Agency owners getting rich off the backs of nurses?

Specialties Agency

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Doesnt it just make you sick??????

This entire article is all about how lucrative travel agencies are...... for the OWNERS of the travel agencies! And about what great timing the owners had to be cashing in on "the shortage".

This guy's travel company managed to earn $518 MILLION for him just last year!! $518 MILLION $$$$ for putting nurses into assignments every few weeks. And what % of those hundreds of MILLIONS did the NURSES who did the actual back-breaking work get? According to the article, at the most, $29/hr.....

It makes me sick........

Not a word about any benefit to the nurses other than working in a new city and not dealing with hospital politics. As if thats all we need. I know travelers who are paid less than $25/hr for the privilege. Considering the MILLIONS that the owners are pulling inoff of our backs, its a disgrace.

How interesting that this owner in the article is a former state legislator. I wonder what he knew. Good thing he's not STILL a legislator. He might not want to see the nursing "shortage" solved. Hmmm.... thats a thought. I wonder if any of these agencies are trying to make sure the nursing "shortage" ISNT solved. Might take away their cash-cow.

I still cant believe it. The nurses working for this guy's travel company managed to earn HIM $518 MILLION just last year alone!! And the article is bragging about it! $518 MILLION $$$$ for sitting in an office & passing nurses around to hospitals every few weeks. And what did the NURSES get???????.......

March 2, 2002

Tony Fong

San Diego Union Tribune

"Filling the need for nurses

Companies profit as they respond to shortage

As hospitals and health-care administrators scramble to deal with a widespread shortage of nurses, a number of companies have emerged to capitalize on the deficiency.

Companies such as San Diego-based AMN Healthcare Services have built a strong business out of supplying temporary nurses to hospitals suffering from a shortage of qualified staffers.By bolstering its roster of nurses and their number of assignments, AMN has seen its revenue grow nearly SIXFOLD during the past three years.

The demand for nursing services has been so strong that AMN and a competitor, Cross Country Inc. of Boca Raton, Fla., were able to buck the weak market for public stock offerings last year.

AMN went public Nov. 13, raising $175 MILLION. Its shares closed yesterday at $25.95, up more than 52 percent from the $17 offering price. Cross Country, which went public Oct. 25, closed yesterday at $26.64, up more than 56 percent from its IPO.

Riding the current bullish wave surrounding the industry, Medical Staffing Network, also in Boca Raton, filed for a public offering in early February.

Since the late 1990s, Wall Street had viewed health care skeptically, but lately the industry has shown signs of life. And for nurse staffing companies, the time has been ripe for investors.

"Right now, AMN is positioned in one of the hottest sectors," said Robert Mains, a health-care analyst at Advest Group in Saratoga Springs, N.Y., a minority underwriter in AMN's public offering.

Fueling such sentiments is a nationwide nursing shortage that experts say is going to get worse because of a shrinking supply of nurses and an expanding need for them.

Unlike some of its competitors, AMN deals only with travel nurses, not per-diem nurses. A per-diem nurse's assignments can last as little as one shift, but travel nurses typically work on 13-week contracts. They can also crisscross the country, going from one assignment to another.

Travel nurses are not a long-term solution for the nursing shortage, but the demand is so great that hospitals have no choice but to use them, said Ann Davis, a vice president with the Sharp HealthCare hospital system.

Sharp typically uses about 100 travel nurses at any time, including 80 from AMN, Davis said.

"The thing that works nicely is they're here for a 13-week contract . . . and if you need supplemental staff, it's better to have them in, have them oriented and have them stay for a length of time," Davis said.

Founded in 1985 by Steven C. Francis and his wife, Gayle, AMN was headquartered in Las Vegas before the couple moved it to San Diego two years later. Steven Francis is a former Nevada state assemblyman.

The company now operates five brands: American Mobile Healthcare, Medical Express, Preferred Healthcare Staffing, Nurses Rx and O'Grady-Peyton International.

During 2001, AMN had revenue of $517.8 MILLION, a nearly SIXFOLD increase from $87.7 million in 1998. AMN has 25,000 nurses in its database, of whom 6,883 were on assignment during the fourth quarter of 2001, up from 4,048 in the year-before period. AMN has 800 corporate employees, including 550 locally.

Haas Wheat & Partners, an equity fund based in Dallas, has a 65 percent ownership stake in the company.

The company contracts with 2,500 hospitals in 50 states, constituting 40 percent of all acute-care hospitals and half of all acute-care beds in the country, making it the biggest travel-nurse company in the nation, AMN officials said.

Although Francis said that "the health of our industry isn't just reliant on the nursing shortage," the shortage obviously was a major factor in the company's decision to go public when it did.

During the fall, when AMN and Cross Country went public, Wall Street was enduring one of its worst years for IPOs. Just 87 IPOs were completed in 2001, the fewest since 1979. In September, there were no public offerings, as the effects of terrorist attacks and a deteriorating economy rattled the markets.

While hospitals have always had to deal with staffing shortages, what makes the current shortage opportune for companies like AMN is its magnitude and the fact that no short-term solutions are in sight, analysts said.

The dilemma is this: There has been an exodus of nurses from the profession, and fewer students are choosing the field. At the same time, as baby boomers grow older, there is an increasing need for nurses.

"In the past, there was a feeling the industry would right itself," but that is no longer true, said Mains of Advest.

This year, the Federation of American Hospitals and the American Hospital Association said one out of seven hospitals nationwide reported having more than 20 percent of their registered-nursing positions unfilled.

While hospitals have offered significant bonuses and recruited nurses from outside the United States, those measures have shown only marginal benefits.

Similarly, the effects of the recent nurse-to-patient ratio requirements established by California are unclear. While nursing officials hail it as a major step toward easing staffing problems, hospital administrators warn that there isn't a large-enough pool of nurses from which to hire. As a result, hospitals may have to mothball beds to meet the requirements.

In the meantime, hospitals have increasingly relied on nurse staffing companies to fill the holes.

Hospitals spent $7.2 billion in 2000 for temporary employees, the majority of whom were nurses, according to the Staffing Industry Report, an industry newsletter. For 2002, it estimated that spending will increase to $10.6 billion.

The current shortage has resulted in more nurses going into the travel-nurse sector, Francis said.

"They're able to get higher pay rates because there's a demand . . . but there's also more opportunity for them," he said. "When you think about it, you can go anywhere in the country and work."

AMN charges hospitals an average of about $45 an hour for its nurses and pays the nurses about $29. AMN also pays for its nurses' housing and health insurance and offers 401(k) benefits.>>>

http://www.uniontrib.com/news/union...ews_1b2amn.html

$518 MILLION dollars last year alone & the RN made just $29/hr in California. These people are becoming millionaires off the backs of nurses. Same as hospital executives.

We should all become independent contractors and cut out the middle man. WE have the skills that are in demand. Why shouldnt WE be the ones earning the big bucks for those skills. Geez..... it never ends. Why do nurses let everybody else feed off of them?

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Completely agreed.

I ran a small accounting/tax firm prior to getting into nursing for about 5 years. I had 6 employees. I charged per hour for their time. I paid them an hourly rate for time worked. In order to make a profit I had to have a bill rate that was about 33% above what I paid the employee. That means that if I paid the employee $25 per hour I had to bill the client $37.50 per hour. Remember, I had to cover overhead expenses like liability insurance, errors and ommissions insurance, work comp, unemployment insurance, health insurance, vacation and sick time (paid for not working), retirement plan contributions, withholding taxes on employee wages, my office space rent, advertising, phone lines and long distance, internet access, association dues, utilities, interest expenses on my line of credit and business startup loan, office supplies, technology costs (new computers, fax machines, copiers, printers, etc.), printing and reproduction costs, office furniture, equipment maintenance, legal fees, chamber of commerce memberships, phone book listings, and on and on and on. After all of this was paid for, I got to pay myself (yay!), which didn't amount to making me an overnight millionaire by any means but was USUALLY a fairly comfortable living. Of course, there were good and bad times and unforeseen expenses that would arise, so I was NEVER guaranteed a specific amount or anything at all for that matter (which was true at times!).

Hmmm... Isn't this EXACTLY the same thing as a nurse agency? I wasn't doing anything wrong. I was running a business. That's how ALL businesses work. We HAVE to pay an employee less than we generate in revenue. Otherwise we don't exist. There are many other costs that come in to play besides your paycheck.

Unless you believe everyone should work for themselves and create their own businesses (that would mean eliminating unions, unemployment benefits, work comp insurance, and on and one in terms of protection) you need to do some real research and formulate an argument based on fact NOT jealousy.

People were always telling me "it must be nice to own the business"... "don't have to report to anyone".... "get to do what you want".... "make your own hours"... "make tons of money".... etc. What those who haven't done it fail to understand is that I SACRAFICED a TON to make that business successful. I worked twice the hours as my employees for no extra pay and if it failed I lost everything I owned.... They just had to find another job. Ultimately, that is part of the reason I chose to sell the business (yes for a nice sum of money) stash the money away for retirement and became a happy working stiff again.

The grass isn't ALWAYS greener and just because you have an opinion doesn't mean you know a thing about what you are talking about.

It's kind of a "Put up or shut up." Otherwise you are WAY out of line.

Thanks for reading.

Good post

Specializes in PeriOp, ICU, PICU, NICU.

It's the same exact thing with construction contractors. They rake in big bucks and pay the workers a fraction of what they are charging to have the construction built. (hubby works as a construction worker)

Needless to say, it would be nice if he could just go out and get an independant job on his own but no one would hire him because you need insurance all this extremely expensive equipment and the help of a team.

There is no other choice but to take it however it comes. :)

I am not going to agree or disagree wether this should be the same thing in nursing cause I am a student and haven't worked in the field, but just wanted to express my view from the contruction point of view :p

Capitalism, you gotta love it......NOT!:angryfire

Any company is set up to make money. Period. Anyone that employs staff has to pay the staff as well as the insurance and all other fees associated with this company. Doesn't matter what business that you are in.............

the compnay needs to make money or should be making money.

Same with any field, not just nursing.................people invest money in something because they want to make money from it. Same for any of you that wish to set up your own agency, you will be billing the facility a certian rate, hopefully based on what your expenses are as well as what you want to be paid........if you hire others to work for you, you will be making money from what they make................and the cycle begins again.............. :)

Any company is set up to make money. Period. Anyone that employs staff has to pay the staff as well as the insurance and all other fees associated with this company. Doesn't matter what business that you are in.............

the compnay needs to make money or should be making money.

Same with any field, not just nursing.................people invest money in something because they want to make money from it. Same for any of you that wish to set up your own agency, you will be billing the facility a certian rate, hopefully based on what your expenses are as well as what you want to be paid........if you hire others to work for you, you will be making money from what they make................and the cycle begins again.............. :)

Well put Suzanne.

So...has anyone here been successful in contracting themselves individually in the community, without going through an agency??

I knew a nurse once who did this himself but he wasn't able to get into the hospitals this way, only LTC. I suspect that doing business this way also sets one up to be an outsider and thus incur a greater liability. Facilities are suspicious and scapegoating enough to agency....would an IC get even worse treatment??

I sure like the idea of being an IC though...although I can imagine it takes up more time and energy to be having to make contacts and recruit for ones self. :)

Specializes in Acute/Chronic hemodialysis.
I have been considering contracting myself out in my area but I'm not sure how to do this. Can you help me? Do you have a sample of a contract that I could see? How do you approach hospitals with this issue?

I would really, really appreciate any advice you could give me.

Please send email if you wouldn't mind letting me see a sample of a contract that is effective.

Go to Delphi Forums at this addy

http://forums.delphiforums.com/ICNurse/start

Lots of great info on IC.

Hope this helps

Juanay

Specializes in Emergency.

Here is a surprise the agency I work for sent me a stock certificate the other day. Apparently I get one share for every shift I work. On top of that I schedule my shifts online. Get paid for referals and not the typical one time bonus at the end of their first assignment but for each and every hour the ever work. I am told the fee for the hospital is typically lower than most agencies as well.

Rj

Ultimately, the nurse has the responsibility to choose the best agency for themselves and (hopefully) the nursing industry. No agency can be a success without nurses. Essentially, the agency with the most nurses wins in the market. Some good questions to ask when selecting an agency are:

1) What % profit do you expect for your services?

2) How are you competitively pricing in the market to ensure availability of work for the nurse?

3) What hospitals can supply you references to both your quality and partnership?

4) How long have you been a staffing firm?

5) What do you bring to the table that warrants a nurse's employment with you?

Hope this helps. I am currently in the business of decreasing profit margins for staffing agencies. I bill the hospitals less than my competitors. I pay the nurse more than my competitors, and my regulatory compliance and quality are the best. This volume pricing has led to recruitment attempts from competitors, but unfortunately not to embrace the low-margin/high volume concept- instead just to remove me as competition. It has only fueled my mission. NURSES- BE AWARE of your agency. We are all in this together- which brings me to one last question to ask-

6) Does this agency have a nurse manager and when was the last time he/she touched a patient?

As for me- I cover 7 states, hundreds of hospitals, and thousands of nurses. Out of touch? Hardly- I pull my third shift this month on Saturday.

do you cover any psych? looking for a hospital in southern florida for the winter.....just curious. thanks, sara

This is why American Mobile is known as the head of the Evil Empire.

Only nurses who don't know any better work for them and the other companies they own. The rest of us travelers make decent money.

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