High turnover has been a persistent challenge in the healthcare industry, especially for skilled nursing facilities (SNFs) and long-term care (LTC) facilities. According to a recent analysis, the median turnover rate is nearly 103% for RNs, 80% for LPNs, and 99% for CNAs in nursing homes.
High turnover negatively impacts SNFs on multiple levels. First, it increases staff workload, which can cause employees to feel overwhelmed and burned out. Burnout can decrease morale and lead to higher turnover. Turnover has also been linked to lower quality care and increased resident mortality.
While wages and workload are common factors contributing to high turnover rates, leadership also matters because it directly impacts morale. Leaders are positioned to create positive, supportive work environments that increase staff satisfaction, boost morale, and lower turnover. By contrast, leaders who demonstrate negative traits, like being critical or judgmental of staff, create an environment where employees feel unappreciated, reducing morale and hindering collaboration.
At First Docs, our medical directors fill a unique role as both clinical and cultural leaders. They’re committed to being accessible and supporting staff with their clinical expertise. In turn, team members feel empowered to overcome challenges, knowing they have a supportive leader backing them up. Our medical directors are also dedicated to developing positive, collaborative environments, working closely with patients’ interdisciplinary teams to achieve shared goals.
Committed medical directors do more than help SNFs meet regulatory requirements — they can transform centers into environments where employees feel supported, heard, and eager to give their best. Here are five ways strong leadership can boost staff morale in skilled nursing facilities, and consequently reduce staff turnover.
While medical directors are required to participate in quality assurance and performance improvement (QAPI) meetings, they aren’t required to be culture builders. However, a strong leader will view QAPI meetings — as well as informal interactions with staff — as opportunities to develop a more collaborative culture. They’ll encourage team members of all levels to voice their concerns and be a role model to others, listening to ideas actively and respectfully. When staff feel heard and respected, morale increases.
Medical directors who are committed to driving patient outcomes are also committed to providing consistent clinical support and guidance. They don’t show up to check boxes — they’re engaged in their work and eager to share their clinical expertise with staff and guide them through challenges. As a result, staff feel more confident in the care they provide and the decisions they make. They also feel more valued and less frustrated in cases where their medical director consistently offers support.
Recognition is a powerful motivator. Based on the findings from a recent, large-scale study, recognition significantly boosts employee engagement and plays a crucial role in improving job satisfaction and morale. Medical directors can take the lead in recognizing staff contributions during QAPI meetings, showing appreciation and enthusiasm for their ideas and hard work. As a result, medical directors can cultivate a sense of pride and purpose among staff members, making them feel more committed to the work they do.
Medical directors can also provide constructive feedback and create a culture of accountability, giving staff a stronger sense of ownership over their work and professional growth, which can lead to a boost in morale.
Strong leaders proactively consider risks that could lead to conflicts. This may involve collaborating with staff to develop protocols that reduce ambiguity and set clear expectations. When staff know what’s expected of them, there’s less room for confusion, frustration, conflict, and ultimately a drop in morale.
Medical directors can also use their leadership roles to influence decisions that impact burnout — a major issue in healthcare that significantly affects staff mental and physical well-being as well as patient care. They may advocate for more staffing, for example, or work with clinical teams to identify and address employee stress.
Lastly, medical directors can support a better work-life balance and greater focus on employee well-being to reduce burnout and improve morale. Prioritizing employee well-being can be an effective staff retention strategy for SNFs. A 2023 analysis shows that turnover rates were roughly 10% lower in nursing homes with leaders who demonstrated a commitment to employee well-being, health, and safety compared to centers that lacked this leadership.
From providing clinical guidance and mentorship during daily rounds to collaborating with teams to identify training needs, medical directors can help create new pathways for staff development. They also play a critical role in ensuring staff are up to date on the latest regulations and evidence-based protocols.
By creating opportunities for staff development, medical directors can help employees develop skills to handle challenges and workloads better. New skills help staff build more confidence, which can prevent or reduce feelings of burnout. Finally, staff development can give employees a sense of accomplishment and purpose, boosting morale and retention.
Since medical directors oversee many clinical facets within SNFs, their leadership has the potential to transform the centers they serve. Unfortunately, it’s common for SNF medical directors to only fulfill the minimum requirements rather than leverage their leadership roles to make major impacts. They often take on medical directorships as part-time roles in addition to handling the demands of running a practice or being a full-time hospitalist. In other words, medical directors are often overworked, unable to dedicate the time and attention required to fully engage with a SNF.
As a result, many SNFs lack strong leadership, which can lead to negative consequences, like decreased staff morale, high turnover, and disrupted patient care. The good news is that First Docs is different.
At First Docs, our medical directors have the space and time to fully embrace their leadership roles within SNFs, guiding clinical teams effectively and inspiring staff to deliver exceptional care. Unlike other physician service providers, our medical directors are committed to consistently being present on-site up to five days a week. They do not spread themselves too thin, so they can be accessible to your staff, take the lead in QAPI meetings, and build a positive, collaborative culture.
While attracting and retaining staff has been a major challenge for SNFs nationwide, there’s hope in strong leadership. When SNFs have committed leaders to support their most critical asset — their employees — they can navigate challenges more seamlessly and move toward a more patient-centered future.
First Docs is your resource for reliable clinical leadership. Our medical directors understand the importance of supporting and mentoring staff to deliver high-quality care and improve patient outcomes.
If you want to see the impact of strong leadership at your SNF, contact First Docs today and see how our medical directors can transform your team.