John O'Connor

It’s no surprise that staff turnover remains alarmingly high at many long-term care communities.

At some places, the annual replacement rate for the field’s most critical staff — frontline caregivers — routinely exceeds 100%. Even for positions such as administrator and director of nursing, 25%-to-30% turnover is the norm at many settings.

I once had a perplexed executive tell me about a thankless soul who departed his fine institution to work at a local department store. He asked if I could believe that this ingrate would leave a place where she could do God’s work, just to work in a shoe department? Actually, I could. Especially after, ahem, putting the proverbial shoe on the other foot.

Let’s see: She was leaving a place where residents sometime berated her, where the work hours were routinely played with and where weekend and holiday shifts were the norm. She accepted another job that eliminated those hassles, and by the way, offered more hours at a higher wage.

Yes, long-term care can be an ennobling line of work. Its psychic and other rewards are often life changing. And few things could be considered more worthwhile than helping those who desperately need assistance.

But too many operators let these potential payoffs get in the way of basic marketplace realities. Chief among them is that employees will generally opt to get the best deal they can. Does that make them selfish and ungrateful? Perhaps, but that’s kind of the way it is.

Given how physically and emotionally draining the work in this field tends to be, a certain level of turnover will always exist. And that’s not necessarily a bad thing. Those who do not possess essential levels of empathy, skill or commitment should not be working in this sector.

That being noted, the number of good people who do depart remains far too high.

Much has been written and said about how to address the sector’s staffing challenges. But one absurdly simple solution often gets lost in the discussion: Make your facility a better place to work.

It starts with offering compensation that your competitors can’t easily overcome. But beyond pay and perks, you need to do other things that keep people around. That includes treating people fairly and with respect, not jerking them around (especially when it comes to pay and work hours), giving them a chance to move up, and not making them work for bosses who are a living nightmare.

It’s easy and perhaps cathartic to talk about how good help is hard to find. But a far better option is to make sure you run a place where good help wants to be.


John O’Connor is McKnight’s Editorial Director.