How One Healthcare Organisation Achieved 50% Lower Turnover by Hiring for the Heart

Lessons from Mozaic Senior Life’s award-winning approach to building culture in senior care

In an industry where staff turnover averages 40-50% annually, one healthcare organisation has cracked the code. Mozaic Senior Life, a Connecticut-based senior care provider, maintains turnover at just half the industry average whilst consistently earning Top Workplace awards. We spoke to Kara Rodrigues, Chief Human Resources Officer on an episode of Culture in Action to find out just how they’ve done that.

Their secret? A radical shift from traditional hiring practices to what they call “hiring for the heart.”

The Trust Test: When Three Executives Choose Your Care

Perhaps the most powerful testament to Mozaic’s culture lies in this remarkable fact: three out of five executive team members have loved ones receiving care from their own organisation. Kara puts it simply: “My mother lives here at Mozaic. She’s been here for two years. To say that I trust the staff is an understatement.”

This level of personal investment creates what Kara calls “firsthand knowledge” in decision-making. When executives are also family members, every policy change, every staffing decision, every cultural initiative gets tested through the lens of “how would my loved one experience this?”

Stop Talking, Start Listening: The Foundation of Cultural Success

When asked about the one thing healthcare leaders should stop doing to improve staff engagement, Kara’s answer was immediate: “Stop talking. And start listening.”

This philosophy underpins Mozaic’s entire approach to culture building. They’ve created structured opportunities for genuine dialogue:

The Sounding Board Approach

Every other month, Mozaic runs three key listening sessions:

• Breakfast with the CEO – Informal gatherings with 10 diverse team members, no agenda, purely for relationship building and feedback
• The Sounding Board – Structured meetings with 20-30 staff members including a “rumour mill” segment where leadership addresses workplace gossip with facts
• New Hire Tea & Birthday Celebrations – Connecting new team members with established staff whilst celebrating everyone annually

The genius lies not just in listening, but in the systematic approach to addressing what they hear. Kara emphasises: “I always do best when I listen and go away and reflect, then you take the emotion out of what you may have just heard. Then you can put an action plan in place.”

Hiring for Heart: The Emotional Intelligence Advantage

Mozaic’s recruitment philosophy turns conventional hiring wisdom on its head. Where most healthcare organisations focus heavily on qualifications and experience, Mozaic prioritises emotional capacity.

“We can teach you the tactical pieces of a job,” Kara explains. “It’s do you have the heart to deliver the care and compassion that is integral to who we are as an organisation?”

Practical Application:

When interviewing candidates, Mozaic looks for:

• Genuine emotional responses to caregiving stories
• Personal experiences with caring for family members
• Natural empathy demonstrated through conversation
• Authentic passion for making a difference in people’s lives

This approach has created a workforce representing 96 countries, united not by geography but by shared values and genuine care for residents.

Building Belonging in a Diverse Workforce

Mozaic’s “flag wall” represents staff from 96 different countries – a visual reminder of their commitment to authentic diversity and inclusion. But diversity means nothing without belonging, and here’s where Mozaic excels.

Kara emphasises the importance of authentic self-expression: “How do you show up and be the best person you are as your authentic self every day?” This isn’t just rhetoric – it’s built into their recognition systems, review processes, and daily interactions.

The Business Case: When Culture Drives Results

The proof of Mozaic’s cultural approach lies in measurable outcomes that matter to healthcare leaders:

Operational Excellence

• Multi-year waiting lists for admission

• Full occupancy maintained throughout the pandemic

• Generational family loyalty with repeated donations and referrals

Staff Engagement

• 50% lower turnover than industry average
• Career progression stories – housekeepers becoming IT specialists, CNAs advancing to RNs
• Award recognition at regional, industry, and national levels

Financial Impact

• Sustained donor relationships with regular contributions
• Legacy gifts from families even after residents pass away
• Reputation-driven referrals reducing marketing costs

You are our reputation. The decisions you make, how you show up every day, the care you provide is our reputation.” – Kara Rodriguez to all Mozaic staff

Practical Takeaways for Healthcare HR Leaders

1. Restructure Your Interview Process

Move beyond technical assessments to emotional intelligence evaluation. Ask candidates about their personal experiences with care, and don’t be afraid of emotional responses – they’re often the best indicator of genuine empathy.

2. Create Systematic Listening Opportunities

Implement regular, structured forums for staff feedback. The key is consistency and follow-through – staff need to see that their input leads to action.

3. Invest in Internal Development Pathways

Mozaic’s success with career progression from housekeeping to IT demonstrates the power of internal mobility. Create clear pathways for advancement across different departments.

4. Make Values Tangible

Don’t just post values on walls. Integrate them into performance reviews, recognition programmes, and daily decision-making processes.

5. Lead with Vulnerability

When CEOs dress up as hot dogs and executives share personal stories, it creates permission for everyone to be authentically human at work.

The Pandemic Test: When Culture Becomes Critical

The true test of any organisational culture comes during crisis. While most healthcare facilities struggled with closures and staffing shortages during the pandemic, Mozaic maintained full occupancy.

Kara attributes this to their foundation of “accountability, compassion, and teamwork.” When external pressures mounted, their cultural investment paid dividends through staff who “showed up for each other and for our residents every single day.”

The lesson for healthcare leaders is clear: culture isn’t a nice-to-have during good times – it’s what sustains you through the inevitable challenges.

Listen to the full podcast episode

Listen to the full episode to hear in Kara’s own words exactly what they do to be a Top Workplace.

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Moving Beyond Buzzwords to Practical Culture

Kara acknowledges the challenge many healthcare organisations face with cultural concepts like psychological safety: “Take it from those current buzzwords to something that’s practical that we can execute on.”

The key is translation – taking abstract concepts and making them concrete, actionable, and measurable within your specific context.

Looking Forward: The Sustainable Culture Model

What makes Mozaic’s approach sustainable isn’t any single initiative – it’s the systematic integration of culture into every aspect of operations. From screensavers sharing staff recognition to structured feedback sessions addressing rumours before they spread, every touchpoint reinforces their values.

For healthcare HR leaders facing mounting pressure from turnover, recruitment challenges, and staff burnout, Mozaic’s example offers hope. The path forward isn’t about competing solely on compensation – it’s about creating workplaces where people feel genuinely seen, heard, and valued.

As Kara puts it: “People join us and they stay. And a big part of that is because they want to do the meaningful work, but they also want to be in an organisation where they feel seen and heard and valued.”

The question for healthcare leaders isn’t whether they can afford to invest in culture – it’s whether they can afford not to.

Want to learn more about building winning cultures in healthcare? Explore Mo’s suite of employee engagement tools designed specifically for healthcare organisations at mo.work