The key to retention in long-term care? Create career paths

Career stall-out is a frustration that many individuals in senior living and care know deeply and painfully. It can be extremely difficult for people to advance in senior care without additional training or education. 

The hard truth is that too many companies just do not offer set career paths, and too many associates do not have the funds or time to invest in further education. In an environment historically replete with high turnover, new associates often don’t have mentors or role models to show them how to thrive in a facility.   

This kind of career stagnation, coupled with the difficult nature of caring for the elderly, is one of the primary driving forces behind the high turnover rates in skilled nursing facilities and assisted living communities. But the inverse is also true — employees are more likely to stay at workplaces where they can envision a future and find role models who care about their success in the organization.  If you’re looking to boost retention at your senior care facility, you need to start by focusing on creating career paths for your employees. Let’s dig in. 

Retention in senior care: The problem

Retaining workers in long-term care facilities is a challenge, period. According to a 2021 study published in Health Affairs, workers in nursing homes turn over at a median rate of 94%. Average turnover rates exceed 100% for registered nurses, certified nursing assistants and licensed practical nurses. 

These high turnover rates impact your quality of care, staff morale and the ever-increasing cost of hiring. These factors were only exacerbated by the level of trauma that the COVID-19 pandemic inflicted on the workplace.  

Additionally, as you are acutely aware, this constant turnover can rob residents and patients of stability and consistent care. And while there’s no simple solution to improving retention in long-term care, creating clear and defined career paths can help your employees envision a future at your company. 

You may not know that employees name “lack of opportunity for advancement or growth” as one of the top five stressors in the workplace. Even more concerning, for every 10 months an employee remains in the same role without advancement, it becomes 1% more likely that they’ll depart the company for their next role. It’s clear that lack of career growth is contributing, at least in part, to the high turnover seen throughout long-term care. 

But creating career paths isn’t always simple — some employees may not have the time or funding to pursue further education and move forward in their careers. Others may not be fully aware of the possibilities within their role. It’s your job to show employees that a bright future is possible without ever leaving senior care.  Here are some of the best strategies to employ. 

Two strategies for building career paths in your facility

1. Education reimbursements

Offer your employees a stipend or reimbursement for educational expenses. In healthcare, employees often need a new set of skills to move forward to positions with more expansive responsibilities and higher salaries. With education reimbursements, employees will be able to acquire the necessary skills without putting unrealistic stress on their budgets.

Tuition reimbursement is an excellent way to retain workers in all healthcare positions, but can be particularly helpful for CNAs. 

CNAs often face low pay and hard work. Even when wages are increased, it’s not always a guarantee for retention. That’s because there’s more than salary at play: CNAs need to feel valued and have clear career pathways to remain in their roles. 

In order to move forward to higher wages, CNAs will likely need education and training that not everyone can afford. But in an ideal world, being a CNA should be an introduction to a long and fruitful career in caring for the elderly.   

Further training and education reimbursement can give CNAs the opportunity to move forward in healthcare. Not to mention, if your CNAs are able to pursue further nursing education while working at your facility, word will spread, and your reputation will grow. In addition to training and retaining existing employees, you’ll also attract new candidates looking for a start in the medical field. 

2. In-house training programs 

In-house training programs, particularly for CNA certification, are always a great asset. CNA training can increase engagement from employees interested in learning new skills and potential candidates looking to break into the medical field. If you open your CNA training program to your non-clinical staff, you could offer these employees a path into healthcare and simultaneously add CNAs to your workforce. 

These training programs can build valuable skills, even if they don’t end in a certification. You can employ outside trainers to train your employees in everything from soft skills (such as customer service and patient interaction) to hard skills that employees will use every day. 

When you offer in-house training, you can also help interested non-clinical employees (such as janitorial staff, housekeepers, chefs and administrators) make the jump to the clinical side of things. Non-clinical workers are an important part of any long-term care facility, and some may be interested in learning about clinical roles. But non-clinical workers often don’t see a way to move over to the healthcare side of the operation, even if they’re very interested. Taking the time to launch a reskilling initiative specifically for non-clinical workers. This can be a great way to fill the gaps in your clinical staffing while simultaneously boosting retention. 

Most of us have some personal experience of what it means to feel stuck in place at a job. But hopefully, you also know what it feels like when a path opens up — to have the stability and excitement of clear goals and a way forward. This is what every employee in long-term care deserves and, ultimately, one critical part of preventing turnover. 

Pat Mulloy sits on the advisory board for Apploi, the leading software solution for healthcare recruiting, applicant tracking, and credential management. Mulloy is currently Of Counsel for Wyatt, Tarrant & Combs, chairman of the Board for Argentum, and formerly served as CEO of Elmcroft Senior Living and president and CEO of Atria Senior Living. Mulloy received his bachelor’s degree from Vanderbilt University and his juris doctorate from Vanderbilt University School of Law.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.