LeadingAge members walked away from this year’s PEAK Leadership Summit with 4 big ideas for improving recruitment and retention of nurses and nursing assistants. The session was moderated by Natasha Bryant, senior research associate at the LeadingAge Center for Applied Research.

Hiring Resident Concierge Representatives

The Challenge: Elim Care wasn’t receiving enough applications from qualified nurses and nursing assistants to fill all the open positions in its organization. After talking with current workers, the organization concluded that most prospective employees don’t know they want to work in the field of aging until they actually start working in the field.

“We wondered how we could get those people in the door,” said Angela Brown, vice president of human resources. “If they don’t have that experience, they may miss out on a career opportunity, and we will miss out on them.”

The Solution: Elim Care created a new position called a resident concierge representative (RCR). RCRs are paid workers who perform tasks that do not require a license. For example, they may deliver trays at meal times, transport residents to and from meals and activities, make beds and straighten rooms. While they carry out these tasks, RCRs are also getting the chance to explore whether aging services, and Elim Care, are a good fit for them.

Implementation Details: Elim Care works with a local workforce training center to recruit RCRs. The training center offers extra support to these individuals, who are often at a time of transition in their lives, or are new to the workforce. The workforce center may pay a portion of an RCR’s wages, and may offer additional support if the individual decides to enter a nursing assistant training class. Elim Care also provides scholarships so RCRs can train as nursing assistants.

“The whole idea is to create that career ladder and to help someone not only take an immediate positon but also advance their career professionally,” said Brown.

Outcomes: RCRs are now working at 3 Elim Care sites. Almost all (86%) of the 7 RCRs at one site became nursing assistants, and all those nursing assistants stayed with Elim Care for more than 6 months. Three-quarters (75%) of the 12 RCRs at another site became nursing assistants and 67% stayed more than 6 months. A third site is just starting the program.

Recruiting Nurses from the Philippines

The Challenge: Presbyterian Homes and Services (PHS) serves 26,000 older adults each year and has developed 72 campuses for itself and other nonprofit organizations since 1991. But a nurse shortage was making it necessary for PHS to pay 2% of its annual expenses to hire agency pool staff, says Traci Larson, vice president of employee experience. Those numbers convinced PHS that it had to find a better way to recruit staff.

The Solution: Since 2002, PHS has filled its open positions by recruiting nurses from the Philippines. The organization currently employs 78 Filipino nurses, who make up 17% of its registered nurse (RN) workforce, and 70 family members of those nurses, who are employed in a variety of positons.

Implementation Details: PHS’s recruitment program is managed by PHS-INR, a wholly owned LLC subsidiary of PHS. A parallel organization named IPR manages the program in the Philippines. PHS-INR works with churches in the Philippines to identify and hire RNs. It also raises money to fund scholarships for Filipino nursing students.

Outcomes: Last year, PHS lowered the costs associated with hiring agency staff to less than .2% of its annual expenses.

National Church Residences University

The Challenge: National Church Residences employs 3,500 workers in 28 states. As the organization grew, it saw the need to create a more reliable system for conducting consistent onboarding and training, offering ongoing education on new programs and implementations, identifying talent, and offering career advancement.

The Solution: In 2005, the organization established National Church Residences University, which provides an online portal through which employees can access a variety of opportunities for education and advancement. The university portal provides courses and other career development opportunities that are specifically designed for housing staff, health care employees, and service coordinators.

Implementation Details: When new employees join National Church Residences, they are given a profile on the university portal. The profile identifies the person’s location, job type and any competencies that are specific to his or her job. In turn, those competencies are linked to available training programs and a personalized training plan.

Employees use the portal to join learning teams and search for a mentor, take part in training and track their educational progress, and identify new opportunities for career development based on that progress.

Outcomes: “We found that we are able to keep people in place by providing those step-by-step career development opportunities,” said Julie Fox, vice president of education and professional development. “It also gives us the opportunity look within the organization when we have job openings and to find out if we have people in the organization that are ready and available and interested.”

Mentor Program for New Employees

The Challenge: Six years ago, managers at Christian Living Communities began noticing that turnover among its 600 employees was beginning to rise. A root cause analysis revealed that workers were leaving the organization because they didn’t know what was expected of them, and didn’t have a friend at work who could answer their questions.

The Solution: Today, each new employee at Christian Living Communities is assigned a mentor who works side-by-side with that employee during his/her first 3 shifts, and makes sure the employee achieves a defined set of competences within the first 30 days on the job. Mentors and new employees continue to meet monthly for the first year of employment.

Mentors, who are compensated for their work, can be nominated by coworkers or supervisors, and go through an interview process before being selected and trained.

“We believe in choosing people who are strongly tied to our mission and values, and have good work standing,” says Susan Grayson, director of clinical quality and compliance.

Outcomes: Retention rates at Christian Living Communities have increased steadily since the mentor program was instituted. The organization’s skilled nursing settings now enjoy a 90% retention rate among certified nursing assistants, up from 49% in 2012.

“Hiring new people can cost up to $10,000 per employee, and our mentor program is costing about $500 per employee,” says Grayson. “But the greatest savings are soft savings. The overall morale has improved. Survey results have gotten better, and our reputation has improved.”