Why agency pay more?

Michael Malecki · May 10, 2004

Cali:

You make some very good points. Your thoughts on working for large agencies are well founded. But don't discount the small agencies. 9 years ago I started off as one of those "small agencies" and grew because people took a chance with me. We have not forgotten those nurses and go above and beyond to thank them.

As with anything... do your homework and always ask co-workers about their experience.

In my opinion, I prefer the more established company that pays me fairly and operates their business efficiently. I try not to get all wrapped up in what they're billing the hospital and paying me. If they have a good enough reputation and can get the hospital to pay them $80/hr for my services, then I say more power to them -- just pay me correctly!

border rn · May 10, 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.

You raise some very interesting issues? I am currently searching for a travel job and all the agencies seem to be promising the moon. How did you go about becoming and independent? How are you covered in regards to liability? Any input would be appreciated.

border rn · May 10, 2004

I have been working for an agency in NJ for the past three years full time. I can say that they advocate for their nurses, pay promptly (same day pay is available and electronic deposits of my payroll check hit every Monday AM). It's been great for me because I am making $48 to $50/hr and when I do overtime at the same facility I get time and a half......can't beat that. I love the flexibility, I am rarely cancelled and I have decent health benefits. It's as close to being indepently employed as I want to be for now. I went back to Graduate school and have total flexibilty over my schedule. I am grateful to be in this position and for this time in my life it works for me! Will I ever get a real job? Maybe if I find something where someone wants to pay me what I'm worth......until then, I feel that my agency is great! I understand that things are different working for an agency in a small state......you can be at almost any hospital within a 60 mile radius and if you work twelve hour shift and batch your time you enjoy great pay (I made $96,000 last year) and have long stretches of time off. (So I can crunch out papers for school or just enjoy life). I can go on and on but won't bore you anymore for now. Sorry to hear that some of you are having a tough time with agency work.

Which Agency are you with? I am just looking into to travel and I am trying to compare agencies. I am not really finding much information in the way of the good the bad and the ugly.

SmylinRN · May 10, 2004

Dear border rn. Really glad to hear that you have had positive experiences with agency. I have found a great agency that does travel and offers good customer service.

ShawnaRN · May 26, 2004

Hello, I am currently looking into traveling and have been doing all the research that i can. What is the name of the Agency you used?

[/quote=heart queen]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.

CA CoCoRN, RN · Jun 8, 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!

Here in CA, working local registry (agency) usually gets you $500-$600/12 hr shift. Which comes out to ~$39-40/hr with true time and 1/2 after 8 hours.

Travelers get more sometimes....or they'll get less but come out with housing stipends, etc. So in the long run, it can be more money. I thought about taking a local travel assignment just for the housing stipend. :coollook:

susanna · Jun 9, 2004

QUESTION: How can you tell an agency nurse/worker from a regular hospital nurse/worker? Are the agency nurses the ones who wear the badges that say "CONTRACTOR" ?

suzanne4, RN · Jun 9, 2004

You actually can't most of the time. I have only worked at one facility that had "contractor" on my badge, all of the other times, it was usually a hospital-issued badge, sometimes one from an agency, but haven't used those in a long time.

It shouldn't matter, should it?

a_clay · Jun 13, 2004

May I ask what hospital that you are referring to? Thanks in advance.

Amy

a_clay · Jun 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!

May I ask which hospital it is that you work at that does this? Thanks in advance.

Amy

RN4NICU, LPN, LVN · Jun 13, 2004

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

YIKES!! :eek: :eek:

I'm afraid to ask what staff RNs there make! :chair:

NursesRmofun, ASN, RN · Jun 23, 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.

One of the hospitals I worked for had an agreeement that they would not cancel agency nurses in 24 hrs. or less before the shift. However, the agency nurse *could* call in sick and the hospital would be stuck...though the agency would *try* to send someone else. I always wondered how much the agencies got for those nurses. I am about to work for an agency for the first time. But it is not a floating thing. I will be working in only one facility, unless it doesn't work out. The money is okay but not BIG bucks. I imagine that it is big bucks between what I get and what the agency gets though.