Why agency pay more?

suzanne4, RN · Feb 11, 2004

When you work for an agency you do not receive all of the benefits that the hospital pays to their staff. Sure you may get 2 weeks vacation, and possibly medical, but the hospitals pay holiday pay if you haven't worked the holiday, disability, life insurance, etc. It usually costs a hospital about 30-35% more for your benefits than what your salary is. Agency work is usually not guaranteed, the hospital can cancel up to 2 hours before your shift. You have to be careful with the agency that you select just like you would be selective when going to work for a hospital. Most depends on what you are looking for............................

WyomingRN · Feb 11, 2004

Oreo,

This is what I originally posted (slightly edited) under "Nurses in Other Professions" (#79) https://allnurses.com/t47950-10--nur...essions--8.html

The very first way agencies screw their nurses is by putting most of the money into their pocket, not giving it to the nurses. Here is an example: An agency charges the facility say, $65.00 / hr as the basic rate. (The present agency rate is $60- $90 for an RN) Then they add to this other charges like specialty positions such as acting as charge nurse, night shift, mileage, lodging, etc. They pay the nurses any where from $23 to $25 / hr. and put the rest in their pockets.

The company I was working for said that if you worked as charge that I would get paid more, HA HA HA. That never happened. My contract said that I would work 36 hrs. a week. I later found out that the agency's contract with the hospital said that the agency was guaranteed to be paid for a 40 hr week. So they got paid for 40 hrs whether I worked 40 or not.

Over head was very low for this agency since it was being run out of their home. I found out that on average, they had 10 - 12 nurses employed at any given time. Another agency was charging the hospital $90.00 / hr and paying the RN $20.00 - $23.00.

Pay checks were supposed to be mailed out on Fridays. Another joke !!!!! You never knew when you would get your check. The excuses were unlimited on why they couldn't be mailed out on time. Also the fax in their office some how always seemed to be down when you tried to fax time cards in, or if it worked, then they would misplace your time card sheet and not find it until after checks had been cut for the week. If you e-mailed time cards in, they would accidentally delete them, saying they thought it was spam, even though it had "time card" in the subject area. Good way to keep from paying their help on time.

I took a short notice shifts, 450 miles away, after being promised extra money for taking it. When paychecks came out, they never remembered making such an agreement. They then agreed that to keep me happy, it would be on the next check; that day never came, so I wouldn't take any more of their short notice shifts.

Before contracting on, I was told that they had a health insurance plan. After hiring on, I was told that they were just setting it up. Took 4 months to get my AAA sent in after my asking every week about it. I, nor anyone else ever did get health insurance.

If you had a complaint or needed to talk to them, you could never could get through to the agency when you called. I have no doubt that they had caller I.D. So I would leave a message and 3 - 4- or maybe a week later, they would call back.

While I was told that I would be paid time and a half for holidays, that never happened either. I later found out that the agency did charge the hospital time and a half for the holidays I worked.

Before hiring on, I was told that I would get $250.00 for any referrals that hired on. They hired three of my referrals but I never got a dime. One of the referrals that worked for them had requested that it be written in her contract that she had 4 - 5 days in a row off every 3 weeks so she could come home to see her daughter, etc. They had her working 400 miles away. Some amazing way, they didn't get that written in the contract. When she questioned about it not being in her contract with them, they told her that they had written it in the contract with the hospital. What a crock of bull, when it didn't happen she checked with the hospital and found out that it wasn't written into their contract with the agency. She kept asking for an assignment closer to home, and kept being told that there wasn't anything closer to home for her. Of course, not, when they could get bigger bucks ( since where she was working was staffed primarily by agency) there then what they could get by working her closer to home. When she told them that she was going to go to another agency, they suddenly found her something closer to home.

Have also found out since I quit, that the agency got paid bonuses for my work and it wasn't passed on to me like the agency said it would be. Lined their pocket again off my work.

I have checked with other agencies around the area. I have talked to others who are more familiar with some of the other agency. After comparing note, the bottom line is same crap different company. Some want a 1 year contract, others want you to only work for them. Agencies never worry after you sign up with them if certifications are kept up to date, etc. They don't worry about the HIPPA ruling or offer HIPPA information. They just leave the nurse out to hang if they aren't current.

One of the worse things about the agency was their constant pushing of overtime. They always wanted us to work over time because while they would have to pay time and a half on my pay of $23.00 hourly rate, they charged the facility time and a half on their $65.00 hourly rate. Obviously they love to push overtime. My husband is a independent businessman. Based upon what they were charging the facilities, and what they were paying the nurses, he calculated the taxes, extra phone line, etc. He figured that this small home office agency was clearing somewhere between $35,000 and $45,000 per month. Even with all the overtime and shift differential, I have never ever even made $40,000 in a single years - much less a month. About a month ago I ran across the lady that was working in the office of this agency during my contract. I point blank asked her what they were making each month. Between $40,000 and $50,00 per month depending on the number of nurses in a given week was her reply. She then commented on how even that was not enough to maintain them in the life style they were living.

Agencies are just like facilities and the health industry. They are in it for money and more money. They have no interest in health care what-so-ever. That is why I decided enough was enough and went independent. Now I have control of what happens, not somebody lining their pocket off my hard work. I can work out of my home just as well as any agency. When I hire other nurses to cover shifts, I can pay them real money for the efforts.

Look at it this way. An agency charges say $65.00 an hour. If the agency has 12 nurses work an average of 8 hours five days a week that comes to 480 of pay time per week. Now figure that they have to pay say 15% (this is way above Wyoming actual rate) in taxes such as unemployment, workman's comp, FICA, etc. That means that they are paying approximately $10 per hour in taxes. So if the agency is paying a nurse $23.00, that means that they are clearing approximately $32.00 per hour. Assuming a overhead of $10 per hour (again way over anything reasonable in Wyoming) their actual profit is only $23.00; but multiply that by 480 hours per week. That comes to more than ten grand a WEEK - More than $40,000 per month. To me that is as outrageous as the facilities. When I work another nurse, I only keep out a couple dollars an hour to cover overhead and make a small profit.

Bottom line - I got tired of the vultures sucking the blood out of me so I went independent. I charge the facility $55-$60 per hour and actually put the money in MY pocket - and the facility is saving money. To heck with the vultures.

If you do work for an agency, get what ever they tell you in writing before you sign your name.

Oreo · Feb 11, 2004

Oh, it's impressive on what they are actually doing! I am glad that I can know these before signing any contract. Thank you for the replies.

Baltimore Nurse · Feb 12, 2004

In Mayland agency nurse make a decent salary it ranges anywhere from 40-60 dollars per hour for ER nurses. The problem here is that the higher paying agencies usually get cancelled. So you may get booked for 3 12 hour shifts at the $60 per hour angency and only work one. But if you can settle for $40 per hour you can get all the time you want. I work agency from time to time [about 3months a year in total] but find that over all the time and half I get on my full time job is just about the same rate. I love agnecy though nothing can compare to the same day or next day pay!

Baltimore Nurse · Feb 12, 2004

why lots of agency can offer 1/3 more or $15-$20 more than the hospital. is that actually they take 40-65% from our wage even though they can offer us a very very good due. is that true? some agency can even offer benefits like medical and dental insurance. i don't understand why hospital pay almost double amount of money to them instead of hire nurses by themselves.

undefined i have often wondered that myself. where i work they gave a ten percent raise accross the bord which increased most nurses salary by 3-4 dollars. they also started an in house agency that pays 45 per hour for critical care nurses and i think it is 35-40 per hour for non critical nurses. since this i have seen a significant decline in outside agency staff. for the first 6 months i seen no angency in the er where i work and it was not until christmas that i see my first agency nurse in months. so that goes to show if you pay your nurses than you dont have to use out side agency as much!

Jennerizer, ASN, RN · Feb 13, 2004

If you're working agency & only making $20-23 an hour...something is wrong. I've never heard of an agency paying under $30/hr. Usually it's closer to $40/hr.

Hellllllo Nurse, BSN, RN · Feb 13, 2004

If you're working agency & only making $20-23 an hour...something is wrong. I've never heard of an agency paying under $30/hr. Usually it's closer to $40/hr.

Agency in Kansas is only paying RNs $16.-$18. per hr.

Tweety, BSN, RN · Feb 13, 2004

per diem agency nurses make good money, up to $35.00/hr here. But as was said they can be canceled up to two hours prior to a schedule shift. Believe me hospitals do whatever they can to not pay an agency. So it's hit and miss work. But in the winter here, agency nurses get plenty of work. In the summer times are much harder. Usually agency nurses here work like crazy during the winter, save their money and relax.

Anothe type of "agency" is those that sign 13 week contracts, for say 36/hr per week. They still get top dollar, maybe not as much as a per diem agency, but still more than a staff nurse and the agency is going to pay their benefits, not the hospital.

Of course, the original point I believe was why don't hospitals pay their staff the same they are paying the agencies so they can perhaps retain more nurses. (Here nurses are going agency in droves.) That's the big mystery of the day.

heart queen · Feb 13, 2004

3rd shift guy, yep, it's completly bogus that agencys' get paid $65/hr. the nurse gets about half if you count housing allowance.

My hospital created an "in house agency" program t remedy this. First you must be currently employed with a year exp. then if you choose, you can keep your current position and add an agency postion. Agency "contracts" pay the nurse $40 per hour flat rate... considered different job. so if you work a normal 40 hrs. then pick up 4 hours in a unit in an agency position, those 4 hours are paid a flat rate of $40, not worth it, my time and 1/2 is more. But if you are able to forgo all your benefits, you can work strickly agency, work 50 hours and the extra ten hours is at time and 1/2 becase you don't hold two different job code postitions. ?Make sense?

So we're trying this to eliminate all agency, infact an agency nurse from an outlying facility can only work a max of 2 contracts. Plus there are many extra hour bonus contracts that if you work an 8 hour shift extra every week for twelve weeks, the first four is paid at $40 per hr. the last fr at time and 1/2 plus a $750 bonus at the end of the 12 weeks.

I've worked outside agency and regular staff, with this shortage there ae no easy answers, but more options if your family situation allows the flexability and nearby facilitys' offer you these choices.

Basically stinks, because If I get where your comming from..if we just pay the nurses a good salary, we will not only bring them in but keep them! Keeping in mind, I've had many a shift where I've said, don't even call me at home tonight offering me double time, it's not worth it.. sad!

heart queen · Feb 13, 2004

Also wanted to add, that whe I worked agency, I ensured that my contract stated a NO cancellation policy. This ensured my hours and pay. If census dropped, My agency, and I were paid, so I was never cancelled. this is fairly common and accepted, it just took a bit of good researching to find. My experience with agency nursing was excellent, my contract was to the tee of what I experienced. Should there have been more options in my immediate area I would have stayed agency nursing, I wanted local, not traveling. Not possible in my area, which is JUST NOW, feeling the nursing crisis.

cannoli · Feb 13, 2004

If you're working agency & only making $20-23 an hour...something is wrong. I've never heard of an agency paying under $30/hr. Usually it's closer to $40/hr.

Have you ever actually worked for an agency?

I work agency, in the southeast, and for med-surg the RN pay is $26.00 an hour.