Orange County & Long Beach, California / Private duty nursing
Deliver more of the nursing hours families were already authorized to receive.
The demand was already there. The agency needed nurses who matched the acuity, location and shift. Recruiting and faster applicant follow-up helped it deliver 404 more hours each week.
Unfilled hours fell from 876 to 600 a week.
Open cases staffed in under half the time.
More of each family’s scheduled care delivered.
Starting position
A $5.8M private duty nursing agency served 44 pediatric and adult cases. It had 2,816 authorized hours a week but delivered only 1,940. Its roster of 69 nurses could not consistently cover the required shifts.
The constraint
More inquiries would not fill the 876 authorized hours going unstaffed each week. Applicants waited 19 hours for a response, and generic recruiting did not reliably identify the nurses available for hard-to-fill shifts.
What Acensus installed
Acensus established an authorized-versus-delivered baseline, captured license, acuity and shift preferences in applicant intake, and installed rapid replies and follow-up. Recruitment focused on night and weekend availability. Matching prioritized blocks the existing roster could support, with progress visible in the weekly Ledger. The agency retained hiring, credentialing, assignment and clinical supervision.
+21%90-day engagement
Investment and return
Gross profit after direct care costs, before overhead. Annualized at the ending weekly pace; not cash collected over 12 months. This engagement ran at our earlier pricing of $7,500 a month.
The economics and what shaped the result
What the investment produced
The additional 404 weekly hours at $12.45 gross profit per hour represent $261,550 in annualized added gross profit. Investment comprised $22,500 in fees and $13,500 in recruiting media. There were 26 hires and 11 departures: a net roster increase of 15. Media cost was $519 per gross hire; fees plus media were $1,385 per gross hire.
Source: the client’s own billing and operating records. Investment includes Acensus fees and stated advertising or messaging costs. Gross profit is after direct care costs, before agency overhead; client staff time and other unlisted costs are excluded. Annualized figures are a forward operating pace, not cash collected over 12 months.
What moved: the full operating schedule
| Measure | Baseline | Day 90 |
|---|---|---|
| Delivered hours / week | 1,940 | 2,344 |
| Authorized hours / week | 2,816 | 2,944 |
| Unfilled hours / week | 876 | 600 |
| Authorization utilization | 68.9% | 79.6% |
| Case-fill time | 22 days | 9 days |
| Applicants / week | 11 | 31 |
| Applicant response | 19h | 11m |
| Interview show rate | 44% | 67% |
| Nurse roster | 69 | 84 |
| Missed-shift rate | 9.4% | 4.1% |
Reporting basis and how to read the figures
404 added weekly hours × $12.45 gross profit per hour × 52. Recruitment costs use 26 gross hires, not the net roster increase of 15.
Operating figures are client-reported endpoint comparisons. Historical client results are specific to the agency and engagement shown.
What else shaped the result
The night-shift differential rose from $2 to $3.50, and turnover increased from 44% to 47%. Two authorization reductions removed 34 weekly hours, even as total authorizations grew. This was a staffing and delivered-care result, not a claim that every new hire was retained.
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