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Addressing the Healthcare Staffing Crisis: Tips from a Senior Living Executive

Addressing the Healthcare Staffing Crisis: Tips from a Senior Living Executive

Financial Wellness
Business
Human Resources
Healthcare

September 1, 2024

September 17, 2026

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The average age of the everyday American is getting older. Job growth in sectors like healthcare has been robust, but with that growth in opportunities also comes a challenge -- how can healthcare companies retain their employees and avoid a constant revolving door of turnover?

We had the opportunity to chat with Tommy Comer, a human resources executive in the senior living space that saw these problems on a daily basis. While Tommy is now leading HR with a new company, his experiences while at Commonwealth Senior Living remain broadly applicable to the industry. The challenge that healthcare companies face when it comes to staffing have not changed, and if anything, are getting more acute.

Let's review the anecdotes about where this industry is heading.

The number one topic in healthcare HR

His first point: he was shocked by the ubiquity of hiring and retention struggles amongst healthcare providers around the country. The old problem, particularly in senior care, was ensuring you had enough residents to keep facilities open. But as the population ages, that's easing slightly.

Now, it's all about caregivers.

"Any conference I go to now, the number one topic is how do you find and keep employees. And senior living, it's literally the biggest problem, even more so than finding and keeping residents."

Tommy's insight here gets at a fundamental issue now in healthcare staffing. The first priority for healthcare companies is to provide the best patient care possible, to as many people as possible. But to serve this mission, companies like Commonwealth Senior Living and others need people: nurses, CNAs, practitioners, back-office clerks. A small army is necessary to keep healthcare companies running.

A stable, qualified workforce is the linchpin for success in the industry. Without it, quality care wouldn’t have the chance to occur.

Searching for the next bright idea in healthcare

 The staffing crisis isn't isolated to a few organizations or regions. As our CHRO noted:

"I think everyone in the HR space in health care is bouncing ideas off each other [to try to solve this problem]. Everyone is asking each other for the next bright idea, because we're all facing this." 

The industry’s collective brainstorm will certainly solve the issue over time, as the constant volley of ideas is pinging around conference halls and email chains. Healthcare HR professionals are actively seeking innovative approaches to attract and retain talent. Big impacts will likely come from expensive programs like subsidized education pathways or pay package increases.

But they're also hunting for easy wins they can test in a few months -- things like employee engagement strategies or financial wellness benefits such as earned wage access.

‍

Impactful solutions likely come in combos

 There's no silver bullet for solving the staffing crisis. As we noted in the beginning, this industry is growing to match the aging population, a trend that might not be reversing any time soon. The strategies that healthcare leaders employ will need to cover several bases, addressing pay packages, benefits, engagement, and support.

The key is to pair the big initiatives with the small, the expensive with the free, to find the right mix.

"I don't want to sugarcoat it. Nothing that we've talked about today is going to cut your turnover in half. But it might be a lever that helps a percentage. And that's important."

Employee retention is impacted by myriad factors. Different demographics require different support, and retention relative to locations can vary widely simply because the labor supply is different. But when healthcare leaders are looking ahead to next year and trying to figure out where they're going to boost retention by ten percentage points, they shouldn't overlook the easy wins.

Supplemental benefits like earned wage access can have a big impact. They don't cost the business anything to set up, work with existing systems, and can give caregivers a chance to control their own cash flow. That can mean the difference between them signing on with you or going down the road. ‍

Here's where the small benefits become big wins

Healthcare leaders that are bargaining with finance on where to expand their benefits packages are looking for the best bang-for-buck. Earned wage access can provide improvements in retention, even incremental, that have significant impacts:

  1. Cost Savings: Reducing turnover, even by a small percentage, leads to substantial savings in recruitment and training costs.
  2. Improved Care Quality: A more stable workforce often translates to better continuity of care for residents and patients.
  3. Enhanced Team Dynamics: Lower turnover rates can lead to stronger team cohesion and improved workplace culture, furthering your retention and engagement goals
  4. Increased Productivity: Experienced employees are typically more efficient and help get newer employees up to speed. The team cohesion flywheel really starts to spin.

Where we go from here

The healthcare staffing crisis, particularly in senior living and home health care, presents a complex challenge with no single solution. However, as our executive revealed, the industry is turning over every rock to find innovative ways to attract and retain talent. This crisis won't stay unsolved for long.

By trying a mix of strategies – from financial wellness programs like earned wage access to training, development, and even pay package increases – healthcare organizations can confront the staffing crisis with a full quiver of arrows. Nothing on its own will solve the problem overnight, but each idea taken together will help build a more stable, satisfied, and effective healthcare workforce.

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tapcheckTapcheck is payroll native. Advances settle as a line-item payroll deduction with automatic reconciliation built into the payroll run. It's visible on the pay stub and in the employer's payroll register. The paycheck is never intercepted or routed through a third party.
DailyPay DailyPay operates a payroll intercept model: before any paycheck reaches an employee, DailyPay takes control of the full payroll disbursement. They hold the employee's earned wages, distribute the advance amount they've already issued, and release the remainder to the employee.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck's real-time payroll integration allows us to calculate earned wages with precision, including tax withholdings and deductions, which is why we can confidently offer employees up to 70% of net pay.
DailyPay DailyPay can offer up to 70%, but because their system doesn't calculate withholdings with the same precision, they often configure employers at 50% to hedge against overpayment risk.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck has no limit on transfers per day or per pay period, so employees access their earned wages as many times as needed.
DailyPay DailyPay limits employees to 5 transfers per day. For employees with multiple smaller financial needs across a week, this daily cap can limit how they use the benefit.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck works with any bank account, debit card, or the Tapcheck Mastercard. No direct deposit requirement and no new account needed, including for unbanked workers.
DailyPay DailyPay requires employees to have direct deposit set up to enroll, per DailyPay's own FAQ. In hospitality and QSR, 15-25% of the workforce may not have direct deposit configured, creating a meaningful enrollment barrier for the employees EWA is designed to serve.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is an ADP Marketplace Platinum Partner with 300+ payroll and timekeeping integrations, including particular depth in mid-market and healthcare systems (Viventium, Infor, Dayforce (Ceridian), iSolved, and Paycor) where DailyPay's coverage is thin or unconfirmed.
DailyPay DailyPay claims 180+ HCM, payroll, and time management integrations, but depth is thinner in the mid-market systems where Tapcheck is strongest.
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sources
  1. DailyPay — "How DailyPay Works" and FAQ (intercept model, direct deposit requirement). dailypay.com/faq‍
  2. DailyPay — Integration count (180+). dailypay.com/integrations
  3. DailyPay — Transfer limit (5 per day). DailyPay Manager's Guide
  4. Tapcheck — 300+ payroll integrations, ADP Marketplace Platinum Partner. tapcheck.com/marketplace
Category
Tapcheck
PayActiv

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is payroll native. Advances settle as a line-item payroll deduction with automatic reconciliation built into the payroll run. It's visible on the pay stub and in the employer's payroll register. The paycheck is never intercepted or routed through a third party.
PayActivPayActiv also uses a payroll-deduction model. However, rather than using actual payroll withholdings data, PayActiv estimates net pay as 80-90% of gross depending on the employer configuration. This estimation approach introduces overpayment risk.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck calculates access against net pay, the employee's actual take-home after taxes, up to 70% per pay period.
PayActivPayActiv estimates the accessible balance as 50% of estimated net pay, where net is approximated as 80-90% of gross rather than calculated from actual payroll data. Using their own example: an employee with $500 in gross earned wages would have an accessible balance of $225. Because the net figure is an estimate, the advance may not reflect actual take-home pay.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck offers unlimited transfers within the pay period.
PayActivPayActiv caps total EWA transfers at $500 per pay period. A single unexpected car repair can easily exceed that ceiling, leaving employees unable to access any remaining earned wages for the rest of the pay period.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is an ADP Marketplace Platinum Partner with approximately 300 integrations, including particular depth in Infor, Viventium, iSolved, Dayforce/Ceridian, and vertical-specific healthcare, staffing, and senior living systems where PayActiv's coverage is limited.
PayActivPayActiv is an ADP Marketplace Platinum Partner and integrates with Paychex, Paycor, UKG, and SAP SuccessFactors. Strong across major enterprise payroll platforms. Mid-market and vertical-specific system depth is less documented.
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sources
  1. PayActiv — Estimated net pay methodology (80–90% of gross). payactiv.com/trust-center/compliance-handbook
  2. PayActiv — Access calculation (50% of estimated net). payactiv.com/get-started
  3. PayActiv — Transfer cap ($500 per pay period). payactiv.com/blog
  4. Tapcheck — 300+ payroll integrations, ADP Marketplace Platinum Partner. tapcheck.com/marketplace
  5. PayActiv — Integrations (ADP Marketplace Platinum Partner). payactiv.com/partnerships
Category
Tapcheck
Rain

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is payroll native. Advances settle as a line-item payroll deduction with automatic reconciliation built into the payroll run. It's visible on the pay stub and in the employer's payroll register. The paycheck is never intercepted or routed through a third party.
RainRain uses a payroll-deduction model and fronts funds from its balance sheet, repaid at the end of the pay period. Rain calculates access on gross pay, before taxes and withholdings, which creates overpayment exposure when hours or deductions change. Employers are responsible for reconciling differences manually.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck calculates access against net pay, the employee's actual take-home after taxes, up to 70% per pay period.
RainRain calculates access against gross earned wages, before taxes and withholdings are applied. This creates real overpayment risk: when hours change, deductions vary, or an employee is terminated mid-period, the amount advanced can exceed what's actually owed on a net basis.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is an ADP Marketplace Platinum Partner with approximately 300 integrations, including Infor, Viventium, iSolved, Dayforce/Ceridian, and vertical-specific healthcare and staffing systems where Rain's depth is thinner in mid-market.
RainRain integrates with Workday (Built on Workday, July 2025), Paylocity, ADP, UKG, Paychex, Fourth, Deputy, and Harri. Strong major-enterprise coverage, but less comprehensive in mid-market and vertical-specific systems.
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sources
  1. Rain — 50% of gross pay calculation. rainapp.com/ewa-provider-guide
  2. Tapcheck — 300+ payroll integrations, ADP Marketplace Platinum Partner. tapcheck.com/marketplace
  3. Rain — Payroll integrations. rainapp.com/integrations
Category
Tapcheck
ZayZoon

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is payroll native. Advances settle as a line-item payroll deduction with automatic reconciliation built into the payroll run. It's visible on the pay stub and in the employer's payroll register. The paycheck is never intercepted or routed through a third party.
ZayZoon ZayZoon uses a payroll-deduction model, fronts funds from its balance sheet, and calculates access against net earned wages. However, access is capped at $1,000 per pay period regardless of what an employee has earned.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck calculates access against net pay, the employee's actual take-home after taxes, up to 70% per pay period.
ZayZoon ZayZoon calculates access at 50% of net earned wages, but applies a hard cap of $1,000 per pay period. For most full-time employees, the dollar cap is hit before the 50% ceiling.

Zero IT required. We configure everything from your existing data feeds — you enable data sharing through your platform settings and that's it. Most partners launch this way, in days, with no engineering resources.

tapcheckTapcheck is an ADP Marketplace Platinum Partner with approximately 300 direct API integrations across major enterprise payroll and HCM systems including ADP, Workday, UKG, Infor, Viventium, iSolved, and Dayforce, plus vertical-specific systems in healthcare and staffing.
ZayZoon ZayZoon has 160+ integrations, primarily through SMB payroll bureaus, PEOs, and platforms like Swipeclock and Payentry. Effective for SMB distribution, but less relevant for enterprise buyers needing direct API connections with major HCM platforms.
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sources
  1. ZayZoon — 50% of net pay, $1,000/period cap, integration count. zayzoon.com/go/paytime_payroll
  2. Tapcheck — 300+ payroll integrations, ADP Marketplace Platinum Partner. tapcheck.com/marketplace
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