Tennessee LTSS Workforce Quality Improvement Survey 2023

Organization Characteristics

95% of services were provided in the west region, 3% in the middle region, and 2% in the east region. 3,561 people received services according to the 32 organizations who responded. 4,414 caregivers/direct support professionals (DSPs) and 915 Frontline Supervisors (FLSs) were employed. Of the 32 organizations who responded, 31% provided residential supports, 81% provided in-home supports, and 44% provided non-residential supports. Service types include 47% ECF CHOICES/1115 Waiver, 47% DIDD/1915c Waiver, 9% vocational rehabilitation, and 79% CHOICES (Non-ECF CHOICES)/1115 waiver.

Caregiver/DSP Employment

Of the 30 organizations who responded to employment types of caregivers/DSPs, 7% were on call or temporary employees, 53% were part-time, and 40% were full-time. 40% of caregivers/DSPs worked across more than one service type.

Caregiver/DSP Vacancy

Of the 31 organizations who responded, overall vacancy rate for caregivers/DSPs was 10%. 12% of part-time positions and 10% of full-time positions were vacant.

Caregiver/DSP Turnover

Overall, there was 62% annual caregiver/DSP turnover in 34 organizations. Of those who left their positions in 2023, 49% of caregivers/DSPs left within 0-6 months of hire, and 28% within 6-12 months of hire.

Organizations were asked to select why caregivers/DSPs left their job. Of the organizations who replied, 74% of organizations indicated caregivers/DSPs were no call/no shows, 57% indicated caregivers/DSPs found another job at another company, 61% indicated caregivers/DSPs were terminated/fired, 30% indicated the caregivers/DSPs were not a good fit for the type of work, 17% indicated caregivers/DSPs left because pay was too low and they needed better pay, 13% indicated they advanced to a new position within the company in a different service, 9% indicated they could not get along with their co-workers, 4% indicated they had too little or poor quality supervision, 4% indicated the training/support was inadequate, 4% indicated they were not recognized for their work, and 17% indicated some other reason.

Caregiver/DSP Wages

32 organizations reported wage data. The hourly starting caregiver/DSP wage was $14.46, the average caregiver/DSP wage was $14.80, and the highest caregiver/DSP wage was $15.83. 18% 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, 15% of caregivers/DSPs were enrolled in health care plans. 31% of organizations offered paid time off, 19% offered sick leave, 29% offered paid vacation, and 15% offered paid personal time to some or all caregivers/DSPs.

Caregiver/DSP Overtime

For the 22 organizations reporting, a total of 900,923 hours of overtime were paid out to caregivers/DSPs in 2023, costing organizations a total of $6,121,411.

FLS Wages

Of the 24 organizations reporting, the average starting frontline supervisor (FLS) annual salary was $39,436. The average FLS annual salary was $42,543. The highest FLS annual salary was $54,492.

FLS Turnover

Overall, there was a 18% FLS turnover rate in 27 organizations reporting. Of those FLSs who left their positions in 2023, 44% of FLSs left within 0-6 months of hire, and 16% left within 6-12 months of hire.

FLS Vacancy

The overall vacancy rate for FLSs in 28 organizations who reported was 4%.