Although the long term care industry seems to be changing dramatically on a daily basis, there seems to be one constant.  That constant is our mission and goal to provide high quality services for the residents entrusted to our care.

As we continue our quest for quality, it is imperative that we not overlook the most basic element of quality -- the continuity of employment among long term care employees.  According to the Center for Health Statistics in Wisconsin's Division of Health, high turnover (or low continuity) can lead to staff shortage, which in turn allows less time for resident care.  A time lag usually occurs between the date an employee leaves a facility and the date a replacement begins work.  Training of new employees also absorbs time.  Therefore, it can be generally assumed that the lower the turnover among nursing employees in a nursing home, the better the quality of care will be.

Turnover is a problem that does not discriminate.  It affects every long term care facility despite location, size, and ownership.

Recognizing turnover as a problem for all long term care facilities, WAHSA's Health Issues Committee has formed a Task Force on Promoting Employment in Long Term Care. Over the past few years, this task force has devoted a considerable amount of time addressing this concern.  While it seems to be a natural course to find creative ways of recruiting quality employees, the committee acknowledged that recruitment does not address the issue of turnover and its impact on quality care.  For this reason, the committee focused its attention and efforts in the area of retention.

A couple of years ago, the Health Issues Committee developed a survey that was sent to all corporate members.  Members were asked to complete the survey with the assistance of CNAs.  In completing the survey, CNAs shared their ideas, concerns and thoughts about working in long term care.  They provided concrete suggestions about what would make their job more rewarding and meaningful to them.

WAHSA staff summarized the information gathered from the survey.  The Task Force on Promoting Employment in Long Term Care refined the survey information, added depth, suggestions and concrete ideas. The result was a valuable resource guide about retention in long term care.

This book was shared with WAHSA members throughout the state and with WAHSA's sister associations across the nation. With WAHSA's permission, the Indiana Association of  Homes for the Aging borrowed our survey tool, sent it to there members, summarized the information, and added even more depth, suggestions, and concrete ideas to WAHSA's first edition of this guidebook.

WAHSA is deeply indebted to the Indiana Association, its staff, and its Human Resource Task Force for so willingly sharing their information which helped to enhance WAHSA's original information.

This all new, improved and updated book is a warehouse of easy to implement, low cost ideas you can incorporate to make the role of the long term care employee more rewarding. These ideas, generated with employee thoughts, concerns, and frustrations in mind, will help your retention efforts, reduce turnover and, in the end, help you fulfill your commitment to quality in long term care.

After reviewing this booklet, if you have any additional items or ideas to share, please forward them to the WAHSA office so they can be included in future updates to this publication.  Please mark the information you submit with the heading "Enhancing Employment."


John Sauer Executive Director

Janice Mashak Member Services Director


Chapter One: Good Wages and Working Conditions

Chapter Two: Scheduling Options

Chapter Three: Recognition

Chapter Four: Feeling In on Things

Chapter Five: Fringe Benefits and Other Incentives

Chapter Six: Growth Opportunities

Additional Resources