A dozen years ago, Demetri Gambrill began working after school at FutureCare Health and Management as an activities assistant. The 28-year-old is now a geriatric nursing assistant, thanks to education that the company sponsored.
"They sent me to school to become a nursing assistant. I didn't have to pay for anything — not books, not tests, not tuition," Gambrill said. All he had to do was write a letter showing interest in the program and commit to working for FutureCare for at least a year after completing the training, he said.
For the second year in a row, FutureCare — a private company founded in 1986 and based in Pasadena — placed first on The Baltimore Sun's Top Workplaces list among large companies in the Baltimore region. Members of FutureCare's staff said that part of the company's continued success in the WorkplaceDynamics survey is because of internal opportunities for advancement. The potential for upward mobility, experts agree, plays a role in keeping employees satisfied.
After nearly a decade as a nursing assistant, Gambrill said he's ready to once again try something new. Since August, he has been training in the medical records division of FutureCare's Sandtown facility.
"I wouldn't mind trying that next" as a full-time job, he said. Though Gambrill admits working in records full time would have at least one shortcoming: "I couldn't go without having interaction with my residents," he said. "Even when I go on vacation, I call and check on them."
Stories of advancement are common among FutureCare's roughly 2,500 employees. The company prides itself on the opportunities for growth at its 12 Baltimore-area skilled nursing centers.
"You may be a great aide, but you may think you would also be a great RN," said Gary L. Attman, FutureCare's president and CEO. "We want you to accomplish your dreams. I think people who work for us know that."
It's not uncommon for staff working at the lowest levels, including housekeepers, to be offered a spot in one of FutureCare's many in-house training programs, said Holly O'Shea, the company's corporate counsel and vice president of human relations.
The company has a dedicated training center at its Irvington facility, where staff members can go for advancement classes including wound care and intravenous venipuncture certifications, she said.
Educational opportunities are not limited to offerings within the company. FutureCare also provides for up to $2,500 a year in tuition reimbursement as long the employee's ability to serve the company is furthered by the course or degree, O'Shea said.
Offering training and tuition reimbursement is smart business, said Susie Coddington, a professor at Johns Hopkins Carey Business School in Baltimore.
"It costs more to get a new employee than keep a good one," Coddington said. Plus, morale is likely to be lower among employees who feel they are in dead-end jobs, she said.
"Where there's potential, they're always willing to give the opportunity, and that in turn leads to quality care being given," said Christie Waterman, 39, the director of nursing at the company's Canton facility.
She started out in 2007 as an evening shift supervisor and was promoted after completing a family nurse practitioner program while working, she said. FutureCare was "really flexible with my schedule" while taking outside classes, she said.
Offering training opportunities and promoting from within motivates employees in two significant ways, said Gilad Chen, a professor of organizational behavior at the University of Maryland's Robert H. Smith School of Business.
First, it "sends a signal that the company cares about treating [current employees] fairly," Chen said. Second, learning and advancement opportunities give employees hope that they could have a long future with the company, he said.
Among the drawbacks of relying too much on internal advancement is the potential for a lack of diversity of new ideas among employees, Chen said. There is also the problem of creating competition among employees, he said.
But overall, Chen said, those who study workplaces "see that companies that promote from within have more motivated workforces."
O'Shea, 40, finished her undergraduate degree and went to law school while working at FutureCare, she said, and believes FutureCare benefits when its employees advance within the company. "Inclination meets opportunity is FutureCare. If you're willing to put forth the effort, FutureCare will meet you," she said.
"We can always move up in FutureCare," agreed Mabel Pilgrim, 56, who was a certified nursing assistant and is now the director of payroll. She's held at least a half-dozen different positions during her years with the company, she said. Each of those positions endowed her with new skills, she added.
"There's nothing that I can't do or nothing that I won't do," Pilgrim said. "That's the bottom line of our job descriptions: And anything else. Residents are the bottom line."
Although most of Brad Segree's time is spent supervising physical therapists at several FutureCare facilities, there are times when he's needed to jump in and actually treat patients, said the 43-year-old Segree, a regional manager of rehabilitation services.
"There's nothing like seeing a patient you've worked with begin to feel better," he said.
Segree started as a physical therapist at FutureCare's NorthPoint facility 11 years ago and believes he could retire from the company: "I'm still learning a lot. I hope to continue to grow."