No occupation in the country is adding more jobs than home health and personal care aides. The Bureau of Labor Statistics counts 4,677,100 aide jobs in 2025, projects 847,300 more by 2035 and expects about 760,500 openings a year over the decade, almost all of them replacing someone who left. The agencies, hospices and home care franchises hiring into that churn compete with every nursing home, assisted living community and hospital in their county, and with retail and food service for the same hourly workers. Recruiting aides well means knowing what the numbers say about supply, which credential each role actually needs, where the trained aides already are, and how to reach a caregiver who is not applying anywhere. This guide covers that in six steps, with the figures from primary sources.
The home care workforce in numbers
The BLS Occupational Outlook Handbook publishes employment, projected openings and median pay for each occupation. The two roles home care employers recruit most look like this for the 2025 to 2035 decade:
| Occupation (BLS) | Jobs, 2025 | Openings per year, 2025 to 2035 | Growth, 2025 to 2035 | Median pay, 2025 | Typical entry education |
|---|---|---|---|---|---|
| Home health and personal care aides | 4,677,100 | About 760,500 | 18% ("much faster than average"), +847,300 jobs | $35,800 a year ($17.21 an hour) | High school diploma or equivalent; short-term on-the-job training |
| Nursing assistants and orderlies | 1,558,700 | About 203,300 | 3% ("as fast as average"), +41,100 jobs | $41,870 a year ($20.13 an hour) | State-approved program and competency exam (nursing assistants) |
Three things stand out. First, the scale: aides are the largest line in the BLS "Most New Jobs" table for 2025 to 2035, with 847,300 projected new jobs against 250,700 for the next occupation and 194,700 for registered nurses. Second, the churn: 847,300 net new jobs over ten years is about 85,000 a year, so of the 760,500 openings the BLS expects each year, roughly nine in ten replace an aide who moved to another employer, changed occupation or left the labor force. Third, the pay band: the median aide earned $35,800 in 2025, with the lowest 10 percent under $27,040 and the highest 10 percent above $45,040. In the same BLS table, stockers and order fillers show a median of $37,330 and restaurant cooks $37,390, which is the competition an aide weighs when a shift does not suit them. An inbound-only strategy fills a handful of the openings with whoever applies this week; the steps below are about reaching the rest.
Why caregivers are harder to recruit than the numbers suggest
- Replacement, not growth, is the job. Nine in ten openings exist because someone left. A recruiter for a 300-aide agency is refilling the same roster every year, so the pipeline has to run continuously rather than per requisition.
- The work is in the client's home, on the client's schedule. The BLS notes that many aides work in clients' homes and that evening and weekend hours depend on clients' needs. A role with a 40-minute drive between visits or a split shift loses candidates to the nursing home down the street before the first message is read.
- Every setting hires from the same roster. Individual and family services employ 51% of aides, home healthcare services 23%, residential disability facilities 6% and continuing care and assisted living communities another 6%. Nursing assistants split across skilled nursing facilities (36%), hospitals (32%) and assisted living (11%), with 5% in home health. Your competitor for a trained aide is as likely to be a hospital as another agency.
- The credential decides who can start Monday. A Medicare-certified agency can only schedule a qualified home health aide, and the federal rule (Step 1) says exactly what that means. Hiring someone who still needs the 75 hours and the competency evaluation is a weeks-long onboarding, not a start date.
- Nobody is on the boards. A caregiver with a full client list is not uploading a résumé. If your sourcing starts from job-board profiles, you are looking at the small share of the market that is already moving, and so is every other agency in the county.
Step 1: Know which credential the role needs
"Caregiver" covers three different hiring problems, and the search has to know which one it is solving. The federal rules draw the lines:
| Role | What qualifies the person | Where the rule comes from | What it means for sourcing |
|---|---|---|---|
| Home health aide (Medicare-certified home health agency) | A training and competency program with classroom and supervised practical training totaling at least 75 hours, with a minimum of 16 hours of classroom training before a minimum of 16 hours of supervised practical training, followed by a competency evaluation; or a state-approved nurse aide program with a listing in good standing on the state nurse aide registry. An aide who has furnished no paid aide services for 24 consecutive months must complete another program, and every aide needs at least 12 hours of in-service training in each 12-month period. | 42 CFR 484.80, the Medicare Conditions of participation for home health aide services | The pool is the people who already hold the training or sit on the nurse aide registry, plus those who lapsed less than 24 months ago. Search on the credential, not the job title. |
| Certified nursing assistant (CNA) | A state-approved nurse aide training and competency evaluation program of no less than 75 clock hours, including at least 16 hours of supervised practical training, then the state's competency exam and a place on the state nurse aide registry. The BLS notes a nursing assistant must be on the registry to work in a nursing home. | 42 CFR 483.152 and the state nurse aide registry | Registry-listed CNAs qualify as home health aides under the rule above, so the CNA population is the deepest reserve of hire-ready home care staff, and the one skilled nursing facilities and hospitals are also drawing from. |
| Personal care aide, companion, caregiver (non-medical home care) | Set by the state, where any requirement exists. The BLS notes that aides may need to meet requirements specific to the state in which they work and may be required to hold first aid and CPR certification. | State home care licensing rules | The widest pool and the least documented. Source on experience in a care setting and on the state's own training requirement, and plan to train the rest. |
Written out this way, the role doubles as the input for the search and the first paragraph of the outreach. On Betterleap the description is the search itself: describe the role as you would to a colleague ("home health aides on the state registry within 25 miles of Dayton") and the agent builds it, or hand it instructions on license type and certifications and adjust them without starting over.
Step 2: Source from the credentialed population, not from job boards
Every CNA sits on a public state nurse aide registry, and every Medicare home health aide holds a documented training and competency record. That credentialed population, not the job boards, is the complete map of the hire-ready home care workforce; job boards and social profiles cover a fraction of it, skewed toward the people already looking. Starting from the credential gives you three things a job board cannot: the whole population, the status of each person's registry listing or training, and the setting they work in now, which tells you what to say to them.
Betterleap's database covers 35M+ healthcare professionals with confirmed licensing information from 25+ state board partnerships, so a search for CNAs or home health aides in a county returns people whose credential is on record, not people who claim one in a profile. For Community Health Network, a system with more than 16,000 caregivers across Central Indiana, replacing outdated profiles and stale contact information with current, verified candidate data produced a 35% increase in sourcing efficiency and about ten hours a week saved per recruiter. Kathy King, its Director of Talent Acquisition, describes the search as typing a query like "ICU nurse within 30 miles of Indianapolis" and receiving targeted results; an aide search works the same way with a different credential.
Step 3: Rediscover the caregivers already in your ATS
The warmest candidates for a home care role are the people who raised a hand once: past applicants who were not selected, aides who left for a nursing home and may be ready to come back, per diem staff who went quiet, and applicants to a different branch or service line. Two problems keep this pool idle. The first is stale data: aides change phone numbers and addresses often, and a two-year-old record reflects none of it. The second is effort: nobody has time to reread last year's applications against this month's openings. The 24-month rule in Step 1 makes this pool unusually valuable in home care: a trained aide who stopped working less than two years ago can start without repeating the program, which no new applicant from a job board can offer. This is work an AI agent does well:
- Sync the ATS so past applicants and former staff are searchable alongside the outside market, not in a separate silo.
- Refresh contact data for every past applicant who matches, so the outreach goes to a phone number and an email address that work.
- Re-rank against the open role using the plain-language description from Step 1 and the branch's territory, not the title of the requisition they applied to originally.
- Send a specific message: "you applied to our Lakewood branch in 2024; we have weekday daytime shifts opening in the same zip code" outperforms "we have exciting opportunities".
Betterleap syncs with 25+ applicant tracking systems for this rediscovery loop and enriches every rediscovered candidate with validated contact data. At Beebe Healthcare the refreshed data produced a 91% contact match rate, the difference between a re-engagement campaign and a bounce report.
Step 4: Write the job the way an aide reads it
A caregiver reads a message on a phone between visits. The questions they want answered are the ones most postings leave out, and a search written without them finds the wrong people:
- Pay per hour, stated. The BLS median is $17.21 an hour nationally; an aide knows what the nursing home and the grocery store pay and compares.
- Schedule and territory. Days or nights, weekday or weekend, live-in or hourly, the number of clients in a shift and the driving radius between them. The BLS notes part-time work is common and hours depend on clients' needs, so say which shifts are actually open.
- The client population. Dementia care, pediatric, hospice, post-surgical, developmental disabilities. An aide with five years in a memory care unit is a different candidate from one who does companion care, and the search should know that.
- Credential and training on offer. Whether the role needs the home health aide training or registry listing on day one, and whether you pay for the program and the 12 annual in-service hours.
- What happens between visits. Mileage, travel time, cancellation pay and guaranteed hours decide whether an hourly worker can afford the job.
Step 5: Write outreach a working caregiver will answer
The messages that get replies from aides share five traits:
- Specific to their work. Name the setting they work in, the city and the shift. Personalization is evidence that someone read their credential and their background, not a first-name merge field.
- The facts first. Hourly pay, shifts, territory, client population, training paid for. These are the questions an aide would ask in the first reply, so answer them in the first message.
- Short enough for a phone. Four or five sentences. The full description can follow once they reply.
- From a real mailbox. Send from the recruiter's own account so replies land in a thread a human is reading, not a no-reply blast.
- Followed up, then stopped. A three- or four-step sequence over two to three weeks, each step with a new reason to reply, that halts the moment they answer, with a working unsubscribe on every message.
Betterleap's agent drafts the multi-step sequence for each candidate from their background, sends it on the recruiter's behalf, follows up automatically and tracks opens, replies and engagement in real time; the recruiter steps in when someone replies. Beebe Healthcare reports a 77% candidate response rate via chat, and its sourcing specialist, Jeremy Strong, describes reaching out directly, chatting with candidates in real time and handing warm leads to recruiters. For an hourly workforce that lives on a phone, that is the conversation an aide actually has.
Step 6: Measure the loop, and hand the repetitive parts to the agent
Of the six steps, two need a recruiter: writing the role (Step 4) and talking to caregivers who reply (Step 5). Building the list, checking the credential, refreshing ATS records, drafting and sending sequences and following up do not. Track four numbers weekly:
- Reply rate per sequence and per branch, split by outside sourcing and ATS rediscovery.
- Qualified-reply rate: replies from people who already hold the credential the role needs, which tells you whether Step 1 is right.
- Time to first shift from requisition open, since a credentialed hire starts in days and an untrained one in weeks.
- Share of hires sourced outbound, the number that justifies the program against the cost of the job boards it replaces.
For reference, Community Health Network reports a 35% increase in sourcing efficiency, a 20% increase in outbound outreach and about ten hours a week saved per recruiter after moving the repetitive steps to Betterleap. The Insights dashboard compares agent and recruiter activity side by side so you can see which steps the agent now carries.
A note on hospice, assisted living and Medicaid programs
The same rules reach beyond home health agencies. The BLS notes that certified home health or hospice agencies receiving payments from federally funded programs such as Medicare must comply with regulations regarding aides' employment, so a hospice aide search is the home health aide search in Step 1. Assisted living and continuing care communities, which employ 6% of aides and 11% of nursing assistants, draw from the same registry-listed population. Where a state Medicaid program sets its own training requirement for personal care aides, that state rule is the one to write into the search, and the state board or health department page that publishes it is the one to cite in the job.
To see this run on your own open aide, CNA or caregiver roles, request a demo.
Sources
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Home Health and Personal Care Aides, 2025 base year and 2025 to 2035 projections (page last modified 27 August 2026), read 9 October 2026.
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Nursing Assistants and Orderlies, 2025 to 2035 (page last modified 27 August 2026), read 9 October 2026.
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Most New Jobs, 2025 to 2035 (page last modified 27 August 2026), read 9 October 2026.
- U.S. Government Publishing Office, Code of Federal Regulations, 42 CFR 484.80, Condition of participation: Home health aide services, 2024 edition, read 9 October 2026.
- U.S. Government Publishing Office, Code of Federal Regulations, 42 CFR 483.152, Requirements for approval of a nurse aide training and competency evaluation program, 2024 edition, read 9 October 2026.
- Betterleap, betterleap.com and the case studies for Community Health Network and Beebe Healthcare.
Frequently asked questions
How many home health aides does the United States need?
The Bureau of Labor Statistics counts 4,677,100 home health and personal care aide jobs in 2025 and projects 847,300 more by 2035, the largest increase of any occupation. It expects about 760,500 openings a year over the decade, most of them replacing aides who transfer to other occupations or leave the labor force.
What training does a home health aide need?
For a Medicare-certified home health agency, 42 CFR 484.80 requires a training and competency program with at least 75 hours of classroom and supervised practical training (a minimum of 16 classroom hours before a minimum of 16 supervised practical hours) and a competency evaluation, or a state-approved nurse aide program with a listing in good standing on the state nurse aide registry. Aides need 12 hours of in-service training every 12 months, and an aide who has provided no paid services for 24 consecutive months must complete another program.
Can a CNA work as a home health aide?
Yes. The federal home health aide rule accepts a state-approved nurse aide training and competency evaluation program (no less than 75 clock hours with at least 16 hours of supervised practical training under 42 CFR 483.152) with a current listing in good standing on the state nurse aide registry. Registry-listed CNAs are the deepest pool of hire-ready home care staff, which is why nursing homes, hospitals and agencies all recruit from it.
Where do you find caregivers who are not applying to job postings?
Start from the credential, not job boards: the state nurse aide registry and documented home health aide training cover the whole hire-ready population, while job boards cover the small share already looking. Search a credential-backed database (Betterleap covers 35M+ healthcare professionals with licensing confirmed through 25+ state board partnerships), then add your own ATS: past applicants, former aides and per diem staff, refreshed with current contact data.
What should a recruiting message to a home health aide say?
The hourly pay, the shifts and territory actually open, the client population, whether the role needs the home health aide training or registry listing on day one and whether you pay for it, and what happens between visits (mileage, travel time, guaranteed hours). Keep it to four or five sentences, send it from a real mailbox, follow up three or four times over two to three weeks and stop the moment they reply.