Grayson County regional health Center is a private, not-for-profit, 225-bed acute care hospital located in the rural community in the southeastern state. The Hospital provide a broad range of inpatient and outpatient services Including Cardiology, obstetric, internal medicine, neurology, general surgery, urology, family medicine, dermatology pediatric, psychiatry, radiology, occupational medicine, and rehabilitation center. the center offers 24- hours emergency care. The center is built on 96- acre site and its service area include Grayson county and parts of the three neighboring rural counties. In the last 20 years, the region has suffered severe economic setbacks. Most of the textile industry has moved out of the region because of outsourcing, and the town itself has fallen into disrepair. An increasing proportion of the population 33 % of children and 22 % of the elderly lives below the poverty line. The County civilian labor force of 27585 and currently has an employment rate of 13 %. The county’s infant’s mortality rate is 2 %, and 24 % of the population does not have Health insurance. The center has 85 Physicians representing 29 subspecialties, On staff. It has affiliation relationship to academic health centers -One about 90 miles away, and the other 100 miles away. The center Employees more than 800 employees, is fully certified by the joint commission and is certified to participate in CMS program. The center is governed by an 18-member board of trustees, which includes the chief of the medical staff, Immediate Past Chief Medical staff, the chief executive officer and 13 Members selected by the board from the community at large. The center has strong community ties. its staff members participate in the community Health screenings, Health education programs and health fairs. It serves as the meeting Place for many supported groups. although it has been under financial stress for the Last five years, it's continued to have a strong support in the community. The Employees turnover rate at the center is 40 %. Over the last few years, The turnover rate from 15 to 50 %. Physician recruitment and retention are also a major concern. Currently, only one radiologist Is practicing in Grayson County, and there is a shortage of physicians in all specialties. The center relies heavily on Medicaid and Medicare revenue, Leaving the hospital in a difficult Financial condition. It is unstable to pay market rate for nurses and other professional, so nursing units are understaffed and staff Feels overworked and underpaid. The quality of patient care to may also be decreasing. A local newspaper article reported that Patient at the center were often left on stretchers in the hallway for a long period of time, Staff were unresponsive to patients and family concerns, and cry in the hallway is not unusual. nurses. and other professional groups report for communication between senior and management and employees. Bad relationship between middle managers and Front-line staff are also a problem in some departments. This situation became particularly difficult two years ago when the center embarked on the large building project. The employee could not understand how the center could afford to build a new facility but was able to play Market staff to its staff. The nursing turnover problem at the center has reached crisis proportions. recent exit interview Surveys indicate that financial concerns are the major reason for leaving. The center has tried numerous strategies including improving the work environment by adding amenities (Such as lower prices in the cafeteria) of the and training middle managers. For a short time 18 months ago, nurse salaries matched Market rates, But the center fell behind again shortly thereafter. The RN vacancy Rate recently 18 %. Ask a consultant to the center, you are expected to make accommodations to address the nursing shortage. Specifically, you have been asked to develop short-term strategies to cope with the current Crisis and long-term strategies to improve the overall recruitment and retention picture. Consider the following A. How would you identify the most important reasons for the current shortage? B. How will you develop a short time and long-term strategies?