Your caregivers’ first 90 days will cost you $136,890—in annual turnover costs, that is. Find out what is causing 57% of your employees to change their minds about your agency in their first 3 months of working with you and what only you can do to prevent it.

T-Minus: 90 days… It’s been said that a child’s first 5 years are the most crucial for their development. But in the life of a caregiver, you only have 90 days at best to develop them into strong employees or risk being handed a resignation letter.

A shocking 57% of caregiver turnover occurs in the crucial first three months of employment—but it’s a statistic that is (almost) entirely preventable.

With 11 million job openings in the U.S. right now, you have just under 3 months to convince your caregivers to stay with your agency by delivering what they’re looking for as a new hire.

Make the next 90 days your top priority by addressing the 5 biggest reasons employees quit within their first 3 months to save yourself $136,890 in turnover costs this year.

The countdown begins.

  • Your interview questions are making you hire the wrong people.

  • You wait until a caregiver’s first shift before communicating what they need to know.

  • Your caregivers don’t feel like they have a say in the hours they’re scheduled.

  • You’re expecting your new hires to be experts.

  • Your caregivers aren’t hearing from you enough.


5. Your Interview Questions Are Making You Hire the Wrong People

“You need to have the highest and strictest hiring standards ever in this industry,” Allen Serfas.

Retention starts with prevention. And sometimes, preventing 90-day caregiver turnover begins right in the interview.

The average agency will hire around 81 caregivers this year, but our research shows that 65% of them will quit by the end of the year. At $2,600 per caregiver, that means it will cost your agency approximately $136,890 in annual caregiver turnover costs to replace them.

So why are your new hires making it past their interview but not their first 90 days of employment?

You’re not asking them the right interview questions.

How to address this:

Interviews go both ways. While you don’t want to misread a candidate’s ability to deliver what your agency needs, your caregiver needs to be able to discern if they would honestly be the best fit for your agency too.

In the 2022 Home Care Growth Summit, John Bennett explained that your interview process should provide applicants with an accurate picture of what they can expect the position to entail:


“There are people you’re going to hire in those first 90 days, regardless of your vetting process, where home care is just not for them—that’s not something you need to change in your retention efforts. You need to do a better job in your screening process and give them a more realistic presentation of what caregiving is all about.

“We tried some different things where we painted a really “happy-go-lucky” picture about home care, which it is very rewarding, but we glossed over more of the difficulties. That increased our recruitment as we were hiring more people in the area, but our retention was worse because people weren’t getting a realistic look of what the job looked like.”

Update your interview questions to include questions about past experiences, skills, and hypothetical scenarios to accurately assess each candidate’s potential and prepare them for what they can expect on the job.


Questions about past experiences:

  • Tell me about a time when you worked with a difficult client or customer. What made it difficult to work with them, and what did you do to resolve the issue? 

  • What is your proudest achievement from a past job? 

  • Tell me about your previous caregiving experiences. What part of the experience was most difficult, and what was most meaningful to you?


Skill based questions:

  • Describe for me how the experience on your resume has helped you build the skills necessary to be a good caregiver.

  • What do you believe is the most important skill for a caregiver to have? Tell me about a time when you’ve demonstrated this skill, as a caregiver or in another line of work.

  • If you were hiring someone for this position, what are the top three skills or traits that you would look for?


Hypothetical scenario questions:

  • If a client of yours refused to [take a shower, eat their meal, go to the bathroom, etc.], how would you deal with the situation?

  • How would you respond to a client who used rude or derogatory language toward you?

  • If we could bring your pet in here right now and ask it for a reference about your personality, what would it say?


Prevent 90-day turnover by hiring long-term caregivers from the start.

4. You Wait Until a Caregiver’s First Shift Before Communicating What They Need to Know

The most common retention mistake agency owners make is starting their retention efforts after a caregiver’s first shift, and not in the first few days leading up to it. If you want your caregivers to stay around longer than three months—it starts from day one.

New hires who experience a positive onboarding experience are 70% more likely to continue working for an organization for more than three years. Especially in the home care industry, a lot of new hires are economically fragile and want to start their first shift as soon as possible; otherwise, they’ll find a job who can add them to their payroll faster than you can.

How to address this:

If you don’t have your new hire’s client schedule figured out yet, don’t panic. Caregivers want to start work as soon as possible, but they also don’t want to be rushed into a client’s home without any training.

Although your new hires don’t need their weekly schedule completely planned out yet, ensure their first training shift is scheduled for as soon as they can start. Proactively share all the details of what their first couple weeks will look like to communicate that you’re ready to invest in them from day one.

As soon as you hire a new caregiver, meet with or call them to discuss:

  • when they can expect to have their first training (preferably their previously stated start date)

  • the type of training topics they can expect

  • what materials and supplies they should prepare in advance

  • when they can expect to meet their clients

  • how many clients they can expect to have

  • who their mentor will be, if your agency has a mentorship program

  • their goals, and record what is most important to them/what they want to get out of your agency

  • common new caregiver FAQs for your agency

  • your contact information


Start your caregivers’ first 90 days on a high note by communicating what they really want to know as soon as you offer them the job.

3. Your Caregivers Don’t Feel Like They Have a Say in the Hours They’re Scheduled

In an effort to prevent 65% of your caregivers from quitting this year, it’s a knee jerk reaction to offer them everything you can to make them stay. But sometimes your employees don’t actually need more from you—they just need balance.

Even if you’ve hired the perfect caregiver, if you don’t have the hours to support what they need, you’re practically ushering them out the door.

As every 1 in 4 caregivers live below the poverty line, your caregivers will quit your agency if they aren’t scheduled the hours they need to pay their bills. Likewise, if a caregiver is overwhelmed at work, they are going to believe the job just isn’t for them and express their exhaustion with their feet.

Reevaluate what your caregivers’ work week looks like to show them your agency prioritizes their financial needs and emotional well-being to keep them coming back each day for years to come.

How to address this:

Your word of the day for the next 90 days is: balance—and it’s something only you can prioritize within the culture of your agency.

Mike McSherry, Director of Partnerships at Hireology, shares what work-life balance looks like in home care, which is easier to provide than you might expect:

“Work-life balance isn’t just about giving people more freedom from work as in less hours or even more flexible hours. It really just boils down to being accommodating and meeting your employees where they are or at least trying to do a better job of it.

“If somebody in the caregiver space needs to have Wednesday afternoons off because they have a loved one or kids at home that they need to take care of on those days of the week—help them schedule around that. Don’t penalize them because they simply have these other things in their life that require their attention.”

Help balance your caregivers workload:

  • Learn the top 3 outcomes your caregivers hope to get from working with your agency.

  • Address your caregivers’ expectations/satisfaction with their work schedule.

  • Have your schedulers record the minimum and maximum number of hours each employee is willing to be scheduled to avoid under or overworking them.

  • Since 80% of caregivers work for multiple organizations to pay the bills, you can stand apart from the 11 million job postings on the market by offering what caregivers really want but are hesitant to ask for: daily pay.


It’s easy to stay somewhere longer than 90 days when you feel seen, respected, and know that your needs are being met. Rather than hosting a recognition party to pay back your caregivers for their hard work, spend time proactively helping your caregivers improve their daily work schedules to see a long-term increase in job satisfaction and retention.

2. You’re Expecting Your New Hires to be Experts

90 days is a long time to not know what you’re doing. Because inexperience breeds vulnerability, caregivers who feel unsure or underprepared in their position for too long will choose to save their dignity and quit to go where they feel competent.

Which is why a client’s home can’t be a caregiver’s first training room. But for nearly half of all home care agencies, it is.

Even though 94% of employees reported they would stay at a company longer if it invested in their learning and development, only 66% of home care providers use a professional training program.

Design a caregiver’s first 90-day training to help them feel confident and competent in their position and prevent their vulnerabilities from convincing them to leave.

How to address this:

In order for caregivers to feel competent in their crucial first three months of employment, refine your training program with these tips to equip a caregiver with everything they need to succeed in their first 90 days:

  • Don’t dismiss willing attitudes for inexperience: The best long-term caregivers were first invested in by their agencies. Promote in your job ads that your agency will pay to train unexperienced applicants, and you’ll see an increase in candidates who are grateful for the opportunity to learn new skills through your agency. 

  • Offer blended learning options: Make training easier to access by providing both online and hands-on learning to accommodate all schedules and learning styles. 

  • For a caregiver to succeed in the basics, cover at least 3 of the following topics: Infection Control, Safety, Nutrition, Communication Skills, Professional Growth, and Client Care Skills. 

  • Offer soft skill training: According to our 2021 Home Care Benchmarking Study, 77% of employers think soft skills are just as important as technical skills, but only 33% are currently offering soft skills training to their employees. By offering professional growth courses such as: Critical Thinking Skills, Professionalism & Work Ethic, Enhancing Attention to Detail, and Dealing With the Bully At Work, you’ll be equipping your caregivers with the tools they need to handle the emotional stresses of work. 

  • Provide further opportunities for caregivers to specialize in their interests: If your caregivers sense that working for your agency is a dead-end job, they won’t be inclined to stay for 90 days, let alone any longer than that. Communicate your opportunities for advancement up the career ladder with your caregivers to illustrate their ability to grow with your agency.


Competent caregivers don’t quit. Once they’ve passed their 90-day mark, the Home Care Pulse Caregiver Learning Ladder shows how to make your competent caregivers proficient in 6 months, and an expert after a year.

1. Your Caregivers Aren’t Hearing from You Enough

Which brings us to our number one cause of 90-day turnover. Lack of communication from an employer is the number one caregiver complaint, according to the 2021 Home Care Benchmarking Study.

In fact, exactly 57% of employees have quit their jobs because of poor leadership and communication skills from their frontline managers (coincidentally, the same percentage of caregivers who also quit in their first 90 days)!

The infamous phrase: people don’t quit their jobs they quit their bosses, may seem like a daunting concept and a heavy weight to carry on your shoulders while you are busy running every detail of your agency.

Fortunately, we know what your caregivers wish you were doing more of and we’re here to help break it down.

How to address this:

Let’s break down just how often you should be communicating with your caregivers in their first 90 days with your agency. Mark down these crucial communication touchpoints to ensure you’re communicating with your caregivers how and when they need you to:

  • Weekly: Send weekly texts with the occasional phone call to show your caregiver that you’re involved in their employment experience. Ask how they’re doing, what you can help with, and if there is anything they need. Mentors can handle touching base with your new hires on a regular basis if your agency has a mentorship program. Have your recruiter set up weekly touchpoints for your caregivers with a mentor or other staff member to address any questions or concerns.

  • First day: Although your caregivers do want to hear from you—you don’t have to do all the communicating yourself, according to John Bennett: “It is so important to get feedback from each caregiver after their first few shifts that we actually have someone in our office who calls caregivers after their first shift. We found that people who we can’t get ahold of or that we don’t engage with, don’t seem to stick around.” Consider hiring someone who works during your caregivers’ off hours to be ready to address their needs at all times.

  • 2 weeks: Keep the weekly communication going and become invested in the details of their experience with your agency to build trust. By now, caregivers will have had the chance to get a little more familiar with their role and will have more questions than they did on their first day. Tatyana Zlotsky, Chief Customer Officer at A Place for Mom, explained that a weekly text can go a long way toward establishing a culture of open communication between employer and employee: “We introduced texting across our business over the last six months, and we’re finding a lot of engagement increases for folks that really prefer this method. I think a lot of these cases are when people are coming out of rehabs or hospitals, or they’re at work. They can’t pick up the phone, they can’t talk to folks, but they have downtime to be texting and asking a lot of questions. We saw as much as 21% engagement lift for the folks that we were talking with a cross channel that included text message besides phones.”

  • 30 days: Schedule a check-in to evaluate if their expectations are being met and whether they’re experiencing any problems or concerns. Ensure they are being scheduled the number of hours they expected and act upon their feedback right away. Bennett shared an example where his communication with a client enabled him to solve a problem before it escalated: “We had a caregiver who was extremely allergic to cats but was put into a home with cats because our hiring manager didn’t pay attention to that, and she was ready to quit. We were able to get her out of there once we found out, and she has been doing a great job since then.”

  • 90 days: Have your recruiter, scheduler, mentor, or other assigned staff member take note of this major milestone and celebrate it! Offer company swag, gift cards, or other small incentives to show your caregivers that you appreciate and value their contribution to your agency. The 90-day mark is also the perfect time to ask your caregiver to review how they feel about working with your company so far to keep them around for years to come.


90 Days is Only the Beginning

Mission accomplished! By addressing these concerns, you’ve successfully made it past a caregiver’s first 90 days—but your retention efforts have only just begun.

What is causing your employees to quit? Find out by getting to the bottom of what your employees think about your agency.

Read how Norwood Seniors Network kept their annual turnover rate under 30% by seeking and acting on caregiver feedback.

Learn more:

HCP’s Care Intelligence Platform offers RN-developed training, satisfaction surveys, and reputation management tools to help you become the best employer and provider in your area—and make sure everyone knows about it.

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