Use These Strategies to Fix Common Staffing Mistakes at Your Senior Care Organization

Part 2 of a 2-part series on common staffing mistakes to avoid at senior care facilities

Marina Aslanyan, CEO of SmartLinx

In part one of our series, we highlighted common staffing mistakes in the senior care industry by talking to several experts who shared the most common mistakes they see senior care organizations making. We also explored the impacts those mistakes can have.

In part two, our staffing experts share solutions to help avoid or fix those common mistakes. 

Providing Control Over Staff Schedules

Marina Aslanyan, CEO of SmartLinx, explains that senior care organizations need to address the issues of asking staff to work long hours. Those long hours can increase stress and lead to burnout, while also reducing levels of patient care. “Employees with greater control over their shifts, including the amount of time worked, on which days, and when, will help organizations avoid short-term staffing pitfalls,” she says. “However, allowing employees to have more control over their shifts also means organizations must adjust how they staff in the first place.”

Rebecca Love, chief clinical officer of IntelyCare

Rebecca Love, RN, MSN, FIEL, chief clinical officer of IntelyCare, suggests that senior care organizations stop relying on a central scheduler to schedule all of the staff. “Turn that around immediately and allow staff to schedule themselves based on the agreements they have,” she explains. “Let them figure out what works best for all employees. When you give the power back, I think a lot of your problems go away.” 

“This used to be common practice in the 1980s, and job satisfaction of nurses was significantly higher,” says Love. She encourages organizations to allow staff to create their schedules, and to then follow up and fill in any remaining gaps.

Love also encourages organizations to redesign their approach to on-call staffing. Under most common models, the best employees are burned out by being on call. “Mandating on-call for employees already going above and beyond daily is a wrong way,” she says. “Redesign those requirements so these individuals feel more empowered and less like they can never leave work behind.” 

Exploring New Staffing Models

To give employees the work-life balance they need, Aslanyan suggests that senior care organizations adopt a different approach to staffing. “The way senior care organizations used to rely on their workforce to deliver quality patient care has changed,” she says. “To avoid turnover rates and overworked full time employees, organizations must adopt a multi-pronged approach to flexible staffing that includes various types of labor across full-time staff, traveling nurses and agency staff.”

Increasing Patient-to-Caregiver Ratios

Love explains that many senior care organizations have increased their patient-to-caregiver ratio. For example, organizations might now have a 1:60 CNA-to-patient ratio as opposed to a 1:30 ratio. “They’re increasing ratios that make it almost unsafe,” says Love. “Or they’re keeping their censuses down to a level where they still have very high ratios, and that then decreases their revenue.” 

Decreasing census and working with less-than-optimal staffing levels not only adds stress and burden to staff, but can negatively impact reimbursement. “They are in this difficult spot where they brought in staff to staff the organization correctly and drive up the top of their census and increase their reimbursement rate, they will do better long-term,” says Love. “They’re getting dinged on reimbursement models.” After a few cycles, Medicare and Medicaid will look at the organization’s star quality ratings. 

Love explains that in such a situation, she would work to optimize census, understand the true cost of staffing, and determine what CNA-to-patient ratio delivered the best outcomes. Then, she would work to establish that ratio for those improved results. 

Addressing Flexible Pay

Aslanyan explains that 51% of employees are more stressed about their finances today than they were during the height of the pandemic. While salaries are increasing to improve retention, the lack of flexibility in both pay and scheduling has prompted employees to look for other options. “Giving employees access to same-day pay is a benefit that can inspire workers to stay at the job for longer,” says Aslanyan. “Its convenience lets employees access their earned wages whenever they want, giving them flexibility and reducing stress.”  

Reducing Administrative Task Burden

According to Aslanyan, “36% of clinicians spend more than half their workdays tending to administrative tasks, and 89% of clinicians must consult different electronic systems at least a few times a day – just to access patient information.” As a result, nurses face increased difficulty in staying on top of tasks and feeling productive. 

To combat this issue, Aslanyan recommends that senior care organizations invest in automation technology to reduce the manual administrative labor that nurses face. 

Ensuring Staff Feel Heard

Love emphasizes that it’s important to focus on your workplace culture. “I don’t think we spend enough time making staff feel heard or appreciated,” she says. She recommends that the CEO visits all three shifts once per month. A CEO should sit down with staff and ask for their ideas. 

Identifying the Pressing Problems

While we’ve highlighted some of the most common staffing problems in senior care organizations, Love notes that it’s essential to identify the problems at work in your specific organization. The best way to do that is to ask your staff. 

While many organizations bring in high-cost consultants, the staff are often most aware of the real challenges that they face daily. “Run a hackathon,” Love suggests. “Have your staff identify the problems that they want to solve, form teams, and identify ways to solve the problems. Give your frontline staff this opportunity, and suddenly you’ve changed the culture at your organization.” 

Creating an ideas box is helpful, but it’s important for the organization to pull out one idea per month and implement it. She says, “Allow your frontline staff to solve the problems that are their problems, as opposed to what you think are their problems, and you’ll have a much happier workforce.”

Did you miss part 1? You can read it here: Are You Making These Staffing Mistakes in Your Senior Care Facility?

Paige Cerulli

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