Three of those are:. Since the cost structure of CNA staffing agencies may not be common knowledge, allow me to share ours. At these rates, my agency breaks even after staffing 30 half-time CNAs every week. The resulting weekly staffing hours are significantly labor-intensive. Lots of hiring, credentialing, and middle-of-the-night phone calls. I share this to give perspective on why fees can approach a 2x multiple of temporary staff pay rates. These are factors that have placed pressure on our pay and therefore bill rates in the last year:.
Those agencies accomplished this by highly automating hiring, credentialing and scheduling processes and by classifying their CNAs as contractors. Both these come at a community cost. The automation has caused these agencies perhaps accidentally to hire away from their own clients. And being classified as contractors deprives CNAs from protections and many benefits they would receive as W2 employees.
Regardless, these agencies have quickly contracted with providers all over San Diego County. We have begun to incrementally raise pay rates and therefore bill rates to compete. A constricted labor supply is causing rates to rise. We regularly give short talks at CNA schools in San Diego to let them know about the opportunities to work with us.
As of November , we are still unable to physically do these talks and some of the CNA schools in operation do not seem to have the same enrollment demand that they did in Agencies like mine must respond to the above challenges and make changes to ensure survival. However, if, as agencies, we are using these challenges as an excuse to expand profit margins beyond reasonable markups, then I do not support that.
Vendors working with healthcare facilities have a civic duty to act as conscientious partners — profitability has an important place but needs to be at reasonable multiples.
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