In this paper we use inductive and deductive methods to explore the role of empathy in caregiving jobs: Specifically, the relationship between empathetic care, patient safety and employee turnover. We argue that empathetic care is evidenced by extra-role behavior, emotional engagement, and relational richness between paid caregivers and clients. We develop our model using qualitative interviews with paid caregivers, and test it using quantitative case studies in six skilled nursing facilities. We find that empathetic care predicts patient safety but not employee turnover. Moreover, we find that job and life circumstances moderate the relationship between empathetic care and safety. Specifically, patient load, overtime work, and financial hardship dampen the otherwise positive relationship between empathetic care and safety. We find some evidence of a moderating effect of employee self-efficacy in influencing the relationship between empathetic care and turnover. We discuss the implications of these findings for the design of care jobs.