What is Workforce Management?

April 18, 2022 Lynne Jackson


Behind every skilled nursing and assisted living facility resides a network of people and the processes they use to deliver resident care 24 hours a day, seven days a week. Workforce management represents a core part of this infrastructure.

Technically, workforce management comprises the systems, processes, and procedures developed to facilitate productivity through employees. For most long-term care and senior living facilities, workforce management systems serve as a silent partner that helps put the right people to work in the right places at the right time.

How Workforce Management Started

Workforce management evolved from manual pen and paper practices to automated software systems designed to streamline everyday operations. Though this progression appears natural, migrating to an automated workforce management system often proves quite complicated, especially for healthcare providers with multiple requirements.

Senior care operators understand the dynamics involved in core workforce management functions and impact on every day operations. These include scheduling, attendance tracking, and enforcement of internal and external policies. They also realize filling schedules with credentialed employees fulfills only part of their responsibilities. After all, some residents need more care than others and their medical needs can change quickly. In addition, providers must comply with complex federal and state regulations, which adds another layer of complexity.

As a result, administrators turned to a variety of tools to manage different aspects of their workforce.  Many facilities deploy basic spreadsheet software for scheduling, a time clock to log attendance, and specialized software to handle payroll. Most facilities use reporting software to generate compliance reports but often require administrators manually collect and upload scheduling and attendance data into reporting fields.

Fortunately, workforce management systems offload many of these labor-intensive tasks. Although their effectiveness can vary significantly between different systems, they deliver similar core functions.

Fundamental Workforce Management Capabilities

Staff scheduling

Scheduling staff represents a fundamental part of workforce management, especially for organizations that depend on hourly and shift workers. However, many skilled nursing and senior care administrators don’t use their workforce management systems to create employee schedules.

Instead they continue to rely on spreadsheet software to create and adjust employee schedules. These change frequently to accommodate resident medical needs as well as employee absences and tardiness. Although they may have a generic workforce management tool at their disposal, administrators often prefer software that’s easier to navigate and targeted at their needs.

“In 2025, 60% of large enterprises with hourly paid workers and variable demand for labor will still be using mostly manual (non-automated) scheduling approaches. Source: Gartner Report Market Guide for Workforce Management Applications in 2019.

Fortunately, workforce management systems designed for senior living and skilled nursing facilities enable administrators to reap the benefits of automated scheduling without cumbersome navigation.  

These workforce management systems alleviate error-prone manual processes. They do this by automatically creating schedules that match the facility’s needs. Then they adjust them to prevent understaffing. For example, SmartLinx workforce management analyzes historical data and deploys an algorithm to calculate staffing needs. This proactive scheduling defines the appropriate staffing level based on the number of residents, resident acuity, and regulatory demands in senior living as well as long-term care and post-acute care facilities. It then continually adjusts schedules to support changing PPD census values. Administrators can determine staffing levels in advance and set up rules to address their specific needs. Although it automates schedule creation and changes, it lets administrators manually adjust schedules when needed.  See how Trilogy optimized schedules for 110 facilities.

Open shift management

Creating an ideal schedule may be a foremost function of workforce management systems. However, it’s far from the only critical capability. In order to keep a facility running, workforce management systems must do more than create static schedules. Static schedules only work in small environments that allow employees to take on co-worker responsibilities when needed.  When healthcare employees take on additional work, the quality of resident care drops dramatically.

The New England Journal of Medicine estimates the mortality rate for understaffed units as 6% higher than their fully staffed counterparts.

 A UCLA study states increasing the number of RNs and hours of nursing care per patient could save 6,700 lives and 4 million days of patient care in hospitals each year.

In addition, post-acute and long-term care facilities risk compliance violations, lower Medicare reimbursements and reputational damage that can drive up insurance costs and lending rates. When staffing levels fall below Centers for Medicare and Medicaid Services (CMS) guidelines, a skilled nursing facility’s Five-Star Rating  can suffer and carry substantial financial implications. 

As a result, facilities must quickly fill open shifts when employees take unscheduled time off or show up late. Fortunately, workforce management systems can help. When employees request last-minute PTO or fail to show up for a scheduled shift, an integrated workforce management system can automatically alert administrators and provide a list of employees qualified to fill the open shift. Some systems can even accommodate specific facility needs, ranking worker availability according to union rules, seniority and more.

SmartLinx takes this a step further. It helps administrators quickly offer open shifts to selected employees in each one’s preferred method, such as text, email, voicemail or in-app notification. Employees can respond immediately on their mobile device, which then alerts the administrator.

In addition to quickly closing open shifts, the workforce management software can improve employee engagement by fairly distributing extra hours. When a shift suddenly opens, managers tend to ask the same employees to work, inadvertently neglecting others, which overworks favored employees and disengages others.

Attendance tracking and management

In many workforce management discussions, attendance tracking and management serves as the silent partner to scheduling. Everyone assumes organizations carefully track employee attendance and absences, especially among hourly workers. After all it’s essential for  accurate payroll services as well as productivity. However, real-time attendance tracking is not prevalent in long-term, post-acute and senior care.

Automated time clocks and corresponding management software have made tallying up paper time card punches at the end of the week nearly obsolete in skilled nursing and senior living. How the attendance software interacts with other core workforce management functions, scheduling and compliance reporting, reveals its effectiveness.

Many workforce management systems create batch attendance reports periodically and upload them into the core system. This level of integration enables administrators to review attendance data alongside schedules and identify scheduling gaps often hours after workers fail to punch in or leave unexpectedly. Then administrators scramble to fill these gaps. Meanwhile quality drops in understaffed units and nursing staff is overburdened.

Other systems can integrate attendance management software with scheduling in near real time. This allows administrators to get faster access to scheduling gaps. If they’re using a generic workforce management system, they’ll have to dig through multiple screens to find the data they need.

Workforce management systems tailored made for skilled nursing and senior living facilities make it easier to spot attendance issues.

For example, SmartLinx presents at-a-glance views of live attendance for all facilities/units on one color-coded display. Users can instantly identify where additional nurses are needed and drill down for details. They also receive real-time alerts when attendance problems arise and can get quick recommendations on how to fill unexpected gaps.

Systems tailor-made for senior care facilities, like SmartLinx, also help enforce attendance policies by preventing buddy punching, late and early punches. Violations like these are automatically tracked and reported in real time. By analyzing workforce attendance and scheduling data, organizations can quickly:

  • Ascertain gaps in coverage.
  • Create strategies to reduce overtime.
  • Improve payroll accuracy.


Compliance covers a broad spectrum of policies and regulations. In workforce management, compliance generally refers to staffing-related regulations. Federal and state regulations define the type and number of healthcare employees needed to care for long-term and post-acute care residents. These are based on the number of residents and their specific needs (acuity). Keeping up with compliance regulations is difficult especially in an industry plagued by a substantial nursing shortage. 

More than 75% of facilities fail to meet federal requirements for RN coverage, according to 2019 study by Vanderbilt and Harvard universities.

Workforce management systems help meet compliance requirements by creating schedules that support the regulations. Systems tailored for skilled nursing also adjust schedules to meet resident acuity needs through PPD census values.

Advanced Workforce Management Capabilities

Generating compliance reports on demand

Centers for Medicare and Medicaid Services (CMS) requirements enforce strict staffing requirements. These govern various aspects from tracking meal breaks to keeping the right staff in the right place and submitting reports. Failure to deliver compliance reports on time or providing late or inaccurate submissions can result in hefty fines. In the healthcare industry, lack of compliance also jeopardizes the provider’s ability to collect federal reimbursements for covered individuals and services. 

Passive workforce management systems can help generate quarterly compliance reports but cannot help facilities stay compliant. In addition, they often require administrators manually collect compliance data to populate the report.

When real-time compliance tracking is integrated with scheduling and attendance, the workforce management system helps administrators recognize when their staffing falls below compliance requirements. In addition, they can demonstrate compliance on demand during a surprise audit.

Controlling labor costs  

In the most basic level, workforce management systems drive efficiency by streamlining routine functions and eliminating error-prone manual tasks. Those with integrated scheduling, attendance and business analytics can also dramatically reduce labor costs, which comprise 50 to 80% of the costs at skilled nursing and senior living facilities.

For example, SmartLinx helps prevent overtime by automatically alerting users when a scheduling gap occurs. It then tells them who can fill it without incurring overtime or agency spend. The software can also support individual facility rules. These include union policies and seniority placement by presenting those workers first in the list. See how Excelerate cut overtime by 30% and overall labor costs by 15%.

Providing advanced analytics

Workforce management systems can also help them trim unnecessary labor expenses. They do this by identifying behavior patterns eroding their bottom line using real-time exception reports and analytics. These systems continually analyze labor costs to project future spends and recommend cost-saving measures. Custom dashboards let users view real-time expenditures across all workforce applications and compare them against projected costs and financial objectives. Systems, like SmartLinx, automatically keep inform administrators of key performance indicators (KPIs) and alert them when thresholds are reached.

“SmartLinx makes it easy to develop a strategic plan that helps you figure out where you want to e and what the costs are going to be in the upcoming years,” said Christine Sils, Director of Clinical Programs at Trilogy Health Services.

Enhancing Five-Star Ratings

Many compliance violations happen after the schedules are in place due to unexpected employee absences and tardiness. Workforce management systems that help close open shifts immediately by recommending and then contacting qualified workers help avert violations. However, this solves only part of the requirement. 

SmartLinx does this and more by automatically tracking staffing against CMS Five Star requirements. It then provides auditable records for each process. The system helps facilities identify scenarios that jeopardize their Five-Star Rating and recommend ways to improve it.

SmartLinx workforce management system with Five-Star Predictor enables you to evaluate for your staffing rating based on Payroll-Based Journal reporting long before the CMS submission deadline. The workforce management system aggregates hourly staffing data in the Payroll-Based Journal, attendance, and employee scheduling systems. It also factors in CMS calculation criteria and evolving requirements. The workforce management system’s Five-Star Predictor automatically rates each facility in real-time. And it displays warnings when any facility’s staffing is poised to jeopardize your desired rating.


Additional Resources:

How to Choose Workforce Management Software

10 Workforce Management Trends in 2020

7 Secrets to Payroll-Based Journal Success

How to Gain Efficiency through Lean Utilization and Workforce Management Systems

The CEO’s Playbook to Deliver Quality Care at Lower Cost


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