Operational Controls for Contract Staff in Skilled Nursing Facilities | Accounting Services for SNFs | Richter

As the current crisis drags on, and with other potential pandemics/ disasters on the horizon, SNFs of all sizes in all corners of the country will find it harder and harder to attract qualified full-time employees, and retain them over time. Not surprisingly, clinical, accounting and financial implications of this are profound. So, how do you endeavor to maintain a full-time employee base, solidify your facility’s finances and provide optimal resident care in the process?

As the current crisis drags on, and with other potential pandemics/ disasters on the horizon, SNFs of all sizes in all corners of the country will find it harder and harder to attract qualified full-time employees, and retain them over time. Not surprisingly, clinical, accounting and financial implications of this are profound. So, how do you endeavor to maintain a full-time employee base, solidify your facility’s finances and provide optimal resident care in the process?

In this blog, we highlight several internal and financial/accounting controls that can help protect your facility and its residents, and maintain a healthy financial outlook.

As we said in a previous blog, in a perfect world, your SNF would be 100 percent staffed, 100 percent of the time by full-time employees. Yet, ours is not a perfect world, so if using contract employees to some extent is a reality for your SNF, make sure you have the proper structures, processes and controls in place to guide and protect your facility, residents, staff—and even the contract employees. In this regard, we recommend establishing the following:

Internal controls

• Implement clear processes and procedures, and ensure that IT support is available to provide access to systems and software when contract staff require access. It’s also important to spend the necessary time up front training them to maximize their efficiency and minimize opportunities for error.
• Maintain vigilant oversight. When you must use contract labor, make sure someone in your SNF is overseeing their work, evaluating the quality of their service and carefully monitoring their time.

Financial/accounting controls

• Contract staffing represents a potentially sizable cash disbursement, so if contract employees are needed, be prepared to manage cash flow very carefully.
• Make sure your accounting staff thoroughly reviews contract employee invoices for accuracy and ensures the invoices are received timely so they are recorded in the proper fiscal period. Inaccurate invoices could lead to incorrect expenses being reporting on your facility’s financials and in the cost report. These direct care contract staff hours and wages are also reported in the payroll-based journal that is reported to CMS. Tasking your accounting staff with verifying those invoice amounts, as well as ensuring that your facility invoices contract labor companies correctly, is vitally important.