Staffing Turnover

The Impacts of Staffing Turnover on Providing Care In ALF’s

Throughout the United States, millions of seniors depend on the compassionate care of facilities like nursing homes and assisted living facilities (ALFs). These long-term care operations are a critical part of the healthcare sector, yet face unique challenges that impact daily operations as well as the wellbeing of residents and staff alike. Staffing turnover issues represent the largest challenge in ALF operations; high employee turnover rates require caregivers to do more with less. Insufficient staffing may put residents at risk, and while assisted living facility insurance is one part of a comprehensive risk management strategy, facility managers need to understand the negative impacts inadequate staffing can have on both safety of residents and of operations. 

Caregiver Turnover in Long-Term Care Facilities

Caregiver turnover in nursing homes, independent living centers, and ALFs has long been a concern for facility managers, and has been studied extensively by the medical research community. In a 2007 study published in The Gerontologist, researchers collected data from nearly 3000 care facilities. The data and a corresponding literature review uncovered several sobering statistics. In many facilities, the annual rate of nurse aide turnover exceeded 100%, and in some facilities, that turnover rate approached 400%. These high numbers have caused concern among state and federal regulatory agencies, as high staff turnover is considered the primary risk factor in negative health outcomes for long-term care facility residents.

Factors Influencing Staff Turnover in Care Facilities

Work in a long-term care facility like an ALF requires long hours and many personal sacrifices on the part of caregivers. These healthcare facilities can be very demanding, with caregivers expected to handle routine health treatments as well as daily activities like assisting residents with dressing, bathing, and exercise. Certain tasks, such as lifting or repositioning patients, may put caregivers at risk of developing injuries. Combined, the demands of these work environments serve to drive caregiver burnout, or the phenomenon by which caregivers lose motivation to perform. 

There are many other factors influencing staffing turnover rates in ALFs besides severe caregiver burnout. These factors include:

  • Intentional understaffing by facility administrators as a means of controlling costs.
  • Poor pay rates; pay scales of nurse aides and registered nurses in ALFs pales in comparison to rates found in other areas of the healthcare sector.
  • Forced or required overtime hours, often with insufficient compensation for the extra work.
  • Dangerously high workloads, with caregivers expected to care for too many residents at once, including residents with complex medical needs.

High staffing turnover rates put residents and fellow staff members at risk. Numerous studies have shown the negative effects of poor staffing on patient outcomes. It is important for facility managers to understand that understaffed facilities and high turnover rates may increase risks associated with negligence or neglect on the part of caregivers, potentially resulting in expensive assisted living facility insurance claims and stiff regulatory penalties. The short-term cost benefits of employing fewer workers is more than outweighed by the increased financial and liability risks associated with this practice. 

How to Avoid Excess Employee Turnover

Healthcare researchers and regulatory agencies have long pointed to high employee turnover rates as a leading risk in long-term care facilities, not only for residents but for fellow staff members as well. How, then, can facility managers protect their employees and residents while reducing high turnover rates? There are several steps managers can take, including:

  • Offering competitive salaries and benefits for caregivers in line with rates in other healthcare sectors.
  • Ensuring adequate staffing levels according to established standards of care and regulatory requirements.
  • Implementing staff wellness programs, including training on stress-reduction techniques, healthy eating habits, and exercise programs.  
  • Reviewing risk management tools, including assisted living facility insurance, to protect staff and facility assets from liability risks. 

With these techniques, care facilities can position themselves as attractive places to work, helping to reduce employee turnover. When caregivers feel like their needs and safety are being addressed by managers, they are far more likely to remain employed by the facility, and resident care improves as a result. Although high turnover continues to plague the long-term care sector, managers have the power to reverse this trend through investment in and training of quality caregivers. 

About Caitlin Morgan

Caitlin Morgan specializes in insuring assisted living facilities and nursing homes and can assist you in providing insurance and risk management services for this niche market. Give us a call to learn more about our programs at 877.226.1027.