Tennessee LTSS Workforce Quality Improvement Survey 2023

Organization Characteristics

31% of services were provided in the west region, 35% in the middle region, and 33% in the east region. 10,876 people received services. 10,753 caregivers/direct support professionals (DSPs) and 1,484 Frontline Supervisors (FLSs) were employed. Of the 109 organizations who responded, 41% provided residential supports, 83% provided in-home supports, and 48% provided non-residential supports. Service types include 55% ECF CHOICES/1115 Waiver, 50% DIDD/1915c Waiver, 18% vocational rehabilitation, and 72% CHOICES (Non-ECF CHOICES)/1115 waiver.

Caregiver/DSP Employment

Of the 98 organizations who responded to employment types of caregivers/DSPs, 5% were on call or temporary employees, 42% were part-time, and 53% were full-time. 41% of caregivers/DSPs worked across more than one service type.

Caregiver/DSP Vacancy

Of the 107 organizations who responded, overall vacancy rate for caregivers/DSPs was 13%. 17% of part-time positions and 14% of full-time positions were vacant.

Caregiver/DSP Turnover

Overall, there was 58% annual caregiver/DSP turnover in 112 organizations. Of those who left their positions in 2023, 55% of caregivers/DSPs left within 0-6 months of hire, and 24% within 6-12 months of hire.

Organizations were asked to select why caregivers/DSPs left their job. Of the organizations who replied, 76% of organizations indicated caregivers/DSPs were no call/no shows, 65% indicated caregivers/DSPs found another job at another company, 63% indicated caregivers/DSPs were terminated/fired, 41% indicated the caregivers/DSPs were not a good fit for the type of work, 36% indicated caregivers/DSPs left because pay was too low and they needed better pay, 19% indicated they advanced to a new position within the company in a different service, 15% indicated they could not get along with their co-workers, 6% indicated they had too little or poor quality supervision, 6% indicated the training/support was inadequate, 4% indicated they were not recognized for their work, and 30% indicated some other reason.

Caregiver/DSP Wages

108 organizations reported wage data. The hourly starting caregiver/DSP wage was $14.55 , the average caregiver/DSP wage was $15.01, and the highest caregiver/DSP wage was $16.69. 12% of organizations paid caregivers/DSPs different wages across service types.

Caregiver/DSP Benefits

64% of organizations offered health insurance to some or all caregivers/DSPs. On average, 29% of caregivers/DSPs were enrolled in health care plans. 38% of organizations offered paid time off, 20% offered sick leave, 31% offered paid vacation, and 21% offered paid personal time to some or all caregivers/DSPs.

Caregiver/DSP Overtime

For the 86 organizations reporting, a total of 2,056,452 hours of overtime were paid out to caregivers/DSPs in 2023, costing organizations a total of $14,853,713.

FLS Wages

Of the 85 organizations reporting, the average starting frontline supervisor (FLS) annual salary was $39,526. The average FLS annual salary was $43,336. The highest FLS annual salary was $50,890.

FLS Turnover

Overall, there was a 17% FLS turnover rate in 91 organizations reporting. Of those FLSs who left their positions in 2023, 32% of FLSs left within 0-6 months of hire, and 28% left within 6-12 months of hire.

FLS Vacancy

The overall vacancy rate for FLSs in 93 organizations who reported was 6%.