It’s no surprise that the principle of understanding employee needs and wants is key to controlling the staffing chaos – an ever-present threat at nursing homes – and yet it is also the step most often applied incorrectly.
According to panelists at a recent Skilled Nursing News webinar titled, Beyond the Chaos: A Proactive Playbook for Building a Top Employment Destination, panelists discussed their company cultures and the strategies they’ve implemented – at employee request.
Success boils down to three ingredients: trust, transparency and communication. And solutions range from higher pay to debt relief to groceries for employees.
Michael Herald, the current president and CEO of Guardian Healthcare, first joined the company as part of its HR team. This meant that he saw “the good, the bad, and the ugly” of what was happening in the organization, and so by the time he stepped into his role as CEO, he knew the company needed a culture shift.
“The desired outcome for the organization was [to] empower people at a local level to make the best possible decisions, to exercise their personal judgment in the most effective way that’s going to generate the best outcome for the residents,” he said.
He and the team sought to create a culture that could be used at facilities large and small. Guardian has a $400 million skilled nursing and ancillary services portfolio, including retail pharmacy, therapy, home health and staffing operations, and more than 5,000 employees.
“Our focus coming in was really to create a foundation that had three pillars that would support the culture change that we wanted to implement,” Herald said. “It was based upon trust, transparency and communication. We wanted to establish trust with our employees. We did that by being transparent with them, and we were transparent with them because we had regular and routine communication.”
In the first six months of changing the culture, Herald focused on communicating leadership’s dedication to implementing and living out these three pillars. Leadership also took on the acronym, A.C.T. for “advise, coach, teach” to help shape how care would be delivered. Herald said making this shift took buy in from all levels of leadership, from corporate down to individual sites. And this move has turnover at Guardian.
“That was all part of this process for how we could work as an organization to really empower those site level decision makers and ultimately, provide the level of care that we expected and wanted for the residents,” Herald said.
Catching burnout early
For John Brown the vice president of human resources at Parker Jewish Institute, building a culture that improves turnover means catching caregiver burnout before it happens. He said the company takes an intentional approach to onboarding to pin down trouble spots early.
“It means pulling them off the floor for 10, 15 minutes and checking in with them,” he said. “It might be a simple question about a paycheck … but sometimes the simple things, when left unaddressed, tend to fester. And they wake up in six months and they pile up and then they say, ‘Okay, I’m going to go somewhere else.’ Many, many times we’ve been able to divert that just by answering some simple questions and making sure that they have their feet on the ground and they’ve landed and they feel comfortable.”
Parker Jewish Institute is a leading provider of short-term rehabilitation and long-term care. The organization has its own medical team and is nationally renowned as a skilled nursing facility, as well as a provider of community-based health care.
Improving lives, compensation
Following the pandemic, Herald said leadership at Guardian took a step back and looked at how it could improve the lives of the frontline staff. The first place leaders looked to change was compensation.
“We did look at things like compensation structure in terms of how we could provide student loan debt relief,” he said. “In other instances, just generally, debt relief for folks if they needed debt forgiveness, and some way that we could help them through that process.”
Herald said this view was taken not only with retention in mind, but also patient care.
“If we hired the right people and treated them fairly and treated them with respect and compensated them fairly, they were going to provide better care to the residents,” he explained.
Brown said Parker Jewish Institute “went against the tide” in its retention strategies. In speaking with the staff, leadership found many didn’t want to work a traditional shift and preferred 12-hour shifts.
“We developed a 12-hour shift in a skilled nursing environment blended in with a regular eight hour shift,” he explained. “The 12-hour shift allowed us to attract staff that we might not otherwise have been able to attract. They would have gone somewhere else.”
Brown emphasized that the scheduler position was also key in implementing this asked for change. .
Supplemental groceries
Brian Buys, chief product officer at Smartlinx, has seen a few examples of solid retention strategies from partner facilities.
One facility, he said, has created an artificial intelligence (AI) model that can analyze an interview transcript and predict the 90-day retention rate.
“They’re piloting that, but it’s an interesting way of thinking about how to have confidence in the hire from the earliest stage,” he said.
Another organization is providing their staff with groceries. Buys explained that anyone making less than $26/hour receives supplemental groceries from the company, covering around 600 employees.
“Their retention rate is through the roof,” he said. “Their team loves that benefit. They have really continued to manage that program creatively and effectively for some time.”