Trust and Post-Acute Care: The Impact of Employee Turnover

After a life-changing event, such as a stroke, heart attack, major joint repair or serious illness, some people need post-acute care. “Post-acute care includes rehabilitation and palliative services,” reports MedPac. Additionally, temporary admission to such facilities, home health care and continuing therapy in another outpatient setting are considered forms of post-acute care. Unfortunately, high employee turnover rates in these key areas can have a serious, detrimental impact on quality standards and continuum of care.

Since seniors rely on your organization to overcome some of health’s greatest challenges, you need to understand how employee turnover results in distrust and problems in both home care and physical rehabilitation facilities.

How Does Demand for Home Health Care Impact Employee Turnover Rates?

Acute care facilities have a close relationship with setting up and helping people understand the role of post-acute care providers, especially when people need home health services. According to the Centers for Disease Control and Prevention (CDC), more than 4.9 million people received home health services in 2013, the most recent year for which statistics are available. Yet, senior demand for home health care, reports the most recent National Health Statistics Report, suggests greater insight into how employee turnover rates impact home health care can be gleaned by understanding exactly what types of conditions impact people receiving these services.

Consider the following types of conditions and how high employee turnover may impact them:

• 48 percent of care recipients had hypertension issues. Thus, blood pressure medications may need to be dispensed at the same time daily, and missing a dose or failing to check a person’s blood pressure could result in a cardiovascular event. When new staff members enter the equation, they may forget to check blood pressure or give medications.
• 32 percent of post-acute care recipients have diabetes mellitus. Simply not realizing this fact could result in severe spikes or drops in blood sugar, increasing the risk for other health problems.
• COPD and respiratory diseases impact 15 percent of recipients as well, so revolving staff members might not have completed appropriate training for administering breathing treatments or preventing harmful behaviors in affected individuals, such as smoking.
• Up to 10 percent of recipients need care for dementia, and since trust plays a role in encouraging seniors with dementia to engage in appropriate daily activities, including physical therapy, high employee turnover can incite aggression and fear in these seniors.

Other Impacts of High Employee Turnover

Among people receiving services in post-acute care facilities, high employee turnover can be seen among nurses, dietary staff, immediate caregivers and ancillary staff. Initially, high employee turnover may not seem like a problem for persons served, but as explained by the National Research Corporation for Health (NRC Health), it contributes to the following increased risks:

• Less accountability results from confusion amidst changing staff members. As employees move on from your company, they may refuse to answer questions regarding a specific individual’s care or activities while under their supervision.
• Higher risk for falls stems from lack of trust. Seniors living with physical weakness or difficulties, including those with dementia, rely on caregivers to help in transfers between living areas, such as the bed, chair, shower and restroom. When a new employee enters this situation, a senior does not know her or him from anyone else. Would you completely trust a new face to not drop you? Instead, you might be more inclined to try to get up and move on your own, even when it increases your risk for falls.
• Decreased funding from government agencies. Depending on the type of facility providing post-acute care services, high employee turnover rates may affect government funding too. If the facility experiences an uptick in the number of complaints or negative treatment outcomes, such as admission for rehabilitation that results in a fall and hip fracture, government agencies may levy penalties and fines against the facility.
• Increased inspections and quality-assurance issues. High employee turnover and complaints may contribute to problems with completing quality-assurance initiatives and maintaining a high continuum of care. This may arise as the number and frequency of inspections increase, and quality-assurance penalties may be assessed as well.
• Increased hiring and training costs.

What’s the Best and Most-Effective Way to Reduce High Employee Turnover?

There are many ways to reduce high employee turnover in your facility, but none have as much an impact as training. The University of New Mexico reports that the costs associated with a single nurse turnover can range from $27,700 to $58,400. This includes the costs of marketing to prospective employees, verifying credentials and completing training. Now, multiple that range by the number of nursing staff members that have been replaced in your facility over the last year. The results can be staggering.

Now, think about the unlicensed caregivers in your facility, such as certified nursing assistants (CNAs). These workers can have a turnover rate of more than double the rate among licensed nurses. On average, the CNA turnover rate is approximately 23.8 percent. So, it is in the best interest of your company to eliminate these costs.

The key to reducing the high cost of caregiver turnover in senior care facilities lies in training. You need a robust, intense and thorough training program in place. When your team members feel as if you have their back regarding best practices, new standards of care and personal well-being, they are more likely to remain working in your organization. Furthermore, training must be flexible. For example, allowing employees to complete training modules on their personal mobile devices can reduce your costs and the stresses associated with attending in-person training.

What You Need to Do Immediately

Your training program should leave employees with a sense of empowerment and resolve to provide the best care possible, regardless of their skill set. To help your organization succeed, you need to re-evaluate your training program immediately and make sure it prepares your staff members properly and thoroughly. If not, your organization will suffer financial setbacks and face ongoing trouble with employee retention.

Interested in learning more? Watch our on-demand webinar that tackles employee turnover and engagement.