As the COVID-19 pandemic puts new pressures on hospice staff, providers are reevaluating and revising their policies to accommodate and maintain their workforce.
Hospices nationwide have restructured and adapted telecommuting policies to transition employees into working remotely from home, easing some of the childcare issues for staff. Reallocating vulnerable or exposed staff to non-patient facing roles has also helped to offset workforce shortage issues for hospice providers.
Hospices are incurring a barrage of additional costs as the pandemic progresses, many of which relate to supporting and maintaining a workforce at constant risk of contracting COVID-19 while continuing to provide patient care. Among the challenges are heavy financial hits from staff requiring increased time off as they face child care demands or become infected with the coronavirus themselves.
“Our health care workers are a critical part of the national infrastructure in this battle against COVID-19,” said President and CEO of Encompass Health (NYSE: EHC), Mark Tarr. “In recognition of their inspiring efforts, we invested approximately $50 million to support our frontline workers in both of our segments through an award of additional paid time off to our teams in the field.”
Staffing issues such as retention, high turnover and shortages were already among the top challenges in 2020 for hospice providers long before the pandemic struck. As the outbreak continues, hospice employees have increasingly needed time off to address needs within their own families. Additional time off requests have also stemmed from staff needing to isolate due to exposure to the virus.
“Team members have had increased reasons for time off during the pandemic,” said Sharon Branham, president and CEO of Kentucky-based Appalachian Hospice Care. “They might have been exposed to the virus through contact of a positive family member or patient, resulting in the need to be quarantined for a 14-day period. We’ve also had pregnant staff near their delivery dates request time off or avoid seeing COVID-positive patients due to their own risks of exposure. For these and other kinds of specific situations, we’ve had to adjust our normal personnel policies and expand time-off policies to have funding support for staff and allow them to be healthy at work. Revisions or new employee handbook policies were created to comply with guidance from health care agencies like the U.S. Centers for Disease Control and Prevention (CDC)].”
However, shifting policies and procedures has taken a toll on employers — including a hefty price tag. Additional and unexpected costs have come from paying regular salary and hourly wages along with increased paid time off and overtime pay for staff maintaining coverage.
“It took significant time and energy to work on the logistics of redeploying and training more than 90 employees to [non-patient facing] roles,” said Lynne Sexten, president and CEO of Agrace Hospice & Palliative Care in Wisconsin. “We have temporarily modified and waived existing policies. Where they would normally need to use [paid time off (PTO)], they have been given the option to either use their PTO or take the time unpaid.”
Federal funding from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) has provided some relief to hospices contending with associated PTO costs. Additionally, some have turned to national agencies for assistance, such as loans granted by the Small Business Association (SBA). The “payroll protection” measures are a potential cushion for hospices hoping to ride out the financial storm from the pandemic.
Hospice providers are looking ahead at how revisions could take shape long term and potential learning opportunities for improvement.
“I feel like I have even more responsibility to support the staff with fashioning policies that give them more flexibility,” Branham told Hospice News. “Moving forward, the pandemic has helped to bring even more importance of hospice care delivery to the forefront. It has shown that providers can make things more streamlined for their staff without additional trips to facilities and more things that can literally be handled in house. The potential for cost savings is there in many ways without impacting quality of care.”