The loss of directors is a “critical issue” for nursing home workflow, morale.

Focused Post Acute Care Partners CEO Mark McKenzie is starting to see burnout among his top executives wreaking havoc across operations, with at least three of the operator’s directors having recently left the profession for other industries.

McKenzie said the administrator and director of nursing losses has become a “critical issue” for the Burleson, Texas company; its highest paid and best trained team members, for the most part, and those with the most experience are leaving the industry altogether and it has been difficult to recruit more.

“When you start to lose these [positions], other problems start to occur. Our industry continues to see a loss of team members within the industry itself, and you are catching it on both sides, ”McKenzie said, referring to a lack of people entering the industry coupled with a lack of people entering the industry. departure of staff.

Eboni Green, a faculty member in Walden University’s Doctor of Healthcare Administration program, says direct care workers and administrators are often inextricably linked to each other – when the administrator leaves , there is a series of certified practical nurses or licensed practical nurses who follow this person. outside.

“I’ve seen this happen a lot, because you build a relationship with the administrator, and sometimes it’s very personal,” Green said. “They understand what’s going on with your kids and your schedule… a change in leadership will not only impact patient care, but it will also impact the lives of staff. “

Green is also a registered nurse and licensed long-term care administrator, and co-founder of Caregiver Support Services in Omaha, Neb.

High stake turnover

Regulatory sanctions and the search for the right replacement can make the loss of an administrator more devastating than that of other institutional staff.

Whenever a director leaves, the operator must communicate it to the state, often triggering an investigation, Green added.

“The staff are already doing extra shifts and trying to make sure residents are meeting their needs, getting the care they need, and now we have to bring in this regulatory body,” a Green explained.

Having a regulator on-site puts additional stress on caregivers, said Green, who is “hanging on to a string” in the first place.

Depending on the state, directors are required to have several years of education before assuming the role, Green explained.

For example, in Iowa, a prospective retirement home administrator must already have a bachelor’s degree in a related field such as business or healthcare before entering a one-year administrator training program.

“It’s more difficult because of the extensive training you need to have on the regulations, whereas when we talk about frontline caregivers, licensed practical nurses, the training is usually 76 to 100 hours of training,” he said. Green said.

Bringing in administrators from different industries is more feasible in assisted living or independent living situations, she said, due to a less regulatory environment.

Money does not go far

Despite an overwhelming number of incentives offered to get directors through the Texas facility gate, the response from applicants has been disappointing, said Reginald Hislop III, Managing Partner of H2 Healthcare.

Login bonus wars are reaching $ 50,000 in an attempt to attract staff to the Dallas, Texas metro market, Hislop told Skilled Nursing News.

“As we see in Texas, it doesn’t matter how much you pay,” Hislop said. “The staff would rather work for each other than for, you know, a $ 25,000 sign-up bonus where they already know they’re going to be forced to work mandatory overtime and 12, in some cases shifts. 24 hours. You try to fill shifts with money. It won’t work, you know, if your environment is harsh and people don’t like working in it.

Hislop said the industry is coming to a point in the workforce crisis where it doesn’t matter how much money is in the equation because there are too many other “core issues”.

“They all said, I’ll watch the industry when [pandemic case numbers] flatten out, ”McKenzie said, referring to early references to flattening the surge in COVID cases. “Since the pandemic, month after month, we continue to see people leaving industry job boards instead of entering. “

Prior to the federal immunization mandate, the flow of applicants to Focused Post Acute was 50% of what it was before the pandemic, McKenzie said. Now that statistic is even lower, hitting 35-40% of what it was last February, after experiencing a brief rise in June.

“At one point, no singular shot was the one that got you out of the industry, it was collecting punches or kicks in the shin or as you mean, to go, ‘today’ hui is the day that broke me, ”McKenzie said.“ We’re starting to see more of these days in the last 60, 90, 120 days than we did at the start. [of the pandemic]. “

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