The Most Powerful Weapons in Hospices’ Recruitment, Retention Arsenals

Knowledge is power when it comes to understanding the key priorities among the hospice workforce.

Hospice providers have taken varied approaches to combating prolific staffing shortages in the industry. Strategies have included offering higher wages, expanded benefits and retention and sign-on bonuses. Operators have also ramped up onboarding and preceptor training programs, provided ongoing education and career growth opportunities, invested in new technologies, and placed a deepened focus on organizational culture development.

Many factors play a role in recruitment and retention, but having a firm grasp of the competing priorities of different interdisciplinary team members is a significant part of sustainable care delivery, according to Tanya Marion, chief human resources officer at Enhabit Inc. (NYSE: EHAB).


Similar to the individualized, person-centered approach involved in end-of-life care, hospices need to shape their retention strategies around the unique needs of their staff, Marion said.

“Having competitive wages and benefits is a basic need for any employee or candidate looking to come onboard,” Marion said during the annual Hospice News Staffing Summit. “But it’s taking a broader approach … so we’re making sure employees’ particular needs are met. You need to know what motivates each of them. [It’s] making sure that we’re asking people what we can do to support what is unique to you and applying some kind of strategy of support for every employee, looking at them individually.”

Part of understanding employee priorities involves having an open line of communication and providing an avenue for employee feedback, according to Eddie Belluomini, COO of 1Care Hospice & 1Care Kids. The Nevada-based hospice provider encourages employees to regularly touch base with leaders, Belluomini stated.


Having a window of direct insight into the day-to-day challenges interdisciplinary staff experience at the bedside can lead to improved understandings of ways to reduce burnout and turnover alongside quality outcomes, according to Belluomini. 

Another important arrow in a hospices’ quiver is having a streamlined onboarding process and solid ongoing training, he said. Reevaluating these policies with employee insight is a large part of sustainable workforce growth, Belloumini said.

“It starts with proper onboarding and training your staff so they can function to the best of their abilities in the field,” Belluomini told Hospice News. “And then it’s to empower your team [so] that every employee has a voice at the company. If they have an idea that’s going to help the patient experience and help workplace cohesion, then we want to hear it. Giving your employees a voice, letting them know we will listen and they’ll be heard, I think it goes a long way.”

Having a sufficient supply of clinicians is another key retention point, Belluomini indicated. 1Care Hospice & 1Care Kids often employs a strategy of “staffing ahead,” or having additional clinical team members on call in case others are unable to provide patient care on any given day. The strategy has played a large role in the balance of clinical capacity, he stated.

“We try to staff ahead and make sure our nurses aren’t going back-to-back on caseloads,” Belluomini said. “We want to make sure that our CNAs don’t get burnt out. We also really try to stay ahead on staffing for all positions. Staffing ahead is so very important, along with lesser caseloads. These are the hardest working people and the backbone of your hospice team. Those are the people that have the most intimate relationships with your patients.”

Understanding what tasks “wear down” staff and implementing measures to avoid burnout and fatigue around them is an important retention factor, Marion said. Technologies that reduce patient documentation times, allow for smoother interdisciplinary collaboration and increase communication touch points with patients and caregivers are one way to improve efficiency and employee satisfaction, she explained.

An additional component is allocating staffing resources with an aim toward resiliency and longevity, which takes careful financial consideration, Marion added. For instance, implementing sign-on and retention bonuses can be helpful in the short-term, but these can carry heavier financial weight in the long run, she said.

“It’s looking at where you can take those same dollars and invest them into providing tools that make that longer-term retention important to those employees,” Marion said. “Make sure that you’re really thinking about if you use this dollar here, you know what the cost of it is of not being able to use it somewhere else. I’m not saying there is never a need for bonuses … but it’s more thinking about what is the long-term investment that you can make in using those dollars wisely.”

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