2024 Survey and Profiles

Wellpoint, UnitedHealthcare, and BlueCare TN have collaborated for a seventh year with TennCare and the Institute on Community Integration (ICI) at the University of Minnesota to conduct the annual Tennessee Long-Term Services and Supports (LTSS) Workforce Quality Improvement Survey about the direct support workforce in Tennessee. The survey is a key component of a comprehensive workforce strategy in the Quality Improvement in Long-Term Services and Supports Initiative in Tennessee. Data gathered each year from this survey are used to inform ongoing discussions and planning about wages, benefits, ways to find and keep qualified and committed caregivers and/or direct support professionals, and enhance access to home and community-based services for people with intellectual and developmental disabilities, physical disabilities, and older adults in Tennessee.

The Year 7 2024 Tennessee LTSS Workforce Quality Improvement Survey is now complete. Survey results are organized into state and regional profiles and outlined in a survey report. Participating organizations also receive a customized data summary about the direct support workforce in their organization.

For more information about the University of Minnesota's efforts on this survey, please contact dsp-tn@umn.edu.

2024 Survey Report

This report provides an overview of state level data in Tennessee. Survey items were also analyzed by region when there was a large enough sample size for analysis. Unless otherwise specified, responses to survey questions reflect calendar year 2024. Most of the report focuses on the results from year 7. Changes to the sample and data collection process that have taken place over the 7 years and workforce development recommendations that emerged from the survey results are also discussed. While there were 118 organizations that participated in the survey, not all organizations answered all questions.

View the 2024 Survey Report

2024 State & Regional Profiles

The 2024 state and regional profiles for Tennessee provide an overview of the direct support workforce for the 118 organizations in Tennessee that responded to the survey. Profiles highlight data on service types and sites, staffing, wages and benefits, turnover and vacancy, and other key data points from information collected in the survey.

Each organization who participated in the survey received an individualized profile that summarizes all the workforce data they submitted at an organization level. Respondents chose whether they wanted to share their organization profiles with managed care organization (MCO) leads in Tennessee for the purposes of technical assistance and training around workforce development initiatives.

If you are an organization who participated in the survey but did not receive a data profile summary, please email dsp-tn@umn.edu.

Use the buttons below to view the Tennessee state and regional profiles:

State

East

Middle

West

Survey Guidance Webinar to Complete the Annual Year 7 Survey

This year’s survey opened on June 2nd, 2025 and invitations to participate in the survey were sent to organizations mid May.

Your involvement and willingness to participate in this survey is voluntary. Partaking in this survey will provide you with important data to target your improvement efforts and to measure your agency’s progress over time. Your agency’s contributions also help to inform future workforce initiatives that may include development of additional workforce tools and supportive training opportunities to address the workforce crisis.

If you are unsure about how to fill out the survey, please watch the webinar below.

The survey guidance webinar is designed to support people who are completing the survey. People who complete the survey should have access to personnel data, benefits information, and financial knowledge. There may be multiple people in your organization who provide information for this survey. Team members will be available for any questions you may have about completing the survey.

Frequently Asked Questions

We operate in multiple states. For the section on Revenue, should I answer these questions based on data from all states we operate in, or should I limit my responses to Tennessee only?

Since this is the Tennessee survey, we're specifically looking for information relevant to Tennessee.

I’m not sure if I should take the survey. These questions don’t apply to our organization.

If you received the survey link, we would like you to take the survey. For more information about this, please watch the webinar. If you have any questions, please contact dsp-tn@umn.edu.

I did not receive a link to the survey and am not receiving any emails. Who can I contact?

If you did not get a link to the survey, please email dsp-tn@umn.edu with your organization name to request a link. We will respond within 1 business day. You can also access a paper copy of the survey at z.umn.edu/TN-workforce.

Does the online version of the survey save? Can I come back and make edits?

You can leave and re-enter your survey as often as you would like, using your personal link. Once you submit the survey, you cannot return to the survey and make any edits. Do not click submit until your survey is fully complete.

How is this data useful or beneficial?

Statewide, this data collection process serves as part of a larger initiative to collect and monitor key workforce data and use it to make data driven decisions that support efforts to strengthen and stabilize direct support workforce (direct support professionals and caregivers) who provide long term services and supports to either people with intellectual and developmental disabilities or older adults and/or adults with physical disabilities.

For example, the results of this survey are used to inform workforce initiatives, such as the DSP Academy, Apprenticeship Program, LINCS, statewide Workforce Task Force groups, provider trainings and opportunities for additional toolkit resources.

At the organization level, providers will receive an individualized data profile that outlines many key workforce metrics at their organization. Organizations who have taken the survey in the past have found this data useful to inform the implementation of individual workforce strategies. Individualized organizational profiles also allow organizations to compare their data to state, regional, and national data to see where you stand and where they can improve. The seventh year of data collection will continue to inform workforce programs and other initiatives in the state of Tennessee.

What is the definition of a caregiver or direct support professional (DSP)?

Direct Support Professional (DSP): A DSP is a paid worker whose primary responsibilities include providing support, guidance, personal assistance, or help with skills development during any activity or at any location (e.g., at work, at home, leisure activities, recreational activities) to adults with intellectual and developmental disabilities (IDD). They may have titles such as Direct Support Workers (DSWs), Personal Care Assistants (PCAs), Employment Specialists (job coaches), Home Health Aides (HHAs), Community Integration Specialists, and many other titles.

Direct support work is their primary job responsibility and at least 50% of their hours are spent in direct support tasks doing direct support work. DSPs may perform some supervisory tasks, but their prime focus of their role is spent doing direct support tasks.

Caregiver: A Caregiver is a paid worker whose primary responsibilities include helping clients to maintain independence, providing personal assistance with Activities of Daily Living (ADLs) [dressing, grooming, toileting, personal hygiene, eating, and basic clinical tasks (helping with prescribed exercises, administering medication, monitoring vital signs, etc.)], assisting with housekeeping, grocery shopping and cooking, accompanying clients to doctor appointments or other errands, companionship, providing support in community engagement, day centers or other day activities, and respite support to older adults and/or people with physical disabilities. Certified Nursing Assistants (CNAs) should be included IF the nursing care they provide is basic (monitoring vital signs, cleaning wounds, helping with prescribed exercises, applying or changing bandages, or administering medications).

Caregiving work is their primary job responsibility and at least 50% of their hours are spent doing direct care and support tasks. Caregivers may perform some supervisory tasks, but the prime focus of their role is spent doing direct care tasks.

Do NOT include:

• Workers who are On-call or PRN, hired through a contract or 1099 arrangement, or a temporary personnel agency, unless otherwise specified
• Clinically licensed staff (registered nurses, licensed practical nurses (LPNs), psychologists, social workers, therapists, etc.), behavior specialists, behavior clinicians, or behavior technicians (BCBA)
• Caregivers that work exclusively in nursing homes
• Those who only provide transportation, home modifications, and/or meal delivery services
• Administrative or supervisory staff, unless they spend 50% or more of their time doing direct support work

Regarding host/foster/family home arrangements: Please respond only about Caregivers/DSPs who are employed and work in addition to the primary shared living/foster care provider.

Regarding Fiscal Intermediaries or Employers of Record for Caregivers/DSPs working for people who are self-directing their own services: If your agency functions solely as a fiscal intermediary or employer of record, please do not respond to this survey.

What is the definition of a frontline supervisor (FLS)?

Frontline Supervisor (FLS): A FLS is an employee whose primary responsibility (more than 50% of their role) is the supervision of Caregivers/DSPs (as defined above). While FLSs may perform direct support tasks, their primary job duty is to supervise employees and manage programs. They are not viewed by the organization as Caregivers/DSPs. These individuals may or may not be in licensed or degreed positions (such as a nurse), but the organization views their role as guiding and directing the work of Caregivers/DSPs more than 50% of their time. FLSs may include house managers if their duties are not primarily direct support. FLSs’ responsibilities usually include conducting performance reviews of Caregivers/DSPs.

We hired frontline supervisors (FLS) to provide supervision duties for more than 50% of the time per their job description, but they have been working as Caregivers/DSPs for more than 50% of the time because of staff shortage. Do we consider them a FLS or a Caregiver/DSP?

We request that a person within an organization be counted as either a Caregiver/DSP or FLS for this survey. They should not be counted as both a Caregiver/DSP and FLS. Organizations will need to determine if they want to consider FLSs who may be working as Caregivers/DSPs for more than 50% of their time due to staffing shortage as FLSs or Caregivers/DSPs. Part of this decision may be determined based on how wages are paid, benefits are provided, and so forth, so that other questions in the survey may be answered accordingly.

Questions 24 and 25: If Caregivers/DSPs start at one salary and increase in two weeks after completing their required training, would this be considered a bonus or just a rate adjustment?

Question 25 asks specifically about a monetary hiring bonus for newly hired Caregivers/DSPs. A hiring bonus is an extra amount of money provided at the time of hire as an incentive to an applicant to accept a job offer or to make up for compensation forfeited at the previous company. Question 24 asks specifically about an hourly wage increase for Caregivers/DSPs once training is completed. In the example given, it sounds like it would be a rate adjustment (question 24) rather than a hiring bonus (question 25).

Question 26: The average number of hours worked per week. How do I calculate this? Do I report the total number of hours or average number of hours per Caregiver/DSP?

We are looking for the average number of hours worked per week per Caregiver/DSP. You would add up the number of hours worked, including overtime hours, across all DSPs in a week and divide by the number of Caregivers/DSPs. If you can split it by part-time and full-time Caregivers/DSPs, you would also do this calculation for them separately.