Why Senior Living Fares Worse Than Other Service Industries on Worker Turnover

The senior living industry does a good job of recruiting entry-level talent, particularly when compared to other service-based industries. But providers need to do a better job at developing internal referral pipelines and reducing turnover, and they need look no further than to those other industries competing for the same talent.

Senior living has a higher voluntary termination percentage for its front line workers — waitstaff, maintenance and housekeeping — than similar positions in the grocery, hospitality, retail and hospital industries, according to data provided to Senior Housing News from Activated Insights, the research firm behind the annual Great Place to Work survey. The top scoring organizations are highlighted in the Fortune magazine “Great Workplaces in Aging Services” list each year.

The departure rate among full-time front line senior housing employees in communities polled by Activated Insights was 29%. The grocery industry departure rate was 13%, hospitals reported a 10% turnover rate, and hotel and retail reported an 18% attrition rate, according to the data that those industries furnished as part of Great Place to Work surveys.

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Those numbers are even more striking when compared to the average number of applicants per opening. Senior housing averaged 30 applicants per opening, compared to 22 for hotels, 21 for retail, 20 in hospitals and 14 in grocery.

“I always say, ‘people join companies and quit bosses.’

Wesley Enhanced Living President and CEO Jeff Petty

These numbers show that while senior living has to interview a few more people to fill a position than other service and health care industries, the bigger problem lies in keeping workers, which reinforces Activated Insights CEO Jacquelyn Kung’s belief that the industry at large does a poor job of conveying to new hires opportunities for promotions, continuing education and career paths available to them.

Kung cites Rochester, New York-based grocery chain Wegmans Food Markets as a prime example of a company that clearly defines its workplace culture and career opportunities, starting with how it recruits new employees to the fold.

“Wegmans’ recruitment strategy is focused on teens, and they ensure to promote from within. It has a high retention rate and it’s a grocery store business,” she said.

Senior living providers can look to other industries for inspiration on how to reduce turnover, and they can also learn from how their peers are tackling the problem, including organizations that scored highly in the Great Workplaces rankings.

Emotional investment

One of the reasons for the high turnover rate among full-time employees is that new hires are not fully prepared for the emotional intensiveness of working in senior living, Summit Vista CEO and Executive Director Mark Erickson told SHN. Summit Vista, based in Taylorsville, Utah, is the first entrance-fee continuing care retirement community in the Beehive State. The community employs 109 people, and ranked 20th in the small and medium company category in this year’s Great Place to Work survey.

Unlike retail and grocery stores where the employee-customer relationship is purely transactional, senior living employees interact with their customers — the same customers — every day. The intensive nature of working in senior living is drilled into candidates from the first interview, and those that are brought in for follow-up interviews are given behavioral assessments to determine their commitment to Summit Vista’s mission and its residents.

“We’re very deliberate about our workplace culture, mission and behaviors, and hold people accountable for [their place in it]. If you aren’t willing to sit down with residents, be flexible, and have hard conversations with them, you won’t last,” Erickson said.

Summit Vista management also conducted exit interviews with employees who quit, in order to capture and study the reasons cited for leaving, and implement best practices and tweaks to the hiring and onboarding process.

In its first year of operation, Summit Vista’s turnover rate is around 35% annualized, which is within the provider’s targets, and Erickson expects that percentage to decrease now that operations have stabilized and best practices are being implemented.

We’re looking to make changes [to operations] that are sustainable.

Wesley Enhanced Living Vice President, Human Potential Pat Lamoreux

Many workers new to senior living enter without having a full understanding of the demands the industry entails, Wesley Enhanced Living President and CEO Jeff Petty told SHN. Warminster, Pennsylvania-based Wesley employs 1,020 employees across six communities, and ranked sixth among large providers in this year’s Great Place to Work survey. Wesley has a 23% turnover rate among full-time employees and is looking to bring that down to under 20%.

“The truth is the jobs that we offer are really challenging jobs. It’s hard work. It’s not work that is necessarily pleasant at times. People get into it without knowing what they’re signing up for,” he said.

Petty believes that there are intangible rewards to working in senior living that cannot be found in other fields — namely, the deeper employee-resident relationship.

“The relationships [staff] form with residents are valuable and important to them that you don’t get [working] in a grocery store,” he said.

Changing old ways of thinking

In order to improve employee retention, providers need to be willing to change with the times, Wesley Vice President, Human Potential Pat Lamoreux told SHN.

Senior living as an industry grew out of a command and control environment where managers who matured in their work environments were trained to control everything about a community’s operations, down to telling people what to do and how to do it. This is an attitude that remains pervasive throughout the industry.

Wesley Enhanced Living
Wesley Enhanced Living Northeast Philadelphia in Burholme, Pennsylvania

Wesley has spent considerable time and energy talking to its leadership about breaking that mold, training them to interview for the intangibles the provider seeks over a particular skillset, and giving front line employees agency in daily processes and the long-term direction of the company.

“We work with managers on looking beyond [skillsets] and how candidates fit with our mission and values. Can [candidates] provide examples? Are they willing to be challenged? do they want to bring change to the organization? What do they bring in character, and their ability to learn and grow?” she said.

The Great Place to Work survey gives Wesley insight into employee satisfaction, and the provider conducts annual surveys where it gathers information and shares it with the entire workforce.

In 2013, Wesley launched a continuous improvement program, SQAPE (Sustainable Quality Assurance and Performance Enhancement) which reflects a commitment to identifying areas of improvement within operations, establishes performance metrics for employees to meet and drills down to the root causes of operational problems and solutions to them.

“The key to this program is ‘sustainable,’ as we’re looking to make changes [to operations] that are sustainable,” Lamoreux said. 

Wesley is competitive with other communities and employers on wages and benefits, has programs in place to assist workers with physical and financial wellness, and offers opportunities for employee advancement.

Summit Vista also has opportunities for front line employees to advance their career tracks, and has promoted 18 workers to higher positions in its first year. The provider is working on its 2020 strategic initiative which will include a talent review process encompassing conversations about workers’ desires for future development and career tracks, Erickson told SHN.

“It forces us to hone in on our employees,” he said.

Another way employees are taking agency in their career arcs is through peer groups or buddy programs, where veteran front line employees share their experiences and insights on day-to-day job responsibilities with new hires. Summit Vista’s culinary arts and front-of-house staff launched their own buddy program and discovered that having each others’ backs in the dining room during meal service makes the time more efficient.

If you aren’t willing to sit down with residents, be flexible, and have hard conversations with them, you won’t last.

Summit Vista CEO and Executive Director Mark Erickson

Wesley does not have a company-wide mentor or buddy program in place, but one community is piloting a mentoring program for its nursing staff, which evolved from employee engagement in the SQAPE program. If the program is successful, the provider will look to scale it company wide, Lamoreux told SHN. 

The practices Wesley and Summit Vista are implementing are not one-size-fits-all solutions, but they can serve as templates for providers looking to change their workforce cultures for the better. But it is a continuous process, and everyone in a chain of command must be willing to ask the hard questions of those who they manage, as well as themselves.

“I always say, ‘people join companies and quit bosses.’ It’s important to us that people like coming to work here. When we find managers turning over a lot of people, inevitably they don’t last long at this organization,” Petty said.

Louisville, Kentucky-based Trilogy Health Services — which employs about 12,000 people — is among other senior living providers making significant investments in workforce programs. Trilogy has a focus on education, offering free online degrees through a partnership with Purdue Global University, helping associates pay off student, and offering apprenticeships that can result in college credits.

Recognizing that senior living is locked in a fierce competition with other service industries for the same talent, Trilogy Senior Vice President of Foundation and Workforce Development Todd Schmiedeler believes that the industry must do a better job of sharing best practices and pushing for collective improvement.

“We’re in competition with Amazon, McDonald’s, Walmart for frontline employees,” he said. “Until we start working together, we’re always going to be behind.”