John O'Connor, Editorial Director

The cost of finding and keeping long-term care employees is staggering. At most communities, labor-related outlays surpass 50% of all operating costs—and the figure is closer to 60% at many.

By some estimates, more than one in four administrators and directors of nursing move on each year. And these are the so-called “stable” positions. For frontline caregivers such as nursing assistants, the rate exceeds 100% in some areas.

So what is going on here? It’s probably safe to say job demands partly explain the field’s chronic staffing challenges. Simply put, long-term care is hard work. On the best days, it can be physically, mentally and emotionally draining. On the bad days, things can get far worse.

And while labor costs are a major budget eater, few employees feel they are overpaid. Let’s face it, when your hardest workers are leaving because the hours and pay are better at nearby fast-food restaurants, something is not right.

So what’s to be done? Offer crunchier carrots? Sharpen the stick? I wish I had the answer. For what it’s worth, a new book examining what really motivates workers appears to offer some much-needed insight.

In “Drive: The Surprising Truth About What Motivates Us,” author Daniel H. Pink argues that it’s time to give workers more freedom. I realize this may be a tall order in a business where excessive regulations, language barriers and potential lawsuits seem to lurk around every corner. So your options may be limited.

Pink suggests that people can be broadly defined either as Type X’s or Type I’s. Type X individuals are more motivated by extrinsic rewards (money, avoidance of punishment), while Type I’s are driven by three primary intrinsic motivations: autonomy, mastery and purpose.

Employees of Type X companies tend to work in a short-term fashion, while those in Type I’s thoroughly analyze and assess the smaller and larger goals set for a specific task. Type I employees enjoy more autonomy over their activities at work and the opportunity to master a challenge. Type I companies pay more than average and set relevant and wide-ranging performance metrics.

So here are two questions to consider. First, is your organization best described as Type X or Type I? Second, how about your people? There’s no need to answer these hypothetical questions. In fact, your firm’s turnover rate probably already has.