Using Transparency To Help Solve Short Staffing

Good morning.

This week’s newsletter brings focus to a simple—but powerful—metric every senior living and skilled nursing leader should be tracking and sharing with their teams.  Not just your leadership team, but the entire team: the Shift Fill Rate. It’s easy to calculate, easy to communicate, and it can change everything—from morale to retention to operational stability and ownership.

Elevate your Leadership

Why Shift Fill Rate Matters

• Staffing directly impacts retention and morale. Maintaining consistent staffing helps reduce burnout and turnover. When employees see shifts consistently filled, it builds trust in leadership and reinforces team stability. Research shows that high turnover has direct negative effects on morale, job satisfaction, and ultimately, quality of care.

• Operational clarity prevents burnout. Understaffed shifts lead to overtime, forced coverage, and fatigue—root causes of burnout and turnover.

• False rumors spread fast.  Working short sucks and it's much more memorable than when you work with a full team.  I can't tell you the number of times the perception of how often teams work short is much greater than reality.  Tracking and communicating the shift fill rate tells the true story, whether it's good or bad.

• Costs add up fast. Filling positions with agency staff or using overtime isn’t just stressful—it’s expensive. Shift fill rate gives you a lead indicator to course correct before costs spike.

What Is Shift Fill Rate—and How Do You Track It?

1. Calculate Your Denominator: Count total shifts in a 24-hour period. For example, if you schedule 12 hour shifts and have:

   • Four CNAs and two nurses on the day shift (4 CNAs + 2 nurses = 6 shifts)

   • Two CNAs and one nurse on the night shift (2 + 1 = 3 shifts)

   • Daily total = 9 shifts; monthly = 9 × 30 = 270 shifts.

2. Count Your Numerator: Count how many of those shifts are actually filled and worked. So, if today is 8/9, tomorrow is 9/9, a Saturday might be 7/9—document it.

3. Monitor Trends: Track day by day, week by week, and monthly. A 30-day run rate gives both the operational baseline and clues on morale.

4. Set an Aspirational—but Attainable—Goal: Maybe you're averaging 85%; target 90%. Make the stretch meaningful, not punitive.

What Happens When You Share It

• Create shared ownership. Post the numbers visibly. Talk about what went right—and what opportunities exist to push closer to the goal.

• Let teams drive solutions. Ask, “How can we move from 8/9 to 9/9 tomorrow?” Let them suggest tactics: swap systems, flexible scheduling, shift trading, cross-training—whatever gives control back to the team.

• Turn it into a friendly competition: units, shifts, or teams can track daily performance. Everyone knows the goal. Everyone knows how they contribute.

• You don’t need to explain the why. When fill rate is front and center—shared and celebrated—teams instinctively understand: "this matters to our quality of care, our workload, our patients, and each other.”

Track and Talk

• Post daily/weekly/monthly fill rate in the breakroom, in huddles, in newsletters—everywhere.

• Celebrate fills. Highlight near-misses. Raise flags early when the trend dips.

• Start projecting your fill rate into the future using call out rates and vacancy rates.  Use trends to predict and allow team members to help solve shortages proactively.

This is leadership in action. One simple metric, tracked and shared openly, becomes a rallying point. It drives clarity, respect, ownership, and operational excellence. Best of all, it aligns with what your staff—and your residents—deserve.

You can implement this today. And feel damn good doing it.

A word from our community:

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👉Take the quick survey here.

The NHA Stand-Up Playlist

🎧 Two Tracks for the Week Submitted by You

This job doesn’t come with a soundtrack… so we made one.
Every week, I’ll drop in two more songs for the playlist — for the moments when you’re holding the line, resetting your mindset, or just need a reminder:
you’re not alone in this.

This week’s additions:

🎵 Good Feeling – Flo Rida
Why it belongs: Because even on days when you're running on fumes, solving chaos with one hand and emailing families with the other — you still find the spark. This one’s for that deep breath before walking into the lobby like a boss.

🎵 Can't Hold Us – Macklemore
Why it belongs: Because you’ve been counted out, second-guessed, and still delivered. This track’s for that moment when you’ve got momentum — and nothing’s stopping you now.

🧠 Whether you’re walking into a staffing meeting or out of a state survey, let this play in the background. It’s fuel made for us.

Got a song you think belongs on here?
Reply to this email and send it in — I’ll add your name next to it when it goes live on the playlist.

🎧 Listen to the full NHA Stand-Up Playlist here

Whenever you're ready, I can help you in a few ways.

1. Leverage our partnership with CEUSrEZ and purchase NAB-approved, online, self-paced, continuing education courses at a 20% discount here.
2. Use our free AI-powered Chatbot trained on all 900 pages of CMS Nursing Home Regulations, proprietary processes, and information from decades of skilled nursing leadership experience.  Click here.
3. Sign up for Assisto and keep track of the regulatory environment in your state.  Know what deficiencies surveyors cite in real-time and ensure you're not at risk for the same tag.  Sign up here.
4. Take our Salary Lens survey and gain access to the largest database of senior living and SNF leadership salaries in the industry.  Check it out here.

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Thanks for reading.  Have a wonderful day.

Kevin Goedeke, Publisher and Founder