The workforce is 1,150 home health aides, 310 registered nurses, 110 licensed practical nurses, 95 therapists and 135 branch staff. Aide turnover is 64% and nurse turnover 27%, so most of the 880 hires made last year were replacements. An aide waits a median of 34 days between applying and working a first shift, and 31% of those who accept an offer never start. There are 47 open nurse vacancies, and a nurse role takes 71 days to fill. Staffing agencies supply 9% of hires but take 54% of external recruiting spend. Branches declined 12% of referred cases last year because no one was available.
Challenges- Aide candidates apply to several employers at once and take the first job that gives them a start date. Our screening, clearance and orientation steps run in sequence and take five weeks.
- Nurse hiring depends on agencies at $9,400 a hire, because hospital nurses do not know what home health work involves or that it pays comparably.
- Nearly four in ten new aides leave within 90 days, so recruiters refill the same positions and branches never get ahead of demand.
We will focus on- Speed for aides: application to first shift in 14 days, with clearance steps run in parallel.
- Referrals and local training programs as the main sources, since hires from both stay longer than job board hires.
- Direct nurse recruiting built on a clear offer: one patient at a time, daytime hours and a manageable caseload.
We will not- Sign-on bonuses for aides. They draw candidates who leave after the payout; the money goes to referral bonuses paid at 90 days and to paid orientation.
- International nurse recruitment. Licensing and visa steps would run past the end of 2027, which puts any hire outside this plan.
- A new-graduate nurse residency. Home visits are unsupervised and we lack preceptor capacity until vacancies fall, so one year of clinical experience stays a requirement.