Home Care Pulse recently released the results of the 2018 Home Care Benchmarking Study. The picture on retention is not pretty. In fact, caregiver turnover is at an all-time high with 66.7% of caregivers leaving a job. It’s concerning that despite much talk on retention, the trend is worsening. By comparison, turnover in 2009 was at 39%, which was a high number. And yet, 9 years later, it is much worse.
High turnover is unhealthy for any business. It’s alarming in senior care when the demand for service is growing and the need for caregivers follows that trend. There is clearly a need for an industry-wide effort to raise the profile and the pay for senior care professions. At the micro level, agency leaders must continue to put a strong emphasis on retention activities. This month of May, we will examine how to reduce turnover and increase caregiver retention.
First, let’s remind ourselves of the cost of turnover. I often use the number recommended by the 2012 study by the Center for American Progress on the cost of employee turnover. It sets the average cost at 16% for jobs paying less than $30K. With wage of $10.50/hour, the total cost of turnover is about $2,600 per caregiver. If this number seems high, you only need to think about the direct costs (e.g. cost of recruiting and training a new employee, overtime to cover extra shifts) and indirect costs (client dissatisfaction, the additional workload for the remaining employees).
Strategies to minimize caregiver turnover:
- Provide quality on-boarding: Home Care Pulse data shows that at least 5 hours of on-boarding decreases turnover by 26%. Of course, length is not the key determinant. Having a quality onboarding program documented and replicable is the way to go. Look at the content of your onboarding. Is it mostly a time for filing in forms for compliance? Or, is it a chance to make a great first impression? Use onboarding to showcase your agency, its staff and how you are different than others the community.
- Create client-caregiver chemistry. Getting the right person in the right position will prevent some turnover. Have the Recruiter and the Scheduler work together to find the best fit in terms of client location and personality for each new caregiver. Tell each side that you have worked to find a good fit. It will pay off with happier clients and a caregiver willing to stay the course.
- Encourage office staff and caregivers to work in tandem. Remind your office staff of the role they play in caregiver retention. Bad relations with the office staff is often a trigger for caregiver resignation. Take the time to introduce each key player (Scheduler, Care Manager, Office Manager, etc.) to all new caregivers.
- Develop the skills of your caregivers. Home Care Pulse was able to quantify that agencies that provide 8+ hours of training per year reduces turnover by 7%. If you are not sure what your training program should include, consider the most frequently requested topics by caregivers are disease management, communication with dementia patients and families, death and dying, personal skills (budgeting, computer literacy).
- Mentoring of new caregivers. As more millennials must enter the profession to meet the need for senior services, your agency will be appealing to them if you offer a mentoring program tailored to the needs and experience of each new caregiver. This will make a significant impact on new caregivers whose turnover rate is traditionally higher than seasoned caregivers’.
- Implement “Stay Interviews.” Schedule a time to listen to each caregiver every 6 to 12 months. Schedule one-on-one meetings in the calendar of the HR Manager or the Agency Administrator. Look for the reasons why each caregiver likes their job and your agency. Ask if anything needs to be improved to make their lives better. Take notes and take action. Let caregivers know what you have done in response to their suggestions.
- Show appreciation with recognition. What caregivers value doesn’t change over the years. Verbal recognition by the supervision or the clients for a job well-done is still the most meaningful way to show appreciation. Caregivers also enjoy an annual bonus, paid time off, a wage increase
There is no silver bullet that resolves your retention woes. But you knew that already. It takes a resolute plan, implemented consistently with the right office staff to stem the trends. Based on my experience, it is possible to lower turnover. At this time in home health, the best agencies have a 30% turnover rate. Can you do better?
