Significant Pay Gap Between Agency & Full-Time Staff Nurses Sparks National Outrage

By Tamara Thomas - Last Updated: December 22, 2022

An analysis of state-by-state pay rates between agency and full-time staff nurses reveals a large pay gap that has sparked outrage among long-term care operators and other providers.

The large pay disparity between agency and full-time staff nurses is not a new discovery and has long been a source of outrage. However, a new report by Becker Hospital review ranking every state by the pay gap between Travel Nurses and RN pay revealed just how egregious these pay gaps are. For example, according to the review, travel nurses in South Dakota earn an average of two hundred and eighty-seven percent, which is nearly triple what non-traveling RNs in the state earn—the highest gap of any state. Even Hawaii, which had the smallest difference, was at one hundred and fifty-one percent.

According to the review, the disparities are likely much wider in long-term care, suffering worse continuing staff shortages than in other healthcare sectors. The high pay gap leads to the exodus of full-time nurses into agency roles. The pay disparity has angered nursing home advocates, who are losing their regular staff to higher paying agency jobs.

The motivation of nurses can be understood, but agency owners need to be called out, Rachel Monger of LeadingAge Kansas added.

“We know that the primary reason our nurses leave for staffing agencies is the higher pay,” Monger told McKnight’s Long-Term Care News. “We have never faulted our nurses and nurse aides for seeking higher wages. They deserve every penny and more.”

“Our criticism lies with staffing agencies that have exploited the nurse shortage for higher profits and discouraged market improvements with forced contract buyouts and non-compete clauses for nurses.”

According to a report released in October by the accounting firm CliftonLarsonAllen, agency nurse use was a major contributor to decreased sector margins. According to the authors, the shift to contract labor did not begin with the pandemic. However, the use of contract labor has increased dramatically in the last three years. Approximately two-thirds of skilled nursing facilities used nursing contract labor in 2021, a fifty percent increase from 2019.

“This alarming (Becker) report further demonstrates the need for government resources that will help long-term care providers offer caregivers more competitive wages,” Porter said in a statement to McKnight’s Friday. “We respect and value our travel nurses, but we need to invest in full-time employees who know their residents intimately. “It’s also time that Congress investigate predatory staffing agencies who have charged exorbitant rates during the pandemic and exacerbated our labor crisis.” Clif Porter, senior vice president of government affairs at the American Health Care Association/National Center for Assisted Living, added in response to the outcry over the loss of regular staff to higher-paying agency jobs.

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