HCA creating own temp nursing staff

  1. 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/a...nt_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.
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  2. 9 Comments

  3. by   Mijourney
    Hi. Seems vintage HCA. They're known all over as pure for profit.
  4. by   nightingale
    Sounds like price fixing, control, and eventually less money for agency nursing. They may be also able to swindle a deal for the agency nurse to "be part of the staff pool" and no buy out money needed to acquire the agency nurse....

    I am going to copy this over to the Agency Forum Board and hope to get more feedback...

    I am with a HCA Hospital as agency now in Denver... There is a terrible shortage there.... They are paying their day nurses double time plus a bonus (in some instances) to allow slots for agency nurses who will fill thier day slots and refuse to work nights....

    Thanks Karen...
  5. by   teeituptom
    I work for a HCA facility in the Dallas area. Before all about nursing was formed, each and every single HCA facility had to negotiate individual contracts with the agencies in the area. The same agency for different HCA hospitals would charge widely varying rates to the hospitals. And it varied for some between 15 and 20 dollars an hour, in differences. What all about nursing does is provide a more equitable charging system. For example Med City Dallas may have been charged 60 dollars an hour for a rn,when North Texas Medical Center may have been charged just 45 dollars an hour. Were similar inequalities going on, YES. Were agencies pulling their nurse from one hospital where they were booked to another hospital that payed the agency more, Again YES. Did this cause Hca facilities to compete against one another. YES. Were the agency nurse themselves seeing any of the differences in their pay, as one hospital paid a higher rate than another, NO. Im aware of this as I am also an agency nurse.
    The agencies themselves gathered 30 to 45 percent of the costs charged to the hospital. They much preferred the 45 percent. That is easily understandable. If the agency however got 35 dollars an hour. It didnt matter which hospital they worked. They did not get a similar increase,Yes agency nursing is big business. Young nurses can go to a higher pay grade than staff and have less experience. Plus have greater freedom arranging their schedule. I dont fault them for this atall. But the agencies themselves were charging usurious markups, and offering little to their employees. Its gotten better in recent years maybe because of businesses such as HCAs Allabout staffing.
    All about staffing also has a smaller markup, wherte more of what they make goes to the nurse. Alomg with generally better benefits. So nurse prosper with it, the company prospers with it. and eventually the patients prosper from it also. Is this price fixing. I dont think so. Does it help to stabilize an out of control marketplace for agencies, I think it helps. Most agencies have gone along with it, leastways in the Dallas-Ft Worth area. HCA has too many interests in this area.
    Has it hurt the agencies in this area,NO. One of my golfing buddies has his own agency. He is still making a bundle. And you ought to see the new clubs hes bought.In fact having preset contracts has made his job even easier, and he gets to play more golf. Cant complain there.
    Somebody said HCA was profit driven, Yes they are. Is there something wrong with making a profit. Not that I can tell as we live in a wonderfull, capitalist society. I love it. And Ive been around for a long time and I hace never seen a hospital that didnt count dollars, and expenses,and costs. And have time studies. They all do in one way or another.
    Ive been staff with HCA for 15 years now.Ive also agency nursed off and on periodically. Staff salaries have raised significantly along with benefits. Agency wages have not raised significantly, nor have their benefits. Their benefits are improving but this may be due to competition from All About Nursing.
    So whether this is all good or bad depends on your personal experiences. I will also leave that part to people who are smarter than me. An economist I am Not, obviously.
    Have fun yall
    Thomas Livingston Rn
  6. by   nightingale
    One of the night nurses confided that she was "offered" a job with All About Staffing instead of her agency.... nice.. oh yeah.. with a $ 12.00 cut in pay... she was smart enough to turn it down....

    Time will tell.... I shall keep my eyes open....

    I love agency work..... I do not like the thought of "one agency" having the upper hand or the edge on the market in hope of winning the nurses, weakening the other agencies, price regulating, and potential for take over of the majority of the market...

    Vivala free enterprise....

    B.
  7. by   Charles S. Smith, RN, MS
    Originally posted by nightngale1998
    Sounds like price fixing, control, and eventually less money for agency nursing. They may be also able to swindle a deal for the agency nurse to "be part of the staff pool" and no buy out money needed to acquire the agency nurse....

    I am going to copy this over to the Agency Forum Board and hope to get more feedback...

    I am with a HCA Hospital as agency now in Denver... There is a terrible shortage there.... They are paying their day nurses double time plus a bonus (in some instances) to allow slots for agency nurses who will fill thier day slots and refuse to work nights....

    Thanks Karen...
    We have experienced the All About Staffing entre here in the Richmond Market. It has been met with mixed reviews. There was talk of a mass walk out just the last couple of months. The experience of nurses who work with them is very mixed. Many are migrating back to agencies. There are many hidden issues that supports this service. So, buyer beware!
  8. by   rjlrn95
    This has been on the Delphi Forum for RN's for 4-6 wks, keep spreading the word and support our fellow nurses and agencies to fight this. We keep losing ground instead of gaining.
  9. by   oramar
    Dear rjlrn59, could you post a link to this Delphi Forum? Would like to go there and see what it is like. When Karen first posted this my first thought was this. This will work if they treat the nurses they hire well. If it is the same old, same old stuff it will not work.
  10. by   -jt
    <All About Staffing instead of her agency.... nice.. oh yeah.. with a $ 12.00 cut in pay... she was smart enough to turn it down.... >


    They figure nurses will accept the cut in pay in return for benefits that most agencies dont offer. But its a nursing shortage - supply and demand principles should rule. They wont if nurses accept this scheme. Good for your friend!
  11. by   nightingale
    You just have to be aware of the options out there.... My agency and others I have talked to will get you to "lock into a set amount of hours with that agency to gain free or almost free benefits such as health care / dental, some even offer PTO (paid time off)

    Knowledge is power.....

    Having All About Staffing "recruit" for the hospital avoids the "hospital" from having to pay a "buy out fee" (usually in the area of $ 5-6,000) to the "agency who first brought the nurse to the facility".... Apparently, they are also trying to lower the fees for rates etc...

    Amazing.... united we stand.. and yes, the market will rule....

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