Staffing, staffing, staffing! We have been talking about it for years, and chances are we will continue talking about it for years to come. The federal nursing home staffing mandate may be gone for now, but that doesn’t mean the staffing conversation is over. In fact, former CMS official Jonathan Blum recently warned that some version of the rule could return. So, while Washington continues to debate staffing requirements, maybe we should be asking another question. What can providers do about nurse retention in long-term care?

A recent nationwide survey from the American Association of Post-Acute Care Nursing (AAPACN) and LTC 100 gives us some insight. Nearly 500 nurses and certified nurse aides participated, and 65.2% of long-term care nurses said they were happy in their current position. Sounds pretty good, right? Well, 73.8% also said their job had become more difficult during the previous 18 months.

So, what makes them stay? According to the survey, meaningful relationships with residents topped the list at 31%. A strong sense of purpose followed at 28%, while work culture came in at 15%. On the other side of the equation, regulatory burden, staffing shortages and leadership gaps contributed to dissatisfaction and burnout. The survey also found that the relationship between a nurse and supervisor can play an important role in the decision to stay or leave.

This isn’t the first research to tell us that staffing and the work environment matter. A JAMA Network Open study looked at 7,887 nurses who had recently left health care employment. Planned retirement was the leading factor overall. However, burnout or emotional exhaustion and insufficient staffing were also among the top reasons nurses left. Among nurses who had worked in residential and nursing home settings, 37% cited insufficient staffing and 32% cited burnout or emotional exhaustion.

Bottom line, nurse retention in long-term care isn’t just about filling open positions. Look at what is happening after you hire someone. What is your work culture like? Do staff feel supported by their supervisors? Do they have flexibility? Are documentation and regulatory requirements creating unnecessary burdens? Most importantly, are you asking your staff what they need to stay?

The staffing mandate may or may not make another appearance, but staffing challenges aren’t going anywhere. Take a look at your culture, leadership and the day-to-day experience of your staff. You may not be able to control what happens in Washington, but there are things you can control within your own community.

Stay well and stay informed!