Using staffing agencies to recruit certified nursing assistants (CNAs) provides convenience, but oftentimes, facilities end up paying for that convenience in the long term.
Agency staffing is expensive, and can add up quickly – 50 to 60 percent more expensive per hour than direct hires, according to a study published in Health Affairs.
It’s also becoming a more common solution among healthcare organizations. Health Affairs reported that, as of 2022, nearly half of nursing homes used agency staff. Those personnel accounted for 11% of direct care hours, and 13% of facilities had agency staff working every day.
With agency staff working so many paid hours, one thing is clear: Facilities with strong staffing numbers aren’t paying extra for temporary workers. Each one is developing its own CNA pipeline of trained, certified and loyal professionals.
Why the Agency Treadmill Can Be a Trap
CNA turnover has reached an average of 44.2%. From mid-2024 to mid-2025, over 65% of senior living facilities used agency staff to fill the gaps.
A staggering 96% of surveyed organizations reported increased staffing costs during the same period. Approximately one in six shared that staffing concerns have had a significant impact on their operating margins.
According to one peer-reviewed study, heavier users of agency staff have higher turnover rates than low utilizers. That means agency reliance may be contributing to, not alleviating, the problem of CNA turnover.
Before spending more on agency staff, calculate how much your organization spent on temporary CNA coverage last fiscal year. That number is the foundation of your business case for building a talent pipeline.
Supporting a Customized CNA Pipeline
A talent pipeline is different than a one-time hiring procedure. It’s a repeatable system that lets you recruit, train, certify and retrain CNAs to align with your facility’s culture and standards.
The in-house training component is essential. It promotes early alignment with the organization’s culture, workflows and patient expectations, so new hires get up to speed sooner. One facility that used this model reported improved initial competency and reduced onboarding time, with graduates ready to provide high-quality care.
Defining Your Pipeline Needs
Specificity is key to an effective CNA pipeline. The first step is to identify your biggest staffing concerns and how they affect your care delivery model. Possibilities include:
- Candidate volume: You don’t have enough qualified CNA applicants to fill all positions.
- Retention: You can fill open positions, but new hires leave within 6 months.
- New hire quality: You fill gaps using agency staff who aren’t familiar with your standards, leading to friction or shortfalls in resident care.
Your top issues will indicate what features you need in a pipeline strategy. For example, if finding qualified candidates is an issue, a train-and-hire model could be the right fit. MedCerts Partner Solutions will locate and screen candidates in your region, then train the applicants you’d like to hire.
If retention issues are leaving you short-staffed, you might build your CNA pipeline around an upskilling solution. Upskilling prepares your internal talent for roles requiring specific skill sets. You keep people who know your culture and standards, and employees can access growth opportunities.
Choosing the Right Training Model
Traditional, in-person CNA training can be logistically complex. With classroom space to acquire, instructors to hire, and clinical schedules to work around, it can be too much for a busy facility to coordinate. A blended online and clinical model alleviates these constraints while maintaining the certification standards.
Consider implementing a sponsored training model in which you cover a candidate’s training costs in exchange for their commitment to work at your facility after certification. This protects your investment, builds loyalty and may help to reduce turnover risk.
Look for a program that is customizable to meet your goals and priorities, and scalable to suit changing training needs. MedCerts’s partner-exclusive CNA program is designed specifically to offer this level of flexibility, whether you’re training a few employees or launching a broader workforce program.
Trainees balance online study with hands-on clinical work, where they apply their knowledge in real-world situations. Practical experience in their future work setting helps to ensure that graduates are ready to contribute immediately, without extensive ramp-up or retraining to meet your community’s needs.
Measuring the CNA Pipeline, Not Just the Headcount
Tracking open CNA positions is important, but it doesn’t tell the whole story. To understand the health of your recruitment and onboarding process, you need to analyze your pipeline. Key performance indicators (KPIs) with that scope include:
- Training completion rates
- Time to certification
- 90-day retention
- Cost per certified hire
Set a 12-month timeline for assessing the value of your CNA pipeline. Your baseline is the amount you spend on agency CNAs, minus the base pay you’d spend on a long-term hire.
Your comparison is the total cost of training or upskilling your own cohort. You can begin tracking retention and cost-per-hire immediately, even before you begin the training program. When your first sponsored trainees graduate, incorporate training completion rates and certification time to add context.
The return-on-investment (ROI) case builds itself.
Invest in a CNA Candidate Pipeline
An upskilling or candidate training program is a commitment to your facility’s long-term success. MedCerts is here to provide customized train-to-hire, upskilling, and direct-hire solutions tailored to your needs. Speak with our Partner Solutions team today to learn more.
