Make the caregiver's pay rise the longer they work. Take a rising chunk of that extra pay out of the management's pay, right to the top to help incentivize the

Make the caregiver's pay rise the longer they work. Take a rising chunk of that extra pay out of the management's pay, right to the top to help incentivize them. As the rate's rise, rise them higher for the higher-level managers. Direct Supervisor of 10 staff. Ward supervisor of 50 staff. Hospital manager of, say, 500 staff. An extra 1-2 hours, +5% pay/hr, manager -1%/10, ward -1%/50, hosp man -1%/500 2nd extra 1-2 hours, +10% pay/hr, manager -2%/10, ward -3%/50, hosp man -5%/500 3rd extra 1-2 hours, +20% pay/hr, manager -5%/10, ward -10%/50, hosp man -20%/500 4th extra 1-2 hours, +35% pay/hr, manager -10%/10, ward -20%/50, hosp man -40%/500 ... While this allows a few overworked people without hurting management much, if it's widespread, it hurts management a lot, especially at the top. You may choose to introduce a cut-off where management starts getting hit hard, without the staff divisor, to really disincentivize working anyone longer than that cutoff point.