The senior care industry has long struggled with high turnover rates, which can reach levels of 30-100% or more per year for critical roles like certified nursing assistants and registered nurses. In fact, it soared to 65.2% in 2022, and then went higher to 77.1%, according to HCP’s 2023 benchmarking report. This turnover not only disrupts resident care and relationships, but also significantly drives up recruiting and onboarding costs for providers.

What drives the churn, and what can senior care organizations do to better engage and retain their top talent? Here we explore some of the data around turnover drivers and evidence-based best practices for retention.

Key Turnover Drivers

Research has uncovered a multitude of factors that predict whether an employee will stay or quit their senior care job. These span from compensation concerns, to work overload, to relationships with leadership.

Some of the most impactful drivers include:

  • Inadequate Wages & Benefits: Low pay paired with limited benefits options saddles many staffers, especially direct care workers, with financial strain. One study found nurse assistants’ intent to leave decreased by 26% when they moved from the lowest to highest wage quartile.
  • Work-Life Imbalance: Long hours and irregular shifts lead to high rates of burnout and work-family conflict, prompting people to seek less demanding jobs.
  • Limited Training & Upward Mobility: Investing in skills development and clear promotion pathways helps employees feel valued and optimistic about their future potential in an organization.
  • Poor Management Relationship: When employees don’t feel recognized, supported, or empowered by their direct manager, they grow detached and often exit. The adage “employees don’t quit jobs, they quit managers” bears out.

Best Retention Practices

While certainly not exhaustive, below are some of the top evidence-backed practices that help senior care providers boost retention:

  • Competitive Wage & Benefits Packages: Compensating staff appropriately signals value and enables them better manage personal/family obligations.
  • Shared Decision-Making & Autonomy: Empowering frontline staffers and engaging them collaboratively in key decisions makes them feel influential and invested in their work.
  • Peer Mentor Programs: Pairing new hires with tenured employees equips them with valuable social capital and know-how to seamlessly transition into their role.
  • Manager Leadership Training: Developing managers’ abilities to provide clarity, recognition, inspirational motivation, and individual consideration has consistently positive effects on retention.

The costs of losing top clinical and cultural carriers in senior living and care settings run high. But by diagnosing turnover drivers and applying tailored organizational interventions, providers can build the stable, thriving workforces needed to deliver excellent and consistent person-centered care.

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