The July CFO Hotline Report from investment bank Ziegler focused on the ongoing workforce recruitment, retention and related costs to organizations, and overall reveals not altogether new trends, but rather the sizable impact of those persistent trends.

Of the senior living and senior care chief financial officer (CFO) group surveyed (~200 organizations across the US,) 36% stated that workforce costs have ‘increased significantly’ and another 60% reported that costs have ‘increased slightly.’ CNA positions continue to be the most difficult to fill and maintain, based on participant responses, and all settings report high turnover and vacancies. Dining staff, followed by RNs, were the second- and third-most challenging to recruit and retain across all regions. Overall, nursing staff were reported to be those most brought in by agency staffing, at 5.7% across all organizations and departments.

While multi-site organization (MSO) providers were more often likely to seek temp agency staffing generally, single site organizations (SSO) showed an increasingly likelihood to do so over the last 12 months as well. One fourth of SSOs and 18% of MSOs also reported that they’d had to turn down admissions to their skilled nursing facilities (SNFs) because of staffing shortages – which has a significant impact on cash flows. Not surprisingly, the SNF setting by far was reported to be the most affected by shortages, at 86% of organization.

Both MSOs and SSOs reported that total staffing costs had surpassed half of their organizations’ total operating costs, with the total average of 56.1% of organizations’ annual operating costs.  The top five approaches that organizations report taking to manage staffing shortages include: 1) focus on positive workplace culture (78%,) 2) increased wages/ bonuses (77%,) 3) internal training/ upskilling (49%,) 4) career pathways/ promotion (46%) and 5) agency/ temp. staffing (46%.) Only 8% of all organizations reported that staffing issues had ‘no impact’ on operating margins; 42% reported staffing issues had a ‘moderate impact’ and 16%, ‘significant impact.’ Surprisingly though, 61% reported they are ‘not pursuing international recruitment,’ with 15% ‘trying to recruit but experiencing visa hurdles’ and only 6% ‘successfully recruiting’ from the international labor pool.

From the survey comments, there are a variety if intriguing, innovating staffing solutions worth reviewing (page 12,) including offering attainable housing, establishing an internal labor pool, and hiring a dedicated Community Healthcare Recruiter.