McKnight's Senior Living, April 2019, Feature 3

The labor-intensive senior living environment — coupled with operators’ ongoing need to curb excess spending and stay ahead of the curve in an increasingly competitive market — is leading more providers to seek tech-based solutions to help them better manage their workforce. It’s a prudent move, considering labor consistently accounts for one of the greatest operational expenses and directly correlates to resident and employee satisfaction and care outcomes.

Effective labor management involves far more than basic payroll applications, however. Today, operators have access to a range of sophisticated solutions to help them recruit and retain top employees, forecast scheduling needs, enhance compliance with staffing-related regulatory requirements and empower employees with real-time access to scheduling, earnings, time off accrual, training and more.

“Managing labor in senior living is a multidimensional issue because it requires a solution that can efficiently manage day-to-day concerns [and ideally help] companies determine proper staffing levels based on current community acuity levels,” notes Trish Cole, chief operating officer and general counsel at Medtelligent Inc.

Experts agree that the key to better labor management is effective capture, utilization and dissemination of valuable data, and customizable and user-friendly technology solutions that facilitate widespread, simplified adoption.

“Current labor management technology reduces waste, decreases payroll error and also [enhances] a facility’s position in the market in terms of being an ‘employer of choice,’” says Susan Reese, DNP, MBA, RN, CPHIMS, chief nursing executive / director for Kronos Inc.’s Healthcare Practice Group. She points out that almost half of employees surveyed by The Workforce Institute at Kronos wish their workplace technology performed like their personal technology, whereas almost one-third of healthcare employees feel that outdated processes and technology make their jobs more difficult — two factors that make smart labor management solutions a wise investment.


A key benefit of today’s labor management solutions lies in its ability to help drive top talent to available positions and build a quality candidate pool for future employment opportunities.

According to Martha Abercrombie, product marketing strategist for HealthcareSource (formerly Vikus), optimal labor management begins with hiring the right people faster, keeping them longer and then fostering their growth along with that of the organization.

“With 75% of directors of nursing services citing staff shortages as their most challenging job duty — and the demand for healthcare labor on the rise — it’s critical for organizations to invest in both recruiting and retention efforts,” she says. “With increasing staff vacancies and overworked employees, it is tempting to just keep filling open positions as quickly as possible rather than slowing down and fixing the real problem, which just might be the hiring process itself.”


Once quality employees are hired, it’s essential that operators assign the best employee for the job and not put too big a load on them, which can negatively affect care and resident and employee satisfaction. Fortunately, today’s sophisticated labor management tools can help mitigate risk, facilitate better care and maximize productivity, as well as revenue.

Gustavo Sapiurka, senior vice president of affordable and senior markets for RealPage, explains that the data captured by robust information technology solutions can take the guesswork out of scheduling and planning through the use of business intelligence, metrics and predictive analytics. Proper use of captured data can help providers determine when and where the most labor-intensive tasks are taking place, he says, and over time, can help operators better assess their future staffing needs based on census and trends with move-in and move-out dates. When more data are captured in labor management solutions and then proactively monitored and evaluated, organizations potentially can even foresee how many emergency department visits related to falls might be coming, for example, based on specific resident averages, metrics and characteristics. This information then can help operators make necessary care and scheduling changes to reduce those risks.

“Understanding the data is very important,” Sapiurka says. He pointed out that executive directors and regional managers are, perhaps, best suited for evaluating data and monitoring trends to better manage labor, occupancy changes and care needs. “You need to go through the data and normalize [them]. As you get more sophisticated in understanding, you can use [them] to project future needs.”

Predictive scheduling solutions also can lend themselves to greater visibility with staffing-related regulatory compliance. Staffing tools can help ensure that employees are receiving proper breaks and taking breaks in adherence to the organization’s policies and labor laws, Reese notes. And because labor levels at senior living communities fluctuate based on staff illness, vacation and other variables, “an advanced forecasting solution can help reallocate labor as needed to avoid open or unfilled shifts on the schedule,” she reasons.

Labor management technology’s artificial intelligence and machine learning capabilities offer increasingly advanced benefits to end users. According to The Workforce Institute, 82% of employees worldwide see an opportunity for AI to improve their jobs and would welcome AI in the workplace if it simplified or automated time-consuming internal processes, helped better balance their workload, increased fairness in subjective decisions or ensured that managers made better choices affecting individual employees.

“It’s worth exploring the intelligent capabilities now available to empower managers with real-time, strategic labor data and engage employees with AI-driven, self-service features to streamline scheduling and requests,” Reese says.


The shift toward computer-based labor management solutions is helping operators mitigate risk on numerous fronts. Not only are manual spreadsheet-based approaches inefficient, they are not secure because information easily can be manipulated or deleted and also can give inaccurate information through slight formula mistakes, Cole says.

“Computer-based solutions help eliminate risk because the system is backed up and numerous people are usually trained on usage, so the tasks can be fairly easily picked up by someone new,” she adds.

Interoperability and integration capabilities lie at the heart of effective, efficient labor management data capture and compliance, allowing operators to manage the entire employee lifecycle — from punch to payroll — with a single solution, as opposed to multiple stand-alone systems. A single solution that unifies labor management with human capital management capabilities, such as payroll, talent acquisition, on-boarding, core human resources and performance management, will offer operators the biggest return on investment, Reese says.

One Michigan-based nonprofit senior services provider with almost 700 clinical employees working across four locations experienced firsthand the challenges associated with a mix of disparate automated and manual scheduling, timekeeping, attendance and payroll systems. Not only were the systems used at Holland Home inefficient and costly to maintain, they made regulatory compliance a struggle, prevented managers from regularly accessing employee time data to avoid unnecessary overtime, and provided no real-time visibility into employees’ accrued time.

After adopting the Kronos for Healthcare automated workforce management suite, Holland Home was able to use a centralized scheduling model to build schedules behind the scenes based on budget. The centralized scheduling department creates schedules for clinical staff for assisted living, skilled nursing and hospice by using a staffing model that indicates the number of registered nurses, licensed practical nurses and nurse aides needed for each unit and shift; that information is built into the Workforce Scheduler. If an employee calls off, any central scheduler can send an open-shift request to a suitable replacement because the solution’s integrated human resources module tracks employees’ skills and certifications and indicates which employee has the right skills to fill an open shift.

Additionally, Holland Home was able to use automated tracking and reporting of regular and contract staff hours, which supported compliance with Affordable Care Act payroll-based journal reporting requirements and provided managers with real-time access to employee accrual balances, as well as daily overtime reports.

“Now we can see overtime by person and look at the schedule census to determine if overtime was needed,” says Doug Himmelein, vice president of human resources for Holland Home. Through efficiencies and a reduction of payroll and scheduling staff, Holland House saves $100,000 in wages annually.


Labor management tools don’t just streamline operational efficiencies for managers; they also give employees at-a-glance access to schedules, time cards, earnings, time-off accrual balances and even training and certification information and resources. Many of today’s solutions allow easy access to the information from a mobile device, which further boosts efficiencies and employee satisfaction.

Additionally, integrated labor management solutions can enhance employee engagement through strategic surveys and e-learning tools and tracking capabilities. “Every time a new employee is added to the HR system, they are entered into the learning system, as well,” Sapiurka says of RealPage’s senior living solution. Staff can be trained and kept up to date on company policies and processes and remain compliant with regulatory requirements such as the Health Insurance Portability and Accountability Act.