Hospices Expect Forward Momentum on Labor in 2023

Seeds of optimism are taking root among hospice providers that industry-wide labor pressures may improve this year.

Though staffing remains the greatest challenge in 2023, conditions are improving, reported more than half (54%) of hospice and palliative care professionals in this year’s Hospice News Industry Outlook Survey, prepared in collaboration with Homecare Homebase. Last year, 68% of respondents identified staffing as their most significant pain point.

Survey respondents included nearly 330 hospice and palliative care industry professionals, including owners, executive leaders and managers, among others.


The labor environment inside hospice and palliative care is showing greater signs of improvement, according to Nick Westfall, CEO of VITAS Healthcare, a subsidiary of Chemed Corporation (NYSE:CHE).

“We will have more VITAS team members in 2023 than we did in 2022,” Westfall told Hospice News. “And so 2023 is going to be an exciting year where we’re able to care for more patients [and] more families, and we’re able to support the communities more than we ever have, because we will have more team members that are able to do that. I’m probably more excited about it than I’ve been in a few years.”

Like many in the hospice space, VITAS has seen workforce clinical capacity compress and impact revenue to varying degrees since 2020. Staffing initiatives such as a retention bonus program and expanded vacation time helped VITAS to make progress on the issue last year.


Hospices nationwide have tried a range of strategies for boosting recruitment and retention, including wage increases, bonuses, enhanced benefits, access to emotional support resources and flexible scheduling.

Others are leveraging technology. About 40% of Outlook Survey respondents cited employee engagement and satisfaction as a top driver for their technology investments this year, compared to 23% last year.

Despite these glimmers of hope, progress may be slow and will vary among operators in different markets.

This may not be the year for drastic change on the labor front, according to Cooper Linton, associate vice president of North Carolina-based Duke HomeCare & Hospice.

“[I’m] not expecting material improvement in staffing,” Linton told Hospice News, when asked where he sees things heading.

And even if recruitment and retention does improve to some extent, providers are still feeling the strain of higher costs for wages and benefits, according to Heart’n Soul Hospice CEO David Turner.

“We still have a long way to go, and the increased wages are making it tough on smaller agencies like mine, but it sure feels better than a year or so ago,” Turner told Hospice News in an email.

The Nashville-Tennessee-based home care and hospice provider has seen responses to job postings improve during the past year and recently hired two full-time RN case managers, Turner stated. In a post-COVID world, more clinicians in other settings also may be considering a career path in end-of-life care due to burnout, as well as growing recognition around the benefits of hospice, he said.

“We recently hired two full-time RN case managers that were coming off of expired contract nursing jobs. One of them was tired of the travel and the other one simply saw the contract expire. I also feel as if the many positive stories that have circulated about hospice, post-COVID, is causing more clinicians to consider end of life care as a career path,” Turner said.

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