Tennessee LTSS Workforce Quality Improvement Survey 2023

Organization Characteristics

Less than 1% of services were provided in the west region, 4% in the middle region, and 96% in the east region. 3,554 people received services according to the 34 organizations who responded. 3,508 caregivers/direct support professionals (DSPs) and 370 Frontline Supervisors (FLSs) were employed. Of the 36 organizations who responded, 53% provided residential supports, 78% provided in-home supports, and 58% provided non-residential supports. Service types include 53% ECF CHOICES/1115 Waiver, 53% DIDD/1915c Waiver, 28% vocational rehabilitation, and 72% CHOICES (Non-ECF CHOICES)/1115 waiver.

Caregiver/DSP Employment

Of the 32 organizations who responded to employment types of caregivers/DSPs, 3% were on call or temporary employees, 41% were part-time, and 56% were full-time. 40% of caregivers/DSPs worked across more than one service type.

Caregiver/DSP Vacancy

Of the 36 organizations who responded, overall vacancy rate for caregivers/DSPs was 14%. 21% of part-time positions and 19% of full-time positions were vacant.

Caregiver/DSP Turnover

Overall, there was 51% annual caregiver/DSP turnover in 37 organizations. Of those who left their positions in 2023, 58% of caregivers/DSPs left within 0-6 months of hire, and 21% within 6-12 months of hire.

Organizations were asked to select why caregivers/DSPs left their job. Of the organizations who replied, 80% of organizations indicated caregivers/DSPs were no call/no shows, 72% indicated caregivers/DSPs found another job at another company, 76% indicated caregivers/DSPs were terminated/fired, 52% indicated the caregivers/DSPs were not a good fit for the type of work, 48% indicated caregivers/DSPs left because pay was too low and they needed better pay, 16% indicated they advanced to a new position within the company in a different service, 32% indicated they could not get along with their co-workers, 12% indicated they had too little or poor quality supervision, 16% indicated the training/support was inadequate, 8% indicated they were not recognized for their work, and 32% indicated some other reason.

Caregiver/DSP Wages

37 organizations reported wage data. The hourly starting caregiver/DSP wage was $14.56 , the average caregiver/DSP wage was $15.14, and the highest caregiver/DSP wage was $17.46. 8% of organizations paid caregivers/DSPs different wages across service types.

Caregiver/DSP Benefits

62% of organizations offered health insurance to some or all caregivers/DSPs. On average, 47% of caregivers/DSPs were enrolled in health care plans. 38% of organizations offered paid time off, 26% offered sick leave, 39% offered paid vacation, and 30% offered paid personal time to some or all caregivers/DSPs.

Caregiver/DSP Overtime

For the 33 organizations reporting, a total of 717,867 hours of overtime were paid out to caregivers/DSPs in 2023, costing organizations a total of $5,534,533.

FLS Wages

Of the 29 organizations reporting, the average starting frontline supervisor (FLS) annual salary was $38,714 . The average FLS annual salary was $40,886. The highest FLS annual salary was $45,950.

FLS Turnover

Overall, there was a 17% FLS turnover rate in 30 organizations reporting. Of those FLSs who left their positions in 2023, 28% of FLSs left within 0-6 months of hire, and 42% left within 6-12 months of hire.

FLS Vacancy

The overall vacancy rate for FLSs in 30 organizations who reported was 7%.