Caregiver staffing isn’t just an HR problem. It’s an operations problem, a quality problem, and for many agencies, the number one limiter of growth. After working with a lot of home health and home care providers, ScaleCare has seen the tactics that work (and the ones that look good on paper but fall apart in the field). Here are 7 practical moves you can implement without turning your agency upside down.
1. Hire the right people (and stop “selling” the wrong job)
Hiring for reliability and fit first, then skills, reduces churn. The fastest turnover happens when the job you advertise doesn’t match what caregivers experience.
Practical upgrades
Make your job ad more honest. Be explicit about client types, driving requirements, weekend expectations, and documentation basics.
Screen for show up behaviors. Ask about transportation, schedule stability, and comfort with last minute changes.
Add a five minute realistic job preview (video or script) before the interview so you don’t hire surprises.
A question that works well
Tell me about a time your schedule changed last minute. How did you handle it?
2. Build a robust onboarding program (first 14 days decide the next 14 months)
Onboarding reduces early churn because it creates confidence and connection, not just compliance.
A simple onboarding structure that works
Day 1: welcome, paperwork, how we work standards, and app or EVV basics
Day 2 to 5: shadow or ride along (or simulated scenarios) plus first client match review
Week 2: supervisor check in, skills gaps review, schedule preferences, and next step training
Non negotiable
A 48 hour check in after the first shift. “How did it go?” beats “Let us know if you need anything.”
3. Reward caregivers (consistency beats occasional big bonuses)
ecognition isn’t fluff. It’s retention infrastructure. Caregivers stay where they feel seen and treated fairly.
What we see work most
Fast, frequent recognition such as “caught you caring” shoutouts, small gift cards, or preferred shifts
Attendance and reliability rewards that are quarterly, transparent, and simple
Pay accuracy and pay clarity so caregivers trust your organization
Quick win
Publish a one page “How to earn more here” ladder that outlines differentials, referral bonuses, and training milestones.
4. Invest in caregiver training (so they feel confident, not thrown into the deep end)
Training isn’t just compliance. It’s confidence. Confidence reduces call outs and quits.
Training topics that move the needle
Dementia communication basics
Safe transfers and fall prevention
Family dynamics and boundaries
Documentation and EVV “what good looks like”
De escalation and personal safety
Bonus
Pair training with a mentor or buddy for the first 30 days.
5. Take career advancement seriously (even if you’re “too small for ladders”)
If your best caregivers can’t see a future, they’ll find one elsewhere.
Career paths that don’t require a huge org
Caregiver I to Caregiver II (specialty cases) to Lead Caregiver (mentor)
Scheduler or Coordinator track for caregivers who want steadier hours
Training assistant roles part time
Specialty pay bumps for dementia, bilingual, or complex mobility
Even modest structure sends a clear message. We invest in you.
6. Communicate clearly and consistently (silence gets interpreted as “we don’t care”)
Home based care is isolating. If caregivers only hear from the office when something goes wrong, they disengage.
Systems that keep caregivers connected
Weekly text huddle with three bullets: wins, reminders, open shifts
Monthly ten minute pulse call for new hires
A clear escalation path so caregivers know who to call and when
Manager training on responsiveness and tone
7. Don’t lose sight of your competition (you’re competing on experience, not just pay)
Pay matters, but many agencies win by building the best caregiver experience.
What wins in competitive markets
Predictable scheduling practices
Fast payroll resolution
Respectful communication
Fair case matching
Visible growth opportunities
Also powerful
Referral programs that are simple, meaningful, and tied to retention, not just hiring.
Try this structure
Referral bonus at hire
Referral bonus at 30 days
Referral bonus at 90 days
A simple scorecard to track (so retention becomes controllable)
Time to first shift
14 day retention
90 day retention
Call out rate
Open shift fill time
Referral hire percent
The bottom line
Recruitment fills shifts. Retention builds capacity.
The agencies that win aren’t doing everything. They’re doing the basics consistently. Hire for fit, onboard well, recognize often, train deliberately, build growth paths, communicate clearly, and keep an eye on competitors.
If you want help pressure testing your caregiver funnel from recruiting to onboarding to scheduling to retention, ScaleCare can help you identify where you’re leaking good people and what to fix first.
