The Travel Nursing Agency Transparency Study Act


The Travel Nursing Agency Transparency Study Act would require the Government Accountability Office to investigate staffing agencies. The GAO will study potential price gouging and “taking of excessive  profits” as alleged by the nursing home industry. The industry pressured legislators to investigate agencies for price-gouging and for “poaching” staff.

The GAO will attempt to determine the difference between the rates contracted nurses were paid and how much facilities were charged, and if bailout money was used for staffing or diverted to related entities or corporate owners. Sen. Kevin Cramer (R-ND) said in announcing the bill:

“Hiring agencies are reportedly taking advantage of the demand created by workforce shortages, charging inflated rates, and keeping a significant percentage for their own profits. Such business operations of these agencies could have far-reaching effects on the quality of our healthcare system in rural America and must be reviewed.”


The Act will increase transparency too. Cramer wants to know how many private equity firms bought travel nurse agencies and the negative impact of those acquisitions. Are facilities diverting funds to related entities who own staffing agencies. The GAO will examine providers’ agency payments too.

Consulting firm Oliver Wyman found the average nurse hours worked increased by up to 15% due to understaffing. The typical nursing assistant now works nearly 52 hours per week. This leads to burnout causing abuse or neglect. 60% of those who left their jobs blamed insufficient staffing as a reason.

Recently, staffing firm IntelyCare paid for an analysis using data from hundreds of providers compiled by Mercer. The analysis of data finds that hiring contingent/temporary workers may be an efficient way to staff without hiring full-time, permanent employees in a tight and expensive labor market.

The study found that on an hourly basis, a full-time employee costs a facility 1.9 to 2.2 times their hourly wage rate when accounting for benefits and recruitment expenses. Staffing firms, however, absorb the cost of recruitment, as well performing payroll and tax duties.

Safe staffing with competitive wages and decent benefits would help recruitment, retention, and the quality of care. Hopefully, this act will help support safe staffing in nursing homes.