10Oct

Providers tackle turnover amid vexing labor shortage – Modern Healthcare article

Providers tackle turnover amid vexing labor shortage – Modern Healthcare article

Providers tackle turnover amid vexing labor shortage

By Alex Kacik  | September 22, 2018

A young professional two years removed from earning her master’s from a Louisiana university sought out Memorial Hermann Health System in Houston to pursue a career in human resources.

For her, the organization’s loan repayment program was a major draw.

“She told me, ‘I just want you to know that you have me for the next 10 years and (the loan program) makes all the difference,’ ” said Lori Knowles, Memorial Hermann’s chief human resources officer. “Student loan debt is crushing. Earning $20,000 to pay off student loans has a huge impact.”

The impetus for the program was the system’s retention rate about three years ago: About 75% of first-year employees stayed. The industry average is 83%.

In recent years, the organization has expanded rapidly and couldn’t properly staff its facilities without improving that metric.

The human resources, nursing and operations teams identified tuition reimbursement, student loan assistance and nurse residency program enhancements as ways to draw talent. They also revamped pay and benefit structures to include a 403(b) match, paid-time-off accrual and out-of-pocket medical cost coverage.

Part of the plan included Memorial Hermann’s Retention Engine program, where managers conduct periodic interviews throughout an employee’s first year to gauge how the new hire is adjusting and what improvements can be made.

It also provides a step-by-step outline for managers to evaluate and interview job candidates, including a guide for job shadowing, an onboarding questionnaire to understand personal goals and preferences, and recommendations on who the employee should meet with on the first day. Retention rates are now included in management’s annual bonus package, which helped everyone buy in.

Over three years, Memorial Hermann has retained 90% of its clinical staff, saving about $54 million in turnover costs. First-year turnover dropped to 14% after the program was fully implemented in 2016.

“As we get more mature in the human resources space about being able to quantify recruitment and retention efforts, it becomes more obvious it is well worth the spend,” Knowles said, adding that the program as a whole cost about $18 million.

Turnover trouble

The healthcare industry has been trying to cope with high turnover along with simultaneous shortages among physicians, nurses and home health aides. This has driven labor costs—already providers’ biggest financial burden—even higher. Turnover can also stunt productivity, hurt the patient experience and jeopardize outcomes.

Providers are trying to stabilize their workforces through offering student debt repayment, development opportunities supported by tuition cost-sharing, employee stock ownership plans, partnerships with academic institutions to keep the pipeline flowing, employee appreciation programs, flexible schedules and more autonomy.

More health systems are adopting loan reimbursement and tuition-assistance programs, said Christopher Duchesne, group vice president of client services at EdAssist, a Bright Horizons division that helped Memorial Hermann with its retention program.

Loan reimbursement can be a compelling offering for employees who want to grow beyond their role or try a different field, he said.

“The labor shortages and stress in finding folks to do the jobs that are needed in healthcare are more acute than almost any other sector,” Duchesne said. “More than in any other industry, healthcare is adopting things like loan repayment programs in greater volume and speed.”

Almost every system out there is facing a huge retention problem, said Alan Rolnick, CEO of Employee Engagement and Retention Advisors.

It’s not just the cost of a replacement but the loss of institutional knowledge, he said. Most healthcare employees are micromanaged, and they typically have no idea of the strategic direction of the organization or what their role is, Rolnick said.

This dynamic could discourage millennials and Gen Xers who make up a large portion of today’s workforce and who place premiums on being fulfilled by their job and taking pride in their companies’ missions.

“Employees are not empowered,” Rolnick said. “They go do the work and there is no effort to get to know them or reinforce good work. Employee alienation is higher than ever before; it’s a mess.”

There is a shortage of about 14,000 primary-care physicians that is acutely felt in rural areas, according to HHS’ Health Resources and Services Administration. Many aspiring doctors choose higher-paying specialties to pay off their debt quicker. If they do choose primary care, they often don’t want to live in rural areas.

The physician data company SK&A estimates that the annual physician relocation rate is 12%. About half of the 17,000 physicians surveyed in a 2016 Merritt Hawkins report said that morale is negative, primarily due to regulatory and paperwork burdens and loss of clinical autonomy. More physicians are in many cases joining health systems in part because of the former, despite less of the latter.

“That day when their autonomy is questioned, and the insurance company says, ‘You can’t do this for the patient,’ that’s when doctors say it’s time for something else,” said Kurt Mosley, vice president of strategic alliances for Merritt Hawkins and Staff Care, companies owned by the staffing agency AMN Healthcare.

Financial bonuses may also be misplaced. Some hospitals reward high citizenship scores related to community involvement, which can be oddly measured by attending hospital-coordinated meetings on the topic, Mosley said. Providers also reward high patient-satisfaction scores, although patients who are happy aren’t necessarily healthier, he said.

It hurts when doctors leave. According to Merritt Hawkins’ 2016 physician retention report, each physician generates an average of $1.56 million in revenue every year for his or her affiliated hospital related to patient care, goods and services purchased and supporting jobs. Gastroenterologists, for instance, generate an average of $1.42 million in net annual revenue for their hospitals. One month without that specialist translates to a $118,556 loss, but it’s more than just a financial loss.

“Turnover really affects quality,” Mosely said. “The cost, quality and effectiveness of care are in a doctor’s hands and it’s important to keep them happy because this new movement toward value is highly doctor-dependent.”

Bringing in scribes to navigate EHRs or an insurance specialist to grapple with payers can free up doctors to allow them to spend more with patients. It makes a major difference, Mosley said. Some systems have liaisons that strictly deal with physician burnout, he said.

Five ways to boost morale 

  • Help with loan payments
    Student loan debt is crushing. More providers are helping employees pay off their debt with contributions often ranging from $5,000 to $30,000.
  • Assist with tuition
    Helping employees hone their skills or move to a different field through higher education can keep them engaged and happy, particularly members of younger generations who value upward mobility and flexibility.
  • Schedule informal check-ins
    Performance reviews are outdated. Scheduling less-formal interviews in three-month increments with first-year employees can help gauge employee satisfaction and identify weak points in the onboarding process.
  • Hire strategic help to reduce burnout
    Hiring a scribe to help physicians navigate electronic health record systems or perhaps another supply chain associate to keep nurses at the bedside could ease the burden on overwhelmed employees.
  • Offer flexible schedules
    More fluid work hours could help single parents manage childcare during their shifts.

M & A mania

Providers continue to consolidate, which often breeds uncertainty that can ultimately lead to burnout and turnover. Employees don’t know if their job or boss will change, or if they will have a job at all.

“It’s a scary time during an acquisition,” said Brenda Doherty, partner at executive search firm Buffkin/Baker. “That’s why leadership has to get out in front of it and set the tone and direction.”

Fewer competitors may be a disservice to both health systems and workers, she said.

“If there are no other places to go in a certain market, it doesn’t attract the talent that systems really need and it keeps competitive wages and benefit structures out of the game,” Doherty said.

Although executive pay continues to rise, median earnings for all full-time healthcare workers fell on average by 2.4%, according to a recent report from the Center for Economic Policy and Research, a left-leaning think tank.

Staffing issues, in fact, may lead to more mergers and acquisitions, said Thomas Fahey, a partner at the law firm Nixon Peabody. For example, state-of-the-art technology is important to physicians, but often cost-prohibitive for independent hospitals, he said.

“The momentum is there for mergers and acquisitions of independent hospitals,” Fahey said.

Healthcare providers hope robust benefit packages cultivate a healthy workplace environment that can stave off consolidation.

Long-term care provider Acuity Healthcare is the country’s only employee-owned hospital company, according to CEO Ed Cooper.

Acuity, which manages three long-term acute-care hospitals in New Jersey, Ohio and West Virginia, started its employee stock ownership program in 2014. Job seekers say that the program is enticing, and Acuity’s employees stay with the company longer.

As long as the company improves, the value of the shares they own go up. If the programs are done well, they can exceed earnings of 401(k)s by 15% to 20%, Cooper said.

“It gives them a reason for more than just clocking in and clocking out,” he said. “This gives them an added incentive to not only fully engage but look at things they don’t normally manage. We provide information on our financial and quality metrics, which improves performance.”

This leads employees to offer unsolicited suggestions even if they don’t fall under their responsibilities, Cooper added.

“I don’t see why more healthcare companies don’t do it.”

In addition to new benefit packages, providers are establishing their own medical schools or bolstering relationships with colleges and universities. Kaiser Permanente, for instance, is building an independent medical school while Providence St. Joseph Health partnered with the University of Great Falls in Montana. Health systems can then customize curricula to prepare students for their organization and insulate themselves from labor shortages.

Call the nurse

Although more registered nurses and nurse practitioners are joining the workforce, the shortage is expected to persist through 2025, according to the Health Resources and Services Administration.

An aging population and a rise in chronic disease coupled with the greater number of insured are driving demand. An older nursing workforce, competition from staffing and traveler agencies, and a lack of training programs and nursing instructors constrain the supply.

Since beginning its nurse residency program in mid-2015, Memorial Hermann has added 1,800 new graduates to the program, in which participants make two-year commitments to the organization. Nurse retention also increased by nearly 19% over three years.

Spending time with new leaders and creating a centralized orientation process were key. Every hospital fended for itself without a uniform protocol, Knowles said.

“There was some mentoring and some accountability measures that they needed because there was some fragmented execution,” she said.

Anytime a first-year employee left the company for anything other than moving from the area, Memorial Hermann’s CEO would personally meet with them, Knowles added.

Quantifying how much a vacancy costs per day helped get everyone on board, she said.

The average cost of turnover for a bedside nurse ranges from $37,700 to $58,400, resulting in the average hospital losing $5.2 million to $8.1 million a year, according to a 2016 report from Nursing Solutions. Each percentage point change in RN turnover could cost or save the average hospital $373,200.

“The numbers were astronomical,” Knowles said.

Parkview Health, a nine-hospital system based in Fort Wayne, Ind., implemented a similar engagement toolkit across its system. It includes periodic check-ins extending beyond 90 days, solutions for common answers to concerns about retention questions and suggestions on how to adapt the process for each of its more than 10,000 employees.

Some providers have eased certain requirements for nurses, like a bachelor’s in nursing, to mitigate shortages.

But the healthcare industry may be focusing too much on retention metrics, said Richard Scheffler, a University of California at Berkeley professor.

“They might be able to do more with less if they are teamed up the right way and are more productive,” he said.

Healthcare organizations have a wealth of competing priorities. From hitting financial targets to meeting compliance standards, employee retention traditionally took a back seat. But that is changing, Buffkin/Baker’s Doherty said.

There is a direct correlation between turnover and readmission rates, as well as a number of other soft and hard costs, she said. All of these financial implications have elevated employee engagement to the top of the priority list, Doherty said.

“An engaged workforce is everything,” she said.

26Jul

ACUITY HEALTHCARE CELEBRATES EMPLOYEE OWNERSHIP – The Only Employee Owned Hospital Company in the Country

ACUITY HEALTHCARE CELEBRATES EMPLOYEE OWNERSHIP – The Only Employee Owned Hospital Company in the Country

Charlotte, North Carolina – (July 25, 2018) – Acuity Healthcare, the country’s only Employee Owned Hospital Company and a leader in long-term acute care, is pleased to kick off a company-wide Employee Ownership week-long celebration.

The company became an Employee Stock Ownership Plan (ESOP) in 2014. This year, Acuity is hosting festivities company-wide to celebrate the ongoing success of being Employee Owned. The Employees planned events and are excited to share in the growth and expansion of Acuity Healthcare.

“Becoming an ESOP was the perfect transition for our company,” said Ed Cooper, President and Chief Executive Officer of Acuity Healthcare. “At our hospitals, we attribute our success from our team of top-notch professionals dedicated to making an impact on the lives of others. We know and recognize the value of having an engaged team of Employee Owners, and this is truly our way to give back.”

“Acuity, an ESOP, allows me to work beside my fellow Employee Owners that have accountability, enthusiasm and deliver the best care and customer service to our patients and their families. Here at Acuity, we treat your family as our own,” said Heather Kemper, Director of Provider Relations at Acuity Specialty Hospital of Ohio Valley.

About Acuity Healthcare:

Acuity Healthcare is an employee-owned (ESOP) long-term acute care hospital company (LTACH) founded in 2001 with headquarters in Charlotte, North Carolina. Acuity Healthcare currently owns and manages three LTACHs in New Jersey, Ohio and West Virginia. Acuity is focused on the development and operation of LTACHs and the delivery of specialized care with  improved outcomes. We offer quality care in a cost-effective manner to medically complex patients who require intensive hospital services for an extended length of stay.

To learn more about Acuity Healthcare, please visit us at www.AcuityHealthcare.net

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14Jun

AMG ACQUIRES ACUITY HOSPITAL OF SOUTH TEXAS

AMG ACQUIRES ACUITY HOSPITAL OF SOUTH TEXAS

San Antonio, Texas – (June 14, 2018) – AMG Integrated Healthcare Management today announced plans to acquire major assets from Acuity Hospital of South Texas who announced plans to close its long-term acute care hospital (LTACH) on July 14, 2018.

“We wanted to make sure that the hospital has a future in the community,” said August J. Rantz, IV, president of AMG Integrated Healthcare Management. “We are excited to build upon the wonderful work that Acuity has done for the community. This is a perfect fit for our footprint and we are committed to the San Antonio community.

AMG Specialty Hospital will be a 30 bed LTACH that will provide treatment for patients with medically complex needs who require hospitalization for an extended period of time. Common medical conditions or treatments include respiratory failure, ventilator weaning, complex wound care, cardiac-related disorders with telemetry monitoring, post-operative complication, infectious disease, renal disease and multi—system failure.

“We worked tirelessly with AMG to ensure that the hospital had a future,” said Ed Cooper, president and chief executive officer of Acuity Healthcare. “Having been a part of the San Antonio community since 2008, we are proud to have played a critical role in providing quality care to 3365 patients during this time. As part of our ongoing commitment to our employees, physicians and the community, our team was committed to supporting AMG during its transition.”

AMG currently owns ten LTACHs in seven states across the country and two Physical Rehabilitation Hospitals in Louisiana and employs over 1100 staff. AMG’s capabilities signify continued growth and expansion for the company with plans on further expansion into other markets in the United States. To learn more about AMG please visit their website amgihm.com.

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31May

The Weirton Daily Times – Judy Antill, Registered Nurse, Has Been Named the 2018 Acuity Healthcare Clinician of the Year

The Weirton Daily Times – Judy Antill, Registered Nurse, Has Been Named the 2018 Acuity Healthcare Clinician of the Year

Antill works at the Acuity Specialty Hospital of Ohio Valley, Weirton, campus. She started her clinical career as a certified respiratory therapist. In 2016, she returned to school to study nursing and graduated from West Virginia Northern Community College with a nursing degree. In 2007, she joined the Acuity team as a certified respiratory therapist.

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08May

ACUITY HEALTHCARE NAMES JOHN BARON VICE PRESIDENT – OPERATIONS SUPPORT

ACUITY HEALTHCARE NAMES JOHN BARON VICE PRESIDENT – OPERATIONS SUPPORT

Charlotte, North Carolina – (April 30, 2018) – Acuity Healthcare, the country’s only Employee Owned Hospital Company and a leader in long-term acute care, is pleased to announce John Baron has been named Vice President – Operations Support.

Baron brings to Acuity over 14 years of senior leadership experience, primarily in healthcare. He is recognized for his leadership abilities, creativity, problem-solving skills and collaborative management approach.

“John joins our team at a time when our markets and healthcare in general is changing and evolving so rapidly.  We are thrilled to have someone with John’s expertise and capability to join our company as we continue to grow, said Ed Cooper, President and Chief Executive Officer of Acuity Healthcare. “He has been a driving force in his previous roles and has a demonstrated track record of success.  We are confident John will contribute significantly to Acuity and the company’s ongoing success.”

“I am honored and excited to join the Acuity Healthcare team,“ said Baron. “Acuity’s commitment to Integrity First, Service Before Self, and Excellence In All We Do is the foundation of its achievements. I look forward to being a part of this unique Employee Owned Company and look forward to contributing and being a part of its continued growth and success.”

John graduated from the State University of New York College.  He resides with his family in Clearwater, Florida.

About Acuity Healthcare:

Acuity Healthcare is an employee-owned (ESOP) long-term acute care hospital company (LTACH) founded in 2001 with headquarters in Charlotte, North Carolina. Acuity Healthcare currently owns and manages four LTACHs in New Jersey, Ohio, West Virginia and Texas. Acuity is focused on the development and operation of LTACHs and the delivery of specialized care with  improved outcomes. We offer quality care in a cost-effective manner to medically complex patients who require intensive hospital services for an extended length of stay.

To learn more about Acuity Healthcare, please visit us at www.AcuityHealthcare.net

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27Apr

ACUITY HEALTHCARE NAMES JUDY ANTILL 2017 CLINICIAN OF THE YEAR AWARD RECIPIENT

ACUITY HEALTHCARE NAMES JUDY ANTILL 2017 CLINICIAN OF THE YEAR AWARD RECIPIENT

Charlotte, North Carolina – (April 27, 2018) – Acuity Healthcare, a leader in long-term acute care, is pleased to announce that Judy Antill, Registered Nurse, has been named the 2017 Acuity Healthcare Clinician of the Year. She works in Acuity Specialty Hospital of Ohio Valley, Weirton, West Virginia campus.

Antill started her clinical career as a Certified Respiratory Therapist (CRT). In 2007, she joined the Acuity team as a CRT. In 2016, she returned to school to study nursing. She graduated from West Virginia Northern Community College with a nursing degree in 2016.

“Winning this award made me appreciate all of my coworkers even more. I was so surprised that they nominated me for this award,“ said Antill RN, CRT. “I cannot say enough about the team and how well we all work together and get along. This team is the best. I am honored to win this award representing the team.”

“Judy is extremely passionate about educating her patients and their families. She truly embodies everything about this award. She provides excellent patient care while creating unity among the clinicians which allows the team to maintain and focus on our standard of excellent patient care,” Judy Weaver, Vice President, Clinical Quality and Chief Clinical Officer of Acuity Healthcare and Chief Executive Officer of Acuity Specialty Hospital of  Ohio Valley.  “You can always find her educating and assisting the team with any questions regarding patients, whether nursing or respiratory-related. Judy faces all challenges head-on and tackles them with both grace and confidence.”

About Acuity Healthcare:

Acuity Healthcare is an employee-owned (ESOP) long-term acute care hospital company (LTACH) founded in 2001 with headquarters in Charlotte, North Carolina. Acuity Healthcare currently owns and manages four LTACHs in New Jersey, Ohio, West Virginia and Texas. Acuity is focused on the development and operation of LTACHs and the delivery of specialized care with  improved outcomes. We offer quality care in a cost-effective manner to medically complex patients who require intensive hospital services for an extended length of stay.

Acuity Specialty Hospital of Ohio Valley:

Our team of healthcare providers has served the Ohio Valley area for over a decade since opening in August 2005. The Acuity Specialty Hospital of Ohio Valley is a 72-bed LTAC hospital with its Main Provider Campus located on the second floor of Belmont Community Hospital in Bellaire, Ohio. Acuity Specialty Hospital of Ohio Valley also operates two additional satellite campuses in Weirton, West Virginia, and Wheeling, West Virginia.

To learn more about Acuity Healthcare, please visit us at www.AcuityHealthcare.net

 

 

Pictured here: (Left to right) Judy Weaver, Vice President, Clinical Quality and Chief Clinical Officer of Acuity Healthcare and Chief Executive Officer of Acuity Specialty Hospital of  Ohio Valley, and Judy Antill, RN/CRT, 2017 Clinician of the Year

11Apr

ACUITY HEALTHCARE ANNOUNCES LAUNCH OF AN APP GEARED TO PATIENTS, FAMILIES AND HEALTHCARE PROVIDERS

ACUITY HEALTHCARE ANNOUNCES LAUNCH OF AN APP GEARED TO PATIENTS, FAMILIES AND HEALTHCARE PROVIDERS

Charlotte, North Carolina – (April 11, 2018) – Acuity Healthcare, a leader in long-term acute care,  announced today the launch of its Acuity Healthcare app available on iOS and Android.  The app is geared to provide comprehensive information about all of the Acuity Specialty Hospitals.

“In an age where apps help people with everything, we are thrilled to launch this app to help people with their long term acute care needs,” said Ed Cooper, founder and president of Acuity Healthcare. We continue to work hard to ensure ongoing communication with our patients and their families. We know and understand how critical timely information is, especially when a family is faced with a critical healthcare situation.”

The functionality of the app offers patients, families and healthcare providers a vast amount of information right on their phone. The app allows for online referral opportunities, as well as a complement to our website, offering families nearby lodging and dining.

About Acuity Healthcare:

Acuity Healthcare is a 100-percent employee-owned (ESOP) long-term acute care hospital company (LTACH) founded in 2001 with headquarters in Charlotte, North Carolina. Acuity Healthcare currently owns and manages four LTACHs in New Jersey, Ohio, and Texas, and with two satellite locations in Wheeling and Weirton, West Virginia.

Acuity  is focused on the development and operation of LTACH hospitals and the delivery of specialized care with  improved outcomes. We offer quality care in a cost-effective manner to medically complex patients who require intensive hospital services for an extended length of stay.

To learn more about Acuity Healthcare, please visit us at www.AcuityHealthcare.net

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