7 travel nurse pay trends for healthcare leaders to know

The COVID-19 pandemic intensified hospitals’ reliance on travel nurses to address staffing shortages and highlighted the gap between full-time workers’ pay and lucrative temporary contracts. In the third year of the pandemic, hospitals continue to rely on travel nurses and grapple with workforce shortages for a variety of reasons. However, some organizations have reduced their reliance on travel nurses, and pay overall is lower compared to certain points of the pandemic, experts told Becker’s

Here are seven travel nurse pay trends for healthcare leaders to know, per Vivian Health, a national healthcare hiring marketplace used by about 800,000 clinicians, and AMN Healthcare, a medical staffing firm based in Coppell, Texas:

1. The average weekly travel nurse pay in July in the U.S. was $2,997, up 12 percent from $2,681 during the same time in 2021, according to a report from Vivian Health. The report, which was shared with Becker’s, is based on proprietary data of job postings on Vivian Health in July.

2. Among states, Alaska saw the largest average increase to travel nurse pay in July compared to the same time in 2021, according to the Vivian Health report. Florida saw the largest average decrease.  

3. When taking a month-over-month view of 2022, average travel nurse pay is declining and coming back to last year’s levels, according to Vivian Health. The company cited several factors for this trend, such as a shift away from travel roles and toward permanent nursing roles as well as less federal money being shifted toward hospitals for large travel contracts.

4. Rishabh Parmar, head of strategy and operations at Vivian Health, told Becker’s: “Compared with July 2021, we still see that travel rates are higher [year over year] — close to around 12 percent to 15 percent — but it seems to be stabilized. Now, in terms of the demand, there’s still a lot of demand out there.”

5. Mr. Parmar estimated that available travel nurse jobs on Vivian Health’s platform doubled in July 2021 compared to pre-pandemic numbers in March 2020. As of July 2022, they were at 2.7 times the rate of March 2020 job numbers.

6. AMN Healthcare also reported lower rates. “According to a recent earnings call, AMN Healthcare expects the company will exit 2022 with travel nurse and allied healthcare professional bill rates at approximately 30 percent lower than first-quarter levels,” the company told Becker’s. “Though demand for travel nurses and allied professionals has declined from an all-time high in Q1, the company expects persistent vacancies and labor shortages to continue.”

7. Some hospitals “are saying, ‘We need to use travel nurses, we just have to use [travel contracts] at lower rates,'” Mr. Parmar said. Some organizations are also offering internal travel programs amid an opportunity to attract workers while decreasing contract labor expenses.

Kentucky nurse charged with murder in death of patient

A nurse was charged with murder Aug. 23 for allegedly causing the death of a 97-year-old patient at Baptist Health Lexington (Ky.), the Lexington Police Department said in a statement

Eyvette Hunter, RN, was indicted in the death of James Morris. Ms. Hunter “intentionally performed actions of medical maltreatment” to Mr. Morris on April 30, and he died as a result of those actions on May 5, police said. 

Ms. Hunter’s nursing license was also suspended this week, according to the Kentucky Board of Nursing. 

The order suspending her license said Ms. Hunter administered lorazepam, a sedative, to Mr. Morris without a physician’s order, according to WKYT. Another nurse found the patient a short time later with labored breathing, and he died May 5. His cause of death was listed as aspirational pneumonia. 

Ms. Hunter admitted to administering the drug to Mr. Morris without an order, according to WKYT

“We have learned that a former nurse at our hospital has been arrested on criminal charges. The nurse has not worked here since April 30,” Baptist Health said in an Aug. 23 statement, according to WKYT. “The nurse was terminated and was reported to the Kentucky Board of Nursing. The hospital has fully cooperated with the police investigation. Patient care and safety are always our top priorities. Out of respect for the family and because this is a criminal matter, we are not able to talk about the investigation.”

UPMC’s operating income sinks 86% in first half of year

UPMC reported higher revenue in the first half of this year than in the same period of 2021, but the Pittsburgh-based health system’s operating income declined year over year, according to financial documents released Aug. 23. 

UPMC reported revenue of $12.5 billion in the first six months of this year, up from $12.2 billion in the same period of 2021. 

Expenses also increased year over year. UPMC reported operating expenses of $12.4 billion in the first half of this year, up from $11.6 billion a year earlier. Expenses increased across all categories, including supplies and salaries and benefits. 

“Throughout 2022, the continued effect of COVID-19, along with conditions in the labor and supply markets have resulted in cost growth in employment, staffing and other operating expenses in excess of revenue growth,” UPMC management wrote in the financial filing

The health system ended the first half of this year with operating income of $81.9 million, down 86 percent from $604.6 million in the same period last year. UPMC’s operating margin was 0.7 percent for the first half of this year, compared with 5 percent in the same period last year. 

UPMC reported a net loss of $844.1 million in the first half of this year, compared to net income of $1.1 billion in the same period of 2021. The system’s loss from investing and financing activities totaled $865.9 million in the first two quarters of 2022, compared to a gain of $531.1 million in the same period a year earlier.

6 hospitals hit with credit downgrades

Credit rating downgrades for several hospitals and health systems were tied to capital expenditures and cash flow issues in recent months.

The following six hospital and health system credit rating downgrades occurred since June: 

  • Boone Hospital Center (Columbia, Mo.) — lowered in August from “Ba1” to “Ba3” (Moody’s Investors Service) 
    “The downgrade to ‘Ba3’ reflects the continued and material deterioration of unrestricted cash, along with simultaneous operational challenges facing BHC,” Moody’s said. “Operating headwinds, along with recent turnover in senior management, will contribute to challenges in attaining performance improvements. These headwinds will include elevated labor and supply costs, partly raised by supply chain system implementation issues, and volume disruption, which has been exacerbated by the on-going pandemic, as well as the absence of state or federal funds in 2022.”
  • Jackson Hospital (Montgomery, Ala.) — lowered in August from “Baa3” to “Ba3” (Moody’s Investors Service) 
    “The downgrade to ‘Ba3’ reflects Jackson Hospital & Clinic’s material and recent deterioration of operating performance and unrestricted cash through June 2022,” Moody’s said. “As a result, headroom to both the debt service coverage and days cash on hand covenants has been materially reduced increasing the risk of a covenant violation, which could lead to immediate acceleration of debt, a governance consideration under our ESG framework.”
  • Memorial Health System (Marietta, Ohio) — lowered in July from “BB-” to “B+” (Fitch Ratings)
    “The downgrade of the IDR to ‘B+’ reflects MHS’s weak net leverage profile through Fitch’s forward-looking scenario analysis given stated growth and spending objectives,” Fitch said. “While operating performance has stabilized over the past three years … and reflects cost efficiency strategies and pandemic relief funding, improved cash flow funded higher levels of capital spending in fiscals 2020 and 2021.”
  • Doylestown (Pa.) Hospital — lowered in June from “Ba1” to “Ba3” (Moody’s Investors Service)
    “The downgrade to Ba3 reflects Doylestown Hospital’s … significant and recent decline in operating performance and unrestricted cash reserves through fiscal 2022, which have materially reduced headroom to the days cash on hand covenant (100 days) and increases the risk of an event of default and immediate acceleration as soon as June 30, 2022, a governance consideration under our ESG framework,” Moody’s said.
  • Jupiter (Fla.) Medical Center — lowered in June from “BBB+” to “BBB” (Fitch Ratings)
    “The ‘BBB’ rating reflects JMC’s increased leverage profile with the issuance of $150 million in additional debt to fund various campus expansion and improvement projects,” Fitch said. “While favorable population growth in the service area and demonstrated demand for services in an increasingly competitive market justify the overall strategic plan and project, the additional debt weakens JMC’s financial profile metrics and increases the overall risk profile.”
  • South Shore Hospital (South Weymouth, Mass.) — lowered in June from “BBB+” to “BBB” (Fitch Ratings)
    “The downgrade to ‘BBB’ reflects SSH’s track record of very weak operating performance over the last four fiscal years, exacerbated by staffing shortages and other pandemic-related challenges, which are stymying the system’s efforts towards an operational turnaround,” Fitch said.