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Cara Silletto

We used to toss the term “workforce crisis” in the care of the elderly before the pandemic. Times were tough, but we had no idea how bad it could and would become.

Many senior care organizations are experiencing turnover of over 80% (or worse) during this workforce shortage crisis. As a workforce expert who has focused solely on retention over the past decade, I’d like to suggest five potential steps to help slow the revolving door. Is it appropriate now to recognize that at least 40% of this turnover is not expected to go away… ever?

We know our profession has its challenges with the difficulty of raising rates to raise wages and the need for people with a “caring heart” to name a few. To top it off, many of our positions are lower paying, less skilled positions that new hires could learn in a short time, as are other industries such as retail, restaurant and manufacturing.

At the recent LeadingAge National Conference in Georgia, I spoke about creating a place people want to work. The biggest takeaway from a few who spoke to me after the session was the enlightenment of our real competition at that time. Unattached (or gig) jobs now allow people to work when they want, where they want. Now, leading retailer Target is joining companies like Uber and DoorDash with Target On-Demand.

If the competitive market has drastically changed this and the participating workforce has shrunk, we will continue to struggle to find enough candidates to fill the vacancies. It is time to operationalize our turnover.

Going forward, let’s start planning 40% annual revenue (forever), budget for it, and imagine a new sustainable business model.

1. Stop asking managers to be “hiring managers”.
It is not sustainable to ask these leaders to continue to take on this hiring responsibility while meeting the regulatory and task-oriented requirements of their department. It’s time to build your hiring capacity with a part-time or full-time hiring manager at each site and let managers become managers again.

If you’re worried about where the funds are coming from for this role, consider the dollars spent on excessive overtime turnover, the use of temp agencies, and the replacement of exhausted key executives. Consider being more proactive with lasting solutions such as staff changes, and not overtime for those near their limits.

2. Designate a true owner of the retention initiatives.
When retention is everyone’s responsibility, no one actually owns the tasks and actions associated with reducing turnover. Organizations are successful when they identify and internally promote, or hire, a part-time or full-time retention specialist (who can be combined with a part-time recruiting role, if needed).

An example of a downloadable job description is available at

3. Create reusable integration checklists.

Make sure you have detailed organizational, departmental, and role-level onboarding checklists that cover what a new hire needs to know by the end of 1) day 1, 2) day 1 week, 3) of the first month and 4) of the first trimester. True integration is not over in a week or two. Make the checklist available to managers and new hires so they can communicate effectively about where they are and where they need to be.

4. Infallible your new hires.
Consider how McDonald’s used to wait for new hires to memorize the menu before they put them at checkout, but now they have a foolproof cash register to guide each new hire through the ordering process to get them right. things. When a customer orders nuggets, for example, the worker can’t continue with the order until they ask the customer what sauce they want. What process could you foolproof? Where do you need to laminate and post step-by-step instructions for new hires to easily access?

5. Automate what you can.

The fear that “robots will take our jobs” is unworkable at this point. We need robots and automation to help our shrinking workforce do their jobs today. Now the question is, which automation has the greatest ROI, since new systems are expensive to implement and there is little payback currently available. I encourage you to follow technology companies in the health field. I find organizations that have a CTO (not just an IT manager) a winner on this one because it takes time to properly review new products, calculate the numbers and, lastly, implement innovations. chosen.

So what’s your plan? Are you going to continue to do as it has always been done? How many employees and department heads still have to leave before we make major changes to our approach to retain talent we can’t afford to lose?

Workforce thought leader Cara Silletto, MBA, CSP, works with organizations of all sizes to reduce UNnecessary staff turnover by bridging generational gaps and making managers more effective in their roles. She is the author of the book Staying Power: Why Your Employees Leave & How to Keep Them Longer.

Opinions expressed in McKnight Long Term Care News guest submissions are those of the author and not necessarily those of McKnight Long Term Care News or its publishers.