Conquering the Crisis: Improving 90-Day Retention

By Stephen Tweed Caregiver turnover in home care hit an all time high of 81.6% in 2018.  That means for every 100 caregivers working in home care, 82 of them quit or were fired.  How can you possibly grow your business when most of your recruiting effort is going to replace the churn of turnover?…

By Stephen Tweed

Caregiver turnover in home care hit an all time high of 81.6% in 2018.  That means for every 100 caregivers working in home care, 82 of them quit or were fired.  How can you possibly grow your business when most of your recruiting effort is going to replace the churn of turnover?

The other big lesson we learned from the annual Home Care Benchmarking Study is that 81% of turnover happens in the first 90 days of employment.  If you could reduce your 90-day turnover you could use more of those new caregivers you are hiring to serve new clients.

As I mentioned in a recent article on “Lessons from Tennis for Home Care Leaders”, there are three big factors in improving your 90-day retention:

Hire the Right Applicant in the First Place

Research from our Caregiver Quality Assurance Program shows clearly that when you do a better job of selection, and hire applicants who are a better fit for the caregiving job, they stay longer, are happier on the job, and get high client satisfaction scores.  Too many home care agencies are so desperate for caregivers that they hire anyone who can breath on a mirror.  Then they are frustrated when 80% of them leave in the first 90 days.  When you do a better job of finding applicants who are a good fit for the job, and a good fit for your company, they stay longer and perform better.

One of the tools for better hiring is the “Culture Fit Interview”.  This is an job interview based on the core values of your company, and some select behavioral interview questions that help to determine of the applicant’s core values are in alignment with your agency’s core values. Many of the members of our Home Care CEO Mastermind Groups are focusing on their company culture, and hiring caregivers who fit the culture as a key to success.

Keep New Caregivers Working the Hours They Want

One big cause of 90-day turnover is new caregivers who aren’t getting enough hours, or who lose a case and are not scheduled for a new client quickly enough.  That new caregiver you just hired and put out on her first shift is not yet on the radar of your schedulers.  As you know, they call the caregivers they know, and often don’t call the caregivers they don’t know.  If you want that new hire to stay with you, make sure they are on the radar of your schedulers and are getting the hours they need and want.

Stay in Touch to Make them Feel Valued and Appreciated

Our research on “Best Caregivers” shows that good employees will stay with you when they are doing meaningful work, and when they feel valued and appreciated.  Specifically, best caregivers want to feel valued by their clients, valued by their supervisor, and valued by company leadership.  You can keep new caregivers past 90 days by having a system to stay in touch with them, learn about them as a person, and help them feel like they are a valued member of your home care team.

Grow Your Business by Improving 90-day Retention

The larger companies in our Home Care CEO Mastermind Groups who have focused on improving 90-day retention are seeing measurable improvement in company growth.  There are several positive things that happen when you focus on improving 90-day retention:

  • You have more caregivers available to accept new clients
  • Your recruiting efforts result in more caregivers and you can take more clients
  • Your clients are happier because they get to keep the same caregiver.  The number one thing clients want is “continuity of care”.  They want the same caregiver every time.
  • Your schedulers experience less burnout because working with experienced caregivers makes their job easier.
  • You have fewer call offs, as experienced caregivers who have a relationship with their clients are less likely to call off
  • Your business grows because you have fewer missed shifts due to staff shortages
  • Your business is more profitable

To learn more about the facts and data related to caregiver recruiting and retention, participate in and purchase a copy of the 2020 Home Care Benchmarking Study from Home Care Pulse

To learn more about how to reduce your 90-day turnover, consider becoming a member of a Home Care CEO Mastermind Group.  


For specific assistance in developing a strategy to grow your business and improve 90-day Retention, consider our Home Care Strategic Advisory Service. I’ll work with you to assess your business, develop a strategy for growth, and provide six months of Strategic Business Coaching.

Stephen Tweed
Stephen Tweed, CSP, began his journey as a business strategist in home health care in 1982. Today, Stephen is among the top thought leaders in Home Care strategy and management. He has worked with top 5% companies from across the US. He is a sought after speaker at from national and state association events.

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