Long-term care leaders sat for a roundtable discussion on hiring practices sponsored by Hireology.

Even though wages and benefits have increased for the long-term care workforce, the sector still suffers from an ongoing shortage of skilled caregivers. Innovative solutions, however, have shown the potential to play a major role in alleviating some of the pain points.

That is reason for hope for all long-term care stakeholders, experts emphasized at a recent McKnight’s roundtable discussion.

Leading innovators in senior care and housing today uncovered the opportunities and challenges in sourcing, enticing and keeping employees at the event, which was moderated by McKnight’s Long-Term Care News Executive Editor James M. Berklan and sponsored by Hireology. 

A ripe state of the market

Long-term care providers have to best strategize how to attract talent best suited for caregiving, emphasized Owen Hammond, CEO of Cascadia Healthcare. 

“It’s finding the right talent in a field where you’re taking orders,” he explained. “We expect them to collaborate, discuss with a partner and figure out the best solution.”

Finding people who are passionate about working in the sector is essential. 

“We’re focusing a lot of our attention to try and build that joy and love for what they do back up,” noted Pilar Carvajal, CEO of Innovation Senior Living.

Negative connotations of senior care and skilled nursing outcomes can weigh heavily on recruitment efforts, participants agreed.

“Skilled nursing is a place where the imagery is where all people go to die,” observed Steve LaForte, chief legal officer and executive vp of corporate affairs at Cascadia Healthcare. “Overcoming that challenge and creating opportunity in employees’ eyes that they’re serving an amazing purpose in taking care of our grandparents, parents and communities is a huge challenge.”

Employee turnover remains a persistent problem, but there is an unwritten threshold, after which the pressure to retain seems to ease for many employees, some experts feel..

“If we get to two-and-a-half years, they tend to stay with us for a longer period of time,” Michael Karicher, chief people officer at Sonida Senior Living, said. “We’re trying to improve that employee experience and onboarding.”

One of the most amazing retention accomplishments has been achieved by the Jack and Nancy Dwyer Workforce Development Center. The center far surpasses the national average with an 84% retention rate, said CEO Barb Clapp.

“[P]erson-centered case management and comprehensive wraparound services” are the keys, she said. “We ask questions like what are your barriers to success, do you have childcare or transportation issues, are your wages garnished, and address them up front.”

Meeting life challenges head-on

Easing caregivers’ pain points can help managers keep their talent. That’s why Sherri Berghoff, CEO of OPS Living, offers life skill training such as financial awareness, childcare backup, car financing and credit improvement, as well as weekly pay options, scheduling flexibility and employee incentive “bucks” that can be used to pay bills.

“We’re trying to be creative in the solutions that we’re coming up with,” she explained. “Changing these life skills for our line staff is what’s going to create longevity for us.”

Investing in trauma-informed care can help prevent employees from walking off the job as they learn to understand their reactions and ultimately, improve resident care.

“If you can figure out why they respond the way they do in certain situations, you now have the leverage point that might be able to impact 100 people,” said Loe Hornbuckle, CEO of Sage Oak Assisted Living.

Recruiting and retention challenges may be most frequent at the front-line level, but the problems are real all the way up the ladder, experts point out. Finding managers to encourage and support talent is especially difficult.

“The highest nurse leader in each of our buildings is by far the hardest to recruit because it requires technical and leadership abilities,” offered Joe Pohlen, founder and partner of Cardinal Senior Living.

Sourcing creative talent channels

Drawing talent from other industries, and other countries, can be clever ways to widen the pool of candidates. 

“The real frontier is finding people to bring into the workforce that are otherwise going to be there that maybe don’t check off all your boxes,” Hornbuckle said. “As we’re consuming labor, there are industries that are letting go.”

Cardinal Senior Living has also successfully sponsored more than 100 employees through a two-year work visa program for people from Nicaragua, Cuba, Venezuela and Haiti. It’s a potential long-term solution to the talent shortage, Pohlen said.

“This is a real actionable thing that we as an industry could do that would benefit not only seniors living in our buildings now but seniors over the next few years,” he said.

Sourcing through nonprofit organizations including foster care, charter schools and Title One schools offers access to a new pool of interested candidates. 

”We find students that lack opportunity but have potential and we work with them,” Clapp said. Encouraging career progression through continuing educational opportunities helps retain them.

“We have people call each one of our scholars and say, these are the seven things you can do now,” she explained. “We are pushing people up through the healthcare system by using that technique.”

Talent all around

Remember that existing employees are great advocates for the work that caregivers do, Karicher said: “We’ve started seeing success in employee referral.”

Company culture, of course, plays a significant role in how employees feel and talk about their work. 

“Create that culture that creates the word of mouth that fuels the referral programs,” LaForte said. For employee sourcing, Cascadia partners with local organizations, such as Boise State University’s Health Services Program and technical schools. “We really like to encourage partnerships with communities because that’s local field-driven,” he explained.

By focusing on potential, Berghoff said she has been able to find talent, such as a server at a restaurant for a dietary manager, out in her community. 

“She had the customer service that I was looking for and we were willing to spend the time to train her up and give her the tools and resources that she needs,” she explained about one job candidate. “The best employees that we’ve brought onto our teams have been employees that we’ve experienced in a different place and invited them to join our team.”

Twists that weren’t possible a generation ago should be put to good use. For example, QR codes on business cards are a convenient way to track and incentivize employee referrals.

“Use that [technology] to equip the things you are already doing and to make it easier on your staff and team,” advised Kristin Tschantz, VP of growth marketing at Hireology. “Your best recruiters are your employees.”

Don’t assume employees know about referral programs, and keep pushing the message out, added Jake Pleban, an account director at Hireology.

Designing more attractive benefits

Benefits are a critical resource for attracting and retaining talent, and many employers are getting more creative about what they offer. 

“My favorite benefit from a moral perspective is giving long-term care insurance to caregivers so that they can actually afford the services they’re providing,” Hornbuckle said.

Benefits addressing specific employee needs also can help drive performance. 

“With our line staff, it’s been about trying to be responsive and flexible with their schedules as much as we possibly can,” Berghoff explained. It’s also important to assess their goals. “Make sure that you’ve identified that and given them opportunities to grow,” she stressed.

In the end, truly understanding who your employees are is essential to employee retention. 

“Those constant touch points create culture and they create knowledge and it allows you to create flexibility,” LaForte explained.

To give employees a sense of ownership in their work, Cascadia Healthcare offers profit-interest sharing. 

“People want to feel like they have a pension, something that’s meaningful to them,” Hammond noted.

“Continue to look at the things that you can do with employee engagement and culture,” Clapp advised. “All of those things make a difference to people and will pay off in the end.”

Roundtable participants:

  • Sherri Berghoff, CEO, OPS Living
  • Pilar Carvajal, CEO, Innovation Senior Living
  • Barb Clapp, CEO, Dwyer Workforce Development
  • Owen Hammond, CEO, Cascadia Healthcare
  • Loe Hornbuckle, CEO, Sage Oak Assisted Living
  • Michael Karicher, chief people officer, Sonida Senior Living
  • Steve LaForte, chief legal officer and executive vp of corporate affairs, Cascadia Healthcare
  • Alex Nault, director, healthcare business development, Hierology
  • Jake Pleban, major account director, Hireology
  • Joe Pohlen, founder and partner, Cardinal Senior Living
  • Kristin Tschantz, VP of growth marketing, Hireology