• Kimberly Hamilton

Homecare / Home Health Business Tips: How to Decide Staff Balance with Caregivers

Home Health Agencies find success in establishing and maintaining the right balance of client to staff ratio.


Several home care agencies lose profits due to over-hiring staff or under-hire and let go of quality. Read on to find the right balance.

To begin with, as an agency owner, you should ask these questions regularly:

  • Is my staff at the right place?

  • Which position should I hire next and in what order?

  • Is the current staff efficient or can fewer people do the job?

  • Is it the right time to hire a sales rep or another sales rep?

  • How many staff members does a home care agency need?

A home care business model is a unique one and the staff positions vary according to what kind of care service your agency offers. It can be either skilled care or offer non-skilled care too. But a general categorization can be done as follows:

  • Executive management consisting of owner or executive

  • The administrative department having billing, secretarial, payroll, etc.

  • Marketing/sales department which can include outside marketers attending referral partners and members getting clients through in-house assessments.

  • Operations department which has staffing coordinators, care supervisors, and schedulers.


Benchmarking your staffing efficiency


When you’re hiring new people for your office team, you must keep in mind that balance between staff and high-quality service is highly important. This translates to keeping your workforce tight while maximizing profits.

One way, or rather say, two ways or metrics of doing this are

  • Sales per full-time employee

Just as it sounds, it lets you calculate how much revenue is generated by your agency for the number of people you employ. Through this, you can compare it with other agencies to see if your agency is working at the optimal level.

In order to calculate sales per full-time employee, you need to divide your annual (or 12-month trailing) revenue by the total full-time employees excluding caregivers. Do add the current owners while counting part-time employees as .5.

You can compare your calculations with the table given below and check how you’re faring against your competition.


  • Billable hours per non-caregiver employee

It is a similar metric to the sales per full-time employee. The billable hour(s) is often associated with your business needs than your revenue. This is because billable hours are the simplest form of measurement of the amount of activity in your business.


The good thing about using both metrics is that it gives you a bigger picture of how good or bad your staffing is when compared to the industry.

In both metrics, if you get a number that is much lower than the median for the revenue, it’s time you take a look at your staffing. You need to cut back on extra employees while reshaping your business management.

On the other, a number that is much higher than the median means that your quality is at stake in exchange for efficiency. SO, you might want to find the right balance between the two.

Caution: There are times when an agency expects strong growth in the future. This might make you hire more staff than you currently need and thus, have extremely low sales per full-time employee. In case that is your actual plan then the low ratios are justified but you should still be cautious when hiring new employees.


Care coordinator: Home care’s most crucial role?


Since the last 5 years, caregiver turnover rates have critically shot up. This has led several home care leaders to assume care coordinators as among the most important profiles in an agency. The reason being their incredible impact on a caregiver’s experience with one’s agency.

Home care isn’t one-size-fits-all


One thing worth noting is that while benchmarking data are a great way to identify what’s wrong with most home caregivers, it’s not a full-proof solution. These data are meant to show you the way and let you make your own decisions considering what’s best for your agency and what will work.

Connor Kunz. (2020). How to Decide How Many Home Care Office Staff to Hire. Home Care Pulse. https://www.homecarepulse.com/articles/how-to-decide-how-many-home-care-office-staff-to-hire/

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