Strategies to Provide Long-Term Care Staff with Upward Mobility Opportunities

The pandemic and the nursing shortage have highlighted the changing priorities and desires of health care staff. To attract and retain staff, senior care organizations need to be flexible and find ways to fulfill these needs and desires, including upward mobility opportunities. By providing upward mobility, a job becomes an opportunity for growth, and staff members who might eventually leave for another employer now have a future within your organization, leading to increased staff retention.

The Value of Upward Mobility

Brandon Dow, chief executive officer of Orion Homes

Brandon Dow, chief executive officer of Orion Homes, explains that upward mobility offers more value to staff and to the organization. “How can we improve employee acquisition, employee retention, and stretch out that employee lifecycle so instead of having an average tenure of three to five years, we can grow that into five to ten years?” he explains. While annual reviews and raises are important, Dow notes that pay only goes so far. “Employees want to know that they are respected and appreciated and that their efforts matter,” he says. “Giving them room to grow in their careers and their responsibilities – in addition to earning more – helps them maintain a sense of purpose.”

He explains that upward mobility has an important secondary effect. When employers offer good wages and robust benefits, employees then have the stability to pursue education and growth opportunities outside of work. As a result, they enjoy more career prospects and a broader quality of life. “By having a minimum of three weeks of paid time off for every employee, increasing our employer match on 401k’s, offering company-paid life insurance, our benefit programs help ease the burden on employees and reduce those stressors that may be eating up their bandwidth to be exceptional,” he explains. As a result, both the employer and employees benefit.

Different Types of Upward Mobility Opportunities for Staff

Dow explains that Orion Homes takes a holistic approach to providing upward mobility opportunities to staff while emphasizing hiring from within. As a result, the organization offers a broad selection of opportunities, including:

• Incremental pay increases for additional training or qualifications, even if a staff member’s primary job role stays the same
• Promotions into shift leader or supervisory positions where staff can begin to develop leadership and management skills
• Augmenting staff out of direct patient care and into other departments where their unique skills and interests can help the organization, such as in human resources, activity leaders, and training
• Offering staff the opportunity to mentor newer employees and paying them an additional differential for taking on that responsibility.

To identify appropriate opportunities, Orion Homes looked at the internal talent pool and considered which skills, experience, and knowledge weren’t being utilized, and how those elements could be used to better care for residents. “Every team and organization is different, but the principles are the same,” he explains. “What are the resources that exist in our team, and how can we create new opportunities to activate them? How can we put someone’s internal, operational knowledge to dynamic use in an administrative role, be it finance, or human resources or clinical management?”

Annual reviews are also key to gathering information about opportunities that would be most meaningful to staff. Dow explains that annual evaluations should include two key questions to help gather this information: “What’s one thing we could add or change about your role that would have the biggest impact on your job satisfaction?” and “Where do you see yourself in two years?” Then, it’s important to find ways to implement those ideas and support those employee goals.

With opportunities in place, it’s also important to ensure that current and new staff are aware of those opportunities. Dow explains that new hires receive a menu of sorts, outlining the role and pay they are being hired for and the steps they can take to increase it. “We also send out job openings and training opportunities to all employees through our internal messaging platforms,” he says. Supervisors are encouraged to talk to teams about advancement opportunities during weekly leadership huddles. “We insist on interviewing internal candidates for every open supervisory or administrative position, and we encourage supervisors to speak up and nominate staff who they think would be a good fit for the role,” says Dow.

Steps to Provide More Upward Mobility Opportunities

Dow encourages senior care organizations who want to offer more upward mobility opportunities to start by looking at their organization charts. “Explore the spaces between the levels,” he says. “Where can you offer incremental advancement opportunities? Where can you differentiate for employees that offer unique skills or knowledge that can improve workflows, team performance, or quality of care? Where can you add rungs to the ladder so employees see a path to move up, rather than feeling like they need to open the door and walk out?”

He explains that it’s important for leaders to consider the benefits to the employee and the organization, rather than just focusing on their own team. “I hate to see talented people leave my team, but I know it’s a positive move for them, and the bigger picture is it strengthens the organization as a whole,” says Dow. He notes that the advancement also encourages leaders to constantly develop their entire team at all levels, ensuring they have a stable team of staff who can step up as another member advances.

Dow notes that it’s important to look broadly at the whole team, rather than just in a particular department, during the hiring process. “Chances are you’ll find someone,” he says. “Leaders need to make an effort and take an interest in knowing their employees and their backgrounds. Sometimes you’ll be surprised about a skill or an interest they aren’t utilizing in their current role that could benefit the organization in the future.”

Making a deliberate effort to support employees through their career growth is essential and can benefit both the employees and the senior care organization. “Residential health care is a high-stress environment in the best of times. You have to really love doing this work to be good at it,” explains Dow. “A lack of direction and a lack of opportunity saps that motivation and enthusiasm. As leaders, we need to ensure that we are constantly supporting the well-being of our employees, including supporting their growth.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.