Every care setting · One platform
Healthcare staff scheduling software for the people who actually run the floor
Healthcare staff scheduling software builds, checks and publishes the working roster for a clinical team. Beyond a generic shift planner, it verifies licences and certifications before anyone is assigned, enforces minimum rest and overtime limits, tracks nurse-to-patient ratios, runs on-call rotations, and rule-checks every shift swap before a manager sees it.
From $99/month per location · No sales call · No card to start
At a glance
- Healthcare staff scheduling software differs from a general shift scheduler in one respect that matters: it refuses assignments that break a clinical rule, rather than warning you about them afterwards.
- The rules that matter in practice are licence and certification validity, federal exclusion screening, minimum rest between shifts, overtime against both the employer's cap and the individual's contract, and nurse-to-patient ratios.
- MedAligna runs twelve of them on every assignment: in the browser as the scheduler drags, and again on the server before the write lands.
- Filling an open shift from your own staff instead of an agency typically saves 30–45% of the bill rate. MedAligna escalates through your own team, float pool and sister sites before it will suggest calling anyone.
- $99–$249 per location per month, published, with a 14-day trial and no card. Most teams publish their first schedule the same afternoon.
What makes healthcare scheduling different from shift planning?
The rules are the product; everything else is a calendar. Any tool can put a name in a box on a Tuesday; what separates the two is what happens when the name is wrong.
Thirteen rules run on every single assignment in MedAligna, and that enforcement is the whole difference: double-booking, minimum rest, maximum shift length, consecutive days, one day in seven free, hours against both the organisation's cap and the individual's own contract, ACGME averaging windows, credential validity, federal exclusion screening, skill and position eligibility, approved and pending time off, stated availability, and employment status. They run in the browser the moment a scheduler drags a shift, and again on the server before the write lands, because a browser can be lied to and a database cannot.
The distinction that matters is between a warning and a block. Overtime is a business decision: MedAligna tells you the shift takes someone to forty-eight hours, and lets you make the call. An expired registered nurse licence is not a business decision, and no amount of being short-staffed makes it one. That assignment is refused, and the reason is written on the cell.
Can one platform serve a hospital, a clinic and a home care agency?
One platform, four very different jobs. A ninety-bed skilled-nursing facility, a twelve-provider clinic, a hospital ICU and a home care agency have almost nothing in common except that all four run a roster.
It can, because the platform is one thing and the rules you switch on are another. Long-term care turns on acuity-weighted staffing, hours per resident day, and the quarterly CMS Payroll-Based Journal export. A residency programme turns on ACGME averaging, which is the only way to express eighty hours averaged over four weeks rather than a flat weekly cap. A home care agency turns on visits rather than shifts, with travel time between clients and caregiver continuity.
None of them are separate products, separate contracts, or separate implementations. A multi-site organisation running a hospital, two clinics and a home care arm runs all of it in one place, with one bill and one staff directory, which matters most for the people who work across more than one of them, because they stop being three different records who cannot be told apart.
How does MedAligna fill an open shift without calling an agency?
Cheaper than the agency call you were about to make. When a shift opens at six in the morning, most tools have nothing useful to say, so the facility calls an agency and pays a markup on a nurse it already employed.
MedAligna escalates an open shift through your own staff first, then your float and per-diem pool, then your other locations, and only then suggests an agency. Every candidate is filtered by the same thirteen rules, so nobody is ever offered a shift they are not eligible to work. And the tier order is policy, not a preference: an agency nurse who scores better on paper cannot leapfrog an eligible employee, because that is precisely how a facility ends up with a bill it never needed.
The saving is shown as a number, from your data, not ours. Fill a twelve-hour shift internally at forty-five dollars an hour instead of buying it from an agency at a thirty-eight per cent markup, and the difference is two hundred and five dollars. Four of those a week is forty-two thousand dollars a year, for shifts your own people could have covered, if anyone had asked them first.
Which mornings does healthcare scheduling actually change?
6:04am, a call-out
A night nurse rings in sick for the 07:00 shift. The charge nurse has forty minutes, a phone, and no idea who is legally available: who has rest hours, whose BLS lapsed last week, who is already at thirty-six hours.
MedAligna lists everyone eligible in tier order, with the ineligible shown and the reason written next to them. One tap sends the open shift to the phones of everyone who can lawfully take it.
The Thursday licence
A nurse's registration expires on Thursday. She is on the rota for Friday, Saturday and the following Tuesday. Nobody notices, because the reminder email went to an inbox nobody reads.
The Friday assignment is refused at the moment it is made, with the reason on the cell. She is warned at sixty, thirty, fourteen and seven days, and so is the administrator.
The quarter-end scramble
A skilled-nursing facility rebuilds three months of hours into a CMS PBJ submission from timesheets, a spreadsheet and memory, in the week it is due.
The file is generated from hours already captured, with positions mapped to CMS job codes. The quarterly panic becomes a download.
What does 'healthcare-native' actually mean?
Three things that a general-purpose shift scheduler has no concept of, and cannot bolt on.
A licence is not a text field
It has a state, an expiry, a document, a verification status, and a hard consequence. MedAligna checks it against the END of the shift, not against today, so a licence lapsing Thursday cannot be scheduled for Friday.
A night shift is not twelve hours
It is eleven the week the clocks go forward and thirteen the week they go back. Rest, overtime and payroll export all use the real elapsed time, so the nurse is paid what she worked.
A ratio is not a headcount
Four nurses on a unit of forty is a different shift from four on a unit of twenty. Census and acuity drive the required staffing, and the coverage row turns red the day it falls short, not at month end.
Which scheduling tool lands where?
The enterprise platforms are genuinely good at clinical rules. They are simply not sold to, or priced for, most of the people who need them.
| Capability | MedAligna | Deputy / When I Work | QGenda / symplr |
|---|---|---|---|
| Blocks a shift when a licence has expired | Yes | No | Yes |
| Federal exclusion (OIG) screening | Yes | No | Partial |
| Nurse-to-patient ratios with acuity | Yes | No | Yes |
| ACGME duty hours (80h averaged over 4 weeks) | Yes | No | Partial |
| On-call rotations, escalation, equity | Yes | No | Yes |
| DST-correct rest and overtime | Yes | Partial | Yes |
| Home-care visits with travel time | Yes | No | No |
| CMS Payroll-Based Journal export | Yes | No | Partial |
| Self-serve: publish today, no sales call | Yes | Yes | No |
| Published pricing | Yes | Yes | No |
Compiled from each vendor's public documentation and pricing pages, July 2026. Deputy, When I Work, QGenda and symplr are trademarks of their respective owners; MedAligna is not affiliated with any of them. If anything here is out of date, tell us and we will correct it.
How to choose healthcare staff scheduling software
Eight questions worth asking any vendor in this category, including us. At least one of them is a question we do not answer well, and we have said so rather than leaving it out.
01Does it block, or does it only warn?
This is the single question that separates healthcare scheduling from shift planning. A tool that emails you about an expiring licence and then lets you schedule the nurse anyway has given you a notification, not a control. Ask any vendor to demonstrate an assignment being refused.
Where MedAligna lands: Blocks. Credentials are checked against the end of the shift, not against today, so a licence lapsing Thursday cannot be scheduled for Friday. An administrator can override with a recorded reason; a knowing exception and an accident should never look the same in an audit.
02How does it compute hours across a daylight-saving change?
A 19:00–07:00 night shift is eleven hours the week the clocks go forward and thirteen the week they go back. Tools that subtract wall-clock times get this wrong twice a year, and the error lands on a payslip. It is the fastest way to find out whether a vendor's engineering is serious.
Where MedAligna lands: Every duration is computed on real elapsed time, so overtime projection, labour cost and payroll export all agree, including on the two nights a year that catch everyone else out.
03Does it screen against the federal exclusion list?
An employer billing Medicare or Medicaid may not employ anyone on the OIG exclusion list. Penalties accrue per item or service, which makes it the one staffing mistake that compounds per claim rather than per incident. Most scheduling tools have never heard of it.
Where MedAligna lands: Screened per staff member with a re-screen interval, because the list is republished monthly. A confirmed exclusion blocks outright; a possible match blocks scheduling until a human resolves it, because names collide and that adjudication is the employer's, not the software's.
04Can staff swap shifts without creating work for you?
Swaps are where most scheduling deployments quietly die. If a manager has to check every trade by hand, she becomes a switchboard; if nobody checks them, the rota drifts out of compliance within a month.
Where MedAligna lands: Swaps are rule-checked before they are even offered, so a trade that would double-book someone or breach rest never reaches a manager. You can require approval or auto-approve the ones where every rule passes.
05What happens when you stop paying?
Ask this before you sign anything. A scheduling tool holds the document that keeps your floor staffed, and a vendor who deletes it, or locks you out of it, over a billing dispute has turned a finance problem into a patient-safety one.
Where MedAligna lands: A lapsed or cancelled account becomes read-only. Nothing is deleted, everything stays exportable to CSV or JSON, indefinitely. We cannot honestly ask you to trust us with the roster and then hold it hostage.
06Will your staff actually use it?
A tool the floor resents gets abandoned on the morning it matters. The test is whether it gives staff something, not merely takes their availability and hands them a rota.
Where MedAligna lands: Staff get swaps, open shifts, self-scheduling, time off, calendar sync, and a credential wallet they own that follows them between employers. They never pay a penny.
07Does it integrate with your EHR?
Some organisations genuinely need this, particularly where census flows automatically from the clinical system. It is worth being clear with yourself about whether you need it, or merely feel you should ask.
Where MedAligna lands: We do not have EHR integrations today. We export hours as a timesheet CSV your payroll system imports, generate the CMS PBJ file, and offer a REST API and webhooks on Enterprise. If a live EHR feed is a requirement, we are not your answer yet, and we would rather say so now than in month three.
08How long until the first schedule is published?
Implementation time is the hidden cost of enterprise software. A six-month rollout means six more months of the spreadsheet that is hurting you today.
Where MedAligna lands: An afternoon. Import staff from a spreadsheet, set coverage and rules once, publish. No consultant, no kick-off call, and you can drive the whole product before speaking to anyone.
What is a float pool, an OIG exclusion, or HPRD?
- Credential blocking
- Refusing to assign someone whose licence or certification will not be valid for the whole of the shift. Distinct from a credential reminder, which merely tells you about the problem and then lets you create it anyway.
- OIG exclusion (LEIE)
- The federal List of Excluded Individuals and Entities. Employing an excluded person while billing Medicare or Medicaid exposes the employer to civil monetary penalties for every item or service that person touches. The list is republished monthly, which is why a screening goes stale.
- Nurse-to-patient ratio
- The required number of nursing staff relative to patient census, sometimes fixed by state law and sometimes by internal policy. Meaningful ratio compliance requires the census, not just a headcount: four nurses on a unit of forty is not the same shift as four on a unit of twenty.
- Acuity
- A weighting applied to census to reflect how much care patients actually need. Staffing to raw headcount is how a facility ends up correctly staffed on paper and short on the floor.
- Minimum rest
- The required gap between the end of one shift and the start of the next. The rule most often broken by a night shift ending at 07:00 followed by a day shift starting at 07:00: different calendar days, zero hours of rest.
- Float pool
- Staff kept deliberately unassigned to a single unit so they can be moved to wherever the gap is. Filling from the float pool is dramatically cheaper than filling from an agency, and most scheduling tools cannot tell the difference.
- Agency markup
- The premium a staffing agency adds on top of the clinician's pay rate, commonly reported in the 30–45% range. It is the largest controllable line in most facilities' labour cost.
- HPRD
- Hours per resident day. A staffing measure used in long-term care, computed from nursing hours worked divided by resident days, and reported to CMS.
- PBJ
- Payroll-Based Journal. The quarterly staffing submission CMS requires from skilled-nursing facilities, reporting hours by job code. It is the single most common reason an SNF buys scheduling software.
- Self-scheduling
- Letting staff choose their own shifts within a window and against caps, usually in seniority tiers. It fails immediately if two people can claim the same shift and one is later un-assigned, which is why the race must be settled before anyone is told they have it.
Questions people actually ask
- What is healthcare staff scheduling software?
- Healthcare staff scheduling software builds and publishes the working roster for a clinical team: who works which shift, on which unit, in which role. Unlike a general shift scheduler, it enforces healthcare rules: it verifies licences and certifications before assigning anyone, screens against the federal exclusion list, enforces minimum rest and overtime limits, tracks nurse-to-patient ratios, manages on-call rotations, and rule-checks shift swaps before a manager reviews them.
- Which rules run on every assignment?
- Twelve: double-booking, minimum rest, maximum shift length, consecutive days, one day in seven free, hours against both the organisation's cap and the individual's own contract, ACGME averaging windows, credential validity, federal exclusion screening, skill and position eligibility, approved and pending time off, stated availability, and employment status. Each one runs in the browser as the scheduler drags a shift, and again on the server before the write lands. Some warn: overtime is a business decision. Some refuse outright, and an expired licence is one of them.
- How is it different from Deputy, When I Work or Connecteam?
- Those are good general-purpose shift schedulers with no concept of a nursing licence, a BLS certification, a patient-to-nurse ratio, an ACGME duty-hour limit, or an on-call escalation chain. They will schedule a nurse whose licence expired last week without a murmur. MedAligna refuses to, and tells you exactly why.
- Is it only for small organisations?
- No. A single clinic and a fifteen-site health system run on the same platform: multi-location organisations, departments and units, cross-facility on-call services, float pools, per-diem and agency staff are all first-class. What is small is the buying process: no sales call, no RFP, no six-month implementation.
- Who sets it up, and how long does it take?
- You do, and it takes an afternoon. Import your staff from a CSV (or paste the spreadsheet straight in), set your coverage and rules once, pick a rotation, and publish. There is no implementation project, no consultant, no kick-off call, and nothing to install. You can drive the entire product on the trial before you speak to anyone, which is the point: a tool that needs a specialist to configure it is a tool your organisation cannot own.
- How much does healthcare scheduling software cost?
- MedAligna is $99, $149 or $249 per month per location depending on team size and features, with a 14-day free trial and no card required to start. Three or more locations get 20% off. Nothing is behind a quote form: the number is on the pricing page, and you can compare it to anyone else's this afternoon.
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