Connecticut Legislation Takes Aim at Nursing Home Temporary Staffing Agencies

As nursing homes around the nation are struggling to find enough staff,[1] agencies that provide temporary staffing have capitalized on this market opportunity and enormously profited, partly by hiking up hourly rates.[2] In January, the American Health Care Association,  which represents nursing homes and assisted living facilities, along with the American Hospital Association, sent a letter to White House officials claiming that staffing agencies were “charging uniformly high prices,” which suggested “widespread coordination and abuse of market position.”[3]

Connecticut’s Attorney General reported that attorneys specializing in antitrust have met with nursing home officials in the state about staffing agencies’ price-gouging practices.[4]  Connecticut Long Term Care Ombudsman Mairead Painter spoke with the Center for Medicare Advocacy about the issues and impacts of temporary staffing agencies in the state. “I don’t believe it started as price-gouging or anything more than supply and demand, but I do believe over time these staffing agencies saw how they could profit and began taking advantage of the situation.” Painter illustrated one way that the staffing agencies not only raise prices, but potentially hurt the quality of care residents receive. “We’ve been told that some of these agencies will commit the same staff member to several buildings in the area and then on the day they are supposed to be working, the staff person will go to the highest bidder.” Painter adds that, “this leaves the residents in the other homes without the care they need, putting them at risk.”

Lawmakers in Connecticut are now taking aim at these staffing agencies with the introduction of two bills that would clamp down on the staffing agencies’ practices. The first – An Act Concerning Registration of Temporary Nursing Services Agencies – would require staffing agencies to annually register with the state’s Department of Public Health. The bill would also establish requirements for the agencies such as minimum nursing qualifications for nurse personnel and annual reporting requirements.[5]

The second bill – An Act Concerning Temporary Price Controls On Services Provided by Temporary Nursing Services Agencies – would establish maximum rates that staffing agencies would be able to charge for nursing personnel, in addition to a registration system and the establishment of agency operation standards. “This bill is needed now more than ever,” Painter explained. “We have some homes where there are shifts with more pool staff working in nursing homes than actual employees of the facility. This impacts continuity of care, as well as the ability for the residents to have person-centered care plans met.”

Painter says the impacts of the skyrocketing hourly wages for temporary staff are felt throughout the facility. “We are seeing cutbacks in other areas of the facility, and this has impacts for the residents as well,” Painter notes. “We have seen a steady increase in complaints related to excessive wait times to the use of the bathroom, having meals served, or getting in and out of bed.” Painter cautions that it’s also difficult to have accountability for safety measures related to abuse and neglect with high rates of temporary staff. “When there is an allegation, the pool staff leaves and returns to their agency with little to no repercussion. It’s unclear if they’re allowed to just go to work in another facility or if there is any report or investigation done by the temporary staffing agency.”

While both bills are under consideration by lawmakers, the destructive impact of the temporary staffing agencies continues to go unchecked while nursing homes scramble to find staff. Painter adds that “the [temporary staffing] agency uses this situation to their advantage, but in the end, it’s the resident who loses.”

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[1] Federal Reserve Economic Data. All Employees, Nursing and Residential Care Facilities. FRED. (Updated March 4, 2022). Available at: https://fred.stlouisfed.org/series/CEU6562300001   
[2] Hicks, J. As nurses demand higher pay, nursing homes and staffing agencies clash on the price. Side Effects | Health and Medical News. (February 17, 2022). Available at: https://www.sideeffectspublicmedia.org/policy-politics/2022-02-17/as-nurses-demand-higher-pay-nursing-homes-and-staffing-agencies-clash-on-the-price 
[3] AHA, & AHCA. AHA-AHCA Joint Letter to the White House. (January 27, 2022). Available at: https://www.ahcancal.org/News-and-Communications/Fact-Sheets/Letters/AHA-AHCA-Letter-Staffing-Agencies.pdf 
[4] Haigh, S. AG Looks at High Rates Nursing Home Staffing Agencies Charge. U.S. New & World Report. (January 13, 2022). Available at: https://www.usnews.com/news/best-states/connecticut/articles/2022-01-13/ag-looks-at-high-rates-nursing-home-staffing-agencies-charge 
[5] CT.gov. Raised Bill No. 5313. Session year 2022. Available at: https://www.cga.ct.gov/2022/TOB/H/PDF/2022HB-05313-R00-HB.PDF