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1. Facility

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2. Number of Beds:

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3. Location (County):

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4. Respondent Name and Email:

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5. Number of Employees Prior to Pandemic:

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6. Number of Employees Today:

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7. Number of Unfilled Positions:

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8. Number of New Hires, Lost Employees in December 2021:

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9. Please check the actions you are taking to address workforce challenges (check all the apply):

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10. What are the reasons that you have vacant (or open) positions (check all that apply)?

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11. What open positions do you currently have (check all that apply)?

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12. Is your facility currently limiting your census to an amount below your capacity because you are unable to staff to full capacity?

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13. Does your facility currently have a hold on all new admissions?

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14. Is your facility currently admitting residents from hospitals?

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15. If yes, has your admissions criteria led your facility to turn away more hospital admissions when compared to pre-COVID-19 pandemic:

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16. Do you currently maintain a waiting list for new admissions?

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17. Which of the following issues presently inform your decision to accept or not accept an admission from a hospital (check all that apply):

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18. What are you biggest staffing challenges currently by position?

(chose three by rank order with one as the highest)

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19. Is your facility currently using pool staff to cover some shifts?

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20. If no, is that because

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21. If “Can’t access pool staff”, will you please provide further detail — is that because…

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22. If yes, how much pool did you use in December 2021

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23. Is your facility currently using overtime/double shifts to cover some shifts?

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24. If yes, how much overtime did you use in December 2021

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25. In the past 60 days, has your facility

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26. In 2021, what do you feel was the direct or indirect reason most related to staff losses?

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27. In 2021, based on your experience, what do you feel was the primary reason staff members left their job?

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28. Please rank the steps that you believe would help improve your ability to recruit and retain staff

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29. Please select from among the following based on your experience since we last conducted this survey in August 2021:

0 of 29 answered
 

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