The main software categories in skilled nursing and long-term care, what to look for in clinical, billing and workforce tools, compliance and privacy considerations, staffing data reporting and how to evaluate vendors.
| Category | Covers |
|---|---|
| Electronic health record (EHR) | Resident records, care plans, assessments, medications, documentation |
| Billing and revenue cycle | Claims, payer rules, resident accounts |
| Workforce scheduling | Shifts by unit, coverage, call-outs, agency use |
| Time and attendance | Clock-ins, breaks, overtime, payroll export |
| HR and credentials | Licenses, certifications, training, employee files |
| Communication | Updates to staff across shifts, family communication |
Some vendors cover several categories; many facilities combine specialist tools. The key is that data flows between them reliably.
To record clock-ins, breaks and overtime automatically, see EZTime time and attendance software.
Involve the director of nursing and frontline nurses and aides in evaluation; clinical usability drives documentation quality.
Staffing is one of the biggest operational and financial challenges in long-term care. Workforce tools should help you build schedules that meet coverage needs on every unit and shift, fill call-outs quickly, track overtime and agency use, and keep credentials current. See healthcare staff scheduling and healthcare worker burnout.
Nursing homes certified by Medicare and Medicaid must submit staffing information to the Centers for Medicare & Medicaid Services (CMS) through the Payroll-Based Journal (PBJ) system, based on payroll and other verifiable data. That makes accurate time and attendance records essential: hours must be captured by employee, job category and date, and agency and contract staff hours must be included. When evaluating workforce software, ask how it supports the data you need for PBJ submissions, whether through direct reports or exports to your payroll or PBJ tool. Confirm current requirements in CMS guidance.
Many nursing home staff are non-exempt. The FLSA allows hospitals and residential care facilities to use the “8 and 80” overtime system by prior agreement, paying overtime after 8 hours in a day and 80 hours in a 14-day period, as an alternative to the 40-hour workweek. State laws may add requirements. Your time system must apply the method you use consistently and handle shift differentials in the regular rate. See FLSA overtime rules and shift differential pay.
Nurses, aides and other staff need current licenses, certifications and training. Track expiry dates, send reminders before they lapse and prevent scheduling of staff whose credentials have expired. See healthcare certifications and healthcare employee training.
Nursing homes run around the clock, and most software decisions eventually touch staffing. Before you compare products, write down how you build schedules today, how you fill call-outs, how you track agency staff, and how hours flow into payroll. Note any state staffing rules or facility policies you must report against, and confirm the current requirements with your state survey agency or the official CMS guidance rather than relying on a vendor summary. If a system claims to help with staffing reports, ask to see the exact output and check it against what you submit today. Clear answers here keep you from buying a clinical platform that leaves scheduling on spreadsheets, or a scheduling tool that cannot share data with the clinical record.
A 120-bed skilled nursing facility schedules staff on spreadsheets and collects hours from a basic time clock, then rebuilds staffing data each quarter for reporting. Agency hours are tracked separately on invoices. The facility moves scheduling and time and attendance into one workforce system with job categories for every employee and agency worker. Quarterly staffing reports now come from the same data as payroll, and the scheduler sees open shifts and overtime risk days in advance.
EZTime is not an EHR or billing system and does not submit data to CMS. It supports the workforce side of care facilities: scheduling by unit and shift, clock-ins from a kiosk or the mobile app, break tracking, overtime rules, labor rule alerts, shift swaps and document expiry reminders in the digital employee file, with payroll-ready reports and Excel exports. See EZTime for healthcare.
Typically an EHR, billing tools and workforce systems for scheduling, time and attendance and credentials, connected by reliable integrations.
A CMS system through which Medicare- and Medicaid-certified nursing homes submit staffing data based on payroll and other verifiable sources.
Residential care facilities may use the FLSA 8 and 80 system by prior agreement with employees; state laws may add requirements.
If they handle protected health information on the facility’s behalf, HIPAA generally requires one.
Include nurses and aides from different shifts in demonstrations and testing.
Including agency hours helps with staffing reports and cost tracking.
Because EZTime links the schedule to the time clock, you can block early clock-ins or punches outside assigned shifts. Pricing starts from $2 per employee a month, and the smallest accounts pay a $20 monthly minimum.