To sustain staffing gains, many nursing home operators are investing in specialized training, attractive wages, and career growth in order to compete better with others across the health care continuum, with many focusing on modernizing onboarding processes.

Retaining certified nursing assistants (CNAs) has been problematic in many facilities, while the highly skilled role of MDS coordinators, for example, has been even more severely understaffed in others.

But take it from some operators who have found success on the staffing front: Addressing these challenges and reducing turnover has required a mix of both old and new strategies.

Panelists at a staffing summit hosted by Skilled Nursing News discussed the usefulness of centralized orientation, personal engagement, and recognition, as well as the use of AI and technology, to make a dent in the sector’s stubborn staffing challenges.

The new ways

Dan Strittmater, VP of innovation and bench strength at Monarch Healthcare Management, noted the importance of using technology and data analytics to improve staffing efficiency. Monarch even went to the extent of creating a dedicated role to parse the data for improving retention.

“We do get a lot of funding from our state government for innovation, so we funded a Retentionist,” he said.

Monarch’s Retentionist analyzes data from human resources, and feedback from new hires and job applicants across its diverse communities, to assess retention and reveal gaps, such as those in the onboarding process.

“I wouldn’t say that we’re the masters of retention [because] we’re kind of all over the state,” said Strittmater. “But, the Retentionist has helped us in pulling back the curtain on what’s working, what’s not, if my onboarding is struggling. She has done a good job pulling that out.”

Monarch has 45 nursing homes throughout the state of Minnesota, and 17 assisted living facilities, with locations in urban and rural communities.

On top of refining retention strategies to suit the needs of employees in a particular community, Monarch has polished its recruiting practices.

“If we can hire, let’s say 400 people a month, [our concern is] can we onboard them successfully,” he said. “Are they having a good experience? And so we focused a lot on that, and we’ve been able to get agency labor out at the CNA level from a number of buildings.”

The Minnesota chain has modernized its hiring process with an applicant tracking system integrated with job boards such as Indeed, resulting in a fourfold increase in applicants.

Moreover, to reduce reliance on agency labor, Monarch has implemented two state-approved nursing assistant training programs, one in-person and one blended. Streamlining the hiring process, especially for nursing assistants, involved collaboration between HR and education departments, Strittmater said.

“Nursing assistant in training is one of the most complicated hires because it’s this entry level position. There’s all these different things that are happening [and] it brings a couple of different divisions together,” he said.

Turning new hires into long-term employees has meant attending to issues like slow onboarding and poor communication, he said.

“What does the end user [new employee or applicant] say about whether they are having a good experience? Sometimes we’ve had people ghost us saying, ‘Oh, you never called me back.’ Or, ‘my onboarding took too long,’ or ‘I couldn’t get into criminal background checks.’ So those are some of the things we started with,” Strittmater said of the initial areas of focus.

Some things never get old

In a competitive market for health care employees, it is important to be cognizant of fair wages and employee recognition, according to Joseph Kiernan, chief strategy officer and senior vice president of network development for Ocean Healthcare.

Ocean Healthcare owns 12 skilled nursing facilities, all located in New Jersey, with over 2,100 beds as well as other assets in long-term care.

“It’s really paying somebody a fair wage and treating them with the dignity and respect that they’re looking for, and that really helps you with your retention down the road, and obviously with customer service and improved care,” Kiernan said. “That recognition is where they feel like they’re part of a family, as opposed to just a number within an organization.”

There are monthly employee recognition events at Ocean Healthcare aimed at “making sure that everybody feels valued, supported and heard.”

For Gurwin Healthcare, a smaller organization with 100 employees, the personalization goes even further.

President and CEO Stuart Almer emphasized personal engagement and a centralized orientation process as well as the importance of employee recognition and training programs, as key features keeping its workforce levels strong.

Gurwin staff have shared the ease of electronically applying to the organization, with the organization’s follow-through process and communication demonstrating a sense of caring to future employees, Almer said.

“We centralized our orientation process. We had a smaller orientation program for each of our services and buildings, and thought that by putting them together, bringing everyone together, it would make everyone feel as part of a whole at those orientations,” Almer said.

Gurwin has reduced turnover rates from around 40% to 30%, he said.

Almer, who sends each of his employees a birthday card, also recommends one-on-one engagement with employees using simple means such as sharing personalized notes – or even meals.

“I have lunch with the staff. It’s simply an opportunity to get acquainted, talk about ourselves, personally, hobbies, interests, whatever that might be. And I find it’s very effective,” Almer said.

And such actions lead not only to the employees feeling valued, but also to some useful insights.

“So last week, I learned – unsolicited – how we’ve refined our human resource process and it is now very effective,” said Almer.