Staff turnover has reached unsustainable levels in the skilled nursing sector, with some staff – particularly certified practical nurses (CPNs) – leaving faster than they can be replaced.
And it goes beyond just raising wages.
Despite a 7.13% national increase in CNA hourly pay in 2021, turnover has still increased significantly at the position — rising to 59.95% from 39.38% in 2020.
Finding ways to keep CNAs in place and filled over the long term will be key to building a better-qualified nursing workforce for the future.
According to Activated Insights CEO Dr. Jacquelyn Kung, promotion from within is one of the ways some of the most skilled nurse operators have been able to separate themselves at a time when most of the industry is facing challenges of similar endowment.
“We want to hire people and grow them,” Kung said during a panel discussion last week at the Skilled Nursing Staffing Summit. “As an industry, on average 15% of our roles are promoted from within. Now look at that compared to hospitals who promote nearly half of their leaders from within. Same with hotels and the retail business.
Kung said hotels and retail promote up to a third of their roles from within, while senior living or senior housing is closer to 17 or 18%.
She and other space thought leaders spoke about how skilled nurse operators need to prioritize their CNA workforce to get ahead through better communication, more flexible way and by providing training and other educational opportunities.
Kung said some of the top skilled nursing providers fill around 40% or more of their roles from the inside, which directly translates to lower turnover as employees then feel like they have a future. within the organization.
“The good news is there are things we can do about it,” Kung said. “We can stand out as employers, we can focus on purpose, and we can promote from within at much higher rates because the best in our industry are doing it.”
More CEOs and upper-level leaders in nursing homes need to think and talk about promoting from within, as it will result in a ‘huge drop’ in staff turnover and a ‘great increase in engagement’ “, she said during the panel.
In fact, employee engagement isn’t just about a community or organization’s mission statement, according to Charles Turner, managing director of digital job marketplace Kare.
Turner said there are “misconceptions” about energy and the operators’ focus on their culture. Company culture means more than a common set of beliefs, processes and rituals and just because a company “has a better culture” doesn’t mean it’s the facility a candidate will automatically choose. .
“Mission statements are fun, but that’s not going to entice the next caregiver to come work for you,” Turner said.
Workforce trends are very clear, Kung added, with skilled nursing facilities receiving fewer applicants and lagging in employee engagement compared to other sectors.
While the latest jobs data shows the health care sector increased by 28,000 jobs in May, only 1,300 of those were nursing home jobs, according to the Bureau of Labor Statistics (BLS ).
Make the CNA role a viable long-term career path
Part of the problem with retention in the SNF industry, at least for Lori Porter, co-founder and CEO of the National Association of Health Care Assistants (NAHCA), is that being a CNA is no longer considered a career. viable in the long term. path.
Porter pointed to research conducted by NAHCA that found only 6% of CNAs want to be nurses, while 34% are interested in being nursing home administrators — but there’s no pathway for that currently.
Providing additional training and opportunities for specialization in primary care roles is one way to tackle the problem.
In fact, CNAs wanting to remain “caregivers” is one of the reasons Activated Insights launched an apprenticeship program with a major Midwestern vendor.
“For every certification you earn, you get paid 25 cents to $1 more [per hour] and it can happen as quickly as every six months,” Kung said.
The elder care provider is said to have implemented a suite of at least five such learning programs through which they have enabled their CNAs to progress while offering other incentives like tuition reimbursement, according to Kung.
“It’s called skilled nursing for a reason,” Porter said. “You have to have skills and those skills have to be trained.”
However, it is not just about providing more education and training opportunities to help CNAs and other frontline staff grow. Facilitating the hiring of new hires will also be key, especially with the Temporary Nurse Aide (TNA) waiver now over.
The waiver allowed certified nursing trainees, or TNAs, to work as caregivers longer than the federally mandated four months before taking a state exam. If hired after June 7, TNAs will have four months from their hire date to meet testing requirements, CMS said.
“The temporary nursing program and the ability to obtain labor and drive that labor quickly from facilities has been exponentially successful from an operator perspective,” Jalene said. Carpenter, president and CEO of the Nebraska Health Care Association. “Our members say this is what we need the most. We have to find ways not to overwhelm someone, but to involve them and give them hands-on training.
Surveys are another tool used by vendors to solicit feedback, gauge responses, and reduce revenue.
Transmit the message
Better communication can be one of the most tangible ways skilled nurse operators can improve retention within their company.
“You can’t engage with your staff if you can’t communicate with your staff and too many facilities still rely on bulletin board communications,” Porter said.
There are still facilities that don’t collect CNA email addresses, according to Porter, and the lack of consistent engagement is one of the “fundamental reasons” why frontline employees feel disrespected.
“I strongly urge any facility to use this or any necessary communication tool, app or otherwise, to be able to have that level of communication, because that’s where the engagement starts,” Porter added.
Kung also advocated for operators to use SMS more with their staff.
“Text messages were read and bounced between 40 and 70 percent of those who received them, which is much higher than email, which is typically between 10 and 20 percent,” she said. declared.