There’s a shift happening in senior housing. While being focused on residents is undoubtedly a hallmark of successful senior housing operations, signs suggest that more businesses are focusing on their employees to boost resident satisfaction and bottom-line results.
Senior housing operators already understand there’s a trickle-down effect from staff to residents that can measurably improve health outcomes of residents and other results. In senior living, it may be that the most effective community engagement starts with employees.
What does it mean for an employee to be “engaged?”
“An engaged employee is checked in, pausing to make a meaningful difference, which of course has huge individual and collective impact,” Dana Ullom-Vucelich, chief human resource and ethics officer of Ohio Presbyterian Retirement Services (OPRS), tells Senior Housing News. “An engaged employee would make a difference in real-time for residents. That’s the full circle of how engaged people translate to senior living.”
OPRS is Ohio’s largest not-for-profit senior housing provider and has 73,000 patients and 3,100 employees across 12 communities. The organization has long worked with Holleran Consulting, which believes one of the best industry benchmarks for many providers is an employee engagement and satisfaction survey that can be conducted every other year or every few years. It provides feedback for senior housing leaders to understand the needs of employees and identify problem areas. For nearly a decade, OPRS has participated in these surveys, and the feedback received has given the executive team valuable insight into the biggest concerns of employees. Since its most recent survey, executives are working to develop action plans based on feedback.
Collecting feedback from employees is the first step, according to senior housing providers. And recognizing the subtle difference between engagement and satisfaction can make a difference in the quality of information gathered.
“We’ve tried to parallel our surveys in the past to find out if our employees are satisfied at the same time our residents are satisfied,” says Fran Casey, vice president of human resources with Goodwin House, a Virginia-based continuing care retirement community that serves over 1,000 residents and has 800 employees across two campuses. “This time around we’ve taken a little different approach and we’ve really just focused on employee engagement because we’ve recognized that having satisfied employees doesn’t necessarily translate to what we would want in terms of engagement. What we’re really trying to build is an engaged workforce as opposed to a satisfied workforce.”
Masonic Villages of Pennsylvania, a senior living provider with five campuses in central Pennsylvania, has tracked its employee engagement initiatives through the Holleran survey since its partnership began in the mid-1990s.
“Sometimes its great because we can benchmark against ourselves,” Lori Seiders, corporate director of organization development and training at Masonic Villages, tells SHN. “But when it comes to nationally benchmarking against other long-term care facilities in the nation, we can measure. We’re very conscious of that because we want to now how we’re doing against the nation, but at the time, how we are doing against ourselves.”
OPRS has the data to back up some of their employee initiatives, and its findings underscore the importance of creating an engaged workplace.
“We have specifically run correlation analysis from our employee opinion survey against our business outcomes,” says Dana Ullom-Vucelich of OPRS. “We have found that in our locations that have higher employee engagement and satisfaction that indeed residents are more satisfied.”
The results are beyond patients feeling more satisfied with the services they receive. In a case study outlined in a white paper on OPRS data from OC Tanner, a human resources and consulting services company, locations with better engagement results also had lower turnover rates among nursing residents.
Most importantly, the actual health outcomes have been found to be influenced by employee engagement levels.
“We have found that those locations that have better employee satisfaction that the people we serve have better health outcomes,” Ullom-Vucelich says. “Specifically, in a community there are fewer urinary tract infections (UTIs), fewer falls and fewer bed sores. In our hospice and home health are, we have reduced hospital readmissions and our clients [perceive less pain].”
Locations with high employee satisfaction had a 4% reduction in urinary infections. Locations with low employee turnover, and thus a more fluent continuum of care with employees, had a 6.5% reduction in pressure sores and 3.25% drop in resident falls, according to the white paper.
Retention and Referrals
Beyond health outcomes, an engaged workforce can influence other business outcomes, including boosting resident referrals and occupancy rates.
Part of the reason is that creating an engaged culture can build stronger relationships between staff and residents, according to Casey of Goodwin House. And that can impact resident satisfaction.
“A lot of what’s going to translate into having an engaged staff and population is that most of our referrals come from word of mouth,” she says. “We have high occupancy and resident satisfaction. We are at an all-time high in terms of occupancy levels. People know the Goodwin House name and brand, and that goes back to the relationship with the resident and staff.”
And residents aren’t the only ones who might stick around longer—worker retention can improve, as well. Goodwin House is one provider that commits to providing more than $100,000 per year for tuition assistance for those who partake in education, development and growth initiatives inside and outside the community. These additional training and growth opportunities means staff are more engaged and likely to stick around longer, but comes as a significant investment.
Still, high turnover rates have a steep cost, too, and losing staff members can also upset the continuum of care for residents who enjoy their connection to their caregivers.
There are a number of challenges to improving engagement among employees, but the nature of the senior housing industry means it’s all the more important, says Allan Tutterow, executive director of Well-Spring Retirement Community, a continuing care retirement community located in Greensboro, North Carolina.
“Senior living is very much a hands-on service business,” Tutterow tells SHN. “Many of these encounters occur one employee to one resident or family member. You’re dealing with an individual employee. That experience for the residents and their families is key to everything we do. If the employees are not engaged, it’s not going to go well.”
With the stakes so high for quality service, it’s essential employees are keyed in. However, just as senior housing providers can differ in their philosophies, missions and services, so too can employees range in their engagement and satisfaction within their roles.
“The challenge is that you can solicit feedback from five different employees and you get five different opinions,” says Ullom-Vucelich, who received a 70% response rate to OPRS’ most recent employee opinion survey from about 3,100 employees. “To assimilate very individual preferences across the board is always a huge challenge when it comes to soliciting employee opinion.”
While OPRS had a strong return on their latest employee survey, Masonic Villages of Pennsylvania struggled to reach a 50% return on its 2015 survey. However, the feedback the provider did receive found that many fundamental changes across the organization took a toll on employees.
With changes in the economy and workforce trends, what employees desire from their workplace can shift, but the ways employers respond to those needs remains the same, says Ullom-Vucelich. Remaining forward-looking is also an important challenge that employers need to overcome to keep up with changing attitudes and workplace preferences.
“Our job as leaders is to awaken that kind of energy, not to tell [employees] how to serve and be engaged. I believe that deep down, as humans, there is a desire to make a difference,” says Ullom-Vucelich. “Our job as leaders is to really find out what makes people tick and afford them the opportunity to bring that to life.”
Written by Amy Baxter