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The regulation senior living needs?

organizational culture regulations senior living turnover Nov 03, 2020

We all know turnover is a real problem. Most everyone would agree that improving turnover rates would make senior living organizations, and the entire field, better. Period.

But slapping organizations on the wrist for it is an interesting proposal.

If they knew how to fix it, wouldn’t they have fixed it already?!

The average turnover in senior living is reportedly 40%. But we think it’s much higher. It is not uncommon to hear of 100% or even 120% turnover in organizations. We hear rates like this all the time.

And we also hear leaders bemoaning their high agency use and overtime costs. And how they just want to get good people. But, do they successfully break the cycle?


Leaders hate wasting money.

Leaders hate staff turnover.

Leaders hate bad reviews.

Leaders hate bad care.

Leaders hate regulations.

Leaders hate penalties.

But sadly, a large majority of leaders will wait for a regulation to seriously optimize their staffing.

Is this a foreshadowing of things to come, field-wide, in senior living?

It wouldn’t surprise me if it was. We know that turnover has direct implications on continuity of care. And isn’t that the point of what we do?  

That’s not hard to debate. What is really hard? Fixing this gosh-forsaken staffing crisis.

Fix your turnover? How about you move a mountain while you are at it!!!

The best advice I can offer is to get ahead of it. And the only way to get ahead of it is to look at your culture.

Understand what is shaping your culture and then you can address what’s driving your turnover… before someone comes knocking on your door looking to regulate it.

Culture, turnover, and a pandemic.

Sounds like a challenge. Then you add in the P-word and it feels impossible.

In our last blog, we talked about how this pandemic is causing change in organizational culture to happen at a faster rate than normal; months versus years.

It may seem unreasonable to embark on a full-fledged effort to improve your culture at a time like this. But it’s not.   

In fact, some may argue this is the best time to do it.

Want some proof of that? A client of ours did comparative Culture Assessments with us two years in a row. The first one in 2019, and the second during the pandemic, in lovely 2020.

During that time, their cultural entropy dropped from 11% to 10%. Cultural entropy represents the degree of dysfunction in an organization’s culture. Dysfunction that is manifested in negative values such as bullying, blame, bureaucracy, and information hoarding, to name a few.

Cultural entropy has an inverse relationship to employee engagement, revenue, and as our most recent data reveals, occupancy. So, in essence, cultural entropy is the negative energy that holds a company back.

When measuring culture for our clients, a cultural entropy score under 14% is exceptional. So this client was already considered very good in terms of their culture the first time we measured it last year. To drop it even further, especially during a time like this, is like losing those nagging five extra pounds during the height of the holiday season!

To say it is gratifying is a huge understatement.

The icing on the culture cake? When we drill down to look at their turnover during that time, we see that along with improving their entropy score, there is also a notable decrease in their turnover. In 2019, it was 34.2% and decreased to 33.7% in 2020. At this point, they are on track for an annualized turnover of 16.9%.  

The fact is, culture improvement creates real outcomes. It pushes the needle on an otherwise tremendously frustrating and complicated challenge, like turnover. Even small improvements in culture create real and far-reaching change.

So the question to you is: Will you take the opportunity to finally make culture your priority? Or will you wait until your hand is forced?



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