These are the results, and the response times behind them, before and after each agency changed how it responds.
Key findings
- Same inquiries, 54% more admissions. A $6.4M Miami agency went from 8.0 to 12.3 admissions a month while inquiries held flat (47 to 46). Before, families calling after hours waited a median 19h 10m for first contact and 61% of after-hours calls were missed. After: 11 minutes and 9%.
- Active referral sources rose from 34 to 58. A $6.9M Orange County agency went from 6.8 to 10.4 admissions a month. Before, the median reply to a professional referral was 5h 10m. After: 14 minutes.
- 288 more care hours delivered each week. A $9.8M Phoenix agency cut care hours turned down each week from 380 to 92. Before, caregiver applicants waited a median 31 hours for first contact. After: 8 minutes, and interview show rate rose from 38% to 64%.
- 404 more nursing hours delivered each week. A $5.8M private duty nursing agency in Orange County and Long Beach raised authorization utilization from 68.9% to 79.6%. First contact with nurse applicants fell from 19 hours to 11 minutes, and interview show rate rose from 44% to 67%.
- 7 admissions from an old inquiry list. A $4.1M Chicago agency contacted 742 past inquiries that had never converted. 83 replied, 18 booked an assessment and 7 signed within 45 days.
Families: first contact after an inquiry
| Agency | Measure | Before | After (Day 90) |
|---|---|---|---|
| Miami, FL ($6.4M, private pay) | First contact, business hours | 4h 20m | 6 min |
| Miami, FL | First contact, after hours | 19h 10m | 11 min |
| Miami, FL | Missed calls, business / after hours | 34% / 61% | 6% / 9% |
| Miami, FL | Inquiry to admission | 17.1% | 26.8% |
| West Los Angeles, CA ($8.2M, private pay) | Inquiry conversion | 12.8% | 19.6% |
Referral sources: reply to a professional referral
| Agency | Measure | Before | After (Day 90) |
|---|---|---|---|
| Orange County, CA ($6.9M, private pay) | Median professional-referral response | 5h 10m | 14 min |
| Orange County, CA | After-hours referral response | Next business day | 21 min |
| Orange County, CA | Active referral sources | 34 | 58 |
| Orange County, CA | Monthly admissions | 6.8 | 10.4 |
Caregiver and nurse applicants: first contact
| Agency | Measure | Before | After (Day 90) |
|---|---|---|---|
| Phoenix, AZ ($9.8M, private pay) | Median first applicant contact | 31 hours | 8 minutes |
| Phoenix, AZ | Interview show rate | 38% | 64% |
| Phoenix, AZ | Time to fill an open case | 26 days | 9 days |
| Phoenix, AZ | Care hours declined each week | 380 | 92 |
| Orange County + Long Beach, CA ($5.8M, private duty nursing) | First contact with nurse applicants | 19 hours | 11 min |
| Orange County + Long Beach, CA | Interview show rate | 44% | 67% |
| Orange County + Long Beach, CA | Case fill time | 22 days | 9 days |
| Orange County + Long Beach, CA | Missed shifts | 9.4% | 4.1% |
Old inquiries: what a dormant list returns
A $4.1M Chicago agency had 1,340 past inquiry records. After removing invalid and duplicate records, 742 were contacted. 83 replied (11.5% of those delivered), 18 booked an assessment and 7 signed within 45 days. Text produced most replies; the email reply rate was 1.9%.
What didn't improve
Faster response is not a cure-all. In the same records:
- Miami's assessment no-show rate moved only from 22% to 19%.
- The nursing agency's annual nurse turnover rose from 44% to 47%. Faster hiring did not fix retention.
- In Nashville, missed calls stayed at 5% to 6% while inquiries grew from 52 to 78 a month, and declined care hours rose from 40 to 64 a week. Growth put pressure on delivery.
Targets these agencies now work to
- An automatic reply to every call and message within 60 seconds, 24/7, set up and run by Acensus. Calls ring the agency's on-call phone first. Acensus staff never answer an agency's phones.
- A human reply to a professional referral within 15 minutes, seven days a week.
- First contact with a caregiver or nurse applicant within minutes, not the next day.
- The owner reviews the median response times every Monday.
How we measured
- Figures come from each agency's own phone system, CRM, applicant tracking and billing records, supplied to Acensus during the engagement.
- "Before" is the baseline at the start of the engagement. "After" is Day 90. Response times are medians as reported.
- Agencies are described by city, size and service type. Names are kept private.
- This is eight agencies, not a survey of the industry. Treat the "before" numbers as a picture of what goes unmeasured, not a national average.
Frequently asked questions
How fast should a home care agency respond to a new inquiry?
Within minutes, day or night. In our records, the agency that cut after-hours first contact from 19 hours to 11 minutes raised inquiry-to-admission from 17.1% to 26.8% with the same number of inquiries.
How fast should an agency reply to a hospital or discharge planner referral?
Within 15 minutes. One Orange County agency moved its median from 5h 10m to 14 minutes, and its active referral sources grew from 34 to 58 in 90 days.
Does applicant response time affect how much care an agency can deliver?
Yes. A Phoenix agency cut first applicant contact from 31 hours to 8 minutes. Interview show rate rose from 38% to 64%, and care hours turned down each week fell from 380 to 92.
Where do these numbers come from?
From the records of eight home-based care agencies that worked with Acensus, a specialty growth firm for home care, home health and private duty nursing agencies. See the full cases at /results.