How to Reduce Nurse Turnover in Long-Term Care (LTC)?

nurse walking with geriatric patient at LTC facility

According to Harrington and others (2020), staffing is one of long-term care facilities’ primary costs. Add to this the claim of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) that some staffing agencies have been price gouging by asking for two to four times what providers pay their staff, and it is easy to understand why long-term care (LTC) facilities have been struggling to get by and functioning with insufficient staff.

In this context, apps, such as Nursa’s per diem staffing app, are lifesavers for facilities that are perpetually in need of staff and cannot afford the excessive hire-away fees that agencies demand. In fact, facilities have saved 50% of staffing expenses by using the Nursa app to cover their needs for RNs, LPNs, and CNAs. 

Read on to better understand the causes behind the nursing shortage and high turnover rates in LTC facilities and learn more about how PRN jobs can help reduce the costs associated with these problems—no strings attached.

Why Are LTC Facilities in Constant Need of Nursing Staff?

staff turnover on a sticky note
Staff turnover rates in LTCs is relatively high compared to other areas of nursing.

According to Statista, the US population is older than ever before, which also means that more people are requiring long-term care. In 2010, 12.98 percent of the US population was sixty-five or older; in 2020, this percentage had increased to 16.63. Furthermore, according to the US Census Bureau, 20 percent of the US population will be at retirement age by 2030. By 2034, this older population will outnumber children for the first time in US history. In other words, the demand for long-term care facilities—and LTC nurses—will grow exponentially over the next decade and beyond. 

According to the US Bureau of Labor Statistics (BLS), as of 2020, only 6 percent of registered nurses (RNs) work in nursing and residential care facilities. A much higher percentage, 38 percent, of licensed practical nurses (LPNs) work in these settings. Furthermore, a whopping 48 percent of certified nursing assistants (CNAs) work in long-term care and skilled nursing facilities combined. However, even though no industry employs more LPNs or CNAs than these particular healthcare industries, the nursing and nursing assistant shortage continues. In fact, according to BLS, from January 2020 to January 2022, 410,200 nursing home employees left their jobs. Furthermore, a survey by the AHCA/NCAL found that almost all nursing homes and assisted living facilities are currently in a staffing crisis.

Why Reducing Staff Is Not an Option

It might be common sense that higher nurse staffing is directly related to increased nursing home quality and that, ideally, facilities should have the recommended number of nurses and nursing assistants around the clock. Nevertheless, these concrete findings will help illustrate why reducing staff is simply not an option. According to Harrington and others (2020), the following are associated specifically with higher RN staffing levels in resident care:

  • Fewer pressure ulcers
  • Less use of restraint
  • Fewer infections
  • Less pain
  • Increased independence in activities of daily living (ADLs) 
  • Less weight loss, dehydration, and inadequate morning care
  • More proper use of antipsychotics
  • Lower mortality rates

Despite the importance of adequate nurse staffing levels and despite the fact that the Centers for Medicare & Medicaid Services (CMS) established the requirement in 2016 that nursing homes must assess the resources and staff necessary to meet patient needs, according to Geng and others (2019), between 2017 and 2018, 75 percent of nursing homes almost never met these staffing standards

Nurses themselves corroborate this information. A recent survey by White and others (2019) of RNs working in nursing homes found that 72 percent missed at least one essential care task on their previous shifts because they lacked time. This missed care is one of the factors leading to nursing burnout, job dissatisfaction, and high turnover rates. In other words, understaffing leads to even higher turnover rates.

How PRN Nursing Can Solve LTC’s Staffing Problems

PRN staffing through Nursa is the easiest and most cost-effective way for LTC facilities to maintain adequate staffing ratios. Furthermore, using Nursa’s per diem staffing app takes the pressure out of the hiring process. If facilities are unhappy with a specific PRN nurse or CNA, they can simply not work with that person again. On the other hand, if facilities are happy with the work of a PRN clinician, they can offer that person a full-time position—with zero hire-away fees. 

There is nothing to lose and everything to gain, so post a job and find a PRN clinician today! Reducing the cost of high nurse turnover rates is now in your hands. Now that we've covered how facilities can reduce turnover costs, learn 5 ways healthcare facilities can reduce turnover among nurses.

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