Leadership

Succession planning for small and mid-size care organizations

A right-sized succession approach based on SHRM guidance, with regulatory requirements for nursing homes and South Carolina CRCFs.

By David Shearer · Aug 27, 2026 · 1 min read · Updated Nov 5, 2026

Small organizations can run succession planning without a talent function. This approach follows SHRM guidance and ties to care-setting requirements.

Why start small

A SHRM survey of HR professionals, reported in 2024, found that more than half had no succession plan:

Succession plan statusShare of organizations
Formal plan21%
Informal plan24%
No plan56%

Lack of time and resources was the reason cited. SHRM's guidance for resource-limited organizations is to start with one leader and one role and tailor the plan to the organization.

Steps (SHRM-based)

  1. Prioritize critical roles. For care organizations that is usually the administrator or executive director, the director of nursing or clinical services, and one or two program leaders.
  2. Assess bench strength. Review current leadership results over the past two years and identify who could step in, and in what time frame.
  3. List specific development gaps for each named successor, such as financial oversight, regulatory knowledge or a required license.
  4. Use development resources you already have, and give leaders visibility into the next cohort, for example through skip-level meetings.
  5. Look externally when no internal successor is ready. Interim leadership is one option to keep operations steady during a search.
  6. Measure and adjust at least annually.

Regulatory hooks

SettingRequirementCitation
Nursing homesEmergency plans must address continuity of operations, including delegations of authority and succession plans42 CFR 483.73(a)(3)
South Carolina CRCFsThe administrator must hold a CRCF administrator license, and a staff member must be designated in writing to act in the administrator's absenceR.60-84 §502

A named successor with the right license is a compliance advantage, not just a leadership one.

Sources: SHRM (April 2024); 42 CFR 483.73; SC R.60-84 §502.

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