The State Of Caregiver Turnover & Tips For Turning It Around

New data shows that while the pandemic has led to an increase in hourly wages for senior living CNAs, turnover has significantly increased over the past year - climbing from 36.37% in 2019 to 48.51% in 2020. This skyrocketing turnover is not isolated among CNAs, as the rate across all assisted living employees increased from 44.05% in 2019 to 53.11% in 2020. This is in spite of the recent pay raises most of these positions are receiving. What's more, the skilled nursing sector fares far worse, with CNA turnover currently sitting at a rate of 120% 

The Detrimental Effects Of Employee Turnover In Senior Care

We all know that high turnover is expensive, costing organizations $3,000-$5,000 to replace each lost employee. That means that an organization with 100 direct-care employees could be spending upwards of $250,000 a year.

Other than being costly in terms of dollars, high employee turnover compromises quality and continuity of care. Research from the Centers for Medicare & Medicaid Services (CMS) has found a direct correlation between staffing levels and quality outcomes. Being short staffed means your current employees are working longer hours, which can lead to burnout and compromise their ability to provide care and notice critical changes in resident acuity and behavior. Additionally, continuity of care is also compromised as new caregivers must get acquainted with the unique needs of each resident. Constant turnover can also negatively impact resident satisfaction, as it takes time to form those bonds that make this line of work so special.

High frontline staff turnover rates also negatively impact company culture. People are more comfortable and happier when working alongside colleagues they know. Having to constantly get re-acquainted with new coworkers makes for a less desirable work environment. Plus, the behavior and attitudes of those at risk of turnover could be hindering morale and engagement across the team.   

High employee turnover can also hurting your recruitment efforts. People talk, and those that leave disgruntled often aren’t shy to tell their friends who work in the industry about their experience and post about it on social media and job boards. 

Tips For Preventing Employee Turnover In Senior Care

Turnover prevention starts with a focus on the employee experience. Are you showing each one of your team members – from new hires to tenured employees – that they are valued for their contributions? Are you doing all you can to support staff both personally and professionally? Asking yourself these questions is a great first step in facilitating a culture that encourages employees to stay long term and show up for work each day ready to give their undivided attention to the residents they serve. Here are a few of the top strategies providers are putting in place to create an employee-centric culture and reduce turnover.

Ensure New Hires Feel At Home

Research shows that 40% of all turnover in LTC and senior living occurs within the first 90 days of employment. The easiest way to find out why that is (and correct it) is to keep a close watch on new employees and survey them at key at key points during the onboarding process.

OnShift Engage, our employee engagement software, for example, sends an automated series of questions 7, 14, 30, 60 and 90 days after their start date. Employees are asked to rate statements such as I feel welcome at my community, I understand the policies and procedures that relate to my job duties and My supervisor(s) supports me to do my job. They can then provide optional feedback, either anonymously or choosing to identify themselves. OnShift Engage has helped providers better understand and refine their onboarding process, ultimately leading to a reduction in turnover of up to 33%.

Measure Staff Satisfaction In Real Time

Surveys can also be used for more tenured employees to gauge overall job satisfaction and to swiftly address and correct issues that might lead to turnover. Frequent staff surveys not only boost engagement, but they offer management an inside look at what employees are experiencing in the day to day. And many providers we work with have been able to make numerous process improvements within their organizations as a result. Pulse surveys, like those in OnShift Engage, are sent straight to employees’ phones post-shift and ask them to rate their day using a five-point emoticon scale.

Staff can provide additional details in an optional comment and remain anonymous if they choose to. These open-ended questions can be a gold mine for understanding the struggles and triumphs of your employees. Many providers have received valuable feedback in the optional comment section of our pulse surveys. In fact, when given the option to elaborate, 55% of OnShift Engage pulse survey respondents leave a comment.  

Keep in mind, it’s crucial to address problems that are brought to light as quickly as possible. The same goes for employees who leave comments about ongoing issues. Not reaching out fast sends the message that staff feedback is not valued nor taken seriously. 

Consistently Reward & Recognize Contributions

Employees want to know their hard work is noticed and appreciated by management. Providers recognize this, as over half of Workforce 360 survey respondents say investing in employee rewards and recognition technology is a top priority. 

Employee engagement platforms directly tie rewards to behaviors that support the community’s stated mission, vision and values – such as punching in and out on time, not calling off, picking up open shifts and providing exceptional care.

Using a systematic rewards program makes it easy for management to distribute rewards and gives employees visibility into their progress and how to earn them. OnShift Engage uses an automated points-based rewards system that tracks employee behaviors so contributions can be rewarded.

Promote Work-Life Balance

Offering more flexible schedules is critical to retaining staff during the crisis and into the future. Many of our customers have implemented new shift times (i.e. shorter shifts at peak times or 12-hour shifts) and continuously work directly with frontline staff to determine their availability and offer best-fit schedules. Additionally, many have begun offering mobile schedules, giving staff the ability to check when they work, pick up open shifts and request PTO anytime, anywhere. These efforts have been critical in helping organizations fill gaps in the schedule and show their commitment to improving life for their employees.

Our Workforce 360 survey revealed that employee scheduling is a high priority technology investment for 70% of organizations. This signals that many providers are looking to upgrade their current scheduling software or invest in platforms to replace their homegrown solutions.

Conduct Stay Interviews

Stay interviews are brief, casual conversations with existing employees and can offer a wealth of insight into the reasons employees stay with a company—as well as the reasons they leave. These 15-20-minute interviews can help save providers the time and money associated with hiring and training new employees.

“We’re a big fan of stay interviews because we want to learn why someone would leave before they leave and we want to get to know every associate,” says Tommy Comer, Chief Human Resource Officer at Commonwealth Senior Living. “They’re a way to personalize things and engage someone in a dialogue with their direct supervisor to find out what’s important to that person and where there are those potential sore spots. We like to ask the questions like, ‘how do you want to be recognized when you do a great job?’ and ‘What are those reasons you could leave?’”

Providers should, of course, be prepared to make changes based on the information gathered in a stay interview. When employees see their employer is willing to adjust to accommodate even a small need or concern, they’ll be more likely to stay and more motivated to work to support the company’s mission.

Similarly, exit interviews can offer a wealth of insight into the daily lives of employees.

Make Mental Health A Priority

Mental health initiatives have taken center stage throughout the pandemic and should continue to be a staple in the senior care industry. This is due to the unfortunate reality that the pandemic has exacerbated many of the challenges frontline workers face daily – especially those related to burnout and compassion fatigue. Our research uncovered that over half of organizations cite difficulties managing fear and anxiety among staff. Providing mental health resources and tools, as well as regularly checking in with employees, reduces the stigma surrounding the subject and shows employees their employer cares about them on a personal level.

Take a fresh look at your EAPs (employee assistance programs) and determine how you can incorporate more resources to support mental health – such as stipends for counseling and/or bringing in mental health professionals to do regular mindfulness sessions. Use pulse surveys to gauge not only job satisfaction, but employee wellbeing. You’d be shocked to learn how many employees are willing to share their thoughts and fears in this kind of forum. Providers that use our employee engagement software have been able to uncover and connect with those that need some extra support.

Support Staff Like Never Before

The little things you do for staff send a big message – one that says that you care about their wellbeing and are invested in helping them live better lives. A simple thank-you note or a gift card for going above and beyond speaks volumes. Larger gestures might include career development opportunities, access to earned wages before payday to promote financial wellness and a commitment to keeping staff safe on the job with a contactless clock-in experience.

Reducing turnover in senior care is all about focusing on the employee experience. When employees feel supported and valued, they tend to stay with their employer long term – and of course, demonstrate their loyalty by taking excellent care of residents.