At Lumina, where staff turnover has run 80 percent higher than usual, “we’ve had job postings for months without any applicants at all,” Dr. Kao said. It has begun offering $2,000 bonuses for registered nurses.
Hospice aides, who are usually certified nursing assistants, are being lured away, too, sometimes leaving health care entirely. “When they’re getting paid in the low double digits and Amazon pays twice that, it’s hard to compete,” Mr. Banach said.
Vaccination resistance is also shrinking hospice staffs in states — roughly 20, according to Leading Age, which represents nonprofit senior care providers — that mandate shots for health care workers.
Hospice organizations have supported such mandates, and report that most workers have complied. But losing even a few resistant hospice staff — perhaps five percent in New York State so far, Ms. Chirico estimated — could bring temporary closures, wait lists or higher caseloads for the remaining staff. (Rules for the Biden administration’s federal mandate, governing all health care providers that receive Medicare and Medicaid funding, including hospices, are expected soon.)
Hospice organizations received aid through several rounds of federal pandemic relief, but they need more to rebuild their staffs, Mr. Banach said. They could also benefit from changes in immigration law to help bolster the work force.
Those kinds of changes take time, however. Hospice workers require specialized training. Even if scrambling hospices could hire nurses tomorrow, it would take several months for most to be fully ready to work with dying patients.
“It’s going to be a tough six months,” Ms. Hansen predicted; other administrators interviewed found her statement optimistic.