Keeper has leveraged app usage history to help you shape and form your healthcare worker recruitment and retention strategy.
Introduction
Keeper is an earned wage access platform designed to help healthcare employers recruit and retain workers through an increasingly requested benefit: daily pay. App users can access earned funds from shifts worked before their next pay day, helping them to bridge financial gaps that might not align with their pay periods.
We’ve studied the numbers very closely, to ensure that the user experience is optimized—not just for caregivers but for operators at every level.
The executive brief version:
This overview provides a glimpse of turnover rates between people who do and don’t use the Keeper app. On the whole, app users are less likely to turnover than those that don’t.
In six months:
- Skilled Nursing turnover without Keeper: 56.95%
- Skilled Nursing turnover with Keeper: 32.89%
In six months:
- Home care turnover without Keeper: 30.24%
- Home care turnover with Keeper: 20.3%
In one year:
- Skilled nursing turnover without Keeper: 127.94%
- Skilled nursing turnover with Keeper: 72.84%
In one year:
- Home care turnover without Keeper: 52.7%
- Home care turnover with Keeper: 43.5%
What does this mean for skilled nursing operators?
Recent research from LeadingAge and the American Health Care Association (ACHA) supports that the average turnover rate of CNAs in nursing homes has dropped slightly to 42.34%, still, an overall significant number.
With the average skilled nursing facility serving 105-115 residents, it likely employs 80-110 staff, depending on state regulations, and other factors. It costs roughly $2,600 to hire one caregiver/CNA, amounting to between ~$208,000 to $286,000.
With 40% of those caregivers turning over each year, it costs—at minimum—$83,200 to replace the caregivers. Beyond the recruiting costs alone, skilled nursing facilities spend upwards of 70% of their total revenue on direct care and labor-related costs. Turnover doesn’t have to be a cost center for operators, it’s an opportunity to improve internal culture and morale to promote a staying culture.
When caregivers feel valued, appreciated, and financially whole, schedule volatility decreases and recurring overtime decreases. This dynamic lowers the temperature on revenue leakage through excessive overtime.
Giving employees access to benefits like earned wage access, puts them 57% less likely to turnover than their peers without it. There’s much more that lies under the surface than simply offering the benefit, it also means:
- Increased financial steadiness despite rotating shifts, variable overtime, and census-related schedule changes
- The ability to access earned pay between payroll runs, easing pressure during high-expense weeks
- Greater readiness to reliably report to work by covering same-day needs like transportation, meals during extended shifts, or emergency childcare
- Fewer situations that push staff toward costly financial stopgaps such as payday loans, credit cards, or bank overdrafts
- A stronger perception that leadership understands and responds to the day-to-day financial realities of frontline clinical work
- Improved sense of security and stability, allowing staff to stay focused during demanding shifts
- Higher likelihood of staying through the critical early employment window, particularly in the first 30–90 days
- Increased benefit awareness as on-site teams share how helpful the benefit is and encourage adoption (driving higher overall benefit utilization)
There are a variety of reasons that caregivers turnover, however, not all of them are controllable—like pay rates in a time when rate cuts happen often—but benefits like earned wage access can minimize or lessen the immediate impact they can have.
Here is one use case featured in a Google Play App Store review of Keeper: “It’s perfect so you won’t acquire overdraft fees and have money every day you work 😁”
What does this mean for home care operators?
Home care benchmarks and various reports put home care turnover at 75%, with some indicating upwards of 126%. When you take the average size agency, hiring roughly 80 caregivers a year, at a cost of $2,600 to acquire each caregiver, that’s a total of $208,000.
If 75% of them turnover, that means having to rehire for each role, putting the replacement cost (conservatively) at $156,000. This is a constant cost cycle that keeps operators in maintenance mode, just trying to maintain volume without increasing. But, that runs counter to how most agencies want to operate.
Operators generally want to grow and that starts with your team. With the average home care company seeing caregivers turnover up to 50% less often, with a benefit that comes at no cost to employers, the upside sells itself.
Perks for home care team members using earned wage access:
- Greater ability to manage income volatility caused by changing schedules, varying client pay rates, and weather-related disruptions
- Reduced stress between pay cycles by accessing earned wages when needed
- Increased flexibility to cover day-of expenses that enable shift acceptance, such as childcare or transportation
- Less dependence on high-cost or predatory financial alternatives, including payday loans, credit cards, and overdrafts
- A stronger sense of employer support and trust, signaling that leadership values caregivers’ financial well-being
- Improved psychological safety, contributing to lower stress and emotional fatigue
- Reduced early-tenure attrition, particularly within the first 90 days of employment
- Lower risk of burnout driven by compounding financial pressure
How healthcare operators can use this information
To caregivers, earned wage access is a helpful financial lifeline. For operators, earned wage access functions as a workforce stability lever, not just a financial perk.
By helping caregivers manage short-term financial stress, EWA supports more reliable attendance, increased willingness to accept last-minute shifts, and stronger retention during the highest-risk early employment period.
It reduces call-outs tied to transportation or childcare barriers, minimizes reliance on costly stopgap solutions, and reinforces a culture of support—without increasing wages or adding administrative burden. Over time, this translates into lower turnover pressure, more predictable scheduling, and a more resilient frontline workforce.
If you’re ready to incorporate earned wage access, get in touch with Keeper today.
