Grand Ronde Ends Hospice Program Due to Workforce Shortage

Oregon-based Grande Ronde Hospital and Clinics will close its hospice program this month due to staffing shortages. The organization indicated that the COVID-19 pandemic exacerbated industry-wide workforce issues, leading to the decision to close. 

Many hospice providers have seen staff turnover rise during the pandemic, as have organizations in other health care settings. Slightly more than 20% of health care workers have considered leaving the field due to stress brought on by the pandemic, and 30% have considered reducing their hours, according to a recent study published in JAMA Network Open.

More than 35% of hospice leaders surveyed by Hospice News earlier this year cited staffing shortages as a top concern for their organizations, along with regaining access to patients in facilities.


“Our community is not exempt from the serious national shortage of health care workers. Over the past year, it has become increasingly difficult to find nursing staff to support our hospice program,” said Grand Ronde President and CEO Jeremy Davis. “Director of Home Care Services Selina Shaffer and her team have worked hard to recruit and keep the program alive. On behalf of the organization, I appreciate the exhaustive efforts they have made.”

The shutdown will not affect Grand Ronde’s home health care services. The organization is working with other hospice providers in their community to help facilitate a seamless transition for their current patients.

Staffing shortages have plagued the hospice industry for years. The United States has 13.35 hospice and palliative care specialists for every 100,000 adults 65 and older, according to an April 2018 study. The research estimated that by 2040 the patient population will need 10,640 to 24,000 specialists; supply is expected to range between 8,100 and 19,000.


Hospice and palliative care providers also experience shortages in non-physician disciplines, including chaplains, nurses, and social workers. As far back as 2008, the U.S. Centers for Medicare & Medicaid Service (CMS) began allowing hospice providers to use contracted nursing staff because not enough nurses were available to fill permanent positions.

The aging baby boomer population is both a challenge and an opportunity for hospice. Hospice utilization is rising; a record 50% of Medicare decedents received hospice care during 2018, according to the National Hospice and Palliative Care Organization (NHPCO). However, many hospice staff members are also approaching retirement, with nearly half of the total nursing workforce expected to retire within the next decade.

Hospices face unique recruitment challenges, particularly because medical, nursing, and social work students receive very little exposure to hospice or palliative care during their training. A 2018 study concluded that most students in clinical disciplines do not feel prepared to provide family care at the end of life.

“It was not a recommendation that we made lightly, as we have provided this service since the 1980s,” said Grand Ronde’s Director of Home Care Services Selina Shaffer. “Over the past year, however, the fallout from COVID-19 has changed the workforce landscape and we are no longer immune to that reality in Union County. At some point, we had to acknowledge that.”

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