Hospices need a nimble, innovative approach to sustainable retention in today’s competitive health care workforce climate.

Prolific staffing shortages and an increasingly crowded hospice market have created an intensely challenging hiring environment, according to Dr. Raihan Faroqui, head of clinical partnerships at Guaranteed Health. The end-of-life, value-based care company operates Guaranteed Hospice in California.

Hospices with an adaptable mindset around clinical workforce retention stand to gain a leg up on competing health care organizations, Faroqui said during Hospice News’ 2025 Industry Outlook webinar.

“The needle has not moved, and the needle hasn’t moved because we’re not brainstorming what’s possible,” Faroqui told Hospice News during the webinar. “Where I seek inspiration from is what’s possible, what’s out there and what has worked in other markets. Bring in those ideas and really have kind of these frank conversations with your staff and with your management and be open to experimenting and seeing what works.”

Hospice providers work in a uniquely stressful atmosphere as they support patients and their families at the end of life, Faroqui said. Added “friction” to their daily workloads can come in the form of time-intense documentation practices that at times add operational burdens for clinical staff, he said. While technology can be leveraged to help reduce documentation strains, hospices need more layers of support to help staff thrive in their roles.

Providing employees with ample opportunities for mental health support is among the largest keys to retention, according to Faroqui. Free access to behavioral health services and therapy, resilience coaching and peer support groups have been some of the most successful avenues to combating staff burnout, he stated.

“Witnessing death and dying every day takes its toll,” Faroqui said. “How are you providing grief decompression time after emotionally intense cases and showing that commitment to emotional well-being, making the role more sustainable and keeping the workforce that we already have plugged in?”

The role of rapid patient turnover

Understanding the diverse scope of competing workforce priorities and daily challenges is a significant part of shaping effective retention strategies that support sustainable growth, according to David Jackson, CEO and founding partner of Choice Health at Home. The Texas-headquartered company provides home health, hospice and rehabilitation services.

Interdisciplinary hospice teams can experience heightened levels of compassion fatigue during periods of larger patient census volumes, which can negatively impact retention, Jackson stated during the webinar. Hospice leaders need to recognize when staff are contending with higher rates of patient deaths and have the infrastructure and policies in place that help ease labor pressures, he said. Most importantly is making staff aware of the supportive programs and employee assistance benefits that may be available to them.

Retention in the hospice industry in large part hinges on leaders’ abilities to tap into the emotional, physical and practical needs of their workforce, Jackson said. This involves a creative approach of constantly asking what is most important to staff satisfaction – one that focuses on empathy, he indicated.

“What can we do to help staff? The biggest thing [is] being cognizant of that,” Jackson told Hospice News during the webinar. “ [It’s] thinking about the staffing complexities of rapid patient turnover. The idea of empathy is very natural to hospice operators, so use it. How do you contemplate more stress or more mental health issues related to the stress of taking care of patients at end of life? How can we help them economically? How can we help them from a work life balance perspective? We are going to have to recruit from other avenues of health care and show them how cool this job is, and then enable them to do it with less cumbersome interaction between them and the patient.”