We’re Home Care Pulse, a leading provider of experience management & surveys, caregiver/CNA training, and online reputation management.

What your clients say about you matters more than any other marketing source for your agency—but only 24% of them are satisfied. After surveying 100,000 clients, we know exactly how you can turn even your worst reviews into opportunities to increase client recruitment and retention.

For the first time in five years, home care client turnover has increased. It jumped from 58% to a staggering 76% in the last year, according to preliminary data from the 2022 HCP Benchmarking Report. So, while client referrals continue to be the number one marketing source for home care agencies, less than a quarter of them are satisfied enough to stay with your agency.

How do home care providers go about reversing this?

The answer is found in your Net Promoter Score (NPS). It’s never been more necessary to learn the good, bad, and ugly of your company before your clients go elsewhere, taking their friends with them.

In fact, companies with a NPS of 6.0 or above will grow at more than twice the rate of their competitors on average. Your agency’s NPS will help you make data-driven decisions, facilitate growth and referrals, and decrease client turnover.

After surveying 100,000 clients, we’ve learned exactly how you can uncover the patterns behind your NPS and utilize each one of your promoters, passives, and detractors like a pro.

  • Capitalize On Your Promoters

  • Learn from the Passives

  • Don’t Discount the Detractors


Promoters, Passives, and Detractors—Oh My!

Finding your NPS is centered around asking clients one question: “How likely are you to recommend your current home care agency to others?”

Your agency’s satisfaction rate depends on your clients’ answers. Rather than getting caught up in the actual score, we recommend looking at the percentage of clients in each satisfaction segment.

Clients are asked to rate how likely they would be to recommend their home care agency to others on a scale of one to ten. They are then organized into one of three categories based on their answers:

  • Promoters (score 9-10) are loyal enthusiasts who will keep using your services and refer others, fueling growth.

  • Passives (score 7-8) are satisfied but unenthusiastic clients who are vulnerable to competitive offerings.

  • Detractors (score 1-6) are unhappy clients who can damage your brand and impede growth through negative word-of-mouth.

NPS Scale Promoters, Passives, and Detractors


While it is natural to focus solely on the highest or lowest scores you receive, all three segments have something to teach you about your agency. Like looking into a glass ball, all three of these results reveal valuable insights into what you could do to serve your clients better and keep them happy with your agency.

How to Calculate Your Net Promoter Score

While there is something to learn from all three of these results, you only need to know the number of your agency’s promoters and detractors to calculate your NPS.
To calculate your NPS, take the percentage of clients who are promoters and subtract the percentage who are detractors. Dividing the result by 10 will give you your Net Promoter Score on a scale of 1-10.


Calculating NPS


Once you’ve done the math, you’re left with a score that quantifies your clients’ satisfaction that you can use to begin improving.

What is a “Normal” Score?

As the industry average Net Promoter Score is 6/10 , acting on client feedback to improve your own NPS is the key to standing out from your competition.

Your NPS allows you to quantify and track your clients’ satisfaction, but it’s important to go beyond a number on a scale. Collecting scores from your clients will:

  • Show what your clients really think about your agency, since all ratings should be collected anonymously

  • Help you better understand your target demographic as you discover patterns and trends

  • Offer unique client perspectives that propose solutions you may not have thought of before

  • Inform you of where to allocate your resources by revealing the practices that are resonating well with your clients (and those that should be scrapped altogether)

  • Demonstrate your commitment to quality as you prove to your clients that their voice matters

But your NPS is only the beginning. The real value happens when you track your clients’ satisfaction regularly and act on the promoters, passives, and detractors’ feedback.

Capitalize On Your Promoters

How to make the most of them:

Over half of home care providers in the Home Care Operators Community Facebook group admitted that if they could hire someone to cover any aspect of their agency, it would be marketing.

What if we told you that your best marketers are already using your services?

According to client feedback taken over the last 6 months, 69% of clients rated their likelihood of recommending their agency to someone else a 9 or 10. Unfortunately, this number is declining.

Utilize your clients as your agency’s first-hand marketing source by:

Promoters also provide the perfect opportunity for you to recognize the caregivers who are treating their clients with exceptional service. Reward them for personally representing your agency’s commitment to quality.

Things to watch out for:

While over half of your clients say they are satisfied, the turnover rate is 76% and climbing. How could this be?

This latest trend may not be as problematic as it sounds. We suspect that the rise in client turnover results from agencies strategically choosing where to best allocate their resources to combat caregiver turnover.

Providers are being particular about who they are letting into their agencies, so you’ll want to make sure those you do recruit stay satisfied with your agency.

Although a high percentage of promoters indicates a satisfied clientele, there is no such thing as a satisfaction safe zone. Be careful not to dismiss this group of survey participants, but instead assure them you are continuing to build off their positive feedback. Have them elaborate on what they liked and take their suggestions into consideration as you learn how to recreate their positive experience for the passives and detractors.


“We’ve used the scores/awards in our recruiting and even hung employee scores in our offices so that new applicants can see what it’s like to work for us from the perspective of a potential peer.” – Richard Ruda

Learn from the Passives

How to make the most of them:

Passives may be the most exciting group you have to work with. While they aren’t yet dissatisfied with your company, they are eager to be won over. They provide you with the opportunity to learn from current clients what your agency could do to enhance their experience.

As passives make up about 23% of an agency’s NPS results, this acts as a manageable sample size for you to experiment with how you can impress the neutral clients to make them truly satisfied with your services.

Listen to this group’s feedback—both in what they are and aren’t saying. While passives are intentionally choosing a lower answer than the promoters, they may not explain or know why. It’s your job to propose solutions and look at their experience from every angle to find the root of the problem before they slip into the detractor range.

Things to watch out for:

Indifference isn’t satisfaction.

Passive people provide you with the most neutral feedback out of all three groups, but they are closer to detractors than you may expect. This is because while only 1 in 26 unhappy customers are going to complain, the other 25 will simply churn.

A passive client will automatically decline down the scale into detractor territory unless you put in conscious and consistent effort to build them up to promoter-level satisfaction.

Sometimes passives may not know what they need to be satisfied. This is where it helps to ask more questions, become involved in your clients’ experience, equip your caregivers to go the extra mile to help them feel special, and learn from the promoters and detractors to help them rise up the scale instead of down.

Don’t Discount the Detractors

How to make the most of them:

Luckily, detractors only make up 9% of the industry’s NPS results, but a box of cereal with 9% burnt pieces still isn’t a box you want to buy. Likewise, this group can quickly spread to your passives and promoters, so their feedback must be acted upon right away.

Despite their ability to negatively impact your reputation, detractors aren’t your enemy. In fact, when approached correctly, they can become your greatest source of learning and offer you the most straightforward advice, as they offer a perspective you wouldn’t have thought of otherwise.

See your detractors as your critics. The role of a critic is to communicate an assessment of their thoughts and opinions about a piece of artwork—a definition that sounds more helpful than damaging.

Things to watch out for:

We have all loved a movie in the theatre, only to hear about how our friends thought about it and suddenly shift our opinion to replicate theirs more closely. The same happens in home care between clients.

Trouble arises when your critics become vocal and cause others who once saw your agency one way to see it in a whole different (negative) light.

However, detractors can also be outliers within your agency’s satisfaction scores. Take every detractor seriously, but with a grain of salt. Some detracting clients may have had an unsatisfactory experience outside of your agency’s control. Listen to what each has to say but know that you can’t turn every critic into a promoter.

Your Agency’s Success is Spelled


Your agency’s success is only one question away.

Client satisfaction doesn’t end with your Net Promoter Score; your NPS is only the beginning. Whether you’re new to using your Net Promoter Score, or you’ve been tracking yours for a while, the only way to keep client turnover at bay is to continually monitor their satisfaction and act on their feedback.

HCP Experience Management will survey your clients and caregivers to bring you the most important insights into your business. Sign up to receive an NPS analysis to see how Home Care Pulse can help you become the agency everyone is raving about.

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