Enhancing employee retention in nursing homes through non-monetary incentives: Insights from focus groups

OBJECTIVE: Employee turnover has been a persistent challenge in U.S. nursing homes. The annual turnover rate of 48.71% among nursing staff has significant negative impacts on residents' quality of care and well-being. This qualitative study aimed to understand the complex factors which influence nursing home employee retention to identify incentives (perks) which have the potential to increase retention in long-term care settings. METHODS: We conducted 3 focus groups with a total of 31 participants at a 115-bed nursing home, with the goal of gathering employee perspectives on factors influencing personal retention decisions. A focus group interview guide was employed to facilitate the discussions, while allowing flexibility for participants to introduce additional topics. Two moderators were present during each session to guide the discussions, take notes, and record meetings. Thematic analysis was used to analyze focus group data. RESULTS: Four main recurrent themes and several subthemes emerged from these discussions: 1. Recognition (subthemes: verbal/written recognition and tangible rewards); 2. Culture (subthemes: interpersonal dynamics, flexibility, and management); 3. Nutrition (subthemes: food and drink); and 4. Other incentives (educational benefits, career promotion). Participants identified traditional benefits, such as salary and dedicated sick leave, as important retention factors. DISCUSSION: Focus group participants indicated that incentives may influence their intention to leave. Future research should explore this area across more specific nursing staff groups and examine policy-level strategies for implementing retention incentives in long-term care settings with the goal of improving care and outcomes among the residents of long-term care facilities.