Carl* oversees eight nursing and rehabilitation facilities in Massachusetts. When his group signed on with Carefam in late 2025, he structured the partnership with clear parameters: LPN roles only, and every candidate had to pass through him before a facility reached a candidate.
“I wanted the only access,” Carl said during a call with his facility HR teams in July 2026. “I was looking at every candidate and approving them and pushing them into the facility.”
His buildings were relying on contracted staff to cover the gaps in the meantime. CMS payroll records from Q4 2025 show the group was filling an estimated 17% of all direct-care nursing hours with agency workers, roughly one in six nursing shifts. At two of the eight facilities, more than half of all RN hours came from contract staff. It was clear to leadership that they needed to make and retain full-time hires.
In their initial, tightly controlled set-up, Carl was able to get candidates in his weekly batch. He had roughly 47 interview requests queued in the portal. Three or four were moving forward. But the rest were waiting on Carl.
Putting Trust in a New Process
On April 15, 2026, Carl restructured how the partnership worked.
He moved all eight buildings to an unlimited model, opened hiring to CNAs and RNs alongside LPNs, and removed the central approval step. The Carefam batches went from seven or eight candidates per week, to sixty. Carl remained the primary user of Carefam for the time being.
Within two weeks, the group went from one pending offer to fifteen. Eleven hires followed in that same window.
Results: New Hires and Less Agency
From March through July 2026, Carl’s group hired 29 permanent clinicians across seven facilities: 23 CNAs, 3 LPNs, and 3 RNs. All 29 are still employed.
Two buildings are now fully staffed and no longer accepting candidates from the platform. The other five are still hiring.
Full Rollout
Twenty-nine hires surfaced a gap in how the group was operating. Each building’s HR team had been receiving candidates but not actively managing the pipeline. Carl had been carrying that.
In July, he organized an onboarding call with HR managers from across his six renewing facilities. His goal was to give each HR team direct access to the candidate portal so they could review profiles, approve or decline candidates, and manage their own pipeline without routing everything through him.
“Now we’re moving into a second stage,” he told the group, “where I’d like every one of the HR teams to work hand-in-hand with Carefam.”
Moving Forward
After the success in Massachusetts, this chain is exploring how additional facilities in New Jersey can benefit.
*Name has been changed for anonymity.
