Recently, a poll was posted inquiring about upcoming retirement plans for MDS Coordinators and Directors of Nursing. The poll was posted in a closed Facebook forum, The MDS Coordinators Discussion Group, hosted by Jim Kilburn which represents over 19,000 post-acute care nurse leaders. Around  300 responses were tabulated with eye-opening results.

When asked “How many of you plan to retire or leave MDS/LTC in the coming years?”, over 48% responded within the next 5 years. A similar poll was posted in a group of around five thousand Directors of Nursing (DON) and though the participation was less, at around forty responses, the results were very similar with 46% planning to exit the setting in the next 5 years.

The breakdown of data on plans to exit the industry were as follows:

Retirement PlanMDS CoordinatorsDirectors of Nursing
Within the next12 months7%13%
Within the next 1-5 years41%32%
Within the next 6-10 years5%31%
Within the next 10-20 years-30%17%
No plans to exit17%7%


These results are in alignment with projections for the general population of the United States to shift with a 47% increase in adults aged 65 and older from 2022 to 2050.

To compound issues created by nurse leaders retiring at this rate, it has also been reported in McKnight’s Long Term Care News, in a recent article the “Great Reshuffle”, that many workers are leaving jobs in their current industry to work elsewhere. Post-acute care nurse leadership positions, particularly DON and MDS roles, require a significant amount of experience, education and investment from employers to ensure success. On average a new nurse leader requires a minimum of six months of support before they are “independent” in their roles, and even then, mentorship, oversight and feedback are needed as new situations arise. Understanding the timeframes by which the experienced workforce is rapidly exiting the industry, providers need to plan and groom the younger workforce members in preparation.


Action steps you should take to prepare for the “great retirement”:

  • Discuss future plans with your team members to understand their life and career goals while planning for transitions collaboratively. Annual reviews are a great time to start this conversation, but open communication is best.
  • Identify strong nurses on your team and invest in education- whether it be furthering a degree, or industry specific education, help to develop your newer nurse team members to be strong supports for your existing team, and to prepare them for roles as future leaders.
  • Have a succession plan- aim for a 6-12 month plan of transition whenever possible, and allow time for your existing leaders to work with the new leaders through cross training, job shadowing and co-leadership opportunities.
  • Consultants- ensure the new leaders have ongoing consultant support whether it is from an internal consultant structure, or a contracted consultant such as Proactive LTC Consulting to support continued growth and provide consistent mentorship and reliable guidance.
  • Keep building a pipeline- work with local high schools and nursing schools on programs to keep a flow new CNAs and Nurses coming in to post-acute care settings.

Based on the numbers, we may have only a few short years as an industry to get a plan in place and ensure continuity of accumulated wisdom to facilitate quality care practices for our elders. Gaps in effective Director of Nursing leadership can lead to negative survey outcomes and contribute to staff turnover. Periods without an experienced MDS nurse negatively impacts reimbursement (through CMI, PDPM), quality measures, as well as survey success. Invest in the future leaders now to save the risk of the negative outcomes of unplanned turnover later.

Join Proactive June 11, 2024 for the upcoming webinar session: Immediate Jeopardy Risk: Cardio-Pulmonary Resuscitation (CPR). This session is part of a 12-month webinar series designed to empower nursing home professionals with the knowledge and strategies needed to navigate the top risk areas associated with Immediate Jeopardy citations.

Proactive also has a plethora of educational resources for new DONs and MDS nurses and a team of experts in both clinical consultation and clinical reimbursement consultation to meet your specific nurse leadership development needs.



Written by Rosanna Benbow, RN, CCM, ICC, IP, DNS-CT, QCP, RAC-CTA
Clinical Consultant

Was this article helpful? Access weekly insights when you sign up for our weekly newsletter!