Skilled nursing organizations are finally realizing the scheduler’s role – crucial in balancing care and budgetary needs – in the ideal form they envisioned amid the crippling staffing shortages that plagued the sector following the COVID-19 pandemic.

Schedulers have proven to be the most effective means of chaos control in facilities, provided they have the right support and tools to assist, according to some nursing home leaders.

Having the right person in the scheduler seat is crucial, Michael Herald, president and CEO of Guardian Healthcare, told Skilled Nursing News. He said the company worked with senior leadership and site leadership on learning just what was needed and how that role functioned within the company’s greater plans. 

“Make sure that you have the right person in that role to be able to adapt to all of the changes that a site can encounter throughout the course of a day, a week, a month, whatever the case may be,” Herald explained.

Guardian Healthcare has a $400 million skilled nursing and ancillary services portfolio, including retail pharmacy, therapy, home health and staffing operations, with over 5000 employees.

‘Right person, right tools’

At Parker Jewish Institute, the company has implemented an app to help wrangle the chaos of scheduling, explained John Brown, vice president of human resources. Employees can know their schedule at a glance and put in time off requests or sick leave without having to place a call. 

“You have to have a really, really sharp tool that really connects with the staff,” Brown said. “How does that make their life easier? They have the tools to communicate with us, and with the employer, with their boss, supervisor, etc, in real time. So leveraging that technology … but then just as important, training them on it, making sure everybody knows how to use it, and people use it. This really becomes embedded in the day-to-day life for folks because it really is very helpful and very useful, and we use it a lot here.”

Parker Jewish Institute is a leading provider of short-term rehabilitation and long-term care. As a leader in teaching and geriatric research, the organization features its own medical team and is nationally renowned as a skilled nursing facility, as well as a provider of community-based health care, such as home health care, medical house calls, palliative care and hospice.

Technology can also help the different functions of a facility run in parallel, explained Brian Buys, chief product officer at Smartlinx. The finance, HR and operations departments all have different goals, with a “little bit of a tug and pull between,” he said. The right person with the right tool in the scheduler seat can smooth the flow for everyone. 

“Really prioritizing this role of planning, coverage and scheduling, and then creating some flexibility around it is critical, and we see the most success regardless of tools being used, when those three sort of stakeholder groups and paradigms are operating in harmony,” he said. 

Soft skills matter most

While technology tools make scheduling easier, Herald emphasized that the scheduler needs to be able to create stability while understanding the challenges that come with creating schedules and acting with empathy.

“Do you have the right person who acts with a sense of empathy, who is out talking to their coworkers and colleagues, who has an understanding of the challenges, who’s anticipating challenges that may come up in the schedule, who’s actively listening during what might be just a random conversation in a break room to identify when there might be an issue or a problem that has to be responded to because it’s going to have an impact on the schedule? Such as someone having a personal issue, or may be at home dealing with an illness or dealing with an unexpected bill,” he said.

On the consistency side, Herald said that is the number one most requested job aspect from Guardian’s employees. Knowing their days and who they’re caring for has made a big difference in both recruitment and retention at Guardian, he explained.

The soft skills are key, Herald said, to managing requests and shifts, and the right person may be different at each site.

“I can tell you examples of buildings where we had senior nursing staff members who were the scheduler because the dynamics of that building required that,” he said. “We’ve had CNAs, who can wear multiple hats, who are effective communicators with their colleagues, who build bridges with all of their colleagues, and could somehow balance it … they could provide patient care and deal with all of the challenges as a scheduler. The administrators and directors of nursing have confidence in them, and put them in their role.”

Brown echoed this, saying the scheduler isn’t an entry level position, and that the person who takes it on must balance all the organizational needs.

“You have to hire some people, put some people on those teams who can handle the employee side, the nursing requirements side, as well as the financial side, because you’re getting pressure from all three,” he said.

The supply chain mindset

Brown said that recruitment at Parker Jewish Institute lives with HR. The company works to instill an ownership mindset with employees, so everyone acts as a recruiter via word of mouth, but HR takes ownership of the hiring process to control the chaos.

“What I mean by that is ensuring that there isn’t bureaucracy that gets in the way, that one department blames another department and so forth, and everybody just keeps blaming everybody, but nobody really owns it,” Brown said. “HR is the owner. If something goes wrong with the chaos of recruitment and onboarding and interviewing, HR owns it. That’s it. They’re the ones. They got to bust through the barriers. They got to work throughout the organization to make sure that this thing stays a smooth functioning machine.”

Brown said the company views recruitment as a supply chain, looking at pinch points in the process to eliminate, whether that’s recruiting and interviewing or onboarding and orientation.

“So every step in the supply chain, we try to lean in and figure out, how do you move it from requisition to in the seated orientation and on the floor, working,” he said.

Guardian Healthcare has partnered with educational institutions to create a network of opportunities for licensed practical nurse (LPN) and certified nurse aid (CNA) students, Herald said.

“That went a long way into helping us establish those new pipelines of candidates who could be then potential frontline caregivers for us,” he said.

In Pennsylvania, Herald explained, the company is certified under the state Department of Education to offer and operate its own CNA courses. The clinical portion of the class is hosted within Guardian’s facilities and gives the instructors a chance to spot high-achieving students that fit the company’s culture.

Parker Jewish Institute is doing something similar, Brown said, in terms of working with nursing students. The company employs RN students from universities. The company doesn’t receive PBJ credit for these employees, but the students provide a lot of floor support.

“They provide support to the RNs on the floor for a variety of ways, [and] the RNs are teaching them and mentoring them,” Brown said. “In a lot of cases, they act as care to the residents, because they are able to do hands-on care with residents as nursing students. So we’re able to sort of leverage them, for lack of a better term, as CNAs.”

Buys added that within the supply chain metaphor, recruiting students makes for a supplemental supply to increase flexibility for all employees. He said that having a diverse pool of candidates will increase the success of recruitment efforts.

“I think that concept of creativity and diversifying the supply chain and really optimizing each of the supply feeds in that supply chain is really a neat way to think about it,” Buys said.