McKnight's Women of Distinction Forum session 2
From left: Alison Kippen, Liza Berger, Steven Chies, Amy Schectman, Brenda Connelly, Jim White and Demetress Harrell discuss the caregiver shortage during a session during the McKnight’s Women of Distinction Forum. (Photo by Tori Soper Photography)

CHICAGO — Combining pay increases with innovative benefits and a culture that rewards loyalty is a key way to improve long-term care hiring and retention, six industry leaders said last week.

What doesn’t work is a cookie-cutter approach that only throws money at would-be workers, agreed speakers at the McKnight’s Women of Distinction Forum on Friday morning.

“I will tell you, having gone through these crises over my entire career, there is not enough money to be spent to solve the problem short-term or long-term,” said Steven Chies, president of North Cities Health Care and a 40-year long-term care veteran. “You’ve got to have the data and the information before you can decide what the solution is. If you think in medical terms, you diagnose and then you prescribe.”

New Brighton, MN-based North Cities offers assisted living and skilled nursing. Chies’ comments came during “Work It: Smart ways to address the caregiver shortage,” an hour-long educational panel moderated by McKnight’s Home Care Editor Liza Berger.

Other panelists included Brenda Connelly, RN, chief operating officer of McMinnville, OR-based senior living provider The Springs Living; Demetress Harrell, CEO of Hospice in the Pines, Lufkin, TX; Alison Kippen, vice president of human resources for Chicago-based long-term care company Senior Lifestyle; Amy Schectman, president and CEO of Boston-based 2Life Communities; and Jim White, partner and chief culture officer at Chicago-based Ignite Medical Resorts. They shared their biggest challenges, innovations that have worked and advice on improving recruiting and retention in other communities.

Although much of the focus has been on staff losses among frontline caregivers, concerns about shortages in management, dining and housekeeping are increasing in healthcare and senior living settings.

“There were folks within the salaried level that were stepping in and providing so much and that strain and struggle really caused them to question: Is the reason I got into this still the same reason?” Connelly recounted. “But it’s also been a tremendous opportunity on the salaried front in particular, to be able to recruit and reach folks from other industries because now, they’re sitting there questioning: Does my job fulfill me?”

Patching new holes

White said that healthcare can be sold as a steady profession with a growth curve ahead, whereas other industries may be retracting. But, he too, has seen challenges grow beyond nursing.

“The therapy discipline has become extremely challenging as well, to where therapists now, because of the increase in wages around, they see that they can leave and make more money,” he said. “Sometimes you can compete and sometimes you can’t. …We’ve actually experienced a big therapy hole this year.”

Ignite Medical Reports grew to 14 locations in the central U.S. during the pandemic. White said that recruitment and retention were aided by the company’s “Superheroes in Scrubs” program, which rewards dependable employees with bonuses for attendance, extra paid time off and gift cards.

“While we may not be able to compete with some of those exorbitant sign-on bonuses or those wages that get paid to travelers or hospitals …I can be competitive enough and have other things behind it that will seem appealing,” White added.

Schechtman’s company doesn’t hire caregiving staff, but she has faced plenty of challenges filling maintenance and dining positions. Despite boosting hourly minimum wages to $19.25 and salaried employees to $40,000 annually, well-trained maintenance workers still were recruited away to union jobs paying more than twice the rate.

Although 2Life has adopted sliding scale insurance premiums and started contributing to 401(k)s even for low-earning workers who don’t pay in themselves, Schechtman said that higher-level solutions are necessary.

“If you’re looking at it from a very micro level, each of us can’t solve it with money,” she said. “If you’re looking at a societal level, there’s plenty of money out there; for example: if we had Medicare for all; if we had a national minimum wage of $25 an hour. …If we made affordable housing an entitlement as opposed to only nursing homes being an entitlement, we could shift so much.”

What’s working for them

Other recent benefits and intangibles added by the panelists’ organizations:

  • Pausing senior-level raises to give lower-earning employees higher increases in the face of inflation.
  • Increasing paid vacation to three weeks for all staff members.
  • Adding separate bereavement leave.
  • New counseling and grief support services.
  • Instant access to paychecks.
  • Initiation of flexible spending accounts to improve childcare affordability.
  • Faster job offers after application and interview.

Harrell added that the hiring conversation needs to start before the individual worker applies. Like Kippen, she said the staffing crisis started before COVID-19, although it has been exacerbated by the pandemic. The problems are worse in areas with suppressed wages.

“Those shortages took nurses out of our communities, and they’re now getting paid at a higher rate of pay to travel,” said Harrell, who noted that of nurses graduating from a community college near her, only 3% went to work locally. “They know that they are going to have that metropolitan dollar versus the rural rate. We might have the resources financially, but we don’t have the person.”

When employers find the person, they need to be “ready set to go” on making an offer, Harrell added. Her comment was echoed by Connelly, whose company joined the social media platform TikTok recently to help build brand excitement and attract applicants.

“Digital marketing is where you have to be,” she said. “Anything has to be displayed beautifully and quickly, because you only capture their attention for a short period of time. And then, once they do reach out, you’ve got to be there immediately and ready to attack the interview process.”

Despite the pressure to work fast and with creativity, human resources staff members still must remain supportive of existing employees. Kippen said that leaders must teach compassion as a key strategy and value.

“I think of it as, I’m hiring this person to care for a human being. It’s my job to care for them,” Kippen said. “Providing them with the basic necessities of life, pay and benefits that are competitive within the marketplace for what they’re doing but then…we have to be compassionate as well. Everybody is exhausted, and they’re finding it harder and harder to be super compassionate, and that is a big piece that we have to overcome.”

The session was the second of three taking place during the annual McKnight’s Women of Distinction Forum. For coverage of the first session, click here.

PointClickCare is the Diamond sponsor of this year’s event. OnShift and PharMerica are the Silver sponsors. The Bronze sponsor is Reliant Rehabilitation. Table sponsors include Dreamscape, Gojo/Purell and Sound Physicians.

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