Hospital's nurse registry fills in staff gaps - Wycoff Heights Hospital, Preferred Health Placement Corp

Healthcare Financial Management, June, 1990 by Deborah A. Teschke

The parent company of a New York hospital has developed what it believes is a solution to the hospital's registered nursing staff shortage and recruitment problems. The solution saves money for the hospital and makes money for the corporation.

The parent company, Preferred Health Network, inc., in Brooklyn, N.Y., has created its own nursing registry to provide temporary nursing help to Wychoff Heights Hospital, a 312-bed, not-for-profit teaching facility. Preferred also manages a freestanding clinic in Brooklyn and a visiting nurse group that provides home health care.

"The agency is a short-term solution to the nursing shortage; the long-term goal is recruitment for the hospital," said Pat Garofalo, Preferred's director of registry and recruitment. Eliminate the middle man

The for-profit, licensed agency, called Preferred Health Placement Corporation, also contracts with other hospitals in the area to provide supplemental nursing staff. It was started last July when Preferred's president, Charles J. Pendola, FHFMA, CPA, decided to "cut out the middle man" and eliminate the high fees the hospital was paying to other registries, Garofalo said.

"We thought, why not start our own registry to fill the same [staff] needs at a lesser cost?... said Garofalo, who had been a staff nurse at Wychoff before being recruited to run the registry.

Since Jan. 1, Wychoff Heights has saved $72,000 in registry fees, she said. Garofalo estimates that the hospital "usually spends $1 million to $2 million a year on registry nurses." For the first quarter of 1990, the agency billed Wychoff $370,000.

Under general business law, Garofalo said, the agency can charge 10 percent above salary and expense (FICA, workers' compensation, unemployment) costs. Preferred charges less than other agencies, she said.

"Having my own registry is a big benefit for us," said Irene Anastascio, Wychoff's associate executive director of nursing. "The cost is less because I don't have to pay administrative fees as with [other agencies). For example, with another registry, I would pay $42 an hour for an intensive care nurse. The nurse only gets $29 an hour and the registry gets the rest as administrative costs."

Flexibility is a key

Nurses are provided depending on Wychoff's needs and nurse availability. The hospital gives Garofalo an order sheet for a two-week period based on shift and unit. More than 200 nurses are registered with the agency, many of them former Wychoff employees, Garofalo said. Registry nurses fill an average of 700 hours a week at the hospital, Anastascio said.

Some of the nurses have worked full-time at the hospital and left to have children, care for sick parents, or for other reasons, and now want to go back to work. However, they do not want to work full-time or cannot work a full shift, and the registry offers them the flexibility to work when they want, Garofalo said.

"Our nurses come back on their terms,' she said. "We offer partial shifts as well as full shifts.

"Some nurses work from 9 a.m. to 2 p. m. - this way they can drop their kids off at school, go to work, and pick them up from school. The hospital prefers total shifts, but if [a partial shift] is the only way to get someone, [the hospital would] rather have them for five hours than no one at all. - The scheduling flexibility also is an advantage for the hospital, Anastascio said.

"The registry has increased productivity," she said. "My head nurses can be more flexible because they get the same nurse regularly. We have no doubt about putting [one of our] registry nurses in charge of medications because we know them. With other agencies, you get somebody new each time and you don't get to know that person as you do someone you have all the time."

Because staff shortages are not limited to registered nurses, Garofalo is researching expanding the registry to other allied health professions such as licensed practical nurses, nurse assistants, and respiratory and radiology technicians.

We are trying to create a staff at the hospital for a minimal amount of money," she said.

[The registry] is a good recruiting tool. Ultimately, we want to get the nurses in the registry to work for the hospital full-time. A few test the waters by signing with the agency. They go into full-time employment if they like it."