Nursing Home Operators Seek Oversight for ‘Unfair’ and ‘Unregulated’ Staffing Agencies

With 14% of its workforce gone since the start of the pandemic, nursing home operators are constantly on the lookout for creative ways to bring in much needed caregivers. While some have looked overseas and advocated for an expedited visa process or immigration reform, other operators are calling on federal officials to step in and even the playing field between nursing homes and staffing agencies.

“One entity is heavily regulated and held accountable for patient care, and rightfully so, and the other entity is price gouging and has no accountability at any regulatory level and they are actually the ones providing patient care,” Moe Freedman, president of Illinois-based-Accolade Healthcare told Skilled Nursing News. “We’re fighting an uphill battle right now. There is no oversight on agencies, on top of the fact that they are price gouging us.”

Freedman expressed frustration with the fact that each time he raised his rates, staffing agencies would also raise rates and that is not something he felt should be allowed to continue.


The increasing use of agency staff has been reported throughout the pandemic, with some operators like Hillebrand Nursing & Rehabilitation Administrator Dan Suer sharing that this was his first time using agency workers in his 36 years in the industry, while others have reported paying up to four times above market for certified nursing assistants (CNAs) and registered nurses (RNs).

Over the course of the pandemic, Ryan Coane, president of Ivy Healthcare, has paid “astronomical rates” for agency nursing staff with wages that have reached $100 an hour for RNs and $50 an hour for CNAs.

“There is more money [for workers] to go to agencies and to go to hospitals and I think COVID has exacerbated that,” he said. “I’m hoping that we find a little bit more stability soon with staffing … but everyone is trying to fight for the same full staff.”


Paying inflated rates for agency staff who are “creating a bad culture” and don’t provide consistent care is a tough expense for Coane to justify.

“Anytime we meet with any Congress folks, we have this conversation with them,” he said. “Agencies just start up, they get all this staff, they are not scrutinized and aren’t getting Medicare and Medicaid reimbursement and aren’t held to the same standards we are and they can slide under the radar.”

Coane was thankful that he wasn’t “cursed” with more agency as he continues to try “to keep agency out as best he can.”

American Health Care Association CEO and President Mark Parkinson has petitioned through AHCA/NCAL for more oversight on the industry moving forward.

“We’re going after the staffing agencies. What the staffing agencies have done is just unconscionable,” he said during a panel at the National Investment Center for Seniors Housing & Care (NIC) conference in Houston earlier this month.

In a letter sent last month, AHCA/NCAL asked the Federal Trade Commission to investigate direct care staffing agencies for price gouging and anticompetitive and unfair practices.

“This price gouging is simply not sustainable for our providers and the current reimbursement system structure,” the letter states.

The letter accused agencies of increasing their prices knowing that the long-term care centers would be receiving COVID-19 specific state funding.

“Our providers have little choice but to pay the exorbitant prices, and hope that the agency does not poach their staff once in the building,” the letter continues.

According to Parkinson, the FTC complaint was “just the beginning”.

Companies featured in this article:

, , ,