1) The pay is awful. on a good week, you'll clear 600 bucks (this was before the recession). May not seem too bad, except you'll work a 50 hour week at the bare minimum, and be on call at least 2 nights a week (depends how many recruiters work in your office).
2) Your staff. Homecare pays considerably less than facility work, so your workers are the absolute bottom of the barrel; weird burnouts with personality problems that have been bounced out of every hospital in the state. They are as reliable as a Russian car. They will no call no show critical patients at 3 in the morning when you are on call, putting you in the position of telling the patients family to call an ambulance (fun times). I wouldn't trust these people to hold my place in line, let alone monitor my ventilator.
3) Scapegoating. Almost everyone gets fired eventually. You can get fired for any reason, at any time; and they do. Not just lower levels, everyone. Everyone I worked with, from the HR girl to my Regional manager has been fired.
4) Legal issues. I'll leave it at that