Allowing employees to have a say in their own work schedules can go a long way toward alleviating long-term care’s long-standing workforce challenges, according to one expert. 

“At the end of the day, engagement matters and it matters when it comes to turnover,” said Beth Baerman, a workforce management expert with Attendance on Demand Inc. 

Baerman’s comments came during a webinar hosted by the American College of Health Care Administrators for its annual Convocation & Expo. The session focused on increasing nursing home employee engagement and retention. 

She noted that recent research has shown that vacancies among all positions in long-term care have risen from 19% in 2018 to 23.5% in 2020. A recent Health Affairs study also found that median turnover among nursing staff was 94% in 2017 and 2018. 

High turnover rates do impact the bottom line, she stressed. It’s estimated that the direct costs to providers for replacing a certified nursing assistant is $2,000. 

“When you’re talking turnover of over 100%, that is a lot of money, but it’s more than just that,” Baerman said. “Another way to look at it, which is also mind-boggling, is just a 10% reduction in turnover can save for an organization … which seems to me to be a pretty achievable goal.” 

The first step for operators is to increase the amount of engaged employees they have on staff. Baerman shared data that showed the turnover rate among disengaged employees (40%) is more than double the rate among engaged workers (18%). Additionally, disengaged staffers are also absent more days than engaged workers. 

Data from long-term care workers shows that 66% of highly-engaged employees plan to stay with their organizations and just 2% are actively looking for another job. Just 12% of disengaged workers plan to stay and 23% are looking for another position. Moderately engaged workers, fall in between: 36% plan to stay and 8% are looking for another job.

Top reasons long-term care workers leave their organization, or the industry entirely, include not feeling supported by their managers, large workloads, tough work schedules and lack of support from colleagues. 

Baerman explained operators must commit to improving communication with employees and help foster strong, trusting colleague relationships to improve retention. Updating the scheduling process can address both issues. 

Operators should consider learning preferable worker hours for employees and then schedule from that,, instead of making standard and predictable schedules with times that don’t necessarily fit their needs, according to Baerman. Utilizing different workforce management systems and phone applications also fosters self-scheduling among staffers. 

She added that making it easier for workers to switch shifts among themselves or to take requested time off also can improve employees’ opinion of an organization.

Other “high impact changes” that reduce turnover include cross-training among different types of staff members, allowing a variety of people to plan social events in facilities, and recognizing which workers want extra training and/or education. 

“If you can change the way you work, change some of your practices, how you schedule employees and bump that 23% disengaged even to moderate engagement, we see a huge drop in actively seeking another job. Right there we’re addressing turnover,” Baerman said. 

“The way you schedule can demonstrate the organizational support that you provide to your employees,” she added. “It provides empowerment and self-direction and communicates with employees that they have a say.”