Recruitment gets someone to day one. What happens between day one and day 100 is where home care, home health, and long-term care organizations either build a career or watch someone quietly plan their exit.
The Industry Is Losing People Fast... and Early
Turnover in home-based care sits at about 75%, down slightly from a 79.2% peak in 2023, according to the 2025 Activated Insights Benchmarking Report. That's an improvement, but it's still nearly three out of four caregivers walking out the door within a year.
Another issue is how early people leave. In home health, roughly 20% of new hires resign within their first 45 days, according to the American Association of Post-Acute Care Nursing (AAPACN), and poor training is one of the reasons they cite. Those departures have a real price tag: AAPACN estimates it costs $3,000 to $6,000 to replace a CNA and $6,000 to $9,000 to replace a nurse.
This isn't a home health and home care problem alone. Nursing assistant turnover in skilled nursing facilities runs close to 100% annually, per peer-reviewed research cited in PHI's 2025 Key Facts report. Recruitment and retention pressure runs across the entire continuum of care.
Understanding the Value of Effective Onboarding
Given how much depends on those first few months, onboarding deserves a closer look, since it's squarely within an organization's control. A well-designed program has many benefits: It prepares staff for their role, provides a positive first impression of your organization, and sends a message that you take safety and quality seriously.
Onboarding should include critical topics like infection control and hand hygiene – compliance education required by federal and state regulations, and the floor every organization has to meet – alongside information that helps staff effectively care for the population they serve. Courses on topics like staff collaboration and avoiding burnout can signal that the organization cares about their employees’ success and health.
What Families Will Start Seeing
Qualifying facilities will also get a "high performer" icon on Nursing Home Care Compare.
Families researching placement have long relied on Five-Star ratings, but that number updates on its own schedule and blends several inputs into one score. The high-performer icon is a bit different, in that it is tied directly to the RBS qualifying criteria. This means it's a fresher, more pointed signal for families: this facility currently meets a specific, quarterly-verified bar for citation history, staffing, and audit accuracy, on top of whatever its Five-Star rating already shows.
In practice, that means families comparing two five-star facilities may now see one with the icon and one without, a distinction likely to catch attention, especially for families who already dig into Care Compare data before making a decision. It's a second, public-facing marker sitting right alongside your Five-Star rating, and it's one more thing prospective residents and their families will start noticing this fall.
It's Not the Whole Story, But It's a Key One
To be clear, onboarding alone doesn't solve turnover. Research from PHI and a review of home health turnover research both point to pay, schedule stability, and the quality of the relationship with a direct supervisor as drivers of whether someone stays.
But training is one lever your organization can actually control. AAPACN names inadequate training as a specific factor in early departures.
Activated Insights found that agencies offering at least 8 hours of onboarding and 12 hours of ongoing training, including compliance content, reported an average annual revenue increase of almost $350,000 compared to organizations offering less.
The likely reason isn't the training hours themselves. It's what those hours produce: fewer vacancies, less scrambling to cover shifts, fewer existing clients lost to inconsistent care, and fewer new patients turned away for lack of staff. Retention allows an organization to run smoothly enough to improve financial performance and deliver quality care.
How Showd.me Can Help
Compliance training is the floor every organization has to meet, and we help you meet it reliably, handling the administrative work of identifying required training and tracking completions across roles.
We also offer the courses that sit above that floor: procedure guides, leadership and professionalism topics, and continuing education built for the teams who deliver care.
If you're ready to talk about what building a strong training program could look like for your team, schedule a conversation or demo with us.