Hospice Clinician Wages Rising at Slower Rate; Turnover Falling

Wages for hospice clinicians continue to go up amid widespread staff shortages, but they grew at a slower rate in 2023 compared to the prior year.

The national average hourly rate for Hospice registered nurses rose 4.58% in 2023, down from a 5.95% increase in 2022, according to a new report by the Hospital & Healthcare Compensation Service (HCS) in cooperation with the National Association for Home Care & Hospice (NAHC).

Meanwhile, turnover rates declined in 2023, representing the first drop in several years, the report indicated.

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“For the first time since 2019, year-over-year turnover rates for RNs, LPNs, HCAs and Administrative Support Staff in hospices declined, after steadily increasing and peaking in 2022,” HCS indicated in a statement. “Turnover rates for RNs decreased to 25.53% in 2023, from 29.15% in 2022; LPN turnover was 29.97% in 2023, compared to 31.52% in 2022; HCAs dropped slightly from 29.84% in 2022 to 28.18% in 2023.”

Nationally, hourly wages for hospice RNs reached $38.08 this year, but geographic variations exist. Hourly rates are highest in California, for example, at $53.74, and lowest in Mississippi at $32.90. Other outliers include Massachusetts ($45.08), Connecticut ($45.15) and on the lower end of the spectrum, Tennessee ($33.93).

LPNs saw a 4.32% wage increase nationwide in 2023, and aides received a 6.23% pay bump. Social worker wages went up 3.78%, as well as a 2.58% increase for chaplains.

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The report takes into account base pay only and does not include bonuses or benefits. The effective date of the research is July 1, 2023.

About 704 hospice providers submitted data on nearly 25,000 employees nationwide via electronic and printed questionnaires that included summary job descriptions and questions about bonuses and fringe benefits. Of those, more than 43% were freestanding hospices; 50% were operated by home health companies and about 7% were affiliated with hospitals.

Nearly 99% of the respondents were Medicare-certified organizations. HCS began performing salary and benefits studies in 1971. 

In addition to the base wage increases, a majority of hospice providers continue to offer bonuses.

“55.54% of participants reported offering sign-on bonuses to attract new employees,” the report said. “RNs received an average bonus of $6,948, with 39.61% of participants reporting bonus data; 19.48% of participants provided bonus data for LPNs, with an average bonus of $4,741; [home care aides] received an average bonus of $2,354, with 24.03% of participants reporting.”

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