The average turnover rate among health care workers was 20.6% in 2017, up dramatically from 15.6% in 2010. Health care was second only to hospitality in its turnover (see the Compdata survey, Pay, Turnover and Recruitment, Oh My! 2017 Healthcare Results Now Available). Drilling down by organization type, about 60% of organizations that provided wraparound programs in 2017 had staff turnover above 25%—of these organizations, 28% experienced turnover above 50% (see Over Half Of Organizations Providing Wraparound Services Have Staff Turnover Above 25%).
What do some of the position-specific, and organization-specific turnover rates look like? Last year, the turnover rate for bedside registered nurses (RN) was 16.8%, and the turnover rate for certified nursing assistant (CNA) was 27.7% (see 2018 National Health Care Retention & RN Staffing Report). The cost of those turnovers averaged $49,500 per position replaced.
In 2016, the average rate of direct support personnel (DSP) turnover was 45.5%. The DSP workforce includes all paid workers whose primary job responsibility is to provide support, training, supervision, and personal assistance to adults with intellectual/developmental disabilities (I/DD) (see Direct Support Personnel Turnover Rate For I/DD Sector Averaged 45.5%). The American Health Care Association (AHCA)/National Center for Assisted Living (NCAL) reports that in 2016, the average annual turnover rate was about 36% among assisted living resident assistants and personal care aides (see National Center For Assisted Living Set New Quality Goals For Assisted Living Facilities). That same report found that the average turnover rate was above 25% for dining services staff (35.7%), certified nurses aides (29.6%), registered nurses (28.7%), and licensed practical nurses (27.4%). The average turnover rate was lowest, 11.3%, among facility executives.
Why is the turnover so high? OPEN MINDS Chief Operating Officer, Stacy DiStefano, summed up the stress of these positions as fundamental in understanding why staff leave, noting, “We are asking our direct care folks to perform stressful, critical functions, in often less than ideal conditions, for a wage similar to the food service industry.”
OPEN MINDS Senior Associate, Annie Medina further explained that it’s a candidates’ market right now, and interviewees for jobs aren’t interested in hearing “you need this job”; but instead want to know why they should choose your organization. She also noted that, unfortunately for many human resources departments, hiring practices are too often akin to “ready, shoot, aim”, and organizations are hiring staff that aren’t the best fit. She explained, “Too frequently, and especially in clinical situations, we’re so intent on filling the vacancy that we don’t spend enough time determining if the fit is going to work, and if the relationship is going to be mutually beneficial.”
What are provider organizations to do about this high-turnover situation? Both Ms. Medina and Ms. DiStefano noted that money can be a very powerful tool for better and more secure staffing, but often it’s effective right up until it’s irrelevant. Illustrating the importance of benefits, culture, and work environment, Ms. Medina offered a series of questions executive teams should ask:
What systems do you have in place to keep people? What systems do you have in place for them to grow and advance professionally? How are you working to prevent burnout (all of these jobs are at high-risk for burnout)? Are you an employee-centered culture? Focusing on employees allows employees to focus on consumers, which is a win for everyone.
Ms. DiStefano pointed out creating a culture which takes into account staff needs will take access to, and ongoing communications between staff and a leadership team that is interested in the short- and long-term goals of your first-line workforce. She noted:
Don’t assume you know what is important to staff. Ask your staff, are they looking for flexible hours to attend school, or work around child care arrangement? Do they seek mentoring and an identified career ladder to advance within your organization? Taking the topic of pay raises off the table due to budget restraints increases the need for creative alternatives such as job sharing, sliding shifts to match school schedules, on-site nutritionist meetings for employees, local gym memberships discounts, and on-site personal finance planning.
For more on staff retention, check out these resources in the OPEN MINDS Industry Library:
- 75% Of Your Management Team Was Offered Another Job This Year
- Does An ‘Agile’ Workforce Want Your Jobs?
- 4 Ways To Retain & Grow Millennial Employees
- Reducing Paraprofessional Employee Turnover
- The High Costs Of Paraprofessional Employee Turnover – Sizing Up The Challenge
- Are You Micromanaging Your Organization?
- How To Grow & Retain Employees In A Chaotic Market
- For Sustainability, Managers Matter
- The Value of Staff Recognition in the Workplace: Now More Important Than Ever
- Don’t Underestimate The Importance Of Your Organization’s Purpose
For more on building an effective team, mark your calendar now for The 2018 OPEN MINDS Executive Leadership Retreat, taking place September 18-20 in Gettysburg, Pennsylvania. And be sure to check out the session, “Building The Management Pipeline: Identifying & Growing Future Leaders,” featuring OPEN MINDS Chief Operating Officer, Stacy DiStefano, OPEN MINDS.