Indiana Providers Adopt ‘Creative Scheduling’ Amid Workforce Pinch

Almost 100% of long-term care (LTC) providers in Indiana are asking staff to pick up additional hours, and more than 70% are asking employees to work double shifts or overtime, according to the preliminary findings from a survey from the Indiana Health Care Association/Indiana Center for Assisted Living (IHCA/INCAL) and other industry groups.

They’re also facing stiff competition from other sectors, such as retail and manufacturing: 74% of providers had certified nursing assistants (CNAs) leave for jobs outside the health care sector.

“I think we had kind of anecdotally assumed that our employees, our labor pool was different from what other places like manufacturing might tap into,” Emily Berger, director of workforce development and member services at IHCA/INCAL, told Skilled Nursing News.


The findings indicated just the opposite. The survey respondents, 125 in total, were asked what local employers were the primary competition for CNAs and home health aides. A little more than 45% indicated manufacturing was the primary competition, while 44.8% listed retail as the main competitor.

Skilled nursing facilities accounted for 75 of the respondents, Berger explained in an email, though these could include SNFs that also have assisted living or independent living on their campus or property. For SNFs and assisted living facilities, dietary, housekeeping and laundry were areas of particular staffing strain, she noted.

The survey as a whole found that 68% of providers need more dietary staff, 43% need more housekeeping workers, and 25% need more for laundry services employees.


Seventy-six percent of providers said there was an insufficient number of qualified applicants for open direct care positions, and one in five providers said they have vacancy rates of 20% or higher. Registered nurses had the highest vacancy rate at 22%.

Faced with staffing crunches at every employment level, it’s perhaps unsurprising that 96% of LTC providers are asking their existing staff to pick up additional hours and that 71% are asking staffers to work overtime or double shifts. But the shifts themselves are evolving as employers try to create more flexibility and work-life balance for direct-care workers, Berger said. Many providers use traditional eight-hour shifts, while others use 12-hour schedules.

And others are using a so-called “Baylor plan” to fill difficult-to-staff weekend shifts.

This plan, created at Baylor University Medical Center, lets employers have a subset of employees that work only on the weekends for 12- or 16-hour shifts while still qualifying for full-time benefits. The schedule is an attractive option for someone like a parent who wants to make sure the kids get on and off the bus on weekdays, Berger explained — and it’s an example of flexible scheduling that can give workers stability while ensuring the facility has workers for unpopular hours.

“I think creative scheduling is one of the biggest things that our members are going to have to embrace to help employees achieve work life-balance,” she told SNN. “That’s challenging in a sector that requires a 24/7 staffing model.”

Written by Maggie Flynn

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