Flexible Part-Time Staffers Could be Future of Skilled Nursing Workforce

Implementing a flexible model of staffing could help skilled nursing providers deal with the lows — and potential highs — in occupancy that are expected over the next several years.

But to do that, they’ll have to overcome competition from outside sectors, the need to deal with higher-acuity patients, and the complexity inherent in flexible scheduling.

Present-day challenges


The skilled nursing workforce is also dealing with some demographic issues of its own.

“We now have five generations in the workforce, which is somewhat unprecedented,” Peter Corless, executive vice president of enterprise development at Cleveland-based software company OnShift, told Skilled Nursing News. “With millennials now making up about 70% of the people coming into post-acute health care, we found that only about 35% of providers have indicated that they’ve changed recruiting and retention tactics to be more appealing to millennials.”

Providers face an uphill battle in appealing to all generations of workers; registered nurse (RN) staffing hours at nursing homes are far short of what’s ideal for clinical care, and nursing homes are the least popular setting for caregivers.


Altercare Integrated Health Services is responding by investing heavily in technology, Christopher Stach, the company’s director of human resources support, told Skilled Nursing News.

“What we’re trying to do is really tailor the staffing strategies to meet the ends of both our employees and our clients,” he said.

Altercare, which provides a range of services that include skilled nursing and has 27 locations in Ohio and one in Michigan, is doing this by using OnShift for scheduling, which allows employees to see what the current needs for shifts are — and to pick them up easily, as opposed to having to call in to gauge availability.

The fact that there was no way to predict which employees would go into overtime pointed to another use, as Altercare was able to gain visibility into how its employees were actually working.

Overtime, for instance, dropped substantially with the implementation of the technology, Stach said. There were also some improvements in keeping employees; the company’s retention is currently about 65% to 75%, an increase of about 5% to 10% from five years ago, when the company began to focus on its workforce and scheduling practices, Stach said.

Multiple providers are looking to adjust staff times and be more flexible, with some offering extra shifts at heavier need times such as meals or four-hour shifts, Corless said.

Looking ahead

SNFs already have their hands full with present-day needs, including the trend toward higher-acuity residents and the expectation among millennial caregivers that their bosses will be sensitive to their needs. But they also need to be looking ahead to the long-anticipated “silver tsunami.”

For his part, Stach expects skilled nursing staffing challenges to increase. He also predicts a rise in the importance of part-time workers.

“I think we’re going to see the increased need for flexibility,” he said. “We’re going to have to understand that employees are maybe going to have multiple jobs.”

As a result, Altercare is trying to hire more part-time workers. The company, which has many of its facilities in the Cleveland area, is also considering internal staffing pools, with employees possibly moving between communities. It could break up the routine or allow employees the chance to see new locations, and could help managers easily schedule around leaves of absence or voids filled by promotions, Stach said.

That said, set shifts for full-time workers will likely still be the predominant model, Corless said. But they’ll be supplemented in new ways.

“You’re going to have more contingent workers that’ll be filling the gaps,” he told SNN. “Ten years from now, your baby boomers will be retiring, but some of them will still want to keep their hand in the workforce. So perhaps adding certain benefits for part-time workers that may not be there currently [will let them] work more and pick up more shifts.”

Written by Maggie Flynn

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