David Peasall
David Peasall


Assisted living communities have always had high turnover rates – generally attributed to the prevalence of non-professional/low paying jobs. Estimates for staff turnover range from a low of 21% to a whopping 135%, with an average of 42%. 

Staff turnover can be incredibly costly in a number of ways. One source says that the cost of replacing an employee is equal to 25 percent of the annual compensation, with a direct cost of at least $2,500. Add to this the indirect costs such as lost productivity, lower quality of care caused by untrained replacements, inadequate staffing and disrupted continuity of care; lost client relationships, lost client revenues, deterioration of employee morale and even increases in on-the-job injuries due to inadequate staffing and poorly trained staff – and the costs skyrocket well past that $2,500.

Reducing turnover

With these factors in mind, it’s clear that reducing employee turnover is a smart management strategy.  Following are some ways to do that.

  • Hire the right people: Before you worry about retention, it’s important to hire the person who is the best fit for the position. In addition to specific job requirements, look for staff who have the right caring and nurturing natures to be able to see beyond the challenges of the physical demands, often-difficult patients and sometimes unreasonable family expectations. Then, once they have been hired, the facility should offer a structured on-boarding process and thorough, hands-on training. 
  • Competitive wages and benefits:  Let’s face it – most of the positions in the assisted living community carry relatively low wages. It’s not unusual for low-wage earners to switch jobs for as little as $.15 per hour.  And even though that’s just $26 per month, it can make a difference for someone living paycheck to paycheck.  However, frontline workers, wherever they are on the pay scale, are the face and heart of the organization, developing and maintaining the relationships that contribute so heavily to resident and family satisfaction.  Retaining these employees is even more challenging now in view of the projected increase in demand for workers such as CNAs. So what can be done? Several studies have demonstrated that a combination of higher wages, healthcare benefits and paid time off can have a significant effect on improved retention.  In fact, in one study, employees with health insurance were twice as likely to stay as those without coverage. 
  • Create a supportive organization: No matter what the position or type of business, a primary reason cited by departing employees is the difficult relationship they had with their manager. Thus, improving the relationship between staff and supervisors and managers/owners can make a real difference.  This may include:
  • Defining and discussing the company’s mission and values
  • Demonstrating respect for employees and residents
  • Offering supervisory and managerial training
  • Creating well-defined job descriptions, career paths and training opportunities
  • Maintaining adequate staffing levels

Doubtless, there are many other programs that can and should be put in place, but the assisted living community that starts with these steps should find that their employees are more satisfied, stay longer and, in the end, provide better resident care. 

David Peasall, SPHR, is human resources director at FrankCrum, a national professional employer organization. He can be reached at [email protected]


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