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Caregiver Retention: Part 1 – 9 Tips For Creating An Effective Caregiver Retention Strategy

Published on May 19, 2021 by Scott Zielski

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Two key priorities for all home care agencies are providing high-quality care and ensuring client/patient satisfaction. At times, however, substantial challenges prevent agencies from delivering on these priorities – challenges that are faced by all agencies but often only overcome by a few.

The top challenge, ranked by home care agencies for many years now, is engaging and retaining caregivers.

Why is caregiver engagement and retention so important?

In addition to being vital for agencies to deliver their two key priorities – providing high-quality care and ensuring client/patient satisfaction – engaging and retaining caregivers is also important because:

  • recruiting and hiring new caregivers costs far more than retaining current employees
  • insufficient staffing levels means that agencies cannot take on more clients/patients, which restricts the growth of their business
  • turning down clients/patients due to lack of caregivers can negatively affect an agency’s relationship with referral partners
  • where caregivers are stretched too thin, it can result in staff and client/patient frustration, producing further turnover
  • caregiver shortage or regular caregiver turnover often results in inferior patient care and lower patient satisfaction scores. 

The ICA Group has estimated that the Home Health Care industry will need to recruit and train more than 13 million new caregivers to meet demand by 2024.

With average turnover rates currently exceeding 64% – reported by Home Health Care News – it is clear to see that most agencies are still finding it challenging to engage and retain caregivers.

Why is the caregiver turnover rate so high?

The most obvious way home care agencies can overcome the challenge of high caregiver turnover is to understand the ‘Whys?’ behind it and address these directly.

A recent HomeCarePulse Survey (2020-2021) has revealed the top 10 complaints caregivers express when leaving an agency:

  • Lack of communication (including scheduling, communicating information they need and what is expected of them in their role)
  • Pay is too low
  • Lack of consistent scheduling and insufficient hours – and/or no schedule flexibility
  • Lack of appreciation and support from office staff
  • Disorganized management where everything is a last-minute rush
  • Inadequate benefits
  • Lack of PPE supplied and/or unsafe working conditions
  • Lack of integrity in management (promises made but not kept)
  • Lack of proper training provided
  • Travel time.

With so many opportunities available to caregivers in the current market, home care agencies seriously need to rethink their engagement and retention strategies if they are to make any progress. For some, this may involve creating a strategy from scratch!

What can home care agencies do to improve caregiver turnover rates?

In an ideal world, offering a substantial pay raise to every caregiver would probably make a big difference, but this is simply not feasible for most home care agencies.

The good news for agency owners is that salary is actually not the star player when it comes to caregiver retention. You don’t necessarily need to pay more money to retain your talented caregivers, but you do need to start paying a lot more attention.

Here we have put together nine tips for creating a strategy that will help you in the battle to retain your talented caregivers and beat the competition.

Which of these works best for your home care agency will depend on several factors specific to your agency – including agency size, market, location, agency goals, team strengths and talents, and the resources you have available. These can all impact the strategies you opt for, so look at the landscape of your agency before building out your plans.

9 Tips For Creating An Effective Caregiver Retention Strategy

caregiver retention rates

1. Recruit and hire to retain

Caregiver engagement and retention begin with your recruitment process, right from the job posting. This is the first interaction you have with future employees and your first opportunity to make a great impression. It’s vital to write powerful job postings that attract the type of caregiver you’re looking for, address the current climate, promote your agency’s culture and ensure you stand out from the crowd.

Optimal recruiting and hiring processes are vital to ensure your agency has a robust network of talented caregivers that will stay with you and deliver the very best, consistent care for your clients/patients. There are lots of strategies that you can implement right now to start optimizing your recruitment and hiring processes to skillfully attract, engage and retain the very best caregivers.

Remember that you also need to treat your onboarding process as part of your hiring process – as a positive experience in the first 90 days of employment is a crucial factor in caregiver retention.

2. Build effective communication

The top complaint from caregivers is ‘lack of communication’ from their agency, so effective communication must be a key part of any retention strategy.

Caregivers can quickly become burnt out and quit without speaking to anyone or asking for help. If you create an open, honest work environment with clear communication channels, your employees are going to have greater job satisfaction and will feel able to come to you if they have any problems, way before they decide to leave.

You also need to ensure you have office staff who are excellent at dealing with caregivers and communicating everything your caregivers need to do their jobs well. This doesn’t need to be a hugely time-consuming task if you have the right software in place, like Smartcare’s mobile app. Smartcare can be accessed by all office staff and caregivers anywhere and at any time and provides various ways for you and your office team to:

  • streamline and organize all communication
  • virtually check-in with caregivers
  • bring your team together
  • communicate clearly with secure messaging and chat
  • securely add and share documents and information
  • automate the caregiver notification process for daily scheduling and open shifts
  • support effective collaboration.

A platform specifically designed for home care, like Smartcare software, ensures all your communication with remote staff and caregivers is fast, fluid and accessible to all – through an online cloud-based information storage system, with HIPAA compliant chat and messaging, and a point-of-care mobile app.

3. Ask for feedback and act on it promptly


Regularly asking for feedback from your caregiver team and really listening to them is a vital part of establishing an effective two-way communication strategy that works to meet the needs of each individual as well as the team overall.

If your agency is slow to respond to any feedback or concerns, the message you send to your caregivers is that you don’t really value them. They will eventually start looking for a better career opportunity in the market. Creating a culture where you deliberately ask for feedback and then act promptly on it can go a very long way to improving caregiver retention:

  • building trust with your dedicated workforce
  • making them feel heard and appreciated
  • helping to build loyalty to your agency.

Some caregivers may be uncomfortable sharing their feedback in team meetings or directly with you, so offer an anonymous feedback option/suggestion box to capture their views and concerns. Every caregiver should know that their voice matters at your agency.

You might also consider creating a quality enhancement team that can work together to address and solve any feedback issues from caregivers before they become bigger problems.

Asking for feedback and collecting the data also gives you an ideal opportunity to look at what your caregivers value and what motivates/incentivizes them, which will come in handy when deciding on the best benefits/rewards to offer.

4. Train and upskill your caregivers

Training is a valuable investment in any agency’s most important asset – their caregivers – and is critical to employee retention.

If your caregivers are looking for additional learning opportunities, it is in your agency’s best interests to find ways to support and assist them. A recent survey revealed that almost 90% of employees said they would definitely stay with their current agency if they invested in their professional development.

By investing in an ongoing, quality training/education program, you remind caregivers how vital their role is on the team and that you care about their development. You want your caregivers to be:

  • learning and growing within your agency
  • feeling a sense of progression
  • acquiring new skills
  • being personally motivated, and so on.

This not only improves caregiver satisfaction but also significantly reflects on client/patient satisfaction too.

As part of your retention strategy, you can also consider creating ‘advanced caregiver roles’ for employees who have completed ongoing training in a specialized field, for example, Alzheimer’s Specialist or Specialist in Hospice Care.

5. Appreciation, recognition and reward

caregiver and old person

If you are serious about retaining your talented caregiver team, your strategy must include ways that recognize and reward their hard work, especially during these challenging times. Around 65% of employees in any organization report that they will find another job if they continue to feel unappreciated, so you really cannot afford to ignore the importance of appreciating, recognizing and rewarding your dedicated caregivers regularly.

In addition to providing frequent verbal and/or written recognition – to remind your caregivers of their value and worth – you can organize a caregiver appreciation program every month to reward your best performers.

You can also use software tools, like Smartcare’s new Caregiver Rewards system, that make it easy to keep caregivers connected and motivated, allowing your agency to offer rewards for meeting ideal performance criteria, like clocking in on time and picking up extra shifts.

Make sure the rewards you offer in all cases are things your caregivers value. This can be a game-changer for your agency if you get it right.

6. Get creative and provide unique benefits

Studies have shown that caregivers are more likely to stay with an agency if they offer an attractive benefits package. It doesn’t need to be a high-cost addition to your retention strategy if you listen to what motivates your caregivers and respond accordingly. They will all have different circumstances and things that they will respond to more favorably, depending on what’s important to them.

Ideas that working for other agencies include:

  • pay structure flexibility, i.e. daily pay/weekly pay (with instant bank transfers via smartphone, there’s no excuse for having outdated payroll systems)
  • flexible scheduling that meets their needs
  • certification training paid for by the agency
  • paid sick leave
  • onsite daycare for caregivers’ children
  • health insurance plans
  • discounts at local businesses (restaurants, hairdressers, cinemas, gas stations, daycare centers, etc.)
  • additional perks, for example, a facility where they can go for self-care spa treatments or a more simple/scalable option that your caregivers value
  • mentoring and success coach programs
  • employee recognition program, like Caregiver Rewards
  • an easy-to-use, mobile-friendly software system that helps them perform their jobs more efficiently and effectively, like Smartcare’s mobile app
  • supply of commonly-used supplies available for complimentary caregiver use (this can include PPE, snacks, other equipment to do their jobs well). Out-of-pocket costs can quickly add up and place a financial burden on caregivers, so remove this burden.

7. Manage your client-caregiver relationships more effectively

caregiver USA

Caregiver retention can be significantly improved by maintaining good relationships between caregivers and their clients/patients. All caregivers will suffer job dissatisfaction if there are ongoing conflicts or negative interactions with clients, and many will look to join another agency to escape a ‘bad’ client/patient.

Your retention strategy needs to look at protecting your caregivers and reducing their stress levels wherever possible. Some agencies have gone so far as to discharge major clients that were rude or unprofessional to their staff. If your focus is on taking great care of your team, you need to back it up. When you do, your caregivers get the message and become even more invested in your agency.

In addition to selecting the right caregivers for your agency, your retention strategy should include carefully selecting suitable clients/patients – and then matching them for maximum caregiver-client satisfaction. With the right strategy in place, you can become the master of matchmaking!

By identifying compatibility in caregiver assignments, you can attract both prospective caregivers (who will stick around longer for good clients) and clients who know that they will be placed with caregivers with the right character strengths rather than just the first available.

Using Smartcare’s exclusive machine learning technology, you can easily find the right caregiver for the right client every time. Smartcare’s unique matching keeps your caregivers and clients happy, increasing both caregiver and client retention. It works like a dream!

8. Implement mentorship and coaching programs

When executed well, mentorship and coaching programs can increase caregiver retention while also improving the level of care they provide to your clients/patients.

Providing new hires with a mentor helps them feel more confident in their skills as a caregiver and helps strengthen the bond between your caregivers, providing them with the essentials needed to be successful at your agency from day one. A bonus is that it also builds a career ladder for those becoming mentors, creating promotion opportunities (and increased pay) for your current caregivers. Growing agencies need experienced caregivers who can train others and provide oversight, so this is a win-win strategy.

Success coaches are also proving beneficial for new caregivers during onboarding to help deal with issues/barriers such as child care, finances, transportation, identifying training needs, building confidence, etc. In a recent survey, agencies adopting this approach found that caregivers who engaged with their success coach had a 97% retention rate. It pays for itself.

9. Create an employee referral program

Caregivers that an agency hires from current employee referrals have a typical turnover rate that is 25% lower than caregivers found via other recruitment sources. You can capitalize on this trend by establishing an employee referral program as part of your retention strategy.

While there will be some costs involved in setting up a referral program, these will be far less than replacing a caregiver (approximately $2,600). A $100-200 bonus is a small price to pay for a quality caregiver that will stick around.

Once you have set up your program, it is essential to communicate it regularly (via SMS, newsletter, online team meetings, etc.) to keep it fresh in the minds of your current caregivers. Make sure you pay out bonuses quickly to those who refer and also keep track of where referrals are coming from, to see if the program is working for you or needs refinement over time.

Some challenges for home care agencies come and go, but caregiver turnover is not one of them! Regardless of what 2021 has in store for home care, your agency will be more successful if you can find and implement the right strategies to overcome the constant challenge of caregiver turnover.

Forward-thinking home care businesses are matching powerful marketing campaigns with equally robust employee retention programs. The agency owners who are mastering recruitment and retention by learning from others and following disciplined practices are best positioned to realize sizable and continued growth.

While retention strategy efforts can be expensive, not taking action on retention will prove far more costly in the long run!