Recruiting and retaining a skilled, motivated workforce continues to be one of the most vexing issues facing the industry, especially as competition has extended far beyond the nursing home down the street.
There is no one “silver bullet” to solve the workforce crisis and staffing solutions are often market specific, industry leaders say.
Indiana-based Majestic Care, for example, recently rolled out an employee focused benefits program that offers incentives such as perfect attendance bonuses, cell phone plans and, in some locations, subsidized housing.
Majestic Care manages 37 skilled nursing facilities in four states.
By far, the perfect attendance bonuses and cell phone plans have been two of the most popular items, according to Majestic Care CEO Bernie McGuinness.
Despite those programs being generally well-liked, there still seems to be notably varying responses from one building to the next — even those across the street from one another.
What was perhaps most surprising to McGuinness, however, was the lukewarm response by staff to the opportunity for discounted housing.
“That’s kind of been a dud for us in most markets. We only have one market where the staff seem to embrace it. I don’t know if it’s a trust issue … But we’re continuing to do it and reinforcing those things,” he said during a panel discussion at the Skilled Nursing News Rethink conference.
To be able to better understand what benefits and flexibilities a staff member wants and needs to stay in a position long-term, an employer must first understand why employees are leaving in the first place, according to Aegis Therapies President and CEO Martha Schram.
Some of the top reasons for turnover at Aegis are family circumstances, the setting, the position or number of hours worked and compensation, she said.
“We talk a lot about value propositions but we have to be a value proposition to our staff or they’re not going to stay — and if the only thing is money, they’re not going to stay very long because the next person who offers them more, they’re going to be gone,” she said during the panel.
Operationalizing flexibility, work-life balance
In many ways, the last two-plus years has catapulted many providers, including Aegis, into developing and honing new service models, including telehealth, Schram said.
Such opportunities have created new clinical pathways, but also new remote or hybrid work opportunities for Aegis as flexibility remains one of the biggest buzzwords coming out of the pandemic.
Aegis had 33 applicants apply for one of their remote positions — a remarkable feat considering as of late one or two applicants for 40% of their open positions was considered a win.
The company is also in the process of developing its own scheduling app to help facilitate the ability for staff to work outside of the traditional eight hour shifts if they so choose.
Aegis has additionally seen success in its decision to provide health coaches and offer personal finance resources through its employee assistance program.
And Aegis is setting agnostic overall, which allows staff to have the flexibility of working in as many, or as few, health care settings as they would like.
McGuinness also touched on the need for providers to boost the overall behind the scenes recruiting infrastructure, such as using analytics to better define the types of candidates applying, interacting with the human resources staff and showing up to an interview.
“We’ve always tracked admissions, discharges, referrals … We’ve taken that talent acquisition team and defined roles kind of like a listing and a closing agent in real estate,” he said.
Majestic Care has seen an uptick in hiring over the last six months and has been able to eliminate agency staffing in 13 of its facilities through these tactics and others — including their own internal float pool which has grown to 80 employees.
Overall, Majestic Care has reduced agency spend by about 50% which amounts to almost $3 million, he said.
Going beyond the classroom
Given the decreasing supply and expected surging demand over the next several years, both Schram and McGuinness agreed much work is still to be done to build back up the labor pool.
Aegis has worked to accelerate its relationships with universities and has just this year introduced 75 students to a career in long-term care — and hired “a good chunk of them,” Schram said.
Taking it one step further, McGuinness said he has spoken with a group of local lawmakers about offering a paid certified nursing assistant (CNA) apprentice-type program during a student’s senior year of high school — similarly to an electrician or a plumber.
That way the student could go on to becoming a licensed practical nurse (LPN) or licensed vocational nurse (LVN) right after high school, he added.
While it is clear no one is sitting idly by waiting for hundreds of thousands of caregivers to rejoin the long-term care workforce, Schram has seen some workers who previously left return.
Aegis is reaching out to anyone who has left the organization over the last 18 months to share the different opportunities and flexibilities the company now has to offer.
“I know it sounds kind of cliche and corny but you know the grass wasn’t always greener on the other side … We’ve made a lot of changes,” she added.
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