Solving Everyday Workforce Challenges in Post-Acute Care & Senior Living

• WORKFORCE 360: • TACKLING STAFFING CHALLENGES WITH

MODERN ENGAGEMENT PRACTICES• Peter Corless, OnShift

Agenda

• Discover how to assess and boost your organization’s culture and implement proven engagement strategies so that team members are happy and they stay

• Learn modern communication and onboarding strategies that quickly assimilate new staff members, reducing turnover during the first 90 days of employment

• Learn key tactics to more regularly measure satisfaction levels and metrics that help management identify the key issues causing turnover

Staffing Challenges Are Magnified

Low Unemployment3.7% - lowest since 2000

Workforce Shortage43,000 open jobs Jan 2019

More CompetitionEmployees have more choices on where to work

High Turnover51% median CNA turnover

Staffing Shortages Become A Vicious Cycle

Increased voluntary overtime (51.2%)

Increased use of temporary staff (19.4%)

Delays in admissions (10%)

Inability to expand services (16%)

Increased staff turnover (41.2%)

Increased resident & staff complaints (14.7%)

Impact To Your Bottom Line

Overtime costs 6% of labor budget

Agency costs

Turnover costs51% rate @ $3500/employee

$144,000 - $360,000

$25,000 - $100,000

$178,500

$347,500 - $638,500Excess labor costs

Based on a single community (100 employees)

5 Steps To Effectuate Culture Change

1. Identify need and plan your course of action.

2. Determine what changes you’ll implement and how you’ll measure progress.

3. Acknowledge that change isn’t easy and obtain buy-in.

4. Communicate, train, reinforce and repeat.

5. Evaluate your results and continue to evolve.

6

Identify Need And Plan Your Course Of Action

Is Your Culture Helping Or Hurting?

of employees feel their employers do not offer the right culture

*TINYpulse Employee Engagement and Organizational Culture Report

64%

Culture Impacts Commitment

Number of caregivers “always looking for a

better job”

Number of caregivers open to new a job

opportunity

Average number of recruitment calls

caregivers receive per week

Get Competitive: Caregiver Trend Report, MyCNAjobs, 2018

What Is Culture?

• It’s the personality of an organization– It comes in many forms and is a

differentiator– How would you classify your

culture?• Fun?• Clinically focused?• Employee-centric?• Top-down?

Why Culture Matters in Senior Care

Helps Attract New Talent Increases Engagement & Retention

Boosts Your Bottom Line Improves Quality of Care

Profile of a Senior Care Employee

12

4 out of 5 are women

60% of workforce is in resident care jobs

90%Have access to internet via computer or smartphone

71% in resident care jobs work 35+ hours per week

29 or younger

30 to 49

50 or older

Argentum, The Senior Living Employee: A Socioeconomic Portrait of Today’s Workforce, 2018

Assessing Culture: Take A Walk Around The Building

Open communicationCollaborative environment

Respect & honestyEquitable

Employees & managers visibly engagedPositive resident/family interactions

Poor communicationUs-vs-them mentality

Lack of trustFavoritism

Employees & managers not smilingResident/family complaints

Assessing Culture: Understanding Your Employees

• Every building is different:– Generational

• Today’s workforce is comprised of five generations

– Background and culture– Responsibilities outside of work– Location– Resident mix & Skill sets– Work experience

Dealing With A Multigenerational Workforce

VeteransPre-1945

Boomers1945-1960

Gen X1961-1980

Gen Y (Millennials)

1980-1995Gen Z

(iGeneration)

1995-2010

Adapting To Today’s Workforce

78% Of new hires in senior care are millennials

35% Of providers have changed their tactics to attract and

engage millennials

What Shapes Culture

Leadership Employees

CommunicationCollaboration

Policies

Values

Benefits

Assessing Culture: Monitor Trends

• Turnover• Satisfaction

– Survey results– Glassdoor reviews

• Attendance policy adherence– Frequency of call-offs/no shows– Willingness to pick up shifts– Leaving early/arriving late

• Performance issues• Lack of motivation & productivity

Correlated with higher employee retention

• Elected healthcare• Elected 401k• Career Ladder participant• Went through AIT program• Attended Leadership training• Received Tuition Reimbursement• Proximity to work location

• Was an employee referral

• Received a sign-on bonus

• Other:– Pay analysis

– Director Nursing housekeeping services

19

Determine What Changes You’ll Implement And How You’ll

Measure Progress

What Does Your Cultural Nirvana

Look Like?

Establish Culture Goals

• Identify key desired achievements by changing your culture?– This should shape programs you will implement

• Reduce turnover during the first 90 days of employment by 5%

• Increase overall retention of CNAs by 10%

• Improve attendance policy adherence by 15%

– Make goals realistic & achievable• Unattainable goals have the potential to cause more dissatisfaction

Refining Culture: Where To Start

• Review your mission, vision and value statements– Are they still relevant? – Do they resonate at all levels?– Are employees bought in?

• Ask, what three words describe your mission– Does it align?

Refreshing Your Mission Statement

• Conduct a culture-change listening tour– Ask leadership, management, staff –

What makes us, us?

• Craft your message– Who is this message for?

– How will it resonate?

• Get buy-in

Able To Attract The Right People

• Have a Waiting Line to Get in the Door– Show off your culture on social media

• Get candidates excited to apply

– Use your job posting to differentiate yourself• It’s not just about the job requirements, it’s

about the experience of working for you organization

– Find candidates through employee referrals• When employees recognize you as a great place

to be, they’re going to talk about it

What Top Brands Are Doing To Attract Talent

Attracting Talent: Snaps, Videos & #Hashtags

McDonald’s, Taco Bell and JPMorgan Chase have started using Snapchat filters and recruitment ads to get applicants

Attracting Talent: Snaps, Videos & #Hashtags

• Mastercard Canada launches hashtag challenge allowing college students to compete for an internship through social media

• Goal: To find more interns

• Result: Received 532 qualified candidates #internswanted

Go Social Often & Across Channels

• Identify top talent and ask them to be brand ambassadors

• Create a Facebook careers page• Your regular page should not be used to

promote all your openings

• Recruitment video testimonials• Share & like the FUN

• Expand reach by encouraging employees to post open jobs on their personal social feeds –it’s free!

Ramp Up Recruiting With Referrals

• Market to passive job seekers• Partner with nursing schools• Promote the benefits & fun of working for your

company • Create a referral program

• Quicker and cheaper to hire than a traditional candidate

• Referred hires stay at their job longer than other hires

• Consider incentives for referrals• Look outside the industry

The 30/40 Program

• Recently launched at a community in Virginia

• CNAs work 30 hours and get paid for 40– Must meet requirements

(arrive on time, no call-offs, etc.)

• Meant to attract CNAs with better work-life balance

Source: Senior Housing News: CCRC to Pay Full-Time for 30 Hours of Work for CNAs

Job Boards Are Still Important

• Job boards are still important

– We’ve learned to simplify our applications

– Only ask for the essentials – including last employment to understand potential certification needs

• Initial applications should take 1–2 minutes

• Apply at your organization and see if you get frustrated

Hiring Challenges

• Slow company response time to applicants causes candidate frustration• 37% of senior care providers cite getting candidate to come in for an interview as a

major hiring pain point• 36% of organizations take 3+ days to schedule a candidate once they apply

Hiring Process Delays

• People prefer texting for scheduling and changing appointments• The average millennial exchanges 67 text messages per day• 95% of text messages are read in 3 minutes (compared to 33% of emails)• The average person checks their phone 150 times per day• 58% of candidates were comfortable interacting with AI• 82% of job seekers believe the ideal recruiter interaction is a mix between human/AI

Candidate Communication Preferences Are

Changing

• Busy hiring managers take days to follow-up on applicants, causing good applicants to get lost quickly

• Hiring managers waste countless hours playing phone tag and sorting through emails • Organizations lack visibility into key hiring metrics

Hiring Inefficiencies

Rethink Candidate Communication

• Phone calls weren’t effective– Hours of phone tag to connect and

schedule applicants for an interview

– Interview no-shows lead to wasted time

– Candidates accept other job offers before organizations reach out

34

Making The Switch To Text-Based Recruiting

• Automate interview scheduling via text message– Avg. text message response time

is only 90 seconds

• 2 times the hires in half the time

• 60% less interview no-shows

Onboarding Is Engaging & Effective

• Roll out the red carpet– Reach out before a new hire starts

– Set up meet & greets throughout week 1– Include new hires in your newsletter– Help them make a friend on day 1

– Get them set-up and trained on systems right away

– Schedule regular check-in’s throughout the first 90 days

Offer Mentorship, Training & Career Development

• Assign a mentor to new hires

• Define career tracks– Show them that they have the potential

to move up (STNA → LPN)

– Identify measurable goals

• Provide continual training– Leadership training for all managers

“Advanced certified nursing assistants - with specialized skills in care

transitions, dementia and other areas - could

become important staff leaders in long-term care

facilities.” - McKnight’s Long-Term Care News

“It’s so convenient to have my schedule on my phone. It’s great!”

Senior Living Communities

Staffing Is Balanced: Work-Life, Care & Cost

• Give staff more control over their schedule– Identify work preferences & availability– Be equitable with open shifts

• Provide real-time staffing visibility for better care– Know where you are over/under-staffed

• Based on census/acuity fluctuations

• Predict overtime before it happens– Proactively find non-overtime replacements– Communicate with staff their preferred way

• Make scheduling transparent

Recognition Is Routine

• Create a recognition program• Incentivize key behaviors

• Award points• Go public & follow the leader

• Leaderboards• Next-in-line motivation

Organizations that dedicate 1% or more of their payroll to values-based recognition programs are more likely to realize a strong return on investment, while instilling and reinforcing corporate values.

Source: Employee Recognition Survey, Human Resource Management/Globoforce, 2016.

Acknowledge That Change Isn’t Easy And Obtain Buy-in

Culture Happens At The People Level

• Culture initiatives may be driven by the organization, but it’s executed by people– Managers play a major role in the

success of a culture• Disengaged staff can be a sign of

disengaged managementof people have left a job at some points to “get away

from their manager to improve their overall life”

50%

Managers Are Cultural Ambassadors

• Establish mentorship programs for management-level employees

• Provide training and career development opportunities

• Make sure they have the resources they need to support their staff

Employees Are Involved

• Find moments of collaboration– Form committees & working

groups• Events/Retention Committee

• Resident Culture Committee

• Shared Governance Committee

– Each group should have clear goals, defined metrics and provide regular updates on their progress

Communicate, Train, Reinforce And Repeat

Share Goals & Communicate Progress

• Make sure all levels are aware of any changes to your mission, values or vision statements– Explain the “why” behind the initiative

• Provide regular updates during company meetings regarding strategies and milestone achievements

• Include quick progress updates during weekly stand-ups

Put Some Incentives Behind It

• If you have an incentive program, be sure to include some people-oriented goals– Incentivize the achievement of

culture-related milestones just as you would other KPIs• Retention goals• Turnover goals• Engagement goals

Evaluate Your Results And Continue To Evolve

Four Measures Posted On Nursing Home Compare

• RN Hours Per Resident Day

• Total Nursing Hours Per Resident Day

• Physical Therapist Hours Per Resident Day

• Average Daily Census

• Turnover and Retention stats are coming!

Don’t Rely On Annual Surveys

• Diagnose staff satisfaction & performance frequently, before it’s too late

• Survey - the more the better– Trend happiness– Rank issues – Put a plan in place to address them

– Execute!

• Important for senior leaders to be involved daily

Constant Communication

• Implement stay interviews– Why do you stay? What would make you

leave?• 10-15 min interviews with open ended questions

• Review exit interviews– What makes people leave?

• Monitor pulse surveys– Fast, frequent surveys that help show you

what’s happening now

Everything At Your Fingertips

• Technology can help!

– Real-time satisfaction surveys

– Performance monitoring

– Onboarding alerts

– Communication tools

– Unified view of staffing• Know who is working when

• Know who is in overtime, at risk for fatigue

Culture Impacts The Entire Employee Journey

Recruitment

Hiring

Onboarding

Engagement

RetentionHigher engagement &

satisfaction

Increased retention

Lower turnover

Decrease in labor costs

Learn More

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