Bayada Offers a Remedy for Shortage of Nurses

Excerpted from the November 10-16, 2000 Philadelphia Business Journal article by Adam Katz-Stone.

The shortage of nurses worsens by the day. Even with hospitals offering generous signing bonuses, the American Association of Colleges of Nursing reports enrollment in bachelor’s programs continues its five-year slide—with current enrollments down 5% from last year. So why is Mark Baiada still in business?

As founder and sole owner of Bayada Nurses, this fellow makes it his business to provide home care patients with qualified RNs, LPNs, HHAs, and other caretakers. Despite the nursing shortage, Bayada Nurses continues its 25-year record of steady growth—placing some 4,700 nurses out of 62 offices in 11 states. Seriously: What gives here?

Baiada’s answer is so simple it almost sounds suspicious. “We care about people,” he says. That isn’t the whole answer, but Baiada insists it is the key to what follows. “If you care about a nurse you will try to help them. You listen to them, respond to them, respect them, and try to make the job more meaningful and fulfilling to them. The work they do is sacred and special, and you want to support that and honor it,” he said.

This raises the natural question: What does it mean to care, in practical terms? How can a business entity truly show that it values its workers as individuals? At Bayada the answer takes many forms. One of the simplest, yet most effective, is the “Hero of the Year” program. “Every quarter we select heroes in three categories—RNs, LPNs, and HHAs—and we honor one of each of those from each of our service offices. Then we select a winner from each of our nine divisions, and then one national winner,” said Raymond Abrahamsen, Director of Communications.

Prizes include family trips to Disney World, free dinners, and gift certificates. It does not sound like much, but Abrahamsen said that kind of thing carries some weight in the competitive market for nursing talent. “People often think of nurses as second-class citizens to doctors and others. They don’t often get appreciated and recognized for the important work that they do,” he said. In its advertising, Bayada refers to its nurses as “Heroes on the Home Front”—and Abrahamsen said that it is much more than just a tag line. It is a reflection of a deeply held belief. “We offer our caregivers the respect and appreciation they don’t often receive,” he said.

Of course, money helps too. “If you would stop nurses on the street, the first thing they would say is that they are underpaid,” said Abrahamsen. Thus, the Bayada budget is heavy on the salary side, with pay scales high enough to leave the company with a scant 1% profit margin after taxes. “In a struggling industry, where we have seen almost 3,000 agencies go out of business nationwide, that is not much of a margin of safety for us, but we feel it is enough for us to get by,” said Abrahamsen.

Even with all these mechanisms in place, Bayada still comes up short from time to time. While in the past the firm has been able to meet all but 1.5% of the orders that have come in for home care workers, today the nursing shortage has pushed that figure to between 3% and 5%.

In a sign of just how severe this labor crunch has become, Bayada recently sent a letter of apology to all its clients, asking for their understanding and support as the company battles to stay on top of a nursing shortage that is taking its toll on medical establishments nationwide. “The nursing shortage is a real and serious problem, and we are doing everything in our power to address it,” the letter reads in part. “Our nurses help by working longer and harder. Our office staff is working twice as hard to find nurses as they did a few years ago. Their searching efforts may not be easily noticed, but I assure you that they understand your crisis. They are conscientious in their duties. Unfortunately, sometimes their efforts are in vain.”

Baiada says that if his company has managed to keep ahead of the curve thus far, it is due mostly to the company’s progressive human resource stance. Worker testimony bears this out: at least some nurses they stick with Bayada because of the respect they get there.

Take Dana Trainor, a registered nurse and certified rehabilitation specialist who works out of Bayada’s Moorestown office. “With the nursing shortage it can be easy to overuse people, to just keep asking them for more and more. But at Bayada if you say you only want to work one weekend a month, they are respectful of that. They always consider the individual,” Trainor said.

The company is able to do that largely because of Mark Baiada’s efforts to create a decentralized organization. Business logic suggests that a single central office would be more efficient than five dozen little offices all over the place. But Bayada executives insist the local office model enables the company to better serve both clients and its precious staff of nurses.

“I believe that you get better results when the people who directly do the work have a sense of ownership over what they do,” said Linda Siessel, division director from the Morristown office. “By having small local offices, it creates an entrepreneurial spirit. It gives people the sense that we are all in this together, that this is only going to work if we all do it together.” When people work on contract, as do Bayada’s nurses, it is important to give them a sense of permanence, she said. “Everybody is looking for competitive pay, but it is not just about the money. Once we get a nurse on board, they tend to stay because they are treated so well,” she said.

In practical terms, “that means standing up when an employee comes in. It means making a fuss, letting them know that we are glad to see them,” Siessel says. “It is very lonely sometimes giving care out in people’s homes. The nurses sometimes feel they are out on their own, and so we are here to be their support, their connection.”