Arkansas hospitals tell Senate committee travel‑nurse bill rates soar amid shortages; lawmakers press for pipeline fixes

Hospital leaders and nursing executives outlined a statewide staffing picture to the Senate Public Health, Welfare and Labor Committee: travel‑nurse usage has climbed during COVID surges, agency bill rates have risen sharply, and state nursing programs lack the faculty and clinical slots to produce and retain enough RNs.

Michael Givens, administrator for St. Bernards Medical Center in Jonesboro, said St. Bernards has used travel nurses for five years but has expanded reliance during COVID and now has "over a hundred travelers in our system." He described rapid increases in ICU capacity — from about 32 to as many as 75 ICU beds at a recent peak — and said travel contracts were the only practical option to staff suddenly expanded bed capacity.

Trinda Ray, chief nursing officer at UAMS, said UAMS also has "over a hundred travelers, covering all of our areas right now" and described the hospitals’ vetting and orientation procedures for travelers. Ray said a new RN starts at just over $22 an hour in internal pay scales and that midcareer nurses at UAMS typically earn in the mid‑$30s per hour; she emphasized those figures do not include benefits.

Representative Stan Love, pressing on costs, asked why facilities are paying a bill rate around $150 per hour while starting pay for new nurses is far lower. "Am I the only one in this room that thinks that is just absolutely nonsensical?" Love asked. Hospital witnesses responded that the bill rate is what facilities pay to staffing companies and that the bill includes travel expenses, housing and insurance for the traveler and therefore is not directly comparable to a staff nurse’s hourly pay.

Jodi Ann Trent of the Arkansas Hospital Association warned that statutory price‑gouging measures and simple caps on contract rates carry tradeoffs: some states that attempted caps lost the ability to recruit nurses. Committee members and hospital leaders discussed options including targeted incentives, loan forgiveness or tax credits for nurse educators, adjunct faculty models to expand clinical instruction, and better coordination between hospitals and nursing schools.

St. Bernards said 43 employees left the facility after its COVID vaccine rollout; Givens said many secured other regional employment. Hospital witnesses stressed margins are thin — Medicaid often reimburses below cost — and that federal pandemic funding previously used to offset extraordinary expenses was crucial to maintain services.

No policy was enacted at the hearing; members asked hospitals to return with nontraditional, implementable recommendations to expand the pipeline and stabilize the workforce.