Pay and benefits for home care, hospice, palliative care and long-term care nurses haven’t always been on par with nurses who work in the acute setting.
But that has changed for post-acute care nurses in the past five to 10 years, according to Andrea Devoti, MSN, MBA, RN, executive vice president of the National Association for Home Care and Hospice.
There are many areas of the country where employers’ salary and benefits packages for these other nursing roles match or are getting close to matching what they offer acute care nurses. That’s because more employers realize that home care, hospice, palliative care and long-term care patients often are as sick as those in the hospital, Devoti said.
“We take care of sick people,” Devoti said. “We take care of ventilated children. We give chemotherapy. We give intensive care level drugs in some cases.”
Employers’ greater awareness of the complexities of taking care of patients outside the hospital setting is timely, given many want to add the post-acute care services because of increased demand.
The National Hospice and Palliative Care Organization reported in its Palliative Care Needs 2018 Survey Results that out of 347 responses from hospice and palliative care member organizations, 53% are providing palliative care services and an additional 35 are considering developing these services.
Only 12% have no plans to develop palliative care services, according to the report.
Are employers meeting post-acute care nurses’ needs?
Nurses in acute care, home care, long-term care and other healthcare settings say salary is most important for job satisfaction, followed by benefits, according to our 2018 Nursing Salary Research Report.
The survey represents responses from 4,520 RNs from 50 U.S. states, the District of Columbia and Puerto Rico.
Although nearly three-quarters of the nurses surveyed ranked salary as the No. 1 aspect of job satisfaction, 15% indicated benefits, including medical and tuition reimbursement, were most important for work satisfaction.
Nursing salaries for home care, hospice, palliative care and long-term care nurses are close to those of nurses in the acute care setting, Devoti said.
In general, these post-acute care nurses might earn $1 per hour or so less than nurses in acute care but that’s better than the pay disparities of $5 or $6 an hour that Devoti said she used to see.
Employer benefits for home care, hospice, palliative care and long-term care nurses often rival those of the acute care setting, but not always, she said.
“We have many health system-affiliated home care, hospices and long-term care facilities that have the same benefits across the continuum,” Devoti said. “There are a number of home care and hospices that are still freestanding, meaning they’re not really affiliated with a health system or an integrated system, so they actually may have lesser benefits when it comes to tuition reimbursement and continuing education reimbursement than the hospitals.”
Jennifer Yost, RN, home hospice case manager at Penn Medicine’s Neighborhood Health in West Chester, Pa., has been a nurse for eight years.
She most recently worked in hospice but has also worked in long-term care and correctional nursing.
Yost, who said the most important benefit to her is quality, affordable medical insurance, noted Penn Medicine’s benefits do not disappoint in comparison to the correctional industry and long-term care.
Nurses appreciate employer’s education benefits
Tuition benefits might be particularly important to nurses born after the baby boomers.
Nearly 80% of millennial nurses, ages 19 to 35, and 57% of Generation X nurses, ages 36 to 56, indicated they planned to earn higher degrees to boost salary potential. That’s compared to less than a quarter of baby boomers, 57 to 74 years old.
Yet, less than half of those surveyed reported receiving tuition reimbursement and 39% received continuing education reimbursement, according to our survey.
Nurses in long-term care and home care skew a little older than in acute care. That’s because many nurses who come out of school think it’s best to get experience in the hospital setting first, not realizing all the experience they can get in home care and hospice, Devoti said.
Still, tuition reimbursement ranks high as a priority for Yost, a generation Xer and diploma-trained RN. Yost plans to go back to school to get her master’s because Penn Medicine offers tuition reimbursement, she said.
“I think the benefits package that I currently have is definitely a factor in deciding to stay where I am,” Yost said.
But it’s not all about dollars and benefits
One of the things that nurses in these settings want that isn’t a tangible benefit is recognition, according to Devoti.
“Nurses in home health and hospice care and long-term care arenas want that professional acknowledgement that all nurses want,” she said. “They want to be acknowledged for skills and expertise.”
Human resource professionals and nurse recruiters should acknowledge nurses who have five years’ experience in any of these areas are equally as qualified as nurses from other areas of the profession, Devoti said.
“Home care, hospice, palliative care and long-term care is clearly as much of a specialty as any on the acute care or primary care sides,” Devoti said. “I think that our nursing colleagues in those arenas have many times felt disenfranchised with the way sometimes they’re treated.”
Take these courses related to post-acute care roles:
Hospice and Palliative Care: Right Patient, Right Time, Right Place
(1 contact hr)
The use of hospice and palliative care services continues to grow in the U.S. However, confusion about what the programs offer remains. This educational activity compares services and reimbursement for hospice and palliative care programs. The goal is to educate nurses so they can discuss options with patients and make appropriate referrals based on patient and family goals of care.
Becoming a Home Health Nurse
(2.5 contact hrs)
According to statistics and projections from the National Bureau of Labor and the Health Resources and Services Administration, the need for nurses skilled at providing care to patients in their homes is growing. This is a good time to consider a career in home health nursing. This course provides an overview of the type of care provided by home health nurses, their roles and responsibilities, and the challenges associated with home healthcare.
Nursing Home Inspections
(1 contact hr)
Nursing home surveys aim to ensure that nursing homes meet national standards of care. The process is detailed in federal regulations. This module provides an overview of the survey process and explains why facilities receive the scores they do. It offers examples of deficiencies and the corrective action needed.