Certainly, the era of undervaluing frontline staff is over in the long term care industry.  For far too long, long term care providers, especially multi-facility providers, have concentrated on labor cost containment as their lead labor management focus.  After distributing periodic "feel good" awards to staff, they approach frontline labor expenses and collective bargaining management as pure cost issues more than they see them as critical asset investments.

There are many reasons why this is a serious strategic mistake. First, there is a substantial training investment made in these workers. This is not just because these workers must pass a state competency examination, but also because each employee successfully learns specific protocols of their center's business and care operations. Replacing and training new staff is truly costly. In many cases, in many markets, acceptable replacements simply can't be found. Undertrained, underprepared workers are, as we now see documented in the recent Health Care Finance Administration's national staffing report, the number one reason for poor clinical outcomes for residents. This leads to even more costly survey deficiencies.

Most of us in the education and support services side of long term care have learned how critical customized, localized community-based strategies are. Ultimately, managing the causes of turnover comes down to a one-on-one approach with individual caregivers.