Stop waiting for applicants. Let Expa find your next hire
Tell Expa which role you need and where, whether it is a director of nursing, an MDS coordinator or a therapist for your rehab gym. Expa finds the licensed clinicians near your building, reaches out, screens the ones who reply and books your interviews.
14,742 certified nursing facilities competing for the same clinicians · 95% with verified personal data
Free to start. Cancel anytime.
Ten minutes, three steps
What happens after you hit start
Describe the role
Paste a job description or say it in plain English. No boolean strings, no filters to learn, no sourcing skill required.
Approve the shortlist & outreach
Expa finds the clinicians, contacts them, follows up, and screens the ones who reply. You approve or reject.
Take the interviews
Approved candidates land in your calendar. That is the whole job on your side.
In plain terms
How Expa sources clinicians for skilled nursing
Expa is an AI-powered healthcare recruiting and clinician sourcing platform. It identifies licensed clinicians who are in-market, verifies their contact details, runs outreach over email, SMS and LinkedIn until they reply, screens the ones who respond, and books interviews with the candidates you approve.
There are 14,742 Medicare and Medicaid certified nursing facilities in the United States, and most of them recruit from the same small local pool of licensed clinicians as the hospital and the home health agency down the road. Turnover makes it harder. A study in Health Affairs that used CMS payroll data found the median nursing home turned over about 94 percent of its nursing staff in a year, and the average was closer to 128 percent, which means a typical building is rehiring for most of its nursing positions every year and recruiting never really stops.
The federal minimum staffing rule CMS finalized in 2024 has been repealed, with the repeal taking effect in February 2026, but the requirements that came before it still stand. A facility still needs a registered nurse on site for at least eight consecutive hours a day, seven days a week, a full-time RN serving as director of nursing, and a qualified dietitian on staff or consulting on a regular schedule. Expa searches for those roles specifically, along with the therapists, nurse practitioners and respiratory therapists a skilled nursing building depends on, filtered by license, long-term care experience, distance from your building and shift.
Why skilled nursing roles stay open
You are competing with hospitals for the same nurses
Hospitals in your market recruit the same RNs and can often offer more, so a skilled nursing building has to reach people directly and make a specific case about the schedule, the patient load and the commute.
Turnover means the search never really ends
When most nursing positions turn over in a year, the job is not filling one opening. It is keeping a pipeline full for roles you already know will open again.
Some seats cannot sit empty, even for a week
A building without an RN director of nursing, or without eight hours of daily RN coverage, is out of compliance, so those vacancies become urgent the day someone gives notice.
Federal requirements that still apply
| Requirement | What it means for hiring | Source |
|---|---|---|
| A registered nurse on site at least 8 consecutive hours a day, 7 days a week | You need enough RNs to cover every day, weekends included | 42 CFR 483.35(b)(1) |
| A registered nurse as full-time director of nursing | The DON role cannot be part-time or left open | 42 CFR 483.35(b)(2) |
| A qualified dietitian on staff, or consulting on a regular schedule | Many buildings share one consultant dietitian across several facilities | 42 CFR 483.60 |
States can grant waivers for some of these requirements, and many states set their own staffing rules on top of the federal ones.
Roles Expa fills in skilled nursing
The licensed roles skilled nursing buildings struggle to fill, and the pages that go deeper on each.
Candidate examples
Boise, ID · 7 miles
12 years in long-term care, 4 as ADON
Meridian, ID · 10 miles
6 years · PDPM assessments and care plans
Nampa, ID · 18 miles
5 years · skilled nursing rehab
Questions
Is the federal nursing home staffing rule still in effect?
No. CMS repealed the minimum staffing standards it finalized in 2024, and the repeal took effect on February 2, 2026. The requirements that existed before that rule still apply, so a facility still needs an RN on site at least eight consecutive hours a day, seven days a week, and a full-time RN director of nursing, unless the state grants a waiver. The separate facility assessment requirement, which asks facilities to staff to the actual needs of their residents, was not repealed.
Why is it so hard to hire nurses for a nursing home?
Mostly because skilled nursing competes with hospitals for the same licensed nurses, and hospitals can often offer higher pay and schedules that feel easier. Turnover adds to it, since a building that loses most of its nursing staff in a year is recruiting all the time. Postings alone rarely work, because the nurses you want are already employed. Reaching them takes direct outreach with a specific role, shift and pay range.
How high is turnover in nursing homes?
A study published in Health Affairs used CMS payroll data covering 2017 and 2018 and found median annual turnover of about 94 percent for total nursing staff, with an average of about 128 percent. Some buildings were far above that and some far below, which is part of why the researchers argued turnover should be reported as a quality measure.
Can Expa find a director of nursing or an MDS coordinator?
Yes. Expa filters on RN licensure, years of long-term care leadership, MDS and RAC-CT experience, and distance from your building. Both roles are hard to fill because the pool of RNs with long-term care leadership or MDS experience in any one market is small, and every building nearby is looking for the same people.
Do you source therapists for skilled nursing rehab?
Yes. Physical therapists, occupational therapists and speech-language pathologists with skilled nursing experience, filtered by license, setting history and schedule. Expa also sources dietitians, including consultants willing to cover several buildings.
Can Expa help an operator with several buildings?
Yes. Expa searches around each building separately, so the shortlist for one facility does not pull candidates from 50 miles away who would never make the drive. If you are hiring for six or more roles across your buildings, the roles selector sends you to book a demo so we can set it up across your portfolio.
Do I have to do the sourcing myself?
No. You describe the role and approve a shortlist. Expa does the searching, the outreach, the follow-up and the screening, then books interviews with the candidates you approve. It takes about ten minutes of your time.
How fast will I see candidates?
A slate of interested, contactable clinicians within 48 hours of starting, often within 24. Time to hire from there depends on your interview process.
How much does Expa cost?
You can start free. For ongoing hiring, Expa pilots start at $6,000 for three months and cover all your open roles, with no per-placement fees. For comparison, a contingency agency placing a single clinician typically charges 15% to 22% of first-year salary.
Start staffing your facility in about ten minutes
Describe the role, approve a shortlist, take the interviews.