How Inflation, The Pandemic, Compliance, and Labor Shortages Are Shaping Medical Staffing in 2022

By lisa,

The Healthcare industry is facing an unprecedented series of challenges impacting its workforce. The situation continues to grow more complex each year. In a new monthly series, the OPA Staffing team will share its ongoing research to assist its clients and employees navigate these challenges. 

Inflation

The U.S. Labor Department recently reported that as of November 2021, Inflation rose 6.8% from a year ago – its fastest pace since 1982. Some of the most startling contributors included:

  • An annualized increase in gasoline prices to 58.1% from over a year ago
  • Energy prices have risen 33.3%
  • Used car and truck prices exploded up to a 31.4% increase
  • Food prices jumping 6.1% over the year

Nationally, gross pay has increased 4.8% over the past year, however, due to the erosion of this severe inflation, real average hourly earnings declined 1.9% for the 12-month period, the Labor Department reported in a separate release.

Specifically for caregiving, the Hospital & Healthcare Compensation Service, reported 2021 wage increases ranging from 3.1% – 7.1% across a variety of roles and health care settings – equally eroding real average earnings.

The Pandemic

To say that the healthcare workforce is sick, tired, and burned out is a gross understatement. There are a myriad of reports publicly available that detail the effects of the COVID-19 pandemic on healthcare workers. For example, according to a recent survey by Morning Consult, a private data intelligence company, approximately 1 in 5 healthcare workers in the US — or around 18 percent — have quit their jobs since February 2020. Additionally, a Washington Post-Kaiser Family Foundation reported that 3 in 10 U.S. healthcare workers were considering leaving their profession while 6 in 10 said that stress from the pandemic had harmed their mental health.

Compliance

Over the past months, thousands of healthcare employers announced COVID-19 vaccination requirements for staff and clinicians as a condition of employment in accordance with Federal and independent state mandates. While it was initially feared that these requirements would exacerbate an accelerating workforce crisis, current reports indicate that the impact has been limited. Fierce Healthcare has begun maintaining a list of hospital reports here.

Labor Shortages

The news has been full of headlines for the past several months referencing the “Great Resignation” as employers face the tightest labor market in recent history. While turnover rates and gap reports vary dramatically by role and health care setting, they all share a common trait – rates are increasing year over year.

For example, in another recent report by the Hospital & Healthcare Compensation Service: “Turnover for CNAs in Nursing Homes increased significantly to 51.38%, as compared to the 2020 turnover rate of 39.38%. The national turnover rate for all employees was 38.68%, up from the 2020 rate of 35.36%.”

The Impact to Medical Staffing in 2022

As we begin 2022, we must be cognizant of the pressures that 2021 has placed on us as described above:

  • Eroding earnings due to inflation
  • The physical and emotional impacts of the ongoing pandemic
  • Accelerating turnover rates and increasing competitiveness to attract and retain staff

Both Healthcare Providers and Staffing Agencies are exploring a myriad of options to address these ongoing situations including:

  • Higher wage increases than previous years
  • Increased sign-on and retention bonuses
  • Expanded retention programs such as career development and professional flexibility

To demonstrate, in a recent nursing study by healthcare staffing firm Cross Country Healthcare Inc. and Florida Atlantic University’s Christine E. Lynn College of Nursing:

  • 97% of respondents agreed that increasing pay rates and other incentives would attract and retain more nurses. 
  • 85% believed cross-training must be improved to respond to crisis events. 
  • Another 85% said a multistate license for nurses would have greatly benefited the country during the pandemic

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The Importance of Building Resilience for Healthcare Workers

By lisa,

There’s a lot of talk out there about Resilience these days due to the effects of the pandemic on so many. However, resilience has been considered an important skill set for healthcare workers for several years. Burnout (defined as mental and physical exhaustion from chronic workplace stress) is an ongoing occupational hazard in healthcare, which harms the healthcare system, patients, and healthcare workers. The pandemic exacerbated that.

The CDC has identified several symptoms of healthcare burnout including:

  • Feeling irritation, anger, or denial
  • Feeling uncertain, nervous, or anxious
  • Feeling helpless or powerless
  • Lacking motivation
  • Feeling tire or, overwhelmed
  • Feeling sad or depressed
  • Having trouble sleeping
  • Having trouble concentrating

A Washington Post survey published this past April of 1,327 front-line health care workers in the United States during the COVID-19 pandemic showed:

  • 55% of front-line health care workers reported burnout 
  • The highest rate (69%) was among those ages 18 to 29
  • That same age group also reported the highest negative impact of the pandemic on their mental health (75%)
  • All healthcare workers (62%) reported some mental health repercussions.

What is Resilience?

Resilience is the ability to adapt to difficult situations so that a person can bounce back to a state of well-being . When faced with stress or trauma, a person still experiences anger, grief and pain, but they’re able to keep functioning — both physically and psychologically. Resilience helps to protect from some mental health conditions such as depression and anxiety. 

For healthcare workers in particular, being able to bounce back with resilience equates to better patient care and outcomes as they will be more alert, positive, and are able to communicate more clearly than if they were more stressed out. Effectively practising resilience can also help healthcare workers advance their careers. People who increase their resilience usually feel naturally energized, motivated, and capable of taking on more responsibilities. Those who are resilient in nature will generally have a higher sense of self-awareness, persistence, and the energy to sustain their mind and body. Resilience is also thought of as part of the foundation to becoming emotionally intelligent, as it requires emotional flexibility, adaptability, a positive outlook and being able to reach out to others for open communication.

Steps for building Resilience

There are many strategies to help healthcare workers improve their sense of resilience:

On The Job

  • Reminding one-self of their strengths. In the face of adversity, many people’s self-esteem can face significant challenges. Replace negative thoughts about a problem with positive ones is important to maintaining a sense of self-worth.
  • Flexibility. Sudden changes can seem very disruptive. Wherever possible, seek positives in the change.
  • Develop positive thinking and optimism. A ‘can-do’ attitude helps see problems clearly and act appropriately.
  • Take action to solve problems as soon as they are encountered. The problem probably isn’t going to go away, and the longer it is left unresolved, the more stress people feel.
  • Set reasonable goals to deal with problems. Break problem-solving down into small manageable steps. Experiment with, and use, a range of problem-solving strategies.

Personal Actions

Healthcare is a demanding profession and it is critical that people care for themselves.

  • Increase a personal sense of control by keeping a consistent daily routine when possible.
  • Try to get adequate sleep.
  • Make time to eat healthy meals.
  • Take breaks during your shift to rest, stretch, and recuperate.
  • When away from work, get exercise. Spend time outdoors either being physically activity or relaxing. Do things you enjoy during non-work hours.
  • Engage in mindfulness techniques such as breathing exercises and meditation.

Social Actions

  • Maintain a supportive social network of healthcare colleagues. Sharing problems and using combined experiences to help solve.
  • Reach out to positive family and friends during breaks
  • Take breaks from watching, reading, or listening to news stories, including social media. 

Additional Resources

Below is a curated list of resources healthcare workers can use: 

Ultimately, for healthcare workers, building resilience is a form of self-care that will benefit both yourself and your patients.

_______________________________________

Lisa Wilson is the Vice President of Systems for OPARASA and OPA Staffing. She is also the co-founder of OPARASA. She can be reached at lisa@oparasa.com.

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Explore A Career As A Licensed Practical Nurse (LPN)

By lisa,

Staffing- Exploring a Career As A Licensed Practical Nurse (LPN)

Do you want a fun and rewarding career where you get to help people every single day with ongoing employment potential? If yes, then look no further. A career as a licensed practical nurse (LPN) may be the one for you.

What does an LPN do?

Licensed practical nurses (LPN) work under the direction of registered nurses and doctors to provide basic medical care. Their typical duties include:

  • Monitoring patients’ health (e.g., checking blood pressure)
  • Administering basic patient care, including changing bandages and inserting catheters
  • Administering medicine under the supervision of a registered nurse or doctor
  • Helping patients to bathe, dress and maintain personal hygiene
  • Discussing the care they are providing with patients and listening to their concerns
  • Reporting each patient’s status and concerns to registered nurses and doctors
  • Maintaining records on each patient’s health

Depending on where they work, LPN’s might have different responsibilities that are included with their general duties.Here are a few examples:

LPN in a Care Facility for the Elderly

These LPN’s are usually employed by assisted living centers, private or public nursing homes, and retirement homes. Common duties may also include:

  • Provide patients with companionship and friendship 
  • Assist with physical therapy routines

LPN in a Nursing Care Facility

The most common employers are residential treatment agencies such as group homes for terminally or mentally ill patients, rehabilitative or hospice services where most of the patients are elderly although some may be younger with disabilities or illnesses.

Common duties may also include:

  • Health assessments to make treatment plans 
  • Supervising nursing aids 
  • Assist in maintaining clean rooms 

LPN in a Hospital

Common employers are hospitals who need LPNs to work in a host of departments including maternity, surgical, and the ER. Common duties may also include:

  • Supervising new nurse’s aides 
  • Assisting with advanced medical practices 

Career Outlook and Pay

LPNs are always in demand! According to the U.S. Bureau of Labor statistics, there are an average of 66,300 open positions annually nationwide. Demand varies by state based on a number of factors such as demographics, number of employers, etc.

It is important to note that the state of Georgia, where OPA Staffing is headquartered, is within the top 10 states. Below is a table that breaks down the average annual number of openings by state (and U.S. territory):

AreaAverage Annual Openings
United States66,300
California7,440
Texas6,770
New York5,250
Florida4,570
Pennsylvania3,690
Ohio3,510
Tennessee2,460
Georgia2,250
Virginia2,000
Minnesota1,580
Illinois1,550
New Jersey1,550
North Carolina1,550
Massachusetts1,450
Indiana1,400
Missouri1,360
Maryland1,280
Michigan1,150
Arkansas1,130
Oklahoma1,070
Alabama1,060
South Carolina990
Connecticut890
Kentucky870
Washington790
Iowa680
Kansas610
Colorado600
Wisconsin580
Nebraska540
West Virginia520
Arizona390
Oregon360
Puerto Rico340
Nevada280
North Dakota230
Delaware220
Utah220
Montana210
New Mexico200
New Hampshire180
Louisiana170
District of Columbia160
South Dakota160
Hawaii120
Vermont100
Maine90
Mississippi90
Rhode Island80
Alaska50
Idaho50
Wyoming50
Virgin Islands10
Guam0

Wages also vary greatly depending upon a number of regional factors and experience. The U.S. Bureau of Labor statistics reports that the range can begin at $17.10 per hour. Below is a table that displays this distribution.

Percentile10%25%50%(Median)75%90%
Hourly Wage$ 17.10$ 20.22$ 23.47$ 27.82$ 31.50
Annual Wage$ 35,570$ 42,060$ 48,820$ 57,860$ 65,520

Is Being an LPN Right for You?

Like any career, it is important to personally reflect on whether this is the right direction for you.  There are many qualities that you will need to thrive as an LPN. These include:

  • Finding great satisfaction in helping others
  • Being a communicator
  • Having the ability to make people feel at ease
  • Being able to work as part of team
  • Being a problem solver 

Additional considerations for being successful:

  • Physical Fitness is a key component. You may struggle to keep up with the demands of the job, which can involve lifting patients and/or standing up and kneeling down for periods of time. 
  • Strong Constitution – Depending upon your work environment, you may be exposed to injuries, incontinence, etc. 
  • Strong Introversion – Your days will be spent interacting with other people.

How To Become an LPN

First, you will need to complete an approved educational program, which includes classroom learning in subjects such as nursing, biology and pharmacology and supervised clinical experience.  These programs award a certificate or diploma and typically take about 1 year to complete. They are commonly offered at technical schools and community colleges.

After completing a state-approved educational program, you can take the National Council Licensure Examination (NCLEX-PN). In all states, they must pass the exam to get a license and work as an LPN. For more information on the NCLEX-PN examination and a list of state boards of nursing, visit the National Council of State Boards of Nursing.

LPNs may also choose to become certified through professional associations in areas such as gerontology and intravenous (IV) therapy. In addition, employers may prefer to hire candidates who are trained to provide cardiopulmonary resuscitation (CPR).

_______________________________________

Lisa Wilson is the Vice President of Systems for OPARASA and OPA Staffing. She is also the co-founder of OPARASA. She can be reached at lisa@oparasa.com.

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JOIN THE “LOVE OPA STAFFING” SOCIAL MEDIA CONTEST!

By lisa,

Dear Colleague,

We are so grateful for your hard work in caring for so many who need your compassion! This Thanksgiving has special meaning for many given the unprecedented challenges of 2020.

We would like to celebrate you by launching the “Love OPA Staffing” Social Media Contest as a way for you to see how many wonderful OPA Staffing Healthcare Team members are out there and showcase the important work we do.

Each person who participates will be entered into a lottery to win a $50.00 Amazon Gift Card. The contest will begin on Monday November 9, 2020 and finish on Friday November 20, 2020.

HERE’S HOW IT WORKS:

1. Snap a selfie at work (please no patient faces, names, or other patient identifying information per HIPAA law).

2. Post it to your favorite social media site (Instagram, Facebook, or LinkedIn).

3. Include what you do (LPN, CNA, etc) and why you love working at OPA Staffing (the people, the clients, the patients, commute, etc).

4. IMPORTANT: Include #loveopastaffing in your post. That is how we’ll find you to enter the lottery.


The winner will be randomly drawn on Monday, November 23, 2020 and notified directly. A follow up announcement will also be sent to everyone.


Congratulations Jan E. for winning the ‘LOVE OPA Staffing Contest’ 

We hope you’ll consider joining us in showing the impact we make for so many.

Sincerely,

Lisa Wilson, Vice President

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Top 3 Factors for Consideration in Choosing a Medical Staffing Company that Understands “Care” Deeply

By lisa,

While COVID-19 keeps many people stuck at home, there are those in the healthcare industry looking for the right candidates to help them during these tough times.

1. Our Company’s Mission.

At OPA Staffing we are committed to working collaboratively to deliver the highest level of service that meets the mission and culture of our valued clients. We accomplish this by recruiting highly-qualified, expertly-trained medical professionals and placing them in the medical facilities with whom we work. We parallel our activities with our non-profit organization and sister company: The OPA RASA Foundation and strongly follow its mission which is “to leverage capitalism to Build Worth in Recovery.” Each organization is purpose-driven, as well as determined to assist in creating meaningful careers for others.

2. How you want, when you want, where you want (from PRN to Permanent Placement)

It is no surprise that we are a flexible organization, open to adjustments. One of the best things OPA Staffing does is to make sure our clients and employees are heard, valued, and cared for. An employee that is heard will put their best effort forward in all that they do. A company that cares and values you as an individual promotes an environment where people are trustworthy and feel safe. As much as we want you to live by our mission, we at OPA Staffing, along with The OPA RASA Foundation, will always lead by example.

It is not difficult to start in PRN work, move to contract work, and eventually into a direct placement role. OPA Staffing works with you every step of the way. We care about your availability, commute time, as well as your pay rate. The same goes with our clients – it is just as important to us that we take care of our client’s needs as well. Yes, you read it right, we truly want everyone to be happy.

3. By healthcare professionals for healthcare professionals

OPA Staffing knows the weight that good healthcare carries. As a healthcare provider, OPA Staffing only recruits the best medical professionals. A successful healthcare outcome means better wellness that leads to a better quality of life. These are a few of the requirements for delivering goals that are important to patients. OPA Staffing never forgets to instill this in their process of recruitment. Just like you, we are a group of healthcare professionals giving value to both employment and patient care.

OPA Staffing also believes the best way to provide healthcare services emerges when leaders and executives are actively engaged in all facets of the process. OPA Staffing seeks more than just knowledge; it also requires empathy from it’s healthcare professionals, so they can best serve their patients during the COVID-19 pandemic.

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Optimizing Your Recruiting Efforts

By lisa,

The Impending Talent Shortage

These are turbulent times for medical recruIters. As overall unemployment rates hover around 14.7% the medical industry is facing an entirely different dichotomous disruption: employee burnout and attrition among Covid-19 workers, and massive furloughs and layoffs in the outpatient and private practice sectors.

In early March, as the coronavirus began to spread, the public health sector rallied to meet the rapidly increasing need as medical employment openings more than tripled in five key states including, Georgia, according to Glassdoor’s Economic Research division. On the flip side, by early April, thousands of medical workers were laid off as elective surgeries and healthy patient check-ups dropped off, or nearly stopped. This created an increasingly complicated environment in the medical recruiting and staffing space, as facilities balanced between supporting a relentless need for more help, while others focused on retaining furloughed workers while they waited for the economy to reopen.

Life isn’t about waiting for the storm to pass…It’s about learning to dance in the rain.”
Vivian Greene

“The fundamentals of today’s medical industry includes using an agency, because staffing is much less expensive in real cost, as well as human factors,“ said Dr. Jason Meyer, a well-known expert in the medical staffing and recruitment industry and owner and founder of Medical Staffing Consultants Inc.

“Do the math. In-house recruiting is expensive and so are employee incentives and overtime. And then there is the added danger of people working for long hours and suffering burn-out. The quality of service suffers, safety is sacrificed, there are quality-of-life issues. This causes good employees to seek positions elsewhere,” he added. “ A staffing agency resolves many of these problems while providing flexibility in an unknown staffing environment. There is no crystal ball, but knowing that you have an agency in your corner can be a huge bonus to support existing staff and as well as keeping your clients happy.”

“As states begin opening more and more of the economy, the demand for talent is going to be back at full throttle,” added Tom Erb, another industry expert and President of Tallann Resources. 

“We are facing unprecedented times,  but that does not mean that we can’t learn from past crisis and downturns and adapt them to our current situation. There are critical activities you can be focused on today to position yourself for the rebound. It’s time to position your company to your upcoming labor needs, and to go a step further to gain a competitive advantage by upgrading your talent.”

OPA Staffing is honored to host Tom’s Free Webinar “Recruiting for the Rebound, “ scheduled for Thursday, May 28th at noon time.

Tom is one of the most highly sought-after national speakers on the subject of recruiting, presenting to a variety of industry organizations including the American Staffing Association (ASA), National Association of Personnel Services, TechServe Alliance, multiple SHRM and ASA chapters, and many others.
A variety of national and regional media outlets including The Wall Street Journal, Monster.com, Columbus CEO, and multiple city business journals have interviewed Tom. He has been published in ASA’s Staffing Success magazine, and has been recognized as one of the Top 25 Online Influencers in Staffing by HR Examiner and has significant experience working with healthcare companies including Summa Health Systems and Cleveland Clinic.

https://event.webinarjam.com/register/1/m2y4qt7

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Medical Staffing Agencies – the New Normal For Replacing Talent Lost During Covid-19

By lisa,

It’s Time to be PROACTIVE Rather than REACTIVE to Staff Your Facility

When Covid-19 reached pandemic status in early-March, it created the perfect storm tocause further upset to an already struggling healthcare system. According to the Bureau of Labor Statistics the need for RNs was increasing rapidly, at a rate of more than 200K  annually, because of the aging Baby Boomer population. While keeping up with the pre-Covid demand was taxing for many facilities, keeping staff in place during the pandemic became even more unmanageable.

In preparation for Covid-19, hospitals and medical centers were forced to delay or cancel the financially healthier part of their enterprise: elective and out-patient procedures and surgeries, to make room for demanding and less-lucrative COVID-19 patients. “To remain solvent, they had to lay off trained staff and very often, all or part of their talent acquisition teams” said Lisa Wilson, VP of Operations at OPA Staffing.

Specialty clinics are facing their own regimen of challenges. “Like the rest of us, healthcare providers occasionally get sick, and they need to be confident that their patients along with their teammates are being taken care of when they are unable to come to work., added Rachael Nuscher, BSN-RN who works at a dialysis clinic. “Having qualified candidates that are ready to step in when needed would alleviate the stress that healthcare workers feel when these things arise.”

As healthcare worker shortages were front and center on the national nightly news cycle, laid off healthcare employees formerly employed to support elective surgeries and preventative care procedures, received little or no coverage.

“There is a lot of noise in the healthcare community right now. Penetrating that noise during Covid-19 is the challenge for medical staffing companies. It is not business as usual,” said

Stephen E. Deason, CEO of OPA Staffing. “Now is the time that meaningful partnerships become more instrumental to navigate the challenges ahead. Drs. offices, clinics, and medical centers were forced to lay off much of their talented labor force due to the priority-shift caused by the Covid-19 pandemic,” added Deason. “As society is reopened, there will be an increased demand for healthcare staffing. In particular, skilled talent will be needed for elective surgeries; such as hernia, cataract, knee and hip replacements, cosmetic and more.”

As elective outpatient and non-urgent admissions within healthcare systems ramp up, staffing shortages are imminent, as well as stiff competition in meeting their specific facility requirements. “A large talent pool was turned loose during Covid-19,” added Denel Sims, Director of Recruiting at OPA Staffing. “We are actively recruiting those people.

“Healthcare facilities need to plan ahead and establish a pipeline to be ready when society reopens and the uptick happens,” added Director of Staffing Operations, Chris Wiley. “That’s one way to meet the challenge of locating and hiring talented, trained, skilled healthcare workers quickly.”

Using a medical staffing company provides a pipeline of qualified workers quickly and also mitigates liabilities should the uptick not be sustainable. “We are in unchartered-territory. There is potential for a down turn,” added CEO, Deason, “and if that is the case, utilizing a medical staffing agency such as OPA Staffing, provides significant flexibility in times of uncertainty and risk.”

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Student Debt Loan Forgiveness for Frontline Health Care Workers

By lisa,

Loan Forgiveness for Covid-19 Responders

The program is called the Student Debt Forgiveness for Frontline Health Care Workers Act, and is focused on workers providing direct patient care in response to the Covid-19 pandemic.

The legislation was introduced by Congresswoman Carolyn Maloney to attract and support medical professionals from all specialties to help with the Pandemic.


New legislation has been introduced by Congresswoman, Carolyn Maloney to eliminate graduate school student debt for healthcare workers risking their lives on the front lines.

“Medical professionals in hospitals and other medical settings are operating in extraordinarily difficult and dangerous circumstances to provide care for critically ill COVID-19 patients and protect our communities,” said Maloney in a statement. “New York City has been hit particularly hard in the pandemic, and many other areas of the country are beginning to experience surges in patients with COVID-19 symptoms, putting great stress on health care institutions and their employees. The least we can do to recognize their service is to forgive their graduate student loan debt so that they are not forced to worry about their financial wellbeing in addition to their health and the health of their families while they respond to a public health emergency.”

The legislation would provide financial relief to new graduates, as well as experienced professionals that are already in the field, including doctors, nurses, and other healthcare professionals.

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OPA Staffing CEO Published in Atlanta Business Chronicle

By lisa,

CEO Stephen Deason, was just one of a handful of Leadership Trust members selected to voice his opinion in Seven Ways Leaders Can Help Troubled Employees Get Back on Track. As founder and Chief Executive Officer of The OPA RASA Group, a Social Enterprise helping people build worth in Recovery and previous CEO of GRYYT, a Socially Conscious MarTech firm, he has a history of applying a compassionate and effective management style to a diverse employee demographic. Stephen is also an active volunteer who sits on four nonprofit boards and the advisory boards of two startup technology and telecommunications firms.

See more at:

https://www.bizjournals.com/atlanta/news/2020/04/08/seven-ways-leaders-can-help-troubled-employees-get-back-on-track.html

The Main Take-Away: “Make them responsible for outcomes.”

“Elevate their interest level. Our entire program is based on this philosophy — as is the leadership training program for the U.S. military. A troubled employee is generally a distracted person. Things are happening that are competing for that person’s time and interest. Elevate their interest level in the tasks at hand by making the outcomes their responsibility. You’ll often find a highly creative problem-solver underneath.” — Stephen Deason, The OPARASA Group, LLC

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Healthcare Providers Struggle with Housing During the COVID-19 Pandemic

By lisa,

While the country hunkers down to fight the COVID-19 pandemic, front-line healthcare workers are being left out in the cold.

 Many traveling nurses and other healthcare providers are struggling to find temporary housing, others are being evicted on short notice, and nervous hosts are cancelling AirBnB reservations.  OPA Staffing is here to help!  We’ve formed an innovative partnership with West Home to provide temporary and flexible housing for traveling medical professionals. West Home has an inventory in both the Atlanta and Nashville market.

West Home provides temporary furnished and unfurnished housing
for medical professionals.

Atlanta units are located in five strategic locations in and around the Atlanta hospital district and are designed to support temporary and traveling medical staffers by offering 1-6 month leases.

Strategic locations for West Home furnished apartments.

Currently there are more than a dozen two-bedroom/two-bath, seven one-bedroom, and 17 studio apartments available. All of them offer around-the-clock support staff, high-speed internet, luxury towels and linens, smart televisions, keyless entries, in-unit washers and dryers, fully stocked kitchens, and more.

West Home also has unfurnished units available.

Furnished & Unfurnished

HOUSING INFO:

www.westhome.co

info@westhome.co

(917) 443-7499

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