Here is something I watched happen at every stop: The home care liaison arrives full of energy. Twelve months later, give or take, they are gone. They quit. They get pushed out for thin numbers. Or they start quietly answering recruiter messages on their lunch break, and by month fourteen, there is a new name on the business card and a new face walking into the same buildings. New person, same desk, same territory, same result a year later.
The industry has a name for this: it calls it a HiRiNg ProBleM.
Oh, we picked the wrong person; we’ll find a better marketer, a better closer this next round. We’ll tighten up the interview, hire someone hungrier, willing to “build something here.”
That’s a lie – and it’s told because it’s hard sometimes to look inward.
I write candidly about the problem, the evidence, and what’s actually happening to home care marketers who leave agencies after a year.
The Home Care Marketer Problem
In Montgomery County (Maryland), there are hundreds of home care agencies.
Hundreds.
Pull the licensing rolls; you’ll lose an afternoon scrolling. Every one of those agencies needs census to survive. Some of these home care agencies send a liaison into the field to bring in referrals (humans). And every one of those liaisons drives to the same hospital systems, skilled nursing facilities, senior centers, and asks to see the same discharge planners, social workers, and case managers.
A small circle of discharge planners, social workers, case managers, aging life care managers, and senior living decision-makers controls the referral relationships that hundreds of agencies in the region compete for.
We all know that’s the entire game board.
Most of the time, home care agencies drop their new liaisons into the field, without proper training – and mostly never without any introductions to the referral sources they’re tasked to cultivate. And here’s the part that dooms these young, energetic souls: their home care agency likely demands an artificially high number based on their perceived productivity, starting the clock on day one.
Home care marketing professionals: Politely request that your agency owner explain how they arrived at those numbers and share the methodology and industry reports. Then talk to me, and I’ll run the statistical analysis. Data nerds do things like that – and I’m one of them.
Month one for a new home care marketer is likely judged by the same yardstick as month twelve. Most of the time, that “ramp-up” phase, as they call it – well, I’m sorry to share, it’s not real.
And that so-called grace period? Unlikely.
And the fact that these new home care marketers may not fundamentally understand what they’re marketing, to whom, or why, or where to begin – that’s an agency problem.
A discharge planner who sends an older-adult patient to a home care agency makes a judgment call; the discharge planner’s judgment is on the line. If an agency caregiver no-shows, or if intake mishandles the perfunctory initial phone call, or if a caregiver treats a family rudely once on-site, it all matters – to all parties involved.
In the DMV, the home care referral relationships worth having are probably already taken. These relationships belong to the marketing professional (and maybe the agency, too?) who got there first and has been showing up for years. The new marketing hire isn’t walking into open territory; they’re walking into a room where every decent seat is filled, trying to pry loose a relationship that another home care agency spent years building.
And when the marketer misses their “numbers,” agency owners who don’t get it will search for somebody to blame. Guess who? The marketer – the one person who controls the least amount of variables.
Want the truth?
The corporate home care agencies oftentimes question the marketing professional who wasn’t properly trained, was thrown into the proverbial deep end, was patted on the head, and was told to be a good soldier and “go out and get those referrals.”
The Home Care Liaison Turnover Rate – Where’s The Data?
I went looking for the home care marketing data – not an opinion, not war stories.
Actual data – because we have to make smart business decisions based on evidence, data, and experience.
I wanted only one number: the number of home care liaisons who leave their agency within their first calendar year employed.
My job is to figure out the “why” after finding the numbers. But I never found the numbers.
I went to the federal workforce databases. I visited the Bureau of Labor Statistics. And I read the trade press that covers the home care industry and its trends. I read the benchmarking reports that every home care software vendor publishes to sell its retention products to agencies. And I even read the academic journals.
The number I’ve been looking for doesn’t exist. Nobody publishes it that I can find; nobody seems to track it. As far as the public record is concerned, the home care liaison turnover rate is a blank space that would make Taylor Swift write another song.
But look at what the home care industry actually measures: caregivers.
That’s fair – but it’s not enough.
Home care caregiver turnover ran at 75% in 2024, down from a peak above 81% in 2018. The trade press writes about it constantly. PHI, the leading direct care workforce research organization, tracks caregiver turnover rates, and there’s an entire software category built to address it. The caregiver revolving door is the single most documented problem in home care today.
Everyone counts this metric, everyone studies it, and everyone sells against it, yet the home care marketing professional’s revolving door becomes invisible. No figure for liaison retention as a category separate from caregivers exists. The one role most directly responsible for whether a home care agency makes money is the one the industry spends little time collecting data on.
Why?
That silence is not proof in itself, but it tells us something important: the home care industry doesn’t seem to measure its churn with anything close to the seriousness it brings to caregiver turnover. The industry counts what it decides is worth counting.
The Pattern That Comes Into Focus
This critical problem points back at the marketing liaison’s job design, which is an easy problem to leave unmeasured – and it’s exactly what has happened in the home care industry over the last decade. When you look at any adjacent field that runs this same playbook, the pattern comes into focus.
Senior living sends an external community relations manager/director into the same places with the same “be the single point of contact for every referral source” pressure, and the same monthly move-in targets. Same job, same churn.
Staffing agencies run recruiters on volume targets until they break, and the trade research in that field is blunt about the cause. The turnover doesn’t come from people failing. Home care marketing professionals are told to push harder, make more calls, work longer hours, and achieve higher activity targets.
Burnout: accelerated. The home care marketing grind eats its best performers.
The sales-territory research says the same thing from a colder, more academic angle. The work studying how companies redraw sales territories found something that hits home care directly: when a salesperson leaves, the relationship with their clients (and customers) is severed, and reassignment creates a real risk of revenue loss.
As Andris Zoltners and his colleagues at Kellogg put it in Harvard Business Review, the difficult question every home care company should ask is who actually owns the customer relationship: the marketing professional or the company. The peer-reviewed research on rep departures is detailed, showing that buyer trust attaches to a human being. An email introduction does not move it. The new rep starts cold.
Home care’s saturated metro areas are the breeding ground for failure for everyone. We have never been willing to write it down.
Why Are Home Care Marketing Professionals Leaving Agencies After Only a Year?
Before I go any further, I’d like to offer the home care agency owners the proper respect they deserve – because I’m emphatically uninterested in telling a one-sided story.
The gumshoe journalist in me demands the other side of the narrative.
A home care owner carries risk with every liaison they hire: salary, payroll tax, mileage, materials, event costs, months of dead air while trust builds, and an introduction to the agency’s best referral relationships.
A marketing liaison can walk and chew bubble gum simultaneously at month six and take all of it to a competitor for $5,000 more. Sometimes it’s a rational attempt to avoid being robbed by the very churn I’m describing.
What about non-competes? Try enforcing non-competes in 2026.
Not every home care sits on fat margins. Private-pay families – even in high net-worth areas in the DMV – are price-sensitive; caregiver wages have climbed precipitously; taxes, regulatory fees, insurance, gas prices, the economy – it all means something different in June 2026 than it did in June 2016.
And there are plenty of honest home care operators doing math at midnight to keep their employees paid.
I’ll share what the home care marketing professionals don’t want to read and hear: some people aren’t cut out for the home care grind, the daily slog. Some of the new marketing professionals are sincerely charming but profoundly disorganized. Some professionals confuse activity with pipeline; they make visits but never create urgency. Some really cannot sell, and no compensation plan fixes that. Bad hires are real, and a thin month can absolutely be on the person. I am not handing anyone a blanket excuse.
But here’s where it turns.
When one person fails, look at that person. But when the same seat fails person after person, year after year, across different hires with different strengths, you’re no longer looking at a people problem. You are looking at a design.
And the design is the agency’s to own.
The quota lands before the relationships can
A marketing professional is handed a referral target calibrated to a fully-ramped producer – and it applies in month one.
But they cannot manufacture trust on a deadline. The discharge planner doesn’t care that a marketer’s quota review is Friday. The discharge planners refer to a marketer when they believe in them. That trust takes a lot to materialize into a referral.
Home care marketing professionals oftentimes spend their first two quarters doing everything right and still missing their numbers- because their agency’s numbers were never tied to the actual pace at which the work produces results. The marketing professional was set up to fail by a broken system that the agency owner (or Growth Director) doesn’t even understand.
Nothing corrodes a good marketer faster than being measured against a standard the job itself makes unreachable within the given timeline.
The Territory is Colder Than the Last Marketer Left It
When a home care agency marketing professional leaves the agency only after a year, what’s next? Most of the time, the home care agency hires a new marketer – but the relationships built previously aren’t transferable.
But the discharge planner doesn’t have a relationship with a home care agency. The social worker and hospital case manager had a relationship with the person who used to bring them coffee and actually solved a problem for them in a pinch. They had a person – and now that person is gone, along with the relationship.
Goodbye referrals.
The new marketing professional introduces themselves to the referral source; still, though, it’s not their relationship. Can you blame the referral sources’ skepticism? They’ve seen a handful of marketing liaisons come and go over the last couple of years.
What makes you so special?
Referral sources stop taking meetings with these agencies – because another home care agency quickly fills the void.
And who’s the first person an agency owner looks at when census numbers drop?
The marketing professional.
Marketing and Sales Aren’t The Same Thing Inside A Home Care Agency
I’m speaking directly to home care marketing professionals.
You were hired as a business development professional. The job posting said relationship building, strategic outreach, and market development. Then the actual day arrives when you head out into the field. You drive a route. You drop off brochures that go straight into a drawer full of other agencies’ brochures. You chase old leads that went cold months ago. You walk into offices uninvited and get two minutes from someone who is looking past you, at their computer monitor – because you’re the third liaison through that door this week saying the same thing.
You’re doing rejection work with a nicer business card.
The gap between the marketing role you were sold and the role you actually do is wide, and every week, that gap drains a little more belief from the person living in it.
I’ve lived it.
Agency Upward Mobility? Good Luck.
Survive the year, hit your stride, finally build a couple of real relationships, and then you look up. There’s a rung above you – maybe an agency director, a couple of office staff, an owner.
And then there’s the marketing professional – the one actually doing their best every single day to bring in the agency’s revenue.
There is no VP of business development seat waiting, no regional role – no path towards upward mobility. The agency cannot offer a promotion that would make staying worthwhile – because it doesn’t have one.
Out is the only way up – and the better you get at your job, the more obvious it becomes that your next step has to happen somewhere else.
It’s Lonely Out There in Home Care Marketing World – The Daily Grind, The Beat
A home care liaison is often a one-person department.
You’re in the car by yourself, carrying your agency’s revenue burden, driving the better part of a tank of gas every other day, eating lunch in a parking lot between account visits, with nobody in the passenger seat and nobody who actually understands what the day felt like.
The caregivers have each other. The office staff has each other. But marketing professionals on the road – they have a windshield. The person who started in January, full of energy and ideas, often feels depleted by October, trying to make the dashboard look green, because they work alone. Nobody sees the decline until the resignation email arrives.
Isolation does not announce itself. It accumulates.
Who Gets Blamed When Census Numbers Drop?
So who is to blame?
Not the saturation that put hundreds of competitors on the same limited circle of referral sources.
Not the scorched territory you inherited.
Not the rejection work.
Not the dead-end ladder.
Not the isolation.
You.
And what does the agency owner think most of the time?
They’ve already concluded you after a few months; their verdict is in. What about the evidence? That evidence was never litigated. Despite the agency throwing you into the deep end, hoping for the best, it blames its marketers because it failed to train them properly or set them up for success by investing in the role beyond the standard weekly check-in meeting, which amounts to wasting time rehashing census numbers and demanding you see more accounts in a week.
So, you, the marketing professional, absorb the blame for a broken system you didn’t design and couldn’t have beaten – and then you leave. And then the agency hires your replacement, hands them your territory now one full cycle colder, sets the same impossible quotas, starts the same clock, tells the next unlucky soul to look at your CRM notes and accounts, and acts genuinely surprised when the same thing happens a year later.
Here’s what this is: the agency builds a seat that manufactures failure, punishes the person sitting in it for failing, and then the firing strips the territory bare for the next hire.
Welcome to the home care vortex hell.
What About The Home Care Marketing Professionals Who Stayed?
Now let me tell you about the other group of marketing professionals – because they’re the strongest counterpattern I have seen.
I can name ten to fifteen marketing professionals in the DMV region who didn’t leave after a year. They stayed. Many years, same agency, still there.
And when I look at where they work, the pattern is hard to ignore. They aren’t at the corporate franchises running a national playbook from a market they’ve never set foot in. No – they’re at well-run local agencies – the ones where the person who signs the checks knows the territory, knows the discharge planners by name, and knows exactly what the liaison’s day should look like.
I’ll be straight with you about what this is and isn’t: I cannot prove that agency structure is the only reason tenured home care marketing professionals have stayed for the long haul. Individual talent, deep local roots, life stage, a spouse with benefits, the agency’s existing brand and caregiver coverage, all of it plays a part. I’m making a qualified field observation; this isn’t a controlled study.
But the pattern is still hard to look away from: the long-tenured liaisons I know are disproportionately at home care agencies where ownership sits close to the field, and the pay is serious and respectable. Professional development is consistent, ongoing, and authentic.
At a local agency that gets it, output expectations are developed using historical data, and the owner who can see the field can quickly adjust the metrics to reality, rather than being enforced by a regional spreadsheet that treats the territory as it would a market a thousand miles away. The territory stays warm because a marketing liaison is allowed to serve as the agency’s face in their community.
The role is real business development with the owner’s ear, not a rote-running script handed down from a corporate office. It doesn’t work that way anymore – and agencies must shift away from the route-based marketing approach that’s desperately broken.
The route-based marketing plan doesn’t work any longer – and if any growth director says otherwise, they’re retelling a false narrative – or they don’t know the difference.
The isolation eases because the liaison is embedded in a tight local team and a community they belong to. And when a month comes in soft, an owner who knows the market doesn’t reach for a scapegoat – because the owner can see the difference between a bad month and a bad hire.
The seat is the same. The difference is that someone built the brakes, and someone is paying attention.
But there is one variable beneath all the others, and it is the one I want to put at the center of this whole piece because it is the one nobody wants to say out loud.
Pay Home Care Marketing Professionals Beyond The Bare Minimum
When you take care of people financially, there is nothing else to debate. It’s the baseline, and it’s where this entire conversation begins and, frankly, where most of it ends.
Think about Montgomery County, Maryland, for a moment. Then think about Washington, DC and Northern Virginia. The region is one of the most expensive places in the country to raise a family. Housing, childcare, health insurance, gas prices, utilities, the cost of simply existing here – all of it’s brutal.
And the home care industry still thinks it is acceptable to start an all-star marketing professional at an astronomically low salary and dangle foolish economic incentives in front of them, knowing full well that it’s never going to happen.
Prove yourself first, and maybe the money will come?
Uh huh.
When agency owners start a seasoned professional with a family at a low number and ask them to subsidize their agency’s risk out of their own pocket until they “prove it,” agency owners are the problem. That’s called building a countdown. The marketing professional will take a better offer the moment it arrives, and it always arrives. The agency owner might call the marketer’s departure a hiring problem.
Try again – it was a compensation decision the agency owner made on their first day. And it was a bad decision. The home care agency owners who keep their team for years treat compensation as a retention strategy, not a probationary afterthought. I have not audited agency payrolls; I will not pretend to quote their numbers.
But you can read it backward from the result: their people do not leave, and people who are being underpaid in a region this expensive do not stay long when better offers are one phone call away. The pay is serious because the retention is real, and in this market, the two do not come apart. There is no clever retention program that survives when you underpay someone who knows their worth.
Pay is baseline, not the whole job.
Once an agency pays its people fairly, it owes them the second half: investment.
There’s a material difference between a marketing professional just starting and a seasoned one. A smart agency owner can recognize and manage these dynamics. Agency owners can offer their newer marketing professionals measurable, articulable KPIs and goals – goals they can actually see and reach – and then they coach them to the next level. What they cannot do is throw a human being into the dreaded referral swamp, tell them their job is to figure out said swamp (all on their own), and act surprised when the marketing professional departs the agency after a year.
If you’re hiring a marketing professional, you’re investing in an actual person. That means you’re a mentor and a coach, or you have no business hiring one. If you are not willing to be either, you don’t actually understand why your marketing professionals leave in under a year.
And let me make “pay them what they are worth” concrete, so nobody can nod along and then ignore it: it means a base a professional can actually live on (not just in the DMV, either) without chasing commission to make rent. It means a real ramp measured by leading indicators in the early months, not full referral volume on day thirty. It means mileage that reflects the actual field burden, and a written pay review at six and twelve months against criteria the person can see coming.
Underpayment is the opposite of all of that: a thin base, a vague promise, and a quota that arrives before the relationships can. A home care agency owner who calls the first thing “fair” and the second thing “a ramp” is fooling themselves, not the marketing liaison.
People leave organizations for numerous reasons; I’m not going to pretend otherwise. But strip those reasons down to the granular level and look at what a home care agency actually controls, the pattern is the same every time: marketers underpaid at the start, thrown into a cold market without serious coaching, judged against a number the structure made unreachable, and then blamed when the seat performed exactly as it was built to perform.
Everything else is variation.
Fixing The Broken Home Care Model
The one-year liaison is not a coincidence, nor a run of bad luck at the interview table. It’s what this job does to the person who holds it. The grind is not a side effect of the work. The grind is the product.
Everything I described – the saturation, the broken ramp, the scorched territory, the rejection dressed up as business development, the dead-end ladder, the isolation, and the misplaced blame – compounds into a role that uses good people and discards them on roughly a twelve-month timer.
Agency owners, hear this part plainly: you are not failing to find the right “closer.” You built a seat that breaks closers. And every time it breaks one, you pay to recruit, hire, and onboard another; you watch your referral relationships reset toward zero. You and the next person are a colder version of the same losing position. You’re not buying growth; you’re renting the same year over and over and calling it turnover.
You can keep doing that – or you can fix the seat.
And fixing it doesn’t begin with a clever new playbook. It starts with the marketing professional’s paycheck. Pay them what they’re worth, up front, in a region where nobody can afford anything less. Then invest in them.
Give your marketing professionals attainable goals they can see and achieve, and coach them to the next level instead of dropping them into the swamp. Protect relationships when a person moves on, rather than letting every departure scorch the ground. Give the role a path and a reason to stay.
Home care agency owners who already do this are not guessing about retention. Their best people have been with them for years. I can name them. The difference was never a secret. They took care of their people – financially and professionally. Their people stay.
Pay them.
Coach them.
Cultivate them.
Do that, and the one-year liaison stops being a statistic you keep writing yourself.
The model was the problem; it always was.
And the model is yours to fix.
Hi, I’m Ryan. I write about healthcare, home care, branding, marketing, statistical analysis, and other nerdy topics that push the envelope. I’ve spent the last decade operating in the healthcare, technology, and home care space. You can reach me at Ryan@RyanRMiner.com.
