Finding Staff for Your Assisted Living Home

The success of your Residential Assisted Living business is dependent on so much more than simply the passion you have and the great ideas you want to implement in it. There are various types of differing roles that need to be filled and so many tasks to accomplish that unless you are Superman, you’re going to need a lot of help. And since you can’t be everywhere all the time, it is of vital importance to surround yourself with staff that you can trust to carry out the tasks that need to get done with the level of excellence that you require.

Whether you are a hands-on owner and operator of a RAL or you have a more hands-off approach and are competent in delegating and evaluating your employees, your staff is the face of your business. They are the front-door representatives of your residential assisted living home, not only to the residents and their families, but to your surrounding community and the success of your business is largely dependent on them.

This is why it is so important to take proper measures in ensuring that you find and hire the right people for the right roles in your business and that you do everything you can to assist in their development so that they remain loyal to your cause and you can depend on them for years to come. In this article, we will highlight some of the key steps to finding, interviewing, hiring, developing and evaluating qualified employees for your residential assisted living business. Here at the RAL Academy, we want you to succeed and we want you to find the best people you can to help move your residential assisted living home forward so that you can provide our nation’s seniors with the most excellent care available in the assisted living industry.

Before we get into all the specifics concerning locating and hiring employees, as a residential assisted living business owner you should first know the kind of help you would be needing for your home. There are so many different ways that people have opened and run assisted living facilities in the U.S., from the hospital-like big-box facilities to the small mom-and-pop style homes, there are various systems that have shown to be effective, some more than others. But just so you know all of the different options that are out there, the following are numerous types of care workers that can be found in various types of assisted living facilities across the country. Although you will not necessarily be interested in many of these types of care workers, it is good to know the options that are available and among this broad spectrum of care workers you will undoubtedly find just the ones that suit your business and the goals of your assisted living facility.

Types of Care Workers that You Could Have on Your Payroll

Personal Care Assistants (PCAs)

The PCAs are usually not certified and can have a varying level of experience. This would be dependent on the years they have spent in the industry before coming to be of service to you. The job description of a PCA involves holding conversations with the patients, providing companionship and walking them. They can also get involved in chores and activities such as general hygiene and clean-up (bathing, using the toilet, etc.), offering transportation to appointments, helping them go shopping and so much more. Before you hire a PCA-type worker, it would be beneficial to check the provisions concerning their employment in your state. Some states require that PCAs have a training while the rules are lax in other states. Ensure you keep to all formal requirements, and you’ll be good to go. For in-home care it is worth noting that PCAs are usually not covered under insurance, and are mostly placed on wages (hourly, daily, weekly, etc.).

Home Health Aides (HHAs)

Unlike the PCAs, HHAs have to be trained and certified before they can get into this service. Like previously mentioned, it is also good to check the state laws regarding home health aides to know what to look out for before hiring. Their job description is one that also requires assisting with parts of daily living such as bathing, dressing up and using the bathroom. Besides that, though, HHAs are trained to monitor the patient’s vitals and observe their conditions to ensure they are kept in the best of health.

Licensed Nursing Assistants (LNAs or CNAs)

The certification level of a Licensed (or Certified) Nursing Assistant is much higher, and that reflects in the added importance of their job type. The personal care provided by certified nursing assistants, and personal attendants is vital to the welfare of residents of assisted living housing. CNAs help with personal care duties that can include bathing, toileting, dressing and mobility. They are tasked with critically monitoring of the patient’s vitals and signs, and are trained to watch for health changes and to report their concerns when issues arise that could compromise patent safety and welfare. For example, when an assisted living resident stops eating or refuses to get out of bed, the CNA alerts the nursing supervisor, who then can arrange for medical tests or transport to the hospital. They are also well versed in the art of setting up medical equipment, changing dressings, taking care of infections and offering more intensive, health-based care to the patient. If there is a medical procedure to be performed, it is the job of the LNA to notify and assist a Registered Nurse to get that done. Otherwise, they can go on assisting the patient in any other way necessary.

Skilled Nursing Providers (SNPs)

Like the previous category, SNPs must meet the federal standard for health and safety, then be licensed by the state they will be practicing in. After years of training and education they are able to offer care services and direct medical care that cannot be provided by any of the professionals listed above this category. Training makes them equipped to administer drugs and shots, changing wound dressings, caring for diabetes patients and providing education for the caregiver and patient, as well as many other medical intensive care tasks. Some of these professionals have added skills to buffer their trade. It is, thus, not surprising to see a SNP with extra skills in occupational, physical and/ or speech therapy.

Registered Nurses (RNs)

RNs probably don’t need much of an introduction and don’t often find themselves in assisted living facilities, but depending on the scope of the facility, they can be employed in senior care and deserve to be mentioned as well. These professionals hold a diploma or degree that allows them practice in the medical field. They have passed all of the exams and licensing requirements from the board of nursing in their state or the state where they wish to practice in. Their job involves providing direct medical care when they can or assisting doctors in more advanced procedures. They also offer guidance to family members in addition to operating intricate medical equipment and administering regulatory level medications. Smaller assisted living facilities or those that focus on cost-cutting measures often use visiting nurses or part-time RNs to oversee the nursing assistants and check on residents. Larger assisted living facilities maintain full-time nursing shifts. CNAs must work under a registered nurse’s supervision, so on-site nurses may be needed to provide more intensive oversight of skilled nursing assistant staff and orderlies. At the same time, facilities that house a range of residents with mental and physical disabilities tend to keep at least one nurse on-site at all times.

The Important Thing Is to Find the Right Staff to Fit Your Specific Needs

Although the latter few occupational health workers will probably not feature in many of your assisted living facilities, knowing the various levels of care and medical professionals that are out there can help inform you as you seek to find the right staff with the right qualifications that will meet your needs. And if you are an owner or operator of an assisted living home or facility, having a more thorough knowledge of the experience, education and training required in the various roles of these care service professionals will only show greater confidence and proficiency to prospective employees as you sit down to interview with them. Another key reason these care professionals were mentioned is that, although you may not hire them as regular employees in your assisted living homes, you may hire them occasionally as independent contractors to come in and meet with or educate your residence and their families on specific health topics, which can only serve to boost your marketability as a superior care facility to your surrounding community.

Know What You Need

Now that we have discussed the various types of care professionals in this industry, it’s time to assess your own residential assisted living operation and determine which types of care professionals will best fit your needs. Depending on the kind of care home that you want to run, you might not need many of the kinds of personnel we have listed above.

The first step you want to take is to determine what type of housing and assistance level you want to provide for your residents. There such a broad spectrum of care and assistance needed by seniors, but the beauty of residential assisted living is that as an independent owner and operator, you get to determine what types of residents you want to care for and what levels of care you want to hire staff for. Just because there are seniors in your community who may require more advanced levels of assistance, does not mean that you necessarily need to cater to that level of clientele.

When people in the general population talk about senior housing or assisted living it is usually all lumped together in one definition with the image of a large hospital-like facility in mind. But that is just not a very good explanation of what assisted living is, nor is it what we as a society should be striving for in caring for our senior population. In this industry, one of the most common ways that we classify senior housing is by the levels of assistance provided. Not all seniors are created equal and not all senior housing needs to be equal either. For example, an active 75-year-old will not need the same kind of support and daily assistance as a much less active 90-year-old with numerous health conditions might. Just as not all seniors are alike, not all who are looking for senior housing are alike either. So as someone who is running their own assisted living business, it is extremely beneficial to know the market and exactly what part of that market you are striving to cater to.

For our purposes here in this resource, there are five basic levels of care and services provided to seniors: senior apartments, independent living, traditional assisted living, memory care, and skilled nursing. All of these types of senior care have specific levels of assistance and depending on the facility in question, many of the services provided under these five levels can overlap in interchange. But for the most part, many of you reading this article will be primarily interested in focusing on the traditional assisted living and memory care models. However, understanding the less intensive and more intensive care models on either side of the spectrum can help inform you of where to market and search for new residents as well as where to refer existing residents whose assistance needs have developed beyond the scope of your assisted living home.

The ‘personal care services’ section illustrated in the image above can be understood in terms of activities of daily living, or ADLs. This is the main area that differentiates independent living from assisted living and involve such activities as:

• Bathing: personal hygiene and grooming
• Dressing: help with dressing and undressing
• Eating: preparing food, feeding and clean up after
• Transferring: assistance with movement and mobility
• Toileting: continence-related tasks including control and hygiene

Whether you are a caregiver, a RAL manager, a RAL owner or simply an investor in the business, understanding the needs of the residents in each type of senior housing business model is important for determining your vision, evaluation and ultimately the success of your RAL home. For example, if the majority of seniors in your surrounding community require a certain level of care, but you have defined the vision of your RAL home to be set up to meet a different level of need, then you might find it hard to fill and keep your home filled. Knowing the options out there and understanding the market of your immediate community will go a long way to determining your success in this business. There are so many ways for a person to invest their time, talent and finances into senior care and is crucial to understand the basic types of facility and community in which you choose to invest yourself.

Once you’ve decided which type of senior care facility aligns with your goals in this industry and once you have determined the level of care you want your facility to provide, you can then make informed decisions about what types of employees will help you achieve those goals. You aren’t going to want to have employees on your payroll that are far more qualified than the job that you have employed them to do, because you will probably be paying far more in wages than you need to and employees who understand their value as being much greater than their current employment won’t take long before they look for a different job. On the other hand, hiring employees who are not qualified to do what you expect of them is also not a good option because it will hurt your business and it isn’t fair to expect employees to accomplish tasks beyond their training and ability. It is all about finding the right tool for the right job.

Of the five different types of care workers that we discussed previously, the average residential assisted living business owner is probably going to want to focus on the first two categories of care workers, personal care assistants and home health aides. In the level of training and expertise for these caregivers will depend on your state and local regulations so it is important to find out exactly what is required in your particular case. Some of the roles you will be hiring for demand special licensing and certifications. So to be on the safe side, check with your state laws to know what is required. Knowing these regulations will also help winnow out prospective employees so you don’t waste your time pursuing and interviewing potential candidates who don’t actually meet the requirements of your assisted living facility.

Look for Experience

Although, it is not always a bad idea to hire marginally less experienced workers, as you can train and develop them into exactly what you’re looking for, but there are many advantages to experience that you just cannot beat. Plus, depending on your residential assisted living home’s level of assistance and the state or local regulations concerning training and certification for care staff, you will probably want to error on the side of more experienced and qualified from the start. Look to see perspective care staff who has spent a few years in the assisted living industry. On the other hand, if your residential assisted living business is relatively new or funds are limited, you might not want to seek care staff with decades of experience as these employees will likely cost significantly more than similarly qualified individuals with only a handful of years in their work history. In fact, there are some states who have very little regulation in terms of what qualifications and certifications care staff possess, and in these cases if you have the desire to start from the ground up and are willing to be patient and pay for new employees to be fully trained, that is also an option to consider. There are numerous organizations that you can find online who train and educate care staff and it is only a matter of resources and time to develop a team around you that facilitates care that meets the standards you have set.

In the end it is all dependent on your goals with your assisted living homes. Here are the RAL Academy, we encourage you to seek excellence and superior standards of care and every element of your assisted living business, however, we realize that there are periods of development that take time to reach her goals. If you are able to find staff, specifically caregivers, who have 3 to 5 years of experience and are dependable, genuinely care about your residents, meet the state and local qualifications and are on board in adopting your mission and goals for your care facility, that is probably a great place to start; besides the fact that they will know what to do right out of the gate.

It is also worth remembering to look to employ more staff than you need at any one time. Having the minimum number of care staff needed to run your operation might become problematic when one or more of them is sick or unable to work, so having alternate options at your disposal is going to ensure that you don’t have any lapse in care when some staff are inevitably unable to fulfill their shifts. Another concept that is worth looking into is the idea of mentorship. When you hire alternate staff to fill in for your regular staff, it might be easier to choose less experienced individuals who, over time, can work alongside more experienced staff and learn from them on the job; almost like hiring an understudy. These less experienced individuals, who are often more plentiful and easier to find in the job market, will grow and develop with the potential to take over and keep running the business in years to come. And because you took a chance on a more inexperienced care worker, and used to resources to develop their ability and help them move forward in their career, there is a greater chance that they will repay you with years of loyalty. After all, most of us at some stage in our professional careers were very inexperienced and along the way someone took a chance on us.

Type of Employees that Work in Assisted Living

So, what types of roles are we looking to fill in our assisted living homes?

It is good to start with the assisted living home manager. Whether you are hands-off or hands-on in your assisted living homes, this is the person that is going to have the most responsibility. They are going to be overseeing day-to-day operations, interacting with residents and their families, setting and maintaining the standards that align with your goals is a RAL owner. In many cases, when the RAL owner has a more hands-off approach to the business, the manager can be responsible for finding, interviewing, hiring, evaluating and firing staff. They can also be responsible for marketing your RAL business and finding new residents when there are beds that need to be filled.

So, what quality should a manager have?

You are looking for somebody who is in control, who can take a system and implement it. Somebody who is genuinely nice to their family, to their spouse, their coworkers. If they are the manager, they need to be fair, but firm with their caregivers underneath them. The manager is responsible for managing the caregivers, doing things like hiring and firing, scheduling, giving somebody a day off when they need it or requiring them to take a day off when they need it.

Managers need to be personal. Those interpersonal relationships are the hardest thing of all to teach and train. At the RAL Academy, we actually provide a whole training course on how to hire a manager, exactly what to look for and exactly what to avoid. If the caregivers are the heart of your organization the manager is the head and overseas the caregivers, providing vision and direction. The manager needs to have experience in human resources as they are responsible for finding, training and retaining caregiving staff. they also need to have the ability to fill the home by attracting new residents, giving tours and developing relationships with prospective residents and their families. When they interact with potential residents they need to have the interpersonal skills to help the seniors and their families feel at ease and comfortable with the living situation that is provided, as well as fostering a comfortable relationship between residents and caregivers. Ultimately, the manager is continually dealing with people, whether communicating with residents, caregivers, the families of residents, outside contractors or suppliers, the ideal candidate needs to be a real people person.

In addition to the relational aspects of the job, the manager also needs to be fairly detail oriented, making sure all the i’s are dotted and the t’s are crossed. They are responsible for keeping records, keeping stock of all necessary products and supplies, contracting maintenance and other services, as well as many other important details. While it is not always easy to find someone who excels at interpersonal communication as well as being extremely detailed, these people do exist and it is just a matter of finding them. Although, it is worthy to note that if, in your search for qualified candidates, you had to error on one side or the other, the far more important skill would be to have excellent interpersonal communication skills.

In addition to the skilled help they receive from trained caregivers, senior residents appreciate all the activities available in assisted living facilities. Depending on how you choose to set up your residential assisted living home, an effective manager can also be responsible for making sure residents have plenty to do. Organizing group activities like yoga, exercise, arts and crafts, karaoke, movie nights, bingo and card games, as well as visits from volunteers to provide entertainment for residents, are also ways to stimulate your residents and add value to the marketing of your RAL home. And depending on the mobility of your residents and the availability of convenient transportation, the manager can also organize off-site trips to museums, theaters and shopping, which are activities that can really benefit your residents.

The next most important role we are looking to fill in our assisted living home is our caregivers. So what kind of qualities should these caregivers have?

It takes a special kind of person to become a caregiver. Not only does it require a compassionate heart and a temperament that is prone to patience, a caregiver must also meet specific standards and possess skills unique to the medical care industry. Caregiving requires excellent communication skills, a dedicated commitment to resident’s health and safety and the ability to be continually flexible in an unpredictable environment.

Being an effective caregiver takes training and the right mindset. The truth is most of us are not innately equipped to take up the great responsibility of caring for others in such a continuous and intimate manner, so finding people who have these important qualifications is critical to being successful in the residential assisted living space. So, if you are looking to secure qualified staff for your residential assisted living home, or if you are a manager or caregiver and are looking for tips on how to become more effective, the information we will discuss further in this article might be helpful to you.

The bottom line is the individuals or directly providing care in your assisted living home are the most important link to your overall success. Skilled, loving, certified and dependable caregivers are the key to a well-run operation. Caregivers are the heart and soul of any quality residential assisted living home. Depending on the state, there will be certain qualifications and training that caregivers must have. In some states these qualifications are minimal and in others the requirements are more rigorous, so it is important to know what regulations exist in your state. And remember, as a RAL owner you are entitled to holding your staff to a higher standard if your states regulations are minimal. After all, your reputation in this industry is critical for success. You want your RAL to be known as a place that employees the best caregivers who provide superior care to your residents. Regardless of what the state requires, we want to make sure that they are the right person for us, how they treat the resident, how they look for solutions when problems arise, how they work with and take direction from the manager.

While most people who live in a residential assisted living home need help with basic living skills, they do not need constant medical oversight. The primary difference between an assisted living facility and a more intensive nursing home is that assisted living residents do not require round-the-clock monitoring for major illnesses and disabilities. For many seniors, assisted living is the ideal option for those who have problems with mobility but cannot arrange for help in their homes, and the added bonus is that this living arrangement also benefits people who prefer to live in a social setting in their senior years.

In addition to finding quality managers and caregivers, it is also important to find good independent contractors when outside help is needed for things like maintenance or a specific service you hire to for your residents. We want contractors with the right attitude, who understand the importance of what we do. Professionals who, when they’re on the job and on our premise, whether dealing with our residents or staff, that they do it with respect, high quality, the best attitude possible. An ideal assisted living home provides a safe environment for its often vulnerable residents. It relies on adequate maintenance and a housekeeping staff to make sure the building is free of hazards, such as cracked sidewalks and burned out lighting. Having a reliable maintenance worker or handyman that you can call at any time to address issues with the property is a must. Or if you prefer, it could be a number of independent contractors and handymen who are able to fix and maintain specific areas of your assisted living home.

Keeping the home in good shape and the cleanliness of the facility is vital for ensuring the health of your residents and preventing the spread of infections. The housekeeping staff cleans rooms and hallways, keeps the facility free of food and debris to avoid attracting rodents and insects and ensures that floors and walkways are safe and dry. In a large portion of residential assisted living homes, the caregivers share many of the housekeeping duties. Although it is always beneficial if you have the financial freedom to hire an individual or a team of individuals to tackle all of the housekeeping duties so that your caregivers can focus more of their time and expertise on your residents.

There is a lot that goes into finding the right people to work in our residential assisted living homes and because they’re play such a big role in our success we want to focus on doing it right the first time. Now that we have discussed some of the general qualifications we are looking for let’s talk about the specifics of how to go about finding and hiring the right people.

Home Care Employment Agencies

While many who start residential assisted living homes do so in a more independent entrepreneurial manner, many benefits can be found by eliciting the help of large organizational employment services.  Home care employment agencies give referrals to people seeking home care nurses and health aides. Clients may contact, hire and pay caregivers directly. When you directly hire home care workers, the advantage of working with a reputable home care employment agency is that they’ve screened each person in their database. Additionally, home care employment agencies may also provide worker training and occasional on-the-job supervision. Ideally a home care agency becomes a family’s trusted partner for senior care. When you meet with the administrator, getting answers to many important questions can help you avoid choosing a mismatch or substandard care.

What is the administrator’s background? All sorts of people direct home care agencies, and some are more qualified than others. A director’s duties are important and diverse: setting the agency’s policies, managing the employees, negotiating with insurance companies, ensuring compliance with healthcare laws, and more. Many states require that two people serve as an agency’s administrators.

The most appropriate educational background for a home care agency leader is in healthcare administration or public health. Typically, an administrator has a master’s degree, but competence for the role is certainly possible with a bachelor’s degree plus work experience. Longtime healthcare professionals such as RNs and psychologists also move into administrative positions.

The best home care agencies are led by people with relevant training and a genuine commitment to human well-being. If you get the sense that money is the manager’s main motivator, then it is probably time to ease your way out of the interview.

Is the agency Medicare certified? To receive Medicare coverage for home care, a patient needs to work with a Medicare Certified Home Health Agency (CHHA).

Is the agency licensed by the state? Not all states have industry-specific licenses for home care agencies. If your state has the option, choose a state licensed home care agency for assurance that state standards are met.

Does the agency carry insurance? Choose an agency that has its caregivers bonded and insured. A well-run agency also has professional liability insurance and general liability insurance.

What services are available? Home care agencies may provide medical services, non-medical services or both. Confirm that the desired services are available. For example, not every state-licensed center has an RN on call 24/7. Some, but not all, have caregivers trained in speech therapy, physical therapy, Alzheimer’s therapy or memory care, and other healthcare specialties.

How are the caregivers trained? The best home care agencies have extensive orientations for caregivers and provide continuing education. One essential part of caregiving is effectively handling emergencies, so be sure to ask if emergency training is included in employee orientation. (Are employees trained in fire safety? Do they know the Heimlich maneuver and CPR?) Continuing education lets caregivers build their healthcare skill sets and stay up-to-date with best practices in home care.

How thorough are the agency’s background checks? Effectively vetting a potential employee involves talking with their previous employer and other references. It also involves getting a full criminal background check to be aware of any felonies, misdemeanors and driving violations.

How many caregivers are assigned to each client? The best home care agencies assign more than one caregiver to each client. Because two or three people become regular visitors, a worker familiar to the senior is available even if one person takes time off or leaves the agency.

If the senior is unhappy with a caregiver, can another worker take the shift? You might also ask the director to explain their procedure for matching clients with caregivers.

How are caregivers managed? When caregivers are treated well, their patients can benefit. Before hiring a home care agency, observe how the management interacts with staff. Ask the director how the agency motivates its workers and recognizes great work.

Also ask about employee supervision and evaluation. Directors should occasionally observe their employees in the field, preferably unannounced to help ensure quality control.

Advertise & Leverage Your Connections

There is no better way to get your first stream of applicants than putting it out there that you are actively looking for caregivers. Use all the mediums at your disposal to get the word out: social media, job websites, your personal website and your network of caregivers, if you have one. Employee recruitment and retention has been an issue in the senior housing industry for some time and the more you can do to get your brand out there, the better off you will be when it comes to finding and retaining the right staff. When using online media, just be aware that taking your ads to sources like Craigslist might generate a lot of interest from individuals who may not meet the standards that you’re hoping for. When posting your job ads, do your best to ensure they are put in the right places so they can be seen by the right eyes. Advertising at CNA schools, for example, will bring qualified and trained caregivers to your door, but these more experienced and medically trained staff will be looking for a certain level of compensation that might be beyond what you are ready to offer at the moment.

When advertising the position, don’t be afraid to get salesy, but not too much that it becomes unprofessional. Quality caregivers know their worth, so throw in descriptions of the benefits you will offer, such as:Great pay

• Flexible working hours
• Optimum working conditions
• Possible health benefits
• Potential training certification to advance their career
• Possible bonus programs, etc.

Overall, you want to make sure the ad is kept short, sweet and straight to the point because most people who are looking for a job are going to be scouring numerous employment resources in high volumes, so having an ad that jumps out and grabs their attention will only help you find the right people faster. And an important tip for those marketing with online sources, make sure to do what you can to separate the careers pages for jobseekers from the marketing for new residents. Because as a business, you don’t want potential residents or families of residents to go to your webpage or Facebook page and immediately see that you are looking to hire 10 new care staff. It just would not set the right message.

Another potential employee source might just be right in your nose. One way to identify employees who are most likely to stay with a senior living organization for the long-term is to turn to that organization’s current staff members. Leverage all of your connections within the assisted living space. Look at the employees who have been brought into your community that have had the most success in integrating into the company’s culture, and follow the connections that led them to being recruited in the first place. It is safe to say that a large portion of those who have been employed in assisted living, at some point were referred to the job by an existing resident, employee or other individual somehow related to assisted living. So do your best to make the most of those connections and you just might find staff with even greater loyalty than you were expecting.

Residential assisted living home owners should also be aware of their public image. Pay closer attention to company review sites like Glassdoor, which is kind of like a Yelp for employers, where current and former employees can openly have their say about your business for all to see. Many smaller RAL businesses won’t really be large enough to have to deal with that, but if you are in assisted living business that has made a name in your community, it is worth knowing what perceptions the public might have about your business.

A final point about using the right resources to find the right staff… Don’t forget to consider looking outside the senior living industry for your next employees. Many assisted living owners and businesses, large and small, can be hesitant to recruit employees from other industries, but this doesn’t necessarily need to be the case. Although this is a very skill-specific industry, it is also a very inward-looking industry, and we just might be far too limiting with our options for prospective employees. We want competent and capable staff who have the training and certification to be able to do their job with excellence right out of the gate, but some of your best and most loyal employees just might come from people who aren’t already in the industry, people who were caring, eager and ready to learn what you have to teach them. In these cases, it is advised to partner with training organizations in your local area to help assist these relatively inexperienced new hires to get the training certification they need. If you are willing to invest in people, they will be much more willing to invest in your mission and vision for your business, and they will probably end up remaining with you a lot longer.

Making the Initial Connections

The key to hiring staff for your RAL is not just getting a caregiver or a manager, but finding the best ones, the right ones, attracting them, training them and retaining them. There are so many potential employees out there, and because the people that you choose will become the voice and face of your organization, sifting through the masses and finding the gems is critical for success. With most elements of society moving more toward online activity, being able to do initial interviews over Skype can save you time and increase the number of potential caregivers that you can filter through. There are numerous placement agencies and online resources to help find potentially qualified employees near you and most of your initial evaluation can be done online. You will, however, want to hold interviews in person as you near the latter stages of the interview process in order to get a better sense of the individual and how they interact with others.

During the preliminary and latter stages of employee interviews, you’ll want to be prepared with more than just standard interview questions and delve into inquiries like, “how would you handle this particular situation? What would you say to this? What do you see as your biggest strength and what do you see as your biggest weakness?” These questions should be gleaned from your experience in the residential assisted living environment and what concerns and issues you have seen in your time working with residents. What you are looking for is how they respond, as you are looking them in the eye and getting a feel for them, you don’t even need to be in the same room. Do they understand what I’m saying?  Do they really have a genuine response or are they just saying what they think I want to hear?

Interviewing Candidates

The following tips and interview questions may be helpful as you hire home care workers, and remember to clarify your needs when interviewing caregivers.

1. List the specific areas in which help is needed. Some possibilities:
Personal Care: bathing, dressing, eating, dressing, using the toilet, lifting out of bed
Homemaking: preparing meals, cleaning, washing laundry, buying groceries
Medical Care: managing medication, physical therapy, intravenous treatments, dialysis, physician’s appointments
Emotional Care: companionship, conversation, enriching activities

2. Calculate how many hours of care are needed daily or weekly. How long is each shift?

3. Decide how much you will pay per hour. Also list any special benefits of the job. For help determining your pay rate, research the wages offered by local home care agencies. Also put yourself in the worker’s shoes, paying the local norm isn’t necessarily fair to the employee, and it’s doesn’t serve your best interest as a RAL owner.

Living on market rates can be especially stressful for entry-level home care workers. If the market rate is just $10/hr in your town, then a full-time worker would take home just $1600/month before taxes. Their annual income would be so low that they would qualify for federal assistance. If home care workers our living on such fine margins, they probably won’t be able to keep up a high level of care for long. When setting a rate, put yourself in the worker’s shoes.

Employment benefits can make your job offer more attractive. Home health care agencies typically offer health care and other benefits to their employees. A few examples of benefits you might offer:

• Meals
• Paid vacation days
• Paid sick days
• Dental insurance
• Health insurance
• Travel opportunities
• Tuition for healthcare education

Figure out how you’ll make payments and comply with the law. When you hire home health workers directly, you need to report the expense to the Internal Revenue Service. Reporting the work may bring tax deductions, plus it gives social security benefits to the employee. For more details, visit the IRS publications page. Finally, write an employment contract to protect yourself and your employees. It’s wise to first have a trial agreement, e.g., for 30 days.

Preliminary Interview by Phone

Before meeting a job applicant in person, interview him or her by phone or over Skype. This can be a great time saver. Covering the following topics in a preliminary interview might rule out a number of applicants and save you lots of time.

• Work hours
• Relevant training and work experience
• Access to transportation
• Why the person is interested in the job

If the preliminary interview is to your liking, then arrange to meet in person. Some employers find that it is a good idea to have the initial meeting in a public place unless you already trust the individual based on a friend’s recommendation. Ask the applicant to bring a photo ID, their job history or resume, contacts for references and any other documentation that you might find useful.

Full Interview in Person

Although there is no set list of interview questions that must be asked, below are some of the many questions that are ideal for most care worker environments. Remember that the main tasks of your interview are: presenting your needs, understanding the applicant’s skills and qualifications, explaining the compensation and deciding whether the applicant is a good match for your residents and families.

When appropriate, you can also have your seniors interact with the interviewee before or after the interview to get a better sense of how they well communicate with your residents. This is easily done if you feel comfortable having the interview at your residential assisted living home. The following questions are key to any caregiver interview. Consider amending them and adding any additional questions that you feel would be helpful to the process.

• Why are you working in home eldercare?
• What is your work experience as a caregiver?
• What do you like about assisted living?
• What are the greatest challenges of home care work?
• Why did you leave your previous job?
• What is your favorite part of the job?
• What is your least favorite part of the job?
• Do you have any other special skill that would be helpful to know about?
• Can you provide documentation of your health status including immunizations?
• Can you provide documentation of your relevant training?
• Are you capable of executing these duties? (List out what you expect from them and make sure they not only understand, but are willing and capable to take on the job).
• What do you think makes for a good work experience and environment?
• Are you certified in CPR or willing to become certified?
• How do you prefer to receive feedback? Would you be comfortable with a weekly or monthly check-in about progress and any problems?

It is a challenging thing to get to know someone really well in a short amount of time, but there is a lot you can glean about a person if you are observant and are equipped with the right questions and answers. After gathering all of the pertinent information you can from their background checks and credentials, it is time for a talk with your preferred candidates.

We generally recommend having three different interviews for your referred candidate. They should go on the lines of:

• A phone interview – This is not the main thing, and should not be treated as such. The importance of a phone interview is to establish contact with the candidate, know a little about them and determine if they meet all the basic requirements you are looking for before you invite them over for an in-person interview.
  
• In-person interview – At this point, only those who have passed the test above are invited for a sit-down. You get to meet them and ask all the relevant questions that will help you determine whether or not they are a good fit for your company.
  
• Second in-person interview – The fact that a person impressed when you interviewed them might not mean that they will be great with the clients too, and vice versa. Thus, give everyone a benefit of the doubt and let them come back for another interview where they meet an older person they will most likely be working with. See how that pans out and you will usually be able to make your pick based on the interaction that happens before your eyes.

After the Interview

Following a positive interview, here are steps you can take to help ensure an effective home care agreement.

Call the job applicant’s references. There will always be a few bad eggs in any business who will take advantage of the employer and or the clients. That is not to say you can always weed them out, but a simple call to references will help you find the right ones most of the time. If you have someone who is unwilling to submit their references, that is a red flag that you should not ignore. No matter how good the rest of their credentials look, stay away. Previous employers and other references might confirm your impressions of the individual, or they might share other “red flags” that you missed. When you speak with other employers, ask about the worker’s punctuality and work quality. Ask why the person no longer holds that job position.

Consider paying for a criminal background check. Another service you can use to check for criminal records and past behavior is Intelius or SentryLink. If they have any dark records, you can be sure to come up with those here. Ask your local police station for guidance to get an accurate report. Many companies offer background checks via smartphone apps or the web, but their reports can be misleading. Some RAL owners might find this step a little intimidating, but it is worth remembering that these potential employees are the face of your business and are responsible for ensuring your resident’s health and safety.

Make the job offer. If the candidate accepts, then put your agreement in writing. Include a mention of a trial period before the job position is considered permanent. A contract for home care should also include: job duties, wages, payment schedule and method, start date, termination policy, time off and other benefits.

Include the Clients

Once you have established that the candidate is likely going to be the person you choose to fill your open position, it is good practice to involve the clients in the process. It can be very beneficial to have them interact with your residents to better evaluate their service of care and their rapport with your clientele and their families. This is a great way to hire someone that your seniors would be able to relate well and communicate better with, not just someone who looks good on paper. After all, this individual will be working daily with your residents. Another helpful tip is to identify common interests with the caregiver, which can be a huge boost to the success of the relationships in your business, not only between you, your manager and the caregivers but also with your residents.

Decide the Terms of Engagement

You can either decide to hire the caregiver as a full-time employee or contractor. The decision will mostly be based on the amount of money you are willing to spend to keep them with you as well as the amount of liabilities you are willing to take on. Making them an employee means you are required, under law, to take care of their taxes and other benefits (Medicare, social security, unemployment tax, etc.).  On the other hand, keeping them as a contractor means they would be paying their own taxes. However, you will still have to file appropriate documents around the terms of engagement (such as a 1099 form with the IRS).

Following the establishment of the terms of engagement above, an employment contract is important to help keep everyone in check about what is expected of them, and what they are entitled to. This would be a great reference in case any altercations come up in the future and can help alleviate any confusion when it is time for employee evaluations.

A solid employment contract should, at least, contain points like:

• The job description
• Expected hours of work
• Schedule to be maintained by the caregiver
• The rate of payment
• Period of payments and
• Every other element that you deem worthy of inclusion, especially everything you agreed upon during the interview process.

Provide your new employee with the proper employment forms, allow them go over it and make sure that all necessary documents are signed before having them begin working, to cover any issues of liability should something unforeseen come up.

It is worth reiterating a previous key point, that when you are going through the hiring process consider hiring backup workers. You are hiring real people, not super humans. Make sure that you are prepared to cover all the needs of your RAL home and its residents without stressing in case an employee falls ill or otherwise needs to skip a shift.

Check in during your caregiver’s work shifts. Especially when the work arrangement is new, spend time at the home to help familiarize the caregiver with your seniors’ needs. Periodically drop by unannounced during a shift to ensure that all is well. When setting up employment, schedule a regular time to meet with employees to address concerns about job duties and to evaluate the status of your residents’ health and well-being.

As you spend more time in your residential assisted living business, you will want to come up with more detailed systems and checklists to streamline your hiring processes that helps you identify and hire the right people. Until you get to that point, though, the tips and information found here will be a good starting point and get you headed in the direction that you want to go.

It is also worth mentioning that sometimes we need to adjust our expectations around staffing. Gone are the days where an employee loyally puts in 20 or 30 years of work into one company. Nowadays, it’s simply unrealistic to believe that most part-time assisted living care staff are going to stay with a RAL home for years on end. This is especially true for the community’s youngest part-time workers. To stand out from the crowd and distance yourself from other competitors, focus on creating an engaging and dynamic community and company culture. If a community can succeed in retaining an employee for one year, their chances of keeping them around long-term may increase exponentially.

Good help might be hard to find at times, but it is very possible. It might take some to get used to new processes, but if you persist in seeking excellence for your residential assisted living home, you will be interviewing a stream of highly qualified applicants in no time.

These are just a few of the numerous methods and tips that we help RAL owners adopt in their businesses to help create models of success in the residential assisted living industry. We have additional training that covers every topic you can imagine concerning RAL homes, setting up and running a successful RAL business, training and managing employees and every other assisted living topic under the sun. As valued members of our community we would like to continue to offer tips to help you find the residents that you are looking for to fill your RAL homes and create greater success in your business. You may already be familiar with some of these tips, so they might be a good reminder for you, or some of them may be new ideas that will help your business grow. And if you would like more information about additional training, visit:

residentialassistedlivingacademy.com/training-programs/

The RAL Academy is here to help you succeed, so don’t put it off any longer. Come out to one of our amazing interactive 3-Day Fast Track events, where industry professionals will teach you everything you need to know to get started and excel in this amazing industry. Take control of your future and get involved in a unique market that allows you to help others while creating a sustainable business that can provide for your family for decades to come.

The Convenience of Home Study

Don’t have the time to set aside a weekend learning about the incredible opportunities in residential assisted living? We’ve got you covered. We offer a Home Study Course that will teach you what you need to know to hit the ground running in assisted living. Learn on your own time and at your own pace. Learn everything from strategies to find funding for your business to how to hire and train care staff, how to market your Residential Assisted Living home to the communities around you, and what not to do that will end up saving you thousands of dollars, and so much more. You will also have access to real-life case studies from students and associates who have taken the course and implemented it, creating countless positive cash flow success stories.

Sign Up for Our Informative Webinar

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Build Your Network with the Residential Assisted Living National Association

We can’t encourage you enough become member of the Residential Assistant Living National Association, which was formed to bring our industry together and to provide critical resources needed by every owner, operator or investor in Residential Assisted Living. Whether you are an owner, operator or an investor or just looking to learn all you can about the incredible opportunities in senior housing, the RAL National Association is the community for you. Get help from industry professionals and learn how Residential Assisted Living is the answer to set you on the path to financial freedom and success.

Some of the invaluable resources for our members include:

• Group purchasing power with access to over 200 companies
• Lobbying and legal support focused on the Fair Housing Act and Zoning
• National Marketing for your RAL home
• Continuing education for direct care staff
• Strengthening and supporting the RAL community
• Monthly newsletters addressing important issues facing RAL homes
• Private Facebook page, building support and community
• Access to business opportunities, investors, qualified operators and administrators
• And much, much more

For anyone who wants to get started, expand, invest in or help support the mission of providing high quality senior housing and care in a residential setting, the RAL National Association is a must for anyone serious about their financial future in assisted living.

– Do Good and Do Well, my friends.