How to Improve Staff Retention in Assisted Living Facilities

September 13, 2021

When you hire a new employee, you hope they'll remain on the job for years to come. Staff retention is a concern in any industry, as constantly having to search for, hire, and train new team members can costs companies quite a bit. Turnover is of particular concern in the senior living facility industry, as low retention rates affect the quality of care and residents' lives.  

Assisted Living Staff Turnover Rates

High nursing turnover rates make it difficult for facilities to maintain the appropriate staffing levels to provide the recommended amount of direct nursing care each day. Most skilled care facilities can only provide 3.8 hours of direct care to residents daily, just shy of the 4.1 hours recommended.

One study published in Health Affairs in 2021 took a novel approach to calculate nursing turnover rates at senior living facilities. The study examined 492 million nursing staff shifts to determine the turnover rate. Using data from payroll-based journals, it examined the percentage of hours a person worked, calculating a higher rate for those who worked more.

It found a median turnover rate of 94% for nursing staff. The average turnover rate was 128%, and some facilities had turnover rates above 300%, The New York Times reported.

The Impact of Aged Care Staff Turnover on Senior Living Facilities

When a facility struggles with nursing staff retention, some of the effects are as follows:

  • Decreased health of residents: The residents at an assisted living facility often rely on a team of nurses for care. They are likely to get better care when they work with the same people consistently. That's because the nursing staff gets to know each resident and their specific needs. But when turnover is high, there's less familiarity, and residents don't get the care they need. That can increase their risk of developing other illnesses.
  • Increased cost of care: When residents' health declines, the cost of caring and treating them often goes up. Increased care costs affect an assisted living facility's bottom line, which can lead to it making cuts in other areas, such as staffing or activities.
  • Decreased job satisfaction: High turnover rates can affect the mindset of employees who remain. A nurse who stays when their colleagues are leaving might start to wonder if there is something better out there, or they might start to feel resentful of their job. If their responsibilities increase and people leave, they are likely to have lower levels of on-the-job satisfaction.

The Importance of Nurse Retention

Ideally, your facility will be doing whatever it can to increase assisted living staff retention and keep people working there for as long as possible. A care facility stands to benefit in several major ways when staff turnover is kept to a minimum. Adopting measures that increase staff retention improves the quality of care your residents receive, and improves the work-life balance of your team, allowing you to better streamline operations.

More Knowledge and Experience

Is it better to keep a highly paid, highly experienced registered nurse on staff or to replace them with a lower-paid, less experienced person? 

Replacing highly paid individuals with employees who will accept lower salaries can seem like a cost-cutting move. But it might be better for your organization's bottom line and the quality of care your offer to keep the staff members you have, even though you may need to pay them more than a new hire.

In addition to the financial cost of turnover, there's the knowledge cost to consider. A nurse with years of experience on the job knows their patients and what they need or expect. A recent graduate might have skills and knowledge on paper, but they don't yet have the knowledge that can only be gained after working for many years. 

When nurses are constantly leaving positions, they don't get the opportunity to build up those years of knowledge and experience.

Additionally, when a person working in nursing or with older adults for many years leaves, they take with them the skills they've gained. You lose their knowledge of each resident's needs and preferences and the rapport they've built up over time with their colleagues, managers, and patients. It can take years for a new hire to gain that sort of expertise and know-how.

Improved Quality of Care

Retaining the same staff can increase the quality of care residents at an assisted living facility receive. The longer people are on the job, the more they know about the particular facility and its residents. They can better spot subtle signs that something may be amiss with a resident and are they are also likely to be more trusted by residents when they remain at the same facility for longer, increasing resident and family satisfaction of that facility.

Furthermore, there's a direct connection between the quality of a facility and its staff retention rate. Every 10% increase in staff turnover results in a 16.5% increase in a facility's deficiency ratings.

Strategies to Retain Nurses in Senior Living Facilities

If high turnover is an issue at your assisted living facility, it can be worthwhile to adopt a strategy that aims to increase retention and reduce employee churn. Although retention efforts can cost money, in the long run, they often help facilities save. Earning a higher Five-Star Quality Rating and being recognized as offering high-quality care to residents also makes retention strategies worth that cost. 

1. Increase Incentives

Offering employees incentives can make the workplace more attractive and make them feel valued as team members, and the incentives your facility offers don't have to be elaborate. One option is to provide food or meals to employees. For example, your facility can stock the break room or nurse's station with snacks or provide meals to people on the job. One study found that offering employees prepaid groceries to take home helps keep team morale up.

On a practical level, offering incentives that make employees feel protected and valued will help them stay on the job. Ensuring team members have appropriate personal protective equipment (PPE) is one way to improve your facility's reputation and make it a place where people want to work.

The same is true of providing people with adequate paid time off. If an employee doesn't have to worry about their employment status if they need to take a day or more off when they are sick, they are more likely to stay at a job. 

2. Improve Scheduling

Scheduling nurses at an assisted living facility can get complicated, as you need to have a certain number of people on for each shift. You are likely working with many "pool" workers who aren't full-time or who don't work a regular schedule. You might have people who call out at the last minute, leaving you scrambling to find a replacement. 

In addition to scheduling your nursing team, you also need to schedule support staff, such as dining and housekeeping staff, nurse aides, and front desk staff. 

Using a schedule optimizer maximizes scheduling with little hassle. You can use the software platform to fill in shifts and schedules without resorting to overtime. If someone does call out, the tool helps you find a substitute quickly. And, if there are open shifts, staff can receive notifications to their smartphone with the option to claim the shifts if they'd like to work more hours.

Scheduling software also lets you plan schedules far enough in advance that employees know where they need to be and when. Giving your team ample notice of when they are expected at work helps them plan the rest of their lives, increasing their stability. When they have steady hours and know their schedule in advance, team members are much less likely to move on to a new position. 

Sometimes, facilities might have several different software programs in use—one for the nursing team, one for the dining staff, and one for the maintenance team, for example. Using separate programs can give each department a level of autonomy but can also create confusion when it comes to scheduling and payroll. 

Finding a program that works for each department helps you streamline operations, reduces confusion, and ensures there are the appropriate staffing levels at all times. When your nursing team doesn't feel overextended, they are more likely to remain at their job.

3. Make the Right Hire

Reducing employee turnover starts with hiring the right people from the start. Improve your hiring process by ensuring the job description matches the responsibilities and requirements of the role. You might need to update descriptions, especially if you find you are getting applications from people who are over or underqualified for the position, While an overqualified individual might not find the work fulfilling and might be more likely to leave the role sooner.

Applicant screening software lets you prescreen potential hires with questions and sort applications as they come in. From there, you can reach out to the candidates who seem like they might be a good fit and set up interviews.

When you have interviews, it's best not to go overboard with the number of people you bring in. Choose the top five candidates from applications and schedule interviews with them. If you're having difficulty narrowing the pool, you can send a pre-interview questionnaire or set up 10-minute phone interviews with a deeper pool of applicants. The phone interview process will help you weed out people who aren't a good match. It also allows candidates to decide for themselves whether a job is worth pursuing.

4. Increase Employee Engagement

A nursing staff that isn't invested in the workplace or that doesn't care about the residents will provide a lower quality of care than a staff of engaged and enthusiastic employees. One way to increase engagement among your team members is to empower them to manage their schedules. Giving your team the tools to request time off or update preferred workdays can help individual employees feel more invested in the workplace. 

Employee engagement software also lets you connect with each team member when they clock in and out for the day. You can program the software to send each employee a message at the start and end of their shift, letting them know you appreciate their efforts and the work they are doing.

Another way to boost employee engagement is by making it easy for staff to get the information they need when they need it. Workforce management software puts your nursing team's information at their fingertips. 

If they need time off, they can submit the request instantly with the software from their mobile phones. They don't have to pay a visit to HR, fill out physical forms, or track down their supervisor for a signature. They can also easily update their information as needed, such as if they move, change their name, or need to change their W-4 information.

5. Identify Issues Before They Become Major Problems

It could be the case that some members of the nursing team are more likely to call out than others. Detecting certain behaviors early on, such as frequent call-outs or tardiness, gives you the opportunity to address them before they lead to a nurse leaving or getting let go. If you use a software program that tracks attendance or awards points for attendance, you can set up a meeting with team members who regularly miss shifts or come in late. 

It could also be that they need to change when they work or how much they work, or they could have a problem that they feel is unaddressed, which causes them to call out. Getting to the bottom of the issue lets you take the appropriate steps before it's too late.

6. Offer Training and Growth Opportunities

Another way to keep people on the job longer is to give them the chance to learn and grow at work. In many cases, nurses need to complete continuing education (CE) programs to maintain their licenses. Offering those programs on the job or giving people paid time off to complete their CE credits can increase their loyalty to your facility. As a bonus, you gain an experienced and knowledgeable team for your facility.

Request a Demo of SmartLinx Today

Software can streamline the process of scheduling and managing employees at your assisted living facility while increasing their engagement and making them feel like part of a team. If you decide to use software, you need a product designed with the needs of a senior care facility in mind. 

Scheduling software designed for use by any type of business won't necessarily have the built-in compliance features needed to help with Payroll-Based Journal (PBJ) reports or other regulatory requirements. SmartLinx software is built with the needs of senior care facilities in mind. It helps you streamline operations, increase staff engagement, and boost your retention rate.

If you're concerned about your turnover rates and how high turnover affects your facility's quality rating, adopting a workforce management solution can be the way to go. SmartLinx software helps you manage your team before and after hiring. Schedule a demo today to learn more.

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