[nightingale]

Noticed this on the Nursing Politics Forum. Hope to hear some more feedback here:


HCA will compete directly with temporary nurse staffing agencies by creating its own, aimed at reducing its temporary hiring costs. The subsidiary, called All About Staffing, will move into markets nationwide.

The Tennessean, Jan. 31, 2002

By BILL LEWIS
Staff Writer
http://www.tennessean.com/business/...ent_ID=13041445


HCA Inc. is going head-on with nurse staffing agencies in its key national markets, including Nashville, in hopes of easing a severe shortage of nurses and cutting its temporary hiring costs.

The national, for-profit hospital company is making a ''very aggressive'' move into the temporary staffing business for nurses in markets across the country, said Vice President Larry Burkhardt. An HCA subsidiary, All About Staffing, is requiring agencies to submit bids for new contracts that cut prices and eliminate non-compete clauses that prevented HCA from hiring nurses away from the agencies.

If the agencies want to do business with HCA's local operating unit, TriStar Health System, they will have to agree to the new rules.

''(For) a lot of these agencies, TriStar is their only client, so they have to come to the table,'' Burkhardt said this week.

TriStar discovered it had up to 35 different contracts and faced a situation in which the same agency might charge different prices to provide nurses to each of the 11 hospitals the company operates in the Nashville region, Burkhardt said.

''Some were getting a good deal and some were not,'' he said.

Patricia Bloch, regional manager for Favorite Nurses, a national nurse staffing agency, said Nashville-based HCA was throwing its weight around in contract negotiations.

''They'll say 'this is what it is' and you have to live with it,'' she said. ''I think it's eliminating free enterprise.''

Executives from several agencies met recently to discuss All About Staffing, Bloch said.

''Is it some kind of antitrust thing? Our company has been looking at that,'' she said.

Burkhardt conceded that some agencies had resisted HCA's overtures at first.

''Their first call was, 'how do we stop this,' '' he said. But so far, only a handful of agencies have refused to submit new bids.

Markets where All About Staffing is either in business or soon will be operating include Florida, Atlanta. Richmond, Va., Dallas, Las Vegas and Denver. Billing for all of those markets will be handled from an office in the Fort Lauderdale, Fla., area, Burkhardt said.

In Nashville, All About Staffing is leasing space for a recruiting office in the 2525 West End Building. That location, not far from Vanderbilt University Medical Center, is an indication of HCA's aggressiveness, he said.

''We're placing that office in the middle of our competition,'' Burkhardt noted. ''I'm very open about this. We're going to do it.''

HCA believes it can cut the $45 to $55 hourly rate charged by the agencies by as much as 30%. In return, nurses who sign up with All About Staffing will qualify for employment benefits, including health insurance and retirement plans.

The company will benefit by having a steady stream of nurses trained in its internal procedures. In the Nashville area, TriStar will rely on independent agencies if the supply of nurses runs short, he said.

Greg Eisenhower, chief financial officer for RehabCare Group, a national, publicly traded company whose StarMed Staffing Group does business with TriStar, said All About Staffing might have difficulty attracting nurses who want to control their own hours. He estimates that up to 20% of registered nurses choose to work through agencies. The nurse staffing business is expected nationally to generate $10 billion in billings this year.

''It is an enormous market and highly fragmented. HCA wants to consolidate it and may have some success,'' Eisenhower said.

''Owning the market seems ambitious,'' he continued. '' Lack of ambition has never been a problem for HCA.''

Bill Lewis covers the health-care business. He can be reached at 259-8075 or at blewis@tennessean.com.

The question that we need to ask ourselves as agency nurses is this: If the hospital associations and their friends in state governments are able to force agencies into lower hourly rates, would you be willing to work for All About which surely offers lower wages than the competing agencies, become a staff nurse again, or find another career? These are questions we need to be asking ourselves now. I fear that the trend will be to legislate us right back into becoming hospital employees again. Any thoughts?

[nightingale]

It is all about economics and control of the nurses.. not me.. no thank you....

I am actively seeking my own contract or through a third party who allows me to get the rate and specifics I deserve as a professional.

I hope we hear some dialogue on this ... feedback please....

B.

[NurseDennie]

Well, if you think about it, it makes a lot of sense.

HCA is all about making money. Ask any nurse at a HCA hospital! To the hospital admin., the agency situation must be galling. To a hospital, nurses are overhead. Not even that, really, it's more like we're equipment. Think about it from a business standpoint, and you'll see that's true. The goal is to make money - I guess the product is patients in and out of the hospital. We're a big part of the machinery that needs to be working correctly for the company to make a profit. If something is wrong with any one part of the the machinery, then you replace it. Quickly. If you can replace it with another machine that costs less - win/win!!!

But - At the agency, the nurse is PROFIT. The agency nurses are the agency's product. The agency provides the machinery to the hospital. They really don't have to make much in the way of investment in the nurses, either.

Hospitals here went through a phase a few years ago where they bought all the physician's private practices they could, in what I would have to assume is an attempt to control which hospital the patients are sent. It didn't work very well - I think most of the local hospitals are trying to sell the practices off!!

But if the hospitals go into the agency nurse business, not only do they stand a chance of influencing/controlling the price of the machinery they need, but they also have the opportunity to profit from the very same transaction.

I guess.

Love

Dennie

[LadyNASDAQ]

I work for AllAbout Staffing as my second job.

They are a very well-run agency. The problem is that they have no Travel company. Once that is in place, I will be first in line. They pay us well and yes, they do beat out the competition. There are good and bad HCA hospitals like anywhere else. It's about where you want to be.

[Peppurr101]

I understand that HCA has hospitals overseas as well, six in London that I know of, and one in Switzerland..
Anybody have any experience with them?

[Ekaye]

I worked for a HCA hospital in the 80's and they were ahead of the time in good treatment of nurses. Having said that--I would not trust them, to be fair to agency nurses. I don't want benefits. I want to work for a trusted company with very good pay. I want to be proud of the company that I represent.

[nightingale]

Update:

I had heard of nurses being approached at the upcoming Allstaffing facilities. They were asked to tke $12.00 an hour cuts in pay. Those nurses I spoke to laughed at the agency. The big apeal, as I see it in Denver, is they state there will be few cut off becasue of the control of staffing (control one of those words that sends me in a tail spin).

As for me, I stopped having my agency schedule me at these facilities (although they included one of my favorites). I now schedule at other facilities. For now, this works for me and I make the customary $ 30 - 34 and hour agency fee for med/surg days.

Has anyone else heard anything about this Allstaffing?

B.

[-jt]

I heard theyre going to offer some small benefits to the agency nurses which those nurses dont get now, in exchange for up to $13/hr less in salary. Their idea is to put the competetion (agencies) out of business, draw you back because they will have the area locked up, & keep your salaries (their overhead) compressed.

[caduca]

I work with AAS as a client. In one city, they provided a great service to the community by stabilizing the ridiculous bill rates that some of the agencies were charging (while still paying low to the agency nurse). We partnered with them and are their largest provider of nurses. Very few nurses joined their agency though for a multitude of reasons- primarily the loss of independence due to forced cross-training and "being pulled" to less desirable areas (that also paid less). In another city, I am not as impressed with the operation. Overall, there are "evils" to this industry that AAS can manage with good use of their leverage as HCA representation- but as an agency I feel they too often take nurses out of their own HCA hospitals to redistribute at higher cost to their own entity. I overheard an Administrator call the use of internal agencies a transfer of $$ from one set of accounting books to another in the same company.