How to Build a Team at a Skilled Nursing Facility: 5 Best Practices

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Written by Katherine Zheng, PhD, BSN Content Writer, IntelyCare
The leader of a team at a skilled nursing facility sits down with a patient.

Skilled nursing facilities (SNFs) offer transitional care to patients who are rehabilitating from a serious medical illness or injury. The team at a skilled nursing facility is quite diverse, consisting of interdisciplinary professionals who help patients regain their functioning before they go home.

If you’re a leader of a SNF, you may be wondering how to shape your staffing structure to best serve your patients. In this article, we’ll outline five best practices that will help you build a successful SNF team.

What Roles Make Up a Team at a Skilled Nursing Facility?

Before we dive into best practices, it’s helpful to get a sense of what a standard SNF team consists of. Exact roles will vary by facility, but you can generally expect SNFs to have a heavily multidisciplinary team. Skilled nursing facility staff typically include the following.

Types of SNF Staff
Administrators The executive leaders are responsible for the overall operational leadership and management of a facility.
Medical directors The physicians or nurse practitioners direct all care decisions.
Nursing staff Registered nurses, licensed practical nurses, nursing assistants, and aides deliver hands-on patient care. There’s also typically a director of nursing (DON) that oversees the flow of nursing care.
Therapists Physical, occupational, and speech-language therapists work one-on-one with patients to help them regain their functioning.
Nutritionists and dietitians These professionals ensure patients are eating and receiving balanced, nutritious meals that help with their recovery.
Counselors and social workers Mental health and social service professionals provide emotional support and assistance with community resources.
Service staff Service staff facilitate the non-clinical aspects of SNF services, such as cooking, billing, housekeeping, and recreational activities.

Building a Team at a Skilled Nursing Facility: 5 Best Practices

While we’ve gone over some of the essential roles at a SNF, you may be wondering how to tailor your team to the unique needs of your facility. Here are five best practices to follow as you develop your ideal team structure.

1. Ensure Your Team Is Compliant

Fundamentally, you’ll need to ensure that the team you’re building complies with all federal and state regulations. At the federal level, SNFs are required to have a medical director and dietitian on their staff. CMS also enforces staffing minimums requiring at least 3.48 hours of nursing care per patient each day. There may also be more specific policies dictating nurse staffing ratios at the state level.

Here are helpful resources that you can use to learn more about local and federal laws impacting your team’s structure:

2. Understand Your Facility’s Goals

You’ll also want to build a team that reflects your facility’s unique mission and goals. For example, do you want to specialize in certain types of rehabilitative care, or are you looking to offer a comprehensive range of services? Focusing your goals will help you determine what type of staff you’ll need to hire. Here are some other questions to consider:

  • How big is my facility and how many staff members do I need to safely deliver care?
  • What type of patient care assistants and aides do I need to support my nursing staff?
  • What type of recreational/social activities do I want to offer, and what type of staff do I need to facilitate them?

3. Establish Clearly Defined Roles and Responsibilities

As a transitional care facility, a SNF may require nursing staff to take on a mix of clinical and non-clinical responsibilities. Some nursing assistants may serve as more of a companion, accompanying patients to recreational activities like yoga. RNs may also take on administrative roles, like quality assurance, to help a SNF comply with state and federal regulations.

When hiring nursing staff, clearly define each role and its responsibilities so that you fill openings with the right candidates. If you’re hiring an RN to take on quality assurance, label the role accordingly (e.g., “quality assurance RN”) and be upfront about the expected duties.

4. Organize Your Team by Program of Care

If your SNF offers a range of rehabilitative care services, it may be helpful to establish different programs of care. For example, you could create separate departments in charge of overseeing neuro rehab, cardiopulmonary rehab, and wound management, respectively. This allows you to hire staff with specialized skills (e.g., wound care nurses) for each program, also ensuring that patients receive care that’s more closely tailored to their needs.

Also, don’t be afraid to think outside the box. For instance, having a rapid response team in skilled nursing facilities is quite uncommon, but it’s becoming an increasing topic of interest in the healthcare community. While you may not need a traditional rapid response team, having a well-defined program for emergency management could help set your SNF apart from others.

5. Don’t Forget About Marketing and Recruitment

In order to hire a strong clinical and service team, it’s also important to build a skilled marketing team. Consider creating a marketing department that can help you attract and recruit top talent in addition to prospective patients. Remember to utilize diverse advertising/recruitment channels that can enable you to reach a wider audience.

Lead Your Skilled Nursing Team to Success

The team at a skilled nursing facility requires a strong leader who not only prioritizes their patients, but also supports the needs of their staff. Striving to become that leader? Get timely, expert-written healthcare management tips and insights delivered straight to your inbox.


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