How Senior Living Providers Can Combat ‘Evaporating’ Sense of Purpose Among Workers

Senior living workforce challenges mounted over the course of the summer, with employee engagement falling and turnover increasing. 

That’s according to data gathered by Activated Insights from about 250,500 senior living and care employees. Activated Insights is the senior care division of Great Place to Work, the organization that puts together the annual Great Places to Work in Aging Services list that appears in Fortune magazine.

The engagement and turnover trends are “somewhat intuitive,” because burnout among staff members became a greater threat across the industry as the Covid-19 pandemic stretched on, Enlivant CEO Jack Callison told Senior Housing News. The Chicago-based provider has a portfolio of about 230 communities across the country.


As so-called Covid fatigue worsened, senior living workers had more options for employment in other sectors during the summer than they did in the spring, when the U.S. economy was in a state of near-total shutdown.

Senior living providers have no control over the duration of the pandemic and can only wait for the development of an effective vaccine. Likewise, providers have no control over the repercussions that the pandemic — and the government’s response — have on the overall economy and the labor market.

But, senior living providers are not powerless, and can take steps to bolster employee engagement and improve retention. Enlivant and Dallas-based Buckner Retirement Services are seeing positive results from the efforts they have undertaken in the midst of Covid-19.


And workforce challenges are familiar to senior living providers, which were facing historically tough labor market conditions even before the pandemic. As has always been the case, having a strong culture forms the underpinning of any other initiatives, and is why Enlivant has been able to buck some of the recent negative trends, Callison argued.

An ‘evaporating’ sense of purpose

When Covid-19 began spreading across the United States in the spring, senior living providers went into crisis response mode. Many providers at the time noted that their associates were rising to the unprecedented challenges of the moment, and the numbers support that this occurred.

In April — the first full month of the pandemic for most providers — the average employee engagement score for senior living providers was 74% out of a possible 100%. This is according to the Great Place to Work Institute’s Trust Index, which reflects survey responses across the dimensions of management credibility, respect, fairness, the pride associates feel in their work, and their sense of camaraderie with colleagues.

In May, the average Trust Index score rose to 81%, which not only was a month-over-month increase, but was 5% higher compared to May 2019. This suggests that workers were highly engaged as they mobilized to protect residents, and that senior living management was doing a good job of leading and supporting them in this effort. That said, some selection bias might be reflected in this score, as communities that were hardest hit by Covid-19 might not have had the bandwidth to fill out surveys during that month.

Over the course of the summer, senior living workers’ sense of purpose “more or less evaporated,” according to a graphic released by Activated Insights. The average Trust Index score fell to 73% in June and 66% in July.

Click to enlarge

The good news is that the score ticked up to 76% in August. However, employee engagement in August 2020 was still 2% lower than it was in August 2019.

During the early weeks of the pandemic, turnover decreased in senior living, likely due to a combination of workers being more highly engaged and the fact that few alternative employment opportunities were available as the economy came to a standstill.

In the summer, however, turnover increased. Turnover increased 14% on an annualized basis in June, and it increased 10% on an annualized basis in July.

Workforce programs make a difference

The Activated Insights data suggest that senior living providers face a tough task in keeping workforce engagement up and turnover down as the pandemic stretches on. But, some companies are finding that efforts to accomplish these twin goals are paying off. 

Although Buckner did see turnover go up in the summer across the organization’s six Texas communities, turnover is down overall about 2.4% since February 2020. And engagement scores were high during that period, which Buckner Retirement Services Vice President Brian Robbins credits to the organization’s concerted efforts.

Like many providers across the country, Buckner implemented a “Heroes Work Here” campaign with t-shirts and celebrations. Buckner also supported employees by providing meals during their shifts and food to take home to their families, including through “employee blessing boxes,” which allowed employees to “shop” for free items at pop-up grocery stores set up at communities.

Maintaining these types of initiatives is important, Robbins emphasized. Too many providers may have lost focus on engaging and rewarding employees over the summer, contributing to the slide in the Trust Index scores.

Taking time off if also necessary to prevent burnout. With travel difficult or impossible, and work more demanding than usual, employees may not have taken summer vacations as they would during a normal year, Robbins noted. So, Buckner is encouraging employees to take time off and “mental health breaks.”

At Enlivant, turnover is down 8.4% and retention of long-term employees is up 6%, year-over-year. The company conducted its Great Place to Work survey in late May and early June. With a participation rate of 91%, the survey results showed that 90% of employees agreed or strongly agreed that their work has special meaning; 85% said they agreed or strongly agreed that they make a difference; and 85% said they feel a sense of pride in what they accomplish.

Callison credits the company’s multifaceted response to Covid-19 and also the strong culture that existed before the pandemic struck.

“Our culture has never been more cohesive and as strong as it is today,” he said.

Enlivant has implemented several workforce support programs directly in response to the pandemic, with communication being an essential area of focus. President and COO Dan Guill began sending out nightly emails to share updates with the entire organization; weekly webinar office hours provide a chance for team members to ask questions of the executive leadership; and bimonthly town halls provide a forum for sharing news and information while nurturing the enterprise’s culture and go-forward vision.

The company has also invested in efforts to improve the quality of interpersonal communication — for instance, by rolling out a series of workshops titled “Listening with Empathy.” These workshops helped leaders develop skills and habits to support their teams from an emotional and mental standpoint, which is so important given the stresses and strains that everyone is facing in 2020, Callison said. Employees also have been able to access webinars that have focused on topics such as stress management, parenting in uncertain times and improving mental toughness.

Efforts to help workers more deeply connect with each other extend to Enlivant’s response to Black Lives Matter. The company began conducting active listening sessions across the country in the spring, created an employee-led council dedicated to issues of anti-racism and racial equity and inclusion, and is maintaining an “intense focus” on making sure that diversity and inclusion are “not just words on an HR packet,” according to Callison.

Like Robbins, Callison also emphasized the importance of taking needed breaks from work. To this end, Enlivant implemented a “buddy” program. The buddies provide shift support for each other, so that they can step away as needed to maintain their mental and physical health. 

The same goes for workers at the corporate level, where work-from-home policies have increased the risk of burnout.

“Like many companies, we’ve found our productivity has gone through the roof,” Callison observed. “It’s just so easy to keep going and work longer with no commutes.”

He and his buddy — Guill — are responsible for prompting each other to take time off on a regular basis.

While proud of Enlivant’s Great Place to Work certification and the performance of the team throughout the year, Callison is circumspect about what the next few months will hold.

“We’re not trying to paint an overly rosy picture about the current environment,” he said. Considering the uncertain timing around vaccine development and distribution, he anticipates that the operating environment will be strained “well into next year.”

Given the hard road ahead, he is keeping the team focused on the organization’s mission, and staying committed to being a “problem solver” for older adults, their families, the cities and towns where they live, and the U.S. health care system.

“That’s what Enlivant’s culture is all about,” he said.

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