What are some ways I can improve the scheduling processes in my agency?
Scheduling is one of the core processes at the heart of a home are agency. As such, it’s one of the most essential workflows to get down to a science.
This piece will walk you through various schedule optimization tips throughout the process, which our team divides into three phases: pre-scheduling, scheduling, and post-scheduling.
We’ll be drawing heavily from an interview with Brett Ringold, VP of A Long Term Companion and a member of the Home Care Association of America Board; those familiar with our content will recognize him as a frequent flyer on our podcast, webinars, and other articles.
The best way to explain Brett’s expertise (which comes from experience in every role at a home care agency as a well as a recipient of home care himself) is that if scheduling is like solving a Rubik’s Cube, Brett is that roommate you had in college who could solve it in 30 seconds behind his back.
You can listen to both of our interviews with Brett here and here. I highly recommend you do so, possibly multiple times. Consider these a quicker, more skimmable companion to the long-form content in the episodes.
Let’s dive in.
The Three Phases of Scheduling
As mentioned, we think about scheduling in three phases. If you aren’t considering the unique needs of each phase, you’re probably missing out on key ways to optimize the process.
- Pre-scheduling: gathering all the necessary information and setting processes in motion to continue gathering them automatically, so that your schedulers always have up-to-date information.
- Scheduling: where the magic happens and the tough questions come up. Which caregiver is the best fit for each client? How should you handle new clients and caregivers? If and when should you allow caregivers to work overtime?
- Post-scheduling: setting processes in place to monitor the success of your scheduling and be nimble in making changes.
This isn’t a comprehensive guide to all steps of scheduling; instead, we’ll walk through each phase and highlight ideas you might not have considered or strategies you might not be using fully.
Pre-Scheduling Tips
#1: Decide an optimal caregiver-to-client ratio based on your business model and track it on an ongoing basis.
Why is this important? Once you find the right ratio and track it continually, watching this one number will help you avoid a variety of other problems.
If this number is too low, it’ll usually impact your ability to fill shifts, especially if anyone calls out. If the number is too high, it will impact caregiver retention as you’ll likely have trouble giving your team full schedules.
Depending on average hours per client, the sweet spot for most agencies will be ratio somewhere between 1.8 to 2.2 caregivers to each client.
#2: Create an automated process that updates caregiver availability once to twice a week so that your scheduler always has updated information.
A relatively simple way to do this is to set up automate text messages within your scheduling software or integrated SMS system that send caregivers a link to update their availability.
Depending on whether your process includes sensitive information, this could be in an online spreadsheet or a HIPAA-compliant form system like JotForm. The caregiver simply takes two minutes to update their upcoming availability, with the data automatically being gathered in a spreadsheet where your scheduler can see it and incorporate the updated info into the next schedule.
#3: Hold a quick meeting between members of different departments to ensure that the number of incoming/available clients and caregivers are in sync.
This should take place no less than biweekly and potentially as often as every day. At least one member from your HR, recruitment, sales, and scheduling teams should be present.
The purpose of the meeting is for the scheduler, who has a clear vision of the daily operations of the agency, to communicate the specific needs of incoming clients (for instance, number of clients starting that week and types of schedules) and coordinate that alongside the availability of caregivers, especially new incoming caregivers.
While keeping a balance between clients and caregivers is easier said than done (many agencies currently have a waitlist of clients), this will still help keep your staffing within your designated caregiver-to-client ratio.
Scheduling Tips
#1: If you can’t schedule someone for their first shift from orientation, schedule them for a shadow shift.
One of the surest ways to lose a new caregiver is to keep them in limbo at the beginning by not giving them a paid shift to look ahead to when they leave their orientation. Scheduling a shadow shift buys you extra time to prevent this from happening.
While this appears to result in extra cost, it’ll save you money by helping you retain more new caregiver hires.
#2: Decide how much overtime you can budget for.
According to our Compensation Report, 88% of agencies offer overtime hours to caregivers. However, that doesn’t you should offer overtime willy-nilly under any circumstance, or become too reactive in offering overtime.
Instead, we suggest using one (or both) of two metrics to decide how to budget your overtime: percentage of total payroll cost allocated to overtime, and percentage of billable hours that can be allocated to overtime. The numbers will vary significantly from agency to agency, but this will help you be intentional about your overtime costs.
Paying overtime can obviously cause some challenges with rates. If you’re relying on government payer sources such as Medicaid, your hands are tied when it comes to charging overtime rates. For private-pay clients, however, you can work an overtime clause into their agreement that passes the overtime cost to them.
We recommend explicitly stating that a requested visit will put their caregiver into overtime and obtain additional verbal permission to charge an overtime rate for the visit.
#3: Track the right metrics to keep an eye on your volume and efficiency.
These will generally include:
- Billable hours
- New clients
- Total client census
- Caregiver to client ratio
- Lateness
- Callouts, split up by same-day callouts, 1-2 day notice callouts, 3-6 day callouts, and 7+ day callouts
Callout trends are particular valuable to track over time, as you’ll begin to spot patterns and learn to predict when callouts might occur and with how much notice.
Our team has spent a significant amount of time researching no-call no-shows; our research shows that the average agency is foregoing an amount equal to 7% of their total revenue due to the impact of no-call no-shows.
Post-Scheduling Tips
If you’ve followed all the tips above, your scheduling and operations will likely be a well-oiled machine. However, there’s at least one more critical step to remember: establish processes to follow up closely on new client/caregiver pairings over their first few weeks to make sure it’s the right match.
At the same time, work to continually build your relationships with caregivers so that (among many other reasons) you can be alert to their capabilities and recognize when their unique skills or traits might be a better fit for a client than that client’s current caregiver.
More Reading
If you’ve read this far, you’re clearly dedicated to keeping solid operations and good scheduling within your agency. Here are some additional resources that might be useful to you:
- Our guide to the perfect caregiver hiring process
- How much money you’re probably losing to no-call no-shows, and what to do about it
- Our tool that might be the solution to prevent no-call no-shows
Lastly, you can join our email list here and learn about our AI-powered home care software here.