Photo by John Merkle.

The more things change, the more they stay the same. Or so they say.

For senior living communities dealing with the challenges of hiring, retaining, scheduling and training a qualified workforce, it’s true that things have pretty much stayed the same. It is still tough to find and keep workers in a market where fast food and retail merchants are competing for the same job applicants.

Yet there are new ideas, tools and systems to ease the burden of staff management available to organizations willing to embrace them. In that sense, the more things change, the more they can.

Any solutions for a senior living industry faced with an imposing labor situation are certainly welcome, says Mark Woodka, CEO at OnShift.

“Low unemployment, high turnover and a workforce shortage have led to a record number of open positions in senior care — this has made it harder to find qualified people today than any time in recent history,” he says. “With turnover rates at 50% or more across the industry, providers need to have a continuous flow of candidates readily available. At the same time, they need to make sure they’re doing everything they can to retain the employees they have.”

Market research points to a looming workforce shortage, Woodka says, but he maintains that data can be deceiving.

“The workforce shortage is here, it’s real and it’s challenging providers – today,” he says. “The shortage has made it very difficult for providers to operate, especially in markets where the supply is minimal given historically low unemployment rates.”

To be sure, as the labor market continues to tighten, finding qualified help has gotten more challenging, says Jan Wilson, director of learning designs and outcomes for Relias.

“Many operators are forced to offer premiums to secure qualified candidates,” she says. “Another interesting wrinkle is that most workers are expecting personal development as a determinant in making their decision to come on board with an organization. So if recruiters and managers aren’t leading with this type of benefit, good people could be lost before they even get to the latter stages of the hiring process.”

Despite the labor shortage, some professionals are having the opposite problem — finding a position in a senior living community.

“Our biggest challenge is actually finding work for all the dietitians we have in our network,” says Heidi Williams, marketing communications manager for Dietitians on Demand. “Administrators don’t anticipate needing a temporary dietitian, so it’s not a service they’re actively researching. Sites will often have one dietitian, so when that person is suddenly gone, they’re not sure where to turn, and the need becomes extremely urgent. In the case of an unexpected extended absence, such as family medical leave, maternity leave, vacancy, census increase or any other reason, we can typically get a temporary dietitian to cover within an average of nine days.”


Using the wealth of digital communications available, provider organizations have more forums for recruitment than ever before. Social media are an effective means for extending beyond traditional job boards for promoting job openings, says Jon Forknell, vice president and general manager for Atlas Business Solutions.

“It is a cost-effective way to fill open jobs by reaching targeted individuals in a specific geography,” he says. “Employee referral programs are a great way to find new hires. They can help identify qualified people who typically stay longer than other employees.”

Simplifying the application process is another way to remove potential hiring obstacles, Woodka says.

“I have heard time and again that organizations lose applicants if it takes more than two minutes to apply online,” he says. “Recruiters are also rethinking how they connect with applicants, so they don’t lose them in the process. Consistent communication is key.”

In today’s connected society, job candidates are doing extensive online research on potential workplaces, so it would serve providers well to promote their attributes on the internet, Woodka says.

“More providers are investing in a strong online presence that highlights their values, people and culture to differentiate themselves,” he says. “Providers who are building up their brand and expanding their digital footprint are more successful than those who don’t, especially with the younger generation, who comprise the largest portion of the workforce.”

Employers also need to understand what job applicants are looking for in terms of shift flexibility, career development, wellness programs and other perks, Woodka says.

“In many cases, a standard eight-hour shift doesn’t work for potential applicants,” he says. “I am seeing more and more providers get creative with their shifts, offering more flexibility with shorter shifts or those outside standard shift times. In addition, providers are now revisiting their employee programs and benefits to not only attract new hires, but to retain their current staff.”


The best way to retain employees is to offer a substantial orientation and training program, Wilson says.

“Most operators are starting to really examine their onboarding processes and practices with an eye toward retention, particularly their orientation programs,” she says. “In the past, orientation programs were viewed as simply a means to teach an established process: ‘Do this, this and that.’”

Providers need to conduct extensive review of their programs, which Wilson contends present too much information in too little time, with a lack of emphasis on real-world settings.

“Little if any time was spent on how all the concepts taught fit together from the lens of the customer,” she says. “Consequently, existing orientation programs did not prepare new hires for the world they would face — with real co-workers and clients — for which they are being asked to provide care. This is increasingly seen as being a contributor to turnover.”

Training programs also need to be analyzed for operational effectiveness, instead of relying on providing job instruction to staff while they are on the floor, Wilson says.

“More effort is being spent on getting new hires ready to face the real world of work with more collaboration between learning and operations, the inclusion of real-world scenarios and the addition of more critical thinking skills and more client-facing instruction,” she says. “Operators are seeing the benefit of enlisting all staff in the customer experience. This helps turnover by preparing new workers with a realistic set of expectations of their role in providing care for the whole person.”


If there is one place where technology has made a significant improvement in staffing operations, it’s with scheduling — a process that can get enormously complicated, says Michele McFadden, vice president of product management and strategy for SmartLinx Solutions.

“When we talk about employee burnout and turnover in the long-term care industry, we often think of the front-line staff,” she says. “However, schedulers have one of the most difficult jobs in the industry. Thanks to technology, a single scheduler can comfortably juggle call-outs, no-shows, PTO, different positions, shifts, departments and even facilities.”

Manual schedule-making can be “a huge jigsaw puzzle with many pieces missing,” McFadden says. “Today, technology enables schedulers to put the right people in the right slots, automatically adjusting schedules to census levels. Modern systems allow schedulers to review totals by PPD or hours. Intuitive consoles alert users when they are under or over their ideal schedule, allowing users to predict compliance and overtime issues before they become problematic.”

Intelligent platforms enable schedulers to quickly post open shifts, automatically excluding staffers who will incur overtime, McFadden says.

Moreover, she maintains that adding outside agencies and their employees is no longer the headache it once was.