Serving the home health, home care and hospice industry since 1999.

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by Tim Rowan, Editor

How often does this sequence happen in your home care agency?

  1. An online job applicant looks promising
  2. The interview goes well
  3. The background check is clean
  4. You bring the new hire in for orientation and training
  5. After that investment, the new employee turns down the first shift you offer
    • then the second
    • then the third
  6. Finally, she stops answering the phone.

What does this cycle cost the typical home care agency? In interviews with agency owners, we have seen calculations as high as $4,500 per incident. How often does it happen? "All the time," most owners tell us.

Unfortunately, it is likely to get worse. According to a December 31 report penned by New York Times business analyst Nelson D. Schwartz, there were more than 800,000 first-time unemployment claims in the last week of the year. While the average unemployment rate stood at 6.7 percent, it was higher, as high as 7.7 percent, for workers with just a high school diploma, the typical non-medical caregiver applicant.

Many of these workers were recently released from temporary jobs such as seasonal retail, package delivery, and 2020 census takers. It is the proverbial perfect storm: they are desperate for work, you have been advertising for workers, and they apply not having any idea how demanding the work might be, until they go through your training. More applicants desperate for a paycheck does not indicate a corresponding increase in the number of people suited for this kind of work.

How does an employer know, though, before orientation and training, whether a new hire is likely to work out or not?

New Technology Reduces Bad Hires, Saves Thousand$

Finally, a new, patented technology that appears to provide just such an insight is making its way into home care. Here is the story of its initial, real-world tests in several locations of one franchise organization.

In July, 2019, ComForCare asked the team from a company called "Here, Inc." to pilot its flagship application, MiliMatch. The company claimed that MiliMatch was able to give the agency HR staff and owners early insights into candidates to assess their potential as caregivers – before the interview. Test sites would be several ComForCare locations known to be anxious to improve employee retention and increase the efficiency of their hiring process. But first, the cautious company selected a single office where MiliMatch would be put to the test before the full pilot would be allowed to go forward.

Pre-Pilot Testing
ComForCare selected West Linn, Indiana, a franchise under the direction of Mark Turnbull, who was surprised to find that implementation was so simple. The MiliMatch system added a single step to his company's online job application: six straightforward questions covering the applicant's experience with and feelings about various aspects of caregiving. Applicants simply enter their answers in two or more sentences per question and submit them with their application.

By applying its patented algorithm to an applicant's answers – not so much the content of the writing but the specific words chosen to construct each sentence – MiliMatch gives each applicant a score. This algorithm is based on the science of Cognitive Linguistics,1 not a new field, but one that Here, Inc. believes it is the first to pioneer in home care.

Turnbull learned over time how to interpret the reports and scoring generated by MiliMatch. He discovered where the line was that separated a likely successful caregiver from one who was likely to become a costly hiring failure. He began to hire only applicants with scores above that line. The result? He reduced turnover in his franchise by more than 30 percent.

Intrigued by West Linn's results, ComForCare recommended four more agencies for the full MiliMatch pilot.

Fort Collins, Colorado
Under Chris and Laura Wining's ownership, the Fort Collins, Colorado franchise applied the MiliMatch technology to their recruits, several of whom are students in Chris's community college classes. Because of an initial assessment that Chris performs, Fort Collins applicants are among the highest scoring of any agency in the MiliMatch pilot.

Fort Collings Hiring Chart

According to Kendra Chandler, the recruiter for Fort Collins, implementing MiliMatch has provided a variety of insights for the team. Not only have they improved retention by 17 percent since implementation, but they also discovered the risks of onboarding new hires who have not gone through the MiliMatch assessment.

"It's very accurate in terms of scoring candidates," Ms. Chandler reports. "We've brought in a few low-scoring applicants who we thought we would take a chance on, and they did not work out."

As the chart on the right illustrates, by incorporating MiliMatch scores into the hiring decision, Chandler and the Winings are finding candidates who stay on the job longer. Candidates who scored higher remained with ComForCare Fort Collins for most of 2020 while most of those onboarded without completing MiliMatch applications did not.

The other benefit the Fort Collins team has realized has been the efficiency of the recruiting effort. By filtering out applicants who have no idea what caregiving is, wasted effort is reduced.

As Ms. Chandler indicates, "It is definitely saving time. It is helping us know the candidates before the phone screen. Everything is over the phone, so it is important to reduce that phone time."


North Indianapolis
Through four months after implementing MiliMatch, the North Indianapolis ComForCare team improved its 30-day retention rate by 26%. Based on that performance, they were able to avoid losing nine caregivers who would have normally left within the first 30 days on the job.

North Indianapolis Hiring Chart

At a cost of $4000 per lost caregiver, the team estimates it has avoided $36,000 in wasted costs. By identifying better qualified candidates they are also able to conduct fewer interviews and have found they are faced with fewer no-shows for orientation.

Here, Inc. CEO Eric Becker stresses that higher scores mean that a candidate offers a better match to be a caregiver long term. Just because someone scores a 45 does not mean that they cannot perform as a caregiver. However, a candidate with a score of 45 will present a higher risk than a candidate scoring higher. The 45 candidate is less likely to stay longer. Hiring data from September 2019, shown in the chart to the right, illustrates this point.

Out of the 12 candidates who scored less than 60%, seven left within 30 days, and nine left within 90 days. Of the six candidates who scored above 80, all stayed on staff more than 90 days. In sum, by using MiliMatch scores to filter candidates, Ryan and his team are able to identify those candidates with a greater potential.


Madison, Wisconsin
Marie Kennedy, recruiter for the Madison, Wisconsin, ComForCare team, speaks of realizing "marked improvement" after implementing MiliMatch. She reports improving 30-day retention from 57% to 70%, an improvement of 30%, and building 90-day retention from 32% to 42%.

Madison Hiring Chart
MiliMatch Scores vs Tenure - Madison, WI Post-MiliMatch Hires
November 2019 - February 2020

The chart at the left illustrates how the Madison team learned how MiliMatch benefits its recruiting practices by graphing the tenure of the hires made since MiliMatch implementation. Tracking candidates' scores has provided recruiters and managers with improved ability to predict role fit. Low scoring candidates, which the team defines as between 40 and 50, showed a much lower tendency to stay on the job, whereas the higher scoring candidates (above 50) tended to persist much longer. Finally, the non-scored candidates (in red and gray) turned out to be highly unpredictable.

As a result, Ms. Kennedy remains committed to helping the Here, Inc. team to enhance the product to offer even more insights into their business.






South Indianapolis
South Indy ComForCare, under Beth Bigham's leadership, was already running at 88% retention (over 30 days) when they signed up for MiliMatch. With an existing, successful process to hire and onboard candidates, it would be reasonable to ask why this office was chosen for the pilot. It turns out Bigham's team was inundated with applications and spending an inordinate amount of time sorting through them. She wanted to find a more efficient system to identify and weed out the many who approached ComForCare while possessing little familiarity with the caregiving role.

South Indianapolis Fiscal Results
South Indianapolis Financial Analysis

"Improvements in efficiency were almost immediate," reports Nikki Conner, the South Indy recruiter. "MiliMatch is 'absolutely' reducing the amount of time we spend sorting through candidates."

As almost a side benefit, in spite of the company's already best-of-breed retention performance, the team was able to improve its 90-day retention even further. In addition to time-savings, Ms. Bigham also measured success in terms of 30-day retention of new hires, the most expensive point of failure. On this scale, South Indy improved from 88 percent to 93 percent. Meanwhile, 90-day retention grew from 68 percent to 86 percent.

"In a case like this," explained Here, Inc.'s Eric Becker, "it is the denominator that causes the positive growth in a company's retention percentage, not the numerator. It's not that they are interviewing and hiring more applicants. They are hiring fewer, but the ones they do not hire are the ones more at risk for quitting early."

Moreover, Ms. Conner observed, MiliMatch has helped increase the connectedness of the interview process. "I feel like I know them before they come through the door," she commented. "I can do a personalized interview. They know I've read their answers about relationships and experiences, because I’m asking them about this."


End Notes:

  • CEO Eric Becker told us Here, Inc. has already begun to move MiliMatch from the ComForCare pilot to a national rollout in 2021.

  • The company takes its product name from the French word "mille," for thousand.

  • Pricing is per applicant, with a menu of packaged, pre-purchase discount options.

  • Reportedly, Mark Turnbull, Chris and Laura Wining, Ryan, Marie Kennedy, and Beth Bigham are not concerned about the product's price.




©2021 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Home Care Technology: The Rowan Report. One copy may be printed for personal use; further reproduction by permission only.