As hospices continue to duke it out in the labor market, more providers are contending with competitors poaching their employees.
A number of hospice leaders have told Hospice News that poaching is becoming a greater source of tension in the industry’s recruitment and retention ground war. This often comes with promises of higher wages, more extensive benefit packages or sign-on bonuses.
Luring staff away from competitors is not a new practice, but it has proliferated as workforce shortages have worsened, according to Lynne Sexten, president and CEO of Agrace, one of the largest nonprofit hospice and supportive care providers in Wisconsin.
“Hospices have long sought to find experienced clinical employees by recruiting them away from other hospices,” Sexten told Hospice News. “Each time a new for-profit hospice attempts to enter our market, they desperately try to recruit away our staff with exorbitant sign-on bonuses or hourly wages.”
Competition on wages and benefits has heated up as demand for new hires continues to outstrip the supply, and providers and employees alike deal with rampant inflation.
Hospice worker wage and salary increases have ranged between 3% to 6% during the last two years, according to the National Association for Home Care & Hospice (NAHC).
Poaching is “pretty common” in hospice, but lagging reimbursement rates have only added fuel to the fire, Christy Whitney Borchard, recently retired CEO of Colorado-based HopeWest, told Hospice News.
The U.S. Centers for Medicare & Medicaid Services (CMS) recently proposed a 2.7% pay increase for Fiscal Year 2023. This has become a point of contention for providers and industry groups who say this is insufficient in light of pandemic headwinds, higher costs and wage increases.
As of April, the rate inflation reached 8.3%, close to a 40-year high, according to the U.S Department of Labor.
Without relief from these headwinds, many hospices could be left in the dust, unable to keep up with escalating wage hikes, Whitney Borchard told Hospice News.
Staffing challenges worsen
Staffing shortages have long plagued the hospice industry, but have only grown more difficult since COVID-19 hit the United States in 2020.
The competition in recruitment and retention of hospice staff has become much more challenging to navigate now than in previous years, according to David Jackson, CEO of Texas-based Choice Health at Home. The pandemic shrank the already limited pool of experienced professionals.
“With the pandemic placing strain on the human capital resources of the entire health care industry, the number of employees moving from sector to sector are limited,” Jackson told Hospice News. “With that strain, the hospice industry as a whole is pressed on retention competencies.”
Roughly 18% of health care workers have left their jobs during the pandemic, while 31% have considered leaving the field altogether, according to a nationwide 2021 Morning Consult survey. Burnout, poor wages and the pandemic itself were leading reasons.
This leaves hospices wrestling with an unfortunate reality: With this labor environment — coupled with a lack of professional education and misconceptions about hospice — they have few options to look for new staff without recruiting from other organizations.
The ability to recruit quality staff with attractive pay is a crucial part of keeping up with demand for care, according to David Williams, CFO of Chemed Corp. (NYSE: CHE), holding company of subsidiary VITAS Healthcare.
“We’re more looking at the landscape for VITAS or hospice as where are the opportunities to poach quality people who are working in our communities but don’t work for VITAS,” said Williams at the Jefferies Healthcare Conference. “As well as opportunities, frankly, to just pick up market share by expanding our workforce if we can get aggressive on hiring and retention bonuses.”
Culture a key to staving off poaching
Wages are a crucial consideration when it comes to attracting new hires, but hospices still have other ways to compete. Workplace culture, flexible schedules and employer adaptability are a hospice’s best defenses in retaining their workforce, according to providers in the space.
“Throwing money at the problem isn’t the answer,” according to Whitney Borchard.
Hospices also have their mission front and center, as those who choose to work in the field often share those values.
“The only way a hospice can compete now is to ensure staff have meaningful work that is doable and feel they are contributing to a greater good,” Whitney Borchard told Hospice News. “We need to help people understand the nature and importance of this work.”
Culture and value-centric work factor significantly as staff decide whether to remain at an organization, said Sexten. Investing time, resources and dollars into cultivating a healthy workforce culture has been a vital part of Agrace’s staff retention efforts, she said.
“Agrace has seen employees recruited away with promises of big sign-on bonuses only for them to return within six months, having learned the importance of working for an employer who truly looks out for employees’ best interests,” said Sexten. “The number one thing that has aided in our retention efforts has been the work we’ve been doing for many years to build our culture.”
The company has put an “extraordinary effort” into creating an environment that empowers employees to balance their work schedules with their personal lives, as well as fostering communication between leadership and employees regarding their needs, according to Sexten.
The hospice provider has also remained nimble and flexible with remote work arrangements, she continued, determining that “one size does not fit all,” when it comes to staff training and scheduling.
Agrace convened a “hybrid work” task force to allow departments within the organization to create a mix of remote and in-person work capabilities for employees. These efforts have led to improved retention and reduced resignation, she stated.
Organizational culture has been vital for hospices in the face of poaching, according to Texas-based Silverstone Hospice CEO Alfonso Montiel. While the hospice hasn’t felt the brunt of poaching, it has seen former employees come back, citing the workplace environment as a leading factor, he told Hospice News.
“While I’m aware of times when a former employee tried to poach key team members from us, it went nowhere,” said Montiel. “Since early 2022 we’ve had waitlists of people wanting to join as nurses, aides, marketers and even front-office roles. We seem to have gotten a few things right. While it hasn’t always been the case, we have become a truly great place to work.”