Hospice, Home Health CEOs: Mission-Driven Culture Key to Staff Retention

As health care providers face staffing shortages in nearly all disciplines, home-based care providers are leveraging their mission of service to help employees remain engaged and fulfilled in their work. In addition to the dearth of clinicians who have hospice or palliative care training, those providers find themselves in tight competition with other care settings to attract both experienced workers as well as new graduates.

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. In a Hospice News survey earlier this year, 35% of hospice leaders indicated that the staffing shortage was their No.1 non-COVID related concern for 2021, compared to 16% who cited increased competition. 

“[Staffing] is what I think about every minute of the day. It’s huge,” said Dorothy Davis, the CEO of the Visiting Nurse Health System, speaking at the Home Health Care News FUTURE conference in Chicago. “What it really just comes down to in our market when we look at nursing data, there’s just not enough supply.”

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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.

A number of 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.

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In this environment, hospice providers of all stripes are seeking best practices that can help them recruit and keep employees. Among these are efforts to keep their organizations’ mission top-of-mind for their staff.

Hospice and home health provider Intrepid USA in 2018 redesigned its human resources department and began to infuse its recruitment and retention efforts with a focus on the personal fulfillment that caring for the seriously and terminally ill can bring, according to CEO John Kunysz. This included implementation of a “culture and vision” orientation program for new hires.

“We were putting the heart back into our business. We called it ‘from our hearts to your home,’” Kunysz said. “People want to work for a company that makes a difference. When we do these orientations they say, ‘you’re making this something that we care about, not just the technical job, but the emotional and psychosocial aspects of work fulfillment.’”

Intrepid rebranded its human resources functions as its “people engagement division” and redesigned the language it uses in job postings to help attract “top-tier talent” and reduce turnover. The approach has yielded results. Prior to these actions, the company had turnover rates in the high 60s. Currently their turnover rate is in the high 20s, Kunysz told Hospice News.

LHC Group (NASDAQ: LHCG) has also stepped up efforts to recruit clinical staff to match the home health and hospice provider’s rate of expansion. LHC Group is taking a regional approach to recruitment across each of its service lines. Each service, such as home health or hospice, has dedicated hiring teams that are focused on specific geographic areas.

The company also 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.

LHC managers now do rounds with staff to gauge not only their job fulfillment, but ways the company can support their long-term career goals while keeping them in their fold. The workplace culture and compensation monitoring site Comparably included LHC Group in its 2021 rankings of “Best Companies for Women” and “Best Culture.”

“Nothing else is more important than culture. Employees have to feel that the place where they go to work every day is more than just a job and a paycheck,” LHC Group Chairman and CEO Keith Myers said at FUTURE. “Culturally, it has to be genuine. It causes some margin compression, but we accept that we have to sacrifice a little bit on margin to be able to ensure our ability to continue to staff the volume that’s coming our way.”

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