Genesis Healthcare’s ‘Pod Model’ Just Cut Agency Staffing by 40% — and Now It’s Growing Its Own Nursing Leaders

Kennebunk, Maine — After emerging from a high-profile bankruptcy, Genesis Healthcare isn’t just trying to stay afloat. The company is rebuilding its entire operating playbook, and early signs suggest the strategy is working.

Genesis has rolled out a locally structured “pod model” that groups three to four facilities under a single pod leader, typically an administrator who stays close to the bedside rather than getting pulled into corporate bureaucracy. It’s a deliberate shift away from the top-down management structure that plagued the company before its Chapter 11 filing, and it’s already producing measurable results.

According to company executives, early pilot pods have cut agency staffing utilization from 10% to roughly 6% of overall hours. That’s a 40% reduction in reliance on temporary workers — a major cost driver and a persistent source of quality concerns across the industry. The pods have also posted better survey results with fewer deficiencies and higher customer satisfaction scores.

“We’ve been able to add to our markets some very strong market leaders that have joined us from other companies during a time of change,” said COO Lauren Murray in an interview with industry sources. “Folks are coming into the organization at a high level to continue that momentum.”

Betting on Homegrown Talent

The pod model isn’t just about operational efficiency. Genesis is using it as a launchpad for a new leadership pipeline, one that trains directors of nursing and administrators from within rather than recruiting externally.

The company’s “administrator-in-training” program is already running with 25 to 30 participants, with a goal of placing one trainee in every pod. A new “DON-in-training” curriculum is also in development, designed to prepare nurses for the clinical and administrative demands of running a facility. The program includes hands-on experience with the Five-Star Rating System, quality metrics, and infection prevention protocols — areas where new graduates often struggle.

“As we see new nurses come into our industry, it really is a learning curve for the Five-Star Rating System and how they can impact it,” said Chief Transformation Officer Nicole Kaufman. “We’ve been excited about the development of a DON-in-training program that can position that new clinical leader for success.”

Genesis is aiming to have 10 nurses in the DON program by year’s end. The company is also recruiting from outside the industry, targeting hospital nurses with leadership experience who may not have skilled nursing backgrounds but are eager to transition.

Culture and Retention Play a Role

Leadership training is only part of the story. Genesis has also launched a “leading with heart” initiative that awards $500 quarterly to standout staff members at each facility, with two $10,000 national winners selected annually. Staff boards focused on clinical priorities like pressure ulcer prevention have also been added.

Combined with the operational changes, these efforts have helped push turnover down by five percentage points in 2025, bringing Genesis to 51% — just below the industry average, according to Murray.

The Genesis turnaround is unfolding against a backdrop of intense financial and regulatory pressure on the broader sector. The company that fills prescriptions for millions of nursing home residents is now in bankruptcy, and multiple operators are navigating workforce shortages, reimbursement cuts, and stricter oversight. For Genesis, the pod model appears to be a bet that local accountability and homegrown leadership can outperform corporate structures that are too far removed from the floor.

Whether the model scales across Genesis’s full footprint — and whether other chains follow suit — remains an open question. But for now, the numbers are moving in the right direction.