Employee turnover is a common and expensive challenge in many nursing homes and assisted living communities. Residents typically want to build relationships with the people caring for them, and high turnover rates can be frustrating and emotionally upsetting.

Leaders at all levels are often charged with increasing retention and reducing turnover, but it can be hard to know which programs will be most effective at a given community. In 2015, some of the most common strategies for reducing turnover included…

  • Retention bonuses: A reported 22.71 percent of communities offered cash payments for employees who stuck around. The average tenure required to earn such a bonus was three years, and the average bonus was just over $600.
  • Recruitment bonuses: These tend to be effective when both the new hire and the recruiter get a bonus, and when the bonus is staggered (i.e., not given in full until the new hire has stayed for a while). On average, these bonuses were $572 in 2015.
  • Tuition reimbursement: Only 12.87 percent of assisted living communities offered this benefit.
  • Mentoring programs: This strategy showed up in just 3.44 percent of communities, perhaps because of the resource-intensive nature of mentorship.

The good news, according to the Hospital & Healthcare Compensation Service’s annual report on retention in assisted living is that turnover rates have gone down in the last two years. The bad news is that they’re still relatively high: 31.71 percent as of 2017. For comparison, research on bedside registered nurses (RNs) in a hospital setting finds turnover rates of just 14.5 percent.

Nurse Turnover Costs More than Retention

So what does that mean for an assisted living community’s bottom line? Let’s get some hard numbers on the table.

Research on turnover in nursing professions (conducted in 2017) found that, while the average salary for a certified nursing aide (CNA) is $27,208, the cost to recruit, orient, and train someone for this position is $30,000.

Let’s imagine a perfectly average assisted living community that employs 10 CNAs. Assuming the community is able to maintain full employment, the cost of salaries for those CNAs would be $272,080.

But this place is average, remember, so the turnover rate is 34.1 percent. So between three and for of the CNAs will leave. For the sake of the example, let’s say three leave.

Well, that just increased your cost of employing CNAs by $90,000. And sure, you won’t be paying salary for however long the positions are vacant, but even a three-month vacancy on a CNA salary “saves” just $6,802.

Of course, part of the challenge of retention is that the costs associated with recruiting, orienting, and training are often hidden. They don’t appear as budget line items, neatly labeled for the board to consider.

Instead, they may be baked into overtime for other nursing staff, or increased payments to healthcare providers as overworked employees develop stress-related conditions. They may manifest as expensive mistakes by overworked CNAs or by those who aren’t yet fully trained. They’re pernicious and they’re easy to ignore.

Technology as a Nursing Retention Strategy

Here’s the good news in all this: investing in an electronic health record (EHR) system may help improve retention rates – and, crucially, employee satisfaction – in your assisted living community or nursing home.

Why? As many as one in five respondents to a 2017 survey agreed that insufficient technology is a factor in employee burnout. In other words, better technology equals happier workers.

And our own research shows that 15 percent of users see almost immediate improvements in job satisfaction after adopting our EHR. Maybe that’s because 29 percent of them see productivity increases almost right away.

That’s huge, especially in an industry where vacancy rates tend to hover around 15 percent: bringing on the right technology help existing workers achieve more in the same amount of time, thus easing the pain associated with unfilled positions.

EHR Adoption to Reduce Nursing Turnover: Do it Right

One word of caution here: adopting new technology can be disruptive, regardless of industry or workplace. The world of assisted living is no different – in fact, the disruption may be more significant than in other industries, as nursing employees are often less tech-savvy than those in office settings.

If you’re considering converting to EHR in your community, commit to a rollout that keeps your nursing staff informed throughout the process to avoid resistance and confusion. For an idea of how other communities have made the switch, check out this case study from Illinois-based Grand Lifestyles.

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