The Spark
Hillcrest Healthcare operates three skilled nursing and long-term care communities in Knoxville with over 450 employees. When COVID hit, the workforce crisis hit long-term care especially hard. Staff left, recruitment stalled, and Hillcrest found itself in what Lavonda Cantrell describes as crisis mode: the residents still needed care, and the organization needed to find creative ways to recruit and retain the people who provide it. Through United Way of Greater Knoxville, Hillcrest connected with the YMCA of East Tennessee, and the conversation shifted from what can we do about staffing to what if the answer is already inside our building?
The Solution
Hillcrest’s Beverly Park location, its largest skilled nursing community with 271 beds, had a lower level with a conference room, two offices, a fenced outdoor area, a separate parking lot, and a commercial kitchen already in operation. The building was already sprinklered and fire marshal-approved. Converting that space into a licensed child care center required minimal construction. Tennessee’s NEW Care Partnership Grant covered all capital expenses, including construction, furniture, playground equipment, and curriculum materials. Hillcrest’s out-of-pocket startup cost before the grant was under $10,000, primarily for architectural drawings.
The YMCA of East Tennessee operates the center entirely: staffing, licensing, curriculum, and enrollment. Hillcrest provides the space, utilities, and meals from its existing kitchen. The center opened in February 2026, serves children from 6 weeks to 5 years old, and runs Monday through Friday from 6:30 a.m. to 6 p.m. It has capacity for 24 children (up to 28 depending on age ratios). All Hillcrest employees across all three communities and all divisions are eligible, with full-time staff receiving priority enrollment. The YMCA helps families navigate state child care vouchers and provides its own grant funding to bridge gaps when state funding is disrupted.
The intergenerational component is what makes this model unlike anything else in this report. The activities team at Beverly Park takes children upstairs to the nursing floors in multi-seat strollers for crafts, sing-alongs, and themed visits like Traveling Tuesdays, Movement Mondays where they travel to Knoxville’s only Intergenerational Playspace also located on the Beverly Park Campus. Residents and children color Easter eggs together, do art projects side by side, and share family-style meals. Family members are excited about their loved ones having the opportunity to connect with younger generations to foster excitement and spark a new sense of purpose. For Hillcrest, the program improves quality of life for residents while simultaneously solving a workforce problem. For families considering long-term care placement, the presence of children in the building is a genuine differentiator.
Hillcrest has also built a workforce pipeline around the center through a partnership with The Mason Center for Healthcare Education. Applicants who want to become certified nursing assistants can enroll their child in the program, complete free CNA coursework through the Mason Center for Healthcare Education (Hillcrest pays tuition; the student covers books and testing) and receive guaranteed employment at one of the three nursing communities upon completion. Child care access, job training, and a career path, all in one package.
The Results
The center is only two months old, so formal financial metrics are not yet available. But the demand signal was immediate: the waitlist filled in 48 hours. Currently, all enrolled children belong to Hillcrest employee families. Roughly four of those families came to Hillcrest specifically because the child care center existed, meaning the benefit is already functioning as a direct recruiting tool.
One long-tenured nurse enrolled her five-year-old daughter and planned to move her to kindergarten in the fall. After two months, she changed her mind. Her daughter is thriving so much in the program that she is keeping her enrolled for another full year. Even employees without children in the program report that seeing the children in the building lifts morale across the board. When Hillcrest offered tours to other healthcare professionals in the area, the reaction was consistent: they could not believe it was real. Lavonda’s response: stay the course, dig your heels in. It is worth it.
THE BLUEPRINT
Investment: Minimal out-of-pocket cost. Tennessee’s NEW Care Partnership Grant covered all capital expenses: construction, furniture, playground equipment, and curriculum materials. Hillcrest’s architectural review costs were under $10,000 before the grant kicked in. Ongoing costs are limited to meals (prepared by the existing kitchen) and utilities for a space that was already part of the building. The YMCA handles staffing, licensing, and operations, funded through tuition, vouchers, and its own grant programs.
Timeline: The initial conversation began in 2020 through United Way. Grant applications and a facility search took several years. Construction and renovation moved quickly once the NEW Care Partnership Grant was awarded. The center opened in February 2026. For another skilled nursing facility with available space and the right partner, the timeline could be significantly shorter.
Partners: YMCA of East Tennessee (operates the center, provides staffing, curriculum, and licensing), United Way of Greater Knoxville (made the initial introduction and provided data on community need), Tennessee Department of Human Services (NEW Care Partnership Grant for capital expenses).
Key Decision: Putting the child care center inside the nursing facility rather than building a separate structure. Beverly Park already had the square footage, the fenced outdoor area, the separate parking lot, the sprinkler system, and the commercial kitchen. Converting a conference room and two offices was all it took. That reuse of existing infrastructure is what made the startup cost nearly zero.
Their Advice: “Find an excellent partner who knows childcare. We didn’t know anything about it, and we didn’t need to, because the YMCA did. Stay the course, dig your heels in, it’s worth it. The benefits outweigh the risk by far.” – Lavonda Cantrell, Hillcrest Healthcare