Chapter Contents

Planning Ahead
Equity and Inclusion
Focused Training
Background Checks
Recruitment and Retention
Fear of Pandemic Spread and Refusal to Come to Work
Staff Resignations/Call-Offs
Resources to Support Discussions about Vaccine Hesitancy in Nursing Homes
Providing Personal Assistance to Staff
Potential New Staff Policies


Your employees are the foundation of your success as a community during an ongoing crisis.  All on-site staff are at risk for contracting an infectious disease, not only in their care and service settings, but also in their own homes and communities. As a result, attention to your staff is critical on a number of fronts. 

Planning Ahead 

While a pandemic is an unprecedented crisis, developing thoughtful plans for before, during, and after a crisis can help communities be as well-prepared as possible. With clear policies and staff supports in place, your community will be prepared to address issues in a calm and organized fashion. Below are some of the essential issues to anticipate and address, many of which are referred to in more detail below:

  • Training on enhanced infection control in your care setting for all staff members.
  • Securing sufficient PPE to protect staff.
  • Ensuring frequent communication with staff using a variety of platforms, e.g., a printed newsletter, an app, automatic phone messages, postings in break rooms, posts on social media platforms, and in-person meetings.
  • Considering redesigning jobs, and a physical redesign of your community to ensure success in a crisis.
  • Conducting an assessment of policies regarding staff vacation, sick leave, and other benefits that may need to be modified. See CDC guidelines and examples under Vacation and Leave Requests below.
  • Assessing the use of staffing agencies and private-duty caregivers.
  • Giving special attention to frontline staff who are the most vulnerable, e.g., by offering wraparound services that include childcare, financial assistance, food and transportation assistance, and temporary accommodations if social isolation is necessary.
  • Identifying staff who need close monitoring, e.g., those who have second jobs, especially in other facilities, and those who may live in underserved areas, thus having limited access to health care or testing.
  • Developing strategies to stretch current staff in the event of a shortage, e.g., 12-hour vs. 8-hour shifts.
  • Reallocating staff to where they are most needed, e.g., housekeepers also serving as hospitality aides in the SNF, or maintenance and landscaping staff assisting in meal delivery.
  • Ensuring management coverage 7 days a week.
  • Developing incentive and recognition programs to address staff morale, e.g., hero/hazard pay, special meals, raffles.
  • Developing tools to address psychological health issues for short-and long-term stress, trauma, bereavement, etc. Evaluate programs you have currently, and what can be enhanced. (Note: This issue is addressed in greater detail in the Wellness Section of this Playbook.)
  • Handling staff turnover and backup strategies.
  • Considering partnerships with local organizations to supplement your organization’s needs.

LeadingAge LTSS Center @UMass Boston research reports:

Equity and Inclusion 


Focused Training 

General Training (including Infection Control)

Cross Training/Maximizing Your Team

Creative Team Setups

Background checks

Recruitment and Retention

Hiring Displaced Workers

Use the Recruitment Center at the Center for Workforce Solutions

Promising Practices Shared by Member Communities

LeadingAge also has a number of trusted business partners who can help with recruitment

Other Recruitment and Retention Resources

Ideas and Trends

Fear of Pandemic Spread and Refusal to Come to Work

Staff Resignations/Call-Offs

Prevention: Support Your Current Staff

Audio interviews on staff support practices:

Resources to Support Discussions about Vaccine Hesitancy in Nursing Homes:

If You Lose Staff

  • Have a ready pool of staff (e.g., those you have cross-trained).
  • Never stop your recruitment efforts (see above).

Audio interviews on emergency staffing and recruitment:

Providing Personal Assistance to Staff


Check first to see if your local community has organized childcare centers for essential workers. LeadingAge member communities have developed creative ways to help staff with childcare:

LeadingAge Member Ideas and Inspiration articles:

Medical Services On-Site/Telehealth 

Start thinking now about providing medical services at your community, or facilitate telehealth appointments.

Can you partner with a local hospital, urgent care, or other health care facility?

Staff Housing

Can you repurpose vacant areas for staff to live at the community for a period of time?

Can you use nearby hotels that may not be filled to capacity?

Some communities have provided tents (set up indoors), used air mattresses, or housed staff in model homes or guest suites.

Potential New Staff Policies

Limiting Staff to One Place of Employment

You may wish to consider limiting staff to work in one community to lessen the spread of the virus (Note: Check your state labor laws). How can you compensate them for making this change? A few considerations:

  • Develop your own pool of these workers to allow them to the first to be called for an open slot.
  • Use the cross-training ideas listed above.
  • Schedule them for 12-hour shifts.

Vacation and Leave Requests

In addition, some of our member communities have implemented the following during a crisis or pandemic:

  • Requiring staff to inform supervisors of the vacation destination.
  • Allowing 2 weeks off, but not consecutively.
  • Requiring quarantine after return from specific destinations.
  • Allowing only one team member to be on vacation at a time.

Other links:


Lessons Learned: Workforce

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