Hospital officials explain costs of hiring itinerant nurses to Arkansas lawmakers

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The University of Arkansas for Medical Sciences and St. Bernards Medical Center in Jonesboro now have more than 100 travel nurses each, officials from both hospitals told state lawmakers on Monday.

St. Bernards pays a company a higher rate than $ 150 an hour for travel nurses and UAMS pays a similar rate, hospital officials said at a joint meeting of public health committees, the welfare and work of the House and the Senate.

They said both hospitals were using travel nurses on short-term contracts before the covid-19 pandemic and have increased their use during the influx of cases.

Rep. Fred Love, D-Little Rock, asked why hospitals pay these rates to travel nursing companies when entry-level nurses in Arkansas are paid much less.

Love asked him if he was the only person in the committee meeting room who thought it didn’t make sense to pay a traveling nursing company more than $ 150 an hour when he said that new RNs were starting to earn just over $ 22 an hour at UAMS.

“It’s absolutely crazy for me,” he said. “What do we do about it?” “

But House Public Health, Welfare and Labor Committee Chairman Jack Ladyman, R-Jonesboro, said the hourly rate of more than $ 22 paid to new RNs at UAMS does not does not include the cost of medical services.

“You have to be careful when you talk about that $ 150 and compare it directly to $ 22 an hour,” he told Love.

“It’s not apples for apples. I don’t know what it is. But there [are] additional costs to that, ”Ladyman said. “We just have to be careful of this. “

In response, UAMS spokesperson Leslie Taylor said a new RN at UAMS without a bachelor’s degree in nursing starts with a salary of $ 22.97 per hour. A new RN at UAMS with a bachelor’s degree in nursing starts with a salary of $ 23.97 an hour, she said.

The average RN at UAMS earns $ 34 an hour, she noted.

INVOICING FEES

Michael Givens, administrator of St. Bernards Medical Center, told lawmakers the billing rate of more than $ 150 per hour was being paid to the travel nursing company.

“We don’t have the privilege of seeing what the nurse is doing,” he said.

The rate paid to the travel nursing company includes travel costs, health care and other additional costs, Givens said.

“This rate comes and goes, so this is our rate right now,” he said. “If you go back a couple of months ago, that rate was way less than $ 100. It is therefore totally subordinate to the covid pandemic and depends on where the hospital admissions hotspots are located. So if the state has significant hospital admissions, you’re going to see that rate rise to where it is now. If the numbers go down, it will go down very quickly. “

Givens said he had never seen rates this high before, and “we don’t particularly like paying these rates either.

“But the other option or the other choice is to close the beds,” he said.

Givens said the medical center started using travel nurses about five years ago due to the lack of registered nurses and licensed practical nurses in the area served by St. Bernards.

“We actually started with two travel agencies,” he said.

Arkansas has a long history of using Filipino nurses, Givens said.

“So we actually used a nursing program… out of Nashville where we actually brought nurses from the Philippines down to Arkansas and in fact they worked for three year contracts and a lot of them. they stayed and ended up being permanent nurses in 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 that the medical center interviews the candidates and “then they give us a rate of billing”.

“The rate they charge us is really set by national rates and based on what we accept or reject,” Givens said. Contracts typically range from six to 12 weeks, he said.

“When we started this we didn’t have much. We just needed to top it up,” he said. “Covid has stepped it up considerably as we had to add extra staff for extra beds.”

For example, in December 2021 the medical center had around 50 more patients than in December 2020, Givens said.

“When you have an already tight labor pool and need to add those beds, this is where mobile nursing becomes that option because you have to raise beds very quickly to meet the demand for covid in. your community. And really the only option is to use travel nursing. “

Representative Mary Bentley, R-Perryville, asked whether the rates charged by travel nursing companies should be turned over to the Attorney General’s office to investigate the price gouging.

Jodiane Tritt, executive vice president of the Arkansas Hospital Association, said other states have tried to cap payments made to travel nursing companies, but have been unable to secure nurses, which made their problem worse.

“I don’t think anyone has the answer because this is a supply and demand problem literally across the country,” she said. “But know that we are trying to do it in a way that makes sense and always rewards those nurses we desperately need in our hospitals to get the job done every day.”

Givens and Tritt thanked lawmakers for allowing federal coronavirus funds to be used for hospitals affected by rising costs due to the pandemic.

In response to another question from Love, Givens said St. Bernards had increased nurses’ salaries over the past two years.

The medical center gives staff the first opportunity to work extra shifts and pay them bonuses and bonuses for extra shifts, he noted.

Ladyman said he understands that pay is a big issue in any job, “but I think availability, supply and demand is another issue here.”

“You could increase that amount to $ 40 an hour and not be able to recruit nurses if there are no qualified, educated and experienced people,” he said.

NURSING SCHOOL

Ladyman said the state has suffered from a shortage of nurses for a long time and one of the problems is the insufficient nursing faculty to train nurses.

“My granddaughter is breastfeeding at the U [of] A and there are no slots available, ”he said.

Noting several discussions with an Arkansas State University nursing program manager, Givens said there needed to be more nursing instructors so the niches for students could be expanded. The state should promote nursing as an attractive profession in secondary schools and provide incentives to enter the field of nursing, he said.

“You have to get to the root of the problem, which I think is the labor pool within our state and deal with it from that perspective,” Givens said.

“Increasingly, this pipeline is critical,” said Trenda Ray, Chief Nurse 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 was only able to hire just over 60.

She said she hopes to hire 60 nursing graduates this fall and so far only 20 have accepted positions. Classes are small and nurses have other options, Ray said.

“I would love to see us target and really find people who want to get into this profession and support them and get there,” she said.

Senator Ben Gilmore, R-Crossett, lobbied Sue Tedford, director of the State Board of Nursing, on what the legislature could do to reduce the nursing shortage.

She praised state lawmakers for increasing student nursing loans from $ 50,000 to $ 100,000 through Law 769 of 2021.

“One thing that has come up in several meetings that I have attended is perhaps the tax credits, especially for professors,” Tedford said.

“We have talked in some committees about giving money to professors. Tax credits could be something that would be sustainable in the long run,” she said.

Some nursing educators come out of graduate school and owe $ 30,000, $ 40,000 or $ 50,000 in loans, “so a loan forgiveness would help too,” Tedford said.

The Nursing Council has approved more than seven new programs in recent years in an attempt to increase the pipeline and she expects two more programs to be approved this week, she said. The state now has a total of 61 nursing programs, she said.

It will take everyone to the table to address the nursing shortage in the state, Tedford said.

There are around 65,000 registered nurses in the state, Department of Health spokeswoman Meg Mirivel later said. This includes 44,719 registered nurses, 14,193 licensed practical nurses and 5,953 advanced practice registered nurses, she said.

Representative Jack Ladyman asks about the Traveling Nursing Program at the Joint House and Senate Meeting on Public Health, Welfare and Labor on Monday January 3, 2022 at the Little State Capitol Rock. (Arkansas Democrat-Gazette / Thomas Metthe)


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