When the Avante Group consolidated its holdings to a single state in a 2018 consolidation, it wasn’t necessarily with workplace culture in mind.
But after centralizing in Florida and coming out of the pandemic, the leaner organization has not only grown its own staff and completely eliminated agency workers; it has promoted a clinically oriented top executive who is hyper-focused on retention as a driver of quality.
Having a corporate team that can get to any building within three or four hours has fostered better teamwork and helped promote two-way communication with building-level staff, President and CEO Kimberly Biegasiewicz told McKnight’s Long-Term Care News.
“You see at the corporate level teams really enjoying what they do and enjoying the time that they spend with each other and creating a culture in which our staff are exhibiting our values,” she said.
“They hear ad nauseam about the culture of Avante and how important it is because staff retention is key,” Biegasiewicz added. “The cost for recruitment and hiring of these staff and turning over and burning these staff or the cost of agency staffing is astronomical. That is really not something that I want to spend dollars on. We want to spend dollars on enhancing quality and enhancing the lives of the residents we serve and supporting our staff.”
To that end, the Avante Group has hired more than 1,100 new full-time employees for its 11 buildings and corporate team since the beginning of 2022, but the company is also investing heavily in programs meant to keep them.
Those range from recognition programs to routine employee satisfaction surveys to a brand new advancement program that offers team members the chance to earn a degree for free in exchange for a long-term commitment to the provider.
Each month, employee achievements — personal and professional — are lauded in public meetings or during virtual “Coffee with the CEO” events. Coworkers and residents can recognize staff with a card in the Way to Go program, and each month, one nominee is selected to win a TV. At the end of the year, the Avante Group sends the employee with the most Way to Go recognition on a three-day cruise with a friend or loved one.
The ROI is worth every penny, Biegasiewicz said.
“The cost that we’re investing into our culture program is far less than the cost of higher turnover rates,” she said.
Advancing at Avante
The goal is not just to retain direct care staff but to help them advance, if they desire.
Happiness is a big part of the messaging at Avante Group, a management company that recently celebrated its 35th anniversary. So is the idea that consistent staffing helps improve care for residents, about 60% of whom are long-stay residents.
“These staff really become our residents’ family outside of their family or, in some cases, their only family because their families don’t visit as often as they could or maybe they don’t have family in their lives. So my staff become their grandkids,” she said. “They get to see them on a regular basis and that consistency, that relationship building is so important in the quality of life and the psychosocial well-being of the residents in our centers.”
And given the right support to provide good care, Biegasiewicz believes staff will lean into the meaning of their work and want to stay year after year.
The Avante has used grant programs to increase certification options and speciality training for all levels of staff, from the CNA to the RN. That extra training has been layered on in part in response to employees who have specifically asked for more professional development.
“What I always tell my staff is, I don’t want you to follow the dollar. I want you to find a purpose in our organization, where you feel like you are really making a difference and then you feel a part of a bigger solution or a bigger project and you don’t want to leave for that dollar,” she said. “Money isn’t always necessarily what drives people. It’s that feeling of importance, that feeling of, I make a difference, I matter in making the decisions in the organization or in my center that is going to ultimately impact the lives of residents.”
Long-time job satisfaction is another key goal.
Avante’s collaboration with the American College for Education allows selected employees to pursue their next level of education, whether that means moving from RN to BSN or earning a master’s or doctorate. Seven employees have already enrolled since the program launched this summer.
The only employee cost is a commitment to continue working for Avante for a time equal to the length of the degree program. Someone in a 12-month program would be expected to stay for an additional year after they complete it.
“No one has hesitated or even blinked to agree to that because they really are using this opportunity to enhance their business skills or their clinical skills to really enhance our company,” Biegasiewicz said. She noted that the degree-program could also help supplement an existing administrator-in-training program.
Thriving on feedback
Biegasiewicz is herself a model of the ability to move up in the LTC ladder. She began her career in 2013, and became chief nursing officer at Avante six years ago. Now in her third year as CEO, she is continuing her own education and pursuing her nursing home administrator license.
“I’ve never lost that hands-on approach and that idea of leading side-by-side and not leading top down,” she said. “I still answer call lights. … I believe as a leader, you can never think any task is below you.”
Asking employees what’s working and what they need has become a core tenet of Avante’s approach.
The company’s technology team created its own software solution to provide workers with regular, anonymous survey opportunities. In 2023, facility-level employees had an 87% satisfaction score, while corporate workers reported just over 97% satisfaction.
It can often be the not-fully satisfied worker whose idea drives the next step to improve the workplace, Biegasiewicz said. The best proof she has that the message on culture is getting through? Workers — who she said “have fair, competitive” wages — know they can ask for other things to support their career.
“Things are education related: I would like more education opportunities. I would like some more training opportunities. I would like to understand what positions are available for internal growth,” she said. “That was really telling. That meant that our culture program was working because nobody was focused on the dollar. They were focused on ways in which to enhance themselves professionally or personally to ultimately provide better care to our residents.”
