MDS Alert

Administrators have never had more reasons to invest in employees.

With the long-term care industry losing at least 380,000 workers since the beginning of the pandemic, keeping workers around is a crucial aspect of doing business. If it seems like the situation now is worse than it has ever been, the numbers paint a chilling reality. Now more than ever, facilities need to focus on keeping employees around.

“It’s more efficient to retain quality employees than to recruit, train, and orient a replacement employee of the same quality,” says Kathy Burkhardt, MSL, RHIA, at an AAPC HEALTHCON Regional presentation in Charleston, South Carolina, in October 2021.

Don’t Faint from the Numbers

The long-term care industry has lost at least 380,000 jobs since the beginning of the pandemic, according to statistics from the U.S. Bureau of Labor. A recent American Health Care Association and National Center for Assisted Living (AHCA/NCAL) survey shows just how the stark the numbers are: 99 percent of nursing homes and 96 percent of assisted-living facilities are facing a staffing shortage.

“Industry employment has fallen every month except one since the World Health Organization declared Covid-19 a global pandemic in March 2020. By contrast, job losses in the leisure and hospitality industry, another hard-hit sector, began reversing in May last year, and the industry has recovered almost 80% of the jobs that were lost in the first months of the pandemic,” said Mark Parkinson, president and CEO of AHCA/NCAL, in an Oct. 19 letter to Lina Khan, chairwoman of the Federal Trade Commission. Parkinson claims that direct care staffing agencies are deliberately price gouging facilities in desperate need of staff.

Define Your Brand by Your Employees

No one knows what the culture of your business is like better than your employees, and just like anything else, word-of-mouth advertising is potent.

Employees are the “public face” of a business, and their experience is how their family, friends, and other networks, including professional contacts, will get to know the organization.

“Happy and engaged employees will spread the word about how proud they are to work for your organization,” Burkhardt says. This can lead to other talented folks joining the business, taking some of the recruiting pressure off managers. The inverse is also true: An employee who feels undervalued or disrespected won’t hesitate to tell people, and may even warn others away from joining that organization.

In his letter to Chairwoman Khan, Parkinson mentions the lengths that facilities are going to now to hire and maintain staff: “sign-on bonuses, wage increases, bonuses when someone fills a shift, calling staff who have left to entice them to come back, referral bonuses paid to staff for each employee they recruit, gift cards, providing free meals to staff, using agency staff to supplement, tuition reimbursement, PTO, flexible scheduling and providing staff training and education.”

Turnover is Annoying and Expensive

If you’ve ever hired an employee, or even been involved in the hiring process, you know that it can be a huge time suck. But hiring costs tangible dollars as well.

“Turnover costs have a significant negative impact on a company’s performance,” Burkhardt says. Although the expense may not be obvious, recruitment advertising, lost productivity, and new hire training and onboarding all cost money, as well as time and energy.

As you incorporate a new hire into your team and workflow, regardless of how talented and smart the new team member may be, you’re going to experience a decrease in productivity and level of service until they’re acclimated, she says. This drop-off in knowledge and service impacts patient satisfaction, as well as team cohesion and efficiency.

If your organization’s culture isn’t wholly focused on valuing employees, you may be facing even more turnover as the pandemic continues to burn out healthcare workers and cause a seismic shift in personal priorities and society at large.

Jobseekers are doing their own research, and the market is competitive both ways. The combination of an immense need for workers and better incentives makes the long-term care industry particularly competitive.

“Candidates research potential employers before they apply, so organizations need to showcase their culture and values via social media, and utilize an engaging career site to shape a candidate’s first impression of your employer brand,” Burkhardt says.

Nursing homes have an especially tough staffing reality, because their employees are everything: facilities rely on attracting and retaining residents to stay in business, and employees are responsible for providing person-centered, comprehensive care. Nursing homes have to juggle keeping multiple populations happy, engaged, and healthy, and so much stems from employee happiness.

Don’t Pigeonhole a Good Candidate

When hiring to fill a vacancy, you need the candidate to be able to perform the job responsibilities and fulfil the expectations of a role. But in some situations, you should hire for potential and not skills, Burkhardt says.

For example, if someone applies to an entry-level job at your organization, aces the interview, seems like an ambitious problem solver, and clicks in all the right ways, you’ll want that candidate to join the team. But maybe you’ll worry that the entry-level position won’t hold their interest or engagement long enough, and there isn’t a clear path for advancement in that particular job within your organization. If you feel strongly that the person is well suited for your organization, but the job won’t be a good fit, you can hedge your bets on asking the candidate to wait.

Burkhard spoke of a situation where a candidate was a great fit, but she worried that the potential employee would be bored by the role advertised. Burkhardt recommended the candidate pursue specific training for a managerial role instead, and months later, hired the candidate for a job with more responsibilities, and the new team member thrived.

Make Mission Central to Staffing

Employees and jobseekers are looking for a workplace with a reputation for excellent culture and a clear mission, she says.

Establishing and maintaining a clear mission can ground your recruiting efforts, too. That way, you have the framework with which you can find employees whose personal values align with your organization’s mission, she says. This approach may help you sort through candidates to find prospective employees who genuinely want to be at your organization, instead of just candidates who just want a job.

“Look for a cultural fit,” Burkhardt says. “If people are aligned to your culture, they tend to be more effective at their jobs.” In other words, happy and valued employees are more productive.

But don’t feel like this is on your shoulders alone, as the hiring manager. Human resources (if you have a human resources role or department), recruiters (if applicable to your organization), and managers should work together as a team to make hiring decisions, she says.

Ultimately, nursing homes are in the business of providing care, and they rely on employees to keep residents healthy and safe. Happy, knowledgeable, confident employees are critical to good care and good business.