Employers expand education and career opportunities for CNAs

In PHI’s recent effort to document how LTC employers are investing in their direct-care workers (a project funded by the Hitachi Foundation), we found multiple employers offering expanded education and advancement opportunities. Employers are searching for ways to get the most value out of their staff—and to increase retention rates among committed and caring individuals.

For example, New Courtland Network in Philadelphia founded a nursing education center where employees can advance their careers along the organization’s “Ladder of Opportunity.” The Center offers free CNA training, an advanced CNA course (CNA specialist) and LPN training. For more advanced nursing courses—including RN, BSN and MSN—New Courtland provides tuition reimbursement.

The CNA specialist course is a seven-week training that focuses on nutrition, wound prevention and skin care, restorative care, and dementia care. After successfully completing the training, CNAs take on new administrative and specialty care responsibilities and receive a $1/hour raise. The next step, an 18-month LPN degree program, is tough for some, but over the last decade, 50 employees have advanced from CNA to LPN positions.

Nicanor Palicarpio, a Filipino employee, began his career at New Courtland as a housekeeper. He has used the free training to advance first to a CNA position, then to CNA specialist, and he is now pursuing his LPN degree. Palicarpio notes that he feels grateful for this opportunity: “If there is no employer doing that, everything would be coming from my pocket. And oh my, I can’t pay for it.”

Palicarpio, who has been with New Courtland for more than seven years, has not had an unusual experience. Among employees who take advantage of the Ladder of Opportunity, New Courtland has only a 10 percent turnover rate.

Loomis House, in Western Massachusetts, provides a four-step career ladder for its nursing assistants. At each stage of the ladder, additional training in areas such as end-of-life care, Alzheimer’s/dementia care and communication lead to incremental salary increases. The final step of the career ladder is a peer mentor position, which pays more than $1/hour more than entry-level CNA positions.

St. Peter Villa in Memphis, Tennessee, offers a three-step ladder that includes mentoring at Level II and assistant management responsibilities at Level III. To engage CNAs more deeply in advancing their careers through learning, St. Peter requires that CNAs teach two in-service trainings to their colleagues to advance to Level II. Level II CNAs also serve on facility committees that address issues such as fall prevention and infection control.

In many skilled nursing facilities, the trend toward individualized care provided through self-managed teams of employees is demanding more of CNAs. With appropriate training and support, however, employers are finding that workers thrive in these environments. A great example is the Green House model, where CNAs from traditional nursing homes are provided extensive training to advance to positions as “Shabazim—direct-care workers who together manage a small household and draw on professional staff as needed.

These are just a few of the career ladders that employers have developed to provide opportunities for their staff while also improving the quality of care for residents. All of these models deserve further exploration, particularly as public dollars shrink and our organizations need to provide better care more efficiently.

What’s missing from these models is portability. Advancing to a CNA specialist at New Courtland Network doesn’t get you a job as a CNA specialist with higher pay anywhere else. Developing an Advanced Aide position that is recognized across the industry would better meet the needs of nursing assistants and also has the greatest potential for providing quality, individualized care at a cost our families and communities can afford.

Susan Misiorski is director of training and organizational development services for PHI. A culture change leader, Susan is also a member of the board of directors, and a former president, of the Pioneer Network.

The opinions expressed in this blog are those of the author and do not necessarily reflect the views of Long-Term Living.

Topics: Facility management , Staffing