Bonuses or wage being paid to a healthcare worker.

Hospice workers saw relatively high wage growth and sign-on bonuses in the last year, according to the 2023-2024 Hospice Salary & Benefits Report released this week from the Hospital & Healthcare Compensation Service. 

Registered nurses in hospices received raises of just over 4.5%, on average, and their national hourly pay totaled just above $45, according to the report, which was made in partnership with the National Association for Home Care & Hospice. The report surveyed 704 hospices across the United States, including those aligned with home health agencies, hospitals and freestanding hospice providers. Licensed practical nurses saw similar wage growth at about 4.3%, but hospice care aides (HCAs) received the highest reported raises at just over 6.8%.

Beyond wage growth, RNs also earned some of the largest reported sign-on bonuses among hospice positions, at nearly $7,000, on average. Sign-on bonuses for LPNs and HCAs roles were lower, at around $4,700 and $2,300, respectively. In recent years, hospices and home health agencies alike have used wage growth and bonuses for recruitment and retention as a tool to solve high rates of turnover and staff vacancy. 

“Sign-on bonuses have been a key factor in addressing workforce challenges and attracting new employees. Continued wage increases since 2019 have helped with retention as well as new hires,” Rosanne Zabka, director of reports at Hospital & Healthcare Compensation Service, said in a statement to McKnight’s Home Care Daily Pulse. “In 2023, employee retention is improving, turnover is declining, and hospices have been able to reduce how much they increased wages by while still remaining externally competitive.”

Enticing sign-on bonuses 

This year, more than 55% of hospice providers reported offering sign-on bonuses as a means of bringing talent in the door. Though year-over-year turnover rates for RNs, HCAs and LPNs declined for the first time since 2019, they still approached 30% for each of these positions. Still, RN turnover saw notable progress, decreasing from 29% in 2022 to 25.5% this past year. 

Still, stubborn turnover statistics have affected boots-on-the-ground staff. Fewer employees means more work for those that stick around, according to Zabka. Average caseloads for RNs, HCAs and LPNs all increased in 2023, she noted.

Modest wage growth for hospice execs

Top-level hospice staff also earned modest wage growth in 2023. Executive directors and chief executive officers saw their salaries increase more than 3.8%; the average salary grew from $224,034 last year to $232,614 today. Still, median salaries for these positions lagged behind those for home health providers. The median salary for a home health CEO was $208,588, whereas it was only $176,731 for a hospice CEO.

Human resources saw the sharpest wage growth at hospices in 2023. HR coordinators and generalists each earned raises approaching 9%. Meanwhile, wages for positions like chief information officers and information technology managers grew by only 0.8%.