Excessive overtime and agency staffing spend from reactive, non‑optimized scheduling

For a mid-size facility, reactive scheduling to protect Medicare Part A compliance drives roughly $200,000–$400,000 per year in avoidable overtime and agency premiums attributed to skilled nursing coverage alone. • For a mid‑size facility, reactive scheduling and lack of census/acuity‑driven staffing alignment drive approximately $200,000–$1,000,000+ per year in avoidable overtime, shift differentials, and agency premiums across all resident populations. • For facilities with a sizable veteran population, this pattern can contribute $50,000–$200,000 per year in additional overtime and agency expense.

HR and unit managers create a base schedule in the HRIS or on paper, then maintain separate Excel trackers for open shifts, sending group texts, emails, and calls to staff and agencies, manually tracking who picked up where. • HR maintains separate or annotated schedules for private-pay heavy units, tracks known high-expectation residents in spreadsheets or notes, and responds to issues by calling in preferred staff for overtime or requesting agency coverage for perceived VIP shifts. • HR manually links payer reports to staff rosters in Excel, highlights underperforming units, and immediately begins calling regular staff for overtime and placing agency orders to increase coverage for those residents, without coordinated rebalancing across the building.