Staffing Industry Analysts has released its 2026 list of the Fastest-Growing U.S. Staffing Firms. Switch came in #2 in per diem nursing and #35 overall across every staffing firm in the country. SIA ranks by compound annual growth rate, which makes it one of the few industry benchmarks measuring something hard to fake.
We’re proud to be on it. But the ranking isn’t the interesting part of the story.
The interesting part is the decision that got us here — and it was a decision to do the opposite of what nearly everyone else in our category was doing.
The bet
Switch was founded by staffing veterans who each brought more than 20 years of industry experience to the table. When the pandemic pulled the floor out from under nurse staffing nationwide, we did what a lot of people did: we built a platform.
Then we watched a wave of staffing apps launch alongside us, all chasing the same premise. Use technology to cut the middle out. Cut the relationship out. Make every shift a transaction between two strangers, matched by an algorithm, forgotten by morning.
We went the other direction. We built our platform to strengthen the relationships between facilities, clinicians, and the team supporting them — not to replace them. Faster credentialing, transparent bidding, same-day pay, real humans who know your building. Technology as infrastructure for continuity, not a substitute for it.
That was the bet. Five years of growth later, we think it was the right one.
“While a lot of tech companies wanted to create the next ‘Uber’ of healthcare staffing, that approach creates more harm than good. Residents — especially in memory care or long-term care — need continuity. Other apps rotate new people in and out every shift. That’s fine for DoorDash, but your grandmother deserves the same face that knows her by name.”
— Scott Vanderhoef, Founder & CEO
Why continuity isn’t a soft metric
In post-acute and senior care, the clinician who’s worked your floor five times knows which resident won’t eat unless someone sits down with her. She knows which hallway sets off which behaviors after 4 p.m. She knows the difference between a resident’s normal confusion and a change worth escalating.
A stranger doesn’t know any of that. A stranger has to be trained, oriented, and watched — every single shift. The facility pays for that in staff time, in errors, and in the quality scores that follow. Residents pay for it in worse care.
Rotation looks efficient on a dashboard. On a floor, it’s a tax.
It’s also measurable, which is the part most people miss. CMS builds three of the six staffing measures in its Five-Star rating out of turnover rather than hours — and those measures count agency and contract clinicians alongside employees once they’ve worked enough hours to qualify. A building that fills every shift with a different face can post respectable hours per resident day and still lose roughly a third of its staffing score. We wrote up exactly how that arithmetic works in how the CMS Five-Star staffing score actually works and how CMS calculates nursing home turnover.
What we’ve built
Switch operates today in Texas, Oklahoma, Colorado, Louisiana, South Carolina, Georgia, and North Carolina.
- Facilities we serve — skilled nursing facilities, nursing homes, rehabilitation and post-acute centers, assisted living communities, hospitals, and health systems.
- Clinicians on the platform — credentialed CNAs, QMAPs, Med Aides, Certified Med Techs, LPNs, LVNs, and RNs.
- How it works for them — they set their own bid rates, choose their own shifts, and get paid the day they work.
That last part matters as much as the continuity piece. Control over your rate and your schedule is what makes a clinician willing to come back to the same building instead of chasing whatever pays most this week. Autonomy and continuity aren’t in tension. Built correctly, they produce each other.
Who this ranking actually belongs to
“A ranking is nice. What it actually represents is a lot of people doing hard things well.”
— Ryan Tipton, President
To our facility partners: you trusted us with your buildings and your residents. We don’t take that lightly.
And to the clinicians on our platform — you’re the reason we’re on any list at all. Growth numbers are a downstream effect of somebody clocking in at 6 a.m. and doing the work well. That’s you.
What’s next
The conviction underneath all of this is simple. Residents deserve consistent, high-quality care. The professionals who provide that care deserve to build careers on their own terms. Those two things aren’t a tradeoff — and any staffing model that treats them like one is solving the wrong problem.
We’ll keep expanding into new markets and new facility types in service of both.
The full announcement is in our press release.
Facilities: if you’re covering shifts with a rotating cast of strangers, there’s a better option. Talk to our team.
Clinicians: set your own rates, pick your own shifts, get paid the day you work. Join Switch.
Sign up. Download. Start today.
Switch is the easiest way to get the shifts you want at the rates you deserve—in the best facilities in your area.