nurse holding hand of older adult male

Turnover rates for hospice aides/certified nursing assistants has continued on an upward trend seen in recent years, according to the Hospital & Healthcare Compensation Service’s Hospice Salary & Benefits Report released this week.

Turnover rates increased to 29.84% in 2022, up from 26.6% a year ago. Turnover was 22.07% in 2019 and 25.72% in 2020.

Despite pay rate increases and sign-on bonuses, agencies reported an average vacancy rate of 19.05% for hospice aides/certified nursing assistants in 2022. Vacancy rates across employees as a whole was lower, at 13.44%.

Hospice aides/certified nursing assistants received hourly pay hikes in 2022 that more than doubled the increases they received in 2021. Those workers received an average hourly rate increase of 9.09% this year compared with a 4.52% increase in 2021. 

Due to vacancies, approximately 8% of hospices surveyed said that they continued to rely on contract workers to fill in care gaps, with an average of 262 hours contracted out per month per company in 2022.

More than half (51.72%) of the respondents said that they are using sign-on bonuses to bolster staffing. Hospice aides/CNAs received an average sign-on bonus of $2,038, which was about half the amount that licensed practical nurses providing hospice care received ($4,056) and almost a third of the average sign-on bonus for registered nurses ($6,330) providing hospice care.

Respondents added that almost a fourth of staff outside of direct care — telehealth RNs, intake coordinators, triage RNs and administrative support staff — still was working remotely as of June 1. They expected that remaining remote employees would be required to return to working on‐site by June 1, 2023.

This is the 31st year the Hospital & Healthcare Compensation Services has conducted the annual Hospice Salary & Benefits Survey. Six-hundred-seventy-four hospices participated. Almost all of the respondents (98.96%) were Medicare-certified agencies.