Rethinking Home Healthcare Recruitment and Retention

The answer to the home healthcare workforce crisis may be diversifying your portfolio. 


Metaphorically speaking, of course.


So says Emily Fagan, MissionCare’s Senior Marketing Coordinator. She’s speaking about the results from The State of The Direct Care Workforce, a comprehensive new study.


The study doesn’t offer any magic bullets. It doesn’t uncover shocking new facts. But it analyzes the data with a fresh approach that can solve one of home healthcare’s most pressing challenges


Even if you’ve heard all the conventional solutions—better benefits, flexible scheduling, employee recognition—keep reading. You may be surprised. 


The story behind the story


“The State of The Direct Care Workforce” is a joint venture of MissionCare Collective and NAHC (National Association for Home Care & Hospice). MissionCare works to improve caregivers’ lives and stabilize the workforce to provide better care. NAHC is a professional association representing home care and hospice clients and organizations.


MissionCare and NAHC teamed up to tackle the worsening workforce shortage and turnover. The statistics are alarming. If the trends continue, aging Baby Boomers may not be able to access necessary home care. “The caregiving workforce needs to increase by 8.2 million jobs to accommodate future needs,” says Bill Dombi, NAHC President.


But instead, it’s shrinking:

  • Since March 2020, providers have 23% fewer HHAs working for them. 
  • 57% of caregivers quit within the first 90 days.
  • 85% of home care providers turn away cases due to a lack of staff.


Home care agencies are well aware of the problem, but current strategies aren’t enough to stem the tide of caregiver defection. The two organizations were determined to get to the root of the issue. “We went searching for the why,” says Emily. 


A new approach to the workforce shortage

Typically, the workforce crisis has been addressed by looking at outside factors such as COVID, wages, and increased demand. But MissionCare approached it from a different angle. Their goal was to transform the industry by “better understanding the amazing people behind the profession,” says Brandi Kurtyka, MissionCare Collective’s CEO.


It’s a simple but previously unexplored premise. Changing the culture of care starts with better understanding the people delivering it. In other words, go to the source, the caregivers themselves. And to that end, they surveyed 67,417 caregivers, CNAs (certified nursing assistants), and HHAs (home healthcare aides) across 90 data points.


The first half of the study offers definitive demographic data:

  • Caregivers are 7x more likely to live in the poorest income category versus the average U.S. population. 
  • Caregivers are 3x more likely to struggle with anxiety and depression versus the average U.S. population.
  • Caregivers are 2x more likely than the average US population to donate to causes they care about.


Those facts may be interesting, but how can agencies use them to improve recruitment and retention? 


That question leads to the second half of the study, a breakdown of caregivers into personas.


Personas are a foundational marketing concept, defining the user types in a target audience. Consider boys’ baseball pants, advertised to both little leaguers and their moms. In each case, the marketing messaging and venues will be slightly different.


The mothers want to know how well the pants will wash clean. That may be the emphasis in the company’s social media ads. But the boys see the stains as a badge of honor and only care about how well they’ll slide into base. During Sunday morning cartoons, that’s what the boys will hear about. 


It’s the same product, but particular benefits are highlighted for each persona.


7 Key Caregiver Personas


Getting back to home healthcare, the study identifies seven key caregiver personas:

       1. Career Caregivers have worked in the field for three or more years. They’re looking for full-time hours since caregiving is their only job.


       2. Caring on the Siders are middle-aged women who hold multiple hourly jobs. They need to schedule shifts around their other work commitments. 


      3. Young and on the Move caregivers are 18-24 yrs old and a mix of students and working professionals. They want to grow and do good but may not know about caregiving as a career option. 


       4. Oodles of Offspring is a class of young female households, often with multiple kids. These women struggle to make ends meet and want to pick up as many shifts as possible.


       5. Single Moving Mommas are single moms who move frequently. Like Oodles of Offspring, they worry about making enough money to support their kids.


       6. Empty Nesters are young retirees or near-retirees. Part-time caregiving appeals to them as a chance to get out of the house and earn extra money to spend on their grandchildren. 


      7. Still Going Strong Retirees are slightly older than Empty Nesters and also looking for part-time work. They feel pressure to earn money while they can so they’ll have enough for their retirement. 


(Those are just brief descriptions of each persona. For a full explanation, see the study here.)


These seven personas encompass a lifetime of ages, stages, and priorities. While some are similar, none are exactly alike. All are currently working in home healthcare.


But if you’re like most agencies, you probably direct your marketing, interviewing, and onboarding only to Career Caregivers. Even agencies who know that not all their employees are alike still treat everyone the same.


And that unintentionally cuts out entire classes of eligible caregivers. This is especially true for potential employees such as Young and On the Move, who may not even know that caregiving jobs are an option.


Personalizing the Employee Journey

From job posting to interviewing to onboarding, each step of an employee’s experience can be more successful if it’s personalized based on persona.


The State of The Direct Care Workforce goes into detail for each persona in each of these categories:


  • Key benefits – Which job benefits mean the most to which persona? The diverse possibilities include stability, client match, training, wages, flexibility, or consistency.


  • Where to recruit – You’ll find different personas at different sites. Online possibilities may be niche recruitment websites, major job boards, or social media. Offline possibilities include church and community events, university recruitment, or referrals. 


  • How to entice – During the interview, how can you make your prospect feel that the job was made for her? Each persona will get excited over specific parts of your company’s culture, whether it’s flexible scheduling, the ability to make a difference, investment in training, or a family-oriented culture. 


  • Tips to engage – How do you connect and build trust with employees during onboarding and beyond? Depending on the persona, you may focus on donating to causes they care about or discussing your company mission and values. Other personas connect to family-centered events or coupons and discounts.


  • Pathway considerations – How can your employees gain meaningful career and skills growth? The study found that 70% of caregivers want to pursue more education. But that education isn’t always about earning a degree. It may mean learning new skills, mentorships, apprenticeships, or training programs. 


  • Turnover risk – What will drive each persona away from your agency or the industry? Poor client match, scheduling conflicts, or lack of growth opportunities are some of the sore points to watch out for. 


  • Recognition tipsHow should you recognize your employees to give them the greatest satisfaction? Some personas want to be recognized for the excellent care they deliver. Others may prefer recognition for picking up extra shifts or hitting goals. 


  • Incentives – How should you reward employees for excellent performance? It depends on the persona, of course. Some of the many options are time off, public praise, wage tiers, or discount programs.


(Again, this was just an overview. To learn the specifics for each persona, get the study here.)

Fresh thinking

The study’s purpose is to “inspire readers to think differently about creating benefits, messaging, and other strategies to refine recruitment and retention strategies.”


Fresh thinking means asking yourself new questions:

  • Does my agency employ caregivers from the full range of personas?
  • Do we have diverse ads that appeal to different personas?
  • Do we personalize our onboarding process?
  • Do we highlight different benefits in our interviews?
  • Are our incentives motivating all our employees?


Recognizing the seven personas is recognizing a big opportunity to turn around a long-standing industry problem. And while it will take time and effort for an agency to diversify its procedures, the potential payoff is a full staff of engaged, happy caregivers. 

Leveraging wage parity benefits

Wage parity benefits can be a strategic element in engaging your employee personas. All your wage parity benefits should be offered to all employees. However, which ones will be most enticing in an interview or during onboarding? That varies by persona.


Benefit Most appealing to. . . 
Dependent care Oodles of Offspring, Single Moving Mommas
Medical and pharmacy Empty Nesters, Still Going Strong Retirees, Career Caregivers, Caring on the Siders
Dental, Vision Empty Nesters, Still Going Strong Retirees, Career Caregivers, Caring on the Siders
401k Career Caregivers
Life insurance Career Caregivers
Education Young and on the Move
Transit All personas!


Some caregivers may not be informed about the importance of a 401k or life insurance. Wage parity can be an opportunity to educate them and earn their trust.


And with Melody Benefits’ electronic benefits cards, employees have easy access to whichever benefits suit them best.


“We’ve already seen that wage parity benefits improve recruitment and retention,” says Shaya Sternhill, Melody’s Head of Marketing and Business Development. “But this study shows us how to take that advantage even further.


“Be in touch to discuss how we can tailor wage benefits to boost your broader recruitment and retention strategy.”

Melody Benefits’ clients enjoy a 90% average employee retention rate.

Staying compliant does more than keep you from incurring penalties. It offers the opportunity to take care of your employees, building loyalty and engagement.

And THAT’s the secret to an agency surviving—and thriving—in an ever-evolving industry.

Discover how 27+ home health care agencies are already maximizing savings and keeping employees satisfied with Melody Benefits.