Meera Riner

Meera Riner, COO of Nexion Health, is blunt when assessing the long-term care sector’s staffing crisis. 

“Staffing is the new pandemic,” Riner said Thursday, when she spoke at the McKnight’s Long-Term Care News Online Expo ‘22. “When you think about the challenges, while we dealt beautifully in our industry with COVID, the long COVID for nursing homes is the staffing impact and the decimation of the few staff we had to begin with.”

Riner is among the many skilled nursing leaders working to move away from using agency workers to help with staffing shortages, in her case, through the development of an in-house staffing pool, or float pool.

Nexion, with facilities in Texas, Louisiana, Mississippi, and Colorado, used agency help for direct care needs. While Nexion had spent $1 million on agency help annually before the pandemic, it spent $15 million in 2021.

“None of the provider relief funds came close to making us whole,” she said. So Nexion turned to the workers it did have – and some who’d recently left – to solve the problem.

The company’s lone Colorado facility provided the impetus, when a massive COVID outbreak created a staffing gap that even local agency couldn’t or wouldn’t fill. Brainstorming led to the creation of a travel pool consisting of as-needed and former employees to help in Colorado. 

Thirteen frontline caregivers flew to Colorado and stayed for 28 days, some of them having never before been on a plane.

After that crisis, the pool has fluctuated in size, as have payment methods. Nexion has used a mix of bonuses, higher wages and flexibility to attract workers.

Today, the company’s Texas facilities rely most on the float pool. The 15-person pool is based there, though members can still travel to other states. Full-time staff hiring has improved, said Riner, attracted by flexible scheduling and competitive wages. Float pool workers can access all the benefits Nexion offers, including tuition assistance, scholarships and wage incentives for continuing education. 

Riner said float pool use has saved money from less agency use but also smaller bonus and overtime expenses for full time staff. The well-being of the staff and safety both increased, she said, because of less staff burnout, resulting in better care of residents.

“We’re in a better place overall,” she said during the webinar, which was sponsored by IntelyCare. “To give a  perspective, when we started this year we had 700 openings and now have slightly shy of 450 so we’ve had a huge impact in filling our positions. We’re trying to use the pool for the facilities that really have that need.”