Cutting caregiver time-to-hire by 48% for a Florida Medicaid agency
A 220-client Miami-Dade agency cut time-to-hire from 21 days to 11 and reduced caregiver attrition by a third with an embedded AxisCare-trained recruiting team.
-48%
Time-to-hire
from 21 to 11 days
-34%
Caregiver attrition
from 38% to 25%
-62%
Cases declined
for staffing shortage
34
Caregivers onboarded / mo
up from 12
The challenge
A 220-client Medicaid-only home care agency in Miami-Dade County was hemorrhaging caregivers to faster competitors and couldn't keep pace with referral volume. Their internal recruiter juggled job-board posting, phone screening, reference checks, and onboarding coordination alone, averaging 21 days from application to first shift. Worse, annual caregiver attrition had climbed to 38%, meaning the agency was re-staffing nearly two-fifths of its workforce every year. The compounding effect was severe: the agency turned down roughly one in five new case referrals for lack of available caregivers, the scheduling desk spent mornings covering call-outs instead of optimizing routes, and the owners were reluctantly paying overtime to a shrinking bench of reliable aides. Hiring a full-time, US-based recruiter at $55,000 plus benefits wasn't justified at their census, yet the cost of empty shifts—lost revenue, family dissatisfaction, and scheduler burnout—was far higher.
The solution
Rising Star Solutions embedded two AxisCare-trained recruiting specialists directly into the agency's workflow. We rebuilt the job-ad copy to lead with what caregivers actually care about—weekly pay, same-day onboarding, and mileage reimbursement—and syndicated it across seven boards plus two local community college job portals. We engineered a structured three-call phone screen that surfaced reliability signals (prior no-call/no-show history, commute distance, shift preferences) before a candidate ever came into the office. Our team then owned the full credentialing checklist—level-2 background, TB test, auto insurance, professional references, and Medicaid orientation completion—so the agency's HR only touched candidates who were hire-ready. We also introduced a 'ready bench' concept: three to five fully credentialed caregivers kept warm for immediate placement, eliminating the gap between an open case and a filled case. Weekly pipeline meetings with the owner kept priorities aligned, and a shared dashboard gave visibility into applications, screens, hires, and 30-day retention.
How we did it
Week 1–2: Discovery & alignment
Shadowed the existing recruiter, mapped every step from application to first shift, audited AxisCare data hygiene, and benchmarked time-to-hire against regional Medicaid agencies.
Week 3–4: Pipeline rebuild
Rewrote all job ads, launched syndication across seven boards plus two community colleges, and built the three-call phone screen and shared recruiting dashboard.
Week 5–8: Credentialing ownership
Took over background checks, TB test, auto insurance, references, and Medicaid orientation end-to-end so HR only handled hire-ready candidates.
Week 9–12: Ready-bench launch
Stood up the 3–5 credentialed 'ready bench' for immediate placement and instituted weekly pipeline reviews with the owner.
Month 4+: Optimization
Refined sourcing mix based on 30-day retention data, shifted budget toward the two boards with the lowest no-show rate, and scaled to two full-time recruiters.
The results
Time-to-hire nearly halved while attrition dropped by a third
-48%
Time-to-hire
from 21 to 11 days
-34%
Caregiver attrition
from 38% to 25%
-62%
Cases declined
for staffing shortage
34
Caregivers onboarded / mo
up from 12
"They don't just find caregivers, they find caregivers who actually show up. We stopped saying no to cases within the first quarter."
— Director of Operations, Miami-Dade home care agency
Frequently asked
Most agencies see the first credentialed hire from our pipeline within two to three weeks of engagement. Full embedded operations—owning the entire application-to-first-shift workflow—typically stabilize by week four.
Yes. Our recruiters are trained on AxisCare, HHAeXchange, ClearCare, WellSky, and Sandata. We work inside your system of record so hires flow directly into your existing onboarding and scheduling workflows without duplicate data entry.
We track 30-day retention as a core metric and treat early attrition as a sourcing problem, not a one-off. Our ready-bench model means a replacement is usually placed within 48 hours, and we adjust sourcing mix based on retention data so quality improves over time.
If you run a homecare agency,
this was built for you.
No long-term contracts. No generalist VAs. A team that already understands your workflows, your software, and what compliance means in your world.
Rising Above. Delivering Excellence.