Hospice, Home Health Providers ‘Squeezing Turnips’ Competing for Clinical Staff

Hospice and home health care providers’ recruitment and retention strategies have narrowed their focus on workers’ key priorities, with organizational culture among the heaviest hitters on their lists.

Amid workforce shortages, hospice and home health providers are often at a disadvantage when it comes to competing with other health care organizations that can have greater financial resources, according to Bill English, president and CEO of Accurate Home Care.

Care delivery costs in home health and hospice have also soared since the pandemic, carrying some lasting impacts on the ability to offer competitive wages, he stated.


Higher compensation may attract clinicians to one organization versus another, but workplace environments carry the most weight in their decisions to stay or leave, English said at Aging Media Network’s CONTINUUM conference in Washington, D.C.

“We can’t just go out to nurses and say, ‘I’ll bump [your pay] a buck an hour,’” English told Hospice News’ sister publication Home Health Care News. “I don’t have the money, I do not have the cash. I’m not a turnip, you’re not going to get blood out of me. We have to focus heavily on culture [and] purpose and try to attract those who have the heart for home care and the money is secondary to them.”

Bill English Merz Photography / Hospice News
Bill English, president and CEO, Accurate Home Care at the CONTINUUM Conference.

Minnesota-based Accurate Home Care provides respite, personal and private duty care, home health, nursing and homemaking services. Like many health care providers, Accurate saw nursing turnover rise during the pandemic, with volumes improving since.


Developing an organizational culture with strong communication and supportive leadership has been a key to retention as well as rebuilding the clinical and nonclinical workforce, English said.

Accurate Home Care reached a 72% retention rate among clinicians in 2023 and a rate of 80% among back-office staff, he stated. Workplace culture and leadership have been vital parts of retention efforts, English indicated.

“It’s not because we pay the most, it’s because of the culture that we built. We bond with our people, even though they’re all around Minnesota,” he said.

Having quality leadership and a supportive work environment can give hospice and home health operators a competitive edge in the face of challenging financial times, according to Fran Casey, chief people officer at Goodwin Living, which operates Goodwin Hospice.

The Virginia-based nonprofit provides a facility- and community-based range of services including an aging-in-place program, rehabilitation, home health and hospice.

“We have put our energy into focusing on our team members knowing they’re the ones that are closest to our residents [and] it makes a difference,” Casey said at the conference. “People see that and they want to understand the culture. For those of you looking at every penny and there are very slim margins, what do you do? You stand out because you care. You listen, you provide the resources, you provide the heart, you provide the wisdom. And it translates into a really loyal team.”

Fran Casey Merz Photography / Hospice News
Fran Casey, chief people officer, Goodwin Living at the CONTINUUM Conference.

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