Home Care Agency Owners: How Do You Manage Unreliable Caregivers?

I'm having some difficulty with caregivers and wanted to see how other people in the home care space manage this.

I knew going into this business that caregivers and staffing were going to be challenging. Sometimes you get caregivers who are really good, reliable and easy to work with, and then you get others who are super flaky, standoffish, call out last minute, or just don't show up.

How do you guys manage the stress of it? Does it ever keep you up at night worrying about whether someone is actually going to show up for their shift?

I'm also curious how you manage your caregiver pool. Do you purposely keep more caregivers around than you actually need? Do you have people specifically on-call or available as backups?

And when someone doesn't show up, what do you actually do? Are you going in yourself to cover the shift? Do you have someone from the office go? Or are you calling the family and letting them know you're down a caregiver and trying to figure it out?

I also have some 24-hour clients where we're using multiple caregivers working 12-hour shifts. That's probably the situation that stresses me out the most. If the next caregiver is late or just doesn't show up, the caregiver who's already there can't exactly just leave.

For anyone managing 24-hour cases, what have you done in those situations? Do you have the current caregiver stay until you find coverage? Do you pay them extra/OT? Do you always have someone on standby?

Just trying to figure out what systems other people have put in place so every call-out or no-show doesn't turn into a complete fire drill.