Workplace Culture a Key Differentiator in Hospice Recruitment and Retention

The hospice workforce has been dwindling even as demand for care rises. Factors such as retirement and burnout are leading some clinicians to leave the field, and the limited number of health care workers with hospice and palliative care training have made the industry an employee’s market. Becoming an employer of choice in their markets has become a priority for hospices nearly equal to providing quality care.

This is not a new problem, but it has grown worse for many organizations. Providers across the health care continuum saw higher turnover during the pandemic. Close to 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.

“We’re seeing a shortage. The number of applications that we typically would have seen seeking us out are a little lower than what they have been in the past,” said Anthony Fleming, vice president of talent acquisition at Amedisys (NASDAQ: AMED). “We are having to go out and find that passive talent and share with them why they should consider us. With more experienced nurses, we are finding that more of them are going into other phases of their lives.” 

The industry publication Modern Healthcare recently listed Amedisys among the Best Places to Work in Healthcare. The magazine publishes the list annually to recognize employers that “empower employees to provide patients and customers with the best possible care, products and services.”

Hospice providers of all stripes are seeking best practices that can help them recruit and keep employees. 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. 

“One year into the pandemic, we’ve seen the industry transform to meet the needs of its patients and employees,” said Aurora Aguilar, Modern Healthcare’s editor, in a statement. “Time and time again, the most resilient and successful organizations show that empathy towards their staff, clear vision and compassion towards the patient buoys teams and sets them up for success.”

Developing an organizational culture in which staff feel supported and appreciated seems to be making a difference when it comes to hiring and reducing turnover.

Amedisys routinely surveys employees to gauge their satisfaction in the workplace and conducts regular focus groups of about 50 people in which employees can voice concerns or offer mutual support.

Earlier this year the company convened a group to discuss “caring for the caregiver,” to identify what nursing staff needed from their employer, particularly during the hardships of COVID, Kendra Kimmons, Amedisys’ vice president of marketing and communications, told Hospice News. An upcoming focus group will discuss recruitment strategies.

Amedisys has also provided diversity and inclusion training to its senior management, care center directors and clinical managers, nearly 2,000 people.

These efforts appear to be yielding results. The company’s total voluntary turnover rate dropped to 15.9% in the first quarter of 2021, down from 19.5% in 2020.

“We are working to make sure our leaders in the field are supporting their people,” said Susan Salomone, vice president of the Business Leadership Group and organizational development at Amedisys. “We’ve implemented a new orientation for the directors of our more than 500 care centers that includes not only the necessary information for their management work, but also incorporates leadership development.” 

Private equity-backed Paradigm Health has virtually eliminated turnover among its clinical staff, CEO Jeff Jarecki told Hospice News. The company recently received an influx of capital through an investment from Havencrest Capital Management.

Paradigm has largely avoided rising rates of COVID turnover. Jarecki attributes this to an organizational culture designed to support employee satisfaction and well-being. The company has created 45 new positions to date during 2021.

In addition to keeping staff engaged, encouraging an environment in which employees feel supported also helps bring in new talent.

“The word gets out from our staff and from others that Paradigm is a great place to work,” Jarecki said. “That makes recruitment much easier. We still focus on the things that we need to as a for-profit business. If you take great care of your team and you have good vision and direction, everything else falls into place.”

However, some other providers have seen their growth stunted by the inability to find a sufficient workforce to sustain their operations. Earlier this month the Dare County Board of Commissioners in North Carolina approved the sale of its local home health and hospice agency to BrightSpring Health Services for $2.9 million. They decided to sell because they couldn’t recruit or retain enough staff to meet the community’s needs, county officials told Hospice News.

Oregon-based Grande Ronde Hospital and Clinics in early June completely shut down its community-based hospice program due to staffing shortages.

Providers are innovating as they consider ways to build up the hospice workforce.

LHC Group (NASDAQ: LHCG) is stepping up efforts to recruit clinical staff to match the home health and hospice provider’s rate of expansion, foreseeing rising demand of clinicians amid an 8% growth in same-store hospice admissions during 2021. The company recently invested $20 million in the University of Louisiana at Lafayette College of Nursing and Allied Health Professions to help bring new clinicians into the hospice space.

The workplace culture and compensation monitoring site comparably included LHC Group in its 2021 rankings of “Best Companies for Women” and “Best Culture.”

Amedisys has turned to technology to bolster its employee retention efforts, specifically data analytics. The company has implemented a system that predicts with 80% accuracy whether an employee may be leaving their positions, allowing opportunities for intervention.

“We’ve seen good success when a leader does intervene and talk with that employee and see what’s going on,” Salomone said. “We’ve seen a good reduction in the turnover for those people versus people that might not have had an intervention.”