18% of Home Care Workers Live Below the Federal Poverty Line

Despite the exceedingly high demand for their services, one in six U.S. caregivers lives in poverty.

That’s according to new data from PHI, a New York-based national research, consulting and direct care advocacy organization.

The organization releases an overview of wage and employment trends in the U.S. home care workforce annually. The research gleans information from roughly 2.3 million home care workers and 581,000 nursing assistants working in nursing homes.


The home care industry will need to fill 4.2 million caregiver job openings between 2016 to 2026 in order to keep up with the demand for home care services. In turn, this will create one million new jobs.

“There will be a shocking number of job openings in home care over the next decade,” Stephen Campbell, data and policy analyst at PHI, told Home Health Care News. “If we do not address workforce recruitment and retention now, we will struggle to fill 4.2 million job openings by 2026.”

In PHI’s workforce overview, researchers note that nine in 10 home care workers are women. Meanwhile, people of color comprise 62% of home care workers; 31% are immigrants.


Broadly, the home care industry is plagued with high turnover and low retention rates. In 2018, the average turnover rate in the home care industry reached an all-time high of 82%, according to Home Care Pulse.

This is partly due to poor-quality jobs, according to researchers, though industry advocates have also noted the stressful nature of the caregiver position itself, both from a physical and emotional standpoint Previous research out of the University of Massachusetts has found that nearly one-quarter of home care workers face at least one incident of verbal abuse from clients or their family members over the course of a year.

One of the major challenges home care workers face is that wages have improved only slightly over time.

In 2008, the inflation-adjusted median hourly wages were $10.83. A decade later in 2018, inflation-adjusted median hourly wages checked in at $11.52, with workers bringing in an annual income of $16,200.

“More progress is needed,” Campbell said. “In a good economy with a tight labor market, employers across other sectors have also increased wages. Even though wages for home care workers rose, they did not become more competitive. In many parts of the country, employers are competing for workers with fast-food chains and big-box retail stores.”

The apparent inability of home-based providers to compete with companies like Walmart and Amazon was a point of focus during HHCN’s most recent installment in its “Confessions” series.

“I think it’s insulting when somebody says they’d rather work at Walmart, Amazon or a clinic, hospital or wherever,” a long-time industry executive told HHCN. “Why do we concede potential employees to other employers or industries? Ours is the more rewarding work. We should be able to compete with all those other employers.”

Overall, 62% of home care workers work full-time, and 48% live in low-income households. Additionally, 53% of home care workers rely on some form of public assistance.

In order to improve job quality, employers will need to think holistically, according to Campbell.

“Improving training, supervision, opportunities for advancement and other elements of job quality would help stem the tide of turnover in this field,” he said.

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