Why is caregiver turnover so high in home care?
Home care caregiver turnover runs at 75% annually industry-wide. The causes are structural - low wages, unpredictable schedules, isolation, and lack of advancement. But the agencies with lower turnover have identified which of these they can control and built systems around them.
Root causes of 75% annual turnover
- Low wages relative to competing care settings - hospitals, SNFs, and assisted living facilities often pay more for similar work
- Unpredictable scheduling - caregivers who cannot predict their weekly hours cannot budget or plan
- Isolation - home care caregivers work alone, without the team environment of institutional settings
- Travel time and costs - unpaid time between visits and transportation costs reduce effective hourly earnings
- Lack of advancement - limited career pathway visibility beyond caregiver role
What agencies can control
- Wage competitiveness - possible when marketplace staffing replaces high-markup agency spend, freeing margin for caregiver pay
- Scheduling predictability - consistent scheduling systems and advance notice reduce uncertainty
- Payment speed - fast reliable payment is a meaningful retention factor Quinable's prepaid wallet addresses
- Accountability enforcement - platforms that restrict repeat no-shows reduce the burden on reliable caregivers
Agencies paying 40-60% markups to staffing agencies have less margin available for caregiver wages. Shifting flex staffing to a marketplace at 10-15% frees up margin that can go directly to caregiver rates. Higher pay reduces turnover. Lower turnover reduces replacement costs. The math compounds.
High caregiver turnover is partially structural and partially within agency control. The controllable levers - wage competitiveness, scheduling predictability, payment speed, and accountability culture - are all improved by the operational infrastructure a marketplace platform provides.
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