Nursing Home Leaders Connect with Staff in New Ways to Drive Retention

With the federal staffing mandate pending, many nursing home operators are looking for ways to retain their current staff.

Research has shown that the role of regional clinical leadership – and the turnover rates of NH administrators (NHA) and directors of nursing (DON) – have an impact on overall quality.

Stuart Almer, the CEO of Gurwin Healthcare System, and Lori Williams, HR Business Partner at American Health Communities, discussed their strategies to create environments that empower their clinical leadership to create better work environments for their employees and improve overall retention.


Their efforts include new types of meetings and interactions among leaders, as well as new approaches to orientation and mentorship – such as the creation of a “Success Squad.”

Open communication

Almer emphasized the importance of a robust organizational culture, open communication, and innovative approaches to reward and support staff.

“We’re in unique times,” he said. “And the unique times have forced us to look within ourselves to what we can do differently, to better leverage everyone throughout the organization.”


Almer said that as CEO, he recognizes the crucial role he plays in setting the tone for the entire organization. Based on Long Island, Gurwin offers a range of services, including long-term care, short-term rehabilitation and sub-acute care.

In the last year, Almer and his leadership team have been more “in the trenches” – having one-on-one interactions with staff – than at any other time in the company’s history, he told SNN.

In a bid to foster deeper connections with staff, Almer introduced informal gatherings to provide a platform to connect with staff across all levels. He said these sessions are opportunities to discuss organizational updates, express support and address any concerns.

“I don’t conduct them with human resources,” he said. “I don’t conduct them with other leadership staff, because there’s just a connection between me and the staff.”

In addition to these one-on-one meetings, Almer has laid significant emphasis on holding regular department head meetings. He said these gatherings involve numerous department heads.

“We’re a large organization and we employ close to 1,200 staff,” he said. “So, when I meet with the managers across the system, we’re talking about 40-plus individuals.”

Yet Almer said he wants to use the leadership of managers across the system to make teams feel smaller and more personable.

He shared an incident in which he encountered a staff member in an office building. They chatted briefly, and she mentioned her busy schedule, not having time for lunch. Almer said he offered to get lunch for both her and another staff member who overheard the conversation.

“So, I’ve given this example to all of management,” he said. “We had a special presentation just on this subject of what they can do to leverage and reward staff.”

Almer said that in addition to better communication, by increasing nursing salaries, enhancing shift differentials, and introducing new benefits, the organization has managed to significantly improve staff retention.

Orientation and mentorship

Williams discussed American Health Communities’ strategy around creating a supportive, nurturing environment for staff, including a retention program that consists of two phases: orientation and mentorship. American Health Communities is part of American Health Partners, and operates 29 skilled nursing and rehab facilities through the Southeast.

During orientation, new team members are introduced to the company’s values and goals, she said. Phase two involves the assignment of a ‘success squad leader’ from various areas and roles within the community, such as dietary, housekeeping, laundry, CNA, LPN, and others. These squad leaders not only represent the community but also serve as mentors, she said.

“It propels them forward and empowers them to want to do more, and a lot of times they do look to our internal leaders as that gauge,” she said.

Williams pointed to an 89% success rate in staff retention during the first 90 days of a new employee’s tenure since the introduction of the program, compared to a 70% retention rate during the same period in the previous year.

A key aspect of the success squad program is the emphasis on creating opportunities for career growth, she said. This extends beyond the clinical realm. CNAs, for example, can take advantage of a clinical scholarship program that supports them in achieving certifications.

In addition to these components, regular evaluations are conducted at 30, 60, and 90 days to provide feedback and address areas for improvement.

Williams said a key component of the success of these initiatives is empowering her leaders to be instrumental in the program.

“As humans, we need that affirmation,” she said. “And so that’s why it is so important for our administrators to really be attentive and hands-on with this program, because not only does it help that new team member, but it also helps their department.”

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