Survey Findings: Members Share Workforce Challenges

CFAR | April 06, 2017 | by Natasha S. Bryant

What are the most pressing workforce issues facing LeadingAge members? The results of our recent workforce survey offer a glimpse. 

The LeadingAge Center for Applied Research recently surveyed LeadingAge members about the most pressing workforce issues affecting nursing homes, assisted living communities, and home and community-based services (HCBS). About 17% (470) of the 2,778 survey recipients completed the survey.

Here’s an overview of the findings:

Workforce Challenges

Survey respondents reported that they face numerous workforce-related challenges, with the greatest challenges being:

  • Insufficient quality applicants (52.7%)
  • Staff turnover (25.9%)
  • Competitive wages (19.8%)
  • Staff vacancy (14.9%)
  • Staff retention (13.0%)

Respondents reported that the following positions are “very difficult” to fill:

  • RNs (30.6%)
  • Aides (27.5%)
  • Directors of nursing (24.7%) 
  • LPNs/LVNs (22.2%)

Consequences of Worker Shortages

Only 13.6% of respondents reported that they are not experiencing any consequences because of worker shortages. Other respondents reported experiencing consequences in 3 general categories: staffing, wages, and services.

Staffing: Respondents reported several staffing issues associated with employee shortages, including:

  • Increased workloads (64.1%)
  • Increased voluntary overtime (51.2%)
  • Low staff morale (45.4%)
  • Increased staff turnover (41.2%)
  • Increased absenteeism (25.8%)
  • Increased use of temporary staff (19.4%)

Wages: A quarter of providers (26.5%) reported that they are increasing wages to recruit and retain staff.

Services: Respondents reported that staff shortages are causing:

  • Difficulty completing documentation on time (18.5%)
  • Inability to expand services (16%)
  • Increased resident and staff complaints (14.7%)
  • Delays in providing care (13.4%)
  • Increased number of incident reports (11.4%)
  • Delays in admissions (10%)

Strategies for Recruiting and Retaining Staff

Providers are implementing a wide variety of strategies to recruit and retain staff. The primary recruitment tools are:

  • Online ads (93.5%)
  • Frontline staff involvement in recruitment efforts (62.5%)
  • Job fairs (57.4%)
  • Bonuses for recruiting other staff (57.1%)
  • Partnerships with colleges and universities or other educational organizations (42.9%)

To a lesser extent, providers are recruiting staff by building relationships with public and private human service agencies (37.9%), using sign-on bonuses (30.6%), and hosting internship programs (21.7%).

Only a small percentage (2.3%) of providers are not utilizing any strategies to retain staff. Most survey respondents said they are implementing a variety of strategies to keep staff on the job. The primary retention strategies are:

  • Tuition reimbursement or direct payment for employees (52%)
  • Competitive wages and benefits (48.7%)
  • Direct care staff empowerment (46.4%)
  • Employee recognition programs (42.6%)
  • Cross-train of staff (41.7%)

Employee Satisfaction Surveys

More than two-thirds of providers conduct an employee satisfaction survey. A majority of these providers survey employees at least once a year (61.1%), while one-quarter conduct the survey every 2 years.

A plurality of providers use satisfaction survey results to focus on the top identified needs and make targeted improvements (45%). Providers also use survey results to:

  • Develop action plans for the organization or individual departments (28.9%)
  • Develop new programs (6.6%)
  • Evaluate employee benefits (5.2%)
  • Develop training and professional development programs (3.3%)

Survey Limitations

Results from the LeadingAge Workforce Survey are regionally unrepresentative of the LeadingAge membership. Providers in the Midwest were over-represented among the survey sample. However, the survey results can be generalized to LeadingAge members who responded.