Many so-called “people businesses” are essentially focused on encouraging customers to make a purchase—whether it’s a new car, an insurance policy or a home. However, the long-term living (LTC) industry is truly a people business in the most literal and direct sense; it is an industry where people care for people.
To be successful, long-term living businesses need to focus not only on their residents, but also on the people who are providing the services—the staff. However, the LTC industry often considers high turnover rates—particularly among certified nursing assistants—to be simply part of the business.
Rather than accepting turnover as an inevitable cost of doing business and focusing instead on investing in the most up-to-date facilities, LTC businesses should also focus efforts on building a permanent, dedicated and engaged workforce. Operators who invest in their staffs take a critical step toward business success. As a lender, turnover rates and quality of care are fundamental criteria that we examine when assessing potential opportunities.
Addressing common issues
Two of the biggest issues that impact seniors are nutrition and the feeling of isolation. A facility’s staff can have a tremendous impact on both these issues. An engaged staff gets to know the residents as individuals, building relationships that can alleviate loneliness. Dedicated staff members who are invested in the people they care for can transform a facility into a home and a community.
Whenever I take site tours, I look for staff members who go the extra mile to offer a wide variety of social activities—from gardening and crafting to Wii Bowling. When I see the staff members participating in the activities alongside the residents, I know I am seeing a well-run facility.
Similarly, a staff that connects with its residents is a staff that more effectively feeds its residents. Knowing the likes, dislikes and special nutritional needs of each resident is a basic requirement for effective care, but too many facilities fall short. Alleviating these two common problems can make an immediate difference in creating high-quality outcomes for residents.
Better care, better business
At the same time, we need to consider the business element of this “people business.” The primary source for resident referrals is hospitals, which discharge their patients to facilities with the expectation that they will receive appropriate care. Driven by current healthcare regulations where hospitals are penalized if a patient is readmitted within 30 days for certain conditions or diagnoses, hospitals prefer to refer patients only to those LTC facilities with the best care. Hospitals won’t recommend assisted living, home health or skilled nursing facilities that offer unacceptable outcomes, as measured by the hospital re-admittance rate.
Operators need to understand that dedicated staff members who are invested in the health and happiness of their residents will deliver a high level of care, which in turn will encourage hospitals to discharge more patients to the facility, leading to better results. Facilities that consistently offer high-quality care also may become a top choice in the local area, which can translate to higher occupancy rates, higher demand and the potential to earn higher rent.
Simply put, facilities must prove to hospital administrators and potential residents, through demonstrated quality outcomes, that they can deliver results. And those results are achieved by a strong staff that has the support of its employer.
Building engagement and loyalty
Turnover is the enemy of a cohesive, happy staff. Businesses need to address the root causes of turnover, including workload, compensation and opportunity. A facility should look at its employee-resident ratio to ensure that staff members are not overwhelmed by an unreasonable workload. It’s also no secret that compensation is critical; investing in competitive wages for employees can work wonders in reducing turnover.
Last but not least, LTC facilities should strongly consider offering programs to help their employees with their personal career goals. Many certified nursing assistants (CNAs) strive to become registered nurses (RNs). By offering programs to help them achieve this goal, and then offering them positions as RNs, businesses can create significant loyalty among employees, and in the process reduce the inevitable costs that turnover imposes.
More than a mission statement
Any facility can say they care about their residents and staff. Any facility can come up with a mission statement and have it framed by the front door. But by investing in the workforce in foundational and programmatic ways, a LTC business puts words into action by creating a culture of caring—the employer cares for its employees and the employees care for the residents. With the direct correlation between staff tenure and quality-of-care results, employees should always be a top priority to the operators of LTC facilities.
Imran Javaid is a Managing Director, Healthcare Real Estate at Capital One Bank.