The Ultimate Guide To Compliance Training In Post-Acute Care

Employee turnover is an ever-present challenge in post-acute care. With high burnout rates, physically and emotionally demanding work, and often limited resources, many organizations struggle to maintain consistent staffing. However, staff retention isn’t just a logistical issue—it has significant implications for client and resident outcomes, compliance with regulatory standards, and overall organizational efficiency. 

This guide provides insights and best practices that post-acute care organizations can use to improve staff retention by addressing the common causes of turnover and implementing practical strategies for creating a workplace where employees feel valued, supported, and motivated to stay.

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    Latest Turnover Rates In Post-Acute Care

    The turnover issue in post-acute is not a secret. But how does your organization compare to the latest turnover benchmarks across the industry? Here are the latest turnover statistics by segment:

    • Home Care Turnover Rates: 79.2% (Source)
    • Home Health Turnover Rates: 29.1% (Source)
    • Skilled Nursing Turnover Rates: 53.9% (Source
    • Assisted Living Turnover Rates: 42.1% (Source

    It’s important to keep in mind that there are various formulas for calculating turnover rates that vary from industry to industry, segment to segment, and even organization to organization. However, these rates can give you a general idea of where you stand against the post-acute care industry. Meanwhile, internal benchmarking can help you understand how your efforts to improve retention are working. 

    Understanding the Root Causes of Turnover in Post-Acute Care

    Turnover is multifaceted, but understanding the core causes allows organizations to target specific areas for improvement. Here are the leading contributors:

    1. Workplace Stress and Burnout
      Recent studies have linked nurse burnout to lower quality of care and safety, as well as decreased patient satisfaction. It is also one of the key drivers of turnover. The post-acute workforce often faces work that is both physically and emotionally demanding. This, paired with ongoing staff shortages, leads to an increase in stress and ultimately, burnout. 
    2. Lack of Growth Opportunities
      Today’s workforce, particularly millennials and Gen Z, is looking for employers that support ongoing growth and upward movement. Employees need to see a clear career path. When there’s no room for advancement, they feel stagnant and may leave for more promising opportunities. 
    3. Inadequate Onboarding
      Statistically, turnover is highest in the first 90 days of employment. First impressions are everything. Without a structured onboarding process, new hires may feel unsupported in their new roles, and ultimately, seek other opportunities. 
    4. Too Many or Too Few Hours: Recent studies show a “U-shaped relationship” between hours worked and turnover. While working excessive hours leads to burnout, working too few hours can lead to financial strain. It’s important to work with both new hires and existing employees to make sure the hours they are working meet their expectations. 
    5. Inconsistent Schedules: To best support work-life balance, today’s workforce is looking for consistency in when they work. Of course, this is also beneficial to your residents and clients, as consistent assignment is shown to improve care outcomes due to the ability to more quickly identify changes in acuity. 
    6. Inconsistent Work Environment: Research shows that high variability in who employees work with, especially CNAs, can increase turnover. Consistent assignment is also important to home health and home care workers, with many preferring predictability and consistency in terms of which days they work with which clients. 
    7. Training Gaps: According to a LinkedIn Learning report, 94% of employees would stay at a company longer if it invested in their career development. This means providing adequate, relevant training that helps them feel more confident and prepared for the role they have today, while also offering opportunities for training that can enhance their careers and further develop their skills.

    Best Practices for Reducing Burnout and Improving Well-Being

    With ongoing staff shortages and higher acuity levels among residents and clients, it’s no surprise that burnout is ever present in post-acute care. In fact, studies show that an estimated 49% of healthcare workers have experienced burnout. What’s more is 57% of those experiencing burnout have considered leaving their job because of it. Given this, leadership and management must be able to recognize the signs of burnout, including: 

    • Physical Exhaustion: Persistent fatigue, headaches, or digestive issues
    • Emotional Detachment: Increased cynicism, irritability, or a sense of numbness toward patients
    • Decreased Performance: Decline in focus, productivity, and commitment to quality care
    • Feelings of Helplessness: Sense of being overwhelmed by job demands, often resulting in increased absenteeism

    Providers can also be more proactive against burnout by implementing the right policies and offering impactful benefits that allow for a supportive, nurturing workplace. Some tactics include:

    1. Cultivating a Culture of Support
      Employees are more likely to stay at an organization if when they feel supported, especially if they are impacted by burnout. Leaders should encourage open communication both in a team setting and one-on-one. Employees should feel comfortable expressing concerns or issues, and organizations should show a good faith effort to address them. 
    2. Offering Impactful Employee Assistance Programs (EAPs)
      Offering access to mental health services, financial counseling, or stress management programs can be a lifeline for overwhelmed staff. These programs show employees that their well-being is valued beyond their job performance. These benefits can extend to things like wellness apps, mental health apps, or even earned wage access. Consistently remind employees of what’s available to them and provide clear instructions on how to access. 
    3. Scheduling To Support Work-Life Balance
      Today’s workforce expects to have a say in when they work. Make sure you are offering scheduling offers that help support work-life balance by prioritizing shift preferences and making it easy to swap or pick up shifts. Regularly check in with your team to make sure the schedule they have works for them. Doing so not only supports work-life balance but can dramatically reduce call-offs. The scheduling options you provide will likely vary based on the needs of your employees. Some organizations have worked with their staff to offer longer shift times, such as 12-hour shifts, that require employees to work more hours in a day, but fewer days a week. Others have implemented “self-scheduling” systems, where employees can choose their shifts within certain guidelines.
    4. Workload Management
      One practical solution to reducing burnout is adjusting staffing models to ensure better distribution of tasks. For some, this means scheduling based on acuity levels, working to balance out the number of high, medium, and low acuity clients or residents they interact with each day. In skilled nursing, organizations are increasing their number of PRN staff and scheduling them strategically during peak hours to help lighten the load for their full-time and part-time employees.
    5. Proactive Training
      A growing number of providers are making stress and burnout prevention part of annual training. These courses can help employees better identify signs of stress and burnout, while also offering strategies to manage and prevent them to maintain personal well-being and professional effectiveness. Regular training can also help employees and managers better identify symptoms of burnout and stress in those they work with, allowing them to proactively offer help, support, and resources. 

    Effective Onboarding Strategies to Foster Early Engagement

    Statistically, turnover is said to be highest in the first 90 days of employment. In fact, surveys show that across all industries, 34% of employees quit during their first three months, with some in post-acute care estimating turnover rates of 40% during that same time period. 

    Needless to say, there’s a lot riding on your onboarding experience. A poor experience can leave new employees feeling frustrated, unsupported, and lost as they begin their new role. On the other hand, a well-structured onboarding program not only introduces new hires to the organization and their individual role, but also sets the tone for long-term success. But according to a survey from Paychex, only about half of new hires are satisfied with their onboarding experience

    New hire turnover is not only disruptive to your remaining staff and those you care for, but costly for your organization, averaging up to $4,700 per employee

    Here are some strategies to consider to ensure your onboarding program is setting new hires up for success:

    1. Process is Structured & Consistent
      The best way to measure the success of your onboarding process is to make sure it is consistent across all new hires. Doing so will allow you to more accurately measure where things are working and where there are gaps. Creating an onboarding checklist and holding key stakeholders, including managers and supervisors, accountable for following those steps can help keep everyone on track, especially your new hires. 
    2. Simplifies the Mundane
      Every new job comes with paperwork. But far too many employees are still spending their first day in a room filling out forms. Onboarding solutions, such as those offered by Showd.me, move this process online so workers can complete necessary paperwork before day one or even during the candidate evaluation process. For one home care provider, moving this process online helped them increase new hires by 33%
    3. Offers Support from Mentors
      Research consistently shows the benefits of mentorship programs.  One study found higher retention rates among mentees (72%) and mentors (67%), compared to those who did not participate in a mentoring program (49%). One senior care provider saw new hire retention rates rise from 70% to 89% in just one year after assigning what they call a ‘success squad leader’ to every new hire. These leaders come from various roles and areas within the community to offer support, as well as to serve as help them navigate the many opportunities available to new hires, including career development. 
    4. Builds Relationships with Leadership
      When new hires are brought on, everyone is eager to get them out into the field or on the floor in the community. But this should never come at the cost of getting to know key leaders within the organization, including managers, supervisors, Directors of Nursing, Administrators, etc. Conducting regular one-on-ones helps to build trust, discuss personal matters, as well as offer dedicated time to identify additional training or support needs. These ongoing conversations should be established early on with employees and continued regularly throughout their tenure. 
    5. Prioritizes Tailored Training
      Training is an essential part of the new hire journey. Not only does it allow your organization to meet any necessary state or federal requirements, but it is also an opportunity to ensure every new employee is equipped with the skills and knowledge they need to confidently provide quality care. Because of this, training should be tailored based on specific roles, departments, or training gaps identified during any post-hire skills assessments. 

    Of course, these strategies just skim the surface. If you are seeing significant turnover in the first 90 days, it’s essential to identify the root of the problem, so you can take action. Look at metrics such as time to onboard, average tenure of a new hire, as well as any turnover trends within specific roles or departments. Conducting new hire surveys across key tenure milestones, including at 1 week, 2 weeks, 30 days, 60 days, and 90 days can help you identify where individual candidates need support and identify trends before your next great hire leaves you for a competitor.

    Creating a Culture of Continuous Learning

    A commitment to continuous learning is essential for employee retention in post-acute care, where staff need skills to manage complex patient needs, adapt to evolving care standards, and address pressing challenges like patient aggression and burnout. And for many employees, providing ongoing learning opportunities (beyond required annual training), access to continuing education, and ongoing professional development opportunities is not a nice-to-have; it’s a must-have. 

    1. Foster Learning as a Core Value: To create a learning culture, leadership should prioritize professional growth and make it a visible, shared value. Leaders can demonstrate this commitment by participating in training themselves, promoting learning opportunities, and recognizing training achievements.
    2. Offer Personalized Training Experiences: In post-acute care, where roles are varied and each patient presents unique care challenges, personalized learning ensures each team member gains relevant, applicable skills. Start by tailoring annual training based on criteria such as role, position, or department. Tools like assessments can help further align training with staff needs. Offering electives, such as soft skills training, leadership skills, or dementia care, allows employees to choose learning opportunities based on their personal preference. 
    3. Make Learning Accessible and Flexible: Flexibility is especially valuable for shift workers in post-acute care settings, where time is limited, and conditions are often fast-paced. Because of this, training programs should be accessible both in format and scheduling. Offering mobile-friendly, online courses allows caregivers to complete training when it best fits their work schedule and energy levels. Training can be completed anytime, anywher,e and at their own pace. 
    4. Support Career Growth Through Continuing Education: While the onus of meeting Continuing Education (CE) requirements is on licensed professionals, investing in programs and tools that help them meet these requirements is a great perk that showcases your commitment to learning. Online continuing education programs, such as those offered by Showd.me, can be a cost-effective way to support staff in meeting necessary requirements, leading to higher satisfaction. 
    5. Encourage Peer-to-Peer Learning: Facilitating opportunities for experienced team members to share knowledge promotes camaraderie and allows junior staff to learn from real-world experiences. Mentorship programs and case-study discussions help embed learning within daily workflows, making it part of the team culture.
    6. Regularly Recognize and Reward Progress: Recognizing staff for completing training can reinforce the value placed on learning. Simple acknowledgments, such as shoutouts in team meetings, or small rewards such as gift cards to the first 25 who complete training, show your appreciation and encourages continued growth.
    7. Use Data to Demonstrate Impact: Show staff how their learning efforts improve care outcomes, compliance, and patient satisfaction. For example, if fall prevention training resulted in an 80% drop in resident falls, share that achievement with the team. When staff see how their training leads to real improvements, it deepens their commitment to ongoing learning. Regularly connecting training outcomes to what employees value most—such as enhanced patient care and job performance—can also boost motivation and engagement. Sharing measurable outcomes from training also builds morale and underscores the purpose of ongoing training. 

    A culture of continuous learning not only equips staff with the skills they need to excel but also cultivates a supportive environment where employees feel valued, prepared, confident, and empowered. 

    The Role Of Compensation and Benefits Packages

    Competitive compensation and benefits packages are key to attracting and retaining top talent. Practical approaches include:

    Benchmarking Salaries
    Regularly review and adjust pay rates to stay competitive within the industry. Tools like Payscale or industry-specific salary surveys such as those offered by Hospital & Healthcare Compensation Service offer valuable insights into pay, bonuses, and benefits across the post-acute care industry both nationally and by state. This can help ensure that your compensation and benefits package is on pace with competitors in your area.

    1. Recognition & Rewards Programs

    What gets recognized gets repeated. So it’s no wonder that a Glassdoor survey found that 79% of employees said they work harder when they feel appreciated and that nearly 63% said that recognition and rewards make them more likely to stay at their job. Today’s workforce wants to be recognized for a job well done. In response, many post-acute care providers are rethinking their approach to recognition and rewards. 

    Many are moving towards performance-based incentives in which employees earn points based on their behaviors at work. Others are leaning towards peer-to-peer recognition programs, in which colleagues recognize each other’s contributions, fostering teamwork and boosting engagement. Service awards are also common, with organizations celebrating things like tenure milestones or going above and beyond for a client or resident. 

    How organizations reward employees varies as well, ranging from bonuses, gift cards, hand-written thank-you notes, certificates, extra PTO days or even raffles. Work with your employees to see which rewards they’d be more excited to earn.

    2. Comprehensive Benefits

    Oftentimes, your benefits package is just as, if not more, important than what you pay. And in many cases, a stellar benefits package can help offset a wage offering that is lower than your competition. 

    In general, most employees expect their organization to offer health, dental and vision insurance, as well as life insurance, and a FSA (flex spending acccout) or HSA (health savings account). To differentiate your organization, consider benefits like tuition reimbursement for nursing schools, non-clinical degrees for management or continuing education, student loan assistance, subsidized childcare, or subsidized transportation, which are benefits that can make your employees’ lives easier. Instant pay or earned wage access is another popular benefit that can have a big impact on the overall financial wellness of your employees. 

    3. Non-Monetary Benefits

    There are also a growing number of non-monetary benefits that can make your organization more attractive, such as wellness programs, flexible scheduling, and career development opportunities, including upskilling, mentorship programs, or “in-training” programs. These, in addition to providing a supporting, positive work environment, can go a long way in attracting new hires and retaining lifelong employees. 

    Be sure to regularly revisit your compensation package and benefits, taking into consideration any employee feedback you receive. To ensure you remain competitive, regularly review what your competitors are offering, both in and outside the industry, including retailers and restaurants, which are typically at the forefront of unique and impactful benefits. 

    Leadership’s Role in Employee Retention

    Leadership plays a pivotal role in shaping the workplace culture, directly influencing employee engagement, job satisfaction, and retention. Strong leadership can create a sense of belonging and purpose, which encourages employees to stay long-term. By implementing effective strategies that prioritize communication, empowerment, and career growth, leaders can significantly reduce turnover and foster a positive work environment. Here’s how leadership can contribute to improved retention:

    Lead by Example

    Leaders set the tone for the entire organization. When they model the behaviors they want to see in their employees—such as empathy, effective communication, and a commitment to quality care—they set a positive example for the rest of the team.

    • Demonstrate commitment to care: When leadership steps in to help during busy shifts or care emergencies, it reinforces teamwork and demonstrates that everyone, no matter their role, is committed to high-quality care.
    • Promote work-life balance: Leaders who take their own time off, set boundaries, and encourage employees to do the same help normalize self-care. This reduces burnout and supports a healthier, more sustainable work environment.
    • Show appreciation regularly: Simple acts of recognition—like acknowledging staff accomplishments in meetings, or writing personalized thank-you notes—can boost morale and encourage a culture of appreciation.

    Encourage Open Communication

    Creating an open, transparent communication environment helps employees feel valued and heard. Leadership should foster a space where staff feel comfortable sharing concerns, offering feedback, and suggesting improvements without fear of retaliation.

    • Create an open forum: Offer employees a dedicated time to ask questions, raise concerns and get updates on organizational initiatives. Regular town halls or culture clubs are a simple, but effective way, to keep employee involved and engaged. 
    • One-on-one check-ins: Personalized meetings between leadership, managers and employees help build trust and provide an opportunity to address individual concerns and provide guidance. It’s important that one-on-ones are not just transactional in nature. Instead, they should focus on building deeper connections with employees. 
    • Anonymous feedback channels: Anonymous surveys or suggestion boxes give employees a safe outlet to voice concerns or propose improvements, allowing leadership to address potential issues before they become larger problems.

    Empower Employees

    Empowered employees are more engaged and invested in their work, leading to better job satisfaction and lower turnover. Leaders can foster autonomy by providing employees the tools and opportunities to make decisions that directly impact their role and responsibilities.

    • Offer decision-making autonomy: Employees feel more engaged and valued when they have a say in decisions that affect their daily work. One way to provide autonomy is through flexible scheduling, allowing staff to participate in self-scheduling or shift bidding to better align with their availability. Similarly, unit-based decision-making enables teams to structure their workflow and task assignments, promoting efficiency and teamwork. Allowing direct care staff to have input on patient care plans is another way to promote autonomy, as their firsthand observations can lead to better patient outcomes and a greater sense of ownership over their work.
    • Create employee-led councils to drive innovation: Create CNA councils, nurse advisory boards, or interdisciplinary leadership groups where frontline staff can discuss challenges and propose improvements. These councils should meet regularly and have a direct line to leadership, ensuring that employee-driven solutions are heard, tested, and implemented. When staff see their ideas leading to real changes—whether it's improved workflows, new training opportunities, or better patient care protocols—they feel more invested in the organization's success.
    • Support career growth through in-training programs: Implementing “in-training” programs enables employees to pursue their career aspirations within the organization. For example, a CNA who wants to transition into an administrative role can receive mentorship and training, or a server who dreams of becoming a chef can participate in a culinary mentorship program. These programs provide employees with the support and guidance they need to reach their long-term career goals, creating a sense of loyalty and reducing turnover.

    Handle Conflict Effectively

    Conflict is inevitable in any workplace, but how it is addressed can make all the difference in employee retention. Leaders must be proactive in resolving conflicts to prevent them from escalating and causing long-term disengagement.

    • Address issues early: Leaders should encourage open communication and provide a platform for employees to discuss concerns before they escalate into larger problems.
    • Provide conflict resolution training: Regular training for both staff and leadership in effective conflict resolution and communication skills helps to prevent misunderstandings and fosters a collaborative environment.
    • Be fair and impartial: Handling conflicts transparently and consistently builds trust within the team. When employees see that their concerns are taken seriously and resolved fairly, they are more likely to stay engaged and committed to the organization.

    Fostering a Positive Work Environment

    A positive work environment is key to employee retention, especially in the post-acute care industry, where staff burnout and turnover are prevalent. When employees feel supported, safe, and valued, they are more likely to remain committed to their roles. Here are several practices that can help foster such an environment:

    • Building a Sense of Community
      Creating a sense of camaraderie among employees is essential for job satisfaction. Encourage team-building activities, shared meals, and small social events. These efforts can strengthen interpersonal relationships and create a supportive network where employees feel connected to one another, reducing isolation and fostering a collaborative atmosphere.
    • Workplace Safety
      Workplace violence is a growing concern in healthcare. In 2020, healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence, according to the U.S. Bureau of Labor Statistics. Long-term care staff are particularly at risk, as residents may act out due to confusion, frustration, or mental health conditions. Home care workers face similar challenges—over 50% of caregivers in home-based care have experienced workplace violence or harassment.

    To ensure safety, caregivers need comprehensive training in de-escalation tactics, recognizing early warning signs, cultural sensitivity, and self-care strategies for managing stress. Training should also emphasize emotional resilience and empower workers to make informed safety decisions, including knowing when to remove themselves from dangerous situations without fear of employer retaliation.

    • Addressing Bullying and Microaggressions
      A healthy work environment cannot tolerate bullying in any form. Workplace bullying—whether through intimidation, verbal abuse, or deliberate exclusion—creates a toxic culture that drives employees away. Organizations must implement clear, zero-tolerance policies, establish reporting mechanisms, and ensure leadership is actively involved in preventing and addressing bullying behavior. When employees feel protected and respected, they are more likely to stay engaged and committed to their work.

    Microaggressions, on the other hand, are often unintentional but can still have a significant impact on workplace morale. These subtle, everyday comments or actions—such as making assumptions about a colleague’s background or dismissing their perspectives—can contribute to feelings of exclusion and disengagement over time. Training employees to recognize and address microaggressions fosters awareness and helps create a culture of mutual respect

    Conclusion: Building a Resilient Workforce for the Future

    Employee retention in post-acute care isn’t just about reducing turnover—it’s about creating a workplace where caregivers feel valued, supported, and empowered to provide the best possible care. By prioritizing strong leadership, meaningful recognition, continuous learning, and a culture of respect and inclusion, organizations can foster a positive work environment that enhances both employee satisfaction and patient outcomes.

    Retention strategies don’t happen overnight, but small, intentional changes can have a lasting impact. Whether it’s improving onboarding, addressing burnout, or strengthening communication, investing in your workforce today will lead to a more stable, engaged, and high-performing team tomorrow.

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