20 Strategies for Rural Hospitals to Attract and Retain Staff

20 Strategies for Rural Hospitals to Attract and Retain Staff

Rural health care facilities often struggle to find and keep talent

Denise Bland, MHA

The demand for health care professionals is not limited to one area of the country, but rural areas are certainly beleaguered by the deficits. Many rural hospitals have an existing staff recruitment and retention problem. Several organizations have invested in virtual career fairs, built partnerships with medical schools, and developed system-wide marketing efforts to address the serious nature of the problem. The extensive geography of the issue emphasizes the market condition and suggests that staff recruitment and retention will continue to be an obstacle for the foreseeable future. The following are some creative tactics that rural hospitals can apply to recruitment and retention:


Some physicians and health care professionals desire a return to their community roots. It is advisable for hospitals to promote scholarship programs for students from the area, with obligations to return to the area upon school completion.


An often undervalued resource is existing staff. Many excellent candidates originate from in-house employee recommendations. Also, do not underestimate the leverage of local societies and the power of relationship-building at other hospitals in the vicinity.

3Résumé File

Keeping a résumé file and a spreadsheet of candidate abilities, along with interview notes, is essential. You will often find that going back to these references helps you recover your original thoughts  on whether the potential candidate is the right fit for the job.

4Train Your Own

Online schooling and on-site internship opportunities can go a long way. They enable employees to develop their careers, thereby encouraging employee retention. Show your employees that you care about their continued growth through a program for tuition assistance. Many companies get significantly discounted rates through community and state colleges. Consider a partnership with colleges and universities nearby and through distance learning.

5Consider Other Skilled Workers for Associated Tasks

Look at the job description and make sure it is accurate regarding the qualifications for the position. Remind yourself of the reasons those qualifications exist. Do all of the tasks require an advanced skilled worker? Perhaps modifying the job description will allow the advanced skilled worker to handle additional volume while a lab assistant assumes the responsibilities that were not essential to the job description. Such job task changes can have a high impact.


Consider how software and instrumentation can help your existing staff focus on higher-quality tasks for patient care rather than mindless repetitive tasks that are amenable to automation.

7Social Media

While you are not interested  in the volume of candidates as much as the quality, social media sites get significant traffic. Consider having managers advertise positions on their professional LinkedIn pages or other platforms.


Certain companies have started expanding benefits to include student loan repayment. The longer staff members stay in their jobs, the more repayment they get on their loans.

9Market Your Area

Entice candidates with the aspects of your community that are attractive. Allow candidates to bring their families when they visit and get to know the area. Ask existing employees to provide information on local schools and daycares or other tips about the area.  Consider presenting this information on a blog associated with your career page.

10Focus on Cost of Living

Those in rural communities should point out the low cost of living in their area. Candidates sometimes turn down positions in bigger cities because added pay ends up going toward daily survival.

11Behaviorial Interviewing

Using situational questions and asking candidates to give examples to answer questions helps ensure the candidate is the right fit for the job. Physical task completion during interviews is advisable for laboratory roles to demonstrate competency.

Behavioral Interview Sample Questions

“Describe a stressful situation you have been in at work and how you handled it.”

“Give an example of how you’ve worked effectively as part of a team.”

“How have you handled difficult situations with coworkers?”

“Tell me about a time when you took initiative at work.”

“Give an example of a time you made a mistake and how you handled it.”

12Present an IT Strategy

Have a comprehensive IT strategy to present to the candidate. The perception is that rural communities and small health care facilities are behind the times; you want to convince the candidate that your facility is technologically up to date.

13Consider Remote Workers

With telehealth, it may not be necessary to have all employees in your community. This option would be especially appealing to candidates who place a premium on work/life balance.

14Support Continued Learning

Budget cuts often mean that educational support for continuing education, travel to seminars or conferences, and registration fees to local conferences for existing staff are cut first. This is shortsighted when considering employee retention.

15HR Strategy

Do not forget a valuable asset: the HR generalist. The HR generalist can make suggestions for low-interest home loans, relocation expenses, practice setup costs, assistance with finding spousal employment, and assistance with locating daycare, among other incentives.

16Competitive Salary

A market salary adjustment should be a top consideration. Perform a market salary adjustment for existing staff and incoming candidates at least annually.

17On-Site Daycare

Consider what benefits on-site daycare would bring to all staff and ask employees for suggestions on how it would be maintained.  If employees would like to creatively staff an on-site daycare, it is worth discussing.

18Multiple Job Strategy

Consider that some employees may want opportunities for overtime and would like to fill other part-time positions.

19Hire Family Members

It has been a strategy at some institutions to hire spouses with appropriate backgrounds. This package deal approach encourages employee retention.

20Active Recruiting

Keep a constant goal of attracting new employees. In some situations, you may consider slightly overstaffing to keep a buffer on difficult-to-fill positions; it is likely that you need additional full-time equivalents in key role areas anyway. Creative budget strategies and shared duties across job functions will help achieve this goal.