Member of long-term care workforce shaking hands during recruiting job interview.

DALLAS — Recruiting and retaining employees has challenged senior living companies for years, and the pandemic has exacerbated the issue.

“Before COVID, employee turnover was 65% in our industry. Now, it’s north of 85%,” Jacquelyn Kung, CEO of Activated Insights, said Friday at what National Investment Center for Seniors Housing & Care President and CEO Brian Jurutka said was “probably the most important session” at the group’s Spring Conference.

Employee turnover, Kung said, negatively affects resident and family experiences. Fixing the issue, she added, can earn operators approximately $275,000 in net operating income per building. “So it’s pretty significant,” she said.

But leaders “can’t just double down on solutions that we’ve used for the past 10, 20, 30 years,” said Myra Norton, CEO of Arena Analytics. “It takes new solutions to navigate market disruptions.” Those solutions, she added, will be anchored by an organization’s mission, vision and values and supported by everyone in the organization.

Kung, Norton and two other session speakers shared 12 tips to aid providers in recruiting and retaining staff members and helping those employees feel a sense of purpose in their work.

1. Try to stand out

Hotels, hospitals and retail brands receive an average of 21 to 25 applicants per job posting, but senior living operators average 13 to 15 applicants per opening, Kung said.

The good news, she added, is that operators on Fortune’s list of Best Workplaces in Aging Services average more applicants per job opening than do other industries. Fortune publishes the list in partnership with people analytics firm Great Place to Work and Activated Insights, which is the senior living and care affiliate of Great Place to Work.

Great Place to Work-certified operators survey their employees using a 60-question “trust index survey” and have at least 70% of workers say that the organization is a great place to work. Once certified, operators automatically are included in Fortune’s ranking process.

“The takeaway from this is, in order to get great candidates in recruiting, you want to stand out. You want to become great,” Kung said.

2. Prioritize

When it comes to retaining workers, Kung said, Fortune 100 Best Workplaces across all industries average an 87 on the zero-to-100 scale of the employee trust index, but the best senior living companies average only 78 on the scale.

“When you have higher trust, you have more engagement,” she said, noting that when workers trust their employers, they are not afraid of being fired or penalized for their ideas.

Despite having a lower trust-related score than the all-industry average, the good news for senior living, Kung said, is that “our industry beats every industry and the Fortune 100 in terms of the statement, ‘My work has special meaning. This is not just a job.’ ”

To capitalize on that sentiment, she said, companies must prioritize where they focus their efforts.

“Eighty percent of our time is spent on the 20% of our communities that have a lot of problems. Is that where we want to spend our time?” she said. “We’ve found that, if that is where we spend our time, we need to prioritize what we work on and really move the needle on employee engagement, or spend more time on the other 80% of communities.”

3. Increase internal hiring

Hotels and retail settings promote approximately one third of their candidates from within, Kung said. “In our industry, it’s 17%,” she added, noting, however, that the top senior living providers fill more than 40% of their roles, especially leadership roles such as executive directors and department directors, from within.

“Set a goal,” Kung said. “We would recommend setting a goal of 40% of your hires being filled internally.”

4. Tap into nontraditional candidate pools

“Fishing in the same ponds that we’ve always fished in and expecting different results is a variation on the definition of insanity,” Norton said. “Let’s seek outside the industry.”

Operators should rethink job requirements and “what work actually is inside of our organizations,” she said.

Tapping into nontraditional talent pools when recruiting, Norton added, will diversify an organization as far as employee backgrounds, experience, education and other factors. “And that diversity actually helps reinforce our ability to innovate and solve problems as an organization,” she said.

5. Support work/life integration

“People want their lives to come first,” Norton said. “For us to win as organizations on the other side of that, we need to help support that.”

Work/personal life integration, she said, is “about understanding how we help the people in our organizations integrate the meaningful work they do with us into their lives.

6. Hire for outcomes

Operators tapping into nontraditional candidate pools are “going to find people that we’re not used to evaluating,” Norton said. “We’re now seeing a different type of person, a different profile, a different set of experiences, different backgrounds.”

Instead of using old markers and traits to analyze someone’s performance, she said, senior living employers will need to hire for outcomes, which requires realizing that “what I want to bring into my organization are folks that are going to help deliver the outcomes that matter to the residents that I care for, to the community that I operate in.”

7. Rethink the staffing mix

“There’s a huge opportunity here in terms of how we think about part-time workers, full-time workers, seasonal workers, etc.,” Norton said.

Data show that more than 40% of part-time workers want more hours, she added. “We’re struggling to staff our buildings. We should be taking advantage of that reality” to retain workers, she said.

8. Co-create solutions

“The answers to navigating this current market disruption sit inside of your organizations with people on the front lines,” Norton said. “Working together to create solutions that achieve the outcomes that are win-win is probably one of the most effective things you can go back and do today. …So tap into the wisdom of the people that are living the realities that you are trying to navigate” related to recruiting and retaining employees.

9. Know and care for yourself as a leader

“We have to understand ourselves and take care of ourselves if we’re going to create engaging workforces,” said speaker Ed Frauenheim, co-founder of the Teal Team. “In particular, what we’re talking about is knowing our strengths and weaknesses, what we’re good at and not good at [and] knowing our blind spots, especially in the world of a more diverse workplace.”

Leaders also must pay attention to their own health and well-being, he said.

“Are we aware of when we’re getting burned out?” Frauenheim asked. “Are we able to pause and prevent our own stress from rippling out and affecting everybody in the organization? And are we willing to take some time off to take care of ourselves, which of course then gives permission to other people in the organization to engage in self-care and therefore feel cared for?”

10. Know and care for employees

Leaders must try to find out what employees want, need and fear, the latter especially as it pertains to questions of safety and workplace protocols as the COVID-19 pandemic lingers, Frauenheim said.

“People also want to be supported as individual people and know that you’re encouraging their growth as human beings,” he said.

“When you know and care about your people, you get better engagement, better attention, and you get innovation as well,” Frauenheim added.

11. Help your employees know and care for each other

A culture of mutual care and camaraderie can be created in many ways, Frauenhiem said, citing employee happy hours, staff recognition parties and virtual coffee dates as possibilities that enable people from across the organization to meet and interact.

“You can simply start meetings with a check-in. That’s just asking people how they’re feeling at the beginning of a meeting during these stressful times,” he said. “And when we do this work of creating a culture of camaraderie, it’s really not the ‘soft stuff’ that you can skip anymore. This is success stuff that’s going to help you survive.”

12. Round for outcomes

“I would highly encourage you to systematize the practice of rounding for outcomes,” said speaker Craig Deao, managing director of Huron Consulting Group.

Rounding for outcomes, he added, “is a once-a-month conversation with direct reports that ‘touches the base’ on all the key things that people say they want out of their relationship with their supervisor. It starts with a personal connection.”

The first step, Deao said, is building a foundation of trust.

“We’re going to ask people what’s working well, because we don’t ask that question enough,” he said. “We can’t have people live in a state of negativity around the workplace. Even when things are tough, there’s always something we can be grateful for, and great leaders help people bring that top of mind.”

Ask workers who has helped them, and thank those people on their behalf, Deao advised. “We want to build relationships laterally as well,” he said.


Much of the advice to help with recruiting and retaining employees shared during the session boils down to engagement, Deao said. And engagement, he stressed, is not the same as satisfaction.

“Engagement is about being emotionally invested in the organization,” Deao said. “It’s about giving back. It’s about creating value.”

Satisfaction, he said, measures what a person is getting out of a relationship, whereas engagement measures what that person is giving back to the relationship. “And it’s why, as owners, as operators, as caregivers, engagement is the higher order that we want to achieve,” Deao said.

Employers can’t force engagement, but they can create an environment that encourages workers to engage, he said.

“Senior leaders have an important role. You have to create the playing field where engagement is possible,” he said. “You have to pay me a living wage and address a lot of the structural, systematic things.”

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