Hospice Providers Developing New Strategies for Recruitment, Retention

Having a solid understanding of worker priorities will give hospices an advantage in hunting for new recruits as workforce shortages continue.

Hospices are entering a “new normal,” and many are reshaping their recruitment and retention strategies, according to Lynne Sexten, president and CEO of Agrace Hospice & Supportive Care.

Enduring the past two years of COVID-related staffing headwinds has been a “very painful” experience for many hospice providers amid rising demand and skyrocketing levels of turnover, Sexten said. But these experiences have uncovered areas for improvement and innovation, she stated.


“We saw a tremendous uptick in our census at a time when we were struggling with the amount of vacant positions,” Sexten said during the recent Hospice News Virtual Staffing Summit. “It was all hands on deck. We got through the worst of the crisis … but that crisis really made us take a step back and realize traditional recruitment and retention techniques are probably not going to continue to work like they have in the past. We really started to put deliberate, long-range plans into place.”

Agrace provides hospice, palliative, pediatric and memory care, adult day services, advance care planning and grief support, among other services. Established in 1978, the nonprofit hospice and palliative care provider serves 19 counties across southern Wisconsin.

Agrace has an average daily census of 1,700 patients and a workforce of nearly 900 employees. The organization’s revenue reached $84.65 million last year, according to its 2022 annual report.


Putting together the pieces of Agrace’s staffing strategy required a great deal of time, effort and financial investment, Sexten added. A key starting point was Agrace’s assessment of employee’s reasons for staying at or leaving the organization.

The nonprofit provider has added staff to its recruitment teams to attract job seekers and solicit feedback on prospective employees’ top priorities. Common themes included competitive pay and benefits, career mobility, flexible scheduling and organizational culture, Sexten indicated.

Armed with these kinds of data, hospices can take a more diversified approach to workplace policies and practices, according to Sexten.

One key strategy is to focus on developing relationships with various community groups across a hospice’s service region to better understand candidates’ cultures, beliefs and values, she indicated.

“We’re in many markets, and there are different norms, preferences and important things to each of those markets,” Sexten said. “We profiled what the ideal candidates would like and built customized recruitment campaigns. We really dove into the idea of partnerships in our community. A lot of these strategies have really paid off.”

Agrace has seen recruitment and retention rates improve since partnering with local organizations that train clinicians with diverse cultural and ethnic backgrounds, Sexten added. Having ties to different community groups has allowed the hospice provider to find more candidates, including those in non-clinical roles, she said.

One crucial practice is to gain an understanding of prospective employees’ financial priorities and identify ways to better support them, Sexten stated.

Health insurance coverage is one of the “huge concerns” that employees express that can impact whether they remain with an organization, Sexten said.

Agrace launched a workforce initiative at the start of this year that expanded employee benefits and raised compensation rates. The three-pronged initiative included a higher minimum hourly wage, year-end “gratitude bonuses” for all employees and lower health insurance premiums for lower-wage earners.

Expanding employee benefits and raising wages have also “paid off” as far as the ability to support and retain workers, Sexten stated.

“That was a huge win and enabled some of our lower-paid staff to get health insurance for the first time,” Sexten told Hospice News during the summit. “It allowed us to be much more flexible in providing the kind of benefits that our employees were truly interested in, rather than having to kind of ‘buy off the shelf.’ We were able to establish tiered rates for employees making a certain amount. They pay less towards health insurance.”

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