Traveling nurses’ pay detailed
Companies charge hospitals $150 hourly rate, panel told
The University of Arkansas for Medical Sciences and St. Bernards Medical Center in Jonesboro now have more than 100 travel nurses each, officials for the two hospitals told state lawmakers Monday.
St. Bernards pays a rate exceeding $150 an hour to a company for travel nurses and UAMS pays a similar rate, officials for the hospitals told a joint meeting of the House and Senate Public Health, Welfare and Labor Committees.
They said the two hospitals used travel nurses under short-term contracts before the covid-19 pandemic and have increased their use during surges of cases.
Rep. Fred Love, D-Little Rock, asked why the hospitals pay these rates to travel nurse companies when starting nurses in Arkansas are paid much less.
Love asked whether he was the only person in the committee meeting room who thinks that it doesn’t make sense to pay a traveling nurse company more than $150 an hour when he said new registered nurses start making slightly more than $22 an hour at UAMS.
“This is absolutely crazy to me,” he said. “What are we doing about it?”
But House Public Health, Welfare and Labor Committee Chairman Jack Ladyman, R-Jonesboro, said the $22-plus hourly rate paid to new registered nurses at UAMS doesn’t include the cost of medical benefits.
“You got to be careful when talking about that $150 and comparing it directly to $22 an hour,” he told Love.
“It is not apples to apples. I don’t know what is. But there [are] additional costs to this,” Ladyman said. “We just have got to be careful about that.”
In response, UAMS spokes
woman Leslie Taylor said a new registered nurse at UAMS without a bachelor’s of science in nursing starts with a salary of $22.97 an hour. A new registered nurse at UAMS with a bachelor’s of science in nursing starts with a salary of $23.97 an hour, she said.
The average registered nurse at UAMS makes $34 an hour, she noted.
BILLING COSTS
Michael Givens, administrator at St. Bernards Medical Center, told lawmakers that the bill rate of more than $150 an hour is paid to the travel nursing company.
“We are not privileged to what the nurse makes,” he said.
The rate paid to the travel nursing company includes travel, health care and other additional costs, Givens said.
“That rate does ebb and flow, so right now that’s what our rate is,” he said. “If you go back two to three months ago, that rate was well below $100. So it is totally contingent right now upon the covid pandemic and contingent upon where the hot spots are with hospital admissions. So if the state has significant hospital admissions, you are going to see that rate rise to the level that it presently is. If the numbers go down, it is going to drop very quickly.”
Givens said he’s never seen rates this high before, and “we don’t specifically like paying those rates either.
“But the other option or the other choice is to actually close beds,” he said.
Givens said the medical center started using travel nurses about five years ago because of the lack of registered nurses and licensed practical nurses in the region St. Bernards serves.
“We actually started with two travel companies,” he said.
Arkansas has had a long-standing history of using nurses from the Philippines, Givens said.
“So we actually used a nursing program … out of Nashville, where we actually brought nurses from the Philippines on site to Arkansas and actually they worked for three-year contracts and many of them actually stayed and ended up being permanent nurses at our facility,” he said.
Givens added that the medical center started using a company that acts as a clearinghouse to find candidates with different travel nursing companies and the medical center interviews the candidates and “then they give us a bill rate.”
“The rate they bill us is set by really by the rates nationally and based upon that we either accept or decline,” Givens said. The contracts usually range from six to 12 weeks, he said.
“When we started that, we didn’t have a great deal. We just needed to supplement,” he said. “Covid has significantly intensified it as we have had to add additional staffing for additional beds.”
For example, in December 2021, the medical center had about 50 more patients than it had in December 2020, Givens said.
“When you have a labor pool that is already strained and you have to add those beds, that’s where traveling nursing becomes that option because you have to stand up beds very quickly to meet the demand of covid within in your community. And really the only option is to utilize travel nursing.”
Rep. Mary Bentley, R-Perryville, asked whether the rates charged by travel nursing companies should be turned over the attorney general’s office to investigate for price gouging.
Jodiane Tritt, executive vice president for the Arkansas Hospital Association, said other states have tried to place caps on payments made to travel nursing companies, but they were unable to obtain nurses so that worsened their problem.
“I don’t think anybody has the answer because it is a supply and demand issue literally all over the country,” she said, ”But please know we are trying to do it in a way that makes sense and that still rewards those nurses that we desperately need in our hospitals doing the work every day.”
Givens and Tritt thanked lawmakers for authorizing the use of federal coronavirus funds for hospitals hit with rising costs due to the pandemic.
In response to another question by Love, Givens said St. Bernards has increased salaries for nurses in the past two years.
The medical center gives the staff the first opportunity to work additional shifts and pay them incentive and bonus pay for the additional shifts, he noted.
Ladyman said he understands that pay is a significant issue in any job, “but I think availability, and supply and demand is another issue here.”
“You might raise that to $40 an hour and still not be able to get nurses if there are not qualified, educated, experienced people out there,” he said.
NURSING SCHOOL
Ladyman said the state has had a nursing shortage for a long time and one problem is insufficient nursing faculty to educate nurses.
“My granddaughter is in nursing up at the U [of] A and there is not slots available,” he said.
Noting several discussions with an Arkansas State University nursing program official, Givens said there needs to be more nursing instructors so the slots for students can be expanded. The state needs to promote nursing as an attractive profession in high schools and provide incentives to go into the nursing field, he said.
“You do have to go all the way down to the root issue, which I think is the labor pool within our state and address it from that perspective,” Givens said.
“Increasingly that pipeline is critical,” said Trenda Ray, chief nursing officer and associate vice chancellor for patient care services at UAMS.
For example, she said her goal was to hire about 100 more nursing graduates last summer, but she was only able to hire just over 60.
She said she hoped to hire 60 nursing graduates this fall and so far only about 20 have accepted positions. The class sizes are small and nurses have other options, Ray said.
“I would love to see us target and really find individuals who want to come into this profession and support them and make that happen,” she said.
Sen. Ben Gilmore, R-Crossett, pressed Sue Tedford, director of the state Board of Nursing, about what the Legislature could do to reduce the shortage of nurses.
She praised state lawmakers for increasing from $50,000 to $100,000 the amount of nursing student loans through Act 769 of 2021.
“One thing that has been talked in several meetings that I have been in is possibly tax credits particularly for faculty,” Tedford said.
“We have talked about in some of the committees about giving money to faculty. Tax credits might be something that would be sustainable over a long-term period,” she said.
Some nursing educators come out of graduate school owing $30,000, $40,000 or $50,000 in loans, “so some loan forgiveness would help, too,” Tedford said.
The Board of Nursing has approved more than seven new programs over the last few years to try to increase the pipeline and she anticipates two more programs will be approved this week, she said. The state now has a total of 61 nursing programs, she said.
It is going to take everybody coming to the table to fix the shortage of nurses in the state, Tedford said.
There are about 65,000 licensed nurses in the state, Department of Health spokeswoman Meg Mirivel said afterwards. That includes 44,719 registered nurses, 14,193 licensed practical nurses and 5,953 advanced practice registered nurses, she said.