Recruitment in Home Health and Home Care Staff is Urgent, not just an Issue
July 12, 2025
One of the biggest challenges for home care and home health agencies is the recruitment of staff to provide care for the clients/patients. Whether the agency is skilled or non-skilled, the high cost of recruitment and hiring is only exceeded by the severe problem of retention of staff.
RECRUITMENT:
The health care industry as a whole is struggling with recruitment of care giving staff. As I wrote in last week’s blog, Navigating the Supply and Demand Challenges in Home Care, there are reasons for the short supply of caregiving staff. As a result, there is significant competition for all levels of caregivers, whether RNs, LPNs or aides. The recruitment strategies will vary based on the caregiver types below:
- For home care aides, there are many diverse methods such as online job boards, employee referrals, sign on bonuses and the use of recruitment software. Whether it is one of the above recruitment strategies or a combination, the process can prove to be costly. When you add to the additional costs of onboarding, an agency is looking at a costly investment. To determine total costs, you must look at the cost of recruitment dollars spent and onboarding (screening, interview time, criminal background checks, reference checks, TB screening and HPB vaccination, orientation, skills lab, additional training needed and orientation to your population served). Cost can be as high as $2,600 to $5,000 per aide depending on strategies used.
The average annual caregiver turnover cost for home care agencies is approximately $171,600. This cost encompasses expenses such as job postings, interviews, screening, hiring time, training, management time, and lost productivity until a new hire becomes proficient. Another estimate states the average home-based care provider spends around $174,174 on turnover annually. [ AI mode Google]
As you can see, it is expensive to recruit and hire and even more to replace those who resigned. You must consider and account for lost opportunity costs to the agency when you do not have enough staff to fill shifts. According to the Home Care Association of America, turnover rates are exceeding 79%. This means that roughly four out of every five caregivers may leave their positions within the first year. This high turnover rate significantly impacts the continuity and quality of care provided to individuals in need of home-based support.
2. Home health agencies face several significant challenges in recruiting and retaining Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). Some contributing factors are:
- High Demand vs. Low Supply: There's a national shortage of qualified nurses across various healthcare settings, including home health. This was discussed in an earlier blog on supply and demand and as of this writing, continues to be a major issue for recruiting RNs and LPNs.
- Aging Workforce: A substantial portion of the current nursing workforce is nearing retirement, exacerbating the shortage.
- Insufficient Educational Capacity: Limited access to nursing education programs due to faculty shortages, lack of clinical sites, and resource constraints restrict the number of new nurses entering the field.
3. Other issues reported by AI Google as barriers to attracting nurses to home health are:
- Competition: Home health agencies often compete with hospitals and SNFs for talent, both of which may offer higher salaries, sign on bonuses, and more comprehensive benefits.
- Lower Compensation and Benefits: Home health care can struggle to offer competitive wages and benefits due to factors like Medicare and Medicaid reimbursement rates. This will only get worse in the following years as the newly released CMS reports that CY 2026 is estimated contain a $1.13 billion cut in payments with an additional 10 new regulations to comply with.
- Some perceptions of home health: Some nurses may perceive home health as less prestigious or challenging compared to hospital-based positions. Hospital nursing is still seen as more glamorous than working from your car and in different homes. It takes a special kind of nurse to do home health.
- Lack of Structure is another cited reason for difficulty in getting nurses to work in home health. Nurses often work independently with little contact with other nurses or professionals. This lack of structure and immediate peer support found in hospital settings is lacking and for some nurses not as attractive.
While recruitment for both professional and paraprofessional workers in home health is sometimes difficult, there are strategies that can help your agency overcome these barriers. If you need help with these issues, Kenyon Home Care Consulting senior consultants are tenured in the industry and able to assist you in achieving success. Call 206 7251 5091 or email gkenyon@kenyonhcc.com
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