Jul 12, 2022

Prioritizing Caregiver Well-Being: Strategies for Staff Retention

Average staff turnover in assisted living communities is approaching 50% annually, according to the Bureau of Labor Statistics –- and still rising. In addition to the disruption in resident care, the average cost of replacing a lost employee can run as high as 25% of annual compensation.

Not surprisingly, many facilities react to the situation by concentrating on the hiring process. However, in today’s labor market, equal attention should be paid to supporting team well-being as part of an organization’s staff retention strategy.

Preparing for Growing Staffing Challenges

Born between 1946-1964, Baby Boomers are currently between 58 and 76 years of age. Those who are 65 or older will be doubling by 2060 to about 95 million people. Experts project that this will increase the need for additional caregivers by about a million workers over the next five years alone. The labor force is only expected to increase by about 14% during that period, so available workers will continue to be in short supply.

Labor-intensive, low-paying work; irregular hours; low opportunity for advancement; and job burnout fuel staff turnover. As of November 30, 2021, roughly 1,802,000 job openings existed in the U.S. healthcare and social assistance sector, up from 1,234,000 one year earlier on November 30, 2020, according to U.S. Chamber.com. With so much opportunity, it’s very easy for workers to change employers.

Employee Retention Strategies that Prioritize Well-Being

Employee well-being involves more than just providing a pleasant place to work. Employees want to feel safe and secure financially, physically, and emotionally. If you can help them achieve these goals, it stands to reason that they will be less likely to seek other employment. While some of these ideas may seem expensive, they may be much more affordable than reacting to the ongoing labor churn that many care facilities are experiencing.

Tips to Facilitate Financial Health

  • Offer the Best Wages Possible. Notice that we didn’t say “competitive wages.” Most direct-care workers’ pay falls consistently within the bottom 25% of hourly wages and below half of the American national average. Many jobs are also part-time. Paying above the local average will help you stand out from competing employers.
  • Arrange a 401(k) or Similar Retirement Plan. Employer-sponsored retirement plans make it easy for employees to set aside funds, usually tax-free, toward their retirement fund. Employers save by not having to pay FICA matching on the amounts set aside. Many employers match a certain level of the employee’s contribution to encourage participation.
  • Sponsor Personal Finance Classes or Apps. Most non-profit community credit counseling services offer free group classes on such topics as budgeting, handling credit, etc. Private financial planners often do the same. There are also many online apps to help employees take control of their finances.
  • Support Staff Career Paths. Continuously engage staff and reinforce community values through professional development and interaction such as interdisciplinary meetings, team building, and professional growth opportunities (external and in-house). Use recognition programs (cash bonuses and gift cards are always popular) as rewards for those that have gone above and beyond.
  • Plan for the Future Together. Talk about career paths when providing feedback – both through informal chats and one or more annual professional evaluations. It’s an employee retention strategy that costs essentially nothing, and the employee will feel that you value them as a long-term staff member.

Tips to Facilitate Physical Health

  • Provide Healthcare Benefits or Assistance. If you cannot afford to provide a group health plan, consider offering an Individual Coverage Health Reimbursement Arrangement (ICHRA). This lets you assist with employee healthcare coverage by reimbursing part or all of their premiums for getting a policy of their own.

In addition to healthcare coverage or an ICHRA, consider offering a Flexible Spending Account (FSA) for healthcare or dependent care. The employee saves on taxes for anything they set aside in these accounts from their paycheck and the employer saves by not paying FICA matching on the amounts set aside.

  • Encourage Simple Physical Fitness During the Workday. Host a five-minute stretch a few times each day. Encourage employees to walk on their breaks. For an extra incentive, consider a reward system related to steps taken. If you have meetings, consider making them walking meetings. Of course, the feasibility of these ideas will vary depending on your facility and the employees involved. The point is to get creative with how you support your team’s wellness.
  • Offer Discounts or Subsidies for Wellness Efforts. Some employees may subscribe to Peloton. Others may belong to a yoga studio or a gym. Some may use a healthy eating subscription-like Daily Harvest. Find a way to offer a personalized benefit that employees can apply to whatever fuels their well-being. See more on this topic in the “Lifestyle Spending Account” paragraph below.

Tips to Facilitate Mental Health

  • Re-Think Scheduling. Undoubtedly, the pandemic has demanded more out of caregivers. Overtime without relief is a surefire way to drive up turnover. Some residential facilities have adopted a two-tiered schedule (see this example). Others study past work schedules to identify call-off and overtime patterns and regular scheduling gaps to pull in part-time staff more effectively.
  • Support Those Who Support Your Residents. With staff regularly putting in overtime, you may want to help their workers keep up with areas that may be falling behind in their personal lives. This could involve providing free healthy lunches, additional uniforms to cut down on laundry needs, and transit passes, to name a few ideas.

Offering time off to care for loved ones can greatly reduce employee stress. On-site access to chaplains to help employees stay spiritually engaged can also be highly beneficial and usually fairly easy to arrange. Sponsoring classes to teach meditation or subscriptions to meditation apps can also be effective.

  • Consider Offering a Lifestyle Spending Account. Lifestyle spending accounts are a fairly recent type of employee benefit in which the employer reimburses employees for certain approved expenses. The accounts were originally created to help with physical fitness but have since expanded into supporting mental health and financial well-being as well. The employer sets the eligible expenses, which could include activities that promote mental health, such as counseling, “getaway” travel, extra time off, etc. Employees submit paid receipts to prove participation for reimbursement.


Making staff well-being a priority can pay many dividends beyond just reducing turnover. Additional benefits include better resident care, which can impact your facility’s reputation among families and potential future residents.

Retention is contagious. The longer you keep quality workers, the more stable your staff and the easier it will be to attract new ones. Make your facility a place where caregivers want to work by adopting these employee retention strategies.

If you need assistance, contact us. PCALIC provides insurance and risk management for assisted living facilities. Learn more.