Two senior living providers offered a look at different workforce solutions to address one of the sector’s top challenges, staffing, Thursday during a session at the 2021 Ziegler LeadingAge National Virtual Senior Living CFO Workshop.

Minimum wage pressures, recruiting, and the use of agency staffing were among the workforce challenges senior living operators grappled with even before the pandemic. COVID-19 added burnout and mental health concerns to that list.


Mark Sperka, chief financial officer for LindenGrove Communities, said the New Berlin, WI-based provider created an internal staffing agency, known as the NursingPros Department, after struggling with staffing issues.

“We were spending in excess of 10% of our staffing costs on agencies,” Sperka said, adding that the NursingPros concept came from the philosophy of “If you can’t beat ’em, join ’em.” “The agencies always seemed to have staff available to us, so why not create our own?” he said.

LindenGrove hired a director for the agency and merged its internal campus nursing pools. The company then aggressively hired additional staff members with a goal of having a large enough pool of workers to eliminate the need for nursing agencies. 

Using Kronos centralized scheduling software, LindenGrove fills shifts first with internal staff members, then opens the schedule to NursingPros employees. The goal of the program is to fill difficult-to-fill shifts that typically occur over nights and weekends.

Sperka said that the NursingPros staff is composed of 110 certified nursing assistants, 33% of whom are nursing students. The model attracts caregivers looking for flexibility in their work schedules as well as higher pay rates with no benefits. NursingPros employees are required to work a minimum of four shifts per month to stay on the team, and they work a maximum of 28 hours per week.

LindenGrove, he said, has made significant inroads in reducing its nursing agency costs.

International recruiting

Chicago Methodist Senior Services, with offerings across the long-term care continuum, took a different route to address its nursing shortage. Statistics showed that half of skilled nursing facility RNs leave the sector annually, according to the nonprofit’s president and CEO, William Lowe. The prospect of a nurse going into geriatric care tends to be at the bottom of the list due to other opportunities in the field, he added.

“There is a general nursing shortage, but this industry suffers the most from interested candidates,” Lowe said. “We struggled with what to do about it.”

In 2005, Chicago Methodist Senior Services “dabbled” in recruiting nurses from the Philippines, where exporting human resources is big business. The country does a great job in educating nurses, who come to the United States with a five-year degree and a one-year internship, Lowe said. The Philippines, he added, has a reputation for great care, its nurses are taught in English, and relocating to the United States is a motivator.

The early process was cumbersome and long, Lowe said. And rather than pay a Philippines-based agency to recruit nurses, Chicago Methodist Senior Services loaned its vice president of nursing, herself a Filipino, to start a recruitment agency. The endeavor was so successful that the company realized it could offer the nursing solution to other nonprofits around the country. Today the company has a waiting list of providers wanting to tap into the supply chain of nurses.

Fifteen percent of U.S. nurses are foreign-educated, Lowe said. At Chicago Methodist Senior Services, every RN on staff is a recruit from the Philippines. The company hasn’t used an agency in years for its positions, he said.