Caregiver Education
and its Effects on Staff Retention


The Institute for Professional Care Education has four business lines that serve the education needs of senior care communities. These include:

The Institute for Professional Care Education (IPCed) partnered with select senior living communities to identify the relationship between effective online training for caregivers and corresponding retention rates. Focusing primarily on Assisted Living Facilities (ALFs), the intent was to demonstrate that effective training for paraprofessional staff directly reduces turnover in ALFs.

This study was conducted over a 12-month period of time, comparing three facilities with low training rates to three facilities with high training rates.

The Challenge

The largest issue facing senior care communities in the United States today is the retention and recruitment of talented employees. While the nursing shortage has been well documented, there is a drastic shortage of aides and other paraprofessional caregivers.

As the Baby Boomer generation continues to enter retirement, demand outpaces supply. One of the fastest occupations in the US is skilled nursing and with approximately 3 million nurses; it also makes up health care’s largest segment. According to the Bureau of Labor Statistics, 1.2 million nurse vacancies were projected to emerge between 2014 and 2022. By 2025, the shortfall is expected to be “more than twice as large as any nurse shortage since the introduction of Medicare and Medicaid in the mid-1960s.1

This shortage is not exclusive to skilled staff, but also includes those we refer to as direct care workers. These include home health aides, nurse aides, and personal care aides. Key to long-term care delivery, these paraprofessional staff are crucial to the US healthcare system.

The reason for the importance of paraprofessional staff is directly linked to our economy. The fact is that chronic disease such as COPD, CHF and diabetes is the leading cause of death in the US. It is also the biggest expense and strain on our healthcare system. Over 50% of Americans have some sort of chronic disease, with 7 out of 10 deaths being directly attributed to chronic disease. In terms of cost, chronic disease takes up 86% of our US healthcare budget, for a nation that spends 17.4% (or $2.9 trillion) of its gross domestic product on healthcare.

The fact is that chronic care disease can be linked back to lifestyle: tobacco use, improper nutrition, lack of exercise, and over indulgence of alcohol – none of which require a nurse until it’s too late. Much of this can be managed through paraprofessional staff, which is less costly than skilled nurses or primary care physicians.

Preventing chronic conditions, and ultimately saving the US economy, is dependent on the recruitment and retention of competent skilled and paraprofessional staff.

The Solution

Given that the staff turnover is a problem facing many communities, a long term training plan can be seen as an investment as opposed to an additional overhead cost. Therefore, select locations opted to subscribe to IPCed’s Online Campus. Typically, an investment in online training allows providers to fully witness how effective training can be in lowering staff turnover costs. IPCed’s Online Campus includes access to a library of over 800 training resources for all levels of staff from the caregivers to the administrators.

Data was analyzed at facilities with high training utilization rates 2 (84.35%) in California. This data was then compared to three locations with significantly lower training utilization rates 2 (3.21%) in Washington State. Across the California facilities, 167 employees were enrolled in the IPCed Online Campus. This was compared to 72 employees enrolled in Washington State.


Of the 167 California employees monitored during a 12-month period, 101 left their positions (either dismissed or leaving by choice). This represented a 60.48% turnover rate. While this may appear high, of the 72 employees in Washington State, over the same 12-month period, 104 employees had left. This represented a turnover rate of 144.44%, essentially stating that Washington State facilities were losing more employees in a year than they were hiring – essentially moving backward.

While this study can be seen as a comparison of extremes, the turnover difference was still significant, with the California facilities having 41.93% less turnover than those in Washington.

When turning these numbers into dollars, one can conservatively estimate that the cost per person of turnover would be $2,500. This means that the turnover cost of California employees reached a total cost of $252,500. In comparison, the cost of turnover for employees in Washington State was $260,000.

Using the same cost of $2,500, with a reduced turnover rate of 60.48% (rate of California facilities) among 104 employees in Washington, it amounts to a savings of $102,778 per year.


While the analysis included only a small sample size of facilities, the possibilities for saving for the Washington facilities is significant. Over $100,000 in savings would allow these facilities to invest in other priorities and ultimately focus on improving outcomes while increasing their margins.

This study is simply a marker as IPCed continues to delve into comparing the effect of retention and its relationship to effective online learning.

1. Buerhaus, P. I., & And, D. I. (n.d.). Peter I. Buerhaus. Retrieved October 17, 2016, from
2. Training utilization rate refers to the number of completed courses completed within a given time frame.

Caregiver Education and its Effects on Staff Retention

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