Agency Advice: Why It’s So Important To Keep Up With Compliance
By Ryann Adoum, benefits manager for LiquidAgents Healthcare What is the first thing running through your mind after you get the exciting news from your recruiter that you have been offered a travel contract? Maybe it’s how you’re going to get there or how soon they need you to start, or where you’re going to live. These are all things you’re probably thinking of as you begin to tune out your recruiter’s onboarding rant. “I am going to need a copy of your most recent TB, Mask Fit Test, Hep B, MMR, Varicella, TDaP, Flu Vaccine, BLS…” your recruiter continues as you suddenly snap back to reality. Do you really need all of these things she is listing off? You should already have most of these documents ready to go, and here’s why. Importance of compliance documents The world of travel nursing is extremely fast-paced, and the room for error is slim. Once you have been extended a job offer, you are expected to get the ball rolling on compliance as soon as possible. You will need to be compliant with your agency first, and then your future facility. If you are not organized or committed to the process, onboarding might be much more of a headache than it needs to be. Compliance can be a hassle, and it means a lot of running around on your part, but there are certainly benefits to getting it done quickly. Not only does it build a great rapport with your agency, but it also means that your start date could be pushed up by the facility. Orientations for travelers are typically held every 2 weeks, so if you are quick enough on compliance to make it at least 2 weeks ahead of schedule, you could start working sooner than expected. There are several ways you can manage your compliance documents digitally so that they are easy to access when you need them, like using an online file dropbox or signing up for free compliance managing tools. Compliance items you should always have ready Along with signing your contract and human resources paperwork, a compliance department will always ask for these industry standard items. These requirements are directly from the Joint Commission, and any agency or facility who is JCAHO certified will require these. RN License Certifications Physical TB MMR, varicella, hep B TDaP vaccine Flu vaccine Mask fit test Ensure that you always have copies at your disposal, ready to send over to your agency immediately after an offer has been extended. Remember, these are just the base requirements, and you will more than likely be subject to additional documentation and testing before becoming totally compliant. Keeping compliance items current Along with keeping copies of your compliance documents, you should also ensure that certain items do not expire. Health documents such as the TB skin test, physical, vaccines, and certifications all expire and can set your potential start date back if you need to get new ones. Titer results take a few days to come in, TB skin tests require a 48-72 hour window for results, and certification classes take time to coordinate on top of the actual class time. The last thing you want is to push back your start date further– or even worse, have your contract canceled because of non-compliance. Once you are working with an agency, your compliance manager should keep track of the expiration dates for you so that you can focus on doing what you do best- working on the hospital floor! If you ever have a question about your documents, or you need to know the expiration date of something, get in touch with your compliance manager. They are happy to help, and being proactive in the compliance process will help both of you stay on track.
Travel Nurse Agency: 3 Signs It’s Time to Find A New One
When you started traveling, you may have had a great relationship with the people at your travel nurse agency. But like all relationships, things can change. The people you enjoy working with move on. Shifting business goals can mean that focuses switch, and things just aren’t what they used to be. Whatever the reason, that relationship that you once had is different now. It’s just not working for you, and you’re thinking about making a switch. Before you make any agency change, you may want to consider switching recruiters, especially if you’re with an agency that generally has a good reputation. But if you’re seeing any of these signs, a recruiter change may not be enough. It could be time to break up with your agency. Your travel nurse agency’s response time is more than 24 hours. How quickly does your agency respond to issues? What about submittals? How quickly can they find answers for you? If you contact your agency and someone there doesn’t respond to you on the same day–extenuating circumstances excluded–then they are taking too long. Keep in mind that you have the power to create urgency. If you call and leave a message that tells your recruiter your question isn’t critical and that they can get back to you at their convenience, then that “same day” timing may slip some. But no agency should leave you hanging, and if yours does then it’s time to find a new one. The recruiters aren’t nurse-centered. Who is your recruiter most concerned about, you or the agency? If your recruiter continually pushes you toward jobs that you don’t want in locations you have no interest on shifts that don’t match your needs, then they likely aren’t worried as much about you being happy as they are about lining their agency’s pockets. The control over what job you take should always be in your hands. Your recruiter should be listening to what you want and tailoring a plan around that. He should know your goals and help you meet them. You feel like you aren’t getting the whole story. Transparency is the hallmark of a good agency/traveler relationship, and if you feel at all like your travel nurse agency is keeping things from you then it’s time to start shopping for a new one. How do you know if you aren’t getting the whole story? Look for indirect answers to direct questions. That’s usually a good sign. If they hem and haw when you ask about pay for a potential contract, they aren’t being transparent. Same is true about jobs. Sometimes, jobs just aren’t available that meet your criteria. A good recruiter and a good agency are going to tell you that.
Ask a Recruiter: 5 Things a New Travel Nurse Should Know
Talk to most recruiters and they will tell you that the number of travel nurses is growing rapidly. A lot of that growth can be attributed to new nurses trying traveling for the first time. They hear stories of fun adventures or higher pay from a traveler working an assignment at their hospital, they check it out, and they decide to dive in–often with too little education to know what they are actually getting into. We sat down with David McKenzie, a recruiter with LiquidAgents Healthcare. McKenzie has been a recruiter for almost 5 years and is passionate about educating first-time travelers. HCT Today asked him what travelers should know before they hit the road for the first time. Here’s what he told us. The nuts and bolts of the pay package McKenzie says the pay package is the first thing that a first-time traveler should understand. That’s why McKenzie spends time with his new travelers or nurses just exploring traveling and breaks down the different elements of a pay package. The gross pay: The total value of the contract The non-taxed portion of the pay package: These are any stipends or per diems that are included in the package, as long as the nurse meets IRS requirements to receive them. The taxed portion of the pay package: These are the hourly wages, but can also include any stipends and per diems that are taxed because the nurse does not meet requirements to receive them tax free. The take-home: This is what the nurse gets at the end of the day Knowing how their pay breaks down and what they should expect on a paycheck helps the nurse, but it also helps McKenzie avoid panicked phone calls later from nurses who fear they’ve been somehow cheated. The Bucket Theory Many first-time travelers hear stories before they get into traveling about stipends, reimbursements and per diems and get visions in their heads of free money. McKenzie says that it’s not true. Many travelers, especially first-timers, don’t understand that there is essentially one big bucket of money that everything they are going to get paid comes from. That money comes from the hourly rate that the hospital is willing to pay for that traveler. How that money is divided is up to the nurse. So, they are free to ask for things like money for travel, but that doesn’t mean they are getting additional money. It means the pay rate is being lowered to account for the shift of money to cover travel, and the same goes for housing allowances or per diems. Both are money from the same bucket, so you aren’t getting anything additional. You decide whether it’s more important to get the tax-free money or have more in your take-home pay. Sometimes a traveler will be tempted to ask for more money on a contract. There are only two ways that kind of request gets approved. Either the hospital agrees to a rate increase, making the bucket bigger, or the agency wasn’t maxing out what it was able to pay in the first place. The 3 Pillars of Travel Nursing Pay, location and shift. That’s what McKenzie calls the pillars, and he tells first-time travelers that they need to pick one of these as the most important because they can’t all be the priority. As an experienced traveler will tell you, finding all three in a single placement is rare. New travel nurses should decide early whether the right shift is the priority. Or maybe it’s being someplace relatively close to home. Or maybe they’ll sacrifice both of those for a good-sized paycheck. Pick the most important. Be flexible on the others, and the recruiter can likely always find a job. “Having some wiggle room on one of those factors, you can get anything to move,” McKenzie says. Know how far is too far McKenzie says that even when first-time travelers decide that location is one of the pillars where they have some flexibility, it’s important for them to know how far from home is too far. Most traveling contracts are 13 weeks long, which can be a long time to be far from home for many first-timers. For some travelers, that adventure is what draws them to the job. But for many, having the ability to get back home easily, whether it’s for an emergency or just to recharge around familiar faces, is still a comfort, and one that McKenzie says first-timers should consider before taking an assignment. The process for getting hired There’s a bit of time between a new traveler deciding she wants to hit the road and when she starts her first job, and McKenzie said it’s important new travel nurses understand the steps it takes to land that first assignment. It starts with creating a resume that will get them hired, and the next step is to find jobs to submit the traveler to. Then a review by the facility, hopefully an interview, and then an offer. But things don’t end with the acceptance of an offer. Next comes verification of compliance documents, potential drug testing, and possible pre-employment testing. McKenzie says educating the first-time traveler on all those intermittent steps is important because it will ensure they don’t get confused as the process plays out.
Here’s Why Establishing A Tax Home Is Important For Travelers
Thanks to President Donald Trump’s approval in December of the most extensive changes to U.S. tax law in the past 30 years and the recent start of income tax filing season, millions of U.S. citizens have taxes on the brain, travel nurses included. The new tax changes won’t affect the filing process for 2017 taxes. They do eliminate employment expense deductions starting this year, but they won’t affect the tax-free stipends available to travelers, as long as they’ve established a tax home. But what is a tax home? For a busy professional who regularly has to travel for business, qualifying for tax-free stipends is a simple process, but for travelers, it’s a bit more complex. Definition and benefits of a tax home The IRS Tax Code defines a tax home as the geographical area where workers earn most of their income, which may not be the same place as their permanent residence–the place where they own a home, where their family lives or where they’ve been issued a driver’s license. As an example, say an employee works for a company in Michigan eight months out of the year, but that person owns a home in Wyoming to stay close to relatives. The employee’s company asks him to travel back to Wyoming for a business-related reason, so he decides to stay at home because it’s easier than booking a hotel for a weekend. Even though this person traveled to their personal residence, the employee’s travel expenses are still technically deductible because he is leaving his tax home on business. Having a tax home means big savings in terms of a travel nurse’s ability to accept tax-free stipends, or per diems, which can add up to anywhere from $20,000-$50,000 in tax-free benefits. “This can result in $6,000-$9000 per year in tax savings,” said Joseph Smith, a travel nurse tax expert and owner of TravelTax.com. “But then you have to remember to subtract your living expenses from that (savings figure),” Smith said. “If you’re paying 600 a month for an apartment, which is then $7,200 a year, that’s a significant amount from savings. That’s why you don’t see travelers living in places like San Francisco unless they have a tax home due to a regular job in the area.” Some travel nurse staffing agencies also won’t give contracts to nurses who don’t have a tax home in order to avoid being penalized during an IRS audit because of a travel nurse who accepted tax-free stipends without a tax home. Criteria to qualify for a tax home If this geographical definition was the only one used to determine who has a tax home, travelers would never qualify since the job requires frequent relocation, meaning there’s not one place where they earn a majority of their income. Thanks to clarifications of the code in IRS Publication 463, three factors are used to determine tax home status. At least two of these three criteria must be satisfied in order to qualify for a tax home. If only one factor is met, that person is considered an itinerant worker, meaning their tax home is their permanent residence and they don’t qualify for tax-free stipends or reimbursements. You perform part of your business in the area of your main home and use that home for lodging while doing business in the area. You have living expenses at your main home that you duplicate because your business requires you to be away from that home. You have a member or members of your family living at your main home or you often use that home for lodging. Since most travelers don’t work at home, they often try to meet the second and third criteria to establish a tax home. The third criteria is easy enough to meet by returning regularly to a home or apartment owned or rented, but their tax home status could be disrupted by not matching duplicate expenses. Duplicate expenses While it’s not stated in bold print, duplicate living expenses need to be significant enough to meet the second criteria. For example, say a traveler rents an apartment for $800 per month in their home state of Arizona, and leaves for a five month job in Colorado. They have a friend in Colorado who owns a home and will let them stay in a spare room for $50 a month while they’re working. Even though the traveler is paying the friend to stay there, that incredibly low “rent” charged by their friend won’t qualify as duplicated expenses. That traveler would need to at least pay fair market value for rental of the space, which differs based on location but can be determined by comparing local rental listings for similar properties. Temporary worker status It is possible for travelers to avoid paying duplicate expenses and still qualify for a tax home by meeting the first criteria and planning to work some in their home state, but they must make sure they are a significant distance away from their permanent residence or risk losing their temporary worker status. A temporary worker is someone who fulfills job appointments lasting 12 months or less, according to the U.S. Department of Labor Statistics. If a traveler works for more than a year in a single geographic area, it’s considered an indefinite job appointment. That means their previous tax home is moved to their current job because it’s their new primary location of income, and they are classified as an “itinerant” worker. This rule applies even with short-term contracts. If a traveler plans to work in a location for eight months, then accepts another five month contract in the same area but at a different hospital, the job assignment would still be considered indefinite rather than temporary since they planned to stay for 13 months total in the same geographic region. Unfortunately, there isn’t a specific distance a traveler needs to be away from their previous placement to be considered safe, and the “50-mile” rule travelers might hear about is not