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Health Care Demands Push Growth of NLR’s Travel Nurse

6 min read

Although it barely missed making it onto this year’s list of largest private companies in Arkansas, Travel Nurse Across America appears poised to capture a spot next year as the demand for what it supplies — nurses — soars and the supply dwindles.

The company, based in North Little Rock, reported $115 million in revenue in 2016 (putting it at No. 76 in the rankings), up from $85 million in 2015. And Gene Scott, president and CEO, expects to see substantial growth this year over 2016.

With its purchase in January of Trinity Healthcare Staffing Group of Florence, South Carolina, Travel Nurse became one of the five largest travel nurse staffing firms in the country.

The nursing shortage facing the United States is acute, Scott said. “I have eight jobs for every nurse I have to fill those jobs,” he said. “That’s not just me; that’s everyone.”

And it will get worse. The average age of a nurse now is 50, Scott said, and 54 percent of the nurses over 50 are going to retire from nursing by 2020.

Also looming is the aging and large — estimated at 74.1 million in April — baby boomer population, whose need for health care will only increase.

Scott’s use of the phrase “perfect storm” to describe this confluence of events is perfectly justified in this context.

“We’re in kind of a crisis mode here,” he said in an interview last week at Travel Nurse’s headquarters in North Little Rock.

“And right now there are no good solutions. They opened up enrollment at nursing schools hoping that they could catch up to that a little bit, but what they’re finding is that 40 percent of new nursing graduates are leaving the acute care environment after three years.”

That’s because nursing, particularly acute care nursing, is a hard work. “It’s stressful. It’s physical,” he said. “They’re dealing with difficult situations, and they’re leaving the positions to go to work in clinic environments, surgery centers. A lot of them are going into administration. So it’s a tough thing.”

But it’s also an opportunity for Travel Nurse. “It’s a huge opportunity for growth for us,” Scott agreed. “Our biggest challenge is finding the nurses to send.”

Travel Nurse staffs a unique employment niche: nurses who want to travel and who typically want a temporary assignment, usually of 13 weeks (see So What’s a Travel Nurse?). “Because of the uniqueness of what we do, there’s that group of nurses that want to travel and so they’re available,” Scott said. “But there are a lot of people competing for them.”

And that’s where technological innovation comes in. The company works to ensure the best match possible between nurse and job. To do that, it has built proprietary systems that can post jobs from health care providers in real time and then search Travel Nurse’s database of nurses who are looking for jobs in certain areas or for certain kinds of jobs. It can make a match and then inform nurses of a job availability within minutes, Scott said.

He describes the process as “the Match.com of nursing.” And it gives nurses who sign up with Travel Nurse Across America an advantage, Scott said, “because if it’s an attractive job, whether it be rate or location, someone else will snatch it up.” Good jobs, like good boyfriend or girlfriend prospects, go fast.

Also contributing to a climate of growth is a shift in what hospitals base payments on, a shift accelerated by the Affordable Care Act, which encourages payment based on the value of care and away from a fee-for-service model. Before the ACA, “hospitals used to get reimbursed from Medicare based upon their cost structure,” Scott said.

“Now hospitals are moving to a payment structure or reimbursement structure that’s based upon patient outcomes and patient satisfaction. The patient outcomes and the patient satisfaction are directly affected by your nurse-to-patient ratios.”

That means that hospitals may see nurses “not necessarily as a cost center but as a path to a higher reimbursement by way of better care for the patient and higher satisfaction,” Scott said. “That’s the way it should be.”

A Best Place to Work
The primary reason, however, for Travel Nurse’s continued revenue growth, Scott said, is its culture. It was named a Best Place to Work in September and was a finalist for Arkansas Business of the Year in the 76-300 employees category this year and last year as well. It was previously named a Best Place to Work in 2014 and 2015, and it won the 2014 Arkansas Business of the Year Award in the 26-75 employees category.

“Not only are we one of the largest, but we believe we’re pushing the mark for the best in what we do,” he said. “We’ve been one of the fastest-growing travel nurse agencies organically in the last four years in the entire industry. We believe that is attributable to the level of quality we bring to the table — the quality of nurses and the quality of personnel that works with our agents.”

Travel Nurse, founded in 1999, provides nurses to acute care facilities in all 50 states, averaged over 1,500 nurses out on assignment in the first quarter of this year. With the acquisition of Trinity Healthcare, it now has 230 corporate employees and two offices, in North Little Rock and Florence. Fifty percent of those corporate employees work remotely, Scott said.

“That is unique to our agency,” he said. Having so many remote employees allows Travel Nurse to cover all time zones and allows the company to have employees who are familiar with the locales in which Travel Nurse places nurses. For example, “If I have someone that wants to know about Southern California, I have a lot of people in the San Diego area,” he said.

“It also is where I can find a lot of talent,” Scott said. “I have the large metropolitan areas around the country where people are tired of the hour-and-a-half commute to work every day, and they can work from home just as easily as they can work from their office.” And that contributes to the accommodating culture of the company.

Employees Needed
Travel Nurse Across America now occupies about 14,000 SF in a building at 5020 Northshore Drive in Northshore Business Park. But Edafio Technology Partners, which occupies about 4,000 SF in the building, is moving to a new, larger headquarters, and Travel Nurse will take up the space Edafio vacates.

Travel Nurse Across America’s growth has it in need of good employees. “We are growing and we’re not just looking for nurses,” Scott said. “We have to have our corporate employees to support the nurses that are on assignment. So I’m looking for recruiters; I’m looking for accounting people. I’m looking for clinicians that want to work in administrative roles; I’m looking for credentialing specialists. The reason I’m telling you this is because we’re looking for these people.

“Average compensation structure here is very high for the state of Arkansas,” he said. “Our compensation and benefits plans are some of the top in the state.”

So What’s a Travel Nurse?
Travel nursing arose as a response to nursing shortages that developed in the 1980s. It began as a short-term solution, but evolved “into an essential part of hospital operations,” according to the American Society of Registered Nurses.

This is how Gene Scott, CEO of Travel Nurse Across America, describes what his company does:

“We staff RNs, multispecialty to acute care facilities, hospitals in all 50 states. They’re usually there on a temporary assignment that lasts approximately 13 weeks. And then at the end of that assignment, they can either renew at the existing location or take an assignment someplace else in the country.”

It can be exciting, and it’s a good way to see the country or to build up a resume with assignments at top institutions, Scott said.

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