CUSTOMER STORY
Fewer Staff Exits, Happier Residents: How Real-Time Feedback Drove a 19-Point Drop in Turnover and 34% Recruitment Cost Savings at Nexion Health
Fewer Staff Exits, Happier Residents: How Real-Time Feedback Drove a 19-Point Drop in Turnover and 34% Recruitment Cost Savings at Nexion Health
About Retain
Nexion Health, founded in 2000 and based in Maryland, operates over 50 skilled nursing and rehabilitation facilities across the South and Midwest. They offer services like short-term rehab, long-term care, memory care, and telemedicine. Known for patient-centered care and a strong workplace culture, Nexion emphasizes innovation, inclusion, and quality outcomes in post-acute healthcare.
At Nexion Health, people aren’t just at the center of care, they’re the reason for it. For more than 25 years, the organization has built a reputation for long-term employee retention and outstanding resident outcomes. But as the senior care landscape changed, so did the needs of new hires entering the workforce.
While many team members had been with Nexion for years—even decades—the challenge wasn’t holding onto experienced staff. It was helping new employees feel supported, connected, and confident in their first days on the job. Because those early moments? They matter.
And sometimes, it’s the smallest things that make a difference: a name badge that never arrived, confusion around supplies, or a night shift that feels especially lonely. Left unaddressed, those details can shape a new hire’s entire experience and send them quietly walking out the door before they ever find their rhythm.
That’s where Activated Insights came in.
With tools like Retain and customer satisfaction surveys, Nexion shifted from outdated feedback systems to a smarter, more human approach. Instead of waiting for problems to surface, they were able to step in sooner, respond faster, and create a culture of support that extended from frontline staff to residents and families, even during the most isolating months of COVID-19.
What began as a focus on resident satisfaction quickly expanded because Nexion recognized that resident experience and employee engagement are deeply connected. One can’t succeed without the other. With Activated Insights, they found a way to elevate both.
“Resident satisfaction and employee engagement rank 1 and 1.1 on my priority list because they’re just that important,” said Riner. “The more engaged the employee, the better outcomes for the residents. When those two things happen, everything else falls in place… because of the feedback you get from Activated Insights.”
Rather than choosing between residents and staff, Nexion doubled down on both—and discovered that when they rise together, everything else falls into place.
The Challenge: Getting New Hires to Stay Long Enough to Thrive
Nexion has always done an exceptional job at keeping long-term staff engaged. Many of their core team members have been with the company since its founding—a testament to the nurturing culture they’ve built.
But the early-stage experience was another story.
“We’ve always done a good job retaining long-term employees,” said Meera Riner, Chief Operating Officer at Nexion Health. “But getting new hires to feel that same connection—that was our challenge.”
Before Retain, new hire feedback was gathered using tools like MyInterview, often through paper surveys or forms that didn’t feel meaningful or actionable. Leaders lacked real-time visibility into what new employees were going through and when issues did arise, it was often too late to course-correct.
“We were using paper-based systems that took away the conversational element of what feedback should be,” Riner said. “We couldn’t catch red flags early enough.”
This was especially true during COVID, when onboarding felt even more disconnected. Team meetings went virtual. Coworkers stayed six feet apart. Family visits were suspended. New hires were walking into environments that felt sterile, quiet, and unfamiliar.
It wasn’t just a logistics problem. It was a risk to the culture Nexion had worked so hard to build.
Nexion recognized the need for a better system—one that could engage new hires early, surface concerns quickly, and strengthen retention before frustrations led to turnover.
The Solution: Early Engagement, Real-Time Feedback, and Actionable Alerts
Everything shifted after a chance conversation between Meera and a member of the Activated Insights team at an industry event. What started as a discussion about resident feedback quickly evolved, because at Nexion, it’s clear that meaningful resident experiences depend on engaged, supported employees. You can’t improve one without investing in the other.
First, Nexion implemented customer satisfaction surveys to better understand and respond to residents’ needs in real time. With real-time insights and alerts, leaders could respond faster than ever, leading to a noticeable improvement in resident satisfaction scores, with Nexion communities now consistently outperforming national benchmarks.
Then came Retain. Retain is a solution designed specifically to support employees during their most vulnerable period—their first 90 to 100 days on the job. By checking in more frequently, identifying concerns early, and acting quickly, Nexion created a proactive engagement model that helped reduce turnover by 19 percentage points, from 79% in 2023 to 60% over the past year. These prompt interventions helped employees feel valued, supported, and more likely to stay.
“If an employee says they’re ‘just okay,’ that’s a sign they’re probably not going to stay,” Riner said. “Retain helped us act on those signals.”
Feedback wasn’t just easier to collect, it was easier to use. Administrators could pull key comments, recognize high performers with certificates, and make data-driven decisions that showed employees they were being heard.
More importantly, the process felt personal. As Meera explained, the old paper-based approach took away “the conversational element of what should be happening when receiving feedback.” With Retain, responses felt more like face-to-face review, giving leadership the opportunity to respond in a human, meaningful way. This not only improved the quality of insights but also built trust. Employees could see that their feedback led to real action, which strengthened the culture and encouraged even more open communication across the organization.
The culture of trust and responsiveness extended beyond the employee experience.
Customer satisfaction surveys triggered real-time Comment Alerts, allowing Nexion’s leadership to instantly respond to concerns from residents and families. The moment a comment came in, whether it involved care quality, communication, or a misunderstanding, it triggered a new task and alert for the VP of Compliance, prompting immediate follow-up.
“Even if it’s a tough alert, we’d rather know about it and address it. Those alerts are critical,” Riner shared.
The ability to respond early not only mitigated risk, but it also helped Nexion reinforce its commitment to transparency and trust at every level. But the benefits didn’t stop at damage control. Over time, patterns in resident and family feedback revealed recurring issues—allowing Nexion to proactively coach staff, adjust workflows, and prevent issues before they arose.
Teams began using this feedback to anticipate challenges before they happened—adjusting workflows, strengthening training, and coaching staff based on real-time trends. This proactive approach meant fewer Comment Alerts, more engaged employees, and ultimately, happier residents.
The Outcome: Early Intervention, Deeper Engagement, and a Culture of Accountability
Retain didn’t just streamline onboarding—it gave Nexion a reliable way to spot early signs of disengagement, foster recognition, and empower leaders to take action in real time.
By listening to employees more frequently, the team:
- Strengthened new hire retention, reducing overall turnover by 19 percentage points—from 79% in 2023 to 60% over the past year
- Created faster feedback loops between staff and supervisors, resolving concerns in real time through structured workflows
- Reduced administrative burden, giving leadership more time to focus on coaching, engagement, and training
- Recognized employee contributions more consistently
- Improved communication and training formats
- Lowered recruitment-related costs by 34% annually, thanks to improved retention and fewer rehires
- Boosted employee satisfaction and engagement scores, with post-Retain results (3.8–3.9) consistently outperforming national averages (3.72–3.78)
It also sparked improvements in resident engagement, driven by more responsive, better-supported staff.
“These tools didn’t just help us listen—they helped us show up,” Riner said. “For our staff. For our residents. For each other.”
Today, Nexion continues to expand its use of Activated Insights solutions across its communities. Whether it’s leveraging their Great Place to Work® certification, gathering real-time feedback, or preventing issues before they escalate, Nexion is proving that when employees feel heard and valued early—they stay longer, contribute more, and help deliver better care.
And for Riner, these tools have become irreplaceable.
“If we didn’t have them, I’d be highly frustrated,” she said. “It would leave a big void and a real setback in our ability to be successful. I’d be desperately searching for something to fill that gap.”
“They’ve become our co-pilot for employee and resident engagement,” Riner said.
