Integrating agency staff into senior living: Best practices for success

Agency staff play a vital role in maintaining resident safety and care continuity in senior living communities. However, research shows that facilities heavily reliant on agency staff often experience lower CMS star ratings.1 To mitigate this risk and uphold high standards of care, it is essential to implement structured onboarding, training, and integration practices for all agency personnel.

Regulatory compliance and onboarding

All contracted staff must adhere to your facility’s established onboarding policies, in alignment with the Centers for Medicare and Medicaid Services (CMS), the Americans with Disabilities Act (ADA), the Equal Employment Opportunity Commission (EEOC), and applicable state-specific health and labor regulations.

Onboarding considerations:

• Profile review: Conduct comprehensive reviews of all agency staff profiles, including interviews (phone or in-person) prior to orientation.
• Background checks: While many companies handle background paperwork via your contract, consider keeping the employees' background checks and references on file at the facility. This ensures that the background check is completed according to your facility's protocol and provides easy access for surveys.
• Length of contract: Instead of utilizing agency staff on an as-needed basis, consider engaging them for a minimum of three months. This approach allows for the establishment of a set rotational schedule with consistent staffing assignments.
• Educational verification: Verify the educational qualifications of clinical staff, including active licensure.
• Orientation: Require agency staff to complete your facility’s full orientation and training program. 

Fostering a supportive and inclusive environment:

Creating a welcoming culture helps agency staff feel valued and perform at their best. Consider the following strategies:

• Mentorship programs: Pair new staff with experienced team members who can provide guidance and support.
• Regular check-ins: Schedule regular meetings to discuss any challenges and provide feedback. 
• Team-building activities: Organize activities that foster team spirit and help agency staff feel more integrated.
• Clear communication: Ensure that all staff, including agency staff, are kept informed about any changes or updates within the facility.

Training, competency, and performance evaluation

Contract staff should receive the same training as permanent employees, guided by your facility assessment and the scope of services provided. Include them in ongoing education, competency evaluations, and in-service training.

Consider the following areas for training for contract staff:²

• Abuse, neglect, and misappropriation policy and reporting protocol
• Assistive devices policy and training
• Behavioral health
• Communication (resident, family members, coworkers)
• Compliance and ethics program
• Dementia care
• Emergency preparedness and response protocol
• Fall prevention
• Facility policies and procedures
• Grievance and complaint reporting
• Infection control preparedness including personal protective equipment (PPE)
• Quality assurance and performance improvement (QAPI)
• Resident rights and confidentiality
• Response to call lights, door alarms, and other response systems
• Technology and documentation

Additionally, ensure completion of job-specific training checklists. For example, dietary aides should be trained and tested on hand hygiene, food service protocols, and specialized diets.

Integrating agency staff into senior living communities is more than a logistical task; it’s a strategic opportunity to enhance care, strengthen teams, and improve resident satisfaction. With structured onboarding, clear training, and a supportive culture, agency staff can contribute meaningfully and consistently to overall facility success.