Report: Home Health Sector Improving Turnover Rate, Continues Increasing Compensation

Hourly pay rates for licensed practical nurses (LPNs) at home health agencies increased nearly 4% from 2022 to 2023. That rate of increase represents a significant drop from the year before.

Meanwhile, turnover rates for RNs, LPNs and home care aides declined for the second year in a row, clocking in at 28% in 2023.

That’s according to the latest Home Care Salary & Benefits report from Hospital & Healthcare Compensation Service.


The Oakland, New Jersey-based company provides salary and benefits studies — along with custom marketplace studies — for the health care industry. The report is published in cooperation with the National Association for Home Care & Hospice (NAHC).

“Our main takeaways would be the declining turnover rates and rate increases,” Rich Cioffe, director at Hospital & Healthcare Compensation Service, told Home Health Care News in an email. “Across all of our health care reports, we’re seeing that the combination of considerable rate increases — which far exceeded the routine increases of 2-4% seen prior to 2020 — along with the utilization of sign-on bonuses are having a positive effect on increasing retention rates and helping attract new talent.”

The latest report is based on responses from more than 1,000 home health agencies across the U.S.


As Cioffe pointed out, home health RNs, LPNs and home care aides saw hourly rate increases ranging from 6% to 10% in 2022. These increases ranged from 4-5% in 2023 — still above the “norm” pre-2020, but no longer nearly double, he said.

RN turnover rates dropped below 30%, which is an encouraging sign for the industry, as that number is approaching pre-pandemic levels.

Compared to other agency settings, RNs in nonprofit, community-based settings are paid the most.

According to the report, nurses in home health agencies that are overseen by Visiting Nurse Associations (VNAs) received the highest pay, with an hourly rate of $43.

The hourly rate for home health aides in hospital-based agencies was $41.29, while for-profit agency nurse hourly pay was $36.86.

“The highest pay rates for home health aides was in the hospital setting, which has generally been the case over the years,” Cioffe said. “Hospitals have the benefit of larger revenues, budgets and funding sources compared to smaller agencies that are run by a single owner or smaller not-for-profit.”

Nonprofit agencies checked in slightly below for-profit at $38.72 per hour.

California holds the highest average salary for RNs for the second year in a row at $58.85 per hour.

On the lower spectrum, nurses in Mississippi received $31.76 an hour, while nurses in North Dakota and Tennessee received $32.29 and $33.27 an hour, respectively.

Home care aides, meanwhile, saw an 8.96% increase in hourly rates in 2022, compared to a 5.01% increase in 2023.

In order to combat shortfalls, providers have upped the ante for sign-on bonuses in the sector.

Source: Hospital & Healthcare Compensation Service

According to the report, nearly half of agencies – 47.19% – reported offering sign-on bonuses to attract new employees. Of those that offered sign-on bonuses, 78.57% of respondents reported sign-on bonus data for RNs, with an average bonus of $7,056.

“As employee retention improved, turnover declined and staffing issues seemingly began to stabilize, agencies have been able to reduce how much they increased wages by while still remaining externally competitive,” Cioffe said.