Healthcare Perspectives


What are You Doing to Create a Positive Workplace Culture?

Aug 04, 2016
By: Stephanie L. Ferrario

Staff turnover rates in the senior living industry continue to be increasingly high. Losing employees impacts your facility tremendously by decreasing the quality of care, decreasing resident satisfaction, and increasing recruitment and retention costs. 

We continue to hear the following themes from senior living facilities: we can’t find people to fill our positions, there’s a LOT of competition for candidates, and it’s very difficult to keep good employees, especially certified nursing assistants (CNAs). But what if your facility focused on retaining your employees with the same energy that you focus on taking care of your residents? While senior living facilities tend to concentrate on providing excellent customer service to their residents, they need to remember to also devote attention to the satisfaction of their employees. 

Your organizational culture can be a strong recruiting and retention tool. When you base your facility’s culture on its greatest asset, its employees, the result can be an engaged staff focused on resident satisfaction. Like all major strategic initiatives, workplace culture should be instilled at the senior most level, and communicating that culture to all employees should be a priority. Senior living facilities should focus on the Three Ps that are crucial in any business: People, Products/Services, and Process. While all of these are important, when it comes to focusing on retention, the most important aspect is the process. Products and services grow from the processes that are in place to develop them. People are hired, trained, coached, recognized, and rewarded from the processes that your facility uses to develop them. 

Retention is not something that should be viewed as being “out of our control.” It should be tracked, discussed regularly, and supervisors should be held accountable for it. Retention should be tracked just like revenue, costs, service, quality, and safety initiatives are. Your facility should know what their turnover rate was for the last year, what it was by department, by shift, and what the costs of it were. Retention programs require full management participation. The human resources department is not responsible for employee retention; it is a management responsibility. HR can help set parameters, provide training, and monitor and measure results, but they are not responsible for implementing it. It is the responsibility of managers and supervisors to do so. 

Employee retention is largely driven by the relationships employees have with their supervisors. The way employees view their direct supervisor impacts how they view everything about their employment relationship. Supervisors build unique relationships that drive retention…or turnover. Employees need to hear directly from their supervisor that they care about them and that they want them to stay and grow with the facility. This is especially true for the millennial generation of employees who like and expect constant feedback. 

What better way to share with an employee that you value them and appreciate what they provide to your organization than by conducting a stay interview with them? During a stay interview, you ask a valued current employee why they continue to work for your organization. It is an opportunity to find out what they like about their job and about your facility as a whole. Stay interviews provide information to assess the degree of employee satisfaction and engagement that exists. Stay interviews should be conducted by the employee’s supervisor. Supervisors will need training on how to handle the interview and what questions to ask. Listening and taking good notes are key. Some great questions to ask during stay interviews include:

  • What do you like best about working here? 
  • If you could change one thing about your job or our workplace, what would it be?
  • Do you have the tools, equipment, or resources you need to do your job?
  • Why do you stay here?
  • What type of additional training or education would you like to receive?
  • What other areas of the facility are you interested in learning more about or working in?

Supervisors should not trivialize any feelings that are shared by employees during stay interviews.  It’s the feedback of the employee that you need to get to create or maintain a workplace culture that promotes open communication between employees and supervisors. If you’d like to reduce the amount of exit interviews you hold, a good place to start is by conducting stay interviews with valued employees. Stay interviews build trust, which is an essential component in good working relationships and maintaining a workplace culture of engaged employees.  

The following are suggestions for using workplace culture to improve employee retention:

  • Make culture a priority! Encourage managers and their direct reports to devote time to facility activities. Develop activities that will include both residents and staff.
  • Make retention a management objective that is measured and discussed regularly. Decisions should be made at the senior staff level and support employee participation in the culture. Encourage adoption of the culture across all staff levels and seek feedback from staff.
  • Conduct stay interviews with respected employees. Let them know that they provide value to your organization and that you want them to stay. Listen to any suggestions that they have, and implement an action plan to use their feedback to make positive changes in the facility. 
  • Encourage employees to get involved in residents’ lives. Employees should not be so consumed with their duties that they fail to get to know the residents. Engaged employees show enthusiasm for those they care for because they get to know them as family members. 

Engaged employees provide love, compassion, and dignity to those they care for. Without employee engagement, senior living communities will not be as successful as they can be.


Stephanie L. Ferrario
Senior Consultant
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