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McKnights Article: Recruiting, retention strategies shared by McKnight’s Women of Distinction

“Hire the right people, and hire them as quickly as possible.”
“There are employees out there; they're just not working for you.”
“Be grateful for your employees.” 

Those were just a few of the sentiments expressed during a McKnight's Women of Distinction Forum panel Tuesday afternoon featuring five current or previous honorees. Titled “The long-term care workforce shortage: Surviving and thriving,” the discussion was moderated by McKnight's Home Care Editor Liza Berger. 

In the midst of a workforce shortage, employee retention is more important than ever. Lisa King, regional vice president for All Ways Caring HomeCare and a 2024 Hall of Honor inductee, said she believes that the needs of each individual employee are not “one size fits all,” so it is important to learn what makes them tick as individuals. 

“The workforce is very diverse. You have multigenerational people who are interested in working in our industry, and I think we have to provide what each of those generations might be looking for,” King said. “One of the key factors today is just getting out and talking about what we do and inviting people to see.”

To learn about employees, employers need to solicit their feedback. For Aimee Middleton, vice president of operations at the Evangelical Lutheran Good Samaritan Society and a 2023 Hall of Honor inductee, the employee survey is a critical tool when it comes to assessing operations.

“The best way that we manage our workforce is to listen to them. We have to get their feedback,” Middleton said. “We're going through our annual employee surveys, and we're up to 75% participation. That is a great number that tells me that a lot of people participated. I may not always like what they say, but it is real.”

Fierce competition 

One key workforce challenge operators often face, the panelists agreed, is competition for employees across sectors. Sometimes, the deeper pockets of large corporations will win out, so it is necessary for employers to stay competitive when it comes to salary and benefits, said Sharon Eyster, vice president of operations and chief operating officer at United Church of Christ Homes and a 2024 Hall of Honor inductee. The pandemic changed workforce dynamics, she noted. 

“One of the main things that I noticed is, we lost a lot of our workforce,” Eyster said. “We were already an industry that was in crisis with staffing, and I saw a lot of people leave long-term care. I myself had a number of my long-term CNAs, who have 20- to 30-year careers and who were very proud of what they've done, go to work for warehouses like Amazon, and they were very happy because the work is not as hard, at least from their perspective.”

Part of the solution is making long-term care jobs not only appealing but giving potential workers more exposure to them. Programs such as SkillSpring in New York City have been successful at not only encouraging students to go into the sector but also preparing them for life after school, said Ruth Katz, president and CEO of the Association of Jewish Aging Services and a 2024 Hall of Honor inductee.

“By the time these young people graduate from 12th grade, they are ready for the world,” Katz said. “Of course, many of them go into aging services; that's the goal. This program is to help them graduate from high school, and now every single one of them has graduated from college, and two of them graduated from medical school.” 

The rural staffing problem 

In rural, sparsely populated regions, trained staff members are typically more difficult to find without poaching from neighboring communities. Sarah Weiland, vice president of clinical strategies and initiatives at session sponsor Sentrics, suggested that more unconventional approaches will need to be taken to service those regions. 

“I think that we're going to have to get more creative, and I think the industry is going to become more of a shared staff model within regions,” Weiland said. “I know in Missouri during COVID-19, there were hospital systems that were competitors, but they created a model so they could share their staff.”

Providers, however, can do only so much on their own. Legacy Healthcare Administrator and 2024 Rising Star Kate Gilday said she believes that the government should be more active in encouraging workers to enter the aging services sector. 
“I think that the federal government should be doing something to incentivize the workers coming into our industry, whether that be student loan reimbursement or tax incentives,” Gilday said. “What are we doing to provide healthcare workers, nurses, CNAs, frontline workers with some sort of reason to work in this industry outside of it's something very good to do?”

Regulations on the horizon

Some newly finalized regulations might compound the industry's staffing problems, the panelists said. The Medicaid Access Rule's 80/20 provision, finalized in April, mandates that home- and community-based services providers spend 80% of Medicaid payments for home health, personal care and homemaker services directly on workers' compensation. And the government also has imposed strict staffing minimums the require nursing homes to have a registered nurse on-site 24 hours a day, seven days per week, and deliver 3.48 hours of daily direct care per patient/resident. The staffing rule applies only to nursing homes, although assisted living communities and other providers on the long-term care continuum believe they also will be affected, because they hire from the same pool of workers. 

“This will have devastating impacts,” Middleton said regarding the nursing home rule. “Not just to our residents but our team members that are part of that community and have been working there for a really long time.” 

Providers have years to become compliant with those new regulations — six years for the 80/20 provision and two years for the nursing home minimum staffing mandate — which is ample time for them to advocate for a change, according to King.

“The thing that we have to do is, we all have come together,” she said. “That's a long time to work really hard to get something changed that we know is going to affect those that we support every day.”

And to help the stretched workforce in the meantime, she added, “I think we have to continue doing what we are doing every day again with recruiting and retention. We have to spend the time, we have to listen and we have to respond to take action on what the employees that again do want to work for us are looking for.”

Sessions precede reception, dinner

The other session of the McKnight's Women of Distinction Forum focused on long-term care mentorship and leadership and was moderated by McKnight's Senior Living Editor Lois A. Bowers (look for an article in a future e-newsletter). Both sessions preceded a cocktail reception and awards dinner celebrating this year's honorees. Read more about this year's winners in this digital commemorative booklet.

Healthcare Services Group was the Platinum sponsor of this year's McKnight's Women of Distinction Awards and Forum. PointClickCare was the Gold sponsor, and PharMerica was the Silver sponsor. Other sponsors included Curana Health, DirecTV for Business, Easyshifts, Hireology, Reliant Rehabilitation, ShiftKey and Sentrics.

Pictured above: McKnight's Home Care Editor Liza Berger, far left, moderates a panel on long-term care workforce challenges during the 2024 McKnight's Women of Distinction Forum in Chicago. Panelists were Evangelical Lutheran Good Samaritan Society Vice President of Operations Aimee Middleton, Sentrics Vice President of Clinical Strategy and Initiatives Sara Weiland, Association of Jewish Aging Services President and CEO Ruth Katz, Legacy Healthcare Administrator Kate Gilday, United Church of Christ Homes Vice President of Operations/COO Sharon Eyster and (not pictured) All Ways Caring HomeCare Regional Vice President Lisa King. (Photo by Tori Soper Photography)

Staff contact: bhawkins@mehca.org