Two national staffing agencies will pay more than $700,000 combined to resolve allegations that they billed long-term care facilities too much for nursing services in one of the two states with rate caps.
Massachusetts Attorney General Andrea Joy Campbell announced the violations and the settlement Tuesday. It is the state’s third publicized crackdown on billing practices that do not comply with maximum nursing rates set and routinely updated by the Executive Office of Health and Human Services.
It’s also a move many skilled nursing providers likely wished to see possible in their own states during the pandemic.
The percentage of nursing homes that used agency care workers more than doubled from 2018 to 2022 — from less than 20% to nearly 50%. In addition, many of those users went to relying on agency staff most days of the year, according to a 2024 Health Affairs study.
Owners, operators and advocates clamored for more regulation of staffing agencies as the cost of that temporary help soared. But most of the dozen-plus states that moved to restrict some practices associated with price gouging still shied away from price restrictions.
Massachusetts and Minnesota were the only states with rate caps in place before the pandemic. The Oregon Legislature adopted a cap system in 2023, but new rules and associated rates are not set to go into effect until Jan. 1, 2025, according to the Oregon Health Authority.
Widespread rate abuse?
As anecdotal evidence mounts that the sector’s reliance on temporary staff is lessening, many providers still report agencies charging highly elevated rates.
In Massachusetts, the latest settlements involved IntelyCare Inc., and connectRN, both of which are based in the state. The attorney general’s office did not say when the alleged violations took place, or how many providers had been impacted.
Under separate settlements, Intelycare will pay more than $500,000, including more than $236,000 in restitution to affected long-term care facilities and approximately $270,000 in penalties.
connectRN will pay more than $100,000, including more than $43,000 in restitution to affected long-term care facilities and $65,000 in penalties to the Long-Term Care Facility Quality Improvement Fund.
The attorney general’s office said the penalties will be distributed to the Commonwealth’s Long-Term Care Facility Quality Improvement Fund, which was created to improve the quality of care at long-term care facilities.
In a statement emailed to McKnight’s Long-Term Care News late Wednesday, IntelyCare said it worked closely with the Massachusetts Attorney General throughout its investigation.
“The alleged overages occurred between October 2021 and February 2023, representing less than 2% of IntelyCare’s total completed shifts in Massachusetts during that period,” the company said. “Over 90% of the alleged overages were related to rate increases established by the long-term care facilities to meet urgent staffing needs during the height of the pandemic, with the vast majority occurring in 2021.
“IntelyCare cooperated fully with the Attorney General’s investigation and proactively implemented enhanced measures to ensure continued compliance. IntelyCare has communicated with all impacted clients and distributed reimbursements to all affected clients. IntelyCare is grateful for our clients’ continued trust and support, and we remain committed to providing the highest quality solutions to help our clients stay fully staffed and elevate care.”
IntelyCare and connectRN agreed to update their software and practices to ensure compliance with EOHHS regulations, the attorney general’s office said. Both companies have significantly downsized since demand for their services peaked during the height of COVID, and connectRN did not respond to McKnight’s request for comment Wednesday.
The latest settlements follow a January agreement with three different, out-of-state nurse agencies accused of gouging skilled nursing and assisted living operators in at least 10 different ways. They were forced to pay more than $260,000.
Last year, following a series of complaints to her office, Campbell warned agencies that unscrupulous billing would be stamped out by her team.
“Affordability continues to be a major challenge for Massachusetts residents and their loved ones seeking long-term care, which is why temporary nurse staffing agencies need to adhere to state regulations,” she said at the time. “Today’s advisory serves as a resource to these agencies and a reminder that my office stands ready to act if temporary nursing agencies attempt to overcharge or mislead long-term care facilities in the Commonwealth.”
