For Nebraska home health agencies

Three ways to cover an open visit. One of them was built for visits.

A caregiver calls out at 6:40 AM. You can phone a staffing agency, post a shift on a per diem app, or let Rayva offer the visit to verified caregivers nearby with the price already on it. Here is what each one actually does.

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Pay per filled visit. No subscription, no setup fee, no minimums.

The three options

Two of these were built for buildings.

Staffing agencies

The traditional answer. A recruiter fills the gap from a bench of travel or per diem staff, bills you an hourly rate with a markup, and the caregiver drives wherever the patient is on their own dime. Reliable for long contracts, slow and expensive for a single Tuesday visit.

Per diem shift apps

Nursa, ShiftKey, ShiftMed and IntelyCare (which bought CareRev in January 2026) let clinicians claim shifts at facilities. They fill a lot of facility shifts, and they are built around a building: one address, one block of hours. None of them route in-home visits or price mileage.

Rayva

Built for the visit, not the shift. Your schedule flags the gap, nearby verified caregivers get an offer with base, mileage and boost already priced, the first to accept is written back into your calendar, and you pay per filled visit.

Side by side

What happens to one open visit.

Covering an open home health visit in Nebraska, three ways
	Staffing agency	Per diem shift app	Rayva
Built for	Facility shifts and travel contracts	Facility shifts: hospitals, SNFs, assisted living	In-home visits, routed and priced one at a time
How a gap gets filled	You call a recruiter; they call their bench	You post a shift; clinicians claim or bid on it	Your schedule flags the gap; matched local caregivers get a priced offer
Who does the routing	Nobody. The clinician figures out the drive	Nobody. Shifts are at one address	Rayva. Mileage is priced in and visits are chained into a loop
Continuity of care	Whoever is on the bench	Whoever claims first	Caregivers who already know the patient are offered the visit first
Pricing	Hourly bill rate with a markup, contract minimums common	Per shift, platform fee on top of the clinician's rate	Per filled visit. No subscription, no setup fee, no minimums
Mileage	Usually the clinician's problem	Not applicable; one site per shift	Priced into every offer, paid to the caregiver
Storm days and call-outs	Same phone tree, longer	Shift may go unclaimed; you raise the rate by hand	Boosts apply automatically, up to 2x, and offers cascade until covered
Credentialing	Agency-verified, re-done per contract	Platform-verified for facility work	One credential passport: license, background check, CPR, competency, shared with every agency
Writes back to your schedule	No. Someone re-keys it	No. Someone re-keys it	Yes. The fill lands in your calendar with the caregiver's name
Where it works today	Everywhere, at a price	Cities with facilities; Nebraska coverage is metro-only	Nebraska, county by county, as caregivers join

Staffing agency and per diem app columns describe the typical model, not any one vendor. Nursa, ShiftKey, ShiftMed and IntelyCare all serve facilities; see their sites for current coverage. Rayva is opening county by county in Nebraska during 2026.

An honest read

When each one makes sense.

Use a staffing agency when

You need a nurse for thirteen weeks, a specialty you do not employ, or coverage in a state where you have no bench. Contracts are what they are good at.

Use a per diem app when

You run a facility. A twelve-hour shift at one address with a bidding pool is exactly the problem those apps solve, and they solve it well in metro areas.

Use Rayva when

The gap is a visit, not a shift. A personal care stop in Beatrice, a wound care visit in Fremont, a start of care in Holdrege. Anything with a drive in it and a plan of care behind it.

Fair questions.

Can I use Rayva alongside a staffing agency?

Yes. Most agencies keep a staffing relationship for long contracts and use Rayva for the single visits and call-outs that a recruiter cannot fill in time. There is no exclusivity and no minimum.

How is Rayva priced?

Per filled visit. You pay only when a caregiver completes a visit Rayva covered. No subscription, no setup fee, no minimums. The caregiver's base rate, mileage and any boost are set before the offer goes out, and Rayva's fee is on top of that, never taken from the caregiver.

Do the per diem apps cover home health at all?

Some list home health agencies as clients, but the product is a facility shift: one address and a block of hours. They do not route between homes, price mileage, or write the fill back into a home health schedule.

Who verifies the caregivers?

Rayva does, once, and re-checks automatically: state license or registry, state and national background check, abuse and neglect registries, CPR, and for aides the Medicare competency evaluation. You see a verified passport, not a stack of PDFs.

What does Rayva need from us to start?

A schedule connection or a manual gap entry, your visit types and rates, and a supervising RN of record for skilled visits. Join the agency waitlist and we will walk through it with you before your county opens.

Stop dialing. Start filling.

Join the agency waitlist and we will show you how a filled visit lands in your schedule before your county opens. Pay per filled visit, nothing else.

Join the agency waitlist

Want the caregiver side? See how visits reach workers or where Rayva opens first.