Wednesday, March 2, 2022

Perverse incentives

The old-folks home where Mom is a resident is advertising for Certified Nurse Assistants and for RNs.

They are offering a $10,000 signing bonus. That works out to a $5/hour raise if it requires a one-year vesting period.

Now suppose you are one of the old-timers at this facility and you are making $15 an hour when a less experienced CNA walks in and is not only being paid $18 an hour but stands to get another $5 an hour on top of that with the signing bonus.

You ask your supervisor for the same. The supervisor says, "I can bump you up to $18 an hour but I cannot give you the signing bonus."

Pissed off? You bet they are.

But if one old-folks home is doing it then there are probably a bunch that are doing the same. The old-timers leave in droves to nail down the best deal they can find.

The problem is that workers in that sector of the economy were depopulated by Covid more severely than other parts of the economy. It is a game of musical chairs except it is not a case of fewer chairs than players, it is a case of too many positions and not enough players. Some chairs, somewhere, are going to be empty.

If you work your way back to the starting place of the avalanche, it was the panic the media whipped up over Covid, Governor Whitmer's requiring old-folks home to admit Covid-postive patients to free up hospital beds* and the great purge of medical support people over age 55 due to fear and onerous working conditions.

*Whitmer did the insurance industry a "solid" by forcing old-folks homes to accept Covid patients that were discharged from hospitals. Insurance companies cheered because old-folks homes are incredibly inexpensive compared to hospitals. It should be noted that Whitmer's father has been a life-long executive in the insurance industry.

There are documented cases of young patients recovering from Covid beating older, disabled residents to death.

8 comments:

  1. This practice is common in healthcare. I have a university degree and 4+ decades experience. My employer will offer a green newly minted person MORE than they pay me....and get mad when I say something. The line is "You're NOT supposed to know what others make". Almost ALL healthcare facilities pull this crap and then wonder why their HR office looks like a revolving door in a circus. And you KNOW this constant rotation of employees means the vast majority are not fully up to speed at work and that affects patient care. But you can't tell bean counters that....you can't tell them anything. If I wasn't so closed to retiring I'd move on....but at my age it's not worth the effort.

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  2. ERJ, this is common in my industry as well: they will hire from outside at a higher rate than promoting people from within and if they do, it will never be at the same rate (or, they will simply hire a consultant for way more than any serving employee to give exactly the same answers the regular employees give). It certainly encourages people to move around in the industry.

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  3. In a pleasantly surprising turn of events, *MY* employer is both offering a mid level recruitment bonus, but, also, paid a *retention* bonus!

    Been in the sick people business since 1975. This is unprecedented.

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  4. My Mum, who also resides in an assisted living facility, has mentioned the turnover of nursing assistants. She also said that some of those that left previously for other employment, have returned noting that the grass wasn't necessarily greener at their new place of employ, even though the dollars were greener and in larger abundance.

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  5. If you're the $15/hr person how do you know how much the $18/hr person is being paid?

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    Replies
    1. Because the ads post the offer, and new hires talk.

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  6. I doubt that $10K is offered to the CNAs.
    RNs, yes. CNAs no way.

    An RN is a 3-4 year degree. The going rate for private schools here is $40-50K.

    CNAs are literally entry-level grunt-work jobs, open to pre-adult teenagers. The training even in Califrutopia amounts to about how long it takes to mint an EMT, about 150 hrs or so. The tuition runs under $2K.

    Ain't nobody paying a new one of those a $10K bonus, unless they're crazy.

    As for RNs, the bonus usually works as 1/2 after 6 months, the other 1/2 after a year.

    And then HR is shocked when the one-year bailout rate runs 50%.
    And they spend $80K, on average, including that bonus, to recruit one successful applicant.

    That's why in nursing, like most relationships, you have to walk out to get respect.
    get a job, leave for greener pastures, come back with more experience, get a bigger bonus, leave for a bigger bonus, come back with more experience with a bigger bonus. Around here, with 120 major hospitals to pick from, it's a round-robin merry-go-round.

    CNAs, OTOH, are the same as busboys at a restaurant: they always come in at minimum wage, and if they stick around, they might get another $1/hr after four raises over as many years. If you're still doing it at 30, even if you're good at it, it says a lot about your skill level. The good ones are going to nursing school, PA school, or medical school, to actually get a professional license and a decent salary. The lifers are career human janitorial staff: they clean butts, give showers, and babysit those too infirm to do for themselves.
    Don't get me wrong: the good ones are worth their weight in gold, but not the way HR sees it. And never will be.

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