Hospices Compete for Staff in Job Seekers’ Market

Hospice providers are competing more intensely to fill their ranks from a smaller pool of prospective employees. Hospices will need to offer flexible schedules, mental health support and a diverse and inclusive culture to attract and retain staff in what has become a job seekers’ market.

Workforce shortages have long predated the coronavirus pandemic, but COVID-19 has exacerbated the issues as hospice providers ramp up recruitment and retention efforts. The outbreak has taken a tremendous toll on the nation’s health care workforce. Stress brought on by the pandemic has led a little more than 20% of health care workers to consider leaving the field, while about 30% have considered reducing their hours, according to a recent study published in JAMA Network Open.

“It’s hard to take on patients when we don’t have enough nurses to take care of them. There’s just not enough of them out there,” said Shelley Henry, founder and president of The Amity Group, a Louisiana-based hospice staffing agency. “One thing that has to be done is that patients can’t be accepted if you don’t have the nurses to take care of them. Maybe you take fewer patients right now, but you’re going to keep your staff happier and you can grow stronger over time. Hospices that stick to their staffing ratios have a very stable staff.”

The nation’s health care workforce has been reduced by 502,000 people since February 2020, according to a report from the Bureau of Labor Statistics. Likewise, upwards of 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 facility-based settings.

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

Kristen Yntema, president and CEO of North Carolina-based AuthoraCare Collective. Encourages providers to survey staff regularly to discover their unique needs that “fill their cups.”

“Self care is essential for the serious and taxing work that hospice care entails. Administrators need to review staff surveys and collaboratively create the supportive environment desired,” said Yntema. “It is an employee and team-centered approach to discovering and implementing benefits that are meaningful. Robust programming and strong benefits that promote and support self care will set the hospice apart from competing employers.”

Staff burnout has been putting pressure on the hospice community. About 62% of hospice clinicians have experienced burnout at some point in their careers, according to a 2019 study. Scheduling flexibility and employee programs that help support both physical and mental health can be important benefits, according to Jake Massacci, vice president of human resources for Jet Health.

Jet Health, a Texas-based home health and hospice provider, is backed by private equity firms SV Health Investors and Health Enterprise Partners. The company also operates locations in New Mexico, Colorado and Idaho.

Hospices have been reevaluating their staffing policies, including applying increased paid time off and holidays, with many restructuring and adapting telecommuting policies during the pandemic as more employees began working from home.

Allowing for more flexible schedules will go a long way towards recruitment and retention, according to Massacci.

“Aside from price points, people are really looking beyond that and saying, flexible schedules really do make a difference for me and my family,” Massacci told Hospice News. “Flexibility is probably the biggest thing that really sticks out to me that makes an organization more attractive. Unfortunately, offering that staff flexibility is getting more and more difficult when you look at where the market is with a shortage of employees out there who are willing and able to come to work every day.”

The ability to strike a healthy balance between workload and personal life has become increasingly challenging for hospice providers, given the rising demand and the dwindling workforce. Seniors 65 and older will number 1 billion or roughly 12% of the global population by 2030, the U.S. Census Bureau projected in 2018. This represents a yawning gap for hospices to fill.

The shortage is impacting a range of disciplines, including physicians. 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.

While offering higher wages, competitive pay and attractive benefits packages can go a long way to staff recruitment, an employer’s working environment and overall culture go farther when it comes to retention, according to Yntema. Featuring employee engagement activities and offering job-sharing opportunities as career path explorations can help hospices to keep staff interested and engaged in growing with their organization.

Hospices are also casting a wider net as they seek a more diverse and inclusive workforce, according to Yntema.

“Employers need to work to create an inclusive workplace and also support their staff as they navigate home-based care amid a diverse patient population. Staff need to feel supported and that their differences are recognized, celebrated, and leveraged as a collective strength,” Yntema told Hospice News. “Creating belonging — both for employees and patients — requires a robust and authentic commitment to diversity, equity and inclusion work.”

Hospices nationwide have made diversity initiatives a rising priority. Many hospices that are trying to address racial and ethnic health care disparities among their patient populations are also working to establish a more diverse workforce, according to a 2020 study published in the BMJ Supportive & Palliative Care Journal. More than 70% of organizations surveyed in an Axxess report of home-based and hospice providers indicated that they would increase resources in 2021 for staffing diversity, equity and inclusion.

A hospice’s workplace reputation can be a key differentiator when it comes to having a strong and inclusive culture, according to Henry. Gauging their reputation against competing hospices will be essential to knowing where an organization measures up in a crowded employee market..

“A lot of agencies may have a reputation that they don’t even know about, or one that’s not deserved,” said Henry. “It’s really important that each agency truly takes measures to find out what is being said about them in the community, because maybe it’s something that’s not even true and they need to be able to counter that or if it is something that’s accurate, they need to ask how they can fix it. It’s really important that the company is known for standing behind their nurses and supporting their nurses — even above sciences and even about profit.”

Though competition for staffing resources is fierce, hospices may see some improvement in coming years. Employment in health care occupations is anticipated to outpace other sectors with the addition of roughly 2.4 million jobs, a growth by 15% from 2019 to 2029, according to projections the Bureau made this May. The Bureau indicated the jump was largely attributed to an anticipated rising demand for health care fueled by demographic tailwinds of an aging population.