Case Study
A senior living community had become dependent on agency staffing to fill shifts. What started as a temporary solution to cover shifts had become a crutch. Agency caregivers were filling 67% of shifts every week, at premium rates that strained the budget.
The costs went beyond the invoices. Agency staff don’t know residents the way full time team members do. They don’t know that Mr. Smith needs some extra TLC to accept his medicine, or that Mrs. Rodriguez becomes anxious if her routine changes. Care quality suffers when the providers are constantly rotating.
Agency dependence also undermines permanent staff morale. Regular employees see agency workers earning higher hourly rates while knowing less about the residents. They cover for agency staff who don’t know where supplies are kept or how the building’s systems work. Resentment builds, and good employees start wondering why they stay.
Eliminating agency required solving the underlying staffing problems that created the dependence in the first place.
The team conducted an honest assessment of why positions were vacant or why permanent staff weren’t available for shifts. The answers varied: some positions had been open for months with inadequate recruiting effort, some staff had reduced availability due to scheduling conflicts that could have been accommodated, and some shifts were chronically short because turnover kept depleting the team. And the staff that were left felt overworked and underappreciated! They felt like no one listened.
Recruiting efforts intensified. Job postings were refreshed, pay rates were benchmarked against competitors, and the hiring process was streamlined to move faster when good candidates appeared. Every open position received active attention. There were so many vacancies we actually made a pipeline whiteboard with the team. It showed every stage of the hiring & on boarding process and every candidate listed at the stage they were in.
We also took staff feedback to heart. They wanted clearer communication from leadership about scheduling, call off procedures, leave procedures. They wanted leaders who would jump in when staff was short. This took buy in- and some off hours commitment- from the whole team. The factors driving turnover (see related case study) were addressed systematically. Staff who had reduced their hours were approached about increasing availability, with genuine flexibility offered in return.
Scheduling practices improved. Better forecasting of needs, cross-training to increase flexibility, and willingness to adjust shifts to accommodate staff lives all contributed to having the right people available for the right shifts.
The community achieved complete elimination of agency staffing (it took six months!):
The community has maintained agency-free operations since the transition.
Agency staffing is a symptom, not a root cause. Communities that simply try to reduce agency usage without fixing underlying staffing problems will fail. Those that address morale and team spirit, recruiting, retention, and scheduling systemically can break the dependency entirely. The financial savings are significant, but the improvements to care quality and staff morale matter even more.
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