Tennessee LTSS Workforce Quality Improvement Survey 2023

Organization Characteristics

3% of services were provided in the west region, 93% in the middle region, and 4% in the east region. 3,761 people received services according to the 40 organizations who responded. 2,831 caregivers/direct support professionals (DSPs) and 199 Frontline Supervisors (FLSs) were employed. Of the 41 organizations who responded, 39% provided residential supports, 88% provided in-home supports, and 41% provided non-residential supports. Service types include 63% ECF CHOICES/1115 Waiver, 51% DIDD/1915c Waiver, 17% vocational rehabilitation, and 66% CHOICES (Non-ECF CHOICES)/1115 waiver.

Caregiver/DSP Employment

Of the 36 organizations who responded to employment types of caregivers/DSPs, 5% were on call or temporary employees, 34% were part-time, and 61% were full-time. 42% of caregivers/DSPs worked across more than one service type.

Caregiver/DSP Vacancy

Of the 40 organizations who responded, overall vacancy rate for caregivers/DSPs was 13%. 19% of part-time positions and 13% of full-time positions were vacant.

Caregiver/DSP Turnover

Overall, there was 61% annual caregiver/DSP turnover in 41 organizations. Of those who left their positions in 2023, 57% of caregivers/DSPs left within 0-6 months of hire, and 23% within 6-12 months of hire.

Organizations were asked to select why caregivers/DSPs left their job. Of the organizations who replied, 75% of organizations indicated caregivers/DSPs were no call/no shows, 66% indicated caregivers/DSPs found another job at another company, 53% indicated caregivers/DSPs were terminated/fired, 41% indicated the caregivers/DSPs were not a good fit for the type of work, 41% indicated caregivers/DSPs left because pay was too low and they needed better pay, 25% indicated they advanced to a new position within the company in a different service, 6% indicated they could not get along with their co-workers, 3% indicated they had too little or poor quality supervision, 0% indicated the training/support was inadequate, 0% indicated they were not recognized for their work, and 38% indicated some other reason.

Caregiver/DSP Wages

39 organizations reported wage data. The hourly starting caregiver/DSP wage was $14.62, the average caregiver/DSP wage was $15.06, and the highest caregiver/DSP wage was $16.70. 12% of organizations paid caregivers/DSPs different wages across service types.

Caregiver/DSP Benefits

66% of organizations offered health insurance to some or all caregivers/DSPs. On average, 24% of caregivers/DSPs were enrolled in health care plans. 44% of organizations offered paid time off, 16% offered sick leave, 26% offered paid vacation, and 19% offered paid personal time to some or all caregivers/DSPs.

Caregiver/DSP Overtime

For the 31 organizations reporting, a total of 437,661 hours of overtime were paid out to caregivers/DSPs in 2023, costing organizations a total of $3,197,769.

FLS Wages

Of the 32 organizations reporting, the average starting frontline supervisor (FLS) annual salary was $40,280. The average FLS annual salary was $46,151. The highest FLS annual salary was $52,510.

FLS Turnover

Overall, there was a 18% FLS turnover rate in 34 organizations reporting. Of those FLSs who left their positions in 2023, 21% of FLSs left within 0-6 months of hire, and 27% left within 6-12 months of hire.

FLS Vacancy

The overall vacancy rate for FLSs in 35 organizations who reported was 6%.