2055 State Street East Petersburg, PA RN FACT SHEET

Transcription

1 NSI NSI NURSING SOLUTIONS, INC 2055 State Street East Petersburg, PA RN FACT SHEET THE HEALTHCARE ENVIRONMENT... STAFF SHORTAGES AND COSTS RISE. Is a an amalgamation study accumulated from over 100 sources NSI NURSING SOLUTIONS, INC.

2 NURSING SHORTAGE 2015 GNs are flowing from nursing schools, but not enough to replace the exiting or retiring RNs, let alone the RNs needed to fill newly created nursing jobs. (Robert Rosseter,, ACCN) According to the NEJM's, the RN workforce supply expansion is a temporary bubble that is deflating, due to an improved economy and as unemployment rates fall. It is estimated that 118,000 FTE RNs will exit the workforce, between FierceHealthcare reports, this RN exit is happening simultaneous to 136,000 RN retirements occurring by While 58% of hospitals are unprepared for RN retirements. All contributing to rising levels of an RN under-supply projected at 254,000; which is confirmed by the BLS that projects 274,500 RN demand. Also Dr. Kathryn Grams estimated that the supply/demand gap is expected to be 20% by (Dean of the University of West Georgia School of Nursing; BLS, 12/18/13)

3 HEALTH REFORM IMPACT ON STAFFING So how will hospitals respond? With 77% of CNOs believing vacancy is creeping up, typically the first recruitment response is sign-on bonuses, which currently ranges $3,000- $15,000, with an average of $6,881...For context, the pre-recession recession era sign-on bonuses ranged $5,000- $25,000, with an average of $9,135. Expect this to increase dramatically. The second recruitment response is engaging travel nurses, a a very expensive approach. Hospitals (63%) are now using more travel nurses according to FierceHealthcare, with a projected 3%-6% increase, in (ASA) In 2015 ASA & SIA predict a price increase of 2%-4%. Further, for contract labor (RNs) "it "it s s no longer a buyer s (hospitals) market. As the economy improves, hospitals hiring contract labor (RNs) no longer have the upper hand... So (hospitals) should expect tougher negotiations and to pay more for contract staff. The market has changed, and attitudes are different... so be prepared for...higher prices,"...all leading to margin concerns. (SIA; US Federal Beige Book)

4 THE RN WORKFORCE-COST DILEMMA According to an ANA September, 2014 study, 1.13 million additional RNs, representing a 20.2% increased need will occur over the next 7 years (2022). An additional 574,400 RNs will be needed for the newly created jobs and another 555,100 to replace the retiring nurses, pushing double digit vacancy rates and turnover rates up, expected by 63% of CNOs. According to the BLS, 38 states project a 15%-20% annual new job growth rate, primarily in the: West, South, Southwest and Southeast. According to the US Census Bureau 77% of hospitals are already feeling the beginnings of a nursing shortage, pushing 63% of hospitals to use contract RNs. The projected RN cost of contract labor is expected to average $69.23/hr in 2015.

5 RN VACANCY, RECRUITMENT AND STAFFING In 2015 and in anticipation of Health Reform, Do CNEs think the RN Vacancy Rate will Worsen? RN Recruitment will be more difficult? Need to use Travel Nurses will be greater? Use of Overtime will be greater? Hospitals will Divert more often? Hospitals will need to Shut Down Beds more often, due to Short Staffing? Hospitals will need to Shut Down Units more often, due to Short Staffing? Hospitals will need to delay Surgeries, more often, due to Short Staffing? YES N=539 72% 57% 63% 59% 5% 2% 1% 2%

6 WHERE WILL THE NURSES COME FROM? The BLS reports there are 2.8 million RNs...not nearly enough since the ACA kicked-in, with 32 million newly insured & 78 million baby boomers needing more care and with potential RN retirements up 8% in 2015 forecasts show: Number of GNS added not enough to keep up with the 10% population growth: (HRSA) Percent working in hospitals: (ACS) Number of Advanced Practice Nurses: (HRSA) Number of CNS: (HRSA) Number of CRNAs: (National Academy of Sciences) Percent of RNs with BSN: (HRSA) Percent with Associate Degrees: (HRSA) Percent with Diploma: (HRSA) RN demand in 2014 jumped by: (BLS) RN demand expected in 2015 to rise by: (BLS) RNs reporting being short staffed: (Nursing Times) 500, % 153,348 59,242 34,821 42% 38% 12% 23% 12% 80%

7 WHERE WILL NURSES COME FROM? There is a forecasted APN shortage by 2025 of: (AJN) 198,000 Forecasted annual RN new job growth. (BLS; HRSA; US Census Bureau; Nurse Leader; Bloomberg; Rand; AONE; AYA Medical News Today; The Street) 2015 the newly created RN job growth & RN replacement needs are forecasted to increase: (RN retirements, exits & turnover): 2016 the new RN job growth: 2017 the new RN job growth: 2022 the new RN job growth: 12% 15% 17% 19% Forecasted RNs needed due to RN replacements (BLS; HRSA; US Census Bureau; AONE) through 2020 is: (555,100 RNs by 2022) 495,600 additional RN replacements needed per year: 82,600 States reporting shortages: AL, AZ, CA, CO, FL, GA, ID, IA, MO, MT, ND, NV, NM, NC, OH, OK, SC, SD, TN, TX, UT & WY (Wikianswers)

8 AGENCY/TRAVEL NURSES RN CONTRACT LABOR USE, COSTS, ROI & BOTTOM LINE IMPACTS Number of hospitals using more contract RNs: (ASA; SIA) Contract Labor Effectiveness Rate is: (Healthcare Trends) Hospitals planning to transition contract labor to "permanent status. : (SIA) 63.1% 28.2% 45% Stabilizing regular staffing can achieve 5% to 8% savings, ranging $3 to $16 million. (Huron Group) The Agency/Travel penetration (use) rate is and has eclipsed the record reached in 2014, suggesting a 3% recruiting crunch: (SIA; Bloomberg; ASA) Agency fees in 2014 rose: Agency fees forecasted to rise in 2015 and per year thru 2018 at: Agencies passing-along along ACA costs to hospitals ranged 1% to 3%: (SIA; ASA) 6% 3%-5% 64%

9 AGENCY/TRAVEL NURSES RN CONTRACT LABOR USE, COSTS, ROI & BOTTOM LINE RNs reporting uneven workloads distributed: RNs reporting excessive workloads-- --short staffing: RNs reporting staffing as inadequate: The average excess cost per travel nurse per year: (HealthLeaders; Healthcare Trends) IMPACTS--continued The average travel nurse rate is: (BLS; SIA) The average travel nurse cost per year: (BLS; SIA) The average travel nurse range per hour: (Bloomberg) The average annual cost range is: Cost difference of employed RN to contact RN: Every 20 travel nurses replaced with permanent regular staff, saves a hospital: (Healthcare Trends; 2015 Amalgamation Study) 58% 59% 42% $69.23/hr $143,998 $58 to $93.50/hr $120,640 to 194, % -237% $59,564 $1,191,280

10 RN RETIREMENTS Percent of hospitals unprepared for RN 55% retirements: (FierceHealthcare; HRSA) Number of RNs retirement eligible over the next 6 years: 495,500 55% of retirement eligible RNs planning to retire by year: 2010 to %; 2018 to % 2012 to % 2021 to % 2016 to % 2023 to % (BLS; HRSA; ACS; Kaiser Foundation; HRSA; Hodes; Retention Institute) 2015 RN retirements are forecasted to increase significantly (SIA; AONE; Becker) RN hours worked by RN age group: (US Census Bureau) 51 to 60 averaged 36 hours 61 to 70 averaged 34 hours 71+ average 26 hours Average RN age: (HRSA; AACN) 44.6 years

11 RN TURNOVER, COSTS & VACANCIES Average 2014 RN turnover rate is: (KPMG) RN turn-over range is: (KPMG) 15.1% 3.9% to 32.2% The average RN unemployment rate: (US News & World Reports) 2% Average 2015 forecasted RN turnover rate is: (KPMG) RN 2015 forecasted turn-over range is: (KPMG; AACN) 17.7% 4% to 35% Average GN turnover range is: First year new hire RN turnover rate ranges: 45% to 60% 30% to 35% RNs planning to turnover between pushing 42% turnover rates up: (SIA; Harris Interactive) RNs actively looking to turnover today: (SIA; Harris Interactive) 18% RN Cost of turnover ranges: $72,585 to $145,172 per RN First year RN Cost of turnover: (National Academy Sciences) $88,000 RN Fellowships/Residences program cost range: (AONE, Nurse Leader, FierceHealthcare) Cost of orientation costs: (Nurse Leader) $80,000 to $140,000 per RN depending on specialty $39,000 to $65,000

12 RECRUITMENT DATA, SIGN-ON BONUSES, TIME TO FILL COSTS DATA Hospitals now feeling the beginnings of a nursing 77% shortage: (FierceHealthcare; Colorado Center For Nursing) Hospitals with high vacancies: (Rand) Hospitals having difficulties filling vacancies: (SIA) RN recruitment r difficulty rate increased: (SIA) 2014 average RN recruitment r difficulty rate: In 2015 the average RN recruitment r difficulty rate is forecasted at: (Healthcare Trends; Workforce Analytics) 23% 43% 13.6% 76.6% 77.2% Sign-on bonuses 2015 forecast: (Job Board) $5,000 to $25,000 Forecasted 2015 average sign-on s bonus: (Job Boards) $6, projected annual applicant flow range: 2015 average RN time-to-fill is forecasted at: 2015 RN time-to-fill ranges is forecasted at: 49 to 872 RNs 79.2 days 59 to 97.8 days RN Cost per hire rising to: (SIA; BLS) $31,902 to $34,765 per RN

13 RN COMPENSATION AND OVERTIME TRENDS 2015 forecasted average RN salary): (Compensation Consulting Firms; BLS) 2015 number of employers raising wages for existing staff: (Randstad) 2015 Number of employers raising RN start $72,585 ($34.89/hr) 72% 53% salaries: (Randstad; Mercer; Hay) 2015 average RN salary increase: (Randstad; Mercer; Hay) 2015 RN salary increase range: (Randstad; Mercer) RNs report working more overtime: (Nursing Times) RNs reporting more work related stress: (have taken more sick-leave, than usual) (Nursing Times, 2013) RNs although feeling ill yet felt pressured to 3.5% 2.9% to 4.7% 46% 39% 71% return to duty : (Nursing Times, 2013) RNs reported vacancies affecting scheduling and overtime --- "more often than anticipated : 73%

14 2015 RN SALARIES Hewett Associates; Hay Group; William M. Mercer; Salary.com/Nurses; CareerBuilders; SalaryExpert.com BY SPECIALTY ICU/CCU Range $62,819 to $86,885 ED Range $64,742 to $83,114 OR Range $62,971 to $85,839 Oncology Range $62,930 to $83,664 M/S Range $60,960 to $79,780 Orthopedics Range $60,991 to $78,322 OR First Assist Range $75,197 to $102,660 PACU Range $65,575 to $85,426 OB/GYN Range $62,176 to $78,659 Pediatrics Range $61,314 to $71,985 Psychiatry Range $61,219 to $78,059 Average Rates $73,972 ($35,56/hr) $78,310 ($37.65/hr) $79,776 ($38.35/hr) $73,988 ($35.57/hr) $71,868 ($34.55/hr) $71,666 ($34.45/hr) $87,126 ($41.88/hr) $73,178 ($35.16/hr) $68,995 ($33.17/hr) $70,123 ($33.71/hr) $70,730 ($34.00/hr)

15 2015 STATE AVERAGE RN SALARIES Amalgamation Study, 2015; HHS, HRSA; Advance for Nurses, Advance Watch; ihirenursing.com; BLS; Economic Research Institute STATE MT AK IA KS WI DE Al AZ AR CA CO CT FL GA IL MI SALARY $65,987 ($31.72) $86,122 ($41.40) $68,918 ($33.13) $67,857 ($32.31) $67,990 ($32.68) $71,488 ($34.36) $71,624 ($34.43) $73,777 ($35.46) $65,333 ($31.41) $81,995 ($39.42) $76,803 ($36.92) $74,971 ($36.04) $65,879 ($31.67) $69,914 ($33.61) $71,472 ($34.36) $68,400 ($32.88) STATE ME MA MN NB PA KY ID LA MD IN MS MO NV NM NC WY SALARY $69,924 ($33.61) $72,880 ($35.04) $73,951 ($35.56) $68,618 ($32.99) $70,170 ($33.73) $68,356 ($32.86) $68,912 ($33.13) $66,513 ($31.97) $76,313 ($36.69) $68,870 ($33.15) $65,968 ($31.71) $67,623 ($32.51) $79,940 ($38.43) $68,511 ($32.93) $66,262 ($31,85) $64,888 ($31.19) STATE OH UT DC WV NJ OK OR PA SC TN TX VA WA SALARY $68,830 ($33.09) $68,787 ($30.07) $77,413 ($37.21) $65,451 ($31.46) $74,406 ($35.77) $66,336 ($31.89) $73,913 ($35.53) $68,700 ($33.03) $67,955 ($32.67) $67,999 ($32.69) $74,148 ($35.65) $69,393 ($33.33) $74,622 ($35.88) U.S. $72,586 ($34.89)

16 American Staffing Association, 2013, 2014 ASHHRA, 2014 AONE, 2012, 2014 AHA, 2013, 2014 AJN, 2013, 2014 AMA, 2013, 2014 ACS, 2013 ACHE, 2013, 2014 AAMC, 2012, 2014 AACN, 2013, 2014 Accenture, 2013 Amer. Medical News, 2013 BLS, 3/29/12, 7/13,17/12, 8/3/12, 12/18/13 Bloomberg, 2012 Beckers Hospital Review, 2013 Center for Health Workforce Studies 2012 Federal Beige Book, 2013, 2014 HHS, 2012, 2013 SG2, 2013 D. Staiger,, Dartmouth Univ. SOURCES FierceHealthcare, 2014 Shari Sandifer, AONE Group, 2013, 2014 Hodes, 2013, 2014 Huron Group, 2013 Harris Interactive HRSA, 2013, 2014 Healthcare Management Healthcare Trends, 2013, 2014, 2015 H&HN, 2013 HealthLeaders, 2012, 2014 Harris Interactive, 2013 KPMG, 2013 Jackson Healthcare, 2013 J. Nursing Administration, 2013 Kaiser Foundation, 2012 Health Affairs, 2013 IQNdex, 2013 Modern Healthcare, 2013 Modern Physician, 2013 Medical Access for America, 2012 PwC, 2013, 2014 Nurse Economics, 2013 Nurse.com, 2012 NYT, 7/12/12 Nurse Management, 2012 Nursing Times, 2013 NLN, 2012, 2014 National Center for Health Statistics, 2013 NSI Amalgamation Studies, 2013, 2014, 2014 NPR, 2012 Hay Associates, 2013, 2014 William F. Mercer, 2013, 2014 Moody s, 2013, 2014 Health Affairs, 2012 Journal of Healthcare Management, 2012, 2013 Retention Institute, 2013, 2015 SIA, 2012, 2013, 2014 The Street, 6/13/13 Wanted Analytics, 2013 Wikianswers, 2013 US Census Bureau, 2013, 2014 Reuters, 2013, 2014 Randstad, 2013, 2014

17 NSI NSI NSI NURSING SOLUTIONS, INC 2055 State Street East Petersburg, PA NSI NURSING SOLUTIONS, INC is a 15 year old national high volume U.S. nurse recruitment firm; that recruits only within the continental U.S. for American Experienced Nurses, as your core employee staff, in an average time-to-fill of 32 days. NSI is not a foreign recruiter nor a travel or temporary agency. NSI The partnership is RISK FREE, since you must hire the nurses BEFORE NSI is paid. NSI The relationship is also a WIN-WIN, since not only are the nurses guaranteed for 6 months, NSI provides On-Boarding Coaching for the nurses, for 365 days.