How Can Home Health Agencies Improve Employee Retention?

Andjelka Prvulovic
Last update on:
April 18, 2024 2:48 AM
Published on:

The home health care sector is one of the fastest-growing industries in the United States economy. According to the Bureau of Labor Statistics, employment of home health and personal care assistants is expected to grow 33 percent from 2020 to 2030. Such growth is much faster than the average for all professions. 

Growing market demand calls for solid strategies to improve home health employee retention in the sector that is deeply hindered by employee churn.

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High Turnover Rates Disturbing the Industry

Improving employee retention is crucial, as turnover rates harm everyone involved in the health home care industry. For the agencies, high employee churn means high financial costs. On average, caregiver turnover costs agencies $171,600 annually. Besides that, the agency also loses its productivity, patients, and the service's quality declines. 

For the still working employees, churn means additional hours, often leading to burnout or an injury.  High turnover rates are detrimental to the patients, too, as they don't get the help and the attention they need.

For many of them, consistent interaction with an employee is vital for feeling secure. But, without a good home health employee retention strategy, this is impossible to achieve.

With the increasing demand for home healthcare, high turnover rates disturb the industry. According to last year's Home Care Salary & Benefits Report published by NAHC, rates continued to worsen in 2020, hitting 22.18% - a slight increase from 2019's rate of 21.89%. 

The churn primarily affects front-line worker positions. Last year, home care aides had the highest turnover rate of all home health positions, 36.53%. The churn rates for registered nurses and licensed practical nurses were also high, at 25.85% and 34.30%.

So, how do home health workers retain? Follow these strategies to learn the best ways to engage and keep your staff.

Respect Work-Life Balance 

Fluctuating schedules are of significant concern for home health care employees and a potential driver of turnover. A recent study has found a strong relationship between variation in daily schedules and a full-time home health nurse’s probability to quit. Full-time registered nurses with the least variations in their daily schedules were 40% less likely to leave than average. In comparison, full-time nurses with the most volatile schedules were 50% more likely to churn.

The field workers' schedules can indeed be exhausting, as they often have to work around the clock. Not knowing how many days they'll work or what their hours will look like can be tiresome for your staff. Your employees want to have a work-life balance. If their schedule varies drastically from week to week, they lack the means to ensure this balance.

Most of the employees in this sector want flexible schedules that they can match with their other commitments. To ensure home health employee retention in your agency, think about allowing a wide array of scheduling options. Employees will notice your readiness to adjust the schedule to fit their personal needs. They will be more satisfied with their job and more likely to stay loyal to your agency.

Scheduling home health employees' shifts is not easy. Your patients' needs are constantly changing, and you have to be able to adapt as they come. But, there are still ways to improve your scheduling. One of the most efficient ways is to streamline the entire process using reliable home health management software.

Using an app that, like Timeero, has a scheduling option will provide considerable benefits to your employees and your agency. It will give your field workers more visibility and control over their workdays. 

Timeero scheduling

On the other side, your care coordinators will have timely insight into the employee's availability. It will allow them to match patients with their favorite caregivers. At the same time, coordinators will be able to consider caregivers’ preferences. And if the urgent need emerges, they can easily assign a free carer to fill in a shift. 

Comprehensive Training

If your employees have no opportunity to learn and grow with your agency, chances are high they may start searching for another place to work. To increase caregiver retention, your organization needs to provide various options for your employees to learn and improve. 

Besides that, if your employees know that their efforts will be acknowledged and that there is a chance to get a promotion, they will more likely stay with your agency in the long run.

Ongoing and comprehensive education and training can help you achieve your home health employee retention goals. It is essential to provide your employees with the opportunity to improve their people skills and offer training specifically for their job. A Cornel study determined that receiving disease-specific training improves home health workers’ job satisfaction and position as valued members of their teams, which is crucial for retention.

There are two ways to promote ongoing learning in your team. 

First, having a clearly defined employee development plan can help you keep your staff engaged with your business. If you establish a development plan for each of your employees, your team will know that there will be opportunities for them to grow.

The second way is providing enough training opportunities. This way, your employees will have the chance to learn and develop new skills and improve the skills they already have. Training will provide them with the tools they need to reach their career goals. Having satisfied employees on board will enhance your patients' satisfaction, supporting your business as a whole.

Apart from enhancing home health employee retention, training opportunities are also an important selling point when searching for new employees. Job candidates are more attracted to employers that can offer them more chances to improve and advance. You can win over the best candidates by highlighting the training, skills, and experience you offer.

Offer Good Pay and Benefits 

To keep your good employees, your agency needs to increase engagement and maintain job satisfaction among the entire team. Offering good pay and benefits is the primary factor in this area. 

Home care is infamous for its reputation as a low-wage industry. And not only that, but when employees find out how much agencies are charging their patients, compared to the amount they're paid, it's easy to become discouraged.

The more competitive home care agencies are in salaries, the easier it will be to attract and keep the best staff.

As your home healthcare agency grows, the need for high-quality staff increases. Competitive salaries, bonuses, and other benefits gain on their importance. Due to high turnover rates, agencies need to weigh the advantages of attractive and competitive compensation to improve home health employee retention.

The federal laws require you to provide certain benefits, such as Social Security, Medicare, FICA, unemployment insurance, workers' compensation insurance, family and medical leave. 

Health insurance is a must if your agency has more than 50 full-time employees. Each state may also have its benefit requirements, so make sure you comply with them.

However, to retain your employees, you need to go beyond the essential benefits. 

To stay competitive, think about implementing some of the extras other agencies are providing:

  1. Commuting and mileage reimbursement,
  2. Paid time off,
  3. Health insurance plans (including dental and vision),
  4. Retirement savings plan or a 401k matching plan,
  5. Paid sick leave,
  6. Maternity and parental leave,
  7. Overtime pay,
  8. Team building activities,
  9. Paid day off on their birthday,
  10. Local discounts – restaurants, entertainment, etc.
  11. Wellness incentives, such as company fitness courses or gym memberships.

Implementing home healthcare workforce management software like Timeero includes time and mileage tracking features that can help you pay your employees properly and reimburse their mileage costs while helping you optimize your agency's expenses. 

home health employee retention

Give Recognition

Bonuses and rewards are always welcomed by the employees and can contribute to home health employee retention. While negative reinforcement is a sure way to inspire field staff to seek a job elsewhere, rewards will encourage them to keep up the excellent work. 

Verbal acknowledgment or a bonus will boost their morale, improve their job satisfaction and keep them engaged with your agency, enhancing home health agency staff retention.

The bonus can be as small as a local coffee shop gift card or a day off. For extra accomplishments, if your finances allow, you can reward your employee with a bonus check or even allocate a fair rise in the regular pay. The other team members will hear of the positive rewards for good work and follow. You will achieve much more by rewarding a well-done job than expecting your employees to go over and above for no benefits.

Balance the Workload 

The quickest way to cause employee churn is to let your field staff burn out because your agency lacks adequate staffing. Some employees may genuinely enjoy their jobs.  But eventually, they might decide that it’s too difficult for them to complete their assigned tasks and that their current job is too much for them to handle. 

 You must consider the time your employees need for doing the paperwork and leave them enough hours to finish it. If you don't, your home care workers will be doing their paperwork after working hours. They will eventually burn out and leave when another agency offers them a job with more reasonable expectations. Regularly evaluate and ensure adequate staff to cover the demands and enable the agency's growth.

Besides adequate staffing, a solution to this challenge also lies in leveraging new technology solutions and streamlining the paperwork process. Some platforms, like Timeroo, can help you with many other management strategies to grow your home care business

By streamlining paperwork, you will reduce your employees' administrative burden and balance their workload. This way, your employees will be more satisfied and will finally have more time to focus on what matters – the patients. 

Establish Positive Culture 

An efficient way to improve home health employee retention is to establish a positive company culture. Even though this can seem challenging due to the nature of the work, it is all the more critical for precisely the same reason. 

Positive company culture will ensure that your workers feel connected to their colleagues and superiors, regardless of their physical locations. Such a sense of belonging will improve their job satisfaction and make them less likely to leave.

One of the best ways to improve your company's culture is by enhancing communication between your employees. A simple way is for coordinators to create messaging groups and allow employees to ask questions, brainstorm their ideas, or share success stories. They can also think about adding some fun elements to the chat to bring some laughter into their days and keep them engaged in the group.


Open communication channels will build trust and respect among your employees. At the same time, they will be able to form solid and collaborative relationships even if they are physically distant.

Also, ask your employees for frequent feedback. You can use surveys to find out what is important to your team members, get their suggestions, and determine what they think about their job. It will cost your agency a bit of effort, but the benefits that effort brings are enormous.

Identify the Causes of Turnover

It’s difficult to design a home health employee retention strategy without first discovering the unresolved issues within your agency. First, you need to determine what is forcing your employees to churn by really listening to them, asking them questions, and understanding their concerns and complaints. When you gain a thorough insight into the problem, you can begin crafting a solution.

An excellent way to begin is by creating a quick, anonymous survey for your staff to complete and trying to find out what’s weakening your agency. Here are some of the topics you can ask about:

  1. the mission of this agency,
  2.  encouragement from the team leader,
  3.  teamwork among staff,
  4. accountability of the employees,
  5. the openness of communication and sharing of information,
  6. the amount and the pace of the work,
  7. opportunities for professional growth,
  8. training opportunities,
  9. access to tools they need,
  10.  feeling valued for the work they do.

The answers to these questions can help you identify the weakest points in your agency, and you can use that insight to establish the strategy and the action plan to prevent and decrease further churn.

So, How Do You Improve  Home Health Employee Retention?

Due to the high turnover rate, improving home care staff retention is a challenge in the home care industry. The key to preventing turnover is to show your employees how much you value them, not only by your words but also by your deeds.

You can achieve this by supporting your employees to establish a work-life balance, helping them enhance their skills, and providing fair pay, benefits, and recognition. Building a positive company culture that will make your employees feel appreciated and connected will bring you even closer to fulfilling your goal.

The right home health software can help you solve some of the major pain points. With such a tool, you can pay your employees properly, reimburse their mileage costs, provide more control over the scheduling process, and streamline the administrative tasks. 

When you strategically address your employees’ major concerns and needs,  they will feel more satisfied and engaged with their work and less likely to leave.

Timeero Can Help You Retain Your Home Health Staff.

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Andjelka Prvulovic

Andjelka is a sociologist turned digital marketer. She specializes in creating content for SaaS and software companies. When she’s not researching the most effective employee management techniques, Andjelka loves cooking, reading, and fighting for human rights.

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