3 Ways to Get Ahead of the Wage War Nicole Carter, Learning & Development Director, Signature HealthCARE

Healthcare, specifically long-term care, faces more challenges today than ever before. Payment has shifted from fee-for-service to value-based and bundled arrangements, and overwhelming regulatory pressures and decreased funding contribute to daily pressures. But an even greater problem is increasingly causing concern among providers: recruiting and retaining enough staff to provide consistent, quality care.

While the industry has historically been plagued with staffing challenges—turnover rates for certified nursing assistants (CNAs) or nurse aides can run close to 100 percent in some facilities—recent wage increases mean that healthcare providers are no longer competing just within their industry for staff. Last year McDonald’s began offering their workers pay hikes to help spur a turnaround. This January, Walmart announced that 1.2 million of its U.S. employees would receive a wage increase. And Walmart’s plans aren’t stopping with wage increases. On March 5, the company rolled out a new paid time off system that enables workers to use time as soon as it’s earned, allows carryover of time off, and even pays associates for unused time over the maximum carryover amount.

Healthcare workers have to ask themselves: Why deal with the emotionally draining and backbreaking work of being a CNA when they can make more money by working the drive-thru window instead?

Shawn Cates, regional vice president of operations for Signature HealthCARE, had this to say: “Staffing shortages are what keep operators up at night. They create a whirlwind of distraction and hurt every department in a facility, not just nursing. Unfortunately, there’s no intersection between what the government can afford, what a provider can provide, and what the public is willing to accept. Unlike McDonald’s, which can generate more profit by increasing their menu prices in response to, say, beef shortages, long-term care is limited to federal and state reimbursement rates.”

Most companies understand that wages and benefits are attractive to employees, even when they aren’t necessarily looking to jump ship. The lure of an additional dollar per hour can be a powerful motivator for a CNA who’s trying to pay rent and put food on the table. But how much does money matter? And, perhaps more important, who is less likely to consider leaving? The answer might surprise you. According to research conducted by global performance-management consultant Gallup, engaged employees are less likely to consider leaving. In fact, the majority of actively disengaged workers are likely to bolt for almost any raise, while the majority of engaged workers would require more than a 20 percent raise to leave their current company.

So how do talent professionals—and healthcare organizations—drive employee engagement to get past the “wage war”?

1. Build a culture that counts.

At Signature HealthCARE, we believe that culture is a key differentiator for attracting and retaining the right talent. Case in point: We require every senior executive to become a CNA. This sends a strong message to both the executives and the CNAs when hired. It shows that the company has a culture of care for both the CNAs and the residents. When the CNAs work side by side with their senior leaders on the floor, it shows respect, humility, and dedication to caring for the residents and listening to the caregivers in the workforce.

2. Capture the hearts and minds of stakeholders.

Everyone has heard the saying, “You’ll never get a second chance to make a great first impression.” It’s no secret to talent professionals that onboarding matters. Until last year, our new hire orientation was primarily focused on benefits, compliance, and clinical competency. With staffing challenges at an all-time high, we knew the focus had to shift and do more than just cover the basics. We had to capture the hearts and minds of our stakeholders and get them engaged in our vision right away. Our first day of orientation now uses stories, poetry, and interactive discussions to drive home the point that caring for the elderly is not just a job; it’s a calling and an opportunity to make a real difference in someone’s life.

3. Engage a new workforce.

One of the many advantages of requiring every executive to become a CNA is that we get to experience the training for ourselves. We quickly learned that nurse aide training courses range from four to eight weeks in the classroom, leaving participants without a paycheck and having to find childcare options to attend. Online options aren’t available in every state, and the states that do offer mediocre programs at best. This left us asking ourselves, “How will we attract and engage a growing workforce of Millennials to become CNAs?” For us, it was a complex challenge, made even more so by the fact that we operate in multiple states (all with different curriculums and approval processes). It took the right partner, who shared a passion for transforming entry-level workers into skilled employees, to be able to accomplish this. We’re now working closely with Cognotion to create an engaging, tablet-based training program for CNA certification that will be the first online program of its kind to match regulations and best practices in all 50 states. The program not only meets curriculum guidelines, but it also highlights the CNA as the “hero” of the care team.

Whether the long-term care industry likes it or not, the wage war is upon us. If healthcare organizations want to be competitive in the workforce, high employee engagement will be just one factor of many that we’ll need to re-evaluate.