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Float Pools- Are they working the way you expect?

Posted by Tim Teague on Fri, Dec 11, 2015 @ 10:51 AM


If your float pool or staffing bank is not providing the results you need, you are not alone. One of the great challenges in the acute care setting is the ability to meet the challenge of daily staffing expectations. Two of the major drivers in this challenge can be the random “call-offs” in an already short-staffed cost center, coupled with a census that is becoming more and more volatile.

From a budgetary perspective, what I call “just-in-time” decisions for staffing don’t seem too onerous on that day, but as days turn to weeks, and weeks to months, these daily “quick fixes” can grow out of control.

Just as I tell my kids to scrape the last bit of peanut butter from the jar before throwing it away, too many staffing departments are “buying” new jars before they have truly utilized what is available.

The solution to maximizing a float pool is most often a technical solution. There are a few basic questions that can determine if the float pool is really being maximized.

During the development of the pool, were all affiliated offices, facilities, and units informed of the intent?

  • Are there any “crossover” competencies from participants that might be of use? (Maybe an L&D nurse has had come ED experience.)
  • Is there a true “search and find” function that quickly uncovers all possible matches that include-
    1. Availability (granular down to the hours available)
    2. Matching competencies
    3. Current credentials
    4. Location (within established distances)
    5. Prior experience and amount of time worked (if any) in the requesting unit.
  • Is there a true “interactive” system of delivery and response to needs that incudes text message response to accept or reject?

We find that those facilities that are answering “yes” to these questions are truly “getting every last bit of peanut butter” from the jar and are maximizing available resources while minimizing cost.

Tags: Healthcare, medical staffing, VMS, hospital float pool,, staffing

Trick or Treat - Happy Halloween!

Posted by Jennifer Kardell on Thu, Oct 29, 2015 @ 11:05 AM

It's that time of year again...

halloween ghostRushing around trying to find the perfect costumes, buying candy for all the little trick-or-treaters, and baking lots of goodies for halloween parties. Once this is all done the chaos turns in to parents rushing their kids door-to-door to fill their bags and buckets full of candy before their bed time. However, this seems to be all people really know of Halloween - ring a doorbell and get candy. There's more to the holiday than that.

The orange-and-black holiday originated in a country known for green, Ireland. This holiday celebration was brought over to North America by immigrants from Europe who would share ghost stories, sing, dance and tell fortunes around a bonfire. Jack-o-lanterns weren't always carved in to pumpkins, turnips were originally used in an attempt to keep away spirits and ghosts. There is still so much more to know about this holiday, so test your knowledge below!

Think you know everything about Halloween?...Test your knowledge!

(Answers below...don't cheat!)

1. True or False: Tootsie Rolls were the first wrapped penny candy in America.

2. Halloween candy sales average ____ in the US each year.

         a.3 million   b. 2 billion   c. 100 million   d. 5 million

3. Halloween ranks second to which holiday when it comes to commercial success?

         a. Christmas   b. Thanksgiving   c. 4th of July   d. New Year's Eve

4. True or False: Pumpkins also come in white, blue and green

5. The most popular candy given is _____.

         a. gum   b. suckers   c. gummi/chewy candies   d. chocolate

6. ______ is the number 1 U.S. city for trick-or-treating.

         a. Chicago   b. Nashville   c. San Francisco   d. New York

7. According to the National Confectioner’s Association, more than ____ pounds of candy corn will be produced this year.

         a. 10,000   b. 35 million   c. 100,000   d. 1 billion

8. True or False: In the United States, the first citywide celebration was in Anoka, Minnesota.

9. ___% of parents admit to sneaking goodies from their kids’ Halloween trick-or-treat bags.

         a. 90   b. 75   c. 40   d.25

10. According to superstition, if you stare into a mirror at midnight on Halloween, what will you see?

         a. bloody mary   b. your future spouse   c. your death   d. dead ancestors


row of pumpkins


Answers: 1. True, 2. b. 2 billion, 3. a. Christmas, 4. True, 5. d. chocolate, 6. c. San Francisco, 7. b. 35 million, 8. True, 9. a. 90, 10. b. your future spouse

Tags: halloween, holidays, trick or treat, costumes, trivia, happy halloween, Blogging, healthcare scheduling software, healthcare staffing software, healthcare staffing agency

5 Ways to Reduce Risk with Your Background Screening Program

Posted by Guest Post on Tue, Oct 20, 2015 @ 09:45 AM

We hope you enjoy a guest post from our BlueSky partner Dr. Alan Lasky at United Background Screening.


Over the past few years, litigation has tripled in employment background screening, due to increased regulations and scrutiny of the background screening process by the Equal Employment Opportunity Commission (EEOC), Federal Trade Commission (FTC), and other industry-specific auditing agencies.   Recently, employee/candidates have filed a significant number of class-action lawsuits, causing companies to pay out millions of dollars in settlements, creating a wake-up call for organizations to take more time and care in reviewing their background screening and hiring programs.   Universal Background Screening has listed five strong areas to review with your legal counsel, pertaining to your employment screening program, to help reduce risk:

1)      Following the FTC and EEOC Guidance Factors/Requirements – Over the past few years, both the EEOC and FTC have focused more on the topic of employment screening, making sure organizations are fair and just in their practice of hiring candidates.   In April 2012, the EEOC launched updated guidance factors, focused on how organizations use criminal records and how it impacts Title VII of the Civil Rights Act of 1964, prohibiting discrimination based on race, color, religion, sex, or national origin of a candidate.   In addition, the FTC and EEOC created documents to educate both the employer and potential employee on the proper background screening process.   It is important for employers to know these guidance factors are best practice processes to reduce the risk of perceived discrimination and for educating those firms not following proper screening requirements.

2)      Working with an Accredited Firm – Although there are hundreds of screening firms in the United States, there are only a handful that have taken the time and care of becoming an accredited firm with the National Association of Professional Background Screeners (NAPBS).   This important accreditation certifies that the employment screening firm has been audited for proper procedures, securely protects private information and understands both state and federal requirements.   You should always ask your screening firm whether they have obtained this accreditation since it is one of the only recognized certifications in the employment screening industry.

3)      Providing the Proper Disclosure and Authorization Forms to a Candidate – Many of the latest class action lawsuits have ensued, due to organizations failing to provide the candidate a form that has the correct disclosure and authorization language, many times unfortunately including extraneous information. In addition, a job application form should never be merged with the background screening disclosure and authorization.  Moreover, a candidate should always sign an authorization form prior to any firm conducting a background check and the signed copy should be kept within the employer’s organization, in the event that anyone ever questions the legitimacy of the authorization.  Your background screening firm should have a sample form for your review; you should also always confer with your legal counsel to verify that your company has sound employee background screening processes and procedures in place.

4)      Following the Adverse Action Process Properly – If at any time, any part of a candidate’s report influences your organization to potentially not hire a candidate, that candidate has a right to dispute the reported information for any inaccuracies. This is called the Adverse Action Process.  Many organizations have been sued for not following the federally required procedures, which likely could have been avoided if they had understood the simple, but required, process.   It is an excellent idea to work with your company’s legal counsel and background screening firm to confirm that you have the proper procedures prepared and that your organization’s employees, including new hires, know, understand and follow the required process.

5)      Reviewing Your Own Policies/Procedures with your Legal – It is always recommended to work with your legal counsel as often as necessary to verify that no changes to the laws/regulations pertaining to employment screening have occurred either federally or in your state(s).  Also, the periodic review of internal hiring procedures is essential so that your organization reduces its risk by committing to legally sound, standardized screening and hiring procedures.   By providing information to your employees in your written company policies and procedures manual and regularly updating hiring staff on the required procedures, you will ensure consistency in your hiring program.

 By paying attention to these five areas in your background screening program, you will help reduce risk of lawsuits or other unintentional consequences from inadequate processes. If any additional information is needed, we always suggest speaking with your legal counsel and you can always reach out to Universal Background Screening, a partner of the BlueSky, dedicated to providing compliant and accurate employment screening.


Tags: integrations, Universal Background Screening

BlueSky gets a new look

Posted by Kate Akers on Mon, Sep 28, 2015 @ 12:12 PM

On September 27, 2015, BlueSky launched a new website to help visitors learn more about the software and it’s integrated partners, and more is to come.  Screen_Shot_2015-09-28_at_9.56.57_AM

The new mobile responsive, updated site created by Staffing Robot features videos and details features and integrations and explains how BlueSky can aid medical staffing agencies and facilities to streamline processes and improve efficiency. In addition to learning about BlueSky Medical Staffing Software, visitors can read BlueSky’s blog that covers hot button, relevant issues as well as request a demo, ask a question or reach support.

More change is to come for BlueSky, however, currently underway is a project to revise the user interface for the BlueSky Software itself.

If you are attending Healthcare Staffing Summit in Las Vegas, please be sure to visit BlueSky in booth 112 to see screen shots the software’s new look.

Tags: News

Healthcare Staffing a Great Place to Be

Posted by Tim Teague on Thu, Aug 13, 2015 @ 09:00 AM

The growth or contraction of the healthcare staffing industry has typically followed the direction of the economy.13 Since hospital census typically takes a dive when unemployment spikes, the need for additional labor softens.

However, the recent rulings by the Supreme Court that essentially left the Affordable Care Act intact and will provide a buffer for such economic downturns. The government subsidized insurance plans will continue to generate revenue for hospitals despite dips in the economy.

A quick look at the macro picture of Affordable Care Act outcomes can be seen in the adjusted revenue projections of insurance giant United Health Group UNH and HCA Holdings HCA. HCA increased its revenue projections for 2015 by nearly a billion dollars, and United Health increased its outlook by $2 billion dollars.

Considering these adjustments came prior to the most recent ruling by the Supreme Court that effectively cleared the way for state expansion of Medicaid, these numbers are likely to rise.

It is likely that the continued subsidization of insurance would be politically untouchable in the years to come. Whether friend or foe of the legislation, it portends positively for the healthcare staffing industry.

Tags: Healthcare, medical staffing, ACA

The Secret to Surving the Nurse Shortage

Posted by Tim Teague on Mon, Aug 03, 2015 @ 09:30 AM

A recent study by Nursing Solutions, Inc. found that the turnover rate for bedside RNs was higher in 2014 than in any of the past five years. Their study indicated an improving economy parallels the increase in turnover fnurse_copyor RNs.
Their study examined turnover by specialty and discovered the highest rate of turnover existing in the behavioral health area, followed by the emergency department and med/surg. 

Their RN Recruitment Difficulty Index averaged 85 days, which continues to pose strategic hurdles for HR departments.

One area that healthcare providers have been slow to embrace is “cross-training” for the purposes of minimizing overtime within the organization. The main reason this philosophy has been slow to gain traction in healthcare is the myriad of credential requirements for RNs working in Joint Commission required facilities.

Today employee matching software if readily available that can scour an organization for “hidden” personnel assets that can be deployed to minimize overtime spend. When examining the skill sets of ALL employees, most organizations find that there is an under-utilization of human resources that are already on the payroll! The two keys to maximizing this lower cost alternative to overtime is instantaneous communication to all matches, and of course matching the multiple skill sets of employees to emerging needs. BlueSky has been a pioneer in making this technological advances in the healthcare HR space.

Tags: medical staffing, Nurse Shortage, overtime

Customize your VMS Portals

Posted by Tim Teague on Mon, Jul 20, 2015 @ 11:03 AM

Today, businesses require customizable and efficient workflow, especially for healthcare-staffing VMS portals.

The early days of the VMS/MSP penetration into the healthcare staffing industry, thfeatures-news1e choices were pretty vanilla. While purchasing departments had been using the process for everything from syringes to bed linens, the management of outsourced personnel was slower to catch on. Much of the hesitation was the minimal amount of documentation available in most systems for the extensive list of credentials, work histories and any Joint Commission required documentation.

Early examples of the system were simple pass-throughs of time and attendance with minimal information regarding the actual temp. The acquisition of a commodity such as syringes could be easily identified with a few required specifications. The number of requirements for personnel, however, was so complex that part of the process was usually handled outside the VMS application.

As the industry has become more sophisticated, most of the criteria for personnel have been added to the applications via portals that are viewable at the client end.

BlueSky has taken this one step further to allow subcontractors to “customize” their portal, and even allow for the end client to customize their portal to look and feel the way they want.  Although BlueSky provides a simple plug-and-play template for the VMS application, there are actually over 2,100 variable permissions that may be customized to better meet the client, or subcontractors’ needs.

Tags: VMS, MSP, hospital float pool,

6 Points on Selling your Staffing Firm: # 5 Design your Payday

Posted by Tim Teague on Thu, Jul 16, 2015 @ 09:15 AM

Now that we’ve discussed some of the preliminaries of selling your healthcare staffing firm, it’s time to taksell your healthcare recruiting firma look at the often-used “earn out” strategy. An earn out strategy is a means by which a price to purchase a company is negotiated with

part of the payment tied to performance during some future period. This strategy typically ties the seller to the business for a prescribed period of time to assist in hitting agreed upon numbers for full payment.

What does this really mean? From the buyer’s perspective, they are, to some extent, buying an unknown.  Contracts could be ready to expire or other internal issues may be lurking that could have a serious detrimental impact on the earnings of the company being bought. If part of the purchase price is 

It is not uncommon for 50% to 60% of a purchase price be deferred as an earn out over three to five years. This provides some deferral of income on the part of the seller, and if negotiated correctly can provide an even greater sale price than originally established. If created poorly, the earn out provision could become a nightmare for the seller.contingent on the seller remaining in place to meet certain benchmarks this provides a level of security to the purchaser.

According to Inc. magazine, about three quarters of all mergers and acquisitions fall short of expectations published at time of deal, and about half of all deals result in a decrease in value for shareholders of the purchasing company.  With those figures in mind, it’s important to negotiate an earn out that is fair, but does not tie your hands behind your back. More on that later.  

Tags: Selling your firm

6 Lessons on Selling your Staffing Firm: # 4 Getting Paid!

Posted by Tim Teague on Fri, Jul 10, 2015 @ 09:03 AM

How much cash do you really get when you sell your business?

When suitors come calling to make an “offer you can’t refuse”, there is a tendency to look at that number and assume you have “hit the jackpot”.  Not so fast my friend! Whatever that number may be, by thcashe time the dust has settled from the sale, without carefully planning you may end up with half that amount!

The largest single determinant of the true value of your payday is how you structure the tax treatment of the sale. If this treatment does not become a bargaining chip in the negotiation, you either sold to an uninformed buyer, or you haven’t taken a close enough look at the structure of the deal.

To keep things simple, we will only discuss Uncle Sam’s piece of the pie and leave the state and/or local to your own investigation. In layman’s terms, when you sell your company, what is considered ordinary income, and what is considered capital gains. If you have owned your company more than a year, we can assume that these capital gains will fall under the category of Long-Term capital gains.

This example is NOT for the sale of a c-corp, and/or the sale of stock only, although a c-corp can structure the sale on an asset-by-asset basis.

The number one issue in determining what the IRS’ share of your take will be is how much of your proceeds are the result of a capital gain, and how much is considered income. This is a point of negotiation, since what is good for you, may not be good for the buyer. Don’t forget that Uncle Sam is operating on both sides of the table, so always remember the taxes are a two way street. As an example, the portion of the proceeds that are considered ordinary income would be at your highest tax rate, (nearly 40% Federal alone!), but can be expensed immediately by the seller. On the other side of this tax treatment are capital gains. The assets that have been categorized as capital gains will typically be taxed to you at a maximum of 15%, which leaves you with 85% of these proceeds. The problem for the buyer is the inability to quickly expense these capital assets.  

In more simple terms, the parts of your company that you sell as capital assets will give you 85 cents on the dollar, whereas the parts that are considered ordinary income will only generate about 60 cents on the dollar. Although there are multitudes of ways to structure a sale, if you want to maximize your net proceeds, get an experienced professional to help you sort through these issues.

Tags: Selling your firm

6 Lessons on Selling your Staffing Firm: # 3 valuation (liabilities)

Posted by Tim Teague on Wed, Jul 01, 2015 @ 10:35 AM


As we discussed last time, the benefits taken by you the owner should be carefully examined prior to any healthcare recruiting firm sale.  Another important factor: Take a close look at your company's liabilities.  

Carefully consider the tax consequences of the sale, both to you and to the buyer. In most cases a buyer will want to purchase the assets of your company, not your stock. (If you are a c-corp this may be different.) Why does a buyer not typically want your stock? Stock in the company represents all assets, along with all liabilities. 

A purchaser has no interest in the current, or future liabilities of your company. Some of the liabilities to consider are short and long term debt, notes payable to investors, the balance of any lease agreements.

It is imperative to take some time and analyze all your equipment payment agreements carefully, as some will have auto-renew provisions that require notice of cancellation 30, 60, or even 90 deements, or any other agreement that binds the company to any short or long term financial commitments. Those leased copy machines, automobiles, and rent payments will suddenly move from the income statement as monthly expenses to a current liability due at time of sale, unless the buyer has agreed to assume them, which is highly unlikely.  

One more note on current and/or future liabilities, as a staffing agency you have had dozens or even hundreds of employees that have provided services on a subcontracted basis. Any claims that arise from negligence on behalf of your staff can arise long after the sale of your company assets. Unless you sold the stock, these claims will be your responsibility, albeit through the entity you still hold. Check all your insurance policies for premium coverage periods, and whether coverage is for date of occurrence, or date of claim. Most companies can provide “tail” coverage that can protect you for a period following the sale.

Tags: Health Care Staffing, Selling your firm

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