Why Healthcare Facilities Are Turning to Staffing Agencies — and What to Look For in a Partner

Ontario's healthcare sector is in the midst of a workforce crisis that shows no signs of resolving quickly. Long-term care homes, group homes, developmental services agencies, and community support organizations across the province are routinely operating with unfilled shifts, overtime-exhausted permanent staff, and significant pressure on quality of care.

In this environment, the question for most facility administrators is no longer whether to use staffing agency support — it is how to do it well. This article explores the structural reasons behind the current shortage, the genuine benefits a well-chosen staffing partner can provide, and the five questions every facility should ask before entering into a staffing agreement.

Understanding Ontario's Healthcare Staffing Shortage

The workforce challenges facing Ontario's healthcare and community support sectors are multi-factorial and structural. Key drivers include:

• An aging workforce: A significant proportion of PSWs, DSWs, and RPNs in Ontario are approaching retirement age, and the pipeline of incoming graduates has not kept pace with attrition.
• Wage and working conditions competition: The retail, hospitality, and logistics sectors have increased wages substantially in recent years, drawing potential workers away from healthcare careers that historically offered modest compensation despite high emotional and physical demands.
• Post-pandemic workforce reshaping: COVID-19 accelerated the exit of many experienced workers from institutional settings, particularly long-term care, and many have not returned.
• Growing demand: Ontario's population of adults over 75 is growing steadily, as is the proportion of adults with complex developmental and mental health needs requiring supported living.
• Geographic concentration of workers: Most trained healthcare workers are concentrated in the Greater Toronto Area and other urban centres, leaving rural and smaller communities chronically underserved.

The result is that most Ontario facilities are not choosing between agency staffing and a stable internal workforce. They are choosing between agency staffing and unmet need.

What a Good Staffing Agency Actually Provides

The most common objection to agency staffing is cost. It is a valid concern — agency workers typically cost more per shift than equivalent permanent employees when comparing direct labour costs. But the real cost comparison is more nuanced.

A quality staffing agency provides:

• Screened, credentialed workers: Vulnerability screening, credential verification, CPR/first aid confirmation, and reference checks — all of which take significant administrative time to manage internally.
• Coverage reliability: When a permanent employee calls in sick, the burden of finding replacement coverage typically falls on a supervisor or charge nurse. An agency absorbs that burden.
• Specialization matching: A good agency maintains workers with specific expertise — ABI, dementia care, g-tube management, NVCI-trained workers, bilingual workers — and can match based on your specific client population.
• Reduced HR overhead: Payroll, benefits administration, scheduling, and disciplinary processes for agency workers are handled externally.
• Scalability: Agencies allow facilities to scale staffing up or down in response to census changes, seasonal fluctuations, or program expansions without the complications of laying off permanent staff.

"The real question is not whether we can afford to use agency staff. It is whether we can afford the consequences of unfilled shifts — on our residents, on our permanent staff, and on our liability exposure."

The Five Criteria to Apply Before Signing a Staffing Agreement

Not all staffing agencies are equal. Some are genuinely invested in quality, compliance, and long-term partnership. Others are transactional intermediaries primarily interested in volume. Here is how to tell the difference.

1. Screening Rigour

Ask for the agency's written screening protocol. At minimum it should include: police record check with vulnerable sector screening; credential and diploma verification; employment reference checks (not just character references); and confirmation of current CPR/first aid certification. If the agency cannot show you a clear, documented process — or if it is vague about what checks are conducted — that is a red flag.

2. Worker Classification and Liability

Are agency workers employees of the agency, or independent contractors? This distinction matters significantly for liability purposes. Employed workers are covered by the agency's WSIB coverage, general liability insurance, and errors and omissions policies. Independent contractors may not be. Ask to see the agency's liability insurance certificate and confirm that it covers the work being performed at your facility.

3. Specialization and Matching Capability

Does the agency have workers with experience in your specific client population? A general healthcare staffing agency may be able to supply RNs and RPNs, but may not have workers with meaningful experience in developmental services, ABI, or dementia care. Ask specifically about the population you serve. A quality agency will be able to describe the training profile of the workers they are placing with you.

4. Communication and Account Management

When there is a problem — and at some point, there will be — who do you call? Is there a named account manager who knows your facility? Is there a clear escalation process? The difference between a good and poor agency experience often comes down to the quality of communication when something goes wrong, not just when everything is running smoothly.

5. Compliance with Ontario's Regulated Healthcare Sectors

If you operate in a regulated sector — long-term care under the Fixing Long-Term Care Act, a regulated developmental services organization, or a hospital — confirm that the agency understands your compliance obligations. This includes Ministry of Long-Term Care requirements, Infection Prevention and Control (IPAC) standards, and any sector-specific training mandates. An agency that sends workers unfamiliar with IPAC protocols or mandatory training requirements creates risk for your facility and your residents.

Questions to Ask Before You Sign

Beyond the five criteria above, these specific questions are worth asking in any conversation with a potential agency partner:

• What is your average fill rate for requests submitted with 24 hours' notice? With 48 hours?
• What is your cancellation rate — how often do workers cancel on the day of a shift?
• What happens if a worker placed with us does not meet our standards? Is there a replacement guarantee?
• How do you handle complaints from facility staff or residents about agency workers?
• Do you have workers available in our geographic area, or do your workers travel significant distances?
• Can you provide references from facilities similar to ours?

The Case for a Long-Term Partnership Approach

Many facilities approach agency staffing as a pure transactional arrangement — a back-fill option to be used reluctantly and replaced at the first opportunity. This approach tends to produce the worst outcomes for everyone involved.

Facilities that have the most success with agency partnerships tend to approach them differently: as a planned, integrated component of their workforce strategy. They communicate proactively with their agency contact about upcoming staffing needs, build relationships with the workers they have placed, and provide feedback when placements go well or poorly.

The agencies best suited to this kind of partnership are the ones that prioritize quality over volume — that are genuinely invested in the long-term success of the facilities they serve, not just in filling shifts.

How SFCS Approaches Facility Partnerships

At Shield Family Care Services, we work directly with facility administrators and care managers to understand your specific client population, staffing structure, and compliance requirements before placing any worker. We do not dispatch from a generic pool — we match based on experience, training, and fit with your environment.

We serve long-term care homes, group homes, developmental services agencies, and community organizations across Ontario. If you would like to explore what a partnership might look like, our facility liaison team is ready to talk.