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:


  1. 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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controlling chronic diseases
By Ginny Kenyon April 25, 2026
In the rapidly evolving landscape of healthcare, the burden of care is increasingly shifting from clinical facilities to the home. As the population ages, the prevalence of chronic conditions—such as heart disease, diabetes, and respiratory disorders—has reached unprecedented levels. For home care agencies, the quality of service is no longer just about assistance with daily living; it is more and more defined by the clinical competencies and disease-specific knowledge of your field staff. Chronic disease education for home care staff is not a luxury, is a strategic necessity that directly impacts patient outcomes, caregiver confidence, and the business’s bottom line. 1. Enhancing Clinical Outcomes and Safety Home care staff are the "eyes and ears" of the healthcare system. When aides and clinicians are highly educated on chronic disease processes, they can identify subtle shifts in a patient's condition before they escalate into emergencies. · Early Intervention: An educated caregiver can recognize the early signs of fluid retention in a Congestive Heart Failure (CHF) patient or skin changes in a diabetic patient, allowing for proactive adjustments rather than reactive ER visits. · Medication Adherence: Understanding why a medication is prescribed for a specific chronic condition helps staff reinforce the importance of adherence to the patient, reducing the risk of complications. 2. Reducing Hospital Readmissions Hospital readmission rates are a primary metric for home health success. Chronic diseases are the leading cause of "revolving door" hospitalizations. By providing specialized education, agencies empower their staff to implement Evidence-Based Practices at the bedside. When staff can effectively manage symptoms and educate patients on self-care, the likelihood of a patient staying stable at home increases dramatically. This not only benefits the patient but also strengthens the agency’s reputation with referral sources like hospitals and physician groups. 3. Boosting Staff Confidence and Retention The home care industry faces significant challenges with staff turnover. Often, burnout is fueled by the stress of feeling unprepared for complex patient needs. Knowledge is Empowerment: When staff members receive robust training, they feel more confident in their roles. This professional growth fosters a sense of value and belonging within the organization, leading to higher job satisfaction and lower turnover rates. 4. Improving Documentation Accuracy In an era of increased regulatory scrutiny, clinical documentation must be precise. Education on chronic diseases ensures that staff members use the correct terminology and focus on the most relevant clinical indicators during their assessments. · OASIS Accuracy: For Medicare-certified agencies, a deep understanding of chronic conditions leads to more accurate OASIS scoring, which directly influences reimbursement and quality ratings. · Audit Readiness: Well-educated staff produce notes that clearly reflect the necessity of care, making the agency much more resilient during regulatory surveys or audits. 5. Bridging the Communication Gap Effective chronic disease management requires a multidisciplinary approach. A caregiver who understands the nuances of a disease can communicate more effectively with: · Physicians: Providing clear, clinical updates that help doctors make informed decisions. · Family Members: Offering clear explanations and peace of mind to stressed family caregivers. · The Internal Team: Ensuring a seamless transition of care and consistent messaging across all disciplines. Conclusion Investing in chronic disease education is an investment in the agency’s future. By elevating the knowledge of the frontline workforce, home care providers can transform from basic service agencies into high-value clinical partners. In the end, the goal is simple: providing the highest quality of life for patients in the comfort of their own homes, a goal that can only be met through a highly trained and knowledgeable staff. If you do not know where to get comprehensive education for Chronic diseases, contact Kenyon Homecare Consulting at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help
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