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Why is Home Healthcare Employee Turnover Increasing and Retention Decreasing? 

According to this Brightstar Care article, becoming a home health nurse has its benefits and is a great long-term career. Some of these benefits are work schedule flexibility and various work activities.  

Work Schedule Flexibility  

When working as a certified nurse assistant (CNA) or a home health aide (HHA), you can work weekends, evenings or a regular 9-5 schedule. You also have the choice to work for an agency or yourself. However, it is good to note that your client’s health can change, which would result in a modified work schedule if they end up in a hospital or do not require the care that day. 

Long Term Career  

The CNA or an HHA provides an excellent opportunity for a long-term career. In a typical workday, time on the job sharpens and strengthens your skills and prowess for unforeseen challenges. According to bls.gov, an estimated 1-million home healthcare positions will be needed over the next 10-years. 

High Turnover in CNA and HHA Employees  

Despite these benefits and viability as a long-term career, a study shows that the turnover rate for home health aides who worked less than a year is estimated to be 40 percent to 60 percent. The turnover rate within a year is 80 percent to 90 percent. Here are a few reasons why there is such high turnover: 

Lack of Proper Training  

According to a Medcom article, one reason is that some agencies hire employees with no training or background in the industry. This can result in new hires being unprepared to handle the assigned tasks. It could be as simple as changing a diaper, changing sheets, and making a bed. Also, if the managers who are charged with training new hires are also unprepared and untrained, it results in inefficiencies in all aspects of the home care department.  

Work Environment Safety  

From an article by the National Institute for Occupational Safety and Health (NIOSH), working in healthcare also has risks. Some employees are confronted with illegal drugs, guns, verbal abuse, violence, and, at times, assault.  

They can also be at risk of exposure to: 

  • Blood-borne pathogens  
  • Communicable diseases  
  • Unhygienic conditions  

These can lead to potential workers’ compensation, personal injury claims, and a valued employee’s possible loss. 

Salary and Benefits Leaves Much to be Desired  

The U.S. Bureau of Labor Statistics publication shows that home healthcare employees had a median annual wage of $29,430 in May 2021. The lowest 10 percent earned $22,290 or less, and the highest 10 percent earned $37,010 or more. With such a low wage, it is understandable that home healthcare aids leave once a better opportunity is presented to them. With the rise in costs from inflation, it would be expected that both HHAs and NCAs are looking for ways to improve their financial situation, even if they love the work they do. 


Costs of High Turnover at Home Healthcare Agencies 

Between the modest salary and rise in inflation, home care agencies have a high turnover, which comes at a high cost for any home care agency. According to a study, the hiring and training of a replacement for an employee earning less than $30,000 per year cost approximately $2,600, about 16 percent of the employee’s salary. 

This estimate also aligns with the Institute for the Future of Aging Services (IFAS) report, which gave a minimum estimate of $2,500 to replace a direct care worker, such as a home healthcare worker.  

Besides the costs of hiring and training replacements, home healthcare agencies are affected negatively in other ways: 

  • Perpetual strain on HR to interview and hire replacements 
  • Loss of morale within the employees and company 
  • Loss of productivity from constant replacement training 
  • Lowering healthcare quality. 


How to Lower Turnover and Retain Employees at Home Healthcare Agencies 

A way to retain employees and lower turnover are to investigate your employee engagement. How many of your employees truly feel engaged and appreciated?  

According to Gallup’s survey, there are 12 needs that need to be met for employees. Below are some of the questions to ask employees for insight into the actual state of employee engagement within the home healthcare agency: 

  • Do you know what is expected in your role? 
  • Do you have the materials and equipment to work? 
  • Does your opinion seem to count at work? 
  • Does your supervisor or someone at work seem to care about you as a person? 

If the answers to the questions are no, it is worthwhile to start implementing ways to improve all 12 facets of employee needs. With the improvement of all 12 needs and the benefits that are already or should be in place (such as medical insurance, 401k, and paid time off), the retention of home healthcare employees should improve and lower turnover! An additional by-product is that your company will also attract better employees and retain them when hiring. 

  • Are you interested in learning more about the importance of employee engagement and how to improve employee retention for your company? We provide a tried-and-true model that brings desired results in managing employee retention and hiring at your home healthcare agency. Call us today at 219.281.2459! 

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