New Hire Series: Preparing for a Home Health Interview
I recall when interviewing for home health positions that several of my friends and family often said, “Are you sure?” To them the thought of going into someone’s home was, well, frightening. To me it was the ultimate setting for truly functional therapy. I liked the thought of traveling, to have my car as an office. I wanted a change from a SNF to a home health environment. I wanted to expand my skill-set and was experiencing, unknown to me at the time, burn-out.
After years of increasing paperwork (insurance updates, screens, documentation), productivity pressures, progressive loss of benefits and being exhausted from a fast-paced environment, I needed a change. I spoke with several home health therapists and they were very happy with their current positions. Their satisfaction validated my thoughts and the pursuit of a transition.
I interviewed several therapists in the field and asked them what they would ask in an interview? What specifically they liked about their current position? What challenges they encountered and how they handled these? I also requested ride-alongs from companies with an SLP to witness and gain an appreciation for what therapy looked like in someone’s home. And, throughout these experiences, began to familiarize myself with a new set of terminology/acronyms (i.e. OASIS) and developed a list of questions for my interviews.
What I Learned On The Job
- The demographics of the caseload really surprised me. My patients were much younger. Yes, I certainly worked with seniors, but several young adults as well. I did therapy with in-home ventilators and tracheostomies, programmed and applied for speech generating devices, saw a variety of dysphagia-related cases and several patients with TBIs and CVAs.
- What I didn’t think about was how important a through orientation was in this arena. I was anxious for a transition and thought I did my research. Looking back on the experience, I would have selected an in-house company with a comprehensive orientation. I selected a contract company and my orientation was 2 hours in a coffee shop. The average training time for other companies was between 4-6 weeks. I did inquire about the discrepancy/variation between orientation lengths/training period and was told it was related to regulations associated with in-house companies. Yes, the pay is typically less during orientation for in-house companies but it’s worth it. In hindsight I was not prepared for the logistics of home health and would have been with a thorough orientation.
- I learned that home health therapists are quite skilled and, due to the variety of cases they see, have a tremendous amount of knowledge and experience.
- I witnessed patients being overwhelmed by the number of home health workers and other equipment companies (i.e. oxygen supplies) coming into their residence. SLPs can significantly improve a patient’s transition back home by developing visual aids/cognitive prosthetics to track visits from home health workers and other medical supply companies.
- The most functional therapy I’ve ever conducted was in this setting. In a SNF I was simulating/anticipating situations, in the home it’s as real as it gets. You clearly see the patient’s strengths and challenges. Caregiver training was essential and often a significant part/focus of my visits.
- I also learned there are exclusive therapy teams to assisted living facilities (typically organizations that own/operate several ALFs) and, though considered home health, they only work in ALFs.
- Finally I learned that I’m best suited for SNFs. I had to leave a SNF to realize this. Trying something new helps you to understand your niche. Nelson Mandela once said, “I never lose. I either win or learn”. So true.
I’m including the questions I developed for my home health interviews. I’ve amended them to reflect the knowledge I gained while working in the home health sector. I hope they assist you in learning more about home health wether this is your first position as a CF or transitioning as a seasoned SLP. To access these questions in a free download which includes space for jotting-down answers, click here.
Home Healthcare Questions
- What is a typical speech-language pathologist’s caseload/day like?
- Is there a dress code?
- Do you have any modalities (i.e. Vital Sim)? If so how do I access these? Do I meet someone in the field or pick-up at the office?
- Do you provide supplies (ie thickener, tongue depressors, etc) for swallowing evaluations? Do patients provide the drink/food?
- Are there opportunities to collaborate with other disciplines re: patient needs (i.e. safety concerns)?
- How can I succeed at this job?
- What do you like about (insert name of company you’re interviewing)?
- Are you expanding the SLP team or did someone recently leave the position I’m filing? If related to the latter, why did they leave?
- What is your retention rate like?
- Do you offer money for CEUs and/or supplies?
- Do I need to purchase my own blood pressure cuff? Thermometer? Double bag? If so will you reimburse me?
- Please tell me about your benefits package.
- Do you offer reimbursement for gas or mileage? Am I paid for travel in-between visits?
- What is your documentation system? What do your therapists say about it? Does it track and notify treating SLP when documents are due? What do therapists say about how they manage their paperwork?
- Do I receive my own laptop/iPad/PDA? Does it work on or off line?
- What medical information about the patient do I have access to? How will I know if they have allergies/food allergies?
- How long does it take the average therapist to become proficient with your computer system and handling a caseload?
- Do your SLPs open cases/do an OASIS?
- How do you measure efficiency? Number of visits or points? What do you consider full-time?
- May I do a ride along?
- What is your orientation process like? Length? What is the pay rate during this time period before transitioning to the field?
- How do you staff holidays/weekends?
- What if the weather is bad (i.e. snow)? May I reschedule patients?
- What is your policy on bed bugs? Homes I’m not comfortable going into/if I feel unsafe? Missed visits?
- Can I request non-smoking patients? Assisted-living facilities? Homes without pets? How do I handle patients who are hoarders? What are the protocols and resources in these situations? Does your orientation cover this?
- What are the expectations for contacting the ordering physician after initial assessment is completed?
- What is the relationship like between your therapists and your other clinical staff (i.e. social worker, respiratory therapist, physician, etc)? Do you accept CF SLPs? If so, what does that support structure look like?
- Who is your primary referral source? Hospitals? SNFs? Will I have the contact information of the prior treating SLP for continuity of care if patient is transitioning from hospital/SNF to home?
- What is your rate per visit? Per evaluation? Per reassessment? Per discharge? Per OASIS?
- What’s next in the hiring process?