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.
Why Retention Matters More Than Ever
Demand for direct care workers keeps climbing, making it more important than ever to retain the people already doing this work. PHI's 2025 Key Facts report projects 9.7 million direct care job openings nationally between 2024 and 2034, a number driven by turnover and workers leaving the field in addition to job growth. That demand is only going to grow: The population of adults 65 and older is projected to increase from 57.8 million to 88.8 million by 2060.
Meanwhile, industry sources report that staff turnover is as high as 75 percent in parts of the industry, and has historically run even higher for nursing assistants in nursing homes.
Early departures are especially costly. As an example, roughly 20 percent of new hires in home health resign within their first 45 days, according to the American Association of Post-Acute Care Nursing (AAPACN), often citing poor training. Replacing them adds up fast: AAPACN estimates $3,000 to $6,000 to replace a CNA and $6,000 to $9,000 to replace a nurse.
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.
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.
Recent industry survey data 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.