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This HR executive is tackling a vexing labor shortage dilemma in the health care industry
"There are not many Kal Mistrys out there,” says Tim O’Toole, CEO of Miami-based VITAS Healthcare Corp., the largest hospice care provider in the United States. O’Toole says his senior vice president of human resources, Kalpana “Kal” Mistry, SPHR, has “raised the HR function to a higher level of professionalism” and increased its involvement in VITAS’ operational strategies.
That was the goal, says David Wester, president of VITAS. When the company set out in 2002 to strengthen the HR function, Wester knew it could do more to improve its recruitment, retention and employee motivation efforts. “We had a vision of what the HR role should be,” he says. “We were looking for someone who could step out of the HR arena and think about the business as a whole.” Wester says Mistry’s combination of strong HR skills and business savvy filled the bill on all counts.
After conducting a nationwide search and reviewing many candidates, he says, “We get a chuckle now out of the fact that the person we were looking for was right here in our own backyard” in Miami.
Mistry is the recipient of the first Society for Human Resource Management Human Capital Business Leader of the Year Award. It is given to a senior human resource professional who serves as a leading force in executing organizational strategy that directly impacts the organization’s performance and prominence
Personal and Professional Challenges
The road to VITAS and Human Capital Business Leader of the Year has been a long one for Mistry. “As a child growing up in Uganda,” she says, “I could never have imagined the journey that would take me here today.” It’s a journey that has included both personal and professional challenges.
Born in Uganda, East Africa, to parents of Indian descent, Mistry and her family were forced to flee the country when military dictator Idi Amin Dada seized power in the 1970s. She was 13 when the family escaped to England.
Mistry completed her education in England and began her HR career there at 19, when she was hired as a personnel and training assistant for a soft-drink manufacturer. After earning a bachelor’s degree in industrial relations and personnel management from the University of East London, however, her life took another dramatic turn.
Following an arranged marriage in the Indian tradition, Mistry moved to Miami to live with her new husband and his family. Once again, her world was turned upside down, as she adjusted to a very restrictive traditional environment that didn’t permit her to work.
Forced to leave an abusive situation, Mistry took her two young children (ages 3 and 4) and began her career “at the bottom again,” in an entry-level clerical position with a national search firm.
After six months with the search firm, Mistry landed a position as employment supervisor for Capital Bank in Miami. Within seven years, she worked her way up to vice president of HR.
When she was recruited in 1996 to head the HR function for Sterling Healthcare (which later merged with FPA Medical Management) in Coral Gables, Fla., Mistry had the opportunity to start an HR function from the ground up. She established the corporate HR function in Miami and set up branch offices throughout the country.
But the period of expansion was followed by cash flow problems that resulted in the company filing for bankruptcy and being sold. It was then that Mistry faced what she considers the most difficult, but possibly most important, part of an HR manager’s job—“being a part of management as well as a part of the workforce.”
Before leaving the company in June 1999, she drew on her own difficult life experiences to help employees who were dealing with the trauma of instability, uncertainty and job loss.
Mistry spent the next three years as an associate superintendent of human resources for the School Board of Broward County, Fla. “It was a rewarding position,” says Mistry, “and I wasn’t particularly looking to make a move when I was recruited by VITAS.”
However, when Mistry discovered the world of hospice care, she realized this opportunity represented the culmination of everything she had worked for in her career. “As an HR professional, my work for VITAS gives me the greatest opportunity to fulfill a wonderful mission—caring for people at the end of their lives. It also allows me to achieve my longtime goal of working for a higher purpose and contributing to humanity as a whole.”
When Mistry joined VITAS in 2002, the company was experiencing explosive growth that continues today. There are now more than 9,000 employees in 16 states, with revenues of more than $700 million. O’Toole expects the company to double in size in the next five years and to add more locations. This rapid growth, coupled with changes caused by the company’s shift from a privately held company to a public company, has presented many challenges for HR.
As Mistry set about reorganizing the HR function, she realized the importance of building a good team, establishing a clear mission and providing the directions to achieve it. “HR must really understand the company’s business,” she says, “as well as the financials, and be able to recommend strategies to senior management.”
And for a hospice like VITAS, the employees are a vital part of the business.
“It takes a very special person to do this work,” says Peggy Pettit, executive vice president and chief operating officer. For most employees, she says, it is a mission.
Members of a hospice team—which include home health aides, nurses, doctors, social workers, chaplains and volunteers—deal with death and dying every day. “Almost all our patients die, even the infants,” says Wester, “so hospice care workers need a support network.”
Because the work is so physically and emotionally draining, he says, “You can never really do too much for the employees.” That’s a lesson Mistry seems to have learned. When she first arrived at VITAS, turnover in key positions such as sales representatives and nurses was high, so in 2003 she conducted an employee satisfaction survey.
The survey helped identify 10 areas that needed work, says Mistry, including compensation, performance evaluations, and communication between management and staff.
As Wester describes it, “We took the survey and built a road map—here’s what employees said, here’s what we did about it.” They discovered, for example, that most turnover occurred during the first 90 days of employment. Now, new hires are surveyed after two weeks rather than 60 days as had been the previous practice.
As she gathered data through surveys and exit interviews, Mistry began addressing employee concerns with the goal of making VITAS an employer of choice. She developed a nationwide compensation program that is regionalized for market competitiveness. She improved employee benefits and increased the company’s 401(k) match. She implemented an affirmative action plan.
Mistry also set up employee committees at each VITAS location to discuss staff concerns. The committees revealed that employees felt there was a need for a formal reward and recognition program. In response, four to six employees are now nominated by their peers and honored quarterly with cash awards and companywide recognition.
Mistry also began a campaign to facilitate open communication between employees and management. The marketing department created a life-sized cardboard cutout of O’Toole that urges employees to “talk to me.” Attached to the cutout are cards on which employees can write their questions. O’Toole says it has been widely used, and he includes examples of the kinds of questions he receives in the employee newsletter.
The employee satisfaction survey revealed one very heartening finding: VITAS employees are extremely committed and have a high work ethic. “We benchmarked VITAS against Aon Consulting’s 2003 Workforce Commitment Index for health care,” says Mistry, “and found that VITAS ranked 107.5 against a national norm of 99.”
While end-of-life care is professionally challenging and personally rewarding, says Wester, it’s also extremely difficult. “I think you’re either bitten by the hospice bug or you’re not,” so this evidence of the staff’s dedication was very encouraging.
However, 40 percent of VITAS’ workforce is nurses, whose average age is 48, says Mistry; many can be expected to retire within six to eight years. To address the serious shortage of nurses, Mistry developed a partnership with her former boss, Superintendent Frank Till of the Broward County Public Schools.
VITAS worked with the school system to develop a “Hospice 101” curriculum in the system’s vocational and technical schools. Mistry says the program helps the school system as well as the hospice industry. In classes taught by VITAS’ clinical staff, licensed practical nursing students learn the specialized skills needed by end-of-life caregivers. In addition, they receive help in writing resumes and developing interview skills. The first students graduated from the program in June 2006 and will be interviewed for positions at VITAS.
A Mission-Driven Person
Mistry’s work extends beyond just making VITAS a great place to work.
“One of the ways I’ve appreciated Kal’s compassionate nature and her understanding of the business we’re in,” says Pettit, “is her handling of our employee special needs fund.” The fund was set up to help employees who are suffering hardships, which may include financial needs.
Since most patient care is provided in the patient’s home, says Pettit, employees must travel in all types of weather. “Last year, we had a nurse on the road for us when her car was struck by a dump truck.” The woman suffered multiple fractures and was comatose initially. After many months in a nursing home undergoing rehabilitation, the woman is finally learning to walk again. Through the special fund, VITAS is helping the nurse and her family financially, beyond what is covered by the standard long-term and short-term disability programs.
“I think Kal is a mission-driven person whose personal commitment to people—both patients and staff—makes her the right fit for this company,” says Pettit. “Hers is not an administrative role; Kal helps make business decisions
A Clear Sense of Where She's Heading
O’Toole describes Mistry as “an optimist and a realist” who has a clear sense of where she’s heading. “Kal is a great role model for the company and its employees,” he says. “Many people ask, ‘Why me [when faced with difficult challenges]?’ Kal asks, ‘Why not me? I can do it.’ ” O’Toole says he appreciates her supportive, can-do attitude. “Balance and judgment is everything,” he says, “and she’s got it.”
And, he adds, "she’s got a lot of moxie."
Ann Pomeroy is senior writer for HR Magazine.
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