The industry’s turnover rate was one of the biggest topics of conversation in home care in 2019.
And that was for good reason. The median rate had skyrocketed all the way to 81.6%, according to data collected by the research and education company HCP.
But since that point, it had significantly improved. From 2019 to 2021, the median turnover rate floated marginally from 64.3% to 65.2%. In 2022, however, it soared back to 77.1%, according to HCP’s 2023 benchmarking report.
“During COVID, we called them care heroes, we clapped, we celebrated – we did so well there,” Kristen Duell, chief marketing officer at HCP, told Home Health Care News. “Raising people up through all of that during those hard times. And now that those hard times have kind of passed, the recognition tends to slip. It just points to the need to stay focused and stay on recognizing and making sure employees feel valued through all of it, even when there’s not a pandemic.”
The 2022 data from HCP is taken from over 92,000 surveys with home-based care professionals.
In addition to recognition, training remains vital to reducing turnover.
“I think [training] is critical, that really should be at the core,” Jeff Knapp, chief people officer at Bayada Home Health Care, said last week during the HHCN Staffing Summit. “That’s simply a prime reason people leave, because they don’t feel like they’re able to access career development opportunities.”
The rise in turnover is obviously troublesome for the industry. In home-based care – where workforce shortages are significant – providers have seen retention as one of the only ways to mitigate staffing woes.
“Employee turnover in our industry has been high for years,” Amanda Sternklar, the director of marketing at HCP, told HHCN. “But it stayed relatively steady for the last couple of years. This year, with that jump to 77% turnover, that was obviously fairly surprising.”
One other factor contributing to higher turnover in home-based care generally could be the one-time sign-on bonuses that have been leveraged by home-based care providers over the last few years.
“There’s ample evidence that there are still a contingent of workers who are out there and really taking advantage of going from one sign-on bonus to another,” Amedisys Inc. (Nasdaq: AMED) Chief People Officer Adam Holton also said during the Staffing Summit.
Still, sign-on bonuses are likely a smaller part of the overall turnover picture. In the end, monetary factors are generally behind other factors that contribute to turnover, such as things like culture, training and recognition.
The way a worker is recruited to an agency in the first place can also contribute to turnover. For instance, job sites like Indeed are responsible for a great deal of application volume, but they are also more expensive and more likely to lead to turnover.
Right now, Indeed is responsible for nearly 40% of caregiver recruitment. At the same time, it’s responsible for an 85.7% turnover rate. It also has a mean cost of $367 per caregiver acquisition, more than that of a word-of-mouth referral or from the company website.
“Those internet sources like Indeed are still the highest volume,” Sternklar said. “They’re also the highest turnover sources. Whereas with things like word of mouth, and referrals from current employees, the turnover is significantly lower.”
Holton also mentioned that Amedisys considers word-of-mouth and employee referrals as key to its strategy.
That’s generally because there’s a “horizontal commitment” in home-based care agencies, where the workers really value each other’s opinions.
Moving forward, Sternklar and Duell see that as a path for other home-based care agencies to refine their staffing strategies as well.
“There’s a huge opportunity for employers to really focus in on on retention with bonuses,” Sternklar said. “Not just for employees that they’re hiring to keep past the first 100 days. But incentives for the employees who are referring those really high-quality employees who will stick around.”
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