Gain Efficiency through Lean Utilization and Workforce Management Systems

April 18, 2022 Lynne Jackson

Understanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providersUnderstanding the staffing shortage plaguing healthcare providers

The aging population and intensifying nursing shortage threaten to create a cataclysmic need for skilled nursing resources over the next few years. The United States Registered Nurse Workforce Report Card believes the shortage will continue until at least 2030. Meanwhile the demand for skilled nursing care is continuing to soar. The number of Americans over 65 doubles to 95 million by 2060, according to the US Census Bureau. Workforce management systems play a key role in caring for senior living and skilled nursing residents.

These systems empower healthcare facilities with the ability to assign medical personnel, track attendance, and ensure regulatory compliance. But are these same workforce management systems prepared to help skilled nursing and senior care facilities navigate these growing staffing and operation demands?

Well, maybe. The answer depends on the operator’s:

  • Management Strategy
  • Workforce Management System’s Capabilities

Management strategy

Management strategy dictates how the facility will address the growing demand, strict regulatory requirements, and staffing limitations. A legacy approach that deploys workforce management systems in the background to create schedules, document attendance and run reports won’t suffice. To succeed, skilled nursing and senior care providers must take a proactive, innovative strategy to:

  • Anticipate staffing needs
  • Quickly resolve issues
  • Adjust to changing resident populations and acuity in real time
  • Derive real-time workforce analytics to make smarter decisions, faster
  • Use technology to improve employee hiring and engagement

Workforce management system capabilities. Not all workforce management systems are created equal. In skilled nursing and senior care, providers must ensure their workforce management system can promote the business outcomes that advance quality and counter staffing shortages. They must also ensure the workforce management system is:

  • Easy to navigate so administrators can find needed information at a glance.
  • Provides real-time notifications when quality thresholds are violated.
  • Pushes out recommendations for staffing shortages and openings.
  • Helps remediate quality issues before they affect a facility’s Five-Star Rating.

Before they can create an effective strategy to counter the staffing crisis, providers must analyze its underlying causes and how specific measures can address these causes and affect their environment.

Understanding the Staffing Shortage Plaguing Healthcare Providers


Rising Employee Turnover

High turnover means providers tasked with caring for the aging population face even greater workforce challenges than their peers at other healthcare facilities. This includes long-term, post-acute and senior care facilities. In skilled nursing and senior care facilities, turnover rates among nursing staff range from 30 to 80% annually with nursing homes experiencing the highest turnover. Consequently, many providers are enhancing salary and benefit packages to attract candidates as well as devoting more resources to hiring.

Employee turnover isn’t necessarily a negative reflection on the skilled nursing or senior care facility. Some turnover is natural and should be expected as many experienced nurses approach retirement age. It’s the quantity of nurses approaching retirement that exacerbates the already drained resource pool. An impending “silver Tsunami” is expected to hit by 2030 as 1 million RNs retire. Despite ample forewarning, the industry does not expect to suitable replacements ready to take over.

“The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform,” according to the American Association of Colleges and Nursing (AACN).

High turnover compounds daily problems at many facilities striving to keep shifts filled.

Argentum’s The 2019 Forecast Report: Workforce Trends states that 1.2 million jobs remain unfilled in healthcare and social assistance industry, which includes skilled nursing and senior care.

Workforce management systems are helping providers battle turnover by streamlining applicant recruiting, hiring, and onboarding processes. Though critical, leveraging workforce management systems for recruiting is not enough to stem the tsunami facing providers.

Healthcare providers are looking to other industries that have successfully navigated similar scenarios. For example, lean approaches and workforce management systems help industries, like manufacturing and retail, consistently deliver high service levels with limited resources. However, skilled nursing and senior care providers face additional challenges. This is because quality of care hinges on the availability of skilled medical personnel. As a result, providers must break down the shortage’s impact on quality of care. They must also analyze what specific measures can alleviate their staff’s burdens and better position staff to deliver quality care. Learn more, see  Understand Staffing Shortages ebook.

How the Shortage Impacts Skilled Nursing and Senior Care

Lack of educated nurses directly correlates with poor resident care and even leads to fatalities. According to research, a 10% increase in the number of bachelor’s degree nurses equates to 7% decrease in patient mortality in overall healthcare practices. A report in the New England Journal of Medicine confirms this research. It also estimates the understaffed units have a 6% higher patient mortality rate than fully staffed counterparts.

When facilities are short-staffed, nurses spend less time with each patient and are more likely to make mistakes.

In fact, research proves when RNs are on site, residents experience fewer falls and are less likely to need emergency medical treatment.

However, skilled nursing facilities are having trouble keeping the proper number of RNs onsite every day. In a July 2019 study by Harvard and Vanderbilt universities, researchers estimate 75% of nursing homes fail to meet federal requirements for RN coverage, especially on weekends.

Long-term and post-acute care facilities are feeling the pain in more than one way. Certified nursing assistants and other direct care workers make up the majority of a facility’s nursing staff. They are also in short supply. MIT Professor Paul Osterman projects a national shortage of 151,000 paid direct-care workers by 2030. He also projects an estimated gap of 355,000 by 2040. Since CNAs lack the knowledge and expertise needed to troubleshoot resident care needs. Forcing them to take on this responsibility jeopardizes resident care. In addition, the lack of staffing is causing facilities to suffer financially. Facilities without an RN onsite every day can lose one full star in the Five Star Rating for staffing. Centers for Medicaid and Medicare Services (CMS) uses Five Star Ratings to base per patient reimbursements and awards facilities with the highest stars the most. Discover The Growing Influence of Five-Star Quality Ratings in LTPAC.

Pursing Quality with Lean Utilization and Workforce Management Systems

Since spreading nurses over a greater patient population hinders their ability to provide quality care, providers must find ways to alleviate the burden on nurses while maximizing the productivity of their available resources. The right workforce management system that leverages lean principles can help.

Workforce management systems and lean principles cannot increase the labor pool of RNs and certified nursing assistants. But when part of a comprehensive strategy, workforce management systems following lean principles can increase employee productivity, job satisfaction, and promote career advancement, which in turn reduces turnover as well as enhances quality care.

Applying Lean Principles with Workforce Management Systems

Lean principles have been helping organizations in multiple industries, especially manufacturing, reach productivity goals for decades. It seeks to fundamentally change organization thinking and value, which helps transform organizational culture. Lean comprises a set of operating philosophies and methods designed to maximize value for patients by reducing waste and waits, according to the National Institute of Health.

This Lean utilization helps fuel lean principles and compliment workforce management systems by helping the workforce expand their abilities. Lean utilization requires developing employees to their highest level of skill through role enhancement, which often includes delegation skills, flexibility, and technology, especially workforce management systems. Doing so impacts quality of care. To find out more, see Is Your Organization Wasting Its Most Valuable Resource.

·Enhancing Rules 

According to the NIH, role enhancement involves expanding worker skills through innovative and non-traditional roles so they can assume a broader range of responsibilities. Ongoing professional development expands nursing skills and enables nurses to provide current, safe, and expert care.

Skilled nursing providers, including Greek American Rehabilitation Care Centre, use their workforce management systems to look for development-minded nursing candidates. The provider trains them in multiple skills from wound care and EMR to QA auditing, and quality management measures.

Enabling staff to spread their wings enhances their engagement and advances their career path while increasing productivity and care quality. In the activities department, staff are also trained in feeding residents as well as managing the facility gift shop. “We try to expand their horizons as much as possible,” said Mordecai Finkel, Greek American HR Director. “The result? Staff are more likely to be invested in their profession.” Find out How Company Culture & Happy Employees Go Hand in Hand.

·Delegating with Ease with Workforce Management Systems

Teaching staff in delegation practices enables them to communicate more effectively with co-workers and reduces stress. In addition, delegation practices increase productivity by helping teams finish tasks on time rather than cramming tasks to the end of the shift, which often spirals into unnecessary overtime. Everyone must understand expectations and responsibility.

The six steps to teaching better delegation are:

  1. Prepare
  2. Assign
  3. Confirm understanding
  4. Confirm commitment
  5. Avoid “reverse delegating”
  6. Ensure accountability

Basic workforce management systems can ensure properly qualified staff are working in the appropriate positions and clock in and out on time. More sophisticated workforce management systems can also identify trends that diminish workforce attendance and productivity.  Learn how SmartLinx Spotlight enlightens decisions.

·Driving Flexibility Through Workforce Management Systems

Developing a flexible skillset and mindset promotes cost efficiencies and superior performance. Greek American’s Human Resources Director learned this first hand after eliminating the word specialist from job titles as a result. 

“I can’t tell you how inefficient things are when a person specializes in one area and can’t move on to another skill or task. At our facility, every CNA is trained in rehab skills, in feeding, and creating a fine dining experience. This is above and beyond their regular job description. We’re never going to be stuck if one of our ‘specialists’ calls out one day, so all of our employees are trained to do all of the different aspects of the other responsibilities as well.”

Integrated workforce management systems promote flexibility by enabling providers to create staffing policies that support their unique needs and incorporate expanded employee skills. Advanced workforce management systems can factor these skills and policies into scheduling and compliance functions and apply them when creating schedules and filling open shifts.

However, these tailored capabilities only work when the workforce management system is designed specifically for skilled nursing and senior care facilities. Many workforce management systems treat all healthcare environments the same, which limits their ability to apply lean principles and resolve staffing issues.

In addition, generic workforce management system often prove difficult to navigate, forcing administrators to dig through multiple screens to perform desired tasks. SmartLinx designed its workforce management system (functions and interface) to support on what skilled nursing and senior care administrators experience. 

How SmartLinx Workforce Management System Can Fuel Lean Principles


Lean principles help organizations focus on value to boost productivity and resource utilization as well as better understand costs. When tailored for the organization’s environment, workforce management systems represent an ideal technology for organizations striving to apply lean principles.

Promoting Quality and Effective Resource Utilization

Skilled nursing and senior care providers must abide by different regulations than other healthcare providers. For example, the Centers for Medicaid and Medicare Services (CMS) places strict regulations on staffing at long-term care and post-acute care facilities. CMS regulations define the number and type of staff required based on the size of the resident population and its acuity needs. 

SmartLinx workforce management systems can staff according to CMS requirements and Lean principles. In addition to scheduling staff based on the number of residents and services provided, SmartLinx workforce management system also quickly adjusts schedules to match changing resident needs. To promote Lean productivity and resource utilization, SmartLinx automatically adjusts schedules to changing PPD census values and notifies administrators when a sudden scheduling change (missed shift, tardiness) causes a facility to fall out of compliance. See how SmartLinx workforce management system streamlines scheduling at 110 facilities.

Administrators can verify full staffing at every facility by glancing at the SmartLinx dashboard. Then, they can quickly drilling down to discover the source behind any scheduling issue. In addition to alerting them of open shifts, the workforce management system automatically presents administrators with a list of qualified employees able to close the scheduling gap.

With the click of the mouse, administrators can offer the shift to employees in each one’s preferred method, such as the SmartLinx Go mobile app, a text message, email, or phone call. SmartLinx workforce management system automatically collects employee responses and notifies administrators, who can easily close the gap.


Increasing Productivity and Eliminating Inefficiencies Using Workforce Management Systems

SmartLinx workforce management system was specifically designed for skilled nursing and senior care providers. The system streamlines the administrative processes by presenting all scheduling functions in an intuitive graphical dashboard. Administrators can quickly access what they need and modify schedules on the fly. Not only that, the SmartLinx centralized console lets administrators view schedule status for all their facilities at once and drill down to details. See how Excelerate cut overtime by 30% and overall labor costs by 15% with SmartLinx workforce management system.

Using advanced business analytics, SmartLinx workforce management system helps providers prevent overtime. Using the system’s unified dashboard, administrators can quickly ascertain who’s approaching overtime and adjust schedules accordingly. When a shift opens, SmartLinx automatically recommends qualified employees who can work without incurring overtime while also supporting internal policies, such as seniority. With a click of the mouse, administrators can send out shift requests knowing the workforce management software will notify them when employees respond.

SmartLinx workforce management system advances productivity by enabling employees to adjust their schedules on demand. Employees can also receive and respond to open shift requests in real-time on their mobile device. If they cannot work a scheduled shift, employees can use SmartLinx mobile workforce management system to swap shifts with qualified co-workers and view responses in real time. Discover How to use a Mobile App to Enhance Productivity.

SmartLinx workforce management system helps providers evaluate their staffing rating long before the CMS Payroll-Based Journal deadline. The system automatically rates each facility in real-time and displays warnings when any facility’s staffing falls below established thresholds. The system recommends steps for resolving the issue before it impacts their desired Five-Star Rating. 

Reducing Costs with SmartLinx Workforce Management System

Every day, many employees clock in a little early and clock out a little late. Over time, these extra minutes add up to substantial costs. Instead of having administrators sift through volumes of attendance data to identify these incidents and then manually address them, SmartLinx workforce management system presents all incidental overtime on one unified console. Administrators can quickly spot trends and implement policies to block early punches, late punch outs, and buddy punching. In addition,

Avoiding Noncompliance Penalties

Workforce management software helps providers comply with CMS reporting requirements by generating complete and accurate Payroll-Based Journal reports. However, in many workforce management systems, this process is time-consuming and error prone. This puts providers at risk of hefty penalties and lower reimbursements. In addition, late and inaccurate Payroll-Based Journal Reports can damage a provider’s Five-Star Rating and their reputation.

SmartLinx workforce management system automatically generates fully compliant Payroll-Based Journal reports in real time. SmartLinx integrates PBJ reporting with live attendance and scheduling information. Therefor, it can display compliance information for all facilities at a glance via a unified dashboard. Providers can identify and resolve noncompliance issues before they impact their Five-Star Rating. See how Greek American used SmartLinx workforce management system to refute a compliance allegation in moments.  


For skilled nursing and senior care providers, demonstrating quality care and compliance will remain a top key performance indicator. Integrated workforce management systems that support lean utilization principles will empower providers with the ability to maximize their workforce and productivity while eliminating unproductive, tedious tasks. Providers can use workforce management systems, like SmartLinx. SmartLinx proactively reduces labor costs while ensuring staffing meets quality standards and complies with evolving CMS regulations.


Previous Article
How Workforce Management Technology Enables Quality Care & Cost Efficiency for Skilled Nursing Facilities
How Workforce Management Technology Enables Quality Care & Cost Efficiency for Skilled Nursing Facilities

Learn about unique workforce and compliance challenges that skilled nursing facility operators are facing a...

Next Article
How to Improve Employee Engagement with SmartLinx Go
How to Improve Employee Engagement with SmartLinx Go

SmartLinx Go provides real-time access to schedules, pertinent work information, and self-scheduling capabi...


Subscribe to Smartlinx News and Latest Industry Insights

First Name
Last Name
You've been subscribed! Thank you!
Error - something went wrong!