This tool-kit is organized to allow each reader to use it in your own way. Retention of current staff is the best place to start. Too many organizations make the mistake of focusing mainly on recruitment. Recruiting new staff does not help if your nursing home is not able to retain them. Recruitment is always more successful when new employees come into a stable environment.  If you stabilize through retention, the rest will follow.

The various sections of this guide will include:

• The process for getting started, and outlining how to include staff from every department in your efforts.

• Providing tips on management practices that support stability related to: recruiting, hiring, welcoming staff, attendance, scheduling, consistent assignments, and creating a positive chain of leadership

• The introduction of a tool for “drilling down” into the data, to learn more about your current state of stability or instability, including how to gather and analyze data about turnover, absenteeism, and financial incentives.

• A case study describing how Birchwood Terrace put these very tools and practices to use to achieve staff stability. It shares how they used the drill down process to identify the root causes of their instability and re-allocate their financial and management resources to support stability.

• How to use training strategically to grow your staff’s abilities and thereby grow your organization’s capacity, including information about workforce development, and other resources available to help employers provide training. It also includes information about state-based technical assistance resources to aid in stabilizing staffing.

Program Documents:

The toolkit can be downloaded by choosing the ‘Download Toolkit PDF’ button below, or by clicking on the image towards the top of the page. You may download the corresponding worksheets listed below, by clicking the ‘Download All Worksheets’ button. (Note: Once you un-zip the worksheet files, they are in Excel format.)

• Worksheet 1: Employment Status

• Worksheet 2: Current Staff by Length of Service

• Worksheet 3: Vacancies

• Worksheet 4: Turnover Rates

• Worksheet 5: Turnover Replacement Costs

• Worksheet 6: Terminations by Length of Service

• Worksheet 7: Absenteeism

• Worksheet 8: Call-In Log

• Worksheet 9: Incentives
  

Origins of the Toolkit:

This tool-kit applies concepts and practices based on the work of Susan Eaton, who in 2002 completed a CMS funded study, What a Difference Management Makes.

Dr. Eaton’s study compared practices at high and low turnover nursing homes in the same labor market. Strategies and techniques based on her findings have been successfully piloted in Better Jobs Better Care Vermont (BJBC-VT), a CMS funded pilot involving 254 nursing homes in 21 states, called Improving the Nursing Home Culture (INHC), with nursing homes nationally through the QIO program, and in New England through workforce development programs. The program has now been expanded for use in New Orleans and Lake Charles, Louisiana amongst approximately 100 additional nursing homes. 

Press:

1. Brady, C., Frank, B., & Farrell, D. (2016, January). 10 Steps to Staff Stability, Part One. Provider Magazine. Retrieved from http://www.providermagazine.com/archives/2016_Archives/Pages/0116/10-Steps-To-Staff-Stability.aspx#magazine-article

2. Brady, C., Frank, B., & Farrell, D. (2016, February). 10 Steps to Staff Stability, Part Two. Provider Magazine. Retrieved from http://www.providermagazine.com/archives/2016_Archives/Pages/0216/Ten-Steps-To-Staff-Stability-Part-Two.aspx

A Special Thanks:

A special thank you to The Commonwealth Fund, who were instrumental in providing funding for this project. This would not have been possible without them!