Thursday, September 6, 2007

Caregiver Turnover - an Expense We Cannot Ignore

Do you realize that the turnover rate for CNAs in nursing homes today stands at over 70%? That means in a given year 7 out of 10 caregivers will leave their jobs – and the people in their care. That’s incredible – and an issue none of us can afford to ignore.

During my mother’s stay in a nursing home following her auto accident last fall she came to know her caregivers well. She listened as they told her stories about their kids and personal lives, and she shared her own stories with them. They got to know her as a person, and got to know her individual care needs and wishes.

My mother, mind you, is not only a lactose intolerant vegetarian but she is also a retired RN who worked her entire career in long term care. Meeting her needs in a way that met her standards was challenging, to say the least. Imagine the increased challenge to discover, just when she had one trained, he/she left only to be replaced by a “caregiver in training.”

Families rely on caregivers to notice when something changes in their loved one; when something seems a little “off” or when behaviors can signal a problem.

To the brand new caregiver, agitation might mean the doctor gets called and an order for an anti-anxiety medication gets added. For the experienced caregiver, this may simply have been an alert to a medical problem like a bladder infection that needs diagnosed and treated.

In fact, reduced caregiver turnover is directly tied to the quality of resident care and to client/resident satisfaction, according to Better Jobs Better Care, an organization focuses on improving the turnover rate among direct care staff and “contribut[ing] to improved workforce quality.”

BJBC found that, among other things, turnover costs the organization an average of $2,500 per person, racking up millions of dollars of costs that get passed to the consumer either directly, as a portion of the cost of care, or indirectly, as governmental programs reimburse care services.

In a recent article published in FutureAge (“The Business Case for Investing in Staff Retention”, March/April, 2007) David Farrell of Medical Hill Rehabilitation Center shared what happened when his community began to seriously invest in proven staff retention strategies (things like increased staff training – near to my heart – seniority wage increases, peer mentoring and more): “Over the past six months, as staffing stabilized, the results have been dramatic: Our annualized CNA turnover rate has dropped from 94 percent to 29 percent, representing significant savings.”

As the result of this savings, Medical Hill was able to increase staff wages (one significant factor in high turnover) without adding to overall expenses.

Investing in improved staff training and other turnover-reducing measures pays off financially, but it also pays off in a more significant way to those of us who need the services of a care community: it pays off in better care for our loved ones. And that’s a payoff we all have a stake in.

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