While demand for home-based care services continues to rise, workforce shortages are limiting providers’ ability to take on new patients.
A new report from Homecare Homebase found that 63.3% of home health providers reported turning down referrals. The analysis also found that referral conversion rates have declined 13%, while referral rejections tied to staffing shortages remain about twice as high as they were before the COVID-19 pandemic.
The report points to administrative friction, limited visibility into workload, unpredictable scheduling and after-hours documentation as operational factors that can contribute to burnout and turnover.
“Retention is often discussed as a staffing issue,” the report reads. “In practice, it is an operational issue with workforce consequences.”
Dallas-based Homecare Homebase is one of the largest technology and administrative services companies serving the home-based care sector.
Home health registered nurse turnover stands at 25.46%, according to the report, while home health aide turnover is 34%. Meanwhile, personal care providers face caregiver turnover exceeding 70% annually in many markets.
The report also points to a particular risk among newer employees. Within home health agencies, turnover is disproportionately concentrated among clinicians in their first year, according to data from Homecare Homebase. Burnout is also a concern among less-senior workers, with nearly half of nurses with fewer than 10 years of experience reporting it.
The report identified five areas where home health providers can improve the clinician and caregiver experience and improve workforce sustainability.
Homecare Homebase identified five areas clinicians say are central to a more sustainable work experience: more time with patients, less after-hours work, more predictable schedules, clearer visibility into workload expectations and tools that reduce administrative burden.
Per the report, these requests reveal that clinicians are asking for a sustainable workload — making sustainability the top retention strategy.
“The implications extend far beyond staffing levels,” the report reads. “High early-career turnover increases onboarding and training costs, reduces institutional knowledge, places additional strain on experienced clinicians, and affects continuity of care. In an environment where demand for home-based care continues to grow, organizations risk losing clinicians faster than the workforce pipeline can replace them. Viewed through this lens, retention becomes more than a workforce metric. It becomes a capacity strategy.”
Caregivers, meanwhile, are signaling a somewhat different set of priorities. While competitive compensation remains foundational, caregivers also want consistent schedules, reliable hours, simpler administrative processes, stronger communication and greater day-to-day stability, according to the report.
“As home-based care organizations navigate growing demand and workforce challenges, leaders have an opportunity to rethink how operational decisions shape the clinician experience every day,” Homecare Homebase Chief People Officer Martha Stuart Williams said in a statement. “By reducing unnecessary administrative friction and investing in technology that supports clinicians, organizations can build stronger, more sustainable teams while creating greater capacity to serve patients.”
Home-based care providers have embarked on a variety of retention-focused initiatives to improve the status quo for clinicians and caregivers. Efforts include improved transparency between leadership and frontline workers, educational support and hands-on training and even gamification software tools.