Salaries of temporary nurses skyrocket, leaving nursing homes and hospitals rushing to staff facilities

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These days, hiring a temporary nurse looks like an eBay bidding war, said Brendan Williams.

Williams, president and CEO of the NH Health Care Association, said nursing homes and hospitals – desperate for a shortage of registered nurses – are all calling for the same few medical staff who parachute from faraway states to fill vacant positions.

Each interested party increasingly raises the prices charged by the agency until the hourly rates for nurses are triple or quadruple what a facility would pay their regular staff.

In the past year, nurses in New Hampshire have quit their posts en masse – since the start of the pandemic, 2,796 nursing licenses have expired for a net loss of 287 registered nurses, according to data from the NH Board of Nursing. The most recent survey from the Centers for Medicare and Medicaid Services found that 95% of nursing homes in Granite State reported a clinical staff shortage and more than half had nursing shortages.

In order to maintain staff-resident ratios required by the federal government, nursing homes often rely on temporary nurses to fill their shifts. Lawyers say recruitment agencies have taken advantage of a moment of desperation and have increased prices exponentially in recent months. Institutions are forced to pay high prices, even if this means that they can no longer afford to care for so many residents.

“Hospitals and nursing homes are being held hostage by recruitment agencies,” Williams said. “You might as well hand over a blank check if you want to get an RN. “

David Ross, the administrator of the Hillsborough County Nursing Home, said he was concerned about what rising costs mean for the sustainability of long-term care.

“It’s going to get out of hand, where the costs far exceed any ability to pay for them,” Ross said. “This is going to require us, as a whole state, to really take a look at what we can afford to provide for services for the elderly. ”

The high cost of personnel has forced many retirement homes to make difficult choices.

Ross said there were over a hundred people waiting for a bed at one point. When a bed opens, some families beg him not to have any other options. In previous years, the nursing home could accept a resident in an emergency. The establishment is no longer able to do so, he said.

On average, about a quarter of New Hampshire nursing home beds are unoccupied, according to data collected by the Centers for Medicare and Medicaid Services. Ross said this directly reflects the beds that nursing homes are no longer able to staff, either because they can’t find regular employees or can’t afford temporary workers.

Matt Lagos, the administrator of the Merrimack County Nursing Home, said his home had to consolidate two wings of the facility, taking 44 beds offline. This is in addition to the 44-bed COVID wing the house reserves to isolate sick residents.

LeadingAge, an association that represents thousands of nursing homes, many based in New Hampshire, sent a letter to the Federal Trade Commission earlier this month, asking the organization to investigate the nursing agencies. recruitment for anti-competitive and unfair practices.

“On any day or night shift, 50% or more of the direct care staff on duty are temporary agency staff,” the letter said. “As a result, nursing staffing agencies have harnessed this momentum by raising prices for long-term care providers in most markets across the country. “

Other state governments have taken the problem into their own hands. Massachusetts capped the salaries of temporary nurses, then increased maximum salaries when the demand for staff became even greater. Williams said he doubts New Hampshire officials will impose a similar cap because the state’s mantra of “live free or die” generally prevents politicians from interfering with the market.

The current hiring climate doesn’t look like a free market for Williams. He said the federally mandated workforce and the shortage of registered nurses in New Hampshire leaves nursing homes without bargaining power.

Steve Ahnen, president and CEO of the New Hampshire Hospital Association, said hiring temporary nurses was quickly becoming a major expense for hospitals.

Catholic Medical Center spokesperson Lauren Collins-Cline said in some cases a temporary nurse can earn a full year’s salary during a three-month assignment.

“It certainly contributes to the challenge and certainly contributes to the escalating costs of fighting and managing the pandemic,” Ahnen said.

Ross said his facility is in a better position than most – his annual contract with a recruiting agency insulates him from weekly or monthly rate increases. However, he said he believed agencies were making their staff more available for facilities that did not have a contract and could be charged much more.

Ross said he was concerned about the impact the experience would have on permanent staff, who work alongside agency workers for up to four times less money. Some have left the retirement home for an agency that can pay them up to $ 2,000 a week, he said.

“It’s pretty clear what this does for people: it’s very demoralizing and very frustrating,” he said.


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