Staff Turnover in Home Health

Over the past decade, payment for home health care services has more than doubled, and its importance has increased with the rise of care coordination and shared savings models. Home health care is also a key component of strategies to reduce institutional long-term care. Home health agencies report high turnover rates – over 21% on average – that challenge their ability to deliver high quality services. Nursing turnover accounts for a quarter of total health care industry turnover costs, with the cost of a single nurse turnover often over $100,000. This study will use detailed data from one of the 5 largest home health providers in the US, operating in 30 states, to study factors associated with turnover.

This study will use the most comprehensive analytical dataset available to study nursing turnover in home health, including variables extracted from human resources, payroll data, visit logs, discharge records, physical and mental assessments, care plan, and other patient encounter data.


Key Questions

  • Which factors are the most important predictors of turnover in home health care?
  • Are there differences in turnover predictors for each type of personnel employed in home health?
  • Are there differences in turnover predictors for each source of turnover (e.g., retirement, dissatisfaction with job, relocation)?
  • Are there regulatory and policy variables that affect turnover (e.g., scope of practice regulations)?


Journal Articles

Bergman, A, Song, H, David, G, Spetz, J, Candon, M. The Role of Schedule Volatility in Home Health Nursing Turnover. Medical Care Research and Review. First online July 26, 2021.

Candon, M, Bergman, A, Rose, A, Song, H, David, G, Spetz, J. The Relationship Between Scope of Practice Laws for Task Delegation and Nurse Turnover in Home Health. Journal of the American Medical Directors Association. First online August 24, 2023.


For more information, contact Joanne Spetz.