Weighing Your Options: Solutions to Combat the Staffing Crisis

Nurse staffing shortages have escalated nationwide to such an extreme level they are now labeled a staffing crisis. Skilled nursing facilities have implemented wait lists, declined new admissions, and even closed units as a result of the staffing crisis.

While the nation is currently gripped by the pandemic, long-term care providers will absorb the ripple effects of the staffing crisis for years to come. Industry experts anticipate providers will see declined reimbursement, as well as increased federal auditing due to use of PHE waivers. In addition, providers should expect to see Five Star rating reductions for survey non-compliance related to infection control surveys, with zero tolerance resulting in immediate jeopardy tags. Five Star ratings for staffing may see effects from burnout, vaccine mandates and other constraints placed on healthcare workers.

This leaves providers asking, what options are available now to lessen the likelihood of undesirable outcomes?

Reassign and Rotate Nurse Positions
Shifting nurses between patient care and reimbursement (MDS Coordinator) positions to support patient care activities.


  • Minimal added expense, if any


  • Potential for gaps in MDS assessment schedule, drops in quality of assessment
  • Offers little flexibility for coverage during unanticipated vacancies
  • MDS nurses may not have current clinical competencies to care for complex admissions, due to being off the floors and away from patient care, some for decades

Maintain a Roster of Per Diem Nurses
Hiring nurses on a part time or per diem basis affords providers some flexibility in the staffing crisis.


  • Provides a backup to full time nurses
  • Lessens chances of gaps in MDS assessment schedule, drops in quality of assessment


  • Assume expenses of the traditional hiring process
  • Limited to local candidates, potential knowledge deficit or limited reimbursement competencies
  • Responsible for onboarding, continued education, scheduling
  • Lack of recent clinical skills to manage residents

Strengthen Your Team with MDSRescue
Accessing external support for MDS assessment completion allows nursing staff employed at the facility to be assigned to patient care activities.

MDSRescue provides remote interim MDS completion services for facilities nationwide. Subject matter experts ensure assessment completion conforms to regulations, is accurate and timely, which improves 5-Star ratings.


  • Provides PRN service as a backup to full time nurses
  • Utilize PRN services throughout the year on a per diem basis to assist with intermittent rises in caseload, coverage during shortages or staff vacations
  • Avoid costs associated with traditional hiring process
  • Eliminate unnecessary expenses, provider is only charged for productive time
  • Assistance begins rapidly through electronic access
  • Access to high-level, qualified staff, including many Resident Assessment Coordinator-certified nurses, as well as Master Teachers
  • Offers confidence that your assessments are correct and timely, avoiding revenue losses for your facility

Rescue your revenue and improve accuracy with MDSRescue.

Maureen McCarthy is the founder, President, and CEO of Celtic Consulting; nationally recognized as a luminary amongst long-term care operators and clinicians for Reimbursement and Regulatory matters, Audits, Enhancing Operational Efficiency, Education and Litigation Support. Maureen combines clinical expertise with regulatory acuity, to assist clients with developing sustainable remediation plans. She is a registered nurse with over two decades of work experience, including direct patient care, MDS Coordinator, Director of Nursing, Rehab Director, and Medicare biller.

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