Thinking About Discharging A Client For Cause? Sometimes The Only Answer Is To Do It Now.

June 9, 2023

As a home care agency, you work so hard for clients. Your goal is to get the referral, provide the requested care, and then have a satisfied customer for years, right? Realistically, you normally spend more time on those who are not satisfied than the ones who are. If you are at wit's end, then you need to consider if it is time for the client to go somewhere else. Ultimately, it may be the best thing for your agency as well as the client.

Reasons To Discharge A Client For Cause:

  1. Abuse of Caregivers: We have all had these clients. There is certainly a difference between the client who can be grumpy at times versus those clients that have caused your agency to lose good staff. Now your abusive client has caused you staffing issues across the board because caregivers resigned. There is no question that we cannot afford to lose good staff because they are treated poorly in client homes. Caregivers do not have to endure physical or verbal/ emotional abuse and agencies should not tolerate it. 
  2. Client Needs do not fit agency expertise: If you determine the client has needs your staff does not have the skill set to provide, don't take the client. If you already have, then work with the client to find an agency able to provide the services that meet their. There is nothing wrong with communicating to your client that your specific specialty is different and that the client would be better served elsewhere.
  3. You do everything as asked, but it is never enough: All of you are currently picturing a particular client, aren't you? These individuals take up a ton of staff time without a true resolution to "problems". As soon as you fix one thing, it is something else. Ultimately, you have to ask yourself if you actually lose dollars by continuing to serve the client. You may have a lot of time invested versus the reimbursement you receive. Plus, you have to ask what kind of complaining this individual does in the community and whether servicing them hurts your business.
  4. Accusations against staff: Of course, any accusation against a caregiver needs investigated. In working with agencies, we have seen those clients who accuse multiple caregivers of the same infraction such as theft of medication or items of value. These same caregivers may be in many homes with never a complaint from anyone. One wrong accusation throughout the communities you serve can hurt your businesses.
  5. Expect Discounted Services: We have found that agencies offering discounts for services often have the clients who are never satisfied. If the client has gotten discounts related to complaints, then the client is potentially incentivized to complain. We understand the client may have financial concerns, but discounting your services minimizes your value.

We understand your agency wants to keep as many current clients as possible, but not all clients help you build your business, retain employees, and have a positive profit margin. For these clients, there may be an agency that is a better fit or the client may need to have different and realistic expectations from the caregivers in the agency.

At Kenyon Homecare Consulting, we help agencies achieve clinical, operational, and financial goals while providing high quality care. Call us today at 206-721-5091 or contact us online to see how we can help you get there.


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

practical teaching
By Ginny Kenyon September 2, 2026
Home health is a vital bridge between acute hospital intervention and long-term wellness which requires shifting focus from crisis management to patient empowerment.
interim management
By Ginny Kenyon August 29, 2026
An interim manager offers immediate stability, proven expertise, and a fresh perspective while the organization searches for a permanent leader in administration
Competitive advantage
By Ginny Kenyon August 26, 2026
Product features can be copied, and prices undercut, but a highly trained field team that consistently delivers stronger clinical outcomes is difficult to beat.
policy and procedure manual
By Ginny Kenyon August 22, 2026
A policy manual is only as good as its last update. Agencies should establish a routine—at least annually, and following regulatory shifts—to review and revise.
increase revenue
By Ginny Kenyon August 21, 2026
Chronic disease education is more than clinical compliance; it is business strategy. Staff becoming chronic care experts increases revenue and improves retention.
improve care
By Ginny Kenyon August 15, 2026
In an era of rising healthcare costs and widespread clinician burnout, healthcare organizations are facing a critical challenge: how to deliver superior patient care while maintaining a stable, motivated workforce and a thriving business model.
Stroke training
By Ginny Kenyon August 12, 2026
When a patient returns home after a stroke, the clinical landscape changes instantly. Survival is just the first hurdle; the real challenge lies in navigating the complex, often unpredictable journey of rehabilitation and long-term care. For home health and home care agencies and senior care facilities, caring for a stroke survivor requires more than help with Activities of Daily Living (ADLs). Stroke can affect a patient’s neurological, physical, and emotional functioning simultaneously. That’s why specialized, stroke-specific clinical training for caregivers is essential to improving patient outcomes, supporting staff retention, and strengthening the agency’s overall performance. The Multidimensional Complexity of Post-Stroke Care A stroke is not a singular event with a linear recovery path. Depending on the location and severity of the brain injury, caregivers may confront a baffling array of concurrent deficits: Physical and Motor Deficits: Hemiparesis (one-sided weakness) or hemiplegia (one-sided paralysis) completely alters transfer techniques. Improperly moving a patient can cause severe shoulder subluxation or skin tears. Cognitive and Communication Barriers: Aphasia (difficulty speaking or understanding speech) and dysphagia (swallowing difficulties) require immense patience and highly specific intervention techniques to prevent profound frustration or life-threatening aspiration pneumonia. Neurobehavioral Changes: Sudden emotional lability, post-stroke depression, or structural personality changes can easily overwhelm an untrained caregiver, leading to burnout or adversarial dynamics in the home. Without structured education, caregivers are left to rely on intuition. In complex neurological care, intuition is rarely enough to prevent adverse events. 4 Strategic Benefits of Specialized Stroke Education Investing in robust stroke-specific training programs transforms an agency's frontline staff from general monitors into clinical assets. 1. Drastic Reduction in Hospital Readmissions The first 30 to 90 days post-discharge are high-risk windows for stroke survivors. Educated caregivers act as the eyes and ears of the clinical team. They are trained to look past basic symptoms and identify subtle warning signs early: Recognizing micro-signs of silent aspiration during meals. Monitoring for deep vein thrombosis (DVT) in affected limbs. Identifying skin breakdown early on the hemiplegic side. Spotting the warning signs of a secondary stroke using the B.E. F.A.S.T. protocol (Balance, Eyes, Face, Arms, Speech, Time). Early identification allows for timely home health or physician interventions, keeping the patient safe at home and protecting the agency's rehospitalization metrics. 2. Safeguarding Staff and Patients (Risk Mitigation) The process of transferring a patient with dense hemiparesis requires precise biomechanical knowledge. Specialized education teaches caregivers how to support the affected side without pulling on weakened joints, how to properly utilize assistive devices (gait belts, sit-to-stand lifts), and how to manage one-sided neglect (where a patient completely forgets one side of their body exists). Proper training mitigates the risk of catastrophic falls and shields caregivers from debilitating musculoskeletal injuries, directly lowering workers' compensation claims and liability exposure. 3. Boosting Staff Retention and Professional Empowerment High turnover in caregiving is often caused by burnout and feeling unprepared for challenging cases. When an agency provides specialized clinical training, helping staff understand stroke-related behaviors and advanced transfer methods, it strengthens the caregiver’s role. Staff members feel empowered, confident, and valued as professionals rather than viewed as standard domestic labor. This professional dignity translates directly into higher job satisfaction and improved staff retention. 4. A Powerful Market Differentiator In a crowded marketplace, families and hospital discharge planners look for specialized expertise. An agency that can explicitly state, "Our caregiving staff undergoes advanced, competency-verified training in post-stroke neurological care, dysphagia management, and transfer safety," holds a massive competitive advantage. It builds immediate trust with families and establishes preferred provider relationships with local health systems and stroke centers. Building a Competency-Based Training Framework Effective stroke education cannot be a passive, check-the-box exercise. To truly impact care quality, an agency's training framework should combine foundational knowledge with hands-on validation: Neurological Fundamentals Core Focus Areas: Types of strokes, one-sided neglect, emotional lability, and aphasia communication strategies. Competency Verification: Written scenario analysis and communication roleplay. Mobility & Safety Core Focus Areas: Safe transfers (bed to chair), handling the flaccid or spastic limb, fall prevention, and skin integrity. Competency Verification: Hands-on return demonstration with a mechanical lift/gait belt. Nutritional Security Core Focus Areas: Dysphagia precautions, recognizing pocketed food, fluid thickening consistency, and aspiration prevention. Competency Verification: Direct observation of meal prep and feeding techniques. Conclusion: An Investment in Excellence The care of a stroke survivor is inherently complex, demanding, and volatile. Expecting caregivers to navigate these intricacies without targeted clinical education places an unfair burden on the employee and exposes the patient and the agency to significant risk. By prioritizing advanced stroke education, agencies and facilities do more than just improve compliance; they foster a culture of clinical excellence. The results are undeniable: safer patients, more confident and loyal caregivers, and a highly respected agency brand that stands out as a leader in complex home-based care. For in-depth education on caring for a person with a stroke, contact Kenyon HomeCare Consulting, which offers an 8-hour DSHS-certified continuing education course . Each chronic disease course includes a certification with a red-and-yellow flag guide that can be laminated for caregiving staff. To learn more, call 206-721-5091 or email gkenyon@kenyonhcc.com .
MS care
By Ginny Kenyon August 8, 2026
MS is notorious for its volatility. Understanding nuances like the MS Hug or Uthoff's phenomenon are crucial to providing the quality of care these patient's need.
arthritis care
By Ginny Kenyon August 5, 2026
Arthritis can cause daily pain taking a massive toll on patients, often leading to depression and anxiety. Education bridges the gap between frustration and empathy.
Depression patient
By Ginny Kenyon July 30, 2026
Educating staff on depression isn't just a treating mental health issue—it is actively preventing a cascade of physical declines and re-hospitalizations.