With its workforce burdened by crushing student loan debt, Trilogy Health Services started a repayment assistance program. About four years after starting that program, the Louisville-based senior housing and care provider is paying out nearly $2 million annually to about 1,500 associates, and is seeing a dramatically better retention among these workers.
But loan repayment assistance is only part of Trilogy’s larger push to offer education-related benefits to its workforce of about 12,000 people. Earlier this year, the company struck a partnership with Purdue Global University to fully fund online college for its associates.
And, Trilogy awarded about 2,500 scholarships last year and has about 5,000 employees in a registered apprenticeship program, Todd Schmiedeler, senior vice president of foundation and workforce development, told Senior Housing News.
Given the intense labor challenges facing the senior living sector, he is pushing for other providers to make similarly large investments in their employees, to create a more well-trained workforce overall and improve the 40% to 60% turnover rates plaguing the health care industry.
“We make millions of dollars of investments in this, our employee wellbeing, and we know other people aren’t doing it yet,” he said. “That’s why we want to share, we’re not hiding it.”
Workers strapped with $36 million in debt
The idea for the loan repayment program came from an associate who spoke with CEO Randy Bufford about the burden of student loans, Schmiedeler said. That conversation occurred about four years ago and set the wheels in motion right away.
For the first three years, Trilogy would cut a $250 check each quarter for everyone in the program, and the process was managed internally. By last year, that was becoming untenable. The program had expanded to about 700 people, and Trilogy leaders recognized that they could not scale it any further given administrative burdens.
“We knew we had a winner, but didn’t have an efficient process,” Schmiedeler said, of the program.
So, Trilogy put out a request for proposals and through that process contracted with a company called Tuition.io.
Now, rather than cutting about 7,000 checks a year, Trilogy just cuts 12 — one each month that goes to Tuition.io, Schmiedeler said. Tuition.io has relationships with just about all the major student loan servicers and has efficient e-payment mechanisms set up.
In addition, working with Tuition.io mitigates financial risks and complications to Trilogy by enabling monthly payments of $100. If an employee leaves the company, there is not the overhang of a potential quarterly payment owed. And, although Trilogy already was collecting data about the program, Tuition.io expands those capabilities as well.
With this new partnership, Trilogy made a push to increase enrollment in the program. In the spring, 700 new enrollments occurred. At that point, 1,200 people were involved carrying a total student debt load of $36 million, Schmiedeler said.
That number underscores the seriousness of the issue and demonstrates why it has become a topic of such pressing nationwide concern.
“Watch any presidential debate and it’s in the top three to five things being discussed,” Schmiedeler pointed out. “Employees are pressured under the student loan debt they have.”
Recently, about 500 more people were added, meaning Trilogy has met a 2019 goal to double the size of the program. With each participant slated to receive $1,200 a year, that brings the total annual payouts for this group to $1.8 million.
But this is money well spent, Schmiedeler said, pointing to retention numbers.
In July, he put together a report comparing the tenure of people in the student loan repayment program with a similar cohort of people not in the program. He found that program participants had an average tenure of 3.4 years, versus 1.28 years for people not receiving student loan assistance.
“When I saw that and our board saw that, we said, this is exactly why we have this program,” Schmiedeler said.
The application process for the program takes about two minutes to complete, he explained. About 40% of participants are nurses, with therapists also making up a high percentage of enrollees. Executive directors and administrative professionals in areas such as marketing or payroll also are involved.
An investment versus a response
While Trilogy is spending a lot of money on its loan repayment assistance, this program is just part of a wraparound effort on supporting its workers’ educational endeavors.
There’s also a scholarship program to help defray the cost of schooling right out of the gate, which has been a focus for Schmiedeler since he joined Trilogy about a decade ago. In 2010, the company awarded 25 scholarships. Last year, it awarded 2,600.
Simplifying the application process was one driver for this growth. Originally, scholarships were only available to those already enrolled in school, and the application involved providing tax information, furnishing letters of recommendation.
This requirements seemed unnecessary to Schmiedeler, given that Trilogy had already screened its workers in the hiring process and knew how much income they were earning from the company. Furthermore, he recognized that the inability to pay for school was a major roadblock preventing people from applying in the first place. He began to offer scholarships of around $1,000 to $1,500 even before people had been accepted to a program, as a motivator for them to apply.
Within 12 months of receiving their last scholarship payment, 80% of those workers are still with Trilogy, Schmiedeler said.
For those workers who do not want to pursue a college education or are not yet ready, there is an apprenticeship program. Each time an apprentice learns new skills and knowledge and earns a certificate, they receive a pay raise. And, the certificates are tied to college credits, so apprentices can get a jumpstart on that educational path if they decide to eventually enter a degree program.
In the most recent initiative, Trilogy in June announced the partnership with Purdue University Global, an affiliate of West Lafayette, Indiana-based Purdue University. Through this program, Trilogy associates receive free access to about 180 different online degree programs.
About 120 days in, there are now 400 Trilogy workers enrolled with Purdue University Global, according to Schmiedeler.
Beyond these educational benefits, Trilogy is investing in its workforce in other ways, including in wage increases. The company shifted to quarterly instead of annual pay raises, which compound so that most workers end up earning more of a 12-month period.
Maintaining competitive wages is necessary, Schmiedeler emphasized, but just paying more in response to rising pay rates in tight labor markets is not an adequate approach. He stressed the more holistic benefits of programs like loan repayment and tuition assistance, which have the multiple advantages of easing workers’ financial hardships, helping increase their on-the-job skills, and — hopefully — earning their loyalty.
“It’s an investment versus just a response,” he said.
Simple but not easy
With occupancy near historic lows on a nationwide basis and labor costs rising, senior living providers are under margin pressure. This no doubt makes major workforce investments difficult, Schmiedeler acknowledged, but he also thinks that with the right leadership and infrastructure, more providers should be able to emulate Trilogy.
In Trilogy’s case, a “people helping people” approach helps support its programs, some of which are company-driven and some of which are driven by contributions from the foundation. Out of the roughly 12,000 Trilogy employees, 70% make contributions to the foundation from every paycheck, Schmiedeler said.
“That’s how we do this,” he said. “Everybody does a little to help out people.”
However, simply finding and allocating the needed capital is just one piece of the puzzle, and Schmiedeler also credits the leadership of Bufford and Leigh Ann Barney, who recently succeeded Bufford as CEO.
“It takes visionary leadership to take those risks and know that doing the right thing is going to pay off,” he said.
A third requirement to pursuing major workforce initiatives is the willingness and bandwidth to put in the hard yards required to make them work, from structuring the programs to finding the right partners, to educating employees and driving participation.
“Any CEO in our space … will tell you they want to help people grow and get out of debt, but it’s not always easy to do,” Schmiedeler said.
He quoted a saying that he picked up from his mother, which he believes applies to these types of efforts: Life is simple, but it’s not easy. These workforce programs are relatively simple, but they are not easy.
With that in mind, Schmiedeler is eager to spread the word about what Trilogy has been doing, speaking to peers at conferences and working with Argentum on launching an apprenticeship program. Some providers might be deterred from sharing their secret sauce for retaining workers, given fierce competition for labor — but Schmiedeler points out that workers are always apt to move from provider to provider for a variety of reasons, and the industry needs to take a broader view.
“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.”