I struggle with balancing retention against the need to free up an employee's future who is just not doing the job. Frequent rounding, goal setting, and encouragement does not seem to "cure" the old habits of those who have skated along for years, doing the minimum. Any suggestions?

Victor, it is unfortunate that the system has become that "not negative" references are given on individuals who should not be recommended. In addition to the traditional references I encourage you to become somewhat of a P.I., make your own phone calls...call the units, call the supervisors..sometimes you get individuals who will speak with you.

Priscilla, do you have a disciplinary procedure to document your findings and progress or lack of progress by the employee? If so, while it is not our goal to "write up" employees...you need to set expectations (action plans), hold staff accountable and then based on their performance, reward or dismiss.

I feel for your Pricilla. In a rural setting where high retention is not always a good thing, many people stay because there are not other employment options in the area. You do end up with those that do the minimum and are ingrained in the culture that is not always desirable.
It is a source of frustration to me and even when following Joanne's advice and creating action plans, they rise the minimum of that expectation, but never to the best job performance.
Sometimes we have had to just let them go anyhow.
Do people ever really change? Sometimes I wonder.

Don't forget the Internet. I recently learned a person I was about to do business with was a felon; healthcare fraud no less. I just googled a name and location.

I have a problem with an employee that relates well to the patients but not her co-workers. It is exhausting! I feel I spend 80% of my time on her. I have do the action plan & she does enough to skate along. It is frustrating. I have really worked with the other staff to help make her accountable because I am not there all of the time. This has seemed to help. The staff have noticed the difference since they don't enable the behavior as much. We continue to work on this process. The real problem is that she doesn't think she has a problem.