Compliance and HR managers responsible for staffing should stay apprised of events that may have repercussions within the healthcare space. An increasing trend of nurse strikes and hospital staffing shortages across the country in early 2023 has led many healthcare organizations to turn to travel nurses and staffing agencies to fulfill their workforce needs. However, this solution comes with its share of compliance risks, especially if interstate licenses are involved. While the healthcare industry may have proven itself adaptable during a staffing crisis, organizations should still closely monitor and even anticipate potential compliance risks associated with these strikes and workforce shortages.
There’s no doubt that frontline nurses have been warriors throughout the spread of COVID-19, providing critical care during an unstable and dangerous time. When the pandemic hit, many hospitals were flooded with too many patients to accommodate and too few staff to attend to their needs. Workers soon became overworked and overwhelmed, and COVID quickly proved that many hospitals don’t have sufficient equipment or staff available to deal with a sudden public health emergency. It’s no wonder nurse strikes have been on the rise.
Nurse Strikes and Interim Solutions Present Licensure Challenges
In 2021 and 2022, hospitals like Mount Sinai in New York and St. Vincent Hospital in Massachusetts faced days- and even months-long protests from their workers. The St. Vincent Hospital strike in Worcester, Massachusetts, saw more than 700 nurses go on strike for 301 days, the longest strike in Massachusetts history. These strikes were organized by unions of nurses fighting for better pay and benefits, as well as improved working conditions and more staff to help them shoulder heavier workloads.
When nurses go on strike or leave their jobs due to burnout, hospitals rely on staffing agencies and travel nurses to maintain adequate staffing levels. But working with staffing agencies and travel nurses comes with its own unique set of compliance risks.
A travel nurse could be hired to work at a hospital located in a state where they are not licensed to practice. This can spell trouble for everyone involved. Healthcare organizations will need to ensure that their providers are properly licensed for the state in which they are working, but this can be challenging as licensing requirements vary by state. It is also a good idea for a healthcare organization to bolster its license verification and monitoring practices to capture license information from across the country in order to get a complete profile of a possible temporary or travel nurse.
The Nurse Licensure Compact and Interstate Licensure
The Nurse Licensure Compact (NLC) is a multi-state agreement that allows nurses to practice in any of the 38 participating states. Although it is intended to facilitate mobility for nurses and encourage access to healthcare services across state lines, it’s challenging to monitor. For starters, each state has its own process, rules, and regulations for monitoring licensed nurses. In addition, the NLC relies on nurses and their employers to identify exclusions. That means nurses are required to disclose any exclusions or disciplinary actions taken against them, and employers are required to report exclusions and actions against nurses in their employ. Self-disclosure is not the most reliable method of monitoring a nursing population. Without an ongoing compliance monitoring program, exclusions and license verification issues may not be caught in time for hire or may be missed entirely.
Unfortunately, travel nurses are, in general, a challenging population regarding ongoing compliance and credential monitoring. As the largest category of licensed caregivers, they are also the most commonly excluded discipline. High demand and frequent turnover mean travel nurses are often moving from one state to the next to provide care wherever they are needed. Compliance monitoring can get tricky with so much back and forth. It is crucial to have a monitoring program in place, especially as interstate moving is a common tactic bad actors employ to outrun any disciplinary sanctions and exclusions they may have against them. These exclusions and disciplinary sanctions often go unreported to the NLC.
Hospitals and healthcare administrations might find it difficult to monitor different licensing boards across multiple states, but staffing agencies provide a number of services that help with initial compliance monitoring. Once a travel nurse is considered for placement, the staffing agency will run a background check and screen the candidate. They will evaluate the travel nurse’s experience and employment references and make sure their certifications and licenses are active and in good standing. While these agencies are certainly helpful and play an important role in credentialing providers, ongoing exclusion monitoring is ultimately the healthcare organization’s responsibility. After all, these travel nurses provide care not as individual providers but on behalf of healthcare organizations.
Staffing agencies and travel nurses have become important players in the nurse strikes and hospital workforce shortages. The need for expert medical care will never be scarce, and the demand for skilled healthcare workers continues to grow. As nurse strikes continue and hospitals struggle to maintain a sufficient number of available providers, compliance managers should consider the challenges their healthcare organizations could face. Any gaps in a compliance program could leave organizations susceptible to fraud and penalties if the supplemental workforce is not being closely monitored. By taking a proactive approach and anticipating potential compliance risks that may come from relying on staffing agencies and travel nurses, healthcare organizations can ensure that patient safety is never compromised.
How ProviderTrust Can Help
ProviderTrust simplifies and automates the license and credential verification monitoring process for healthcare’s top HR and compliance teams in one powerful platform. Working as a complement to existing credentialing processes, ProviderTrust provides up to daily exact match results from the primary source, monitoring all 50 states and all boards. This allows healthcare organizations to focus on their patients, with in-house and contracted staff, saving time and money while ensuring credentials are always in good standing. Accessible healthcare does not have to compromise the standard of care.
