The Complete Guide To
Employee Engagement For
Senior Care Organizations

Your best employees are your most engaged employees. They are the ones who look forward to coming to work in the morning, feel liked and respected and have the interests of your community at heart as they work with residents and each other.

So how can you go about boosting employee engagement in senior care? That is where this guide comes in. You'll learn how to develop a workplace culture that fosters communication, work-life balance and rewards and recognition. The end result is a workplace where employees want to stay long-term. This is critically important as the industry continues to face a workforce shortage and high turnover rates.

What Is Employee Engagement?

Employee engagement is often confused with employee satisfaction. The latter refers to how happy employees are, with no regard to their performance. Employee engagement is the “emotional commitment the employee has to the organization and its goals,” measured at least in part by the amount of “discretionary effort” an employee expends on behalf of the organization. In short, engaged employees are those who routinely go above and beyond without being asked.

Engaged employees lead to...

& Quality



Employee Productivity



Customer Satisfaction


Employee Retention






Unfortunately, engaged employees are probably a small percentage of your workforce. Current levels of workplace engagement are low. A recent Gallup study reported that only 29% of American workers are engaged in their jobs. Worse, another 18% of employees are “actively disengaged,” meaning that they dislike their jobs, are unproductive, and spread their negativity to others.


Let's Take A Look At The Numbers

Gallup research also found that companies with an average of 9.3 engaged employees for every actively disengaged one beat their competition by 147% in earnings per share (EPS), while those with fewer engaged employee have substantially lower EPS. Another study by Towers Watson finds that engaged employees have much lower turnover: 18% versus 40% for the disengaged. They also have lower rates of absenteeism: 3.2 versus 4.2 days per year.

This situation is particularly critical among senior care communities, which report annual caregiver turnover rates of up to 51%. In total, turnover is costing the long-term care industry $4.1 billion per year. What’s more, this doesn’t even count the intangible but very real cost of poor morale and lost productivity among disengaged and disempowered employees, along with its inevitable impact on quality of care.

A senior care community with 100 direct-care employees could be spending upwards of $250,000 a year.

Did you know that most turnover happens in the first 90 days? The tenure of an employee, and therefore the success of your entire workforce, hinges on their experiences in the three-month window after they are hired.

Turnover In Senior Care

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What Fosters Employee Engagement?

Engagement is formed through mutual trust: it is a tangible value that can be managed. It represents an implicit and often unspoken commitment to transparency, fairness and understanding between employees and the organization. According to organizational expert Edward Lawler, employee engagement revolves around providing employees with power, information, knowledge and rewards. However, simply making a verbal commitment to values like these – or even putting them into a mission statement – are not enough. What’s required are employee engagement practices that turn these values into action within day-to-day corporate and community activities.

"Employee engagement revolves around providing employees with power, information, knowledge and rewards."
-Edward Lawler, Organizational Expert

Consider the following five practical steps to increase employee engagement among your communities. Each step offers proven ways to empower your employees, so engagement increases and your staff stability grows, leading to higher quality throughout operations.

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Learn what Delta, Hilton & others are doing to attract & retain staff & how their strategies can be applied to senior care.

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Onboarding: Focus On The First 90 Days

Onboarding is one of the most critical parts of facilitating engagement among employees, right from the start. Employee turnover is the highest during the first 90 days of employment. This is especially true in long-term care and senior living, which has historically struggled with high turnover.

First Things First: Institute A Mentor Program

If you could just clone those employees who are considered your best and brightest, you’d be good to go, right? That’s exactly what a mentor or team coaching program is intended to do – take the skills, attitude, and habits of your best employees and make them available for other staff members to adopt.

To get started, work with your director of nursing or care director to determine a short list of mentor candidates among your staff. Base your short list on technical skills, customer service ratings and work attendance. Remember, a mentor can’t just be good at one thing – they need to be good at everything.

Once you have identified a pool of mentor candidates among your employees, they must be interviewed. Confirm your initial findings and determine if the candidates have the “extras” needed to become an effective mentor. These “extras” are based on the capacity, attitude and disposition of the candidates.

Instituting a mentor program is like having a proactive support line for your staff. Mentors play a huge role in engaging new and current staff members alike by routinely checking in to answer questions, teach and encourage them. And the bonus? These programs keep your mentors engaged through recognition of their expertise and their valuable feedback and input into key staffing practices and other community processes.

Mentor Shadowing Is A Must During Job Orientation

Mentor engagement is valuable to new hires because they are available to show them the ropes, answer questions and introduce them to other staff members. Mentors accelerate the process of new employees becoming self-sufficient and successful in taking care of residents. They also help ensure new employees are not overwhelmed.  

Treat The First Day As An Event

Treat a new employee like a special guest. A simple act like hanging a welcome sign is a powerful gesture that will leave a lasting impression on new hires. In addition, open the lines of communication from day one between staff members and leadership. Leadership should have an active role in general orientation by welcoming staff and having lunch with the new hires.

Assess Capabilities & Provide Feedback After Job Orientation

Job orientation is done, but is your new hire ready to fly solo? Mentors can help assess the capabilities demonstrated during the orientation process to determine if the new hire is ready. Remember, it’s okay if the new employee is not ready. The job of a mentor is to help employees be successful and their feedback is necessary in making this happen.

Track Your New Hire To Ensure Success

Use employee engagement software with onboarding dashboards that monitor new employees’ work performance – such as punching in and out on time and not calling off - to correct any issues and promote retention.

Implement A 30-Day No-Rotation Policy

Once new hires have demonstrated the skills to handle their own work load start them off slow and try to eliminate “curveballs.” Start new hires with two to three residents to care for and ramp up to a full work load once comfortable.

“I feel facilities should have a 30-day ‘no rotation’ policy for new hires. By providing familiarity in staffing assignments you are helping new hires develop confidence when interacting with residents and coworkers.”
Shelly Szarek-Skodny, CEO
Century Care Oak Center

Monitor Progress

After 30 days, the new hire’s supervisor should conduct a formal review to assess performance and establish goals to make sure they are both on the same page. It’s also a good idea to have the executive director or administrator check in to see how the new hire is doing. “Schedule a coffee meeting with new staff members after 30 days for one-on-one time to get their perspective on how things are going. This goes a long way in creating an open line of communication between staff and management" says Shelly Szarek-Skodny, CEO, Century Oak Care Center. Mentors should continue with weekly touch base meetings to talk, answer questions, and provide the guidance and support new employees need to be successful in their role.


So what steps can you take to make the most of an employees’ first 90 days? Here’s a handy cheat sheet.

  • Send the new employee a gift prior to their even starting the job to let them know how much you are looking forward to their joining the team.
  • Distribute an agenda for the first week on the job.
  • Schedule times for new employees to meet key staff members.
  • Assign a mentor to new hires to serve as a resource for questions and key information.
  • Put dates on your calendar to meet with the new employee to assess their progress & provide feedback throughout training.
  • Schedule a formal feedback session after 90 days in the new role.
  • Have management & leadership conduct frequent check-ins. Make sure that the employee has a fair workload, the equipment &  supplies to do their job &  that they are making friends.


Celebrate The 90-Day Milestone

By the time a new hire has made it to the three-month mark, it is not just a milestone – it should be a celebration! Mark this occasion with your community by acknowledging them at a company meeting, providing a certificate of accomplishment or creating a mini graduation ceremony. Make sure to also recognize the mentors that helped them along the way. Consider rewarding the mentors when new hires reach the 90-day benchmark with a financial bonus or thank you lunch. This will provide additional incentive to make each and every new hire successful and engaged with your organization.

Onboarding With A Purpose

Turnover is a massive problem, with costs reaching $5,000 to replace each lost employee, while also risking the care and service your residents receive. Download our latest whitepaper to learn tips and tricks to better onboarding in the first 90 days.

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Make Employees Part Of The Scheduling Process

When a parent is trying to get their child to eat their vegetables, one simple question often does the trick: “Which do you want, broccoli or carrots?” When people feel a sense of control, it’s much easier for them to buy in. The same principle applies to scheduling and your staff: if you give them a voice in the process and effectively communicate options, they will feel much better about the outcome.


Give Employees A Voice

To do this, you should start by asking each employee about their work preferences – what days do they prefer? What shift times? What unit are they most comfortable working in? Once preferences are identified, do your best to balance these requests with the needs of the organization. It’s unlikely that staff will get 100% of their requests but showing that you are listening and making attempts to meet their needs will not go unnoticed. After all, today’s workforce values work-life balance, so they’re likely to appreciate you working with them to build best-fit schedules.

Schedule Control Keeps Them Engaged

When it comes to the very central issue of work scheduling, your team members will feel more engaged if they have a greater sense of control over their own work schedules. Consider technologies and processes that allow staff to set their work availability preferences, request specific shifts and negotiate swaps and time off.

Keep Lines Of Communication Open

Make sure that scheduling communications are equal and open. When open shifts become available, notify all available and qualified employees instead of going to the same group of employees to pick up the shift. This will eliminate any perception of favoritism when filling shifts and it distributes extra shifts more equitably among your staff.

Boost Engagement By Going Mobile

One of the biggest complaints of employees – and one of the biggest detriments to employee engagement – is the perception that they aren’t in the loop. OnShift's staff scheduling and labor management software keeps staff informed by alerting them about shift opportunities via text, email, automated phone call, or mobile push notification.

Scheduling software on the market today gives employees 24/7 access to schedules from their mobile devices. They can even request PTO, swap shifts and pick up open shifts from their phones. And since employees can see when they work at all times, it holds them accountable to their schedules.

Survey Staff To Track Engagement Levels

How do you find out how engaged your employees are? Simple: you ask.

Conducting staff surveys allows you to see your organization through the eyes of your staff members. Surveys are critical in obtaining ongoing feedback from staff and improving internal processes. Your survey can be sent weekly or bi-weekly after each employee’s shift, as long as you are consistent in. your cadence. The question can be as simple as “how was your day?” with a rating scale of 1 to 5.

Measure Results

Measuring survey results is critical in pinpointing engagement levels among your workforce. Sounds simple enough, right? Except that it isn’t always that simple. What do you measure? How good is “good?” What do you do with this data?

These questions underscore the importance of using a formal survey to assess your level of employee engagement and tracking these results over time. Pay close attention to the ratings and look for trends in your data.

Strive For Perfection

According to a study by Xerox and Bain and Company, customers who rate a business “4” on a scale of 0 to 5 are six times more likely to leave for a competitor. In the same way, the goal of employee engagement is for survey items to have perfect scores. The worst thing you can do is settle for being average. Explore and troubleshoot areas where people rate you below the top score.

Look For Changes In Your Ratings

A subtle but important metric is the number of people who rate you with all perfect scores, particularly with a short survey. If the number of people who give you top scores across the board starts to drop, it deserves your attention – even if your overall numerical scores do not drop much.

Correlate Your Scores To Your Schedules

Consider mapping your engagement scores to patterns of employee work habits. For example, look at employees’ histories of calling off or even not showing up for shifts. Review your open shifts and how they get filled. How many of your employees have been willing and at the ready to help out when a shift opens up? Comparing survey scores to shift patterns and behaviors may uncover meaningful issues that are impacting your employees’ engagement with your organization.

Show You Value Employee Feedback

Allow staff to freely express their opinions by providing a comments section in the survey. Show them that you value their feedback by following up on these comments and working with employees and management to fix any issues expressed.

“It is often what people fill out in the comments that turn out to be most important and actionable."
Shelly Szarek-Skodny, CEO
Century Oak Care Center

Are Your Managers Driving Employee Engagement?

50% of employees, at some point, left a job to get away from their manager to improve their overall life. In fact, managers account for at least 70% of the variance in employee engagement. Managers Matter when it comes to driving engagement.

Access our white paper on the 7 Must-Have Manager Qualities That Drive Employee Engagement Today!

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Show Your Staff You Care

Your staff works hard each and every day – and let’s be honest – the work they do isn’t always easy. That’s why it’s crucial that providers make employees feel valued and do all they can to improve quality of life for them – at work and outside of it.

Start An Employee Rewards Program

Did you know that 69% of employees would work harder if they felt their efforts were better appreciated?

Providers can implement a points-based rewards system tied to behaviors such as regularly arriving to work on time, picking up open shifts and going above and beyond to provide quality resident care and service. Automated reward platforms track these metrics and distribute rewards as their earned and incentivize employees with leaderboards that highlight top performers.

Perks Over Pay

Given the current industry wage pressures, providers should evaluate how they can invest in their employees. Doing so not only attracts new people but keeps staff you have on hand happy and committed. Whether that’s health insurance, flexible spending accounts or stipends at a local gym, it’s these little “extras” that go a long way in building loyalty to your company.

One perk that has really picked up steam is offering some form of employee financial wellness. OnShift Wallet, for example, offers access to earned but unpaid wages between paychecks to help employees achieve financial stability. Just think of the horrific pay day loans and high interest debt employees escape when they have access to their money when a financial emergency occurs. A flat tire, an unexpected medical bill – you never know what life is going to throw your way.

Top Perks Senior Care Providers Offer

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Create An Employee Task Force

Use the information gathered from staff surveys to identify actionable areas to improve your business. Once you have identified the area of need, get staff involved to help address and resolve the issue by creating a problem-solving task force. When employees have a role in solving an issue, they tend to have greater buy-in – particularly when it is an issue they deemed important.

Select Members From Multiple Departments

When creating a task force, select members representing multiple departments to provide a wider range of perspectives. Also, keep the group to about five members to enable you to keep meetings focused and productive. Rotate task force members every quarter so you are able to include a wide range of employees in this valuable process.

Task force meetings should occur monthly for 30 minutes. This should be plenty of time to identify an improvement plan. Just stay focused. The administrator or executive director should be present to oversee and provide guidance when appropriate.

“It’s valuable to have the chance to act on employee feedback gathered in OnShift. Before OnShift we did not have a standard method or tool to consistently connect with our employees to measure their satisfaction, until we started to use OnShift Engage."
Lisa Whited, HR Director
Washington Odd Fellows Home

Boost Organizational Performance With Employee Engagement
Software For Senior Care

Employee engagement can be as all-encompassing as a top strategic initiative or as simple as purchasing a basket of inexpensive gifts to reward your employees. OnShift's easy-to-use employee engagement software that focuses on what matters most...your people.