Healthcare providers are continually looking for new ways to attract and retain talent, with greater flexibility increasingly becoming part of the workforce conversation. Persistent workforce shortages and changing employee expectations are challenging organizations to reconsider how they compete for a limited pool of qualified employees.

Across healthcare, employers are responding with a range of strategies, from compressed schedules and alternative shift structures to changes in compensation, workplace culture, recognition and employee engagement. Hospitals and health systems have been among the earliest adopters, creating additional competitive pressure for senior living providers drawing from many of the same clinical and operational talent pools.

Mark Mitchener, Corporate Vice President of Clinical Operations at Greystone, explains:

“There isn't one workforce strategy that will work for every organization. What we're seeing is a broader shift in what employees expect from their employers. The opportunity for senior living leaders is to understand what their workforce needs and make sure their strategies are evolving with the labor market.”

Workforce Strategy Is a Competitive Advantage

Labor remains one of the largest and least predictable expenses in the healthcare levels of living at senior living providers. Evaluating workforce initiatives solely through hourly wages or staffing ratios, however, provides an incomplete picture. The cost of workforce instability also includes:

• Turnover and vacancy duration

• Agency utilization and overtime

• Recruitment and onboarding costs

• Leadership time devoted to filling vacancies, managing coverage, and rebuilding teams

Understanding the full cost of instability allows leaders to evaluate workforce investments against their broader operational and financial impact. Strategies that improve retention, reduce temporary labor, or strengthen staffing consistency can increase operating predictability while strengthening an organization’s position in the labor market. The competitive advantage is the ability to build a more stable workforce while managing the full cost of labor more effectively.

Experience across Greystone-managed communities points to a practical framework for doing so: diagnose the workforce challenge, define the desired outcome and build the strategy around the need.

Diagnose the Workforce Challenge

High agency utilization, persistent vacancies, turnover, and employee disengagement may all signal workforce instability, but identifying the underlying cause is critical to determining the appropriate response. Scheduling flexibility may address a recruitment challenge, while investments in culture, communication, or recognition may be more effective when retention and engagement are the concern.

Define the Desired Outcome

Leadership should then establish what success will look like and how it will be measured. Depending on the challenge, meaningful measures may include:

• Turnover and retention

• Vacancy duration

• Agency utilization and overtime

• Recruitment and onboarding costs

• Employee engagement

• Staffing consistency

• Total labor cost

Establishing these measures before implementation creates a basis for determining whether an initiative is improving workforce performance.

Build the Strategy Around the Need

The appropriate response will vary by community, department, and role. Greater scheduling flexibility may be effective in one environment, while stronger communication, recognition, or leadership practices may have greater impact on another.

Two Greystone-managed communities demonstrate how this framework can lead to distinctly different approaches.

Legacy Pointe at UCF: Reducing Agency Reliance Through Workforce Innovation

Faced with persistent staffing challenges and high reliance on agency personnel, leadership at Legacy Pointe at UCF identified agency utilization as a significant workforce and operating-cost challenge.

Leadership evaluated several potential responses, including compensation, scheduling, and workplace culture, while also considering how the community could differentiate itself in the local labor market.  After evaluating alternative scheduling approaches, Legacy Pointe transitioned its nurses to 12-hour shifts as a strategy to strengthen recruitment and reduce agency reliance.

Implementation required more than changing the schedule. Leadership developed new staffing templates, assessed the impact on clinical workflows and resident care, updated technology and policies, and established a structured transition plan. The team also addressed potential risks, including employee fatigue and the greater operational impact of call-offs, while communicating directly with nurses about the rationale for the change and available schedule options.

In January 2025, agency staffing costs totaled $51,564, reflecting a trend that was expected to continue. Planning for the new model began in October 2025, and the 12-hour schedule launched in January 2026. By February, agency staffing costs had declined to $3,051, a 94% reduction.

For Legacy Pointe, the strategy addressed a defined workforce challenge with a measurable result: significantly reduced reliance on agency staffing.

The Trillium Tysons: Building Workforce Stability Through Culture

The Trillium Tysons took a different approach, focusing on employee engagement and retention through workplace culture. The community developed a coordinated strategy designed to strengthen recognition, communication, and connection.

Key initiatives include:

• Resident-driven recognition: Team Member Shout-Out Cards give residents a direct way to recognize employees who make a meaningful difference in their daily lives

• Team member appreciation: Monthly events recognize employees while creating opportunities for team building and connection

• Consistent communication: Monthly town halls across all shifts provide a regular forum for leadership communication, employee feedback, and dialogue

• Formal recognition: Structured recognition programs provide additional opportunities to acknowledge individual and team contributions

The community has maintained a fully staffed team with minimal turnover, demonstrating how intentional investment in workplace culture can support retention and staffing consistency.

Together, Legacy Pointe and The Trillium Tysons demonstrate the value of beginning with the workforce challenge rather than a predetermined solution. One used scheduling innovation to address agency reliance. The other invested in culture to support engagement and retention. Both aligned the strategy with a defined organizational need.

Evolving With the Labor Market  

As the healthcare labor market and employee expectations evolve, senior living leaders must continually assess whether existing workforce practices remain effective. Keeping pace does not mean adopting every new trend. It means understanding the organization’s workforce challenges and applying a consistent discipline: diagnose the challenge, define the desired outcome, and build the strategy around the need.

That discipline can help providers compete for talent, manage the full cost of labor, and strengthen organizational stability while maintaining the operational and financial performance required to serve residents well.

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