A coalition of 30 healthcare staffing firms sent a letter to the US Department of Labor on Aug. 3 asking it to issue an opinion letter confirming that temporary nursing staff placed in post-acute care facilities should be classified as employees rather than independent contractors. 

“The coalition members employ their nursing staff as W-2 employees, but similar agencies that follow the same — or substantially similar — staffing model classify their nursing staff as independent contractors,” according to the letter. “The coalition believes that independent contractor status for temporary nursing staff working in post-acute healthcare settings violates the [Fair Labor Standards Act].”

The request comes as the Department of Labor prepares to finalize new guidelines for determining whether workers should be classified as employees or independent contractors.

“We need clarity from the Department of Labor — once and for all — that this practice is wrong and enforcement that puts it to a stop,” Tony Braswell, president and founder of Gale Healthcare Solutions, said in a press release. “Without it, we can expect a race to the bottom that puts more stress on our healthcare system and steadily erodes the quality of patient care.”

Braswell said, “Independent contractors are key to many parts of our economy, but they are not appropriate for nurses providing bedside care in nursing homes.”

Post-acute facilities include those that provide long-term care, assisted living and skilled nursing, and, historically, temporary nursing staff have been classified as W-2 employees. But the letter said half a dozen tech-enabled firms began classifying their nursing staff as independent contractors during the pandemic. As a result, the coalition asserts that a significant number of nurses and [certified nursing assistants] are improperly classified.

The letter said healthcare professionals operating as independent contractors face risk by being denied benefits such as overtime pay, access to employer-provided healthcare insurance, unemployment insurance and workers’ compensation. There are other risks as well.

“Temporary nursing staff interact directly with a vulnerable population, and they are responsible for the well-being and health of those patients,” according to the letter. “The nature of the job inherently requires a higher level of oversight, training and control to ensure optimal patient outcomes and achieve the required standards of care. Facilities that rely on independent contractors significantly increase the risk of substandard patient care and malpractice claims because the agencies providing independent contractor staff do not provide the necessary clinical and professional oversight for their workers, resulting in insufficient levels of training, continuing education and support.”

The coalition also argued that nurse staff do not qualify as independent contractors under the law.

In addition to Gale Healthcare, the letter was signed by representatives of IntelyCare Inc, ShiftMed LLC and connectRN Inc.

The following firms endorsed the letter: Advantis Medical Staffing, AMN Healthcare, Assured Healthcare Staffing LLC, ATC Healthcare Services, Blu MedStaff LLC, Camillus Staffing LLC, Davin Healthcare Workforce Solutions Inc., Favorite Healthcare Staffing LLC, GigWorx Healthcare, GrapeTree Medical Staffing LLC, HealthPro Innovation Workforce Solutions LLC, HealthTrust Workforce Solutions, Integrity Health Group LLC, LeaderStat Ltd., Medical Solutions LLC, MedPro Healthcare Staffing, OneStaff Medical, OPA Medical Staffing LLC, Pluto Healthcare, Provenir LLC, Superior Medical LLC, Supplemental Health Care, TemPositions Health Care Inc., The Royster Group, Travel Nurse Across America LLC and Trusted Health Inc.