The DFW area has an agency called Group One, which is owned and operated by the DFW Hospital Association. Under the guise of a consumer credit reporting agency, all heathcare workers can legally be blacklisted by any manager who holds a grudge or has an employee complain. Once a negative mark is put on the Group One record, it is almost impossible to find work.
IMO, this is what holds wages down for the area and why the need to get out of town nurses to fill slots, when there are over 8 nursing schools
pumping out new grads in droves every 6 months.
BTW, it is not only the hospitals that use Group One, it is also the staffing agencies, too.