Weekly BD focus: Maryland, Wisconsin, South Carolina.
Facility/vendor-facing BD prioritization for Jose Suarez, Business Development Specialist, for the week of July 20-24, 2026 — screened against MNA's active-license gate and scored with a 100-point demand/access model.
1. Executive recommendation
Three primary states, two secondary/watch-list states, and two states ruled out this week.
Maryland (MD)
PrimaryAscension Saint Agnes (Baltimore) held a second strike July 6, 2026, over unresolved patient-safety/retention issues; Maryland's new Safe Staffing Act (SB 411, signed April 28, 2026) mandates hospital staffing committees; RN vacancy up to 25.4%.
Wisconsin (WI)
PrimaryReady-to-deploy southeast Wisconsin standby recruiting package plus an active regional narrative (NEW Healthcare Alliance), even as the state ratio bill stalls this session.
South Carolina (SC)
PrimaryCNA certification-testing backlog remains unresolved (~4,000 trained aides still not working), continuing to squeeze LTC staffing; Prisma Health / Qualivis-SCHA remains MNA's most actionable direct pipeline.
North Dakota (ND)
SecondaryFederal 24/7 RN mandate will hit rural ND nursing homes hard (~14% currently compliant); Golden Acres Manor relationship remains a usable rate anchor for cross-sell.
Michigan (MI)
Watch-listMichigan Medicine dispute resolved July 9, removing last week's acute driver. MyMichigan Alma's own strike (~July 1-4) still signals volatility worth monitoring, not acting on.
Arkansas (AR)
Ruled outNo new signal since May 5, 2026, when Woodruff County Health Center declined new agreements. On hold until that internal signal changes.
Pennsylvania (PA)
Ruled outStill crossed out pending license renewal confirmation as of the May 8, 2026 licensing document. No newer authoritative source confirms renewal.
2. Ranked evidence table
100-point model: 30 demand · 25 access · 20 fit · 15 urgency · 10 feasibility.
| Rank | State | Confidence | Demand signal | Actionable opening | Main barrier | Action this week |
|---|---|---|---|---|---|---|
| 1 | Maryland89/100 | High | 2nd Ascension Saint Agnes strike + Safe Staffing Act mandate | Direct outreach to non-Ascension systems & independent SNFs | Ascension itself uses a contracted vendor already | Build/enrich MD direct lead list; open non-strike-affected systems |
| 2 | Wisconsin84/100 | Medium-High | NEW Healthcare Alliance regional coordination | Deploy existing SE Wisconsin standby package | Ratio bill unlikely to pass this session | Deploy standby package; call Bellin Health / ThedaCare |
| 3 | South Carolina81/100 | High | CNA testing backlog (~4,000 aides) squeezing LTC | Prisma Health contact list + Qualivis/SCHA path | MSP-controlled at Prisma; registration not started | Get Isabel's approval for Prisma outreach; start Qualivis/SCHA reg. |
| 4 | North Dakota77/100 | High | Federal 24/7 RN mandate hitting rural facilities | Golden Acres Manor reference pricing for cross-sell | Small total regional volume | Call rural ND SNFs near Carrington using GAM as reference |
| 5 | Virginia70/100 | Medium | 17,000+ unfilled RN positions statewide | Independent SNF direct outreach (no ratio law yet) | No established MNA pipeline in VA | Build initial VA lead list; flag for a future week |
| 6 | Michigan64/100 | Medium | MI Medicine dispute resolved; MyMichigan Alma strike early July | Direct outreach if new signals emerge | Acute urgency has cooled since last week | Monitor only; do not lead outreach with Michigan |
| 7 | Georgia60/100 | Low | 2nd-worst projected nursing shortage nationally | Rural county hospitals/clinics without an incumbent | Saturated Metro Atlanta; no MNA pipeline yet | Monitor for a specific rural GA opening |
| 8 | Texas58/100 | Low | Persistent statewide travel-nurse demand | State/county procurement portals | Dominated by restricted national MSPs | Monitor public-sector bid portals only |
| 9 | Ohio55/100 | Low | Stalled state staffing-ratio legislation | Direct outreach to independent community hospitals | No mandated ratio, no acute trigger this week | Monitor legislature and central-OH hospital news |
| 10 | Oklahoma50/100 | Low | Persistent RN shortage (1.77/100 residents) | Cherokee Nation/OU education partnership signals | No acute event, no MNA pipeline | Monitor only; revisit once pipeline data matures |
Michigan's score dropped from 92 (last week) to 64 because the tentative Michigan Medicine agreement removed its primary urgency driver. Virginia and Georgia show strong demand but score lower on role/pipeline fit — MNA has no established contacts or MSP relationships in either state yet.
3. Evidence brief — primary states
Maryland (MD) High confidence
Why now
Ascension Saint Agnes RNs struck July 6, 2026 (2nd strike in a first-contract dispute open since Jan 2024). Maryland's Safe Staffing Act (SB 411, signed April 28, 2026) requires every licensed hospital to form a clinical staffing committee by July 2028. RN vacancy runs up to 25.4%, with a projected need for 13,800 more RNs by 2035. MNA holds an active, non-expiring MD Nursing Pool License.
Best facility types
Independent and non-Ascension acute-care hospitals, community hospitals, and independent SNFs not already locked into a strike-contingency vendor.
Channel status
No confirmed MSP/VMS channel yet — direct outreach assumed pending research (evidence gap). Ascension Saint Agnes is confirmed on a contracted work-stoppage vendor and should not be approached.
Target organizations
- The Johns Hopkins Hospital (Baltimore) — active travel RN openings
- MedStar Harbor Hospital (Baltimore) — active travel RN openings
- MedStar Saint Mary's Hospital (Leonardtown)
- University of Maryland Medical Center (Baltimore)
- Adventist HealthCare (Rockville/Gaithersburg)
- Independent SNFs, Baltimore metro & Eastern Shore (names not yet sourced)
Prioritized call/research list
- Build the initial MD direct-facility lead list this week and confirm current travel/contract staffing contacts.
- Do not approach Ascension Saint Agnes — active vendor + unresolved, sensitive labor dispute.
- Research independent MD SNFs as a second-tier list, leading with the non-expiring Nursing Pool License.
- Ascension Saint Agnes second strike — WYPR, July 6, 2026
- Maryland Safe Staffing Act (SB 411) signed — Governor's Office, April 28, 2026; Maryland Daily Record, June 22, 2026
Wisconsin (WI) Medium-high confidence
Why now
The Nurse Staffing and Patient Protection Act is unlikely to advance further this session (Assembly adjourned), but MNA's SE Wisconsin standby recruiting package (drafted June 18, 2026) is ready and undeployed, and the NEW Healthcare Alliance (launched late June 2026) is an active regional coordination effort worth engaging directly.
Best facility types
Community hospitals and regional health systems in southeast and northeast Wisconsin; county-operated SNFs.
Channel status
Primarily direct and FocusOne (clear channels, unchanged from last week).
Target organizations
- Bellin Health (Green Bay)
- ThedaCare (NE WI) — NEW Healthcare Alliance participant
- Aurora Health Care (SE WI) — standby-package target
- Froedtert Health (SE WI)
- Marshfield Clinic Health System
- Gundersen Health System (La Crosse)
- County SNFs — Kenosha, Racine, Milwaukee
Prioritized call/research list
- Deploy the SE Wisconsin standby package this week — ready since June 18, still not sent.
- Call Bellin Health and ThedaCare, opening with the NEW Healthcare Alliance rather than the stalled ratio bill.
- Monitor Milwaukee County procurement portals for county-funded temp staffing bids.
- Ratio bill unlikely to advance — Wisconsin Hospital Association newsletter, Feb 26, 2026
- NEW Healthcare Alliance launch — The Business News, June 29, 2026
South Carolina (SC) High confidence
Why now
SC's CNA certification-testing backlog remains unresolved — roughly 4,000 trained aides still can't start work, with only one testing vendor and eight facilities statewide. MNA's most actionable path stays Prisma Health, where CNO/HR/TA/Supply Chain contacts were compiled in May 2026 and Qualivis/SCHA is the identified vendor portal, though neither outreach nor registration has started.
Best facility types
Large acute-care systems (Prisma Health), regional hospitals, and LTC facilities affected by the CNA backlog.
Channel status
MSP-controlled via Qualivis/SCHA for Prisma Health specifically; status for other SC systems unconfirmed.
Target organizations
- Prisma Health Richland Hospital (Columbia)
- Prisma Health Greenville Memorial Hospital
- Prisma Health Baptist Hospital (Columbia)
- MUSC Health (Charleston/Midlands)
- McLeod Health (Florence)
- Spartanburg Regional Healthcare System
- Roper St. Francis Healthcare (Charleston)
Prioritized call/research list
- Secure Isabel's approval for Prisma Health first-touch outreach — pending since last week, should not slip again.
- Initiate Qualivis/SCHA vendor portal registration for Prisma Health.
- Contact SC LTC facilities to offer backup CNA/LPN travel staffing, framed around the CNA backlog.
- SC CNA testing backlog, ~4,000 workers affected — WISTV, May 29, 2026
- Prisma Health active RN hiring / sign-on incentives — Prisma Health Careers portal, July 2026
4. Five-day BD action plan
Monday-Friday, one person, no external sends without required approval.
Maryland research & compliance gate
- Confirm no restricted-MSP facilities in targeting logs
- Compile 10 new direct MD leads (excl. Ascension Saint Agnes)
- Confirm MSP/VMS status per MD facility before assuming direct access
South Carolina & Prisma prep
- Draft Prisma first-touch email; send to Isabel for approval
- Begin Qualivis/SCHA vendor portal registration
- Verify 5 follow-up contacts within Prisma Health
Active outreach: MD & WI
- Call/email the 10 MD leads — frame around Safe Staffing Act + MD Nursing Pool License
- Deploy WI standby package; call Bellin Health & ThedaCare
ND cross-sell & MI monitoring
- Call rural Carrington-area SNFs using Golden Acres Manor as reference (RN $76 / LPN $63 / CNA $42 / housing $1,000/mo)
- 30 min scanning for new Michigan signals — log only, don't act
VA scouting & weekly wrap-up
- Start an initial Virginia scouting list (no pipeline yet, no outreach hours committed)
- Update weekly Excel log; coordinate recruiter availability for MD & WI
5. Weekly BD focus email draft
Subject: BD Focus Week of 07/20/26 Good morning, Primary focus: - Outreach (calls) - MD, WI, SC - Recruiter-sent leads - Build the Maryland direct-facility lead list and get Isabel's approval on the Prisma Health (SC) first-touch email Secondary focus: - MSPs - Government accounts - Deploy the Wisconsin standby recruiting social and copy package - Monitor Michigan and North Dakota for new developments; no new Michigan outreach this week given the Michigan Medicine contract resolution Please let me know if you have any questions or need me to prioritize anything else. With appreciation, Jose Suarez Business Development Specialist
6. Sources & uncertainty
- Maryland channel status: no confirmed MSP/VMS channel identified yet; all MD targets treated as direct-outreach candidates pending confirmation.
- Maryland contacts: build-from-scratch lead list — unlike SC (Prisma) or ND (Golden Acres Manor), which have relationship history.
- Ascension Saint Agnes: confirmed already on a contracted work-stoppage vendor and in an unresolved, sensitive labor dispute — do not approach this account this week.
- SC CNA backlog: newest coverage found was dated May 29, 2026; confirm no newer resolution before referencing it as still-active in outreach copy.
- MNA licensure: confirmed unchanged from the May 8, 2026 source (31-state list, PA still excluded).
- Prisma Health contacts: compiled May 2026, carried forward two consecutive weeks — verify before first-touch outreach, which should not slip a third week.
- Virginia & Georgia: strong demand signals, no MNA pipeline or contacts — flagged for future scouting, not this week's action.