Home Health Turnover Worsens in 2019

Home health turnover rates worsened slightly in 2019 compared to the prior year.

Most salaries, however, saw a slight bump.

That’s according to the latest Home Care Salary & Benefits Report from the Oakland, New Jersey-based Hospital & Healthcare Compensation Service, which provides salary and benefits studies along with custom marketplace studies, for the health care sector. The annual salary and benefits report is published in conjunction with the National Association for Home Care & Hospice (NAHC).


At 25.36%, home care aides saw the highest turnover rate in 2019, followed by licensed practical nurses (LPNs) at 22.50%.

Mirroring last year’s findings, therapists saw the lowest turnover rate — only 12.52%. Therapy turnover will be interesting to keep an eye on in the year ahead, as most industry insiders expect home health agencies to make substantial changes to their therapy strategies tied to the Patient-Driven Groupings Model (PDGM).

Top-level executive turnover in 2019 checked in at 16.11%.


Overall, the national average turnover rate for all home health employees was 21.89% in 2019, a very small increase of 0.66% compared to 2018. Although almost negligible, the uptick in turnover for all home health employees is bad news for an industry that has historically struggled with the recruitment and retention of workers.

The Home Care Salary & Benefits Report is an analysis and compilation of statistics from nearly 1,030 home care agencies, which combined to submit data on more than 39,300 employees working across the United States.

Of the home care agencies that participated in the report, 29% were nonprofit, 64% were for-profit and 7% were hospital-based.

From 2018 to 2019, the average actual base-pay for management-level employees increased by 2.70%. The average actual base pay for therapists, social workers and aides increases by 2.64%, 2.58% and 2.60%, respectively.

Home health therapy-position wages are likewise something to follow in 2020.

Genesis HealthCare (NYSE: GEN) CEO George Hager recently spoke about therapy economics tied to the Patient-Driven Payment Model (PDPM) — an overhaul similar to PDGM for the skilled nursing space — during a third-quarter earnings call.

“With lower staffing levels in the therapy gyms throughout the industry, I think that would ease any wage pressure, and that assessment is accurate,” Hager said. “We don’t see any wage pressure whatsoever in the therapy side of the business.”

Apart from turnover and salary information, the new report also breaks down average caseload — or the average number of patients assigned to a specific employee at any given time.

Physical and occupational therapists had an average caseload of 20.82 and 18.92 patients in 2019. Meanwhile, RNs and LPNs each had a caseload slightly above 21 patients.

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