When discussing internship, the jobs that usually get mentioned are welders, electricians, plumbers, mechanics, and carpenters. However, internship programs can be a great opportunity for the senior living industry, as they allow organization to recruit, train, and keep a greater number of skilled workers. It can also increase the satisfaction of employees, and residents themselves and their families, while also reducing the high turnover costs.
Kristy VanDerWiel, vice president of people and culture for WesleyLife said, “In the senior living industry, the number of people looking to us for our services outpaces the number of people who are entering jobs in senior living. Many people don’t know about the wide variety of career opportunities that exist, and old stereotypes of what it means to serve older adults prevail. Younger people aren’t aspiring to work in senior living due to these barriers.”
During 2018, Johnston, an IA-based WesleyLife introduced some changes in their organization and started working closely with the Iowa Department of Labor so as to do some research into defining and developing an internship program for Certified Nursing Assistants, or CNAs. As of June, 2018, WesleyLife is the first ever healthcare organization in Iowa that offers a Registered Apprenticeship Program for CNAs.
What They Realized?
After they found out that a certain number of people become CNAs before converting into nurses, WesleyLife decided to provide full carrier growth support for its members, and started exploring new ways in which to engage and keep their workforce.
“Apprenticeships provide an easy framework for a career development path,” said VanDerWiel. “They allow us to communicate the potential for growth with incoming team members—who may not yet understand all the possibilities available to them in our field—and also provide a way for us to structure succession planning in direct care roles,” he added.
Apart from its 8 communities for healthy living and new approvals for buying out or building 4 more communities during mid-to-late 2019, WesleyLife also provides Home and Community Based Services in 15 other Iowa counties. These services include home health services; non-medical services such as cooking, cleaning, and dog-walking; nutrition; transportation; adult day services; and public health nursing. Besides being known for its communities, WesleyLife provides its services to a large number of Iowa State residents that wish to stay in their homes.
Their CNA internship program started off during June, and it included freshly hired CNAs, with three high schools showing interest in starting off their own CNA internship program under WesleyLife’s guidance in carrying out their “On the Job Training” section.
“We also have entertained discussions with Iowa Jobs for America’s Graduates (i-JAG), given their interest in developing pre-apprenticeship programs,” said VanDerWiel. “Projections are potentially anticipated for as early as fall 2019, yet may not happen until 2020—largely due to the time required for each party to create the program and align resources accordingly,” he added.
Upon the completing three levels of competency, the WesleyLife members are granted with a national apprenticeship certification as CNAs, Advanced CNAs, or CAN Specialists. They are hopeful of being able to provide consistent Dementia specialization in the near future, with Geriatric and Restorative specialization in the works as well.
There is also a possibility for potential candidates to obtain Level IV designations as CAN Mentors or Certified Medication Techs, which provide an additional national certification once they are completed. Salaries are also supposed to increase with new skill advancements.
All new CNAs are also being placed in this new internship program, something that the already enrolled CNAs able to do as well. Team members are expected to use local scholarship funds for costs coverage. In addition to that, WesleyLife provides a tuition reimbursement program as well.
What Others Are Doing?
These internships also open the doors for tax credits in certain states. Agape Senior, a long term care service provider in Columbia, SC, was among the first such providers to look into why healthcare employees haven’t made use of the internship programs, especially so for the post-acute and long-term care sectors. After that, South Carolina provided an annual tax credit of $1,000 per employee that was registered in a federally-approved Registered Apprenticeship Program (RAP).
Agape’s push on remote learning internship programs eventually got them a $60,000 workforce tax credits for workforce education. IN addition, their retention rates have increased exponentially.
Within 5 years, around 242 people graduated from their RAP program for CNAs, and Agape can boast about their retention rates of 74% for their 2011 graduate cohort and 99% for their 2014 graduate cohort.
Another thing that Agape noticed is that voluntary participants in their internship program makes it clear if participants are eligible to work in the organization. People that usually registered and dropped out earlier than others were also more likely to quit their jobs, as opposed to people that underwent their job-related education with confidence and showed greater chances of staying on their jobs for longer periods of time.
“The increased CNA retention rates significantly lowered costs associated with recruitment and training of front-line employees,” said Jimmie Williamson, Ph.D., who as Agape senior chief human capital officer was instrumental in developing the original RAP for CNAs. “Satisfaction surveys showed increases among residents and families, because CNAs were much more knowledgeable about the body and disease processes, felt empowered, and there was more consistency of care,” he added.
Subsequently, Agape applied this model for other positions such as mid-level manager positions for department manager employees, as well as faculty administrators and nurses, and ended up having more than 1,000 courses. “We were more successful growing our own employees than recruiting from the outside,” said Williamson.
How They Expanded?
During 2016, Agape split into two units – the first one focused on hospice care, while the latter one focused on training programs that went under the name of Long-Term Care Health Solutions (LTC Health Solutions). They also formed the Long-Term Care University (LTCU for short) so as to provide support for their online learning management system designed for internship and other internal education requirements.
“Agape Senior has gone through many changes and morphed into other areas but continues to hold onto the apprenticeship model as such a part of its corporate culture, we try to tie it to everything we do,” said Williamson, a president of LTCU and executive director of the Agape Senior Foundation.
At the moment, Agape offers a certain level of service with one of the other business lines for more than 120 assisted living/nursing facilities in South Carolina. Additionally, they own two hospice houses with a third one under construction, all three of them having a license for skilled facilities.
In July 15th, 2018 LTC Health Solutions started SC House Calls – a new service for in-home physician visits that has nurse practitioners from all over the state. They have over 100 providers, in addition to a 24/7 call center operated by professional medical personnel. SC House Calls offer in-home palliative care, bringing home-based primary care at their patients’ own premises. Moreover, LTC health Solutions operates seven primary care clinics that go under the name of Main Street Physicians.
“Because of such growth in providers—our physicians and nurse practitioners are making 20,000 visits per month serving companies like Trident Health System—we also put together an apprenticeship program on palliative care on the continuum of care so all providers understand the palliative care piece,” Williamson noted.
LTC Health Solutions advises their healthcare providers network to open their own RAP, and provides their LTCU instruction for sale, because of its generic training nature, making it ideal for the healthcare field, as well as for its South Carolina laws compliance.
“Agape Senior CEO Scott Middletown has said that the way you get a raise in the company is to earn an advanced degree directly related to your job or enroll in an apprenticeship program,” said Williamson. “It’s really to incentivize everyone to be in a RAP. There are programs for nurses, nurse practitioners, physicians and managers,” he added.
How to Motivate Employees?
Following their first year, every employee earns a 5% bonus added to their base salary. After their second year, they are granted another 3% increase, on the new total salary, which includes the 5% bonus. However, if their internship lasts longer than two years, that bonus comes down to 2%.
“When we had 2800 employees, we were getting $250,000 to $300,000 in state tax credits annually,” said Williamson. “But it’s not the money….It’s the benefits of a highly educated workforce. When you have a CNA who understands the various stages of dementia, the different types and what residents are going through, they have a wealth of knowledge. You’ve invested very little in their education, and the ROI is huge.”
We can Help! Our local advisors can help your family make a confident decision about senior living.