top of page

Turnover in the Senior Care Industry

Updated: Mar 28, 2022

The Bureau of Labor Statistics expresses that the most jobs to be added to the economy will be from the healthcare and personal care industries by the next decade. Correspondingly, 1 in 6 individuals will be 65 and older by 2050, compared to 2019 with 1 in 11.

Turnover rates

Home healthcare is one industry that is having a difficult time when it comes to retaining its employees. Many see the shortage of workers as the main threat for home care agencies this year.

The turnover rate in 2018 for the home care industry reached new and high heights of 82% (Holly, 2020).

In 2020, the turnover rate across various home care providers in the United States was 65.2% (Holly, 2021). Additionally, the turnover rate for home care aides in 2020 was 36.53% (Holly, 2020).

Before the pandemic, "the median staff turnover at U.S. nursing homes was nearly 100%” (Spanko, 2021). In 2017 and 2018, the median and mean turnover rate was 94% and 128% among the workers in nursing homes (Spanko, 2021). Before the start of the pandemic, 75% of nursing homes did not have enough staffing (Maxouris, 2021).

A study published in Health Affairs indicates that the average yearly turnover rate in nursing homes across the US was 128%, while other facilities were over 300% (Abelson, 2021).

In 2017 and 2018, the average national turnover rate of registered nurses working in nursing homes was greater than 140% (Maxouris, 2021). In the long-term care industry, the turnover rates for nurses and aides ranged between 55% - 75% (Barbera, 2014). In other words, recruiting and retention are the major issues for the long-term care industry.

The turnover rate in assisted living communities are high, where there are estimates that the “staff turnover range from a low of 21% to a whopping 135%, with an average of 42%” (Peasall, 2014). Meanwhile, the assisted living certified nursing assistants turnover rates went from an “average of 36.37% in 2019 to 48.51% last year” (Regan, 2021). The turnover rate among assisted living and nursing home workers are 94% (McKay, 2021).

Source/Attribution: Visual Capitalist

What are the issues with high turnover rates?

Turnover rates affect everyone and are detrimental to employers, employees, and patients. For the employer, turnover rates are costly. High turnover rates for the employer means that they lose productivity, clients, and the quality of their service declines. It can also increase employee absenteeism and accidents.

For the employees who are still working, many may face burnout. High turnover rates mean that employees would have to work additional hours to make up for the demand. Current employees are left “to do more with less” (Caitlin Morgan, 2020). Employees who are working in an understaffed environment have a greater risk of injury.

Then there is the patient perspective. High turnover rates in the senior care industry are detrimental to the patients. High turnover in nursing homes is one of the reasons that may have caused an outbreak in these homes. A shortage of workers in nursing homes can result in errors in medication, infections, and IVs that are leaking. For many patients to feel secure and reduce mistakes, consistent interaction from the patient to the employee is vital, but this is not feasible when there is a constant stream of new employees due to the high turnover rates. When there is adequate staff in nursing homes, it helps to decrease rehospitalizations.

Reasons why there are such high turnover rates

There are many reasons why workers in senior care are leaving. For some, it is both physically and mentally exhausting. For others, it is the combination of low pay, inconsistent schedules, lack of advancement opportunities, little appreciation, lack of staffing, ambiguous roles and responsibilities, and harmful work environment that have led to this growing issue.

Aside from those factors, the job itself is another reason. Many individuals often don't want the stress and the workload to care for those with physical disabilities and those struggling with mental health.

Importance of employee happiness

Employee happiness in the senior care industry needs improvement based on the high turnover rates.

To Herb Kelleher, the co-founder of the Board of Southwest Airlines, the most important were employees, ahead of customers, and shareholders for a company. When the employees are happy, they will treat their customers right, which will make the shareholders content. Essentially, there is a domino effect, and it starts with the happiness of the employees.

A report highlights that engaged employees results in an increase of 20% in sales. When the company allows the employee to feel valued, that employee will work to the greatest of their abilities every day.

How to retain healthcare workers

Retention starts with understanding why employees are leaving your company. Conducting exit interviews to collect and analyze real-time exit feedback data over time allows you to identify turnover reasons and trends. Many employees are willing to disclose their new offer details and this gives employers the opportunity to get real-time salary and total compensation benchmarking data. Exit interviews help employers understand why their employee is leaving and take that information to make changes to their onboarding process.

In addition to exit interviews, employers should also conduct at minimum a once a year annual employee engagement survey to gauge the pulse of current employees. This allows employers to proactively improve engagement to reduce turnover.

Other ways to reduce turnover and increase retention is allowing employees to be involved with decision-making, making them feel valued, providing opportunities, helping employees cope with stress, offering better salaries and benefits.

Employee feedback provides answers to the employer and allows them to know what steps to take to improve their employee’s experience. It also gives insights into what the employer can do to retain their employees by asking questions relating to topics such as; overall job satisfaction, work-life balance and flexibility, employee recognition, total compensation, manager, and career growth and opportunities.

How we can help

Feedback in the workplace is extremely vital because it allows the employees to feel that they are making a change and are valued. Surveys are a great way to deploy these questions to their employees. Pulse surveys are short, frequent surveys that can be tailored to specific topics to assess their change over time. Pulse surveys allow staff members to see the impact of their changes in real-time. The frequent nature of pulse surveys means the information management and staff members see will always be current.

Retainify is an employee engagement software that offers a unified solution that allows you to track employee sentiment and measure engagement in real-time. Proactively identify issues that are preventing them from being their best at work. Improve business outcomes by improving the employee experience, and enhance company culture one feedback at a time. Turn Feedback into Action.

Questions or Feedback?



  1. Abelson, R. (2021, March 01). High Staff Turnover at U.S. Nursing Homes Poses Risks for Residents’ Care. Retrieved September 08, 2021, from

  2. Barbera, F. E. (2014, February 07). The keys to reducing turnover in long-term care. Retrieved September 08, 2021, from

  3. Bevis, J. (2018, July 31). How to Reduce Turnover with your Homecare Staff. Retrieved August 04, 2021, from

  4. Bittle, J. (2021, February 09). Overworked, Underpaid, and Cutting Corners: The Crisis in Home Health Care. Retrieved August 04, 2021, from

  5. Caitlin Morgan. (2020, May 8). The Impacts of Staffing Turnover on Providing Care In ALF’s. Retrieved September 08, 2021, from

  6. Campbell, A. (2019, August 21). Home health aides care for the elderly. Who will care for them? Retrieved July 27, 2021, from

  7. Farrell, C. (2018, April 18). The Shortage Of Home Care Workers: Worse Than You Think. Retrieved July 27, 2021, from

  8. Galewitz, P. (2021, June 30). With Workers In Short Supply, Seniors Often Wait Months For Home Health Care. Retrieved August 04, 2021, from

  9. Holly, R. (2021, May 19). 'A Huge Victory': Home Care Turnover Remains Stable at 65.2%. Retrieved August 04, 2021, from

  10. Holly, R. (2020, June 17). Caregiver Turnover Rate Falls to 64% as Home Care Agencies 'Flatten the Curve'. Retrieved August 04, 2021, from

  11. Holly, R. (2020, October 27). Home Health Turnover Rate Hits 22.18%. Retrieved August 04, 2021, from

  12. Hyken, S. (2017, May 27). How Happy Employees Make Happy Customers. Retrieved August 04, 2021, from

  13. Lim, D. (2020, April 23). How to reduce caregiver turnover rates during the pandemic and afterward. Retrieved August 06, 2021, from https://www.mcknightss

  14. Maxouris, C. (2021, July 6). Covid-19 exposed the devastating consequences of staff shortages in nursing homes. But the problem isn't new. Retrieved September 08, 2021, from

  15. McKay, M. (2021, July 27). More staffing and boosting wages for staff leaves NY's nursing homes asking: Who will pay? Retrieved September 08, 2021, from

  16. Medcom. (2019, December 20). IMPROVING EMPLOYEE RETENTION IN HOME HEALTH, HOSPICE AND HOME CARE. Retrieved August 04, 2021, from

  17. Peasall, D. (2014, March 31). Improving your staff turnover rate in assisted living. Retrieved September 08, 2021, from

  18. Quilter, D. (2019, June 11). What Some Nursing Homes Do To Retain Quality Staff. Retrieved September 08, 2021, from

  19. Regan, T. (2021, January 24). Assisted Living CNA Pay Grew in 2020, But Turnover Skyrocketed. Retrieved September 08, 2021, from

  20. Spanko, Alex. (2021, March 02). Nursing Homes Have 94% Staff Turnover Rate — With Even Higher Churn at Low-Rated Facilities. Retrieved September 08, 2021, from

  21. Stone, R. I., & Wiener, J. M. (2001, April 30). Who Will Care For Us? Addressing the Long-Term Care Workforce Crisis. Retrieved August 04, 2021, from

  22. Sudo, C. (2019, November 22). Why Senior Living Fares Worse Than Other Service Industries on Worker Turnover. Retrieved September 08, 2021, from

  23. United Nations. (2019, June 17). World Population Prospects 2019: Highlights. Retrieved September 08, 2021, from

249 views0 comments

Recent Posts

See All
bottom of page