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A Perfect Storm: High Turnover & Increasing Demand for LTC Workers

March 20, 2015 | Irene Fleshner


recruit and retain ltc employees“I am finally fully staffed, and then one of my employees resigns.” How often have you experienced this situation?  If you’re like many senior care operators, this happens all too frequently.  A study entitled “Entry and Exit of Workers in Long Term Care” conducted by the University of California San Francisco Health Workforce Research Center on Long-Term Care (HWRC) found that the rate at which workers are leaving LTC is outpacing the entry rate across all LTC sectors.  And this situation promises to get more challenging as the demand for LTC workers is expected to increase as the population ages.  For example, skilled nursing facility employment is projected to grow about 24% between 2012 and 2022. 

So in order to stem the tide of turnover, it is important to understand our workforce and characteristics associated with turnover of LTC workers.  The study identified that the LTC workforce is comprised predominately of women, with minorities representing about 40 percent of the workforce.  The researchers found that those who stayed in their positions tended to be married and have higher annual wages while those who left were younger, worked part time, were likely to have children under age 5 and be lower wage earners.  Many of the leavers held unskilled positions, especially in hospitality and maintenance, and the rate of poverty was relatively high among entrants and leavers across all of LTC.  The researchers recommend investment in training and education to increase recruitment and retention of these low income, unskilled workers.

While I think training and education is important, I’m not convinced that it, alone, will change the turnover issues in LTC.  As we all know, there is no one size fits all answer.  Each organization and its workforce are different.  The most important factor is to gain a clear understanding of your own workforce and the issues that are important to them. Consider taking a quality improvement approach. Collect and analyze your data so you can identify the root cause of your turnover challenges.  Once you understand your workforce and what’s important to them you can develop targeted recruitment and retention strategies.

The key to achieving quality care and patient and resident satisfaction is through a stable, committed quality workforce.  With the median turnover in skilled nursing facilities at 44% in 2012 and the rapid job growth that is projected to occur, we will all need to have a renewed focus on strategies to recruit and retain employees.

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Recruit, Engage, Retain

Operational Excellence

Payroll-Based Journal

About Irene Fleshner

Irene Fleshner, RN, MHA, FACHE, serves as a Principal for Reno Davis & Associates and the Senior Vice President for Strategic Nursing Initiatives for Genesis HealthCare.

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