The challenges of caregiver turnover and keys to boost retention in home health care

Caregiver turnover continues to be an increasing issue in the home care industry. Agencies who take the time to understand the causes and implement programs to reduce it will have a clear competitive advantage over the companies who are unable to improve caregiver satisfaction.

When are caregivers most likely to leave your agency?

On average, a home care agency will lose 67% of their caregivers within their first year of employment according to the 2018 Home Care Benchmarking Study. Out of that 67% who leave, 57% of them will do so within 90 days. And just over one-fourth of those caregivers quit in the four- to six-month range. So engaging new caregivers within the first three and six months of their employment is crucial to cutting turnover.

Breakout of the 67% of caregivers who quit within a year

Data according to telephone surveys conducted by Home Care Pulse.

What caregivers really want in home care companies. 3 keys to unlock higher retention rates.

Discover more easy-to-implement tactics and tips to boost caregiver retention and keep growing your home care agency.

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The true costs of caregiver turnover for home health agencies

How much is turnover really costing your home health agency? The predictable costs of replacing a caregiver include placing job postings, screening and interviewing candidates, plus onboarding and training the replacement.

The total of these hard costs averages $2,600 per caregiver based on home care industry benchmarking data and a research study by the Center for American Progress.

However, those direct costs are only part of the true financial picture. The indirect costs are harder to predict and quantify, but they impact every aspect of your business. You must also consider the ongoing expense of the following factors:

Lost productivity: New staff members require more help and attention from coordinators and managers, in addition to their allotted training time. New employees also tend to work slower and can place a burden on more experienced employees who have to pick up the slack. There is a ripple effect of lower productivity as a new employee gets up to speed.

Poor work quality: Caregivers who are new on the job, rarely have the skills and training to consistently deliver the quality of care that your clients expect right out of the gate. It simply takes time to learn the ins and outs of making sure each client is fully satisfied with their care. If this lower quality lingers too long or recurs too often, it can lead to lower demand and fewer referrals from clients.

Lower morale: When turnover rises, morale drops. It can become a vicious cycle. As more employees leave, the ones who remain become more disgruntled. It has a negative impact on company culture and poor attitudes often leads to the perception of poor care.

The reasons behind caregiver turnover

Understanding why caregivers leave is an important component of improving retention. While unique to each individual, these reasons generally fall into six categories:

Company policies
Personality issues
Working conditions
Life changes
Scheduling conflicts
Discharged for cause

It is possible to discover several of these underlining issues during a standard interview screening, if you know what to look for. For a breakdown of the issues within each of these categories, download our bonus guide titled “What caregivers really want – 3 keys to unlock higher retention rates.”

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Fundamental solutions to increase caregiver retention

While there isn’t a magic button you can click to eliminate caregiver turnover overnight, there are several proven tactics you can implement to increase caregiver satisfaction and retention. Some of these methods to boost caregiver rendition require a significant investment and other rely solely on effort and determination.

The evidence is in: increasing wages reduces turnover

It’s stating the obvious, but paying people less increases the odds that they’ll leave for a higher paying opportunity. And research in the 2018 Home Care Benchmarking Study confirms that lower wages are strongly correlated to higher turnover rates.

Caregiver turnover rates based on amount of agencies pay

Data from the 2018 Home Care Benchmarking Study.

As you can see, the highest-paying agencies have a turnover rate of less than half that of the lowest-paying agencies. While your agency size and revenue will dictate the wages you are able to offer, it is recommended that you carefully evaluate if it is feasible to make your compensation package more competitive.

Additional benefits make a big difference

Traditional benefits like health insurance and retirement plans are often citing as factors in employees decision to accept a job offer and remain in that position. Companies are also implementing or experimenting with a variety of other benefits including:

Mileage reimbursement
Free or discounted meal packages
Childcare subsidies
Student loan repayment
Wellness packages
Eldercare consultants

Increase caregiver satisfaction by making their job easier

With the Savii Connect app for Android and iOS, caregivers can arrive to shifts prepared, on time, to provide the best patient care and maintain your agencies reputation. It’s easy to login from anywhere and access driving directions and clock in/out with GPS visit verification. Aides can also manage shift details and the care plan, document tasks and deviation of care, and securely communicate with your agency. Savii Connect is the only integrated app that allows your staff to document care in the field even if they lose connectivity.

What caregivers really want in home care companies. 3 keys to unlock higher retention rates.

Discover more easy-to-implement tactics and tips to boost caregiver retention and keep growing your home care agency.

Download Now

How to recruit quality caregivers who will stay long-term

The most effective way to increase retention is to improve your recruiting. When a shortage hits, it’s tempting to hire whoever you can to fill the hole.

It is far too common for home health care agencies to do a minimum amount of screening beyond background checks. Some may not check references or education, and even fewer do skills tests. Understandable, given the growing need for employees. But this lack of screening puts those caregivers in situations they may not be fully equipped to deal with, which can lead to unsatisfied clients.

Instead, be proactive. Ask your Human Resources team to look at your top caregivers and look at where and how they were recruited.

Also, focus your interview process not just on finding qualified candidates but also ones who share your agency’s vision for providing exceptional care. The goal is to find people who are pursuing their passion and not just a paycheck.

Why your agency needs an Employee Referral Program

The most effective way to find dedicated caregivers is to ask the ones you already have. Word-of-mouth is a power tool. When your best caregivers refer people who they like and trust, everyone benefits. The most consistent way to get referrals from your current caregivers is through an employee referral program that offers a bonus for recommending a successful candidate. Referrals typically outperform candidates from job postings. While such a program can initially increase hiring costs, the investment pays off for everyone involved.

Pay half the bonus on the employee’s start date and half after the new employee is employed six months. This incentivizes your employee to make sure that their friend is happy with the job.

Low cost tactics and tips to reduce caregiver turnover and boost retention

Offering higher wages and better benefits are hard costs that will get results, if you’re willing and able to make the investment. However, there are several proven tactics you should also implement that very low comparative costs.

The two type of training required to increase caregiver retention

Training makes your employees more effective at their jobs, increases their satisfaction with their work, enhances their professional value, and makes your business more competitive. However, most agencies do not offer the right type of training or enough of it over the short and long term.

Onboarding and orientation

Before any employee is sent to work at a client's home, they should complete a training process that reviews all company policies and procedures, as well as training on in-home care and privacy issues. Consider implementing a shadow program, where new employees accompany one of your most experienced caregivers on a client visit.

Also, be sure to review expectations and set clear goals. Cover the basics such the required hours, all locations they’ll travel to, and how to properly perform all the services and tasks their job entails. But also discuss your agency culture and how you expect people to be treated and how every caregiver should be treated in turn. Setting and meeting expectations on both sides will make your caregivers feel more in control of their own success and will increase job satisfaction – especially in that crucial first three

Ongoing training and continuing education

According to the Home Care Benchmarking Study, home care agencies that provide just 8+ hours of ongoing training annually have a 7% lower caregiver turnover rate. Just as important, it’s a win-win for your agency and individual caregivers. They benefit from increasing their skills and the personal fulfillment of growing as a professional. And your agency benefits by being able to more easily place highly skilled workers and the ability to charge more for caregivers with specialized skills and advanced competencies.

Best practices for ongoing training

  • Provide a fair and motivating incentive for our agency staff to attend. Ideally, all trainings should be paid. A “lunch & learn” format with food provided is also appreciated by most employees.
  • Consistency reinforces the benefits, so hold training sessions regularly. Once a month is a good cadence, however you may need to hold multiple sessions of the same content to ensure that everyone is able to attend.

Top training topics requested by caregivers

  • CPR/First aid/medical training
  • Any additional training
  • Hands on/Client specific training
  • Dementia/Alzheimer’s training
  • C.N.A. training

You’ll notice that the second most requested type of training is anything that is offered. Caregivers desire for ongoing training is high, so providing it will strengthen your agency’s reputation for being a desirable place to work.

Why flexible schedules can be more efficient

Work/life balance can be a struggle for anyone, especially for people in jobs that can be emotionally and physically demanding like home health care. A bit of understanding and flexibility can go a long way. While it’s not always possible to work around every event that pops up, offering and following up on scheduling flexibility can help prevent burnout and increases caregiver gratitude for having an employer that cares about their well-being.

  • Tips to maximize the effective of flexible schedule.
  • Minimize commute times as much as possible.
  • Proactively asking for employee input will make people feel more valued and helps prevent last-minute changes.
  • Taking client and caregiver compatibility into account increases the satisfaction of both parties.

Recognize and reward quality service and effort

Everyone enjoys feeling appreciated for their hard work. By acknowledging the dedication and abilities of your caregivers, you can greatly increase both their satisfaction and their future performance.

Out of seven areas of caregiver satisfaction measured annually by the Home Care Benchmarking Study, the industry’s lowest score is in caregiver recognition. This is both a warning and an opportunity. A simple “thank you” goes a long way but implementing a caregiver recognition program will help your agency stand out in the industry.

5 tips for establishing an effective caregiver recognition program

1. Share recognition both privately and publicly. Take one-on-one moments to offer a word of praise to caregivers, but also give formal, public recognition during staff meetings and in agency communications such as internal newsletters.

2. Reward the behavior you want to see, not just unique moments when someone goes above and beyond. For example, you can offer incentives for caregivers who never call off, who pick up extra shifts, or who bring in the most business referrals.

3. Do it consistently. Handing out awards once a year at a company picnic is nice but not enough. Develop a culture of appreciation. But keep in mind that constant praise may feel inauthentic, so find a balance that feels right.eting expectations on both sides will make your caregivers feel more in control of their own success and will increase job satisfaction – especially in that crucial first three

4. Vary the ways and timing that you show recognition. Phycological research shows that intermittent feedback is the most powerful. If it becomes routine or expected, it loses its effectiveness and can eventually be taken for granted.

5. Make recognition specific. Whenever possible, share the exact details or satisfaction ratings received from clients or their loved ones with your caregivers. It lets them know how much they are making an impact.

Ideas for types of recognition:

  • Give a hand written note or card.
  • Surprise someone with a gift card or movie tickets.
  • Announce a “Caregiver of the Month” award.

What caregivers really want in home care companies. 3 keys to unlock higher retention rates.

For more ideas on how to recognize and reward your staff, download our guide.

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The benefits of a caregiver mentoring program

Assigning an experienced caregiver to guide a new caregiver has benefits for both. New hires receive support and additional training while experienced caregivers feel appreciated and gain experience supervising others. Your mentor program can be as informal or structured as your agency culture and workflow dictates. You can call it the Buddy Program or another friendly name and simply ask the assigned caregivers to check in with one another. Alternately, you can require the mentor to accompany their assigned new caregiver on the first few visits and review a checklist of procedures and pointers.

The importance of asking for feedback

Asking for and listening to feedback from your employees isn’t just good for morale. By documenting their everyday frustrations, wins and desires, you’ll create a valuable resource of data that you can use to make your agency better for both caregivers and your clients. Plus, keeping a finger on the pulse of caregiver satisfaction will help you keep a minor issue from becoming a major problem.

Caregiver turnover is caused by a variety of combined factors, so by better understanding your agency’s strengths and weaknesses, you’ll be better able to allocate resources and efforts on improving where it matters most.

How can you get caregivers to honestly provide this useful feedback?

1. Develop an input form. that asks what aspects of the home care field appeal to them the most. Questions like what type of clients they feel comfortable working with, what motivates them to provide quality service, and what their skills/preferences are to best match a client with a caregiver. Finding out each worker's preferences not only makes it more likely they will end up in a job they love, but it also shows you care and are interested in creating a respectful work environment.

2. Put it on your calendars Set structured times for employee feedback including brief monthly check-ins and as part of quarterly performance reviews. However, don’t just wait for the next appointed time to roll around, having informal, spontaneous discussions with individual caregivers shows that your agency truly cares.

3. Actively learn and follow up. Take notes during scheduled reviews and ride along with them on client visits. Take any issues seriously and formally track feedback and next steps. After you take action or change a policy, let caregivers know what been done in response to their suggestions. Develop formal issue resolutions policies and procedures if you don’t have them already.

4. Learn from caregivers who leave. Acknowledge that turnover is an industry problem that you hope to avoid, but that if they do ever consider making a change, you’d appreciate knowing in advance and hearing honest feedback about their reasons. Conducting formal, but friendly exit interviews can facilitate the discussion.

5. Keep the door open. If a good caregiver leaves, let them know that you are open to discussing a return to your agency if their new opportunity doesn’t work out as well as hoped.

Experiment until you find what works for your agency

There is no single formula for preventing turnover that works for every home health care agency. The only secret is to focus on providing an excellent experience for your staff as much as you do so for your clients. After all, your agency’s revenue is directly determined by the number and effectiveness of caregivers you have in the field. Remember that caregivers who feel valued are far more likely to remain happily employed by your agency – and consistently provide superior care to your clients.

What caregivers really want in home care companies. 3 keys to unlock higher retention rates.

Discover more easy-to-implement tactics and tips to boost caregiver retention.

Download Now
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