Post-Acute Leaders: What Keeps You Up at Night?


The COVID-19 pandemic created shockwaves in every part of the healthcare industry. Post-acute facilities, and in particular skilled nursing facilities (SNF), absorbed a massive impact, as they have both an especially vulnerable patient population in residential facilities and a critical labor shortage.

It will impact the industry for years to come, and as the pandemic wanes and transitions into an endemic, significant challenges remain. What fears are keeping post-acute facility leaders awake at night? Staffing, leadership roles, audits and disorganization top the list. While each is difficult, solutions can be found and created.

Adequate Staffing Levels

The pandemic caused many nurses and other clinicians to leave healthcare entirely. Post-acute sites primarily employ the nursing roles that experienced the largest exit from the workforce, including nursing assistants and aides. Consider that 1% of RNs left the workforce from April 2020 to June 2021, while 10% of CNAs left the workforce during that same time. So, in addition to experiencing the rising turnover seen throughout the industry, SNFs are also competing for a smaller number of CNAs.

But a lack of staffing is not particularly new at skilled nursing facilities. Consider these figures from before the pandemic. A study of SNF staffing in 2017-18 estimated average turnover rates for RNs and CNAs at well over 130%. Home health turnover was 64.3% in 2019, far exceeding the 2019 U.S. national turnover rate of 22%.

That’s more than enough to keep a leader awake at night. And, even if post-acute employers were able to return to pre-pandemic staffing levels, the concern remains they would likely still not have enough workers to position themselves for growth.

So, what, if anything, can be done? Cast a wider talent net by partnering with of total workforce solutions that includes a managed services provider (MSP) program. An MSP allows leaders to tap into not just hundreds of internal recruiters, but also a nationwide network of affiliated agencies, all working to fill your urgent needs.

Filled Leadership Roles

Having a licensed director of nursing (DON) and a licensed nursing home administrator (NHA) is critical. Without one of those roles filled, the facility can’t keep its doors open. That too can keep a leader awake at night.

Unlike some other healthcare professionals who moved toward Covid-impacted areas, facility leadership stayed put to address the resident and staff needs closest to them. Now, post lockdown, they may become more professionally mobile. It’s a topic addressed in a recent blog and interview with Todd Davis, the director of post-acute operations at Medical Solutions.

His advice? Get strategic. A strategic staffing plan for a post-pandemic world needs to consider not only possible changes in director-level leaders and administrators, but also RNs and LPNs.

Audit Preparedness

Here’s a scary thought – audits are imminent. Post-acute care organizations are facing routine inspections and audits again. Passing successfully is crucial to maintaining accreditation and status. Yet a common misstep that facilities still face is a lack of preparation.

As addressed in a recent blog, a good offense can be the best defense in the case of an audit. A strategic, short-term, audit-experienced hire like this can improve preparation without taking valuable time away from leadership. An extra, temporary director of nursing (DON) or a registered nurse consultant (RNC) can help with audit preparation. Or consider a minimum data set (MDS) coordinator to help prepare your facility within the audit window or catch up on lagging MDS reports.

Inefficiency from Disorganization

Another common frustration for post-acute leaders? The mess. What mess? The mess they have in filing and credentialling caused by staff coming and going during the pandemic and from so many agencies handling staffing. It’s what makes the prospect of an audit so scary to begin with.

How can you simplify and clean it up? Consider a partnership with an MSP. An MSP does a lot more than widen your search for talent. Medical Solutions can help you with compliance management and provide a dedicated single point of contact (and a single invoice!). Through our easy-to-use app, leaders can access what they need at a moment’s notice.

If your post-acute facility faces any or all of these challenges and needs a strategic staffing partner with industry-leading expertise, reach out to Medical Solutions to start a conversation. Having a proven and trusted partner in the industry may allow you to get a better night’s sleep.

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