Employee Turnover in Senior Care

Uh oh! The economy is good and seems to be growing. Millions of new jobs have been added. There may be more jobs open than qualified people to fill them. Is this a good thing or a bad thing? It’s actually good for employees but not so good for employers. When the economy is down and just scraping along, people hold on to their job, simply because there are a lack of them. When the economy is humming, employees can leave their current job for something better. So, employers need to retain their talent during times of high employee turnover. Let’s look into this a little deeper, shall we?

The Retention Problem in Senior Care

Employee turnover isn’t just bad for the budget. It effects much more than that. When employees are coming and going, many areas of care can and do suffer in the facility. Hospital rates may increase due to lack of continuity in care. Quality of care itself may take a downturn. Staff and resident morale may suffer. And then, of course, replacement costs are high.

Employees who stay may experience greater workloads and stress. They may become dissatisfied with a culture of high turnover and may feel that it will never end. There may be an increase in accidents, absenteeism, overtime costs and family dissatisfaction. In other words, high employee turnover has a trickle-down effect on the entire facility.

The unique and necessary care needs of seniors in long term care cannot be adequately met without competent staff who stay around for a good length of time. Continuity matters. Some studies indicate that up to 80% of STNAs leave during their first year of employment. The majority of these will quit within the first 3 months.

Factors Associated with Employee Turnover

There are many reasons why employees quit their job. Some reasons seem more common than others, and sometimes there are a multitude of reasons employees quit. Some will leave due to short staffing, or what I call “working skinny”. It takes a toll on those employees who stick around to pick up the pieces. Poor wages and benefits are others common reasons employees walk out and find employment elsewhere. One big cause for turnover is the relationship between the employee and their direct supervisor or manager.

Here are some other reasons employee quit:

• Lack of appreciation or recognition
• Disrespect from supervisors and managers
• Poor working conditions or environment
• A work schedule that fails to meet the employees’ needs or expectations
• Lack of role clarity
• A sense of low to no control over their job and performance
• Less experience in the field
• Lack of commitment

Hidden Costs of Employee Turnover

Regardless of the reason or reasons why employees leave, it hurts co-workers, managers, residents, families and others in one way or another. It also hurts the bottom line. Turnover is expensive. Some believe it is among the top 3 most expensive items in long term care, right behind payroll and food costs. There are a number of start-up costs when hiring a new employee including entrance paperwork, interviews, background checks, physicals, want ads, and recruitments efforts. After the employee quits, the costs don’t end. They include exit paperwork, exit interviews (if you can get them!), administrative time and functions, severance pay for administrative staff, overtime for remaining employees and much more.

Who Is Leaving?

I could be funny and say “everyone”, but no one would be laughing. Among the group of employees with the highest turnover rates in senior care are nursing assistants. STNAs, CNAs are whatever a facility may call them, provide the lion’s share of one-on-one care to residents. They are the ones who feed, bathe, dress, toilet and develop relationships with elderly residents who depend on their care. And, they are the ones leaving more than anyone else.

Nurses leave, too, and generally for the reasons I cite above. We are experiencing a shortage of nurses in the country as it already is, but add turnover to the problem and we are in trouble. Social workers leave because many are no longer performing “social work”, but are doing 2 or 3 jobs, including admissions. Many social workers have become disenchanted with their roles in long term care and have left the entire industry.

Administrators and Directors of Nursing may have a shelf life of 1.5 to 2.5 years. That is a shame. They are the leaders we desperately need, and they become burned out and move on. Other professionals also leave including activity professionals and environmental services (laundry and housekeeping).

Now What?

I once read a very good book on employee turnover and retention. The theme is either love your employees or watch them leave. Retention takes a lot of work. What keeps you at your job? Are you paid competitively? Have good benefits? How about your work-life balance? I believe that one of the most important areas in senior care requires constant efforts to retaining good employees. I have covered some of the problems and in another article, I will address how to keep good employees. Good luck with employee retention!

More About Recruiting and Retention

• How to Retain Good Employees
• Successful Employee Retention Strategies
• Recruiting the Best Employees

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