In every home medical equipment company, the entire business usually rests on a core group of employees. These employees handle the jobs that make or break the company. Without this group, it is almost impossible for the company to grow and make it through difficult times. Who are your core employees? How can both small and large companies create a core group? And, once you have key employees in place, how can you keep staff turnover to a minimum?

A core employee is the person who is willing to work on a project that requires more than the hours in their already packed workday. It is the person who can pitch in when other employees are not available. This is the person whom management relies upon for advice on industry regulatory changes and how they will impact operations. The key employee also will inform management when they detect something wrong with the business.

How can you find someone with this type of potential? And, once you find this person, how do you “clone” them to create your company's core group? Whether you hire an individual who possesses the right experience or you identify as a core employee someone who already works for you, potential core employees must possess the right values. That is, they understand that while at work, work is the top priority. They focus on the task at hand and act as representatives of the company. Some potential core employees even feel like “family” to the organization. Further, they can be trusted and they are respected for their work. These core individuals are “natural leaders,” says Laura McIlvaine, director of compliance for Valencia, Calif.-based Shield Healthcare.

What else might you look for in a core employee? McIlvaine says Shield Healthcare develops core employees by working with employees who already are working for the company. “It is an ideal way to breed the core group,” she says.

Other business executives advise taking the time to assess your business and determine what you expect from employees. “Know your business,” advises business proprietor Randy Pumley in a recent issue of the Wall Street Journal. “The more thought you give to the business you run — its advantages and disadvantages for employees — the better you'll be able to gauge the kind of employee who will work best. Once you know whom you are after, you can devise a plan on how to find them — and keep them.”

This advice is absolutely valid for HME companies. Begin by developing a job description that lists the qualifications you are seeking in a core employee. Once you identify the duties required of the position, you should be able to identify the personality traits of the individual who would best handle those job responsibilities. For example, the person who handles CMNs should be detail-oriented and able to follow through in obtaining the signed, complete and accurate documentation necessary for billing; someone who can juggle multiple tasks and can, at times, work amidst chaos.

If you study your needs and try to place the right person in the right position, you will begin to breed more core staff. McIlvaine says that, at Shield Healthcare, “people are allowed to grow in what they are good at. If an [accounts receivable] representative thinks they would be better in customer service, they can request a transfer. Personal growth is important in developing leaders.”

Once you have found these employees, how do you keep them? This is the biggest challenge facing many business owners. Keeping employees happy by giving them tasks that they enjoy makes a difference in retention rates. Tom McAuliffe, owner of Hutchinson Medical in Salem, Mass., has retained 75 percent of his employees for an average of 10 years. One of the ways he does this is by offering them so-called perks. One such perk was a recent trip to the Bermuda for each employee and one family member. This trip was a great morale booster. And, McAuliffe says, “There's plenty of stress in our industry. Consequently, we [encourage] freedom of expression and foster a close-knit environment.” These perks set small, independent companies apart from the large, national companies.

For Roger Miller, chief executive officer and president of Broadview, Ill.-based Dependicare, it is his core group of two vice presidents who have been with him for more than a decade who make the difference. “I liken tenure to a three-legged race: If you are going to win the race, you have to go at the same stride and pace. We know each other so well that our stride is always the same and our pace is the same,” Miller says.

What else can smaller companies do to stay competitive with large national companies? Use size as a selling point. Much like a larger company tries to use its size to its advantage, small companies certainly offer more opportunity for professional growth — people who are creative and exhibit leadership qualities can quickly become part of the core group. Invariably, it is easier to recognize someone inside a small company than a large conglomerate. Within many HME companies, it is often the first delivery technician hired who eventually becomes operations manager. According to McIlvaine, at Shield Healthcare, most management positions are filled from within by employees who have advanced through the organization.

Despite your company's size, your core staff is the group you rely on for day-to-day management of the company. They make the difference between a successful company and a failing one. Moreover, their positive attitude is contagious. Even in the roughest of times, these employees keep the momentum going and the morale high. According to Miller, “When things aren't going so well, and it happens to every company at some point in time, a solid core team can pull a company through more effectively than one that's not so sure about each other.”

If you focus your attention on breeding a quality key staff, you will ultimately benefit the entire business. It is the core group of employees that trains and leads the rest of the employees. If you find a company with a strong key staff — a group committed to the best interest of the business — you have discovered a business that will prosper and flourish.

Miriam Lieber is president of Lieber Consulting, specializing in operations management and reimbursement for the home medical equipment industry. She can be reached via email at mllieber@pacbell.net or via phone at 818/789-0670.