Twelve miles southwest of Philadelphia, there was a nursing and rehabilitation center that had a problem. They were on a hamster wheel of short staffing that is common for skilled nursing facilities: their shifts could not be covered by their full-time clinical workers, so they leaned on staffing agencies to meet their census. Over time, this had degraded both the working culture and the quality of care: they had a 2-star CMS staffing rating, and full-time clinicians were leaving faster than they could hire.
By August 2025, they were spending $59,600 per week on temporary staff, and making up ground on hiring felt out of reach. Agency workers carried a 35-40% markup over direct hire rates, and they would arrive without knowing the residents: their routines, preferences, and the small details that matter during this vulnerable stage of life.
It fell to just one HR manager, Carolina B.*, to follow up on applications, reschedule missed calls, keep candidates warm, and organize orientations. If that was all she was responsible for, it would be barely manageable. But Carolina was also in charge of managing census, compliance, family calls, employee retention, benefits, and everything else needed to keep the building running.
Applications stalled and candidates went cold, and every week agency workers filled the gap. It’s at this point that this facility met Carefam.
Rebuilding the Full-Time Baseline, One Hire At A Time
The facility partnered with Carefam in late August 2025. Carefam surfaced clinicians who weren’t actively searching: candidates who hadn’t applied anywhere recently but were open to the right opportunity. Carefam’s conversational AI reached out to each one individually, asking about their availability and what they were looking for in a next role, and matched the strongest fits to the facility’s open positions.
Each week, Carefam sent Carolina a batch of candidates matched to the open roles and already screened for availability and commuting distance. She reviewed them, clicked “Advance to Interview” on the candidates she wanted to move forward to an interview, and passed on the rest. The whole review took about 12 minutes per week.
Impact on Agency Spend
Agency spending dropped in the first week and kept dropping.
From late August through late January, the facility made 74 permanent hires: 48 CNAs, 22 LPNs, and 4 RNs. Eliminating the temporary workforce also removed approximately $17,000 per week in markup costs, based on the agency rates they’d been paying.
Three months after starting, 83% of those hires were still active (over 1.5x the long-term care industry retention average). In a building that had been cycling through agency and permanent staff alike, that number meant the churn was finally stopping.
“You Guys Make My Life Easier”
Carolina managed hiring at the facility through the fall of 2025 and ran the weekly Carefam candidate batch reviews from the start. Before she left in November: “We’re very happy with Carefam here. A lot of the candidates who still work here came from Carefam.”
After she left, the hiring continued, supervised by the Administrator. Agency spend, which was at $5,000 by late December, reached zero in January.
The Administrator summed it up during their quarterly business review in December: “Last week, our nurses and CNAs were discussing how helpful Carefam was and how much they love it. You guys really make my life easier.”
The Key to AI Hiring Success: Open and Honest Feedback
Results like these take a facility that shows up as a partner. Carolina and her administrator came in open to trying something new, reviewed their weekly candidate batches carefully, and gave Carefam honest feedback week after week. That feedback is what sharpened the matches over time, and gave candidates a superior hiring experience. Ultimately, that feedback loop drove the successful hiring pace for this facility.
Now, this facility is on track to improve their staffing star rating with incremental and consistent improvement.