Competition for Frontline Workers Heats Up Between Nursing Homes

The toughest rival nursing homes face amid this historic staffing shortage may be one another.

While there have been some gains in recent months, the number of workers in long-term care is still far below pre-pandemic levels. With only a finite number of nurses in the worker pool to choose from, nursing homes are inevitably competing with one another for staff — leading to an increase in poaching.

“We’re not just the victims of it, we’re the perpetrators of it every chance we get,” Quality Life Services Chief Administrative Officer Susie Tack Beardsley told Skilled Nursing News. “We’re all fighting for the same nurses. I keep referring to it like a game of musical chairs except when the music stops and everybody sits down, there’s not enough people. There are just chairs.”

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In fact, she’s seen the competition between nursing homes only intensify over the last few months.

“We just had a situation occur in one of our markets where, and this is the first time this has happened to us, where one particular player in that market came in and just put all their chips in and went huge with rates,” Beardsley said. “The answer could be that we go huge plus $1, but we can’t, I’m not even sure how they’re doing it.”

For Beardsley, it’s become all about finding the “sweet spot” when it comes to wages.

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“You can’t afford to be the highest payer, but you can’t afford to be the lowest,” she added.

Thomas Annarella, nursing home administrator at Illinois-based Valley Hi Nursing & Rehabilitation, described it as somewhat of “a race” to see from a pay standpoint who can attract the most nurses from other buildings.

“Certified nursing assistants (CNAs) are all over the place and we’re seeing a lot of increase in CNA pay rates in our area,” he said.

Annarella competes with six facilities in his immediate market space and said his nurse to patient ratios are the highest in the area. Though he admitted that in denser areas the competition is likely much greater.

He avoids getting staff poached to other facilities by keeping a “close eye” on how Valley Hi compares to the market and by making sure that their pay rates are in line.

Feedback and surveys

Pennsylvania-based Concordia Lutheran Ministries’ President and CEO Keith Frndak said he “absolutely” sees poaching from other facilities and doesn’t see it changing any time soon.

“We are getting applicants from a lot of other facilities and we pay more and the combination of compensation and staffing ratios has put us in a superior position,” he said. “We’re getting a lot of frontline people, nurses, food service workers, housekeepers, nursing assistants, we’re getting quite a bit of throughput from other organizations and I don’t think that’s going to change.”

One way Concordia has prevented losing workers to other facilities is by investing in and prioritizing getting worker feedback through frequent reviews and exit interviews.

“We’ve bolstered our orientation programs and we also are conducting interviews annually to make sure people are good,” he said. “When someone does leave, we automatically counter offer them and do exit interviews to find out the reason for their departure.”

“We’ve saved about one in three staffers from leaving that way,” he added.

Managers have also looked to regularly touch base more frequently and several times a week for the first couple of months when a new employee is hired to make sure they are transitioning well.

Valley Hi created an “employee council” that makes sure its staff’s needs are heard and addressed.

“Rather than just doing surveys, which we were not getting the results back that we wanted, we created an employee council that’s run by the employees,” Annarella explained.

He said it was an opportunity for the employees themselves to talk about what’s going on and put a few ideas on the table to work on.

“We were surveying our employees annually on their anniversary month and we just changed that to quarterly. It’s a shorter survey, we’re just giving it more frequently with quicker feedback,” Beardsley added.

Responding to the market

Frndak admits he continues to watch the market and his competitors closely and adjust accordingly.

“We’ve had four wage increases in two years and that’s over 25 locations,” he said. “We do market surveys and we try to be in the top 10%. Unfortunately, what many of our competitors are doing is paying more, but extending ratios.”

One of his best strategies in keeping staff long-term is to offer benefits.

Despite some agencies paying a higher hourly rate than him, Frndak said he’s been able to attract new staff and keep staff on for longer by offering a strong benefit package that, in the end, better compensates them despite the hourly rate difference.

“We’re doing things to make people more aware of the benefits and the value of the benefit packages they have,” he said.

Flexible scheduling has become Quality Life Services’ best tools to compete for staff.

“We’re seeing the generational differences between what Millennials are looking for versus what Gen Z’s are looking for play out in our buildings,” Beardsley said.

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