Business Staffing Plan for a Long-Term Healthcare Facility

Introduction: The Importance of Strategic Healthcare Staffing

The importance of effectively and intuitively staffing a healthcare facility such as a hospital or nursing home cannot be overstated. The correlation between nurse-patient ratios and healthcare outcomes is well established. This is why a staffing plan must be comprehensive and detailed. The outline for staffing solutions for the healthcare institution discussed in prior documentation includes an explanation of the positions required and the structure of their respective roles.

Patient Classification and Staffing Requirements

As we outline the various positions called for, we recognize that evolving legislation, patient needs, and technological capabilities have altered the healthcare staffing landscape. Patient classification systems, such as the one in place at our facility, can help identify staffing requirements. The Expert Nurse Estimation Patient Classification System (ENEPCS) "identifies the uniqueness of each patient using eight categories of care: 1. Cognitive Status, 2. Self-care Status, 3. Emotional Psycho-Social Support needs, 4. Comfort/Pain Management needs, 5. Family information and support needs, 6. Treatment needs, 7. Interdisciplinary coordination, patient teaching, and documentation needs, 8. Transition planning needs." (Malloch, 1)

These classification traits reflect the increased attention given to the relationship between patient classification and staffing needs. The range of caregivers and administrative personnel required to carry out the functions associated with these classifications demands a delegation of tasks and responsibilities that is more nuanced than the simple distribution of numbers. Under these classification terms, availability and workload distribution are only the surface features of a staffing scenario that must also factor in education and credentials relative to patient needs. This means that recruitment, hiring, ongoing career training, and workplace delegation must be guided by the needs produced in classification schemes such as the one described above.

Management Structure and Roles

With that stated, the following outlines the facility's current staffing needs, including desired numbers and justifications. First and foremost, the 65-bed nursing home requires management with designated time slots and departmental assignments. The accounting, administrative, and technology departments would each require two managers to cover peak and off-peak hours of service. The nursing department would employ four nurse managers, with two on coordinated duty at all times in a defined hierarchy based on seniority of tenure. All managers would be full-time employees with salaries ranging from $60,000 to $75,000, along with a full benefits package — bringing the total number of managers to ten.

In total, the facility would employ 55 nurses. The distribution of schedules and shifts among nurses would be shaped by what Ozcan & Hornby (2011) call activity measurement. According to Ozcan & Hornby, "as health service organizations began to emerge from the traditional approaches to determining staffing requirements, they increasingly adopted methods for determining staffing needs, which were based on some form of activity measurement. The staffing norms that emerged are all intended to be specific for the type and location of staff being considered." (Ozcan & Hornby, p. 212)

Nursing Staff: Roles, Shifts, and Compensation

These factors contribute to the breakdown of roles and responsibilities among the 55 nursing professionals. Of these, 20 would be senior Registered Nurses earning roughly $42,000 per annum with benefits. These full-time employees would be distributed across three shifts — day, night, and swing — providing senior staff oversight and ensuring that at least eight RNs are present in the facility at all times.

Twenty practical nurses would serve in support roles but retain many of the same scheduling and shift distribution features. The pay range for practical nurses would be roughly $32,000–$40,000 depending on overtime labor. Fifteen nursing assistants would be employed on a part-time basis, frequently working swing shifts or serving on an on-call basis at a rate of $22 per hour. Additionally, all nurses must dedicate some number of non-productive hours to on-call availability.

With research generally identifying an optimal staffing rate of one nurse per four patient beds, the staffing scenario for this 65-bed long-term care facility means that one nurse will be available for roughly 3.5 beds. The expectation is that this higher investment in comprehensive nurse staffing will result in better health outcomes.