There are more than 18 million health care workers in the United States; 80% of them are women, according to the Bureau of Labor Statistics.

While women make up the vast majority of home health care workers, they are a minority in the C-Suite. Only 40% of the industry’s key decision-makers are female.

 Homecare is a tough space to succeed in, and while org charts may not reflect it, this industry is loaded with strong, determined women doing incredibly meaningful work — they simply do not get the recognition they deserve!

Here at HHAeXchange, we would like to take one small step towards changing that. ‘Extraordinary Women in Homecare’ is a series of feature articles designed to celebrate women who bring strength, passion, and creativity to their roles in the home care industry.

For this edition, we spoke with Nancy Fitterer, President and CEO of the Home Care & Hospice Association of New Jersey (HCHANJ). Founded in 1973 by a group of New Jersey home health agencies, HCHANJ spearheads educational and advocacy programs that equip providers to deliver quality care, optimize business practices, and comply with industry standards. In this article, Nancy shares the most challenging aspects of her work, what surprises her about the homecare industry, and how she’s mastered the art of multitasking.

What brought you to the homecare industry?

Before I joined the homecare industry in 2018, I worked in the New Jersey Attorney General’s office as the Chief of Staff to the Attorney General. Over time, I knew I wanted to be doing something different, something more meaningful. When I heard about this job with the Home Care & Hospice Association, I thought it sounded so interesting. I had no homecare or healthcare experience; I just knew that more people wanted to age at home rather than in an institution or facility.

Coming from the government side, and having that experience and those contacts, has really helped. Still, it was a steep learning curve. Now I pretty much have the running of the office part down, but every day I try to learn something new – either about the industry itself or what we’re lobbying for.

What do you most look forward to each day?

I often get calls from agencies that don’t belong to the association and they’ll say something along the lines of, “I have this question, I don’t know what the answer is, and I am completely lost.”

Again, I came into this role not knowing anything about the industry, so it gives me great satisfaction to be able to say, “These are the rules, these are the regulations, and these are the people you need to talk to.” People are so thankful to be given that information.

They say that a rising tide lifts all boats. I believe that all agencies need to be as good as they possibly can be and follow all the rules and all the regulations in order to succeed.

What’s the most challenging aspect of your work?

Keeping up with the legislation and all of the regulations! There are hundreds of bills, and new regulations come up almost daily, with most affecting healthcare service firms.

I attend tons of meetings each day on a variety of topics. For example, on a given day: I could be talking with a group focused on increasing the personal care assistant rate, and another group focused on increasing the private duty nursing rate; I’ll have a call with the State on EVV; calls with managed care companies and the State on a workforce to determine how to train personal care assistants to help patients with behavioral health issues. I’m also the chairwoman of the New Jersey Caregiver Task Force which is a task force created by the Legislature in 2019 to develop recommendations for legislation or for regulatory changes that would be necessary to supplement, expand, or improve existing caregiver support services in NJ.

Every hour of every day is different, but I like that.

How do you handle the stress of your role?

I can multitask really well. I was once Chief of Staff to a senator in New Jersey, and she was a very demanding boss. She said, “If you can survive me, you can literally do anything.” That was 100% true.

I’ve always been the type of person that comes into a high-stress job and thinks, how can I make this better? When everything is coming at me, I take a moment to breathe, and I handle it.

What is the most important lesson you’ve learned from the COVID-19 pandemic?

Aside from stocking up on PPE which may be the most obvious lesson, I think prioritizing communication with staff is the most important takeaway. At the very beginning of COVID, no one had any idea what was happening, and everyone was scared. Agencies had to create protocols on the fly, which is fine, but they really needed to handhold their staff and walk them through everything. Caregivers and administrative staff needed guidance from their leadership, and they needed compassion as well because they were afraid. We learned a lot of lessons, but I really think communication was key, as it is with almost every aspect of life.

What surprises you most about the homecare industry?

How connected it is. Everyone knows everyone in homecare.

And everyone is so exceptionally nice, which isn’t exactly surprising, but even direct competitors are friends with each other. It’s a very nice environment to work in.

If you weren’t working in homecare, what would you be doing?

I would probably be doing something policy-related back in the Governor’s office. I really like making policy. I’m not a fan of the political part of it; I like getting my hands dirty and actually making that change.

Professionally, what’s the biggest goal you’d like to accomplish by the end of this year?

I would really like to be more of a resource to New Jersey’s smaller agencies. That is what the association’s purpose is – to educate and to be a resource.

The larger companies utilize the association for their particular purpose, but it’s the smaller agencies, the agencies that don’t have their own compliance person or government affairs units, that really need my help. They could be doing something wrong and not even realizing it.

If an agency is not following the law, it reflects poorly not just on that one agency, but on all of homecare. There are bad actors, but I believe that the majority of them do not want to be bad actors – they simply don’t know the law or don’t have the bandwidth to do their own compliance. Things change all the time, and agencies need a place to go for the most current information.

What is the best piece of advice you’ve ever received?

To treat everyone equally and with respect. We learn that in kindergarten, but I feel like it’s something some people forget, especially when they move into certain roles. Whether you’re the janitor or the CEO, if you’re doing your job and you’re doing it well, then you’re on equal footing. No matter what job you have, you need to be kind and perform the job to the best of your abilities.