The long term care profession is navigating a difficult set of challenges: staffing shortages, high turnover, regulatory complexity, financial pressures, rising acuity among residents, and an influx of individuals needing care.

At the core of these challenges are the administrators. They wear many hats and carry the responsibility of ensuring the safety, well-being, and success of the residents, their team members, and the organizations. Turnover of administrators in long term care has exceeded 43 percent and appears to be increasing. This is more than double the turnover rate of administrator positions in other health care settings.

In this environment, organizations cannot afford to lose experienced leaders. Typical strategies such as increasing salaries, bonuses, or occasional perks are not enough. Investing in strategies that create administrator wellness is a missing piece to long term retention. 

What the Research Shows: A National Study Focused on Administrator Wellness

Seeking to better understand what causes administrators to remain or stay with their organization, Dr. Jolynn Hunt conducted a unique national study that focused solely on administrator wellness, job satisfaction, and turnover intention. Her doctoral dissertation, Personal Wellness, Job Satisfaction, and Turnover Intention Amongst Long term Care Administrators, surveyed 109 administrators from skilled nursing and assisted living facilities across the United States.

The research design was a quantitative correlational, regression study. Validated instruments were used that measured the administrators perceived job satisfaction, turnover intention, and six wellness dimensions that included spiritual, physical, intellectual, emotional, social, and psychological wellness. The results challenged traditional theories about retention. 

The Relationship Findings of the Study

The Pearson correlation results indicated there was a significant relationship between all personal wellness dimensions, job satisfaction, and turnover intention. 

• As personal wellness increased, turnover intention decreased. 
• As job satisfaction increased, turnover intention decreased. 

In addition to this, there is a significant relationship between each personal wellness dimension and job satisfaction. 

• As personal wellness increased, job satisfaction increased. 

The Predictive Findings of The Study

Regression results that measure predictive variables indicated that spiritual wellness and job satisfaction are significant predictors of turnover intention. 

• As spiritual wellness and job satisfaction increased, turnover intention decreased. 

Further, physical wellness and intellectual wellness are significant predictors of job satisfaction.

• As these wellness dimensions increased, job satisfaction increased. 

Because job satisfaction was such a significant predictor of turnover intention, understanding what factors predicted job satisfaction was noteworthy. 

The Key Takeaways

Healthy organizations begin with healthy leaders. Creating workplace environments and programs that promote and support personal wellness in each of the six wellness areas can increase job satisfaction and reduce the likelihood of administrators leaving their organization or the profession altogether. Due to their predictive nature, focusing on enhancing spiritual, physical, and intellectual wellness could improve administrators’ job satisfaction and desire to stay.

What does spiritual wellness entail? Spiritual wellness is a person’s sense of meaning, purpose, and connection with themselves, others, their environment, and unifying forces. When individuals understand their role and how their work aligns with their purpose, they are more likely to have a higher perceived spiritual wellness.

What does intellectual wellness involve? Intellectual wellness is the amount of intellectually stimulating activity that an individual engages in. When a person perceives that their work is sufficiently challenging, engaging, and expanding their knowledge, they are more likely to have strong intellectual wellness.

What does physical wellness imply? Physical wellness is the perception that an individual has concerning their physical health such as sleep, fitness level, energy, and work conditions. When a person perceives that their workplace is safe and can perform their job duties, or they feel physically well, they are more likely to have high physical wellness.  

What Are the Next Steps? 

Long term care administrators are at a high risk of burnout and turnover. Due to the nature of their role, they are a foundational component to the overall success of resident care and outcomes, staff retention, and organizational success. Figuring out how to help them carry the load in a healthy manner, so that they don’t merely break down, but rather find balance, well-being, and fulfillment in their work lives is essential. Long term care leaders need support and systems in place that help enhance these areas of their lives. Those organizations that create workplaces and tools to help leaders thrive rather than survive will create a workforce that has greater ability to lead with energy and provide a higher level of care for the residents that they watch over every day. 

Dr. Jolynn Hunt, PhD, MSHCM is the founder and CEO of IO Consulting, a workplace psychologist, and wellness coach. She can be reached at admin@consultingio.com or www.consultingio.com.​

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