By Robert Barron

Staff Writer



As the American population ages, the job of caring for the elderly becomes more difficult and more costly.

Overall employee turnover, which tops 150 percent both nationally and statewide, is especially worrisome to long-term care providers.

Making the market even more competitive is the aging baby boomer generation. A rapidly aging population is creating a shortage of personnel. Studies show by the year 2030, the over-65 population will increase 63 percent. During that same time, the over-85 population will increase 59 percent.

Average turnover of certified nurse aides in Oklahoma is at least 135.5 percent, said Melissa Hill, of Oklahoma Foundation for Medical Quality. Average turnover costs are $120,000, meaning the aggregate cost of the 71 nursing homes participating in OFMQ research is more than $9.1 million.

The foundation, however, has started an initiative to reduce CNA turnover in nursing homes. Certified nurse aides perform personal care for residents under supervision of licensed nurses.

“We began working on a project early this year with a large group of committed nursing homes. We are working on staff satisfaction analysis, how we can improve, and we’ve done some educational workshops and training,” Hill said.

There also is an emergency task force to inject funding into the system to increase the number of CNAs in the program.

“It’s a very thankless and low-paying job. Our population is aging, and clearly we will have to create staff to care for the elderly,” she said.





Burning out quickly



One of the questions to address is how to make nursing homes a better place to be and increase retention rates.

Scott Wagmiller, executive director of Methodist Home in Enid, said he has heard national turnover is higher. Wagmiller said his nursing home is participating with OFMQ in examining turnover and its causes.

“It’s very labor intensive, stressful, to be a certified nurse aide. There is a lot of responsibility, and it’s very emotional, due to the nature of the work,” he said.

Common problems are burnout and a shortage of CNAs. Many facilities are competing for the same people, making the situation more competitive.





Bonus round



The Methodist Home has begun a bonus program that Wagmiller said has been successful. If an employee meets certain criteria, he or she will receive a bonus. There has been some improvement in retention since the bonus program started, but Methodist Home officials also are looking at other incentives, he said.

Brenda Clark, of Highland Park Manor, said she also has high turnovers and knows other long-term care facilities in Enid have the same problem.





The rural perspective



At Fairview Fellowship Home and Village, Adam Martens said his turnover — at close to 70 percent —is lower than state and national figures.

Turnover among nurses and administrative-level employees is lower, he said.

“The average is brought up by dietary and CNA range employees. CNAs are between 96-100 percent, and dietary is along the same lines,” Martens said.

With 150 employees, a 70 percent turnover rate would be 105 employees and would cost the Fairview home $262,000.

Competition for employees has driven up pay, but Martens said turnover is still not high. Fairview is lower than the state and national average, he said. He believes Oklahoma as a whole is lower than the national average. He said the cost of gasoline prevents some employees from job hopping.

“Being a rural community helps. I would like to say the atmosphere keeps them here, as well,” he said.

Martens said burnout contributes to turnover, and the average job life of a CNA is two months.





The future of the industry



Lynne Taylor, coordinator of business and industry services at Autry Technology Center, said enrollment in CNA courses has remained steady for the last 10 years. The school now offers more and diverse programs in long-term care, home health, certification, medication and advanced courses.

Taylor said CNA work is labor intensive, but said it can be rewarding as well because CNAs have one-on-one contact with residents daily.

There has been some pay elevation, but Taylor said she is not sure how much.

“Many factors create demand, (including) turnover, but also increasing aging,” Taylor said.