Travel agency billing for OT

Specialties Travel

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I was told by some people that if a travel agency supplies a nurse for more than full time hours in a week, the hospital has to pay the agency at 1.5x bill rate. Is this true? I would think they could charge the hospital a flat bill rate no matter how many hours, but the agency would be obligated to pay time and a half to the nurses. Does this vary by state? Frankly I'm skeptical of this persons info but just wanted to confirm.

Specializes in ICU.

yes, generally but it can depend on there contract. i believe they get shift diff too.

Historically, the bill rate for overtime is 150% of the base rate, and that goes for specified holidays as well. There are no shift differentials for travelers (thus many more night assignments than day assignments available for most specialties). Currently (and in large part due to the rise of vendor managers), hospitals that offer time and a half on the bill rate are no longer the majority. I've seen contracts at base + $10 (Medefis standard), base x 1.2, base x 1.3, and base x 1.4.

There are some contracts that also pay a flat bill rate for all billable hours. They are a small percentage of all contracts, and usually limited to 48 hour contracts, and some California 36 hour contracts (the key is 12 hour shifts). In fact that is the deal at a California hospital I'm working with now and I've seen it at one more. That is largely due to the California time and a half after 8 hours rule, even on a 12 hour shift. I could explain that one, but it would take some space and be a bit confusing.

What is underlying your query is almost certainly what an agency can afford to pay you for overtime or "gap" hours (between 36 and 40 hours). No matter what the underlying overtime bill rate is, the agency can afford to pay you no less and certainly more than you make during your regular contracted hours. I've gone over the math a number of times here, so I won't get too wordy, but consider what you are actually making for your contracted hours. It is not your base rate of $20 (or whatever), it is your base rate plus housing, plus per diem, plus insurance (if any), plus travel pay. For most travelers at most assignments, this total hourly figure is usually $50 and over per hour.

So think about that! The agency has already made a fair and expected profit on your first 36 or 40 hours and now they want to pay you time and a half on $20 (or whatever). So just when they no longer have to pay any more housing or per diem stipend, they want to drop your pay by $20. Never take less than $60 an hour for overtime. The agency will still make a profit on those hours, even if the bill rate is flat. If it is time and a half on the bill rate, the agency will make out big. If agencies want to make more money, they need to incentivize overtime. Then you both make money and you don't take a pay cut for working extra hours. Same the "gap" hours.

Some agencies will tell you (truthfully) that their payroll cannot handle any overtime rate different than 1.5. If so, discuss extra shift bonuses that will bring the effective overtime rate up to at least $60 an hour. Some agencies (Emerald is one I can name) do this as their standard (after a traveler I advised made a big fuss). That is not as "clean" as simply paying more an hour as it creates fringe possibilities (like working over your scheduled shift by three hours).

By the way, there is a nifty calculator on PanTravelers just for calculating your total pay, and estimating your take home pay. This is useful for all sorts of reasons, not just overtime. For example, it allows you to directly compare quotes from two different agencies and boil them down to a couple of different numbers that allow you to see who is paying the highest gross, and who is paying the highest net. Both numbers are useful for negotiating your compensation.

Specializes in ICU.
There are no shift differentials for travelers (thus many more night assignments than day assignments available for most specialties).

Stop it. About 10-20% of the jobs I see on Facebook have a night rate and day rate. If a hospital has a huge need on nights and a small need on days they will offer both positions but pay the night shift more..

Possible, but unlikely there is a different bill rate. I've seen perhaps a hundred agency to hospital contracts (or vendor manager contracts) and have never seen a differential.

PS if you've seen a hundred agency to hospital contracts, can you send me like 5% of those? OKAY THANKS! (the ones I have are nearly 20 years old if not older, and not complete).

Damn, I typed this huge thing out and submitted and it never actually submitted. Here goes again:

Basically the reason I am asking is that I want to be an IC for my own agency once I get my hands on some decent contracts. I wanted to get a little more creative with the staffing solutions in my area because we often run into the problem of PRN and per diem nurses not able to work when we have the need and travelers working on slow days and then happen to be off when we get slammed. What I would like to do is charge a bit more than the standard agency billing rates for short ~ 4 week contracts where I can guarantee them an ICU nurse (me) within 90 minutes of call for a particular shift (night or day) for the duration of the contract. I will guarantee myself anywhere from 96 to 144 hours that can be used at any time, including all days in a row if the need were to arise that way. With my lifestyle here, I am totally able to fulfill these "on-call" obligations.

When I told my coworker this, he said the hospital would have to pay my agency time and a half, which I don't believe is true. I think you ultimately answered the question that they can pay anything they want, including zero dollars. Is this correct?

I am not sure that I would have to pay myself time and a half or any bonuses whatsoever if I own the company. However, since the company is a separate entity that I work for and happen to own, maybe the company has to depending on state labor laws??? I don't think for tax purposes it matters in the end, but I'm curious on that. It may matter if i traveled and didn't take max tax free money I suppose.

Thanks for all of the info you provide Ned.

PS if you've seen a hundred agency to hospital contracts, can you send me like 5% of those? OKAY THANKS! (the ones I have are nearly 20 years old if not older, and not complete).

There haven't been any contract changes in 20 years that I've seen. Contracts can be as short or as long as you want, you are in control. At their heart, they are just a simple agreement in writing. You are supplying a travel nurse, they are paying for one. You put in details like rate, shift, start/stop dates; perhaps termination, hiring restrictions, and how contract disputes are handled (jurisdiction, arbitration). There isn't much else. You can do it in two pages, or 50. Bottom line is that you are not going to court (unless they don't pay you) so it doesn't have to be full of legalese. Plain english. Any contract you have should give you a start.

Damn, I typed this huge thing out and submitted and it never actually submitted. Here goes again:

Basically the reason I am asking is that I want to be an IC for my own agency once I get my hands on some decent contracts. I wanted to get a little more creative with the staffing solutions in my area because we often run into the problem of PRN and per diem nurses not able to work when we have the need and travelers working on slow days and then happen to be off when we get slammed. What I would like to do is charge a bit more than the standard agency billing rates for short ~ 4 week contracts where I can guarantee them an ICU nurse (me) within 90 minutes of call for a particular shift (night or day) for the duration of the contract. I will guarantee myself anywhere from 96 to 144 hours that can be used at any time, including all days in a row if the need were to arise that way. With my lifestyle here, I am totally able to fulfill these "on-call" obligations.

When I told my coworker this, he said the hospital would have to pay my agency time and a half, which I don't believe is true. I think you ultimately answered the question that they can pay anything they want, including zero dollars. Is this correct?

I am not sure that I would have to pay myself time and a half or any bonuses whatsoever if I own the company. However, since the company is a separate entity that I work for and happen to own, maybe the company has to depending on state labor laws??? I don't think for tax purposes it matters in the end, but I'm curious on that. It may matter if i traveled and didn't take max tax free money I suppose.

Thanks for all of the info you provide Ned.

Most of this boils down to that you can put anything in your contract that the facility agrees to. You are the only two parties that matter in deciding what contract terms you want.

I've successfully negotiated straight time contracts (for an increase in bill rate) because I knew I would only get extra hours. And out of 8 travelers on my unit, I was the only one getting extra hours. It turns out that facilities are run by individuals who do things emotionally. "Travelers cost too much, so no overtime for them." Yet anyone doing the math on a flat rate contract at a higher bill rate will know that it is not a good deal, but they were pleased as punch and thought they had a great deal. "No, overtime? Let's give him lots of work!" But there is no reason to not have an overtime rate without a good reason, as the agency, you will make a lot more money if they extra hours.

On a similar theme, no one (until recently) did the math of time and a half of the bill rate for overtime. Excess profits for agencies, no benefit for the facility, and usually the traveler gets shafted.

Pick up any book on business startup and there will be a discussion of business entities. Default is sole proprietor (you can still pick a business name) and simply add a schedule C to your 1040. If you pick a pass through entity, any left over revenue at the end of the year "passes through" to you to put on your 1040. A regular corp does require you to pay yourself a salary. Corporate structures are state entities (usually - I once sued a D.C hospital that was incorporated by an act of Congress) and most states will charge income tax or some form of annual minimum franchise fees.

Specializes in ICU.
Possible, but unlikely there is a different bill rate. I've seen perhaps a hundred agency to hospital contracts (or vendor manager contracts) and have never seen a differential.

Here is one posted today.

Cedars Sinai.

Days or nights available

17 weeks

NEW RATE! - Days:

$68.24 total hourly

PLUS $600 travel bonus paid on your first check!

$25.08 taxable blended ($903 for 36 hours)

$43.16 nontaxable stipend (maxed at $1554 for 36 hours)

$2457 gross for 36 hours

NEW RATE! - Nights:

$71.26 total hourly

PLUS $600 travel bonus paid on your first check!

$28.29 taxable blended ($1018 for 36 hours)

$43.16 nontaxable stipend (maxed at $1554 for 36 hours)

$2565 gross for 36 hours

Not a huge difference this time around. USC Keck usually offers 300-500 difference from day to nights at times.

Wolf, for which specialty is that?

Specializes in ICU.
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