Hospice leaders: Dollars alone will not solve the problem of staff turnover

Money isn’t everything when it comes to hiring and retaining employees.

While compensation is an important factor in attracting and retaining staff, hospices must consider other important aspects as well. Employee benefits, career path, organizational culture, and management involvement also influence employees’ decisions to join, stay, or leave a hospice.

According to Teresa Acampora, chief operating officer of MJHS Home Health & Hospice, which is part of MJHS’s New York Health System, hospices should take a close look at the employee benefits their organizations offer. Hospice has re-evaluated its benefit packages based on employee feedback, including a revised paid leave policy to reduce burnout.

“We have taken the opportunity to review our benefits package and [hospices] I can’t underestimate how important your benefits package is, including paid time off,” Acampora told Hospice News. “Having a generous paid vacation was very, very important, and [having] a good strong package of medical benefits. They know there is support when they feel burned out.”

Employees also indicated that career advancement potential was another factor in their hiring decision, she added. This has led to the launch of a mentoring program to help clinicians achieve their career aspirations, thereby increasing retention, Acampora said at Hospice News’ virtual human resources summit.

“The other part we did was to develop the Emerging Leaders Program to develop our own clinical leaders, and it was really important that our clinical staff feel like they have a career opportunity within the organization,” Acampora said.

A shortage of staff has plagued the hospice industry for a long time, but the effects of the pandemic have created greater hurdles to sustainability.

For example, turnover among registered hospice nurses reached 25.15% in 2022, according to the 2022-2023 Hospice Salary and Benefits Report released by the Hospital and Healthcare Compensation Service (HCS) in collaboration with the National Home Care Association. and hospice care (NAHC). ).

The turnover rate among assistants and CNAs was 19.05% and 29.84%, respectively. The report indicates that only LPN and LVN had higher rates, reaching 31.52% turnover and 25.12% vacancies.

High staff turnover rates in clinics put a strain on clinical capacity and negatively affect patients’ access to care. Meanwhile, employee turnover and rising labor costs have reduced the margins of hospices across the country.

One of the main costs was the need to offer signup and retention bonuses in order to compete in the job market.

Having a sense of balance when it comes to bonuses is critical, says AccentCare’s chief clinical operations officer, Jennifer Nitz. Hospice, headquartered in Dallas, provides care in 30 states and also offers palliative and personal care, among other services.

“There is an extremely competitive environment across the country right now. We see that in some markets, no matter how high the signup bonuses are, they are really hard to attract. [clinicians]’, Nitz said in an interview with Hospice News during a staffing summit. “In some areas, we have seen that signing bonuses are very, very, very high. We found that some of our current employees might be put off when they see these big signup bonuses, and so we needed to be very thoughtful and balanced about this. We are reasonable and prudent, really trying to protect our current employees.”

HopeHealth President and CEO Diana Franchitto said leadership engagement has become another key element in understanding both the drivers of hospital turnover and responding to a negative trend.

During the pandemic, roughly 25% of the organization’s turnover was with medical staff, she said in an interview with Hospice News. Francitto said during the summit that HopeHealth is seeing improvement as the outbreak abates, with more than 700 staff caring for approximately 2,000 patients daily.

She told Hospice News that in addition to improving workflows and patient workload, achieving the right balance between “aggressive recruiting” and “mindful retention” requires management involvement.

“It has been difficult and difficult, but we have put in place all these workflows and processes that the pandemic forced us to, and as PHE comes to an end, they are part of our daily activities,” Francitto said at the summit. . “After the pandemic, the presence of your CEO [interdisciplinary group meetings] is it so important. This is so important to the staff that the CEO is in no hurry to sit in IDG. It takes a lot of time, you learn a lot and understand what the atmosphere is. It’s not only a shot in the arm, but also that you catch some of the problems and frustrations and bring them back to your team.”

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