'Cap hospital CEO pay,' travel nurses say

As hospitals and lawmakers urge federal authorities to investigate travel staffing agencies for price-gouging, some travel nurses want the scrutiny redirected toward health systems' C-suites.

Nearly 200 House members urged the White House in late January to investigate costs charged by nurse staffing agencies. In a letter addressed to Jeffrey Zients, the White House COVID-19 response team coordinator, the lawmakers accuse nurse staffing agencies of taking advantage of the pandemic to raise prices and increase their profits.

"We have received reports that the nurse staffing agencies are vastly inflating price, by two, three or more times pre-pandemic rates, and then taking 40 percent or more of the amount being charged to the hospitals for themselves in profits," their letter states. 

Shortly after, the American Hospital Association and American Health Care Association/National Center for Assisted Living followed suit, urging Mr. Zients and the White House to investigate staffing agencies. The groups carefully pointed out that staffing agency prices are not directly correlated with the income that individual travel nurses bring in. 

"Please be sure that our concerns focus directly on the agencies and not the personnel they represent," their letter states.  

Although staffing agency prices and travel nurse salaries are two separate things, data shows that travel nurses are earning more than their hospital staff counterparts on average. The average base salary for travel nurses is $2,103 per week, which amounts to $104,000 per year, according to Indeed.com's analysis based on nearly 70,000 reported salaries. Salaries range by staffing agency, with Voyage Healthcare linked to $4,509 per week, and White Glove Placement linked to $3,453. 

By comparison, the median annual pay for registered nurses in 2020 was $75,330, according to the U.S. Bureau of Labor Statistics

The American Nurses Association applauds efforts to end price-gouging by agencies, but wants guarantees from lawmakers that individual travel nurses are not negatively affected in the process. 

"While overhead costs associated with staffing agencies have recently been targeted as a driver of staffing shortages, it is only one symptom of a much larger systemic problem. More needs to be done to effectively investigate and mitigate the root causes of nursing shortages," the ANA stated. "Changes must be made in providing better work environments, appropriate compensation and benefits and making patient safety a top priority to attract and retain nurses today and in the future."

At an individual level, some travel nurses take the argument one step further. When it comes to scrutiny related to pay, they want questions directed toward hospitals' C-level executives earning seven figures and whose leadership they describe as anemic. A Reddit message board for travel nurses is filled with comments questioning why Congress would restrict travel nurse prices but not costs driven by hospital CEO compensation.

"What do the CEOs even do?" one user wrote, citing their CEO earning $4 million in annual salary, not counting bonuses. "If he disappears tomorrow would anyone notice?"

"Ours makes his rounds to tell us to not depend on travelers, and staff nurses need to do more with less," another user posted. "Not kidding, that has literally happened multiple times on my unit."

"A lot of C-suite jobs are basically to justify their own existence. Make up rules, change processes, etc.," one user contends. "Cherry pick statistics to show that what you've implemented has been effective. While I'm sure there are a couple that are useful as far as monitoring finance and securing funding, there is usually a lot of fat that could be trimmed."

Although the 700-plus comments are anonymous, many of them suggest a growing divide between hospitals' front lines and their senior executives. The comments are not about the dollar amount executives earn alone, but the little value they provide to front-line workers or patients — in the nurses' eyes. It's nurses who hold the power, they maintain. 

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