The Four Foundations to Improved Staff Retention in Home Health

Home health agencies face formidable challenges daily, from providing care for the most vulnerable to ensuring compliance with ever-evolving industry changes and regulatory updates. In a recent survey of more than 500 home care professionals working in and alongside the home care industry, staffing is still the most critical challenge for home-based care.  Learn about the reason behind their worries—and what you can do to protect your most valuable asset.

Home healthcare agencies can improve staff retention by refining practices they already have in place while implementing new ideas to encourage loyalty from their employees. Most agencies already have the foundation for employee retention and simply need to build on it.

You may be shocked at how high the cost of employee turnover in an agency is. Don’t waste another moment. There are best-practice steps you can take right now to stop losing good people.

How Can Homecare Agencies Improve Staff Retention?

There is no one-size-fits-all solution for employee turnover because home care agencies vary widely on patient and employee demographics, company size, and location. Available resources such as people, dollars, and time will be different for each company.

Yet while the implementation may look different, there are some key areas that we can all work on regardless of how big or small our agency and our employee roster.

The Four Foundations

Here are the four foundational things you should already be doing in your agency:

1. Ensuring Adequate Paid Training

Training your staff is vital. It is one area that you cannot afford to skimp in.

Spending ample time orienting new employees to your company and their roles not only improves compliance with policies and procedures, but it also helps employee satisfaction. When job expectations are clearly defined, employees have an opportunity to shine. When team members know what to do and how to do it, the job will likely get done. Everyone likes to hear “good job!” or “way to go!” Set your employees up for success, and then watch as they thrive in their new role.

Upskilling, or teaching your workers new job skills, not only improves your agency operations, but it is beneficial to the employee.  By providing adequate paid training for the job, you are enhancing your employee’s skills and experience. This is also an important selling point when recruiting. Candidates are attracted to employers that can do more for them. When your job offer is competing against another company, you will come out on top when you emphasize the training, skills, and experience you offer. Good employees will want to work for you if you enhance their resume and give them more professional options.

2. Investing in Human Resources

Be an HR-driven company. Ensure that Human Resources teams and individuals have adequate resources (including money) to invest in recruiting, hiring, training, and retention. You will find these resources were well-spent, and you will get a good return on investment.

When your Human Resources team dedicates time to improving employee morale, giving frequent and constructive feedback and support, and maximizing time spent onboarding, you will see greater employee satisfaction. Your new hires and your management team will appreciate the efforts. And your staff turnover will decrease, as team members find greater job satisfaction.

3. Creating a Culture of Support & Communication

Communication is critical. Nothing can strain a relationship like a misunderstanding or lack of communication. When employees feel unheard or unsupported, they will likely become dissatisfied with the job.

One way to keep the communication lines open is frequent feedback. Surveys are one easy way you can do this. You can keep employees engaged and stay in constant communication through staff surveys and appraisals. Ask your team members what matters to them, what they think about their job, and what suggestions they have. Open communication costs your agency nothing but a little effort.

Avoid putting too much time and effort into exit surveys conducted with staff who are leaving your company. Those employees have no incentive to give you constructive or helpful observations. This time may not be time well spent. Their comments may not be beneficial.

4. Providing Quality Tools

The right tools make jobs easier, helps attract and retain the right staff, and decrease turnover.

Recently, one large home care provider dramatically reduced turnover by focusing on quality and software improvements, which significantly boosted productivity and profitability.

It’s a no-brainer. If the tools and software your employees use daily are clunky, buggy, or challenging to use, a large portion of their day is spent working in frustration.  Conversely, if the software is easier to use and more streamlined, your employees will be happier, plus regain time for other tasks.

Look at your current EMR software, as well as your business objectively. If there are processes and software that could be modified or changed to help staff, consider its impact on improved retention.

Here is an article that can help you choose the best records management program for your company.

What Do Home Care Employees Want in an Employer?

Once you begin the process of strengthening your foundations, you can implement new ideas for staff retention. But to know how to attract and keep the right employees, you must understand what home care providers want.

Here items on your potential employees’ wish lists:

  • Agency culture of appreciation
  • Growth and development
  • Work-life balance
  • A sense of purpose and job satisfaction that inspires them
  • Good pay and benefits such as paid time off

As a newer generation joins the home care industry, it is beneficial to look at what millennials say they want in a job. An article in Nurse.com says that younger healthcare workers entering the field are looking at these growth and development opportunities. You can attract them with benefits such as tuition reimbursement for pursuing higher education, certification programs, and additional training.

Even small home care agencies can provide such opportunities for relatively little or no cost. By networking with colleagues and vendors, you can arrange in-services, free continuing education programs, and training on new products and medical devices.

In the post-COVID era, remote onboarding, training, or work arrangements may be another idea for home care agencies seeking to attract employees.

How much does turnover cost an agency?

If you have not estimated how much employee turnover costs your agency, you may be startled to learn just how high that price is. The cost to hire and train each staff replacement is around $2,600. This estimate may include job postings, interviewing, screening candidates, hiring time, training time with management, lost productivity until the caregiver is established, and morale lost in the company. The cost is high.

Good employees are hard to find, and harder to keep. That is because they may find better opportunities.

In healthcare, we find ourselves with an increasing nursing shortage and a growing market of need. Estimates show that over 20% of the population in 2050 will be 65-plus compared to 13.7% today. There is no end in sight for the ongoing need for good home care employees. Those qualified to do the job and with a desire to do it are in high demand.

A recent survey reported a 5-year high of 76% turnover rate. These figures show that turnover is draining agency resources. As the need for home care providers increases, so must our dedication to recruiting and retaining the right people for the job.

The costs are more than monetary. High turnover rates cost employees morale, too. When employees leave, patient care is interrupted. This leads to poor outcomes. Clients may suffer emotional and physical effects when reassigned to new caregivers who are not as familiar with their baseline health status or their needs.

When patients are dissatisfied, they may go elsewhere. Sometimes they will leave your agency to follow a nurse or an aide who left to work for the competition. Turnover can mean lost clients.

Not only do homecare companies risk losing patients when their caregivers leave, they also stand to lose future business. Word of mouth travels. Patients who are unhappy with their services will likely share that experience with others who are looking for in-home care. Dissatisfied customers can impact reputation, relationships, and referral sources.


The cost of employee turnover is high. As the need for home care and providers grows, home healthcare agencies should concentrate on improving existing efforts while exploring these new ideas to recruit and retain.

Now is the time to put these concepts to practice and improve your business.

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Alora can help with employee retention.  Easy-to-use software is paramount to staff satisfaction and retention, since they spend all day interacting with it. Software that is frustrating and challenging, has been cited as a primary reason for staff abandoning ship.  One of the top reasons our customers say they love Alora is that it’s so easy to learn and use.

Learn how Alora can create better staff retention >

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