Strategies for Retaining Top Talent in the Home Care Industry

July 17, 2025

While recruiting home care staff can be challenging and costly, losing and replacing staff is more frustrating and expensive. Not only do you incur recruitment and orientation/training costs, but you must also consider and factor in the lost opportunity costs. Together, they are considerably higher than the recruiting and onboarding costs. It is estimated by some experts in the industry that the turnover of health care staff can be as high as 80% a year.

Replacing an employee can cost roughly 6 to 9 months of the departing employee’s salary, according to SHRM.


Some sources suggest a range of 50% to 200% of an employee’s annual salary, depending on the role’s level and specialization. A common formula used for budgeting is to estimate between 1.25 and 1.4 times the employee’s base salary to cover recruitment, onboarding, training, and lost productivity. It’s important to note that these are general estimates, and the actual cost will depend on factors like industry, location, and the specific role being replaced.

TURNOVER COSTS

According to Google AI, the indirect costs of turnover are:

  1. Lost Productivity comes from: Reduced output from the departing employees, time it takes to onboard and train a new employee to full productivity, and potential disruptions to projects and deadlines.
  2. Impact on Morale: The departure of colleagues can create uncertainty and negativity among remaining staff, potentially leading to disengagement and lower productivity.
  3. Knowledge Loss: Departing employees take with them valuable institutional knowledge and expertise, which can disrupt workflows and customer relationships.
  4. Potential for Further Turnover: Low morale and increased workloads can lead to burnout and even more departures, creating a cycle of high turnover.


With this kind of cost to the agency, why would you not spend at least half as much on retention programs to prevent this undesirable cost to your agency?


RETAINING HOME CARE AIDES

In order to develop retention strategies for a group of providers, you must first determine the cause of turnover. According to Google AI, the reasons for aides leaving a health care agency are:

  1. Low Wages and Lack of Benefits: Home health aides often earn low wages and may not receive benefits like health insurance or paid time off which makes it difficult to attract and retain qualified staff.
  2. High Physical and Emotional Demands: The job can be physically demanding with tasks like lifting and transferring patients. It can certainly be emotionally taxing, especially when dealing with clients' health declines or end-of-life care.
  3. Lack of support and recognition: The jobs in the field are difficult and do not have the support of other colleagues on site. The staff need to do the best they can. They leave because no one seems to recognize the hard work they do.
  4. Limited Career Advancement Opportunities: Some agencies may not offer clear paths for career growth or professional development which leads aides to seek opportunities elsewhere.
  5. Burnout and Stress: The combination of physical demands, emotional challenges, and high workloads can lead to burnout and increased stress among aides.


You need to dig down deep and analyze you agency. Why do your aides leave? Is it all of the above? Are there different reasons you need to consider that are specific to your agency?


RETAINING CLINICAL STAFF: RNS, LPNS, PTS ETC

The cost of replacing skilled staff in home health can range from 16% to 200% of the employee's annual salary, according to several reports. For a nurse, this could be around $56,300, according to a Medbridge report. For a position like a home care worker making less than $30,000 per year, it could be around $2,600, according to a report from the Center for American Progress. A report by PHI suggests that replacing allied health personnel can cost at least $6,368; including lost productivity he total cost includes direct expenses like recruitment and training, as well as indirect costs like lost productivity and potential negative impacts on client care.


Here's a breakdown of the cost factors:

  1. Direct Costs: These are expenses associated with finding, hiring, and onboarding new employees. This involves advertising job openings, conducting background checks, providing training, and covering the costs of physicals or drug tests.
  2. Indirect Costs: These are more difficult to quantify but can be significant. It includes the loss of productivity while a position is vacant, the potential for errors due to inexperience, and the negative impact on employee morale when turnover is high.
  3. Specific Roles: The cost of turnover varies depending on the role. Replacing a specialized healthcare professional can be very expensive, potentially reaching 200% of their annual salary, says Oracle.


High turnover rates can significantly impact home health agencies, leading to increased costs and potential disruptions in care. Reducing turnover through improved employee retention strategies is crucial for maintaining a stable workforce and providing quality care.

Given the high cost of turnover in an agency, we would suggest that spending 20% of the potential lost cost on retention strategies would be well worth the expense. As noted, every agency is different depending on the client/patient caseloads and the state and communities in which you operate. If you have high turnover in your agency and are struggling with developing effective retention strategies, contact Kenyon Home Care Consulting by email or call 206 721 5091. We are here to help.

Results Based Consulting

Did you find value in this blog post? Imagine what we can do for your home care or hospice agency. Fill out the form below to see how we're leading the industry with innovation, affordability, and experience.

Contact Us

Oasis accuracy
By Ginny Kenyon January 26, 2026
OASIS and ICD-10 coding influence decision-making, reimbursement, quality reporting, and agency performance. Ensuring accuracy is essential for every home health.
chronic disease education
By Ginny Kenyon January 22, 2026
Chronic diseases account for the majority of healthcare utilization and spending with a disproportionate share of hospital admissions, ER visits & long term costs
Interim Management
By Ginny Kenyon January 20, 2026
An experienced interim manager can provide stability, expertise, and momentum- if the right individual is selected during your time of need and transition.
OASIS success
By Ginny Kenyon January 17, 2026
OASIS plays a critical role in care planning, quality, reimbursement, and regulatory compliance and is also key to success and integrity of Medicare Home Health.
policy and procedure manuals
By Ginny Kenyon January 15, 2026
Policies and procedures serve as the foundation for consistent, fair, and effective operations. Your manual should be a living breathing guide for your agency.
chronic disease education
By Ginny Kenyon January 7, 2026
For aides, education in chronic diseases is not just helpful, it is essential for ensuring safety, dignity, and quality of life for the people they serve.
nurse key to HHCAHPS
December 23, 2025
Educate your staff to the HHCAHPS questions so they remember that performance is measured by the patients and will be reflected in the survey findings and payment
success in home health surveys
December 19, 2025
Surveys are heavily focused on data to serve as evidence of your agency's practices. Create a "Survey Book" containing all required documents for immediate access.
December 18, 2025
For home health agencies, a regulatory survey is not just an inspection—it's a high-stakes assessment of your commitment to patient safety, quality care, and operational compliance. Since repeat surveys are unannounced, the goal is to cultivate a culture of "survey readiness every day." Preparing your agency for a successful survey requires proactive planning, meticulous documentation, and full staff engagement. Below are the steps to build for continuous compliance. 1. Develop a Survey Team: Preparation starts with designating a core team responsible for the survey response. Clear roles ensure a calm, organized, and efficient process when a surveyor walks through the door. Each person needs to know exactly what they are responsible for and what metrics they need to track to be sure the agency is always ready for a survey. The Administrator/Survey Lead: Must be present for the entrance conference. This person is the main point of contact, handles high-level questions, and maintains a professional atmosphere for the organization with the agency staff and with any surveyors. Director of Clinical services/ Supervisor: This team member is responsible for assuring all documentation is reviewed and appropriate. This includes OASIS accuracy, that the plan of care matches the OASIS findings, and visit documentation follows the plan of care. ICD-10 Coders: This team member reviews the OASIS and matches it with the discharge summary to assure accuracy of OASIS (along with DCS or Supervisor). The coders also verify the ICD-10 code accurately reflects findings of the OASIS. Clerical Support: Staff is responsible to all personnel records monthly review for required documents and all new employees for same while reporting any missing documents (e.g. updated license, auto insurance, driver’s license etc.). Create plans and have operations in place to communicate at least a month in advance to employees when items need updated. This person is also responsible for managing the logistical needs when the surveyors are on site (e.g., Wi-Fi password, workspace, etc.) to create a buffer for management. They also discreetly communicate critical questions to the Survey Lead. The team member acting as Survey Lead is considered the survey readiness team leader. Promoting survey readiness should include regular monthly meetings with all of the survey readiness team members. Each team member should be ready to report on the status of their responsibilities and any data to support their findings. These findings include: a. Status of OASIS accuracy and any staff who need training. b. Planned OASIS training that provides regular updates on areas where staff continue to struggle. c. Plan of care with matching visit notes d. Personnel files and any updates when employees are not responding to the request for documents e. Status of continuing education per state or federal requirements f. Yearly evaluations with supervisory visits to support evaluation. Supervision needs to pay particular attention to hand washing according to policy and standard infection control procedure when getting in an out of bag, with client contact, or coming in and out of the home. This remains one of the primary findings by surveyors. g. Evidence of yearly required continuing education such as: • Infection control • Patient Rights and Advocacy to uphold dignity and autonomy • Emergency Preparedness with response protocols; evidence of bi-yearly practice drills for a potential emergency • Medication Management and safety to prevent errors • Updated relevant health care regulations and policies • Cultural competency to enhance communication and care for diverse populations. All data collected by the team members may need to be sent to the compliance manager and may become part of a plan of correction for the Quality Assurance program. Should you need assistance with survey readiness, please continue to part 2 of this series and call Kenyon Homecare Consulting at 206-721-5091 to help you get there!
ICD 10 coding and Oasis
November 25, 2025
In the regulated world of home health, OASIS and ICD-10-CM Coding integrity non-negotiable for quality, compliance, and critically, and agency's financial health!