News, Private Duty

6 tips to address climbing caregiver turnover rates in private duty home care

The national turnover rate for private duty caregivers has soared at an alarming rate, and agency leaders are looking for new ways to keep quality caregivers in place.

Turnover in 2018 climbed to 81.6%, according to the 2019 Home Care Benchmarking Study conducted by Rexburg, Idaho-based Home Care Pulse, which includes responses from 688 providers representing more than 1,100 locations.

By comparison, turnover in 2017 was 66.7%, according to the previous year’s study.

Data show turnover by region, revenue

According to Home Care Pulse’s study, caregiver turnover in 2018 was highest in the Central region (105.9%) and lowest in the Northeast (69.0%) and Pacific (69.5%) regions.

The Central region, as defined by the study, is comprised of 16 states including Texas, Nevada and Colorado.

Meanwhile, turnover rates were highest for agencies with revenue between $800,000 and $2,799,999.

Turnover rates based on revenue were: $0 to $799,999 (64.8%); $800,000 to $1,599,999 (87.2%); $1,600,000 to $2,799,999 (88.3%); $2,800,000 to $4,999,999 (69.9%); and $5,000,000 or more (73.0%).

Why is home care turnover on the rise?

It’s likely that recent changes in overtime rules have been a big factor in increased turnover for caregivers, says Jeff Salter, founder/CEO of San Antonio-based Caring Senior Service.

The federal change involving the overtime exemption created a nationwide challenge for home care providers, he says.

“This [turnover] increase is likely a result of more companies becoming compliant in 2018,” he says.

Tips to help with employee retention

  • Consider a mentorship program. Chicago-based Norwood Seniors Network, which had a 27% turnover rate last year, takes several actions to keep its turnover rate so low, says Laura Shaw-deBruin, the agency’s executive director. The agency set up a mentor program, which keeps caregivers engaged. In addition, the agency provides annual raises and holds a monthly raffle, offers benefits and constantly thanks and celebrates caregivers.
  • Give caregivers an opportunity to move up a rung on their career ladder. Do this by certifying them, for example, in dementia, diabetes, Parkinson’s, multiple sclerosis, mental health, developmental disabilities or end-of-life care. By creating “microladders,” agencies can show potential employees the opportunities that will be available to them to continue their education, receive recognition and increase their earnings.
  • Offer incentives. When rewards are offered for good work at Family Resource Home Care in Spokane, Wash., they are personal. The caregiver who loves hiking will get a gift card to an outdoor recreation store or the foodie will get a gift card to his or her favorite restaurant. An incentive program rewards caregivers with “Way Pay,” company currency that can be used at the company store.
  • Modify and adapt your business to the wants, needs and underlying drivers of Millennial caregivers. “Millennials will continue generating higher turnover rates than past generations,” says Leigh Davis, owner/partner for consulting firm Davis+Delany and president of ELDirect In-Home Elderly Care, both in Fayetteville, Ark. “But owners that have adapted their processes to this generation’s hot buttons are proof this ‘crisis’ can be managed and turnover reduced.” For example, Davis says, owners should understand that Millennials want to: feel like they are a part of the team, get coaching and mentoring, receive honest and genuine appreciation, receive more communication, have a clear employment path within the company, and get more frequent and personal performance assessments.
  • Go paperless and get efficient.For example, Caring Senior Service developed its own proprietary technology that eliminates paper in the process of hiring and day-to-day work for caregivers. “While our caregivers enjoy not having to sign a stack of paperwork at hire, hand write visit notes or go by the office to drop off documents, our technology has provided our staff time [to] focus on smart scheduling and let our systems keep them compliant with HR and documentation,” he says. “Double and triple data entry for staff is a killer; we are 100% paperless in every aspect of the operations.” Going paperless means Caring Senior Service “can process more new applicants and onboard qualified candidates quickly and not get lost in a pile of paperwork,” Salter says.

Editor’s note: Learn more about the study at