How Specific Recruitment Strategies Lead To Better Retention In Home-Based Care

In order to consistently recruit caregivers to home-based care, providers and human resource departments need to better understand what workers want and what they are struggling with.

That was one of the many takeaways from a study conducted by MissionCare Collective and the National Association for Home Care & Hospice (NAHC), which focused on current caregiver challenges and opportunities.

The study evaluated more than 65,000 personal care workers across more than 90 data sources.


“It’s important for providers to ask themselves questions like, ‘Who are you attracting to your organization? What does your messaging look like? What are you doing today to retain those folks?’” Maggie Keen, VP of corporate development at MissionCare Collective, said during a Polsinelli webinar Wednesday. “There’s an opportunity for providers across home-based care to not engage, recruit and retain everyone like everyone is the same.”

One of the high-level insights that Keen pointed out from reviewing the study’s findings is that caregivers are seven times more likely to live in the poorest income category compared to the average U.S. population.

“The reality is that 63% of CNAs, and nearly as many home health aides, have a net worth of less than $25,000,” Keen said. “We already know that retention is a struggle in this industry: 57% of caregivers quit in the first 90 days and 85% of all home care providers are turning away cases due to lack of staff.”


Keen added that 61% of caregivers and 59% of home health aides reported $0 in discretionary income.

The study also found that over half of home care workers and a third of CNAs rely on some form of public assistance, while 90% of caregivers do not have a credit card.

“This report provides some insight that hopefully can be the basis at the beginning of conversations that we’re having with caregivers,” Keen said. “It can be used as a tool to understand, hopefully, some of the challenges that may be facing our direct care workforce. That can be both at a local level – and as an industry as a whole – as we look into expanding our workforce.”

Providers should be able to advertise and market job openings to different types of caregivers, MissionCare suggests. For instance, it uses labels to describe the different types of caregivers, whether those be career ones or those looking for work on the side.

“As we think about our own workforce and as we think about opportunities to expand our workforce, challenge yourself to think about, ‘Does your existing workforce represent all of these groups or just some of them?’” Keen said. “Do you have different job ads for each group? Do you have different sales strategies to recruit each persona? The goal here is to keep them engaged, especially in the first 90 days, so they’re not joining that 57% that are churning.”

Apart from understanding how to better recruit and retain caregivers, it’s also important for providers to stay up to date on immigration policies that will undoubtedly affect the home-based care space.

Replacing the retiree workforce with U.S. workers appears to be a losing battle, Carlos Ortiz, a shareholder with the law firm Polsinelli, said.

From now until 2031, it’s estimated that 332,000 home health and personal care aides will drop out of the workforce each year.

“The difficulty of replacing the retirement workforce with an ever-shrinking population of native-born workers will create substantial shortages in low- and middle- skilled occupations, including the home health care sector,” Ortiz said. “Home health is considered a low-skilled job, but the position demands a high range of physical, psychological and emotional skills, including being able to safely transport people and dealing with diseases such as Alzheimer’s or dementia.”

Today, there are about 2.1 million immigrant workers in the home health space, Ortiz said.

“Even though the sector is already highly dependent on the foreign-born workforce, the U.S. immigration system lacks temporary, non-immigrant and immigrant visa categories designated for low-skilled home care workers,” Ortiz said.

One key piece of workforce law that Ortiz said to keep an eye on is the expiring rule that allows for I-9 workforce employment and identification papers to be filed remotely. That law was changed during the pandemic for flexibility reasons, but is set to expire later this year.

Companies featured in this article: