The first 14 days decide whether caregivers stay

What home care and healthcare leaders can do now to reduce early exits and protect service capacity.

Healthcare is still hiring, but the labor market is not getting easier. In December 2025, unemployment held at 4.4% and overall job growth slowed significantly compared to 2024. Healthcare continued to add jobs, but at a slower pace than last year, which means demand remains strong while competition for reliable talent stays real.

For home care owners and operators, this shows up in everyday business pain. Delayed start dates. Uncovered shifts. Overtime. Client cases you should be able to accept, but cannot staff.

And the hardest truth is that even when you hire, you can still lose the caregiver before they ever stabilize.

Activated Insights reports home based care turnover at 79.2%. PHI also notes turnover in home care was nearly 75% in 2024.

That is why the first 14 days matter.

Why the first 14 days matters?

When a caregiver leaves early, it is rarely because they do not want to work. It is usually because they did not feel prepared, supported, or connected. Confusion becomes frustration. Frustration becomes “I am done.”

This is not just a home care issue. Harvard Business Review notes that up to 20% of turnover can happen within the first 45 days, and a standardized onboarding process is essential.

In home care, where the work is emotionally and physically demanding, those early days are not “administrative.” They are the foundation of confidence, belonging, and stability.

What caregivers experience when onboarding is fragmented?

When systems and handoffs are not connected, the caregiver becomes the coordinator of their own start. They apply in one place, complete forms in another, get trained somewhere else, and still do not know what happens next.

That leads to waiting, repeated questions, missed steps, and a start that feels disorganized.

This is the employee version of operational friction. Deloitte reports that 70% of workers have to enter the same data in multiple systems to get their work done. In home care, that friction becomes real delays and real drop off, especially when instructions are unclear or not designed for the caregiver’s language and context.

Leaders feel the impact as slower time to start, slower time to fill, and higher drop off before the first shift.

The Mercer idea that translates directly to home care….

I will be joining Mercer and Rival for a conversation about a modern HR concept called Operating by Design. In plain language, the mindset shift is this. Stop running HR and operations like separate functions that pass problems from one team to another. Instead, design the work around outcomes, with connected workflows and intentional human plus technology teaming so the experience is consistent and trustworthy. For home care, the outcome is simple. Caregivers start confident, stay longer, and leaders can plan coverage without chaos.

A care first onboarding model for the first 14 days: This is the framework I use with clients. It is intentionally simple.

1. Day one readiness

Before the first shift, the caregiver should know three things. Who to contact. What to expect. How they will be supported.This is where many organizations lose people. The paperwork may be done, but the caregiver does not feel anchored.

Owner action: Create a one page day one guide and assign a single point of contact for the first week.

2. Week one connection

Week one is not about paperwork. It is about belonging and confidence.

Owner action: One structured check in within 48 hours, and one check in before the end of week one. Use a short guide so it is consistent every time.

3. Week two stability

By week two, the caregiver should feel steady in schedule, expectations, and support.

Owner action: A manager check in focused on, “What is unclear, what is hard, and what support do you need to succeed here.”

This is where my philosophy comes in. Viviane Care Group was founded on a simple belief. People need people. Technology should make care easier to deliver, not harder to access.

Human and Technology Working Together

Mercer describes building a connected “digital fabric” so work flows end to end, rather than leaving people to navigate disconnected systems and teams.

Here is what that looks like in home care.

• Technology should handle reminders, document tracking, training assignments, status updates, and workflow steps that create delays when they are manual.

• People must stay visible in welcome, coaching, expectation setting, and the moments where a caregiver is uncertain and needs a human response.

• Caregivers do not stay because the portal works. They stay because they feel respected, prepared, and supported.

Why this matters right now

BLS data shows healthcare continues to add jobs, even as overall job growth slows. JOLTS data also shows continued demand and churn in health care and social assistance, with substantial openings, hires, and separations in a single month.

In this environment, the agencies that win are not only the ones that recruit. They are the ones that reduce early exits.

If you tighten the first 14 days, you reduce three expensive problems. Early attrition. Slow time to start. Manager frustration.

Join the Mercer and Rival conversation

In the upcoming Mercer and Rival talk, we are exploring what it means to modernize without losing trust. For home care, trust is not a soft idea. Trust is whether a caregiver believes your agency will support them, whether a manager believes the system will work, and whether clients experience continuity.