews or mid-year check-ins are one obvious venue for these discussions, but also encourage workers to come to HR with career questions and wishes throughout the year.

When excellent employees leave your organization, conduct exit interviews. You may even consider asking longer-tenured employees why they stay. Ask questions such as: Why did you come to work here? Why have you stayed? What would make you leave? What are your non-negotiable issues? How about your managers? What would you change or improve?

While there are no quick fixes for overtime or turnover, making a few key changes can increase caregiver retention and help alleviate the challenges agencies face by caregiver shortages.