Unlock Profit Growth and Boost Employee Engagement!

September 19, 2025

Every home care/home health agency is in the business to make a profit. To do so one must increase retention of staff you already hired. In previous blogs, I wrote about the cost of recruitment, hiring, orientation and training. It is estimated that it costs an agency around $2000 to $5000 to hire and replace an aide. We also see that the turnover rate is still close to 80% a year. Therefore, it is estimated an agency is spending on average $171,600 per year for an agency per 100 aides. 


What if most of that money spent on recruitment could go to your bottom line? The key to increased profits is increased referrals and retention of staff. Over the years running agencies, I learned that to increase my referrals I had to have the best staff of any other agency in my territory. And,  I had to retain that staff. The key was listening to and investing in the staff. 


For that reason, I created a Chronic Disease University. Each disease process is an 8-hour course divided into 4 modules. There are tests after each module and when someone completes the course material. The courses are “take it until you make it”. They are designed to educate, not pass or fail! The courses are certified by DSHS as 8 hrs. of continuing education for field staff. 


Two of the courses were tested in the acute wing of a nursing home. The facility, in a 6 month time period, had 13 CHF and 3 COPD patients readmitted to the hospital in the first two weeks of admission to the SNF. This resulted in financial penalties to the nursing home. All 32 staff were required to take both of those Kenyon chronic disease courses. It took 3 months for all the staff to complete and become certified. The results were beyond what we had anticipated. Readmission for these two chronic diseases dropped to 0 and 0  not only on the acute wing but for the entire 164 bed building, as the MDS nurses worked the entire building. 


When the hospitals discovered that there were no readmits for these two diagnosis, referrals increased by 30% and the SNF was invited to participate in A Robert Wood Johnson study on CHF. The surprise was the increase in retention. Retention climbed to 80% with those leaving only because they were hired by the area hospitals who paid more than the SNF. Increased referrals, increased retention and increased profits! A win, win, win!!


If you want to win, win, win, go to Kenyon Education under the store tab. Make your agency truly stand out among the rest. Hire the best, train the best, retain the best and let the profits grow! If you need assistance, please contact Ginny Kenyon at gkenyon@kenyonhcc.com or 206-721-5091. 

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

Revenue leaks
By Ginny Kenyon September 17, 2026
Is your Home Health agency making money but not as much as others in your area? Is your clinical and coding team making mistakes that leave money on the table?
Home care and hospice coaching
By Ginny Kenyon September 12, 2026
When evaluating a mentor or advisor for post-acute care leadership, look for these non-negotiable qualities and capabilities to ensure you have what you need.
Unlocking fair reimbursement
By Ginny Kenyon September 9, 2026
The OASIS assessment and ICD-10 coding are not mere administrative paperwork—they form the financial baseline of the entire agency. And, the clinical must match.
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 .