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Anyone who’s worked in home health care is familiar with the revolving door of turnover—and how hard it is to stop it. Many home health agencies report high turnover rates (over 21% on average) that challenge their ability to deliver high-quality services.

The demand for workers is only going to get worse from here as more and more people choose to age in place. Even if a caregiver enjoys their job, salary and growth opportunities may force them elsewhere. This can have devastating effects on patients, who often form meaningful bonds with caregivers.

So what are you to do? We explore the problem and offer solutions.

Challenges in HHA Retention

There are many factors that affect an agency’s ability to retain workers. Let’s break down some of the most common.

1. Low Compensation

The average salary for a home health aide (HHA) is around $27,600 to $33,000. Meanwhile, the poverty line for a family of four in 2023 is $30,000.

It’s not surprising that many HHAs may be struggling to make ends meet. Even if they enjoy the work and feel connected to their customers and co-workers, it may not be enough to make them stay. They may need to leave the industry in order to pursue other financial avenues. Research from Apploi’s partner myCNAjobs found that caregivers are likely to be in the lowest income category—seven times more likely than the average American. Over half (54%) use public assistance to help make ends meet.

2. Limited Career Development

It can be hard for caregivers to envision a career path. Their next steps in healthcare, such as going into nursing or management, usually require more education and financial investment. Further education might be difficult to swing on an HHA’s yearly salary. It can become frustrating to do the same job day after day without knowing if there are growth opportunities available. This frustration could lead to a home health aide leaving their position—or even healthcare overall.

3. Demanding Workloads

Caregiver work isn’t always easy, and this is especially true if your agency is understaffed. Caregivers may need to take on additional work in order to fill in the gaps, but this can quickly lead to burnout. As more caregivers quit, the remaining caregivers are stretched too thin, and the cycle continues.

4. Inadequate Support

For many caregivers, work is almost entirely remote. They might not have easy access to an office where they could quickly ask a question and get support. Instead, they may feel unsupported and isolated as challenges arise. This is especially true if your agency struggles to communicate efficiently with employees. Feeling alone in their positions could easily compound feelings of burnout and lead to an exit from the industry.

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Strategies for Caregiver Retention

We’ve gone over some of the major challenges to caregiver retention. But it’s not all hopeless. Here are seven strategies you can employ to reduce caregiver turnover at your agency.

1. Get Creative With Compensation and Benefits

We know what you’re thinking—the realities of the home health care business might mean that you can’t promise a dramatic increase in wages. But even if you can’t boost compensation, there are certain things you can do to make your salary and benefits more attractive.

First, look at the numbers. Are you losing more in caregiver turnover than you would if you increased salaries? Not every organization will be able to increase salaries across the board, but data can help you make the right decision for you.

If you can’t increase salaries, then attractive benefits are a great way to improve caregiver retention and attract new candidates to your workforce. Some low-cost benefits include:

  • Flexible schedules. Float pools (a pool of HHAs who are on-call to fill open shifts) and job sharing (splitting a job’s duties among two—or more—employees) can help employees fit work into their busy lives. Employees will appreciate that you’re willing to meet them where they are.
  • Employee referral program. Did you know that employees hired through referrals are likely to stay longer at a company than those hired in other ways? Almost half (45%) of employees found through referrals stay for 4 years. Plus, offering bonuses to employees who make successful referrals can increase earning potential for your employees.
  • Invest in travel vouchers. Home health aides often have to travel to their postings. A travel voucher can help them alleviate the cost, whether it’s used for gas or bus fare. Even if this isn’t a huge investment for you, gestures like these show employees that you understand their needs and are invested in their well-being.

2. Provide Professional Development

It may feel counterproductive to help HHAs train to move on to other positions, but this isn’t necessarily the case. Creating career paths helps foster a healthy work environment, where employees feel like their managers truly believe in them. That can both improve caregiver retention and attract new candidates.

If you help employees grow, they’ll be more likely to stay with your company while they work towards other degrees and certifications—compared to quitting their job to go back to school. Techniques for building career paths include:

  • Tuition reimbursement. Offering tuition reimbursement can help HHAs build their skills while they’re working at your agency. You can also get a tax deduction for sponsoring your employee’s tuition.
  • In-house training. It may be difficult to host an in-house training program if your agency is decentralized, but renting a space for this purpose may be worth it. In addition to learning new skills, HHAs will be able to meet and connect with each other, even if none of them typically work in the same location.

3. Invest in a Strong Onboarding Process

Since many caregivers don’t have in-person supervision, onboarding is more crucial than ever. But according to one study, 37% of surveyed employees don’t have much contact with their manager during the onboarding process.

In home health, this can be a huge problem. Remote employees may already feel detached from their company culture, which means a lack of managerial guidance can be felt. Onboarding can help remedy this. During this time, employers can clarify responsibilities, solidify crisis management skills, and build connections with new workers. When employees feel better equipped to do their jobs, they’re less likely to get worn down and experience burnout.

4. Create Effective Communication Channels

In an asynchronous environment, it’s important to invest in good communication software. Texting and emailing manually can get messy quickly. A centralized communication platform can help you respond to crises and questions in real time, and help your employees feel more supported.

The best communication platforms will also supply you with important data. Are your response times fast enough? Could they be improved? Use these findings to tweak your training and communication plans, so every employee feels heard.

5. Recognize and Reward Employees

In home health, it’s easy for employees to feel like they’re working in isolation, with no acknowledgment of all their hard work. A little recognition can go a long way. In fact, one survey found that over 83% of employees feel that being recognized at work increases their motivation for success.

Take time to shout out employees on a public platform, such as in a newsletter, as well as one-on-one.

6. Invest in Practical Shift Scheduling Tools

If you’re using an inefficient or confusing shift management system, you don’t have clear insight into your employees’ schedules. You might not notice issues such as people being overworked, or employees who call out of work too often. This can get frustrating for your employees, too. They might have trouble keeping track of swapped and canceled shifts.

Invest in shift scheduling software to make sure that you’re aware of exactly when and where your employees are working. Shift scheduling software will also make it easier for you to offer flexible scheduling—a meaningful benefit that can attract more candidates to your workforce.

7. Eliminate Payroll Mistakes

Did you know that just two payroll errors can cause almost half (49%) of employees to start looking for a new opportunity? When your payroll platform is messy and complicated, it won’t matter what other benefits you offer. Employees will want to leave.

Partner with the right payroll software to make sure that your payroll is always on time and error- free. Use the power of technology to accurately calculate salaries, no matter how many half-shifts, overtime shifts, or swapped shifts each employee may have.

Hiring and Management With Apploi

With a centralized hiring and management platform, you can focus on retention without having to sacrifice hiring efforts. From hiring to payroll, Apploi offers all the tools you need to ensure your candidates and employees have a smooth experience. With our accurate payroll and shift management integrations, your employees will know that their time and effort are valued—and ultimately, stay with your company. Schedule a demo today.

Melanie Boroosan

Over her six years in healthcare administration, Melanie has managed human resources, legal, compliance, payroll, and recruitment efforts at a corporate level. This oversight granted her a deep appreciation for the unique needs of healthcare managers, and for the direct ways that business operations affect the wellbeing of each employee. As Apploi’s Director of Healthcare Innovation, Melanie draws from her experience in healthcare HR and ancillary long-term care to pursue a vision of holistic healthcare staffing. Her work is rooted in the knowledge that great care begins with improving quality of life for all healthcare workers.